E-drug: EDL - ATC (cont'd)
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This is a comment to the issues raised by Stein Lyftingsmo and
Kirsten Myhr on 25 and 26 June this year.
With regard to the use of ATC codes in the Essential Drug list, there
is still work going on to include an ATC sorted version of the EDL
together with the present version. In the WHO Expert Committee on
the Use of Essential Drugs, there has been a general reluctancy
towards including the ATC classification in the list. The WHO
Centre in Oslo, responsible for the ATC/DDD methodology, has in
the latest years given this work priority, and we agree that it is a
pity that so far ATC codes have not been included in the present
Model List of Essential Drugs. The last version includes, however, a
reference to the ATC classification, which we regard as a step in
the right direction.
Kirsten Myhr comments that information on ATC and DDDs is not
easy to obtain. On our website (www.whocc.nmd.no), we have
included (in our opinion) quite comprehensive information about e.g.
the methodology, the general principles for assignment, lists of
alterations, procedures for requesting new ATC/DDDs and lists of
all the latest assignments and changes. We are of course interested
in suggestions for improvements of the site. However, the main
criticism seems to be the fact that the complete ATC/DDD
publications are only available for a fee. At present, this is
considered as an acceptable way of partly funding the activity of
the Centre (the main source of funding is from the Norwegian
Government). Users with a low ability to pay will, however, on
request always receive the publications free of charge.
More information about the ATC/DDD courses are also requested.
Information about the planned courses will always be available on
our website, but in the future, it might be a good idea also to
announce the courses regularly on E-drug. Thank you, Kirsten, for
this suggestion!
As the course material is designed to fit into a setting with
complementary oral presentations, discussions and working groups,
it will only be useful for people attending the courses. The
ATC/DDD publications and the present content of the website will
give a better overview of the methodology than the slide material
with mainly head words used at the ATC/DDD courses.
It is correct that it was decided some years ago not to continue the
work with the publishing of a drug utilisation bibliography. Due to
the increasing worldwide use of the web, this work was not given
priority. It was considered to be easy for most people to make their
own searches for relevant publications.
Finally, the idea to assign ATC codes and DDDs at the same time as
INNs are assigned came up at the latest EURODURG meeting in
Prague in June. It was at the same meeting replied from the Centre
and the ATC/DDD expert group that this is neither practical nor
possible. INNs are often assigned at a very early stage in the
development of a new drug, while ATC codes and DDDs are and
should be assigned closer to or after the substance has received a
marketing authorisation. These procedures are explained on our
website. I quote: "A new medicinal substance is normally not
included in the ATC system before an application for marketing
authorisation is submitted in at least one country. In some cases it
may be necessary to await a classification until the new substance
has been approved in at least one country (especially for
substances where it is considered difficult to establish a new 5th
level). These conditions are set to avoid including in the ATC
system too many substances which never become marketed.DDDs
are not assigned before marketing is approved in at least one
country."
I hope the above comments answers some of the questions raised
in the previous mails about these issues.
Marit R�nning
WHO Collaborating Centre for Drug Statistics Methodology
P.O.Box 183 Kalbakken
0903 Oslo
Norway
Telephone: +47 22 16 98 10
Telefax: +47 22 16 98 18
E-mail: marit.ronning@nmd.no
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