Lista medicamentelor valabila din 01.04.2015.pdf

of 192 /192

Embed Size (px)

Transcript of Lista medicamentelor valabila din 01.04.2015.pdf

Page 1: Lista medicamentelor valabila din 01.04.2015.pdf
Page 2: Lista medicamentelor valabila din 01.04.2015.pdf

Anexa

Lista denumirilor comerciale şi a preţurilor de decontare a medicamentelor care se acordă bolnavilor cuprinşi în cadrul programelor naţionale de sănătate, corespunzătoare denumirilor comune internaţionale (DCI) cuprinse în sublista C2 a anexei la Hotărârea Guvernului nr. 720/2008 pentru aprobarea Listei cuprinzând denumirile comune internaţionale corespunzătoare medicamentelor de carebeneficiază asiguraţii, cu sau fără contribuţie personală, pe bază de prescripţie medicală în sistemul asigurărilor sociale de sănătate, cu modificările şi completările ulterioare

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

P1: PROGRAMUL NATIONAL DE BOLI TRANSMISIBILE A) SUBPROGRAMUL DE TRATAMENT SI MONITORIZARE A PERSOANELOR CU INFECTIE HIV/SIDA si TRATAMENTUL POSTEXPUNERE

1 W05444002 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 3 BLIST. AL/PVC A CATE 12 COMPR. FILM.

P-RF 36 72,18 2,005000 2,005000 91,26 2,535000 2,535000

2 W05444001 A07AA11 RIFAXIMINUM NORMIX 200 mg COMPR. FILM. 200mg ALFA WASSERMANN SPA ITALIA CUTIE X 1 BLIST. AL/PVC X 12 COMPR. FILM.

P-RF 12 24,49 2,040833 2,040833 33,10 2,758333 2,758333

3 W05445001 A07AA11 RIFAXIMINUM NORMIX 100mg/5ml GRAN. PT. SUSP. ORALA 100mg/5ml ALFA WASSERMANN SPA ITALIA

CUTIE X 1 FLAC. GRAN. PT. 60 ML SUSP. ORALA + 1 MASURA DOZATOARE MARCATA LA 5, 10 SI 15 ML

P-RF 1 14,14 14,140000 14,140000 19,11 19,110000 19,110000

4 W13742001 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 5,05 5,050000 5,050000 6,83 6,830000 6,830000

5 W55641001 D06BB03 ACICLOVIRUM ACICLOVIR 50mg/g CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 5 G CREMA P-

RF 1 3,68 3,680000 3,680000 4,98 4,980000 4,980000

6 W55641002 D06BB03 ACICLOVIRUM ACICLOVIR 50mg/g CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 15 G CREMA P-

RF 1 5,62 5,620000 4,176000 7,60 7,600000 5,640000

7 W00040001 D06BB03 ACICLOVIRUM ZOVIRAX CREMA 5% THE WELLCOME FOUNDATION LTD.

MAREA BRITANIE CUTIE X 1 TUB X 5G CREMA P-

RF 1 15,58 15,580000 4,416000 21,06 21,060000 5,976000

8 W55128001 D06BB03 ACICLOVIRUM ACICLOVIR SLAVIA 50 mg/g CREMA 50mg/g SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA P-RF 1 4,97 4,970000 4,176000 6,72 6,720000 5,640000

9 W53041001 D06BB03 ACICLOVIRUM ACICLOVIR TIS 50mg/g CREMA 50mg/g TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB DIN PEJD X 15 G CREMA P-RF 1 3,48 3,480000 3,480000 4,70 4,700000 4,700000

10 W60557001 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 5 G CREMA PR

F 1 3,68 3,680000 3,680000 4,98 4,980000 4,980000

11 W60557002 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA PR

F 1 5,62 5,620000 4,176000 7,60 7,600000 5,640000

12 W52146002 D06BB03 ACICLOVIRUM ACICLOVIR HYPERION CREMA 50mg/g HYPERION S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 5,42 5,420000 4,176000 7,33 7,330000 5,640000

13 W58038001 D06BB03 ACICLOVIRUM ACICLOVIR TERAPIA 50 mg/g CREMA 50mg/g TERAPIA S.A. ROMANIA CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF 1 4,97 4,970000 4,176000 6,72 6,720000 5,640000

