Indian Essential Medicine List for Cardiovascular Disorders: Time to Revisit

Abstract Background: Management of cardiovascular health issues remains far from satisfactory. To decrease the morbidity and mortality from cardiovascular disorders, it is important to take preventive measures as well as effectively manage them. These can be achieved by ensuring the availability of quality drugs in appropriate dosage forms. An essential drug list is the most effective instrument for ensuring the availability of these drugs to the majority of the population without financial burden. Objectives: This study was planned to compare drugs listed for cardiovascular disorders in the 21st World Health Organization (WHO) Essential Medicines List (EML), the 5th Indian Essential Drug List [National List of Essential Medicines (NLEM)], and the 22nd WHO Essential Medicines List to determine the need to update the Indian Essential Drug List. Materials and Methods: This descriptive study was conducted in the Department of Pharmacology. The 5th NLEM (latest edition) was compared with the 21st WHO Essential Drug List released in 2021 and the 22nd WHO Essential Drug List (latest edition) to determine the categories and subcategories of cardiovascular drug, the number of drugs mentioned in each category, drugs that are present in WHO EML but absent in Indian EML and vice-versa. Results: Specific to cardiovascular disorders, 29 drugs were mentioned in the 5th NLEM compared with 55 in the 21st WHO Essential Drug List, and 58 in the 22nd WHO Essential Drug List. Under the category of cardiovascular disorders, six subcategories were present in all three EMLs, whereas the last subcategory fixed-dose combinations for the prevention of atherosclerotic cardiovascular disease was present in the 22nd WHO EML, this subcategory was missing in the earlier 21st WHO EML and 5th NLEM. Conclusion: There is a need to update the Indian EML for the effective management of cardiovascular disorders.