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ATC-Index Mit DDD-Angaben Für Deutschland Im Jahre 2019

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ATC-Index Mit DDD-Angaben Für Deutschland Im Jahre 2019 Uwe Fricke · Judith Günther · Katja Niepraschk-von Dollen · Anette Zawinell Anatomisch-therapeutisch- chemische Klassifikation mit Tagesdosen für den deutschen Arzneimittelmarkt ATC-Index mit DDD-Angaben Mai 2019 Impressum Die vorliegende Publikation ist ein Beitrag des GKV-Arzneimittelindex im Wissenschaftlichen Institut der AOK (WldO). Anatomisch-therapeutisch-chemische Klassifikation mit Tagesdosen für den deutschen Arzneimittelmarkt ATC-Index mit DDD-Angaben für den deutschen Arzneimittelmarkt Berlin 2019, 18. überarbeitete Auflage Uwe Fricke, Judith Günther, Katja Niepraschk-von Dollen, Anette Zawinell Wissenschaftliches Institut der AOK (WldO) im AOK-Bundesverband GbR Rosenthaler Str. 31, 10178 Berlin Geschäftsführender Vorstand: Martin Litsch (Vorsitzender) Jens Martin Hoyer (stellv. Vorsitzender) http://www.aok-bv.de/impressum/index.html Aufsichtsbehörde: Senatsverwaltung für Gesundheit, Pflege und Gleichstellung –SenGPG– Oranienstraße 106, 10969 Berlin Pharmazeutisch-technische Assistenz: Sandra Heric, Heike Hoffmeister, Sabine Roggan, Manuela Steden Datenverarbeitung: Kenan Ajanovic, Jana Weiss Redaktionelle Bearbeitung: Melanie Hoberg, Manuela Steden Titelfoto: Ulrich Birtel Nachdruck, Wiedergabe, Vervielfältigung und Verbreitung (gleich welcher Art), auch von Teilen des Werkes, bedürfen der ausdrücklichen Genehmigung. E-Mail: [email protected] Internet: http://www.wido.de Inhalt Wissenschaftliche Berater des GKV-Arzneimittelindex ......................................................... 4 Hinweise .............................................................................................................................. 5 Vorwort .............................................................................................................................. 6 1 Nutzungshinweise für den ATC-Index mit DDD-Angaben ...................................... 9 2 ATC-Index mit DDD-Angaben .............................................................................. 11 2.1 ATC-Index mit DDD-Angaben, sortiert nach ATC-Code ............................................. 11 2.2 ATC-Index mit DDD-Angaben, sortiert nach Wirkstoffen ......................................... 12 Wissenschaftliche Berater des 4 GKV-Arzneimittelindex Wissenschaftliche Berater des GKV-Arzneimittelindex Priv.-Doz. Dr. med. Robert Klamroth Vivantes-Klinikum im Friedrichshain Landsberger Allee 49 10249 Berlin Prof. Dr. med. Dr.h.c. Björn Lemmer Institut für Experimentelle und Klinische Pharmakologie und Toxikologie Ruprecht-Karls-Universität Heidelberg Maybachstraße 14 68169 Mannheim Prof. Dr. med. Martin J. Lohse Max- Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC) Robert-Rössle-Straße 10 13125 Berlin Priv.-Doz. Dr. med. Jan Matthes Institut für Pharmakologie Universität zu Köln Gleueler Straße 24 50931 Köln Dr. med. Klaus Mengel Höferstraße 15 68199 Mannheim Prof. Dr. med. Gerhard Schmidt Zentrum Pharmakologie und Toxikologie der Universität Göttingen Robert-Koch-Straße 40 37075 Göttingen Prof. Dr. med. Hasso Scholz Institut für Experimentelle Pharmakologie und Toxikologie Universitäts-Krankenhaus Eppendorf Martinistraße 52 20246 Hamburg Hinweise 5 Hinweise Die vorliegende Publikation ist ein Beitrag des Wissenschaftlichen Instituts der AOK (WIdO) und keine Meinungsäußerung des WHO Collaborating Centre for Drug Statistics Methodology. Die Verwendung von Teilen der Original-WHO-Publikationen „ATC Index with DDDs“ und „Guidelines for ATC classification and DDD assignment“ wurden dem WHO Collaborating Centre for Drug Statistics Methodology angezeigt. Lesehinweis In den folgenden Textkapiteln sind alle Textstellen, die die deutschen Gegebenheiten beschreiben, in kursiver Schrift gesetzt. Textstellen, die nach den Publikationen der WHO zitiert sind, werden in normaler Schrift gesetzt. Wichtiger Hinweis Die Erkenntnisse in der Medizin unterliegen laufendem Wandel durch Forschung und klinische Erfahrungen. Sie sind darüber hinaus vom wissenschaftlichen Standpunkt der Beteiligten als Ausdruck wertenden Dafürhaltens geprägt. Wegen der großen Daten- fülle sind Unrichtigkeiten gleichwohl nicht immer auszuschließen. Alle Angaben erfol- gen insoweit nach bestem Wissen, aber ohne Gewähr. Produkthaftung: Für Angaben über Dosierungshinweise und Applikationsformen können Autoren, Herausgeber und Verlag keine Gewähr übernehmen. Derartige Angaben müssen vom jeweiligen Anwen- der im Einzelfall anhand anderer Literaturstellen und anhand der Beipackzettel der verwendeten Präparate in eigener Verantwortung auf ihre Richtigkeit überprüft wer- den. 6 Vorwort Vorwort Der GKV-Arzneimittelindex im Wissenschaftlichen Institut der AOK (WIdO) sorgt seit 1981 für Transparenz