14 W55128002 D06BB03 ACICLOVIRUM ACICLOVIR SLAVIA 50 mg/g CREMA 50mg/g SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 1 TUB AL X 5 G CREMA P-RF 1 3,99 3,990000 3,990000 5,39 5,390000 5,390000

15 W51339001 G01AF04 MICONAZOLUM GYNOZOL 200 CAPS. VAG. 200mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. X 3 CAPS. VAG. MOI P-RF 6 4,41 0,735000 0,735000 5,96 0,993333 0,993333

16 W51340001 G01AF04 MICONAZOLUM GYNOZOL 400 CAPS. VAG. 400mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 CAPS. VAG. MOI P-RF 3 4,23 1,410000 1,410000 5,72 1,906666 1,906666

17 W04675003 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS.P-RF/S

1.000 242,55 0,242550 0,242550 296,11 0,296110 0,296110

18 W11729001 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,59 0,279500 0,279500 7,55 0,377500 0,355332

19 W04675002 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,25 0,262500 0,262500 7,10 0,355000 0,355000

20 W43090001 J01CF04 OXACILLINUM OXACILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,70 0,285000 0,285000 7,70 0,385000 0,355332

21 W07274001 J01CF04 OXACILLINUM OXACILINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 5,55 0,555000 0,468216 7,50 0,750000 0,571608

22 W13743001 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4,58 0,458000 0,458000 6,19 0,619000 0,571608

23 W12910002 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 50 BLIST. AL/PVC X 10 CAPS.P-RF/S

500 195,09 0,390180 0,390180 238,17 0,476340 0,476340

24 W43092001 J01CF04 OXACILLINUM OXACILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 5,21 0,521000 0,468216 7,04 0,704000 0,571608

25 W12910001 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 8,26 0,413000 0,413000 11,17 0,558500 0,558500

26 W60469001 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA

CU PULB. PT. SOL. INJ./PERF.PRF 1 3,94 3,940000 3,940000 5,33 5,330000 5,330000

27 W60469003 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA

CU PULB. PT. SOL. INJ./PERF.PRF 100 376,06 3,760600 3,760600 448,06 4,480600 4,480600

28 W60468001 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA

CU PULB. PT. SOL. INJ./PERF.PRF 1 3,64 3,640000 3,640000 4,92 4,920000 4,920000

29 W60468003 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA

CU PULB. PT. SOL. INJ./PERF.PRF 100 349,30 3,493000 3,493000 418,89 4,188900 4,188900

30 W04684002 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 500 mg PULB. PT. SOL. INJ./PERF. I.M./I.V. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA INCOLORA

CU PULB. PT. SOL. INJ./PERF. I.M./I.V.

P-RF/S

100 349,30 3,493000 3,493000 418,89 4,188900 4,188900

31 W04684004 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 500 mg PULB. PT. SOL. INJ./PERF. I.M./I.V. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU

PULB. PT. SOL. INJ./PERF. I.M./I.V.P-RF 1 3,64 3,640000 3,640000 4,92 4,920000 4,920000

32 W04682002 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 1 g PULB. PT. SOL. INJ./PERF.I.M./I.V. 1g ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA INCOLORA

CU PULB. PT. SOL. INJ./PERF. I.M./I.V.

P-RF/S

100 376,06 3,760600 3,760600 448,06 4,480600 4,480600

Pagina 1 din 87

Page 3: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

33 W04682003 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 1 g PULB. PT. SOL. INJ./PERF.I.M./I.V. 1g ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU

PULB. PT. SOL. INJ./PERF. I.M./I.V.P-RF 1 3,94 3,940000 3,940000 5,33 5,330000 5,330000

34 W58901002 J01CR01 AMPICILLINUM + SULBACTAM AMPIPLUS 1000 mg/500 mg PULB. PT. SOL. INJ./PERF.

1000mg/500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA

CONTINAND PULB. PT. SOL. INJ./PERF.

PR, PRF

50 633,77 12,675400 12,675400 728,96 14,579200 14,579200

35 W55354004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN SR 1000 mg/62,5 mg COMPR. ELIB. PREL.

1000mg/62,5mg BEECHAM GROUP PLC MAREA

BRITANIECUTIE CU 7 BLIST. AL/PVC-AL X 4 COMPR. ELIB. PREL.

