THE IMPACT OF ESSENTIAL MEDICINES POLICIES ON HEALTH OUTCOMES: A SYSTEMATIC REVIEW
Author(s)
Atousa Bonyani, PharmD, MSc1, Tracy Lin, PhD2;
1University of California, San Francisco, Institute for Global Health Sciences, San Francisco, CA, USA, 2University of California San Francisco, Institute for Health & Aging, San Francisco, CA, USA
1University of California, San Francisco, Institute for Global Health Sciences, San Francisco, CA, USA, 2University of California San Francisco, Institute for Health & Aging, San Francisco, CA, USA
OBJECTIVES: The World Health Organization (WHO) Model List of Essential Medicines (EML) is a policy instrument intended to ensure equitable access to safe, effective, and affordable medicines globally. However, the extent to which essential medicines policies translate into improved population health outcomes remains uncertain.
METHODS: This systematic review followed PRISMA guidelines to identify studies evaluating the relationship between essential medicines policies and health outcomes. Searches were conducted in PubMed, Web of Science, and Google Scholar (June-July 2025). Eligible studies examined the effects of EML related policies on outcomes such as disability-adjusted life years (DALYs), quality-adjusted life years (QALYs), mortality, or the Healthcare Access and Quality (HAQ) Index. Identified studies were screened and assessed using the Mixed Methods Appraisal Tool (MMAT, 2018); data were extracted, using a predetermined matrix, and synthesized descriptively.
RESULTS: Of 9,045 records screened, nine studies met inclusion criteria. Most were cross-sectional, multi-country analyses focusing on noncommunicable diseases. Inclusion of medicines in national EMLs was associated with improved HAQ (n=1; 8%) and mortality outcomes (n=8; 62%) for select conditions—such as hypertensive heart disease and non-melanoma skin cancer—after adjusting for socioeconomic and health system factors. Only one study assessed DALYs and one examined disease-specific clinical outcomes, both exploring associations between medicine consumption and these outcomes; neither found significant effects. Mapping of research coverage revealed major evidence gaps across several WHO EML sections, including diagnostics, blood products, and antiseptics.
CONCLUSIONS: The inclusion of medicines in essential medicines lists alone does not guarantee improved health outcomes. The effectiveness of EML policies depends on broader health system capacity—including financing, supply chain capacity, regulatory strength, and workforce readiness. Further research is needed to understand how these factors shape the real-world effectiveness of essential medicines policies across different settings.
METHODS: This systematic review followed PRISMA guidelines to identify studies evaluating the relationship between essential medicines policies and health outcomes. Searches were conducted in PubMed, Web of Science, and Google Scholar (June-July 2025). Eligible studies examined the effects of EML related policies on outcomes such as disability-adjusted life years (DALYs), quality-adjusted life years (QALYs), mortality, or the Healthcare Access and Quality (HAQ) Index. Identified studies were screened and assessed using the Mixed Methods Appraisal Tool (MMAT, 2018); data were extracted, using a predetermined matrix, and synthesized descriptively.
RESULTS: Of 9,045 records screened, nine studies met inclusion criteria. Most were cross-sectional, multi-country analyses focusing on noncommunicable diseases. Inclusion of medicines in national EMLs was associated with improved HAQ (n=1; 8%) and mortality outcomes (n=8; 62%) for select conditions—such as hypertensive heart disease and non-melanoma skin cancer—after adjusting for socioeconomic and health system factors. Only one study assessed DALYs and one examined disease-specific clinical outcomes, both exploring associations between medicine consumption and these outcomes; neither found significant effects. Mapping of research coverage revealed major evidence gaps across several WHO EML sections, including diagnostics, blood products, and antiseptics.
CONCLUSIONS: The inclusion of medicines in essential medicines lists alone does not guarantee improved health outcomes. The effectiveness of EML policies depends on broader health system capacity—including financing, supply chain capacity, regulatory strength, and workforce readiness. Further research is needed to understand how these factors shape the real-world effectiveness of essential medicines policies across different settings.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH182
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Oncology, STA: Multiple/Other Specialized Treatments