Anatomical Therapeutic Chemical Classification System
The Anatomical Therapeutic Chemical (ATC) Classification System is a drug classification system that classifies the active ingredients of drugs according to the organ or system on which they act and their therapeutic, pharmacological and chemical properties. It is controlled by the World Health Organization Collaborating Centre for Drug Statistics Methodology (WHOCC), and was first published in 1976.
This pharmaceutical coding system divides drugs into different groups according to the organ or system on which they act, their therapeutic intent or nature, and the drug’s chemical characteristics. Different brands share the same code if they have the same active substance and indications. Each bottom-level ATC code stands for a pharmaceutically used substance, or a combination of substances, in a single indication (or use). This means that one drug can have more than one code, for example acetylsalicylic acid (aspirin) has A01AD05 (WHO) as a drug for local oral treatment, B01AC06 (WHO) as a platelet inhibitor, and N02BA01 (WHO) as an analgesic and antipyretic); as well as one code can represent more than one active ingredient, for example C09BB04 (WHO) is the combination of perindopril with amlodipine, two active ingredients that have their own codes (C09AA04 (WHO) and C08CA01 (WHO) respectively) when prescribed alone.
The ATC classification system is a strict hierarchy, meaning that each code necessarily has one and only one parent code, except for the 14 codes at the topmost level which have no parents. The codes are semantic identifiers, meaning they depict in themselves the complete lineage of parenthood.
The ATC system is based on the earlier Anatomical Classification System, which is intended as a tool for the pharmaceutical industry to classify pharmaceutical products (as opposed to their active ingredients). This system, confusingly also called ATC, was initiated in 1971 by the European Pharmaceutical Market Research Association (EphMRA) and is being maintained by the EphMRA and the Pharmaceutical Business Intelligence and Research Group (PBIRG). Its codes are organised into four levels. The WHO’s system, having five levels, is an extension and modification of the EphMRA’s. It was first published in 1976.
In this system, drugs are classified into groups at five different levels:
The first level of the code indicates the anatomical main group and consists of one letter. There are 14 main groups:
|A||Alimentary tract and metabolism|
|B||Blood and blood forming organs|
|G||Genito-urinary system and sex hormones|
|H||Systemic hormonal preparations, excluding sex hormones and insulins|
|J||Antiinfectives for systemic use|
|L||Antineoplastic and immunomodulating agents|
|P||Antiparasitic products, insecticides and repellents|
The second level of the code indicates the therapeutic subgroup and consists of two digits.
The third level of the code indicates the therapeutic/pharmacological subgroup and consists of one letter.
Example: C03C High-ceiling diuretics
The fourth level of the code indicates the chemical/therapeutic/pharmacological subgroup and consists of one letter.
Example: C03CA Sulfonamides
The fifth level of the code indicates the chemical substance and consists of two digits.
Example: C03CA01 furosemide
The Anatomical Therapeutic Chemical Classification System for veterinary medicinal products (ATCvet) is used to classify veterinary drugs. ATCvet codes can be created by placing the letter Q in front of the ATC code of most human medications. For example, furosemide for veterinary use has the code QC03CA01.
Defined daily dose
The ATC system also includes defined daily doses (DDDs) for many drugs. This is a measurement of drug consumption based on the usual daily dose for a given drug. According to the definition, “[t]he DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults.”
Adaptations and updates
National issues of the ATC classification, such as the German Anatomisch-therapeutisch-chemische Klassifikation mit Tagesdosen, may include additional codes and DDDs not present in the WHO version.
ATC follows guidelines in creating new codes for newly approved drugs. In order to create a new ATC code, an application has to be sent to the WHO. New ATC codes are published twice annually. A formal release of new ATC edition occurs once a year.
- Classification of Pharmaco-Therapeutic Referrals (CPR)
- ICD-10 International Classification of Diseases
- International Classification of Primary Care (ICPC-2) / ICPC-2 PLUS
- Medical classification
- Pharmaceutical care
- “ATC/DDD Methodology: History”. WHO Collaborating Centre for Drug Statistics Methodology.
- “Comparison of the WHO ATC Classification & EphMRA/PBIRG Anatomical Classification” (PDF). EphMRA. Retrieved 7 January 2017.
- “EphMRA Anatomical Classification Guidelines 2016” (PDF). EphMRA. Retrieved 7 January 2017.
- “ATC: Structure and principles”. WHO Collaborating Centre for Drug Statistics Methodology.
- “ATC/DDD Index”. WHO Collaborating Centre for Drug Statistics Methodology.
- the Anatomical Therapeutic Chemical (ATC) classification system Structure
- “ATCvet”. WHO Collaborating Centre for Drug Statistics Methodology. Retrieved 2015-02-15.
- “DDD: Definition and general considerations”. WHO Collaborating Centre for Drug Statistics Methodology.
- “ATC-Klassifikation mit DDD: Gesetzlicher Hintergrund” (in German). Deutsches Institut für Medizinische Dokumentation und Information.
- “Guidelines for ATC classification and DDD assignment”. WHO Collaborating Centre for Drug Statistics Methodology. 2014-12-16. Archived from the original on 2015-08-06.
- “New ATC”. WHO Collaborating Centre for Drug Statistics Methodology. 2015-04-29.
- “WHOCC Homepage”. WHO Collaborating Centre for Drug Statistics Methodology.
- “ATC: Introduction”. Family Medicine Research Centre, University of Sydney.
- EphMRA Anatomical Classification (ATC and NFC)