P-RF 28 34,28 1,224285 1,224285 44,84 1,601428 1,601428

36 W00400003 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 1000 mg COMPR. FILM. 1000mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. AL/AL X 7 COMPR.FILM. P-

RF 14 29,92 2,137142 1,086000 39,13 2,795000 1,467428

37 W57628002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 500 mg/125mg COMPR. FILM. 500 mg/125 mg RANBAXY UK LIMITED MAREA

BRITANIE CUTIE X 4 FOLII AL-PEJD X 7 COMPR. FILM. P-RF 28 24,47 0,873928 0,630857 33,07 1,181071 0,852857

38 W54453002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 500/125 mg COMPR. FILM. 500/125mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR.FILM.

P-RF 14 8,01 0,572142 0,572142 10,83 0,773571 0,773571

39 W55163002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 500 mg/125 mg COMPR. FILM. 500mg/125mg BEECHAM GROUP PLC MAREA

BRITANIE

CUTIE CU 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTO

P-RF 14 11,33 0,809285 0,630857 15,32 1,094285 0,852857

40 W54971008 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 500 mg/125 mg COMPR. FILM. 500mg/125

mgAUROBINDO PHARMA LIMITED

MAREA BRITANIE

CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM.

P-RF 14 7,36 0,525714 0,525714 9,95 0,710714 0,710714

41 W00401004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 625 mg COMPR. FILM. 625mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 14 COMPR. FILM. P-

RF 14 20,76 1,482857 0,630857 28,06 2,004285 0,852857

42 W54972008 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 875 mg/125 mg COMPR. FILM. 875mg/125

mgAUROBINDO PHARMA LIMITED

MAREA BRITANIE

CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM.

P-RF 14 12,67 0,905000 0,905000 17,12 1,222857 1,222857

43 W55164001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 875 mg/125 mg COMPR. FILM. 875mg/125mg BEECHAM GROUP PLC MAREA

BRITANIE

CUTIE CU 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTO

P-RF 14 19,50 1,392857 1,086000 26,35 1,882142 1,467428

44 W55401002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 875 mg/125 mg COMPR. FILM. 875mg/125mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PA-AL-PVC/AL X 7

COMPR. FILM.P-RF 14 14,04 1,002857 1,002857 18,97 1,355000 1,355000

45 W51992004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 1000 mg

COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE

1000mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT.

DISPERSIE ORALA/ORODISPERSABILEP-RF 14 18,55 1,325000 1,086000 25,07 1,790714 1,467428

46 W51991002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg

COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE

625mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT.

DISPERSIE ORALA/ORODISPERSABILEP-RF 14 12,23 0,873571 0,630857 16,53 1,180714 0,852857

47 W59739002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 1000 mg/200 mg PULB. PT. SOL. INJ./PERF.

1000mg/200mg ANTIBIOTICE SA ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA

CARE CONTINE PULB. PT. SOL. INJ. / PERF.PRF 50 355,00 7,100000 7,100000 425,10 8,502000 8,502000

48 W10678001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV 156,25 mg/5 ml PULB. PT. SUSP. ORALA

125mg+31,25/5ml MEDOCHEMIE LTD. CIPRU CUTIE X 1 FLAC. CU PULB. PT. 100ML

SUSP. ORALA + LINGURITA DOZATOAREP-RF 1 11,02 11,020000 10,380000 14,90 14,900000 14,028000

49 W00399001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 156,25mg/5ml PULB. PT. SUSP. ORALA

156,25mg/5ml

LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25

MG PULB. PT. 100 ML SUSP. ORALAP-RF 1 8,65 8,650000 8,650000 11,69 11,690000 11,690000

50 W10679001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV FORTE 312,5mg/5ml PULB. PT. SUSP. ORALA

250mg+62,5mg/5ml MEDOCHEMIE LTD. CIPRU CUTIE X 1 FLAC. DIN STICLA BRUNA CU

PULB. PT. 100 ML SUSP.P-RF 1 16,36 16,360000 16,360000 22,11 22,110000 22,110000

51 W08783002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2x PULB. PT. SUSP. ORALA

400mg+57mg/5ml

LEK PHARMACEUTICALS D.D. SLOVENIA

CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 70 ML SUSP.ORALA + SERINGA DOZATOARE

