Essential drugs concept and national essential medicines list MCQs With Answer

Introduction: This quiz collection on the Essential Drugs Concept and the National Essential Medicines List (NEML) is designed for M.Pharm students studying Principles of Quality Use of Medicines (MPP 201T). It focuses on the rationale, selection criteria, structure and operational use of essential medicines lists at national and institutional levels. Questions probe deeper topics such as therapeutic equivalence, fixed-dose combinations, links between standard treatment guidelines and lists, procurement implications, and policy tools like TRIPS flexibilities. These MCQs aim to reinforce conceptual understanding, prepare students for higher-level clinical and policy discussions, and support rational decision-making in medicine selection and supply management.

Q1. When did the World Health Organization first publish the Model List of Essential Medicines?

• 1941
• 1977
• 1991
• 2002

Correct Answer: 1977

Q2. Which combination best describes core selection criteria for including a medicine on an essential medicines list?

• Efficacy, safety, public health relevance and cost-effectiveness
• Brand popularity, high price, marketing approval and patent status
• Manufacturing complexity, export potential, advertising reach and packaging
• Physician preference, hospital profit margin, regional branding and color

Correct Answer: Efficacy, safety, public health relevance and cost-effectiveness

Q3. Which of the following is NOT an intended purpose of a national essential medicines list?

• Guide procurement and supply management
• Ensure availability of priority medicines at all levels of care
• Restrict all off-label use of medicines
• Support rational prescribing and clinical guideline development

Correct Answer: Restrict all off-label use of medicines

Q4. How often does the WHO Model List of Essential Medicines usually undergo revision?

• Annually
• Every two years
• Every five years
• It is never revised

Correct Answer: Every two years

Q5. What is a primary advantage of generic prescribing promoted by essential medicines policies?

• Reduces medicine costs and improves affordability
• Increases the number of patented products in use
• Guarantees better therapeutic effect than brand names
• Promotes more aggressive pharmaceutical marketing

Correct Answer: Reduces medicine costs and improves affordability

Q6. The ATC classification system stands for which of the following?

• Anatomical Therapeutic Chemical
• Applied Therapeutic Category
• Analytical Therapeutics Code
• Authorized Treatment Classification

Correct Answer: Anatomical Therapeutic Chemical

Q7. Which item is typically NOT included within a national essential medicines list document?

• Recommended dosage forms and strengths
• Therapeutic alternatives and essential indications
• Price list for every marketed brand and pack
• Pediatric formulations and special use notes

Correct Answer: Price list for every marketed brand and pack

Q8. Fixed-dose combinations (FDCs) are usually included in an EML when which condition is met?

• They demonstrate clear therapeutic or adherence benefit compared with single agents
• They reduce regulatory oversight regardless of efficacy
• They are introduced primarily for marketing convenience
• They are always cheaper than individual components irrespective of outcome

Correct Answer: They demonstrate clear therapeutic or adherence benefit compared with single agents

Q9. The essential medicines list should be directly linked to which of the following to ensure rational use?

• Standard Treatment Guidelines and national clinical protocols
• Pharmaceutical advertising campaigns
• Hospital cafeteria menus
• Only to international trade agreements

Correct Answer: Standard Treatment Guidelines and national clinical protocols

Q10. In selection criteria for essential medicines, “public health relevance” primarily refers to what?

• Medicines for rare cosmetic conditions
• Drugs addressing high burden diseases and population needs
• Strictly export-oriented pharmaceutical products
• Drugs used only in elective surgeries

Correct Answer: Drugs addressing high burden diseases and population needs

Q11. Which multidisciplinary body typically makes decisions on a National Essential Medicines List?

• National Essential Medicines/Formulary Committee with clinical, pharmacy and public health experts
• Chief Executive Officers of major pharmaceutical companies
• Individual hospital purchasing departments alone
• Retail pharmacy associations

Correct Answer: National Essential Medicines/Formulary Committee with clinical, pharmacy and public health experts

Q12. How does a national EML help improve procurement efficiency?

• By aggregating demand to negotiate better prices and ensure reliable supply
• By increasing the number of different brands purchased to boost competition
• By mandating single-supplier exclusive contracts for all drugs
• By removing all quality specifications to simplify buying

Correct Answer: By aggregating demand to negotiate better prices and ensure reliable supply

Q13. What best describes a “complementary list” in the context of WHO or national lists?

• Medicines that require specialized care, monitoring or facilities and are not suitable at all primary-care levels
• Only over-the-counter medicines used for minor ailments
• List of banned and withdrawn medicines
• Drugs used only in veterinary medicine

Correct Answer: Medicines that require specialized care, monitoring or facilities and are not suitable at all primary-care levels

Q14. Under what circumstance would inclusion of a high-cost oncology drug in a national EML be justifiable?

• When it demonstrates substantial clinical benefit and acceptable cost-effectiveness for a significant public health need
• Whenever the drug is marketed by a multinational company
• Only if it is the most expensive option available
• When patent protection is imminent and countries want to adopt it early

Correct Answer: When it demonstrates substantial clinical benefit and acceptable cost-effectiveness for a significant public health need

Q15. Which policy tool allows countries to improve access to essential medicines despite patent barriers?

• Compulsory licensing and other TRIPS flexibilities
• Extending patent terms and enforcing exclusivity
• Prohibiting generic manufacture under all circumstances
• Only importing branded medicines from a single supplier

Correct Answer: Compulsory licensing and other TRIPS flexibilities

Q16. Which indicator is commonly used to measure availability of an essential medicine at healthcare facilities?

• Percentage of surveyed facilities where the medicine is in stock on the day of survey
• Number of promotional advertisements in the media
• Number of different brands registered nationally
• National mortality rate from non-communicable diseases

Correct Answer: Percentage of surveyed facilities where the medicine is in stock on the day of survey

Q17. Therapeutic equivalence between a generic and a reference medicine implies which of the following?

• The generic delivers the same therapeutic effect and safety profile in clinical practice
• The chemical structures are identical regardless of clinical outcome
• The generic is always manufactured by the original innovator company
• Bioequivalence is irrelevant to therapeutic outcome

Correct Answer: The generic delivers the same therapeutic effect and safety profile in clinical practice

Q18. At the hospital level, which document most directly complements the national EML to guide local procurement and use?

• Hospital formulary adapted from the national EML and local clinical needs
• Marketing brochures from pharmaceutical companies
• Patient information leaflets produced by manufacturers
• Advertising materials used in pharmacies

Correct Answer: Hospital formulary adapted from the national EML and local clinical needs

Q19. The WHO Model List is organized into which two principal categories?

• Core list and complementary list
• Prescription list and non-prescription list
• Export list and import list
• Generic list and patented list

Correct Answer: Core list and complementary list

Q20. Which of the following is NOT an important consideration when selecting pediatric formulations for inclusion in an EML?

• Adult-only packaging without dosing flexibility
• Stability and shelf-life under local conditions
• Dosing flexibility and ease of administration for children
• Palatability and age-appropriate formulations

Correct Answer: Adult-only packaging without dosing flexibility

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