Article type
Abstract
"Background
The World Health Organization (WHO) Essential Medicines List (EML) and WHO guidelines serve as a critical resource for countries to inform decisions on healthcare policies. These instruments should act synergistically through consistent recommendations. However, there is a lack of clarity on the extent and nature of discordance and misalignment between the WHO EML and guidelines which could affect the efficient use and adoption of medicines.
Objectives
To map and analyse the recommendations and indications of medicines between the WHO EML and WHO guidelines to identify discordances, understanding potential causes and implications.
Methods
We will map and analyse recommendations about medicines from the WHO EML and WHO guidelines according to scenarios outlined in Box 1, specifically focusing on recommendation direction discordance, recommendation partial misalignment, and recommendation gaps. We will extract the certainty of evidence and strength of recommendations, and evidence-to-decision (EtD) framework to explain the underlying factors preventing or inducing recommendation direction discordance, partial misalignment, and recommendation gaps.
Results
We will present analyses on:
1) identified areas where EML and guideline complement each other and areas where there is limited overlap;
2) identified discordances between EML and guideline recommendations on medicines for corresponding indications;
3) data derived from scenarios when essential medicines are supported by strong and conditional, positive and negative guideline recommendations.
We will also report on factors that might cause recommendation discordance, misalignment, and gaps between WHO EML and guidelines decisions. This might include lack of sufficient and conclusive evidence, considerations on cost-effectiveness and affordability, implementation and accessibility, panel composition and evaluation approach, and time lag and update frequency.
Conclusions
It is essential to ensure consistent recommendations on medicine use between different actors in the decision-making ecosystem for coordinated evidence-based policies. This consistency can enhance WHO's role in improving global affordability and access to medicines, addressing the time lag between guidelines and EMLs, as well as strengthening the link between the WHO EML and national EMLs. This in turn may improve the responsiveness of both EML and guidelines, and the accessibility and affordability of essential medicines to tackle evolving healthcare needs effectively and efficiently.
Public involvement: Not applicable."
The World Health Organization (WHO) Essential Medicines List (EML) and WHO guidelines serve as a critical resource for countries to inform decisions on healthcare policies. These instruments should act synergistically through consistent recommendations. However, there is a lack of clarity on the extent and nature of discordance and misalignment between the WHO EML and guidelines which could affect the efficient use and adoption of medicines.
Objectives
To map and analyse the recommendations and indications of medicines between the WHO EML and WHO guidelines to identify discordances, understanding potential causes and implications.
Methods
We will map and analyse recommendations about medicines from the WHO EML and WHO guidelines according to scenarios outlined in Box 1, specifically focusing on recommendation direction discordance, recommendation partial misalignment, and recommendation gaps. We will extract the certainty of evidence and strength of recommendations, and evidence-to-decision (EtD) framework to explain the underlying factors preventing or inducing recommendation direction discordance, partial misalignment, and recommendation gaps.
Results
We will present analyses on:
1) identified areas where EML and guideline complement each other and areas where there is limited overlap;
2) identified discordances between EML and guideline recommendations on medicines for corresponding indications;
3) data derived from scenarios when essential medicines are supported by strong and conditional, positive and negative guideline recommendations.
We will also report on factors that might cause recommendation discordance, misalignment, and gaps between WHO EML and guidelines decisions. This might include lack of sufficient and conclusive evidence, considerations on cost-effectiveness and affordability, implementation and accessibility, panel composition and evaluation approach, and time lag and update frequency.
Conclusions
It is essential to ensure consistent recommendations on medicine use between different actors in the decision-making ecosystem for coordinated evidence-based policies. This consistency can enhance WHO's role in improving global affordability and access to medicines, addressing the time lag between guidelines and EMLs, as well as strengthening the link between the WHO EML and national EMLs. This in turn may improve the responsiveness of both EML and guidelines, and the accessibility and affordability of essential medicines to tackle evolving healthcare needs effectively and efficiently.
Public involvement: Not applicable."