The WHO essential medicines library

R.Gray, E. Murray and H.V.Hogerzeil

Dept. of Essential Drugs and Medicines Policy, WHO, Geneva

http://mednet3.who.int/eml/

ICIUM 2004

THE WHO ESSENTIAL MEDICINES LIBRARYGray R, Murray E, Hogerzeil HVDepartment of Essential Drugs and Medicines Policy, WHO, Geneva

Essential medicines are those that satisfy the priority health care needs of thepopulation. They are selected with due regard to public health relevance, evidenceon efficacy and safety, and comparative cost-effectiveness. Essential medicines areintended to be available within the context of a functioning health system at all timesin adequate amounts, in the appropriate dosage forms, with assured quality andadequate information, and at a price the individual and the community can afford.The implementation of the concept of essential medicines is intended to be flexibleand adaptable to many different situations; exactly which medicines are regarded asessential remains a national responsibility. By the end of 1999, 156 countries haddefined a national list of essential medicines.

The WHO Model List of Essential Medicines is intended as a model product and amodel process for the development of such national lists, and has been published byWHO every two years since 1977. In 2000-2002 WHO led a global consultation tostrengthen the procedures for updating the WHO Model List. The main outcomes ofthis process were a change from consensus-based to evidence-based selection, aclear link to clinical guidelines, a transparent process for announcing and reviewingproposed changes, and a careful handling of potential conflicts of interests.

The fact that a certain medicine is listed on the Model List is in itself not enoughjustification for its inclusion on a national list; the reasons and evidence underlyingthe selection are much more important. For this reason WHO has recently developeda web-based Essential Medicines Library, as a user-friendly entry point into the massof information produced by WHO departments, collaborating centres and scientificpartners. This database covers all medicines on the Model List. It presents thereasons for their inclusion, indications for use, model formulary text, reference toWHO clinical guidelines and underlying evidence, price information, and normativeinformation such as the international nonproprietary name (INN), the defined dailydosage (DDD), the Anatomical Chemical Therapeutic (ATC) classification andInternational Pharmacopoeia monographs.

The Essential Medicines Library can be searched with either the medicine name orthe disease as a starting point. A live demonstration will be given.

The WHO essential medicines library

• The WHO Essential Medicines Library (EMLib) is an electronic resource based on the 316 medicines on the WHO Model List. It is primarily intended to assist national, hospital and institutional essential medicines selection committees and is not recommended for direct use by prescribers or consumers.

The WHO essential medicines library

• The medicines are linked to the WHO Model Formulary and 290 diseases, clinical indications and symptoms which, in their turn, link to WHO Clinical Guidelines. There are further links to evidence sources, such as CIRE*, the Cochrane Collaboration and SIGN*, indicative prices, ATC/DDD* information, the WHO INN* site, the WHO Collaborating Centre hosting an adverse drug reactions database* and medicines quality information sites.

*Continuous Identification of Research Evidence (CIRE) system (reproductive health)

*Scottish Intercollegiate Guideline Network (SIGN)

*Anatomic, Therapeutic Chemical classification / Defined Daily Dosage (ATC/DDD); WHO Collaborating Centre for Statistics Methodology, Oslo, Norway

*International Nonproprietary Name

*The Uppsala Monitoring Centre, WHO Collaborating Centre for International Monitoring (adverse drug reactions)

WHOWHOModel ListModel List

Summary of clinical guideline

Reasons for inclusionSystematic reviewsKey references

WHO Model Formulary

Cost:- per unit- per treatment- per month- per case prevented

Quality information:- Basic quality tests- Intern. Pharmacopoea- Reference standards

Clinical guidelineBNF

WHO clusters

MSHUNICEF

MSF

WHO/QSM

WHO/EDM

WHO/EC, Cochrane

Statistics:- ATC- DDD

WCCs Oslo/Uppsala

International Nonproprietary Names (INN)

Adverse drug reactions, Adverse drug reactions, WHO Collaborating WHO Collaborating CentreCentre

The WHO essential medicines library

The WHO essential medicines library

• The site is being continuously modified and a number of summaries of WHO clinical guidelines should be considered as provisional.   In case of doubt or discrepancy between these summaries and the original printed documents, the relevant WHO Department or WHO/EDM should be contacted.

• Comments on content and layout of the website are welcome and should be sent to;

Dr Robin Gray, WHO, Dept. of Essential Drugs and medicines Policy, by fax: 41.22.791.4167 or by E-mail: grayr@who.int

• For issues related to the computerized information management please contact Mr Jörg Hetzke: hetzkej@who.int