Differences Between Essential Medicines Lists in 135 Countries and Model List of Essential Medicines

Completed

• Conditions: Formularies

• Registration Number: NCT03218189
• Lead Sponsor: Unity Health Toronto

Brief Summary

The World Health Organization (WHO) has developed a model list of more than 400 medicines and recommends that each country adapt the list to its own circumstances. More than 100 countries have developed essential medicines lists.

Some countries have essential medicines lists that are very similar to the WHO's model list and other countries have lists that are very different from the WHO's model list. Differences between the WHO list and country lists could be explained by features of the country including population demographics, disease prevalence, Gross Domestic Product (GDP), and healthcare system organization. Other factors such as the influence of particular individuals or organizations may also explain differences between countries.

The purpose of this project is to compare the essential medicines lists developed by countries with the WHO's model list and to identify attributes of countries that are associated with differences from the WHO list. Predictors such as region, population, life expectancy, infant mortality rate, GDP per capita, health expenditure per capita, inequality, and the corruption perception index will be considered.

Detailed Description

Statistical analysis plan for objective 3 (relationship between the total number of differences and country features)

Plots will be generated to show the relationships between variables. Correlation coefficients will be calculated where appropriate. Two separate multivariate models will be fit to the data for outcomes 2a and 2b \[continuous, between 1 and 500\]. A similar model will be fit the total number of differences. The analytical method will be determined by the data and may be liner regression.

Predictors:

Region-Categorical (6)

Population-Continuous

Life expectancy-Continuous

Infant mortality rate-Continuous

GDP per capita-Continuous

Health expenditure per capita

Inequality-Continuous

Corruption Perception Index-Continuous

Study Timeline

• Study Start: 2017-07-05
• Study First Submitted: 2017-07-12
• Study First Submitted QC: 2017-07-12
• Study First Posted: 2017-07-14
• Primary Completion: 2019-04-04
• Study Completion: 2019-04-04
• Status Verified: 2019-09
• Last Update Submitted: 2019-09-05
• Last Update Posted: 2019-09-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 137

Inclusion Criteria

• Countries that have an essential medicines list, and Canada

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Exclusion Criteria

• countries that do not have an essential medicines list that is available online

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Total number of differences between the WHO model list of essential medicines and the essential medicines list in each country	1 year	The total number of differences between the WHO model list of essential medicines and the essential medicines list in each country is comprised of: 1. number of WHO model list medicines not on country list including the number of substitutions within class (i.e. a medicine on WHO list not on country's list but a similar agent in the same class is on the country's list); and the; 2. number of medicines on the country list but not on the WHO model list.

Secondary Outcome Measures

Name	Time	Method
Medications that are on the WHO list but not on the country list	1 year
Medications that are on the country list but not on the WHO list	1 year

Trial Locations

Locations (1)

St Michael's Hospital; 🇨🇦 Toronto, Ontario, Canada