WHO Model Formulary (WMF) 27 June, 2003 WHO Model Formulary (WMF) Dinesh K Mehta September 2004 Rachel and I are here to forge and strengthen the links between the WHO work that is done here and the editorial work on the WHO Model Formulary. Both of us work as editors on the BNF. Although Rachel did a lot of work on the first edition of the WHO Model Formulary, she was officially appointed to take on the prime responsibility for the WMF earlier this year. As you will all know, the WMF was published last year. I think it would be true to say that it has been met with wide acclaim and the WHO has received very positive feedback on it. We want to build on this and make it a publication that is highly valued by healthcare professionals and one that will make a real change to the treatment patients receive. This is a joint presentation. I will talk about some general concepts. Rachel will then talk much more specifically about the work and most importantly how we can all work more closely to produce reliable information on medicines. 1

What healthcare workers want to know about medicines 04/26/99 What healthcare workers want to know about medicines What medicine for a given condition? Is the medicine suitable for my patient? What else do I need to know to prescribe it? What do I need to know about a previously prescribed medicine?

Requirements for prescribing information 04/26/99 Requirements for prescribing information Authoritative Comprehensive Up-to-date Practical Widely distributed Locally relevant

Expert assessment for clinical and local relevance 04/26/99 Systematic reviews Research data Regulatory data Expert assessment for clinical and local relevance Textbooks Expert advice Dissemination Bulletins FORMULARIES Guidelines Prescriber Promotion Peers Costs Other influences

Anatomy of a formulary ‘Front matter’ Notes Monographs Appendices 04/26/99 Anatomy of a formulary ‘Front matter’ Notes Monographs Appendices

How is it presented? The book Digitally Adaptations and translations

Adapting information for local use Language Training Affordability Prevalence of conditions and priorities Healthcare provision Sophistication of technology

WHO Model Formulary: production 27 June, 2003 WHO Model Formulary: production 1995 the WHO Expert Committee on the Use of Essential Drugs recommended development of a WHO Model Formulary to complement the WHO Model List of Essential Drugs (the ‘Model List’) It was to be updated every two years. Useful resource for countries wishing to develop their own national formulary. After April 1996 work was started to draft sections of the text In November 1999 the WHO accept an offer by the Royal Pharmaceutical Society of Great Britain to take responsibility for final data validation, editing and layout. During the validation process all statements in the draft text were compared with the original references and checked for consistency with other WHO documents and recommendations and reputable drug information sources. As this was the first edition of work took almost two years and was completed by the end of 2001. During this process when necessary the text was updated to take into account new information that had become available since the time of writing e.g. monographs were included for the small number of essential drugs that had been added to the Model List in November 1999. Further editions of the WMF will obviously be produced differently now that the 2002 version has been produced 1

Validation of existing text Compare WMF text against New WHO publications Changes between editions of BNF Martindale

Sources BNF Martindale Drug withdrawals Textbooks Readers’ comments WHO experts and Expert Committee WHO programmes WHO publications Summaries of Product Characteristics (SPCs) Original papers and systematic reviews (e.g. Cochrane reviews) BNF Martindale Drug withdrawals Textbooks Readers’ comments

Verification of new text New and amended text: Checked independently by 2 editors Extra check of dose statements Sent to WHO for verification All new or amended text will be checked by at least 2 members of staff (including the Executive Editor) to ensure accuracy and clarity, and to make sure that the style is consistent All new or amended dose statements will also receive an extra check to ensure accuracy All new or amended text will be sent to WHO for verification (i.e. to ensure the information is correct and is consistent with WHO messages) 2

Style WHO style manual Use of XML to code database ensures consistent style of individual elements WHO style manual Use of XML to code database ensures consistent style of individual elements (unfortunately database is coded by humans who may apply codes inconsistently!) 7

How you can help Make thorough use of the resource Report: Areas of disagreement Ambiguity or incomplete information Mistakes! Make suggestions for improvement/expansion

The future Evolution of scope and extent Research on effectiveness Digital versions e.g. PDA (handheld) Translated versions (book and digital)