Patients’ rights advocates have asked the Centre to revise the National List of Essential Medicines (NLEM), saying it excludes dozens of medicines for cancer, diabetes, and other disorders that the World Health Organisation considers essential.
The delay in revising the NLEM, last updated by the Union health ministry in 2022, has denied millions of people access to new essential medicines, a coalition of patients’ rights advocates called the Working Group on Access to Medicines and Treatment said.
The WHO’s model list of essential medicines, revised in 2025, includes 523 medicines, compared with 384 in India’s NLEM. Medicines included in the NLEM are subject to government-imposed price controls and are expected to be available free of charge in government hospitals.
Among the medicines in the WHO list but absent from the NLEM are drugs used to treat cancer, diabetes, high blood pressure, and fungal and bacterial infections, the coalition said in letters sent to health authorities on Friday.
The coalition said 17 cancer drugs and nine monoclonal antibodies used to treat autoimmune diseases, cancers, and rabies, among other conditions, are absent from the NLEM. Other absent medicines include simvastatin, a lipid-lowering drug, and semaglutide, used to treat diabetes and obesity.
“The prolonged delay in revising the NLEM has denied millions of citizens free access to newly recognised essential medicines within the public health system while also restricting affordable access (through) the private sector,” the coalition said.
“Such a delay carries profound constitutional and human rights implications,” it wrote in the letter sent to the health and pharmaceuticals departments and to the Standing National Committee on Medicines.
Health ministry officials were not immediately available for a reaction to the coalition’s letter sought by this newspaper on Saturday.
The coalition said the Supreme Court has consistently affirmed through various judgments that the Right to Life under Article 21 of the Constitution encompasses the right to health and the right to access medical treatment.
Against this backdrop, the non-revision of the NLEM “is not a mere administrative lapse but a potential violation of this fundamental right,” the coalition wrote, calling for the “immediate initiation of a transparent, time-bound and conflict-of-interest-free process” to revise the NLEM 2022.
“It is not essential for India’s new NLEM list to be identical to the WHO’s model list, but the process of updating and expanding our 2022 list is long overdue,” Gargeya Telakapalli, a public health specialist and coalition member, told The Telegraph.
Several of these cancer medicines missing in the NLEM have established clinical benefit to patients and address some cancers common in India, said Chetali Rao, a member of the Third World Network, a think tank engaged in healthcare issues in developing countries.
Among them are abiraterone, a drug used for advanced prostate cancer, anastrozole, a medicine used for certain types of breast cancer, and erlotinib, used against certain types of lung cancer.
Rao said aprepitant, a medicine used to prevent nausea and vomiting in people receiving chemotherapy, is another example of a medicine that needs to be included in a revised NLEM.