Proposal Development for Inclusion of Nicotine Replacement Therapy on India's Essential Medicines List

Tobacco use is the primary cause of preventable death globally, accounting for 10% of cardiovascular disease-related mortality and 14% of all-cause mortality worldwide among adults above age 30.1 Smoking cessation helps individuals regain between 4 to 10 years of life expectancy depending on age.2 Globally, it has been projected that by 2050, if the focus is only on prevention of tobacco initiation and not cessation, the result will be an additional 160 million deaths among smokers.3 Thus, measures to support tobacco cessation are necessary and effective means of supporting the health and economy of all nations. My objectives would be to 1) link our analysis of the medicines survey to individual- and household-level cost data from the National Heart, Lung, and Blood Institute sponsored Acute Coronary Syndrome Quality Improvement in Kerala cluster randomized stepped wedge clinical trial (NCT02256657; PI=Dr. Mark Huffman); and 2) submit a proposal for nicotine replacement therapy to be added to India’s essential medicines list. The second objective would be to submit an application to include nicotine replacement therapy on the essential medicines list (EML) for India. It would include up-to-date information on public health relevance, treatment guidelines, evidence for effectiveness, safety (paying particular importance to the addictive capability of NRT), and cost effectiveness. India’s EML informs decisions about what medicines should be made freely available at government hospitals. A successful EML application could lead to meaningful change that would help millions of tobacco users in India.