Arpit Parmar
Arpit Parmar, Santanu Nath. All India Institute of Medical Sciences, India
Aim. To analyze the national lists of essential medicines (NLEM) of UN Asia Pacific countries to determine how many countries include substance use disorders (SUD) medications (Buprenorphine, Methadone, Naltrexone, Naloxone, Acamprosate, Disulfiram, Bupropion, Nicotine Replacement Therapy, and Varenicline)
Methods. A retrospective observational study was conducted using NLEM of all Asia Pacific countries. NLEM database, World Health Organization (WHO) repository, and other governmental sources were searched for the most recent NLEM. NLEMs from 54 Asia Pacific region countries were accessed, and details of SUD medications were extracted in December 2020. Descriptive analysis was performed using SPSS V20.0.
Results. The WHO essential medicine list 2019 contains 460 medications, including methadone (and buprenorphine), naloxone, and NRT. Of the 54 Asia Pacific region countries, 39 had their NLEM. The total number of medications ranged from 44 to 964 (median 289, IQR: 519-239). The countries contain a median of 220 medications (IQR: 260-177) from the WHO list. Of the nine medications for SUDs, the countries contained a median of 2 medications (IQR: 3.00-1.00). The most common medication available was naloxone (n=36, 92.3% countries). However, other medications were available scarcely. A total of 16 countries had at least one opioid use disorder medication, while 13 countries had at least one alcohol use disorder medication on their respective NLEMs. Only one out of four countries (n=10) had a tobacco use disorder medication on their list. Only four countries had at least one medication each for opioid, alcohol, and tobacco use disorders.
Conclusion. Except for naloxone, SUDs medications do not appear on the NLEM of most Asia Pacific region countries. There is a need to expand the NLEM of these countries, especially considering the high public health burden related to SUDs.