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New cancer, diabetic, antimicrobials, antifungal drugs now essential medicines

The WHO said that high prices for both new, patented medicines and older medicines, like insulin, continue to keep some essential medicines out of reach for many patients. Photo: Ramesh Pathania/Mint Premium
The WHO said that high prices for both new, patented medicines and older medicines, like insulin, continue to keep some essential medicines out of reach for many patients. Photo: Ramesh Pathania/Mint 

  • Across the globe, countries follow the WHO’s Model Lists of Essential Medicines, the medicines that satisfy the priority healthcare needs of majority of the population.

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New Delhi: The World Health Organization (WHO) has included new drugs for treatments of cancer and diabetes, antimicrobials, antifungal drugs and tobacco cessation medicines in the new edition of its Model Lists of Essential Medicines and Essential Medicines for Children, published on Friday.

The development assumes importance as it may reduce prices of treatments for several diseases in India. This also comes amid an increase in the use of antimicrobials and fungal diseases such as mucormycosis during the covid-19 pandemic. The updated Essential Medicines Lists include 20 new medicines for adults and 17 for children and specify new uses for 28 already-listed medicines.

The WHO said that high prices for both new, patented medicines and older medicines, like insulin, continue to keep some essential medicines out of reach for many patients. Across the globe, countries follow the WHO’s Model Lists of Essential Medicines, the medicines that satisfy the priority healthcare needs of majority of the population. The essential medicines list however needs to be country specific addressing the disease burden of the nation and the commonly used medicines at primary, secondary and tertiary healthcare levels.

The WHO noted that diabetes is on the rise globally, and rising faster in low- and middle-income countries. 

“Too many people who need insulin encounter financial hardship in accessing it or go without it and lose their lives. Including insulin analogues (an altered form of insulin) in the Essential Medicines List, coupled with efforts to ensure affordable access to all insulin products and expand use of biosimilars, is a vital step towards ensuring everyone who needs this life-saving product can access it," said Dr Tedros Adhanom Ghebreyesus, Director-General, WHO. As per International Diabetes Federation (IDF), globally, 463 million people had diabetes with 88 million people in the Southeast Asia region. Of the 88 million, 77 million were in India with prevalence of diabetes at 8.9% in the population.

The WHO noted that insulin production is concentrated in a small number of manufacturing facilities, and three manufacturers control most of the global market, with the lack of competition resulting in high prices that are prohibitive for many people and health systems.

Public health experts in India have appreciated the move. “Overall, this step of the WHO is welcome, specifically in relation to availability of life and heart saving SGLT2 inhibitor drugs at primary level. However, decision of provision of insulin analogs at primary levels is intriguing, because these cost 2-5 times more than regular insulin and add nothing to efficacy in lowering blood sugar, apart from lower tendency to cause hypoglycemia. At primary level (and at all levels), low-cost regular insulins work as effectively as any highly publicized expensive insulins," said Dr Anoop Misra, chairman at Fortis-C-DOC and President Diabetes Foundation (India).

Four new medicines for cancer treatment were added to the model lists--enzalutamide, as an alternative to abiraterone, for prostate cancer, Everolimus, for subependymal giant cell astrocytoma (SEGA), a type of brain tumour in children, Ibrutinib, a targeted medicine for chronic lymphocytic leukaemia; and rasburicase, for tumour lysis syndrome, a serious complication of some cancer treatments.

Cancers are among the leading causes of illness and death worldwide, accounting for nearly 10 million deaths in 2020, with seven out of 10 occurring in low- and middle-income countries. 

In India alone, a third of cancer cases are linked to tobacco use, according to a report released by the Indian Council of Medical Research (ICMR)-National Centre for Disease Informatics and Research last week. Considering the increasing burden, two non-nicotine-based medicines – bupropion and varenicline – join nicotine-replacement therapy are now also on the Model List, providing alternative treatment options for people who want to stop smoking.

More so, new medicines listed include cefiderocol, a ‘Reserve’ group antibiotic effective against multi-drug resistant bacteria, echinocandin antifungals for severe fungal infections and monoclonal antibodies for rabies prevention. Also, the updated lists also see new formulations of medicines for common bacterial infections, hepatitis C, HIV and tuberculosis, to better meet dosing and administration needs of both children and adults.

 

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