OBJECTIVES

The ATC/DDD system is an international drug classification method. Its use in drug utilization studies could be limited not considering the bioequivalence. Then, we evaluate purpose of use and fields of application of ATC/DDD system in the scientific research.

METHODS

We conducted a systematic review according to PRISMA Statement. The following keywords were searched into Pubmed and Embase databases as mesh or emtree or in title/abstract: ‘drug, price, reference price, pricing, technology, formulation, anatomical therapeutic classification, ATC’. Boolean operators were OR/AND. Research limits were English language and European geographical context.

RESULTS

1,199 articles were identified and 75 included in the qualitative analysis. 84% (N = 63) represented observational drug utilization studies; of these, 60% evaluated patterns of use of some pharmacological categories, 14% quality of use and 12% clinical outcomes. 13% of the selected studies (n = 10) concern the use of the ATC / DDD system in pharmacovigilance. None of the selected studies deal with bioequivalence.

CONCLUSIONS

The ATC/DDD system should be constantly updated to follow the evolution of pharmaceutical innovation incorporating with the peculiarities of pharmaceutical technology and addressing the problem of bioequivalence.