La Lista Modelo de Medicamentos Esenciales de la OMS (también conocida como Lista de Medicamentos Esenciales o LME [1] ), publicada por la Organización Mundial de la Salud (OMS), contiene los medicamentos considerados más eficaces y seguros para satisfacer las necesidades más importantes de un sistema de salud . [2] Los países utilizan con frecuencia la lista para ayudar a desarrollar sus propias listas locales de medicamentos esenciales . [2] En 2016 [update], más de 155 países han creado listas nacionales de medicamentos esenciales basadas en la lista modelo de la Organización Mundial de la Salud. [1] Esto incluye tanto a países desarrollados como en desarrollo . [2] [3]
La lista se divide en artículos básicos y artículos complementarios. [4] Los artículos básicos se consideran las opciones más rentables para los problemas de salud clave y se pueden utilizar con pocos recursos de atención médica adicionales. [4] Los artículos complementarios requieren infraestructura adicional, como proveedores de atención médica especialmente capacitados o equipos de diagnóstico , o tienen una relación costo-beneficio más baja . [4] Aproximadamente el 25% de los artículos están en la lista complementaria. [5] Algunos medicamentos se enumeran como básicos y complementarios. [6] Si bien la mayoría de los medicamentos en la lista están disponibles como productos genéricos , estar bajo patente no impide su inclusión. [7]
La primera lista se publicó en 1977 e incluía 208 medicamentos. [8] [2] [9] La OMS actualiza la lista cada dos años. [10] Hay 306 medicamentos en la 14.ª lista en 2005, [11] 410 en la 19.ª lista en 2015, [10] 433 en la 20.ª lista en 2017, [12] [13] 460 en la 21.ª lista en 2019, [14] [15] [16] y 479 en la 22.ª lista en 2021. [17] [18] Varias listas nacionales contienen entre 334 y 580 medicamentos. [5] [19] La Lista de Medicamentos Esenciales (LME) se actualizó en julio de 2023 a su 23.ª edición. Esta lista contiene 1200 recomendaciones para 591 medicamentos y 103 equivalentes terapéuticos. [20]
En 2007 se creó una lista separada para niños de hasta 12 años de edad, conocida como Lista Modelo de Medicamentos Esenciales para Niños (EMLc) de la OMS , que se encuentra en su novena edición. [10] [21] [22] [23] Se creó para garantizar que se consideraran sistemáticamente las necesidades de los niños, como la disponibilidad de formulaciones adecuadas . [24] [25] Todo lo que figura en la lista para niños también se incluye en la lista principal. [26] La lista y las notas se basan en la 19.ª a la 23.ª edición de la lista principal. [4] [12] [14] [17] [27] Se enumeran alternativas terapéuticas con un rendimiento clínico similar para algunos medicamentos y pueden considerarse para las listas nacionales de medicamentos esenciales. [17] [18] La novena Lista de Medicamentos Esenciales para Niños se actualizó en julio de 2023. [23] [28]
Nota: Una α indica que un medicamento está en la lista complementaria. [4] [14] [17]
Anestésicos, medicamentos preoperatorios y gases medicinales
Una α indica que el medicamento está en la lista complementaria para la que se necesita un diagnóstico, un seguimiento o una formación especializados. Un artículo también puede figurar como complementario sobre la base de unos costes más elevados o de una relación coste-beneficio menos atractiva . [4] [14]
^(For use in spinal anaesthesia during delivery, to prevent hypotension).
^No more than 30% oxygen should be used to initiate resuscitation of neonates less than or equal to 32 weeks of gestation.
^Not in children less than three months.
^Not recommended for anti‐inflammatory use due to lack of proven benefit to that effect.
^For use in eclampsia and severe pre‐eclampsia and not for other convulsant disorders.
^For buccal administration when solution for oromucosal administration is not available.
^The presence of both 25 mg/5 mL and 30 mg/5 mL strengths on the same market would cause confusion in prescribing and dispensing and should be avoided.
