The World Health Organization has added more cancer treatments and specified diabetes medicines to its essential medicines lists, confirming that patients were not being melodramatic about wanting access to things that keep them alive.
More than 150 countries use the lists to guide public sector purchasing, supply, insurance and reimbursement. A medicine can therefore move from scientifically useful to administratively recognised, which is the second phase of treatment and usually the one involving the most beige furniture.
The new entries include immunotherapies for several cancers. They also include specified diabetes medicines for adults with type 2 diabetes who have established cardiovascular disease or chronic kidney disease and obesity. This is not universal authorisation for every patient, but it is a fairly robust hint that essential should mean more than excellent if your budget permits.
WHO said the committee considered effectiveness, safety, comparative cost and cost effectiveness. Dr Gloria, Convenor of Necessary Things, welcomed the decision. “Essential is a highly technical category,” she explained. “It sits above desirable and just below affordable this quarter.”
WHO also stressed fair pricing, generic competition and better access, since a medicine cannot improve public health while spending its entire career inside a luxury fridge. The list is a policy tool, not a magic dispensary, but it gives health systems a clearer answer when procurement asks whether treating cancer is an optional extra.
Patients may now watch the treatments become essential on paper, desirable in speeches and financially mysterious at the pharmacy counter. Countries have been encouraged to make them available, manufacturers have been invited to behave competitively and finance departments have been asked to investigate the radical proposal that all three might happen before the patient becomes a historical case study.
Real story: World Health Organization.
