The core list provides safe, effective, and economical medications for priority diseases, including the minimal medication requirements for a basic healthcare system. Priority diseases are selected based on their potential for safe and cost-effective treatment as well as their current and projected public health significance. A special restriction for use in children is indicated by the [c] symbol next to the medicine or strength on the core list. Essential medications for priority conditions that require specialized medical treatment, monitoring facilities, and diagnostic tools were listed in the supplementary list before being considered for use in children.
In some cases, medications are categorized as supplementary if they are expensive or if their cost-effectiveness ratio is less favourable. The therapeutic substitutes for listed medications that may be included in national essential medications lists are denoted by the square box symbol (□). At the fourth level of Anatomical Therapeutic Chemical (ATC) classification, alternatives may include one or several medications with comparable clinical efficacy within a pharmacological class.
The drug on the list needs to be the finest representative of the subgroup or class for which the strongest safety and efficacy data are available. According to the drug pricing information source, medicines on the core list were offered at a low cost when there were no differences in effectiveness or safety data.
The square box symbol was not used for selecting drugs specifically for children. A square box is not used to show the difference between biosimilars of biological medications or between generic brands of the same small molecules. Similar symbols were not used by national lists, which made unique choices based on local availability and cost. Pharmaceutical quality is not guaranteed simply because a product is included on the Essential Medicines List.
When relevant goods are interchangeable, it is the prime duty of the national competent or regional drug regulating authorities to ensure each product meets the appropriate pharmaceutical quality standard. Each section of the list presents medicines and dosage forms alphabetically, which does not imply preference for one form over another. The World Health Organization (WHO) has also developed the Access, Watch, Reserve (AWaRe) categorization of antibiotics to decrease the resistance of antimicrobials.
Certain antiretrovirals were considered critical medications for the treatment and prevention of the Human immunodeficiency virus (HIV) infection. According to the WHO, safe and effective treatments for COVID-19 prevention must also be regarded as essential during public health emergencies.
The security of supply is a crucial national objective aimed at preventing blood shortages and meeting patient transfusion needs. The recommendations of the WHO for vaccination policy were based on the work of the Strategic Advisory Group of Experts (SAGE) on Immunization, which publishes vaccine position papers.
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Reference: World Health Organization (WHO). The Selection and Use of Essential Medicines, 2025: WHO Model List of Essential Medicines, 24th List. 2025. https://www.who.int/publications/i/item/B09474
