NATIONAL LIST of ESSENTIAL MEDICINES 2008

CHAPTER IINTRODUCTIONential Medicine in Indonesia was first introduced with the publication of The National Listines (NLEM) in 1980, followed by the National Medicines Policy document in 1983. Thesential Medicines, named DOEN (NLEM) is revised periodically every 3-4 years. DOENdition. The Government's commitment to do periodic revisions is a reputation of its own.e World Health Organization (WHO) has carried out the first phase of Good GovernanceM) program in Indonesia by conducting a survey on transparency of five pharmaceuticalthem is the selection process of essential medicines, which from the aspect ofthess is valued to be insufficient. From the meeting of the 30 WHO Essential Medicine List), it was reiterated that the importance of transparency of the selection process both byers who do revisions, revision process, and revision methods which have got to be moresed medicine (EBM), and the importance of the conflict of interest statement from expertf the above mentioned issues, this year's (2008) revision has been geared into itsse of it, the revision process this time is rather different from the earlier revision process,ovements are as follows:lection of expert panel members has been tightly scrutinized, including valuation againstt of interest.he beginning of discussion, program managers who use medicines in the environment ofistry of Health have been included, not only during the plenary meeting. This endeavor isto be a re-learning process to the internal of the Ministry of Health to fully understand thet of essential medicines.s the opinion and experiences of expert panel members in this revision team, theion of evidence based medicine (EBM) data are important considerations.tire discussion process gives great attention to medicines for children, including itsation. The WHO essential medicines list for children has been used as one of thenes. The siding with the individual rights of children is also shown by electing pediatriciansexpert panel that numbered to 4 (four) persons.n of the medicines list has been holistic and total, meaning weighing all medicines listedLEM 2005 including notes which may no longer be deemed fit. Earlier revisions werethe evaluation of medicines which are suggested to be added in the previous list.arency is also displayed with descriptions of arguments why a medicine must be deleteddded, or even be change of dosage form.ential Medicinesedicines are chosen medicines which are most needed to cater to the diagnoses,therapy, and rehabilitation, which are made available to the health service units ino its functions and tiers.1. Criteria of National Essential Medicinesa. Selection CriteriaSelection of essential medicines is based on these(1) Having got the most beneficial risk-benefit ra(2) Guaranteed of quality, including stability and(3) Practicality in storage and distribution.(4) Practical in use and delivery, which are adfacilities.(5) Advantageous in compliance and reception(6) Having got the highest benefit-cost ratio baspatient.(7) If there is more than one choice which hpreference is made for:- medicines with effects which are know- medicines with pharmacokinetic data- medicines with better stability;- easily obtainable;- medicines that are most familiar.(8) Fixed combination medicines have to follow- the compounded medicine is useful in- combination medicines have got to sindividual component;- ratio of the components of patent comfixed for a large number of patients wh- combination medicines have got to inc- combination antibiotics it must alsoresistance or other disadvantageous eb. Criteria of Additions and Deletions1. When addition of new medicines are considsame indications which may be obsolete sha strong reason to keep both of them.2. Medicines used in special program(s) arewill be assessed by general EM selection cr3. In the revision process, the entire medicineNational Revisions Committee. Deletion oeffective may here be decided upon or abetter medicine has been available.c. Guidance on Evidence and RecommendationProof of evidence and recommendations are adoPolicy and Research. The type of study should rethe list below, but the recommendation shouldavailable data. Testimonials are not considered fotial Medicines 200812