Arnhold Institute for Global Health, Department of Medicine/Health System Design & Global Health, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
J Am Coll Cardiol. 2018 Feb 6;71(5):564-574. doi: 10.1016/j.jacc.2017.11.056.
The World Health Organization (WHO) Model List of Essential Medicines (EML) is a key tool for improving global access to medicines for all conditions, including cardiovascular diseases (CVDs). The WHO EML is used by member states to determine their national essential medicine lists and policies and to guide procurement of medicines in the public sector. Here, we describe our efforts to modernize the EML for global CVD prevention and control. We review the recent history of applications to add, delete, and change indications for CVD medicines, with the aim of aligning the list with contemporary clinical practice guidelines. We have identified 4 issues that affect decisions for the EML and may strengthen future applications: 1) cost and cost-effectiveness; 2) presence in clinical practice guidelines; 3) feedback loops; and 4) community engagement. We share our lessons to stimulate others in the global CVD community to embark on similar efforts.
世界卫生组织(世卫组织)基本药物标准清单(EML)是改善所有人包括心血管疾病(CVD)患者获得药物的全球途径的一个重要工具。世卫组织成员国使用 EML 来确定本国的基本药物清单和政策,并指导公共部门采购药物。在此,我们介绍了为促进全球 CVD 预防和控制而对 EML 进行现代化的努力。我们审查了近年来为添加、删除和更改 CVD 药物适应证而提出的申请,旨在使该清单与当代临床实践指南保持一致。我们已确定影响 EML 决策的 4 个问题,这些问题可能会加强未来的申请:1)成本和成本效益;2)临床实践指南中的存在;3)反馈循环;和 4)社区参与。我们分享经验教训,以激发全球 CVD 界的其他人员开展类似的努力。