The National Essential Drugs List
  1. Introduction
  2. Vision For Health
  3. Background
  4. Essential Drugs List
  5. Conclusion

Click here to view The National Essential Drugs List (pdf format, 240KB, 31 pages)

Note 1: The listed drugs (on the left column) are  underlined and are hyperlinked to the National Pharmaceutical Control Bureau's online search for List of Registered Products, searching by "Active Ingredients".   As there can be a variety of descriptions to the same active ingredient (e.g. Al Hydroxide, Aluminium Hydroxide) you may have to perform a "New QUERY" to refine your search.

Note 2: Currently, searches based on ACTIVE INGREDIENTS are only available for products classified as products that are prescription and OTC pharmaceutical products.

THE NATIONAL ESSENTIAL DRUGS LIST

1. INTRODUCTION

The suggestion to create a National Essential Drugs List for use in both the private and public sectors was first mooted in 1996. In a paper to the Cabinet entitled " Drug Prices in Malaysia" as a response to complaints of rising drug prices, it was stated that Malaysia does not have laws to control drug prices. Instead, market forces were allowed to stabilize prices and foster competition. Laws were not needed to control prices as Malaysia had one of the lowest drug prices in the region. However, the Ministry of Health was of the opinion that several strategies were needed to ensure that the public could afford to purchase drugs. One strategy was to create a National Essential Drugs List for use by all health sectors.

The creation of the National Essential Drugs List is one more step in the formulation of a National Drugs Policy. The National Drugs Policy will be a guide for action, which will outline the national pharmaceutical aims, the priority of these aims and strategies toward achieving them. The National Drugs Policy will ensure that there will be safe, efficacious and good quality drugs with affordable prices for those who need them. It will cover all the pharmaceutical sectors and the roles of those involved in this sector. It will involve the Government acting on behalf of the public’s interests, those who use drugs, the prescribers, manufacturers, distributors and retailers. For the National Drugs Policy to succeed, an open and transparent dialogue is needed among all those who have a stake in the pharmaceutical sector.


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2. VISION FOR HEALTH

The Ministry of Health has formulated a Vision for Health, which states:

Malaysia is to be a nation of healthy individuals, families, and communities, through a health system that is equitable, affordable, efficient, technologically appropriate, environmentally adaptable and consumer friendly, with emphasis on quality, innovation, health promotion and respect for human dignity, and which promotes individual responsibility and community participation towards an enhanced quality of life.

This Vision guarantees equity in healthcare for all citizens including equity in obtaining drugs regardless of economic status or place of residence. The World Health Organization (WHO) has listed 14 items in its charter, "Charter for Equity in Essential Drugs". These are:-

  1. Access for all to drugs that are needed.
  2. Affordable prices for the community and the individual.
  3. Priority to be given to drugs which satisfy the actual needs of the majority of the population.
  4. A fair distribution between urban and rural areas.
  5. An assurance that drugs are safe, efficacious and of quality.
  6. Adequate training for all who prescribe drugs.
  7. Access to objective information.
  8. Meaningful dialogue between the prescriber and the patient.
  9. Empowering the patient through education and information.
  10. Participation of the community.
  11. Developing drugs that are needed by Third World countries and not just the developing countries.
  12. Responsible manufacturing and export.
  13. Ethical promotion and marketing.
  14. An end to donations of dangerous and uneffective products.

Taking into consideration the above Charter, the National Essential Drugs List was formulated with the following objectives:-

  1. Control the rising cost of healthcare and thus help control inflation.
  2. Ensure the cost-effectiveness of treatment through suitable therapy, the use of generic drugs and cheaper alternatives.
  3. Encourage the rational use of drugs by avoiding over-prescribing and mis-prescribing.
  4. Make the healthcare system more transparent.
  5. Ensure the patient’s right to obtain adequate information as promised in the Client’s Charter, especially:-
  1. The right to complete information that is easily understood regarding the drugs that are prescribed and sold.
  2. The right to choose among competitive products.

