Table of Contents
Executive Summary vii
List of participants xix
Declaration of interests xxii
1 Introduction 1
2 Open session 2
3 General items 4
3.1 Alignment of the Essential Medicines List and WHO guidelines 4
3.2 New format for the Technical Report 4
3.3 Increasing the affordability of high-priced medicines 5
3.4 EML Working Groups and comprehensive reviews 5
3.5 Proposal for a WHO list of essential in vitro diagnostics 6
4 Summary of recommendations 7
Additions to Model Lists 7
Delections from Model Lists 8
Changes to listings 8
New indications 8
New dosage form and/or strength 9
Rejected applications 9
5 Applications for the 20th Model List of Essential Medicines and the 6th Model List of Essential Medicines for Children 12
Section 1 Anaesthetics, preoperative medicines and medical gases 12
1.4 Medical gases (new section) 12
Oxygen 12
Section 2 Medicines for pain and palliative care 17
2.1 Non-opioids and non-steroidal anti-inflammatory medicines (NSAIMs) 17
Paracetamol 17
2.2 Opioid analgesics 19
Fentanyl 19
Methadone 24
Tramadol 31
2.3 Medicines for other common symptoms in palliative care 37
Gabapentin 37
Section 5 Anticonvulsants/antiepileptics 45
Lamotrigine 45
Section 6 Anti-infective medicines 55
6.1 Anthelminthics 55
6.1.1 Inestinal anthalminthics 55
Ivermectin 55
6.2 Antibacterials 62
Comprehensive review of antibiotics 62
Overview 62
Community-acquired pneumonia (CAP) 69
Pharyngitis 76
Sinusitis 79
Otitis media 82
Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) 85
Sepsis in children 89
Urinary tract infections 92
Meningitis 96
Complicated intra-abdominal infections 99
Acute infectious diarrhea 112
Sexually transmitted infections 118
Exacerbations of chronic obstructive pulmonary disease 126
Bone and joint infections 130
Febrile neutropenia 134
Severe acute malnutrition 139
Proposal from the McMaster Group for a "conserved" antibiotics list-for preservation, niche indications, and last-resort use. 143
6.2.2 Other antibacterials 146
Azithromycin 146
6.2.4 Antituberculosis medicines 150
Clofazimine 150
Delamanid c 155
Gatifioxacin 159
Isoniazid + pyrazinamide + rifampicin 164
Isoniazid + rifampicin 164
Ofloxacin 168
Streptomycin 171
6.3 Antifungal medicines 173
Itraconazole 173
Voriconazole 181
6.4 Antiviral medicines 186
6.4.2 Antiretrovirals 186
ARV formulations 186
6.4.2.1 Nucleoside/Nucleotide reverse transcriptase inhibitors 191
Abacavir 191
Zidovudine (ZDV or AZT) 194
6.4.2.3 Protease inhibitors 197
Atazanavir + ritonavir 197
Lopinavir + ritonavir 200
6.4.2.4 Integrase inhibitors (new subsection) 204
Dolutegravir 204
Raltegravir 208
Fixed-Dose Combinations 212
Abacavir + lamivudine 212
Cobicistat + elvitegravir + emtricitabine + tenofovir alafenamide 215
Efavirenz + amivudine + tenofovir disoproxil fumarate 220
Emtricitabine + tenofovir alafenamide 223
Emtricitabine + rilpivirine + tenofovir alafenamide 228
Tenofovir disoproxil fumarate 234
Emtricitabine + tenofovir disoproxil fumarate 234
Lamivudine + tenofovi disoproxil fumarate 234
6.4.2.5 Medicines for prevention of HIV-related opportunistic infections (new subsection) 240
Isoniazid + pyridoxine + sulfamethoxazole + trimethoprim 240
6.4.3 Other antivirals 245
Oseltamivir 245
6.4.4 Antihepatitis medicinces 254
6.4.4.1 Medicines for hepatitis B 254
Tenofovir alafenamide 254
6.4.4.2 Medicinces for hepatitis C 259
Elbasvir + grazoprevir 259
Sofosbuvir + velpatasvir 265
6.5 Antiprotozoal medicines 272
6.5.3 Antimalarial medicines 272
6.5.3.1 For curative treatment 272
Artesunate + psyronaridine 272
Artesunate 277
Dihydroartemisinin + piperaquine 281
Section 8 Antineoplastics and immunosuppressives 286
8.2 Cytotoxic and adjuvant medicines 286
Erlotinib, gefitinib, afatinib, crizotinib 286
Nilotinib, dasatinib 293
Trastuzumab emtansine 299
Zoledronic acid 307
8.3 Hormones and antihormones 314
Enzalutamide 314
Section 10 Medicines affecting the blood 320
10.1 Antianaemia medicines 320
Erythropoiesis-stimulating agents 320
Section 12 Cardiovascular medicines 339
12.3 Antihypertensive medicines 339
Lisinopril + hydrochlorothiazide 339
Losartan 345
12.7 Fixed-dose combinations of cardiovascular medicines (new subsection) 351
Aspirin + atorvastatin + ramipril 351
Section 15 Disinfectants and antiseptics 361
15.1 Antiseptics 361
Hypochlorous acid 361
Section 18 Hormones, other endocrine medicines and contraceptives 366
18.3 Contraceptives 366
18.3.1 Oral hormonal contraceptives 366
Ulipristal acetate 366
18.3.2 Injectable hormonal contraceptives 371
Medroxyprogesterone acetate 371
18.5 Insulins and other medicines used for diabetes 375
Long-acting insulin analoyes - 375
Second-line treatments for type 2 diabetes 382
Section 21 Ophthaalmological preparations 401
21.1 Anti-infective agents 401
Natamycin 401
21.6 Anti-vascular endothelial growth factor (VEGF) preparations 405
Bevacizumab 405
Section 22 Oxytocics and antioxytocics 408
22.1 Oxytocics 408
Misoprostol 408
Section 25 Medicines acting on the respiratory tract 413
25.1 Antiasthmatics and medicines for chronic obstructive pulmonary disease 413
Budesonide + formoterol 413
Section 26 Solutions correcting water, electrolyte and acid-base disturbances 418
26.3 Miscellaneous 418
Ready to se therapeutic food (RUTF) 418
Annex 1 WHO Model List of Essential Medicines (March 2017) 424
Annex 2 WHO Model List of Essential Medicines for Children (March 2017) 485
Annex 3 The Anatomical Therapeutic Chemical (ATC) Classification System 531
Annex 4 Alphabetical list of essential medicines (with ATC classification code numbers) 565
