Essential medicines are those that meet the priority health needs of a population. They are selected considering disease prevalence and public health relevance, evidence of efficacy and safety, and comparative cost-effectiveness. Since 1977, the World Health Organization (WHO) has developed model essential drug lists to serve as a guide for the development of national and institutional drug lists. The WHO Model Lists of Essential Medicines are updated every two years by the Committee of Experts on the Selection and Use of Essential Medicines. Current versions, updated in September 2021, include the 22nd Essential Medicines List (EML) and the 8th Essential Medicines List for Children (EMLc).
In order to provide a user-friendly navigation interface and compare drug lists, such as the WHO EML with national drug lists, the Pan American Health Organization (PAHO) created MEDLIST with technical support from BIREME.
MEDLIST is a commentary and annotation-enabled drug and device list portal and is a component of the PAHO Regional Platform for Innovation and Access to Health and Technology. MEDLIST is available at: https://medlist.paho.org/
MEDLIST’s objective is to provide unified access to national, regional, and international drug lists to support users, primarily policy makers, to:
- Select appropriate health technologies;
- Make informed decisions;
- Facilitate purchasing processes, with transparency and negotiation of the best prices; and
- Allow navigation and comparisons between drug lists, such as the WHO Essential Drugs List, PAHO Strategic Fund, High Cost Drug Lists, and National Lists.
Users can browse the WHO, PAHO, and country drug lists available on the MEDLIST portal through its hierarchical structure of sections and subsections. It is also possible to compare the lists to find out which drugs are common among them and to search and retrieve information about drugs.
The platform has three main components, which are a web application for managing drug content (drugs, dosage forms and presentations), evidence summaries and drug lists, a website for browsing and searching through lists and a search engine for retrieving all drug information and evidence available on the platform. The entire platform is multilingual in English, Spanish and Portuguese.
The results obtained during the development of the project were:
- User-friendly web-based interface for managing and browsing the WHO Essential Medicines, National Drugs Formularies, Strategic Fund and High-Cost Medicines lists, allowing comparisons between these lists;
- Mechanisms for uploading evidence summaries related to the WHO Essential Medicines Lists;
- Highlight the differences between the WHO National Medicines Lists and the Essential Medicines Lists to facilitate closer adherence by Member States; and
- Highlight the evidence supporting each inclusion and exclusion on the WHO Essential Medicines Lists.
Currently, MEDLIST has information on drug lists from 14 countries, the WHO EML, and the PAHO Strategic Fund shopping list.
Strengthening the operation of the Annotated Lists of Medicines in 2022 is related to training activities for teams in the area of Health Systems and Services at PAHO Headquarters (HSS) and multipliers, in addition to consultants in the countries for system administration, which will enable the updating of existing lists and creating new country lists. It is important to note that the Caribbean sub-region is underrepresented on MEDLIST as only 2 of the 20 CARICOM states are available on the platform.
The MEDLIST update is an ongoing work, the main objective of the current year being its update according to the latest WHO EML; increasing the number of Essential Lists for CARICOM countries; and analysis of the EML status and content of Caribbean countries.