Essential medicine

Essential medicine

• 1.
  Indian Pharmacopoeia Essential Medicine, RationalUse of Drugs Purnendu Mandal MD PGT Pharmacology BSMC, Bankura
• 2.
  Indian Pharmacopoeia • Pharmacopoeia:the word derives from the ancient Greek word Pharmakon means Drug & Poeia means to make. • It is a legally binding collection, prepared by a national or regional authority & contains list of medicinal substances, crude drug & formulas for making preparation from them.
• 3.
  The Pharmacopoeia Contain Listof drug and other related substances. Sources. Description. Tests. Formulas for preparation ,actions. Uses. Doses. Storage conditions.
• 4.
  INDIAN PHARMACOPOEIA • IndianPharmacopoeia Commission (IPC) is an autonomous institution of the Ministry of Health and Family Welfare. • Sets standards for all drugs that are manufactured, sold and consumed in India • The set of standards are published under the title Indian Pharmacopoeia (IP) • Vision: The IPC is committed to the promotion of the highest standards for drugs for use in the prevention and treatment of diseases in human beings and animals keeping in view the special features of the pharmaceutical industry in India.
• 5.
  HISTORY of INDIANPHARMACOPOEIA • 1944- The process of publishing the first Pharmacopoeia started in the year under the chairmanship of R. N. Chopra . • 1948- government of India appointed an Indian Pharmacopeia committee to prepare ‘Pharmacopeia of India’ . • 1955- 1st edition I. P. 1955 was published • 2018 - 8th Edition I. P.
• 6.
  OVERALL PHILOSOPHY • Officialbook of standards and medicines produced in india must comply with the specified standards . • Pharmacopoeial standards and acceptance criteria are set with the intention that they be used only as compliance requirements and not as requirements to guarantee total quality assurance . • Compliance to pharmacological standards • Maintain quality during storage and distribution. • Good Manufacturing Practices .
• 7.
  Essential Medicine • WHO- Essential Medicines “those that satisfy the priority healthcare needs of the population.” • They are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost effectiveness. Essential medicines are intended • To be available within the context of functioning adequate amounts. • In appropriate dosage forms. • Assured quality and adequate information. • At a price the individual and the community can afford.
• 8.
  WHY ? • onlya handful of medicines out of the multitude available can meet the health care needs of majority of the people. • in any country, and that many well tested and cheaper medicines are equally (or more) efficacious and safe as their newer more expensive congeners. For optimum utilization of resources, governments (especially in developing countries) should concentrate on these medicines by identifying them as Essential medicines.
• 9.
  WHO criteria toguide selectionof an essential medicine (a)Adequate data on its efficacy and safety. (b) Quality, Including Bioavailability, and Stability . (c) Pattern of prevalent diseases; availability of facilities and trained personnel; financial resources; genetic, demographic and environmental factors. (d) In case of two or more similar medicines, relative efficacy, safety, quality, price and availability. Cost-benefit ratio should be a major consideration. (e) Choice may also be influenced by comparative pharmacokinetic properties and local facilities for manufacture and storage. (f) Most essential medicines should be single compounds. Fixed ratio combination products should be included only when dosage of each ingradient meets the requirements of a defined population group, and when the combination has a proven advantage in therapeutic effect, safety, adherence or in decreasing the emergence of drug resistance. (g) changing priorities for public health action, epidemiological conditions as well as availability of better medicines/formulations and progress in pharmacological knowledge. (h) based on rationally developed treatment guidelines.
• 10.
  HISTORY • 1977- WHO-Model List of Essential Drugs This has been revised from time to time and the current is the 17th list (2011- 433 medicines with 25FDCs) • 1996- India produced its National Essential Drugs List in and has revised it in 2011 with the title “National List of Essential Medicines”. (348 medicines ) 2015- 376 medicines with 20FDCs. • Adoption of the essential medicines list for procurement and supply of medicines, especially in the public sector healthcare system, has resulted in improved availability of medicines, cost saving and more rational use of drugs.
• 11.
  Rational Use ofDrugs • "patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community".
• 12.
  12 key interventions 1.Establishment of a multidisciplinary national body to coordinate policies on medicine use. 2. Use of clinical guidelines. 3. Development and use of national essential medicines list. 4. Establishment of drug and therapeutics committees in districts and hospitals 5. Inclusion of problem-based pharmacotherapy training in undergraduate curricula. 6. Continuing in-service medical education as a licensure requirement 7. Supervision, audit and feedback. 8. Use of independent information on medicines. 9. Public education about medicines. 10. Avoidance of perverse financial incentives. 11. Use of appropriate and enforced regulation. 12. Sufficient government expenditure to ensure availability of medicines and staff.
• 13.
  Reasons for Irrationaluse of Drugs 1. Lack of information . 2.Role models – Teachers or seniors . 3. Lack of diagnostic facilities/Uncertainty of diagnosis – medicine for all possible causes. 4.Demand from the patient. 5. Patient load. 6. Promotional activities of pharmaceutical industries. 7.Drug promotion and exaggerated claim by companies . 8.Defective drug supply system & ineffective drug regulation.
• 14.
  Thank you