^ a b cAvoid use in pregnancy and in women and girls of child-bearing potential, unless alternative treatments are ineffective or not tolerated because of the high risk of birth defects and developmental disorders in children exposed to valproate in the womb.
^ a b c d e f g h i j kIncluding quality-assured biosimilars
^Oxamniquine is listed for use when praziquantel treatment fails.
^> 1 month.
^Only for the presumptive treatment of epidemic meningitis in children older than two years and in adults.
^Alternatives are 4th level ATC chemical subgroup (J01CF Beta-lactamase resistant penicillins)
^cloxacillin, dicloxacillin and flucloxacillin are preferred for oral administration due to better bioavailability.
^Use in children <8 years only for life-threatening infections when no alternative exists.
^Procaine benzylpenicillin is not recommended as first-line treatment for neonatal sepsis except in settings with high neonatal mortality, when given by trained health workers in cases where hospital care is not achievable.
^Third-generation cephalosporin of choice for use in hospitalized neonates.
^Do not administer with calcium and avoid in infants with hyperbilirubinemia.
^> 41 weeks corrected gestational age.
^Erythromycin is an alternative as second choice treatment for pharyngitis in children (EMLc only)
^For use in combination regimens for eradication of H. pylori in adults.
^Vancomycin powder for injection may also be used for oral administration
^Imipenem/cilastatin is an alternative for complicated intraabdominal infections and high-risk febrile neutropenia only, except for acute bacterial meningitis in neonates, where meropenem is preferred
^Liposomal amphotericin B has a better safety profile than the sodium deoxycholate formulation and should be prioritized for selection and use depending on local availability and cost.
^ a bTo be used in combination with artesunate 50 mg.
^For use in the management of severe malaria.
^Not recommended in the first trimester of pregnancy or in children below 5 kg.
^For the treatment of 1st and 2nd stage human African trypanosomiasis due to Trypanosoma brucei gambiense infection.
^To be used for the treatment of Trypanosoma brucei gambiense infection.
^To be used for the treatment of the initial phase of Trypanosoma brucei rhodesiense infection.
^To be used for the treatment of Trypanosoma brucei gambiense infection
^Only to be used in combination with eflornithine, for the treatment of Trypanosoma brucei gambiense infection.
^The presence of both 120 mg/5 mL and 125 mg/5mL strengths on the same market would cause confusion in prescribing and dispensing and should be avoided.
^Biscuit or paste of nutritional composition as determined by the UN joint statement on the community-based management of severe acute malnutrition and Codex alimentarius guidelines.
^periconceptual use for prevention of first occurrence of neural tube defects
^Alternatives are 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives)
^Includes atenolol, carvedilol, and metoprolol as alternatives. Atenolol should not be used as a first-line agent in uncomplicated hypertension in patients > 60 years.
^Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain)
^Hydralazine is listed for use only in the acute management of severe pregnancy-induced hypertension. Its use in the treatment of essential hypertension is not recommended in view of the evidence of greater efficacy and safety of other medicines.
^Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain) (for lisinopril) and 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives) (for amlodipine)
^Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain) (for lisinopril) and chlorthalidone, chlorothiazide, indapamide (for hydrochlorothiazide)
^ a bAlternatives are 4th level ATC chemical subgroup (C09CA Angiotensin II receptor blockers (ARBs), plain)
^Methyldopa is listed for use only in the management of pregnancy-induced hypertension. Its use in the treatment of essential hypertension is not recommended in view of the evidence of greater efficacy and safety of other medicines.
^Alternatives are 4th level ATC chemical subgroup (C09CA Angiotensin II receptor blockers (ARBs), plain) (for telmisartan) and 4th level ATC chemical subgroup (C08CA Dihydropyridine derivatives) (for amlodipine)
^Alternatives are 4th level ATC chemical subgroup (C09CA Angiotensin II receptor blockers (ARBs), plain) (for telmisartan) and chlorthalidone, chlorothiazide, indapamide (for hydrochlorothiazide)
^Alternatives are 4th level ATC chemical subgroup (C09AA ACE inhibitors, plain)
^ a b"The WHO Essential Medicines List (EML): 30th anniversary". World Health Organization. Archived from the original on 27 May 2014. Retrieved 26 June 2016.
