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Essential medicines for palliative care

The World Health Organization defines essential medicines as those which satisfy the primary healthcare needs of the population. In 2013, the World Health Organization introduced a new section on medicines for pain and palliative care in the 18th edition of the Model List of Essential Medicine including 15 medicines for the most common symptoms in life-limiting health conditions. More recently, the Lancet Commission on palliative care developed an essential package which also includes equipment and human resources in addition to the essential medicines. The Lancet Commission specified that in order to achieve universal health coverage, coverage of the essential package is recommended by dedicated, pro-poor, public or publicly mandated funding and for all relevant health conditions. However, in many regions of the world, all or some of the essential medicines are not available at all, or if they are available in the country, they are regularly out of stock in the local pharmacy, out-of-pocket costs are so high that patients cannot afford the medicines, or whole families become impoverished buying treatment for their loved one. Problems with accessibility, affordability, and availability are particularly evident with opioid analgesics such as morphine. However, accessibility, affordability, and availability of essential medicines is a pivotal prerequisite for the delivery of quality palliative care.