im Arzneimittelmarkt. Die Erfassung von Umfang und Struk- tur der vertragsärztlichen Arzneimittelverordnungen in Deutschland wird unter ande- rem dadurch ermöglicht, dass das anatomisch-therapeutisch-chemische Klassifikati- onssystem (ATC-System) der Weltgesundheitsorganisation (WHO) als wesentliche me- thodische Grundlage im Rahmen des GKV-Arzneimittelindex verwendet wird. Durch eine Kooperation zwischen der WHO und dem WIdO wurde die Anwendung dieses ATC-Klassifikationssystems zur Untersuchung des Arzneimittelverbrauchs auch für die deutschsprachigen Nutzer erstmalig 2001 ermöglicht. Im Januar 2004 er- klärte das Bundesministerium für Gesundheit und Soziale Sicherung (BMGS) die inter- nationale ATC-Klassifikation der WHO mit Stand 2003 für amtlich. Zur Weiterentwicklung des Klassifikationssystems mit definierten Tagesdosen (DDD) und zur Anpassung an die besonderen Gegebenheiten des deutschen Arzneimittel- marktes wurde im Jahr 2004 im Auftrag des BMGS eine ATC/DDD-Arbeitsgruppe beim Kuratorium für Fragen der Klassifikation im Gesundheitswesen eingesetzt, in der die maßgeblichen Fachkreise vertreten sind. Grundlage für die jährliche Anpassung der amtlichen ATC-Klassifikation ist das ATC-Code-Verzeichnis mit Tagesdosen für den deutschen Arzneimittelmarkt, das das WIdO im Rahmen des langjährigen Forschungs- projekts GKV-Arzneimittelindex an die nationalen Besonderheiten adaptiert hat und jährlich publiziert. Im Rahmen eines Anhörungsverfahrens werden Anmerkungen zur bestehenden ATC-Klassifikation und DDD-Festlegung des GKV-Arzneimittelindex ge- sammelt, inhaltlich geprüft und bewertet. Auf Empfehlung der ATC-Arbeitsgruppe so- wie nach Abstimmung mit dem Bundesministerium für Gesundheit wird die Fassung dann jährlich zum 1. Januar vom BMG für amtlich erklärt. Wie auf internationaler Ebene bedarf es aufgrund der dynamischen Entwicklung des Arzneimittelmarktes auch in Deutschland einer ständigen Anpassung und Überarbei- tung der Daten und der zugrundeliegenden Klassifikationssystematik. Dies macht kon- tinuierliche Aktualisierungen der Klassifikationsdatenbank des GKV-Arzneimittelin- dex im WIdO notwendig. Hierbei erfolgt die Vergabe von ATC-Codes und definierten Tagesdosen (DDD) streng nach den Empfehlungen der WHO (WHO Collaborating Centre for Drug Statistics Methodology 2019a und 2019b), soweit diese die Abbildung der nationalen Gegebenheiten in ausreichendem Maße gewährleisten. Das nun vorliegende Werk publiziert die notwendigen Erweiterungen und Anpassun- gen der ATC-Klassifikation und DDD-Festlegung der WHO, die im Rahmen der Pro- jektarbeit des GKV-Arzneimittelindex für die spezifischen Belange des deutschen Arz- neimittelmarktes vorgenommen wurden. Dies ist insofern notwendig, da im Jahr 2017 aufgrund der Besonderheiten im deutschen Arzneimittelmarkt ungefähr 10 % der Arz- neimittelverordnungen mit einem Umsatzanteil in Höhe von ca. 6 % nicht über das in- ternationale Klassifikationssystem der WHO abgedeckt sind. Die Klassifikation, die der GKV-Arzneimittelindex mit seiner über die WHO hinausführenden ATC-Klassifika- tion und DDD-Festlegung deutscher Arzneimittel seit Jahren aufbereitet, wird seit 1995 jährlich der Öffentlichkeit zugänglich gemacht. Nunmehr liegt die aktuelle Ausgabe des Jahres 2019 vor. Vorwort 7 Die notwendigen Erweiterungen und Anpassungen der ATC-Klassifikation und DDD- Festlegung für die spezifischen deutschen Belange werden dabei vom GKV-Arzneimit- telindex ständig eingearbeitet und haben sich zum deutschen „Goldstandard“ etabliert, der in den verschiedensten Projekten der Arzneimittelverbrauchsforschung angewen- det wird. Eine Auswahl dieser Transparenzprojekte macht deutlich, dass diese Klassi- fikation mit den entsprechenden deutschen Anpassungen von zentraler Bedeutung ist: • Der GKV-Arzneimittelindex im Wissenschaftlichen Institut der AOK (WIdO), der diese Klassifikation erarbeitet hat, pflegt seit 1980 eine Arzneimittelklassifikations- datenbank, die über 150.000 verschiedene Fertigarzneimittel mit den unterschied- lichsten Informationen zu diesen Produkten beinhaltet. Durch die Zusammenfüh- rung von Rezeptdaten, die für die ersten Jahre als repräsentative Stichprobe und heute als Vollerhebung mit jährlich über 650 Millionen Verordnungen vorliegen, können zusammen mit Klassifikationsdaten Arzneimittelverbrauchsanalysen nach einzelnen Marktsegmenten, nach der Facharztgruppe des verordnenden Arztes, nach Alters- und Geschlechtsgruppen der Patienten oder Regionen durchgeführt werden. Seit 1985 werden diese Daten im Arzneiverordnungs-Report analysiert, der unter der Herausgeberschaft von Prof. Dr. Ulrich Schwabe und Dr. Dieter Paffrath jährlich erscheint. Seit dem Jahr 2017 wurde die Herausgeberschaft um Prof. Dr. Wolf-Dieter Ludwig und Jürgen Klauber erweitert. In diesem deutschen Standardwerk analysieren etwa 30 Experten aus Pharmakologie, Medizin
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