WHO adds cancer and diabetes drugs to its essential medicines list

The World Health Organization (WHO) has revised its priority lists for essential medicines, adding drugs for a variety of cancer types and for diabetes with associated comorbidities such as obesity.

The new additions to the Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc), which support global policy decisions around selection and universal coverage of medicines within all health systems, also now include treatments for cystic fibrosis, psoriasis and haemophilia.

Launched in 1977, WHO’s Model Lists have been adopted by over 150 countries and are updated every two years.

New additions to WHO’s EML and EMLc lists

Some 59 applications were submitted for consideration for the latest iterations of the Lists, with the WHO’s Expert Committee on the Selection and Use of Essential Medicines selecting 20 of those medicines for the EML and 15 for the EMLc.

New use indications for seven already-listed products were also added and in total the revised lists now include 523 essential medicines for adults and 374 for children.

As part of their assessment, the committee evaluated evidence of effectiveness, safety, comparative cost and overall cost-effectiveness of the drugs. Proposals relating to the definitions and update of the Access, Watch, Reserve (AWaRe) classification of antibiotics were also considered.

Cancer medicines

To help address current inequalities in cancer care, the Expert Committee included approved cancer medicines known to extend survival by at least four to six months and specifically recommended expanding access to PD-1/PD-L1 immune checkpoint inhibitors.

Merck & Co’s Keytruda (pembrolizumab) was added to the EML as a first-line monotherapy for metastatic cervical cancer, metastatic colorectal cancer, and metastatic non-small cell lung cancer (NSCLC). Roche’s Tecentriq (atezolizumab) and Regeneron’s Libtayo (cemiplimab) were also included as therapeutic alternatives for NSCLC.

GLP-1 medicines

The committee also reviewed evidence for glucagon-like peptide-1 (GLP-1) receptor agonists as a treatment for type 2 diabetes, especially for individuals who also have heart or kidney disease.

As such, Novo Nordisk’s Wegovy (semaglutide), Eli Lilly’s Trulicity (dulaglutide) and liraglutide, which is marked by Novo Nordisk under the Saxenda brand and available in generic form from companies such as Teva Pharmaceuticals, as well as the GLP-1/glucose-dependent insulinotropic polypeptide (GIP) dual receptor agonist Mounjaro (tirzepatide) from Eli Lilly, were added to the EML.

Responding to the WHO’s recent revisions, the UN-backed Medicines Patent Pool, an organisation focused on increasing access to essential medicines, welcomed the update.

It also said it would continue to explore ways to expand access to immune checkpoint inhibitors for “cervical, lung, and colorectal cancers, as well as GLP-1–based therapies for patients with type 2 diabetes and obesity, ensuring close alignment with the updated EML and EMLc”.