^ a b c d"Essential medicines". World Health Organization. Archived from the original on 2 October 2008. Retrieved 19 January 2017.
^Persaud N, Jiang M, Shaikh R, Bali A, Oronsaye E, Woods H, et al. (June 2019). "Comparison of essential medicines lists in 137 countries". Bull. World Health Organ. 97 (6): 394–404C. doi:10.2471/BLT.18.222448. hdl:10665/325509. ISSN 0042-9686. PMC 6560372. PMID 31210677.
^ a b c d e f"19th WHO Model List of Essential Medicines" (PDF). World Health Organization. April 2015. p. Annex 1. Retrieved 17 January 2017.
^ a bBansal D, Purohit VK (January 2013). "Accessibility and use of essential medicines in health care: Current progress and challenges in India". Journal of Pharmacology & Pharmacotherapeutics. 4 (1): 13–18. doi:10.4103/0976-500X.107642. PMC 3643337. PMID 23662019.
^World Health Organization (2003). The selection and use of essential medicines (Report). World Health Organization (WHO). hdl:10665/42826. ISBN 92-4-120920-8. WHO technical report series 920.
^Beall R (2016). "Patents and the WHO Model List of Essential Medicines (18th Edition): Clarifying the Debate on IP and Access" (PDF). World Intellectual Property Organization (WIPO). Retrieved 3 May 2017.
^World Health Organization (1977). The selection of essential drugs: report of a WHO expert committee [meeting held in Geneva from 17 to 21 October 1977]. Geneva: World Health Organization. hdl:10665/41272. ISBN 92-4-120615-2. Technical report series; no. 615.
^Wirtz VJ, Hogerzeil HV, Gray AL, Bigdeli M, de Joncheere CP, Ewen MA, et al. (January 2017). "Essential medicines for universal health coverage". Lancet. 389 (10067): 403–476. doi:10.1016/S0140-6736(16)31599-9. PMC 7159295. PMID 27832874.
^ a b c"WHO Model Lists of Essential Medicines". World Health Organization. The current versions are the 21st WHO Essential Medicines List (EML) and the 7th WHO Essential Medicines List for Children (EMLc) updated in June 2019.
^Prakash B, Nadig P, Nayak A (2016). "Rational Prescription for a Dermatologist". Indian Journal of Dermatology. 61 (1): 32–38. doi:10.4103/0019-5154.174017. PMC 4763692. PMID 26955092.
^ a bWorld Health Organization (2017). WHO model list of essential medicines, 20th list (March 2017, amended August 2017). Geneva. hdl:10665/273826.{{cite book}}: CS1 maint: location missing publisher (link)
^"Essential Medicines List and WHO Model Formulary". World Health Organization. Archived from the original on 3 August 2008. Retrieved 5 May 2018.
^ a b c dWorld Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.{{cite book}}: CS1 maint: location missing publisher (link)
^World Health Organization (2019). Executive summary: the selection and use of essential medicines 2019: report of the 22nd WHO Expert Committee on the selection and use of essential medicines. Geneva. hdl:10665/325773. WHO/MVP/EMP/IAU/2019.05. License: CC BY-NC-SA 3.0 IGO.{{cite book}}: CS1 maint: location missing publisher (link)
^"Strengthening access to essential medicines". World Health Organization. Retrieved 3 May 2020.
^ a b c dWorld Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
^ a bWorld Health Organization (2021). Executive summary: the selection and use of essential medicines 2021: report of the 23rd WHO Expert Committee on the selection and use of essential medicines: virtual meeting, 21 June–2 July 2021. Geneva: World Health Organization. hdl:10665/345554. WHO/MHP/HPS/EML/2021.01.