P-RF 1 9,57 9,570000 9,570000 12,93 12,930000 12,930000

52 W08783001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2x PULB. PT. SUSP. ORALA

400mg+57mg/5ml

LEK PHARMACEUTICALS D.D. SLOVENIA

CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 35 ML SUSP.ORALA + SERINGA DOZATOARE

P-RF 1 4,78 4,780000 4,780000 6,46 6,460000 6,460000

53 W55355002 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA

400mg/57mg/5ml

SMITHKLINE BEECHAM PLC

MAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 70 ML SUSP. ORALA + MASURA DOZATOARE

P-RF 1 14,72 14,720000 11,484000 19,89 19,890000 15,516000

54 W59180001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 400 mg/57 mg/5 ml

PULB. PT. SUSP. ORALA

400mg/57mg/5ml

AUROBINDO PHARMA (MALTA) LIMITED MALTA

CUTIE CU 1 FLAC. PEID CARE CONTINE PULB. PT. SUSP. ORALA PT. OBTINEREA A 35 ML SUSP. RECONSTITUITA + 1 SERINGA DE POLISTIREN CU GRADATII LA INTERVALE DE 0,5 ML

PRF 1 4,79 4,790000 4,790000 6,47 6,470000 6,470000

55 W55355004 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA

400mg/57mg/5ml

SMITHKLINE BEECHAM PLC

MAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + MASURA DOZATOARE

P-RF 1 7,36 7,360000 5,736000 9,95 9,950000 7,752000

56 W55355001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA

400mg/57mg/5ml

SMITHKLINE BEECHAM PLC

MAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + 1 SERINGA PT. ADM. ORALA

P-RF 1 7,36 7,360000 5,736000 9,95 9,950000 7,752000

57 W55342003 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN (R) ES PULB. PT. SUSP. ORALA

600 mg/42,9mg/5ml

SMITHKLINE BEECHAM PLC

MAREA BRITANIE

CUTIE X 1 FLACON DIN STICLA CU PULB. PT. 100 ML SUSP. ORALA + 1 MASURA DOZATOARE

P-RF 1 26,22 26,220000 26,220000 34,30 34,300000 34,300000

58 W00402001 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 312,5mg/5ml PULB. PT.SUSP. ORALA

312,5mg/5ml

LEK PHARMACEUTICALS D.D. SLOVENIA

CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 G PULB. PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE

P-RF 1 17,77 17,770000 17,770000 24,02 24,020000 24,020000

59 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

60 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

61 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

Pagina 2 din 87

Page 4: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

62 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

63 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

64 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

65 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

66 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

67 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

68 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

69 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

70 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

71 W55618001 J01DD04 CEFTRIAXONUM OFRAMAX 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg TERAPIA SA ROMANIA

CUTIE CU 50 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 15 ML CU PULB. PT. SOL. INJ./PERF.

S 50 456,00 9,120000 4,826400 535,19 10,703800 6,313200

72 W13949006 J01DD04 CEFTRIAXONUM CEFORT 1 g PULB. PT. SOL. INJ./PERF. 1g ANTIBIOTICE SA ROMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 10 ML CU PULB. PT. SOL. INJ./PERF.

PR 10 133,84 13,384000 4,826400 163,39 16,339000 6,313200

73 W13949009 J01DD04 CEFTRIAXONUM CEFORT 1 g PULB. PT. SOL. INJ./PERF. 1g ANTIBIOTICE SA ROMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 30 ML CU PULB. PT. SOL. INJ./PERF.

PR 10 133,84 13,384000 4,826400 163,39 16,339000 6,313200

74 W13949012 J01DD04 CEFTRIAXONUM CEFORT 1 g PULB. PT. SOL. INJ./PERF. 1g ANTIBIOTICE SA ROMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 15 ML CU PULB. PT. SOL. INJ./PERF.

PR 10 133,84 13,384000 4,826400 163,39 16,339000 6,313200

75 W13949003 J01DD04 CEFTRIAXONUM CEFORT 1 g PULB. PT. SOL. INJ./PERF. 1g ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. CU PULB. PT. SOL.

