Journal Article

Selection of essential medicines for South Africa - an analysis of in-depth interviews with national essential medicines list committee members

Perumal-Pillay, Velisha Ann, Suleman, Fatima

2017

Overview

Background The South African (SA) public health system has employed an Essential Medicines List (EML) with Standard Treatment Guidelines (STGs) in the public sector since 1996. To date no studies have reported on the process of selection of essential medicines for SA EMLs and how this may have changed over time. This study reports on the decision making process for the selection of essential medicines for SA EMLs, over the years, as described by various members of the National Essential Medicines List Committee (NEMLC) and their task teams. Methods Qualitative in-depth interviews, guided by an interview questionnaire, were conducted with 11 members of the SA NEMLC and their task teams (both past and present members) during the period January – April 2015. Interviews were recorded and transcribed verbatim. Transcripts were then coded by the first author and verified by the second author before being reconciled and input into NVIVO, a qualitative software, to facilitate analysis of the data. Results The interviews conducted suggest that the NEMLC process of medicine selection has been refined over the years. This together with the EML review process is now essentially predominantly an evidence based process where quality, safety and efficacy of a medicine is considered first followed by cost considerations which includes pharmacoeconomic evaluations, and pricing of medicines. Conclusions This is the first study in SA to report on how decisions are taken to include or exclude medicines on SA national EMLs and provides insight into the SA EML medicine selection, review and monitoring processes over time. The results show that the NEMLC has undergone tremendous transformation over the years. Whilst the membership of the committee largely remains unchanged, the committee has developed its policies and processes over the years. However there is still a need to strengthen the monitoring and evaluation aspects of the SA EML policy process.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V
• Subject: Adult / Advisory Committees - organization & administration / Analysis / Committee Membership / Committees / Consent / Decision Making / Drugs / Drugs, Essential / Female / Health Administration / Health aspects / Health care expenditures / Health care policy / Health Informatics / Health systems and services in low and middle income settings / Hospitals / Humans / Interviews / Interviews as Topic / Male / Medical policy / Medical research / Medicine / Medicine & Public Health / Middle Aged / Nursing Research / Pharmaceutical industry / Pharmaceuticals / Practice guidelines (Medicine) / Public Health / Public Sector / Qualitative research / Research Article / Researchers / South Africa