[e-drug] The use of stems in International Nonproprietary Names (3)

["Rago, Lembit" <ragol@who.int>]

E-DRUG: The use of stems in International Nonproprietary Names (3)
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Dear All,

It is good that both INN and ATC systems are in the focus of attention. Emphasizing better cooperation between the two sytems is also a suggestion that can be only wellcome. Cooperations can always be better even if they are already very good. However, one might wish to consider that one system (INNs) started perhaps earlier than the other (ATC/DDD). It would be also good to recall that historically ATC/DDD system started its development in Europe outside WHO Global environment and at some stage of the 
development was brought under WHO umbrella as potential Global system. 

Both systems have also different objectives and are very much complementary, and not exclusive to each other in any way. Where INN system has a limitation the ATC system may be able to over come it. Not likely other way around as the INN system is more rigid (and not without good reasons). 

Now how to get better harmony between the two?

Before starting to do it one has to consider weather this is doable and if yes, what are the consequences. The INN system is basis for a such a huge amount of data generated Globally that any change may cause a confusion of unpredictable dimensions and consequences. All the scientific literature and databases about drugs, all the text books, all the national systems (both in public and private sector) based on INNs ... And this for decades really Globally. I would be very cautious to change anything that can cause retrospective and prospective confusion with potentially putting a lot of patients in danger. Is it possible to take some harmonization attempts prospectively? Each system has its own logic and limitations. Good attempts may not fit to the system and again, the need to change the whole system may arise with all its consequences. As in many cases related to medicines the decisions are based also in the case of classifications on potential benefits versus potential risks. If expected benefits clearly outweigh the risks then one could and should change. If other way around one should be very cautious.

In conclusion, both classifictaions are done by international groups of highly qualified experts. I suggest that this discussion is brought to the attention of both groups. The INN Expert Working Group may wish to discuss it more in depth during its next meeting and give a statement that should be made public including circulation to the E-Drug readers. 

Dr Lembit Rägo
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Lembit Rägo MD, PhD
Coordinator
Quality Assurance and Safety: Medicines
Medicines Policy and Standards
World Health Organization
Geneva
Switzerland
"Rago, Lembit" <ragol@who.int>