WHO Essential Medicines List: Inclusion of GLP-1 Drugs

Context

• WHO updated its Model List of Essential Medicines (EML) .

• Added GLP-1 receptor agonists (semaglutide, dulaglutide, liraglutide, tirzepatide).

• Intended for treatment of type 2 diabetes with comorbidities (CVD, CKD, obesity).

Rationale

• Global burden:

  • 800 million+ people with diabetes (2022), half untreated.

  • 1 billion+ people obese, rising fastest in LMICs (low- and middle-income countries).

• High cost barrier: Drugs too expensive, limiting access.

• Out-of-pocket expenditure on NCDs (esp. medicines) is high in LMICs.

• Inclusion in EML leads pathway for lower costs, generic entry, bulk procurement, better affordability and access.

Medical Significance

• Dual benefit: Glucose control + weight loss.

• Proven impact in reducing cardio-metabolic risks.

• Semaglutide recently approved for metabolic dysfunction-associated steatotic liver disease (MASLD).

Implications for India

• Positive:

  • Could reduce drug prices in long run.

  • May expand access for patients with diabetes + obesity + CVD/CKD.

• Challenges:

• High cost, injectable form, and limited patient affordability.

• Needs to be balanced with ensuring availability of basic essential medicines for larger population base.