Cancer medicines on the WHO Model List of Essential Medicines: processes, challenges, and a way forward

Kristina Jenei, Zeba Aziz, Christopher Booth, Bernadette Cappello, Francesco Ceppi, Elisabeth G E de Vries, Antonio Fojo, Bishal Gyawali, Andre Ilbawi, Dorothy Lombe, Manju Sengar, Richard Sullivan, Dario Trapani, Benedikt D Huttner, Lorenzo Moja

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


The selection of cancer medicines for national procurement requires deliberate evaluation of population benefit, budget impact, sustainability, and health system capacity. However, this process is complicated by numerous challenges, including the large volume and rapid pace of newly developed therapies offering marginal gains at prohibitively high prices. The WHO Model List of Essential Medicines (EML) and Model List of Essential Medicines for Children (EMLc) have undergone a series of evidence-based updates to ensure recommended cancer medicines offer meaningful clinical benefit. This Health Policy paper describes how cancer medicines are listed on the EML and EMLc, including two updated WHO processes: (1) the formation of the Cancer Medicines Working Group, and (2) additional selection principles for recommending cancer medicines, including a minimum overall survival benefit of 4-6 months with improvement to quality of life compared with standard treatment. These updates, along with proposals to include formal price considerations, additional selection criteria, and multisectoral collaboration (eg, voluntary licensing) promote procurement of high-value essential cancer medicines on national formularies in the context of supporting sustainable health systems to achieve universal health coverage. [Abstract copyright: Copyright © 2022 World Health Organization; licensee Elsevier. This is an Open Access article published under the CC BY-NC-ND 3.0 IGO license which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is properly cited. This article shall not be used or reproduced in association with the promotion of commercial products, services or any entity. There should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.]
Original languageEnglish
Article numberS2214-109X(22)00376-X
JournalThe Lancet. Global health
Early online date29 Sept 2022
Publication statusE-pub ahead of print - 29 Sept 2022


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