马拉维：2023年基本药物清单（MEML）（英文）

PREFACE The MEML lists all those medicines considered to be most suitable for current usein the country. Although primarily intended for public sector application, it ispabeinooua Abuos ae o“uaqeaud jorras areud oj areudodde Ajenbato select medicines on the MEML, whenever possible. PROCEDURE FOR AMENDMENTS OF THE MEML Prescribers are encouraged to continually and critically review the relevance of theMEML to current clinical practice.Suggestions for amendments should be made through submission of a proposalin writing to: HTSS-Pharmaceuticals, PO Box 30377, Lilongwe 3, Malawi. Fax: (265) 01 788 502 An amendment form which may be used for this purpose has been included at theend of this booklet. FOR ADVERSEREACTIONS: PRESENTATION OFINFORMATION General Medicines names: As in previous lists, each medicines item is described by its genericname which, according to the National Medicine Policy (NMP) 2014, should be usedfor all prescribing and dispensing. Order of Sections: Medicines are arranged by pharmacological/therapeutic groupsfollowing the same basic format as the *wHO Model List of Essential Medicines 22ndUist, 2021,* with the addition of an extra section (Number 31; Nutritional Disorders)Medicines numbering: each item is numbered within its section and thus can beconveniently identified by a composite number, consisting of the section numberand the medicines numbers (final number): CATEGORISATION/PRIORITISATION OF MEDICINES ITEMS Medicines items have again been categorised using a three letter coding systemaccording to the:approved level of use (H, D or C)therapeutic priority (V or E)procurement system (A or B)Such categorisation is intended to facilitate the prioritisation of selection andsubsequent procurement of drugs both by Central Medical Stores Trust (CMST)and user units. LEVEL OF USE CODE (H, D, OR C) This indicates the level of Health Institution at which the item would normally bepermitted for use:H =Health Centre level (i.e, for use throughout the health system at HealthCentre, District Hospital aind Central Hospital levels).D=District Hospital level (i.e. for use at District Hospital and CentralHospital levels only)C =Central Hospital level (i.e. for use at Central Hospital level only) Thus C drugs should not normally be used at D and H levels, and D drugs should notnormally be used at H level. However, there are possible exceptions to this general rule: Additional clinical expertise: if this is available at H level (e.g. An Ophthalmic MedicalAssistant, Psychiatric Enrolled Nurse/Midwife, clinical officer, etc.), certain D leveldrugs may be made available for use by that particular prescriber. This however, willsinup ar ursi ssH ar Aq aaquesad paeu a o uaa aq pinous uonesuouinebe at the discretion of the Director of Health and Social Services (DHSS). Writtenauthorised and a copy of this sent to the Chief of Health Services (CHS)-Special clinical expertise: Certain DHOs may have access to specialised clinicalexpertise in one or more areas and must request their Regional Medical Stores to make available certain C level drugs for use at the particular district hospital.Authorisation stating name of prescriber, specialty and specified drugs, should besought in writing from the Chief Executive Officer of CMST. Maintenance treatment: Individual patients being treated for chronic conditions mayhave arrangements made for them to receive maintenance treatment with therequired D or C level dlrugs at H level. In these cases, such arrangements shouldlbe authorised by the DHSS and formalised in writing (named patient specifieddrug/s and duration of treatment) with a copy retained at the district. THERAPEUTICPRIORITY CODE(V,E) This code identifies the therapeutic importance of each item using the VEN system asfollows: v (Vital) drugs which: are potentially life-saving have significant withdrawal side-effects making regular supply mandatory. Are of major public health importance(e.g. needed by many patients for treatment of serious. contagious diseases,E (Essential) drugs which: are effective against less severe, but nevertheless significantneeded to control epidemics, etc.)forms of illness PROCUREMENT SYSTEM CODE (A OR B) This third code specifies how items will be procured by CMST and by the user units. A - Listitems: They are generally required for large numbers of patients. Will beroutinely procured and stocked by CMST Include all H level drug. Note: Where funds for procurement are insufficient, first priority will be given to theprocurement and supply of Vital) A- list items (see 2.2 above) i.e, those of the highesttherapeutic importance. If funds remain after securing such VA items, procurement of(Essential) A list items will then be initiated. Thus, ensuring the availability of A-list items isprimarily the responsibility of CMST. B - Listitems: They are generally required for limited number of patients, Will NOTbe routinely procured and stocked by CMST, Estimates of annual r