The concept of essential medicines: lessons for rich countries.

Industrialised countries, faced with increasing demands for quality health care by ageing populations and ever increasing costs of medicines, can learn from low income countries how to respond to pharmaceutical policy issues in a comprehensive way. Since the 1970s many developing countries have started national programmes for essential drugs to promote the availability, accessibility, affordability, quality, and rational use of medicines. The cornerstones of such programmes are the careful selection of essential medicines for public supply and reimbursement, based on a systematic review of comparative efficacy, safety, and value for money; evidence based national clinical guidelines as the basis for training and rational prescribing; and a national medicines policy to balance conflicting policy objectives and to express government commitment to a common goal. Industrialised countries would do well to consider and adopt these approaches, which have been so beneficial to developing countries.