Author + information
- Received August 22, 2017
- Revision received November 30, 2017
- Accepted November 30, 2017
- Published online January 29, 2018.
- Sandeep P. Kishore, MD, PhDa,∗ (, )
- Evan Blank, MDb,
- David J. Heller, MD, MPHa,
- Amisha Patel, MD, MPHc,
- Alexander Peters, MDd,e,f,
- Matthew Priceg,
- Mahesh Vidula, MDh,
- Valentin Fuster, MD, PhDi,
- Oyere Onuma, MDj,
- Mark D. Huffman, MD, MPHk and
- Rajesh Vedanthan, MD, MPHi
- aArnhold Institute for Global Health, Department of Medicine/Health System Design & Global Health, Icahn School of Medicine at Mount Sinai, New York, New York
- bDepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
- cDepartment of Medicine-Cardiology, Columbia University/New York Presbyterian Hospital, New York, New York
- dDepartment of Surgery, Weill Cornell Medicine, New York, New York
- eProgram in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts
- fDepartment of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts
- gIndependent Consultant, Baltimore, Maryland
- hDepartment of Medicine, Massachusetts General Hospital, Boston, Massachusetts
- iZena & Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- jDepartment for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Chicago, Illinois
- kDepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- ↵∗Address for correspondence:
Dr. Sandeep P. Kishore, Arnhold Institute for Global Health, 1216 Fifth Avenue, New York, New York 10029.
The World Health Organization (WHO) Model List of Essential Medicines (EML) is a key tool for improving global access to medicines for all conditions, including cardiovascular diseases (CVDs). The WHO EML is used by member states to determine their national essential medicine lists and policies and to guide procurement of medicines in the public sector. Here, we describe our efforts to modernize the EML for global CVD prevention and control. We review the recent history of applications to add, delete, and change indications for CVD medicines, with the aim of aligning the list with contemporary clinical practice guidelines. We have identified 4 issues that affect decisions for the EML and may strengthen future applications: 1) cost and cost-effectiveness; 2) presence in clinical practice guidelines; 3) feedback loops; and 4) community engagement. We share our lessons to stimulate others in the global CVD community to embark on similar efforts.
Dr. Kishore leads a partnership on multiple chronic conditions supported by the Arnhold Institute for Global Health and Teva Pharmaceuticals. Dr. Heller has been supported by the Fogarty International Center of the National Institutes of Health (award number R21 TW 010452-01); and has received research support from Teva Pharmaceuticals. Dr. Price has served as a consultant for Last Mile Health, which receives funding from Pfizer, Johnson & Johnson, and Medtronic. Neither Last Mile Health nor these funders played any role in this work. Dr. Huffman has been supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (award number R00 HL107749-05); and has received travel support from the World Heart Federation to attend a polypill meeting and to serve as its senior program advisor for the Emerging Leaders Programme, which is supported by Boehringer Ingelheim and Novartis and has been supported by AstraZeneca and Bupa. Dr. Vedanthan has been supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (award number 1R01HL125487-01A1). The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Gerald S. Bloomfield, MD, MPH, served as Guest Editor for this paper.
- Received August 22, 2017.
- Revision received November 30, 2017.
- Accepted November 30, 2017.
- 2018 American College of Cardiology Foundation