Evaluating the validity of the National List of Essential Medicines 2015 for “anesthetic agents” in 2022: An observational cost analysis

BACKGROUND AND AIMS: The concept of essential medicines (EMs) was introduced in 1977 by the World Health Organization. The most recent National List of EMs (NLEM) is the NLEM 2015, comprising 376 drugs. The following study was undertaken due to the lack of similar studies conducted on anesthetic agents and aims at evaluating “Section 1 – anesthetic agents” of NLEM 2015 and the relevance of EMs in India. MATERIALS AND METHODS: The study takes into account the drugs under Section 1 anesthetic agents. Data were collected from MedGuideIndia, a database of medicines marketed in India. Both cost ratio and percentage cost variations were calculated. RESULTS: Under Section 1 – anesthetic agents, atropine 1 ml injection (0.6 mg/1 ml) at 654.72% and lignocaine + adrenaline 30 ml injection has the lowest percentage cost variation at 6.26%. It was identified in the current study that the average percentage cost variation and cost ratio of all the 24 variations of the drugs is 164.51% and 2.64%, respectively. 1.3 – preoperative medication and sedation for short-term procedures have the highest price variation drug, atropine and 1.2 – local anesthetics have the lowest price variation drug, lignocaine + adrenaline. CONCLUSION: This study mainly discusses the large price variations comparing the lower versus the higher priced branded variants under Section 1 anesthetic agents. Appropriate physician education is required and newer pricing regulations require enforcement.