On Tuesday, the revised National List of Essential Medicines (NLEM) 2022 was released by Health Minister, Dr. Mansukh Mandaviya. In the revised list of essential medicines, 384 drugs were included with the addition of 34 drugs, and all the medicines were categorized into 27 therapeutic categories. On the other hand, 26 drugs from the previous NLEM list were dropped. According to Dr. Mandaviya, the drugs deleted from the NLEM were medicines banned in India due to concerns about their safety profile. Another official explained the reasons for the deletion of the drugs and stated that often drugs go off the list if medicine with better efficacy or favorable safety profile and better cost-effectiveness becomes available. Also, if the disease burden for which a medicine is indicated is no longer a national health concern, it is deleted from the NLEM. He further added that in the case of antimicrobial drugs, if the resistance pattern has rendered them ineffective, the drugs are taken off the list.

Dr. Mandaviya stated that the primary purpose of the NLEM is to promote the rational use of medicines considering three important aspects, including cost, safety, and efficacy. It also aids in the most effective use of healthcare resources and budgets, drug procurement policies, health insurance, better prescribing habits, medical education, and the development of pharmaceutical policies. Dr. Bharati Pravin Pawar, Minister of State for Health, stressed the need to enhance awareness regarding antimicrobial resistance (AMR) and explained that AMR is emerging as a big challenge for our scientists and community, and we need to create awareness in society about the situation.

The health ministry noted that the new NLEM includes four drugs that are still under patent, i.e., bedaquiline and delamind, used in the treatment of multiple drug-resistant tuberculosis; dolutegravir,  used to treat human immunodeficiency virus (HIV) infection; and daclatasvir, used in treating viral infections such as Hepatitis C. However, they added that no drugs used for the treatment of COVID-19 have been made part of the list because the committee in charge felt that the clinical trials to check the efficacy of the drugs were not yet conclusive.

Also, several antibiotics, vaccines, and anti-cancer drugs were set to become more affordable with their addition to the list, such as Ivermectin, mupirocin, nicotine replacement therapy, endocrine medicines, and contraceptives (fludrocortisone, ormeloxifene, insulin glargine, and teneligliptin), Montelukast (acts on the respiratory tract), and ophthalmological drugs (latanoprost). Other new drugs added to the list are cardiovascular medicines dabigatran and tenecteplase which are used in palliative care. These drugs in the NLEM are included in the Schedule category and their prices will be regulated by the National Pharmaceutical Pricing Authority.