Summary of the main temporary ATC alterations
Decided at the WHO International Working Group for Drug Statistics Methodology meeting in Oslo 22 -23 March 2006
· Separate ATC group in S01 for agents used in age-related macular degeneration
The heterogeneous S01X group Other ophthalmologicals has been reviewed in order to assess whether a new subgroup for all drugs used in connection with age-related macular degeneration (AMD) should be established.
With the growing population of elderly, the prevalence of AMD will increase and new chemical entities will probably reach the market in the future. It was therefore decided that from a drug utilization point of view it would be appropriate to establish a new ATC 3rd level for the AMD agents.
The following new classification was decided:S01L Agents for age related macular degeneration
S01LA Ocular antineovascularisation agents
01 Verteporfin (altered from L01XD02)
02 Anecortave (altered from S01XA16)
03 Pegaptanib (altered from S01XA17)
04 Ranibizumab (new ATC code)
· Modification of ATC level names in L03/L04
The Centre has been approached by several users of the ATC/DDD system arguing that the current classification in ATC groups L03 and L04 is not optimal.
The main problem seems to be the current naming of the ATC 3rd level L03A Cytokines and immunomodulators, since Immunosuppressive agents in ATC 3rd level L04A could also be considered as immunomodulators. Immunomodulating agents are a growing area and the mechanism of action for new chemical substances is often complex.
It was decided to modify the ATC level names by adding the term immunomodulators to all relevant ATC levels names in L03/L04.
The following ATC level names were decided in L03/L04:L03 Immunomodulators/-stimulants
L03A Cytokines and immunomodulators/-stimulants
L03AX Other cytokines and immunomodulators/-stimulants
L04 Immunomodulators/-suppressants
L04AA Selective immunomodulators/-suppressants
L04AX Other immunomodulators/-suppressants
· Classification of combinations of antivirals for treatment of HIV infections
The ATC classification of a fixed combination and a combination package containing two nucleoside/nucleotide reverse transcriptase inhibitors (ATC group J05AF) and one non-nucleoside reverse transcriptase inhibitor (ATC group J05AG) used in treatment of HIV infections was discussed.
Since combination products have become more important in treatment of HIV infections, it should be possible to identify all the active agents in the different combinations based on the ATC classification. This is important both in the field of drug utilization and in pharmacovigilance. The combinations already classified in J05AF30 should be moved out to a new ATC 4th level for combinations, together with the new combinations.
The following new classification was decided:J05AR Antivirals for treatment of HIV infections, combinations (new ATC 4th level)
01 Zidovudine and lamivudine (altered from J05AF30)
02 Lamivudine and abacavir (altered from J05AF30)
03 Tenofovir disoproxil and emtricitabine (altered from J05AF30)
04 Zidovudine, lamivudine and abacavir (altered from J05AF30)
05 Zidovudine, lamivudine and nevirapine (new code)
06 Emtricitabine, tenofovir disoproxil and efavirenz, (new code)
Oslo, May 2006
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