Provisional 2027 EPHMRA ATC Developments
The following new class structures were voted on by EPHMRA/Intellus in June 2026 and agreed in principle.
These structures will now be used in the next part of the development process which is the detailed refinement of the rules.
Please note that these new class structures are provisional at this time. The 2027 codes, descriptions and Guideline text will be finalised and published by the Committee at the end of 2026. The new structures then come into effect from the beginning of 2027.
L class restructure
The proposal is to
1) Create a new, dedicated 1st level class exclusively for immunological agents and,
2) Promote existing 3rd level antineoplastic classes to the 2nd level. The current L2 class would be unchanged.
This proposal provides a distinction between antineoplastics and immunomodulators and will create capacity in the classification system, allowing it to adapt to future developments, particularly in the antineoplastic area.
The proposed structure is as follows:
- L ANTINEOPLASTICS
- L2 CYTOSTATIC HORMONE THERAPY
- L5 ALKYLATING ANTINEOPLASTICS
- L6 ANTIMETABOLITE ANTINEOPLASTICS
- L7 PLANT-BASED ANTINEOPLASTICS
- L8 ANTIBIOTIC ANTINEOPLASTICS
- L9 PLATINUM ANTINEOPLASTICS
- L10 MONOCLONAL ANTIBODY ANTINEOPLASTICS
- L11 PROTEIN KINASE INHIBITOR ANTINEOPLASTICS
- L12 PROTEASOME INHIBITOR ANTINEOPLASTICS
- L13 LIDOMIDE ANTINEOPLASTICS
- L14 PARP INHIBITOR ANTINEOPLASTICS
- L99 ANTINEOPLASTICS, OTHER
- F IMMUNOMODULATORS
- F1 IMMUNOSTIMULATING AGENTS
- F2 IMMUNOSUPPRESSANTS
Lower-level classification remains consistent with the new levels immediately above, for example:
“current”
L1G MONOCLONAL ANTIBODY ANTINEOPLASTICS
L1G1 Monoclonal antibody antineoplastics, CD20
“proposed”
L10 MONOCLONAL ANTIBODY ANTINEOPLASTICS
L10A MONOCLONAL ANTIBODY ANTINEOPLASTICS, CD20
For further information, please refer to the document of Proposed changes to the current L class: Oncology/Immunology split, available on the EPHMRA Anatomical Classification page https://www.ephmra.org/anatomical-classification