India’s Essential Medicines List Yet to Be Updated
Subject: Science & Technology
Why in News?
A civil society collective has urged the Government of India to revise the National List of Essential Medicines (NLEM), which has remained unchanged since 2022, while the WHO Model List of Essential Medicines (EML) was updated in 2023 and 2025.
Key Highlights
- India’s NLEM (2022) contains 384 essential medicines.
- The latest WHO Model List (2025) includes 523 medicines.
- WHO updates its Essential Medicines List every two years through its Expert Committee.
Concerns Raised
- Delay in revision affects access to medicines for:
- Cancer
- Diabetes
- Other chronic diseases
- India’s NLEM does not include:
- 17 anti-cancer medicines
- 4 supportive cancer-care medicines
- 9 monoclonal antibodies (mAbs) recommended by WHO.
- Absence from NLEM can reduce affordability and accessibility, especially for economically weaker patients.
What are Monoclonal Antibodies (mAbs)?
- Laboratory-produced antibodies designed to target a specific antigen.
- Used for:
- Targeted cancer therapy
- Autoimmune diseases
- Infectious diseases
- Diagnosis and prevention
- They offer greater precision with fewer effects on healthy cells than conventional therapies.
National List of Essential Medicines (NLEM)
What is NLEM?
The National List of Essential Medicines (NLEM) is prepared by the Ministry of Health & Family Welfare (MoHFW) to identify medicines that address India’s priority public health needs.
Importance
- Ensures availability of essential medicines in government hospitals.
- Medicines under NLEM are:
- Provided free or at subsidised rates in public health facilities.
- Covered under price ceilings fixed by the National Pharmaceutical Pricing Authority (NPPA).
- Reduces out-of-pocket healthcare expenditure.
- Promotes rational use of medicines.
History of NLEM
| Year | Revision |
|---|---|
| 1996 | First NLEM (279 medicines) |
| 2003 | Revised |
| 2011 | Revised |
| 2015 | Revised |
| 2022 | Latest revision |
Objectives of NLEM
- Guide treatment of priority diseases.
- Promote rational use of medicines.
- Improve affordability and accessibility.
- Assist States in preparing their own Essential Medicines Lists.
- Guide procurement and supply of medicines in the public healthcare system.
Criteria for Inclusion in NLEM
A medicine is included based on:
- Essentiality for public health.
- Disease burden in India.
- Proven efficacy and safety.
- Cost-effectiveness.
- Therapeutic advantage (especially for Fixed Dose Combinations).
- Clinical need rather than market sales.
When is a Medicine Removed from NLEM?
A medicine may be deleted if:
- It is banned in India.
- Serious safety concerns emerge.
- A safer or more effective alternative becomes available.
- A better cost-effective option exists.
WHO Essential Medicines List (EML)
What is EML?
The WHO Model List of Essential Medicines identifies medicines that satisfy the priority healthcare needs of populations.
Selection Criteria
- Disease prevalence
- Clinical efficacy
- Safety
- Quality
- Comparative cost-effectiveness
History
- 1970: Tanzania became the first country to prepare an Essential Medicines List.
- 1975: World Health Assembly requested WHO to support member countries in selecting essential medicines.
- 1977: WHO published the first Model List containing 186 medicines.
Update Frequency
- Revised every two years by the WHO Expert Committee.
Constitutional Significance
- Article 21 – Right to Life
- The Supreme Court has interpreted Article 21 to include the Right to Health.
- Timely revision of NLEM supports affordable healthcare and access to life-saving medicines.
Difference Between NLEM and WHO EML
| NLEM (India) | WHO Model EML |
|---|---|
| Prepared by Ministry of Health & Family Welfare | Prepared by WHO |
| Focuses on India’s public health priorities | Global reference list |
| 384 medicines (2022) | 523 medicines (2025) |
| Linked to NPPA price regulation | Not legally binding on countries |
| Used for procurement and price control | Serves as a model for national lists |
Mains Question
Q. Discuss the significance of the National List of Essential Medicines (NLEM) in ensuring affordable healthcare in India. Why is periodic revision of the list necessary?