^World Health Organization (2021). The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2021 (including the 22nd WHO model list of essential medicines and the 8th WHO model list of essential medicines for children). Geneva: World Health Organization. hdl:10665/351172. ISBN 978-92-4-004114-1. WHO technical report series;1035. License: CC BY-NC-SA 3.0 IGO.
^"WHO Model Lists of Essential Medicines". World Health Organization. Retrieved 8 August 2023.
^World Health Organization (2019). World Health Organization model list of essential medicines for children: 7th list 2019. Geneva. hdl:10665/325772. WHO/MVP/EMP/IAU/2019.07. License: CC BY-NC-SA 3.0 IGO.{{cite book}}: CS1 maint: location missing publisher (link)
^World Health Organization (2021). World Health Organization model list of essential medicines for children: 8th list (2021). Geneva: World Health Organization. hdl:10665/345534. WHO/MHP/HPS/EML/2021.03.
^ a bWorld Health Organization (2023). The selection and use of essential medicines 2023: web annex B: World Health Organization model list of essential medicines for children: 9th list (2023). Geneva: World Health Organization. hdl:10665/371091. WHO/MHP/HPS/EML/2023.03.
^Rose K, Anker JN (2010). Guide to Paediatric Drug Development and Clinical Research. Karger Medical and Scientific Publishers. p. 42. ISBN 978-3-8055-9362-5.
^Seyberth HW, Rane A, Schwab M (2011). Pediatric Clinical Pharmacology. Springer Science & Business Media. p. 358. ISBN 978-3-642-20195-0.
^Hoppu K (June 2017). "Essential Medicines for Children". Clinical Pharmacology and Therapeutics. 101 (6): 718–720. doi:10.1002/cpt.661. PMID 28182281. S2CID 23873145.
^World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
^World Health Organization (2023). The selection and use of essential medicines 2023: executive summary of the report of the 24th WHO Expert Committee on Selection and Use of Essential Medicines, 24 28 April 2023. Geneva: World Health Organization. hdl:10665/371291. WHO/MHP/HPS/EML/2023.01.
^"The WHO Essential Medicines List Antibiotic Book". World Health Organization (WHO). 24 November 2021. Retrieved 6 October 2022.
^The WHO AWaRe (Access, Watch, Reserve) antibiotic book - Infographics. Geneva: World Health Organization (WHO). 2022. WHO/MHP/HPS/EML/2022.02. Retrieved 29 January 2023.
Further reading
Serafini M, Cargnin S, Massarotti A, Pirali T, Genazzani AA (September 2020). "Essential Medicinal Chemistry of Essential Medicines". Journal of Medicinal Chemistry. 63 (18): 10170–10187. doi:10.1021/acs.jmedchem.0c00415. PMC 8007110. PMID 32352778.
Stuart MC, Kouimtzi M, Hill SR, eds. (2009). WHO Model Formulary 2008. World Health Organization. hdl:10665/44053. ISBN 978-92-4-154765-9.
The selection and use of essential medicines. Twentieth report of the WHO Expert Committee 2015 (including 19th WHO Model List of Essential Medicines and 5th WHO Model List of Essential Medicines for Children). Geneva: World Health Organization. 2015. hdl:10665/189763. ISBN 978-92-4-069494-1. ISSN 0512-3054. WHO technical report series; no. 994.
The selection and use of essential medicines: report of the WHO Expert Committee, 2017 (including the 20th WHO Model List of Essential Medicines and the 6th Model List of Essential Medicines for Children). Geneva: World Health Organization. 2017. hdl:10665/259481. ISBN 978-92-4-121015-7. ISSN 0512-3054. WHO technical report series; no. 1006.
The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2019 (including the 21st WHO Model List of Essential Medicines and the 7th WHO Model List of Essential Medicines for Children). Geneva: World Health Organization. 2019. hdl:10665/330668. ISBN 978-92-4-121030-0. ISSN 0512-3054. WHO technical report series;1021.
Organization WH (2019). "Additions and deletions of medicines on the WHO model lists of essential medicines: 1977–2017". World Health Organization. hdl:10665/278038. WHO/MVP/EMP/IAU/2019.01.
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