WHO’s essential medicines list includes treatments that the organization believes are global standards that should be available everywhere. When conceived, it was hoped that the concept of essential medicines would help countries and policymakers contain the climbing costs of medicine and improve access globally [1]. It now has a core list of 460 medicines, and a complementary list of treatments that require special care or facilities.

In the latest update, WHO has rejected the inclusion of non-small cell lung cancer treatments, Keytruda from Merck, Opdivo from Bristol-Myers Squibb, and Tecentriq from Roche. These breakthrough immunotherapies have made billions of dollars in sales in recent years.

In a statement following the list update, WHO noted that they consider these lung cancer therapies to be in a state of evolution. More data with longer follow-up is needed to truly demonstrate the real magnitude of their benefits. In contrast, Keytruda (pembrolizumab) and Opdivo (nivolumab), have been recommended for advanced melanoma treatment. WHO stated that this is because they have shown to improve survival rates, of a previously incurable condition, by 50%.  

In the list update process, approximately a third of the 65 applications for additions were rejected. A WHO representative noted that changes were based on health benefits available due to new research and new developments, and that it often takes a few years for recommendations to be added to the list.

Medicines that made the list include anticoagulants for preventing stroke and treating deep vein thrombosis; carbetocin for post-partum haemorrhage; and AbbVie's Humira, or adalimumab (and biosimilars of it) for treatment of rheumatoid arthritis and inflammatory disorders.

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Reference
1. Bashaar M, Hassali MA. 40th anniversary of essential medicines: a loud call for improving its access. Generics and Biosimilars Initiative Journal (GaBI Journal). 2017;6(4):174-7. doi:10.5639/gabij.2017.0604.036

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