Anti-cancer, anti-infectives among list of 384 essential medicines; 34 drugs added, 26 dropped

NLEM, also known as scheduled drugs, was last revised in 2015.
For representational purposes
For representational purposes

NEW DELHI: The central government has made medicines for cancer, cardiovascular diseases and other critical ailments more affordable by expanding the National List of Essential Medicines (NLEM) by adding 34 new drugs.

After the revision, 384 drugs for 27 therapeutic categories are now on the list of essential medicines.

At the same time, the popular antacid Ranitidine has been taken off the list because of concerns that it causes cancer. The other 25 drugs like Sucralfate, Atenolol and Methyldopa have also been removed as cost-effective and better options for these medicines are now available.

NLEM, also known as scheduled drugs, was last revised in 2015. It includes medicines that treat prevalent diseases such as fever, infections, heart diseases, hypertension, kidney dysfunction, tuberculosis, diabetes, skin diseases and blood disorders, and cancer.

The other 34 drugs included in the list are anti-tuberculosis medicine Bedaquiline, Rotavirus vaccine, antibiotic Amikacin, anti-filariasis drug Ivermicitin, hormone insulin Glargine used by diabetic patients, anti-asthma drug Montelukast, cardiovascular medicines Dabigatran and Tenecetplace and anti-infectives like ivermectin and mupirocin. The list also includes Nicotine Replacement Therapy.

However, the Covid vaccines have not been included in the list as the data of such medicines is still not conclusive from the regulatory perspective. But, the list includes medicines like Dexamethasone, Enoxaparin, Methylprednisolone, Paracetamol and also oxygen for Covid management.

“The National List of Essential Medicines (NLEM) plays an important role in ensuring accessibility of affordable quality medicines at all levels of healthcare. This will boost cost-effective, quality medicines and contribute towards a reduction in out of pocket expenditure on healthcare for the citizens,” said Union Health Minister Dr Mansukh Mandaviya while releasing the revised NLEM list on Tuesday.

“Essential medicines” satisfy the priority health care needs based on efficacy, safety, quality and total cost of the treatment, he said, adding that it will also help improve the quality of health care, provide cost-effective health care and better management of medicines.

He said the National Pharma Pricing Authority (NPPA) will set its ceiling price, and based on this, and it is decided no company increases cost (of essential medicines) on its own.”

According to Dr Y K Gupta, the vice chairman of the Standing National Committee on Medicines (SNCM), constituted by the health ministry in 2018 to revise the list, four drugs that are still under patent have been included in the list are Bedaquiline and Delaminated used in the treatment of multiple drug-resistant tuberculosis, Doulutegravir used to treat human immunodeficiency virus (HIV) infection, and Daclatasvir used in treating viral infections such as Hepatitis C.

The committee also highlighted the increasing and constant need to educate healthcare professionals and doctors against using several fixed-dose combinations (FDCs) of antibiotics. Although many antibiotic FDCs with multiple antibiotics, analgesics, vitamins, minerals, etc., have been banned, still many combinations are in the market with doubtful rationality, Gupta said.

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