The World Health Organization (WHO) has published new editions of the WHO Model List of Essential Medicines for Adults and for Children. The new editions include several changes, two of which are very important for the field of palliative care:
- There is a new section specific to palliative care entitled: Medicines for Pain and Palliative Care. The lists of medicines for palliative care which were originally located under the oncology section (8.4) have been moved to a new, separate section (section 2). The new section 2 includes three subsections: Non opioids and Non-steroidal anti-inflammatory drugs (NSAIMs); Opioid Analgesics; and Medicines for other symptoms common in palliative care.
- The final subsection: Medicines for other symptoms common in palliative care, includes medications that are not specifically for use in palliative care, but which are commonly used to treat symptoms in palliative care patients.
The previous edition of the WHO Model List did not have any medications for palliative care for adults but the following statement:
Section 8.4 – Medicines used in palliative care
“The WHO Expert Committee recognizes the importance of listing specific medicines in the Palliative Care Section. Some medicines currently used in palliative care are included in the relevant sections of the Model List, according to their therapeutic use, e.g. analgesics. The Guidelines for Palliative Care that were referenced in the previous list are in need of update. The Committee expects applications for medicines needed for palliative care to be submitted for the next meeting. For palliative care medicines in children, see the second EMLc.”
Following the development of the IAHPC List of Medicines for Palliative Care in 2007 and a request from WHO, IAHPC submitted an application of medications for palliative care to be reviewed by the WHO Expert Committee on the Selection and Use of Essential Medicines, which met in Geneva in April 2013. In addition, IAHPC also submitted to the WHO Secretariat a request to move the palliative care list out of the oncology section.
To work on the application, IAHPC formed a working committee which included board members of IAHPC. The group was chaired by Dr Lukas Radbruch and coordinated by Ms Liliana De Lima. Additional members included Doctors Michael Bennett, James Cleary, David Currow, Arthur Lipman, and Roberto Wenk. Doctor Tania Pastrana (Germany) served as research adviser.
The new ‘Pain and Palliative Care’ section in the WHO Model List includes 17 medications. The children’s Model List includes 14 medications. both Model Lists can be downloaded from the WHO website.
Dr Roberto Wenk, chair of the IAHPC board, remarked: “The provision of adequate palliative care is dependent on access to treatment and medications, and the inclusion of a list of medicines for palliative care in the WHO Model List will mark one of the greatest steps in improving care for patients with palliative care needs. We hope that governments and hospital administrators use the WHO Model List to ensure that medications needed for palliative care are available in institutions around the world.”
Dr Lukas Radbruch, chair-elect of IAHPC, stated that: “The IAHPC will continue working in its effort to identify the most safe and effective medicines to treat the most common symptoms in palliative care as part of the organization’s mission to improve and facilitate appropriate policies for the development of palliative care in the world.”
Ms Liliana De Lima, executive director of IAHPC, remarked: “We are very grateful with the WHO Secretariat for its guidance in the application process and the members of the Expert Committee on the Selection and Use of Medicines for their thorough review of the application and final decision. We are also very grateful with the individuals and organizations which supported the applications submitted by IAHPC to the WHO Secretariat.”