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3. BACKGROUND

A Committee For Creating the National Essential Drugs List which is headed by the Director-General of Health was set up to coordinate activities for creating this list. The Committee included representatives from various sectors such as relevant Government agencies, professional bodies, universities and the pharmaceutical industry.

To help the Committee on various aspects of the list, four Sub-Committees were set up, namely:-

  1. The Drugs List Contents Working Committee
  2. The Drugs Prices Working Committee
  3. The Drug Information Working Committee
  4. The Logistics Working Committee

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4. ESSENTIAL DRUGS LIST

4.1 The World Health Organization’s Essential Drugs List

According to the WHO’s definition, essential drugs are those that meet the healthcare needs of the majority of the population; thus should be easily available in adequate quantities and in suitable dosage forms.

The WHO’s Model Essential Drugs List has played an important role in placing access to essential drugs as a national and international agenda. It continues to provide a strong foundation for countries to identify and choose their drug priorities. The choice of drugs depend on many factors such as disease epidemiology, healthcare facilities, training and the experience of available human resources, financial sources together with genetic factors, demography and the environment.

WHO also contributes towards rational use of drugs through its series of model prescription information. These provides the latest independent clinical information on essential drugs including dosages, usage, contraindications and adverse effects; and is meant to be a resource to be used by health authorities, especially those in developing countries. In addition, many WHO programmes have developed therapeutic guidelines.

The WHO Expert Committee on the Selection of Essential Drugs have established several guidelines for creating Essential Drugs Lists. Among them are:

  1. The extent to which a country implements / formulates its essential drugs list is its own national policy.
  2. The concept of Essential Drugs List must take into consideration local conditions in order to satisfy the actual healthcare needs of the population.
  3. A model list should be regarded as a early identification of basic groups that are needed and which possess relevance and widespread usage.
  4. The choice of essential drugs is a continuous process which take into account changing priorities of public health activities and development in the field of pharmacology and pharmaceutics.


4.2 The National Essential Drugs List

The National Essential Drugs List was formulated by using the Ministry of Health’s (MOH) Drugs List as a basis. The MOH Drugs List which was introduced in 1983 serves as the essential drugs list for the public healthcare sector. Every drug in this list is classified according to the category of medical officer or healthcare provider allowed to prescribe it. This list is dynamic and is reviewed every 4 months by a panel consisting of specialists from the main disciplines and pharmacists.

The Committee for Creating the National Essential Drugs List has decided that the List shall consist of two parts. The first part called the Essential Drugs List contains all preparations needed for primary and secondary healthcare treatment commonly used by Medical Officers and paramedics in primary healthcare facilities. Several preparations used in tertiary care are included in order to be consistent with WHO’s Model Essential Drugs List. This part contains 358 chemical entities and 605 preparations.

The second part called the Supplementary List consists of drugs used by specialists for tertiary level treatment. This part contains 257 chemical entities and 391 preparations.


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5. CONCLUSION

With the existence of the National Essential Drugs List, it is hoped that the cost of treatment in the private sector will be controlled through more transparency and rational use of drugs. The local pharmaceutical industry can develop by concentrating on the essential drugs listed. Public education on the correct usage of drugs will be more effective since available resources can be focused on the dissemination of information on the drugs listed in the National Essential Drugs List.

 ACKNOWLEDGEMENTS

The Ministry of Health wishes to express its gratitude to the following organizations which jointly contributed to the development of the National Essential Drugs List.

The Ministry of Domestic Trade and Consumer Affairs
The School of Pharmaceutical Sciences, Science University of Malaysia
The National Poisons Centre
The Faculty of Integrated Health Sciences, National University of Malaysia
The Medical Faculty, University of Malaya
The Malaysian Pharmaceutical Society
The Malaysian Organization of Pharmaceutical Industries
The Pharmaceutical Association of Malaysia
The Malaysian Medical Association
The Federation of Private Medical Practitioners’ Associations of Malaysia
The Private Hospitals Association of Malaysia
The Federation of Malaysian Consumers Associations
Various departments and individuals who have contributed towards the development of this List.


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