PHIC further license to develop an index of drug refer- Drugs are categorised into 4 classes on the database: ence prices that will serve as a basis for drug reimburse- generic, branded generic, proprietary drug with a generic ment in the hope of encouraging the more rational and equivalent, proprietary drug with no generic equivalent.
Demo- graphics captured included college size, mean yearly research dollars, faculty size, and enrollment. Costs to examinees are estimated with minimum gathered for a list of the pharmacologically active and maximum expenses varied for test cases. The survey ingredients most commonly reimbursed by PHIC. The amount drug price data. Other sources of price data included a of reimbursement was tabulated. Most institutions considered board cer- displayed a large degree of variation.
Hysingla ER. Imipramine Hydrochloride. Indocin SR. Intron A. Invokamet XR. Jadenu Sprinkle. Janumet XR. Jentadueto XR. Jornay PM. Keppra XR. Klonopin Rapidly Disintegrating. Kombiglyze XR. Lamictal CD. Lamictal ODT. Lamictal XR.
Lamivudine, Nevirapine and Zidovudine. Limbitrol DS. Lithium Carbonate. Lithium Citrate. Lupron Depot-Ped Kit. Luvox CR. Lyrica CR. Metadate CD. Metoclopramide Hydrochloride. Metozolv ODT. Morphabond ER. Morphine Sulfate. Moxifloxacin Hydrochloride. MS Contin. Multihance Multipack. Since there may be considerable variation in the clinical use of these agerits within individual countries.
Tags book. Labels: book. No comments:. Newer Post Older Post Home. Subscribe to: Post Comments Atom. D Pharmaceutics Ph. ATC was recently integrated in RxNorm. While RxNorm only integrates the terminological features of ATC, and not its defined daily doses and routes of administration, this integration already facilitates the analysis of prescription lists indexed with RxNorm identifiers, by providing a reliable entry point into ATC.
More specifically, we propose to analyze drug classification based on ATC groupings and to compare the prescribed daily dose to the defined daily dose in ATC for a large prescription dataset from Surescripts.
To our knowledge, this study is the first application of ATC to the analysis of a U. The system includes drug classifications at 5 levels; anatomical, therapeutic, pharmacological, chemical and drugs or ingredients.
Also included are defined daily doses DDDs and administration routes assigned to most drugs in accordance to the therapeutic and pharmacological groups. The route of administration Adm. R and the defined daily dose DDD are listed for each of the four 5th-level drugs.
Figure 1. Drugs from the Digitalis glycosides 4th-level group in ATC partial screenshot from the ATC website The active ingredients in the classification include a wide range of chemical entities used in a variety of countries. New ingredients are not included in the ATC system until they are approved for pharmaceutical use in at least one country.
Only herbal medicinal products approved by regulatory authorities are included in the classification. The active moieties are classified according to the main therapeutic use of the main ingredient. Since an ingredient can have therapeutic applications on different anatomical sections, ATC assigns a different code to the same ingredient in different anatomical sections. For example, the beta-blocker timolol has different codes when used as a cardiovascular drug C07AA06 and as a treatment for glaucoma S01ED The defined daily dose DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults.
The DDD is calculated based on adult weight of 70 kg. The DDD can be an average of doses from different countries and might the reflection of the more commonly used strengths.
The DDD is not necessarily the prescribed daily dose, as the latter depends on individual patient characteristics such as age, weight and pharmacokinetic considerations. Topical products, sera, vaccines, antineoplastic agents, allergen extracts, anesthetics and contrast media are not assigned a DDD. The edition of ATC used in this study contains 5th-level ATC drugs, of which correspond to single- active moieties as opposed to combinations.
A clinical drug is defined as a pharmaceutical product with therapeutic or diagnostic properties available to patients. A clinical drug includes the ingredient s , strength or concentration, and dose form appropriate for the intended administration route e. The February edition of RxNorm is used in this study. Base ingredients are the active moieties of clinical drugs e. RxNorm also covers their various salts, esters and complexes e.
Unlike RxNorm, ATC represents mostly base ingredients and does not distinguish between base and precise ingredients. Single-ingredient drugs have a unique chemical component, and multiple-ingredient drugs have two or more e.
Dose forms are administration vehicles, such as pills, tablets, syringes and lotions. RxNorm identifies a subset of drugs intended to be an approximation of the prescription drugs currently marketed in the U.
Since the scopes of RxNorm and ATC are slightly different, the mapping is not expected to be complete. For example, RxNorm includes several hundred allergenic extracts e. Conversely, diagnostic and therapeutic radiopharmaceuticals e. In contrast to RxNorm, in which each ingredient is represented only once, ATC can have multiple codes for the same active moiety, depending on the anatomical system or therapeutic domain in which it is used.
Surescripts dataset The prescription drug list is a de-identified list comprised of , clinical drugs dispensed to emergency room patients over a period of three months in at Suburban Hospital in Bethesda, Maryland. Each drug includes an anonymized prescription identifier, clinical drug name, drug form, strength, prescribed amount, and the intake duration.
This prescription list was annotated with RxNorm identifiers for clinical drugs. When updated against the February version of RxNorm, 99, drugs were valid or could be mapped to a valid code , while were obsolete. Of these, we only investigate the 87, drug codes corresponding to single-ingredient drugs from the prescribable subset of RxNorm. Related work Many studies have been published reporting on drug utilization based on ATC for various classes of drugs, including antibiotics [9, 10], cardiovascular drugs [8], and anti-depressants [11], or across classes [7].
Some studies specifically compare prescribed daily doses to defined daily doses in ATC for anti-epileptic drugs [6] and for several classes of anti-hypertensive drugs [12]. One characteristic of most of these studies is that they were performed in Europe, where ATC is more widely used than in the U. More recently, ATC has also been used as a terminological reference for drugs.
Additionally, ATC has been used as a reference in research projects where drug classes were predicted by integrating chemical-chemical interactions and similarities [14] or through text mining [15]. The specific contribution of our work is the application of ATC in combination with RxNorm, the standard drug vocabulary in the U. While many pharmaco-epidemiology studies leveraging ATC have been published in Europe, to the best of our knowledge, this study is the first analysis of a prescription dataset in the U.
Methods In ATC, a 5th-level code is assigned not to an ingredient, but to an ingredient for a specific therapeutic intent.
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