INJ./PERF.S/P-RF 10 133,84 13,384000 4,826400 163,39 16,339000 6,313200

76 W53779001 J01DD04 CEFTRIAXONUM SEFTRION 1 g PULB. PT. SOL. INJ./PERF. 1g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU

PULB. PT. SOL. INJ./PERFZ.S/P-RF 1 10,31 10,310000 4,826400 13,94 13,940000 6,313200

77 W59397002 J01DD04 CEFTRIAXONUM CEFTRIAXONA-MIP 1 g PULB. PT. SOL. INJ./PERF. 1g MIP PHARMA GMBH GERMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 50 ML CONTINAND PULB. PT. SOL. INJ./PERF.

PR 10 40,22 4,022000 4,022000 52,61 5,261000 5,261000

78 W13948008 J01DD04 CEFTRIAXONUM CEFORT 250 mg PULB. PT. SOL. INJ./PERF. 250mg ANTIBIOTICE SA ROMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CAPACITATE 15 ML CU PULB. PT. SOL. INJ. PERF.

PR 10 54,63 5,463000 5,463000 69,07 6,907000 6,907000

79 W55619001 J01DD04 CEFTRIAXONUM OFRAMAX 250 mg PULB. PT. SOL. INJ./PERF. 250mg TERAPIA SA ROMANIA

CUTIE CU 50 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 5 ML CU PULB. PT. SOL. INJ./PERF.

S 50 246,03 4,920600 4,920600 300,35 6,007000 6,007000

80 W13948004 J01DD04 CEFTRIAXONUM CEFORT 250 mg PULB. PT. SOL. INJ./PERF. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. CU PULB. PT.

SOL.INJ./PERF.S/P-RF 10 54,63 5,463000 5,463000 69,07 6,907000 6,907000

81 W42544001 J01DD04 CEFTRIAXONUM MEDAXONE 2 g PULB. PT. SOL. INJ./PERF. 2g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLACOANE X 2 G PULB. PT.

SOL. INJ./PERF.S/P-RF 10 210,87 21,087000 8,888400 257,43 25,743000 11,238000

82 W59398002 J01DD04 CEFTRIAXONUM CEFTRIAXONA-MIP 2 g PULB. PT. SOL. INJ./PERF. 2g MIP PHARMA GMBH GERMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 50 ML CONTINAND PULB. PT. SOL. INJ./PERF.

PR 10 74,07 7,407000 7,407000 93,65 9,365000 9,365000

83 W13891004 J01DD04 CEFTRIAXONUM CEFORT 2 g PULB. PT. SOL. INJ./PERF. 2g ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. CU PULB. PT. SOL.

INJ./PERF.S/P-RF 10 228,45 22,845000 8,888400 278,89 27,889000 11,238000

84 W53778001 J01DD04 CEFTRIAXONUM SEFTRION 500 mg PULB. PT. SOL. INJ./PERF. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU

PULB. PT. SOL. INJ./PERFZ.S/P-RF 1 7,74 7,740000 7,740000 10,46 10,460000 10,460000

85 W56096001 J01DD04 CEFTRIAXONUM SEFTRION 2 g PULB. PT. SOL. PERF. 2g EIPICO MED SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA

CU PULB. PT. SOL. PERF.P-RF 1 12,94 12,940000 8,888400 17,49 17,490000 11,238000

86 W51335001 J01DD04 CEFTRIAXONUM ROCEPHIN (R) PULB. PT. SOL. PERF. 2g ROCHE ROMANIA S.R.L. ROMANIA

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPCITATEA DE 50ML CONTINAND PULB. PT. SOL. PERFUZ.

S/P-RF 1 44,01 44,010000 8,888400 57,56 57,560000 11,238000

87 W57455001 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 15,95 1,595000 1,595000 21,56 2,156000 2,156000

88 W13701001 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 26,58 2,658000 2,658000 34,77 3,477000 3,477000

89 W60256001 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATE

PRF 5 42,81 8,562000 8,562000 55,99 11,198000 11,198000

90 W60256003 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE

PRF 10 80,08 8,008000 8,008000 101,25 10,125000 10,125000

Pagina 3 din 87

Page 5: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

91 W13676001 J01DD12 CEFOPERAZONUM MEDOCEF 1 g PULB. PT. SOL. INJ. 1g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 154,50 15,450000 8,448000 188,61 18,861000 11,412000

92 W13677001 J01DD12 CEFOPERAZONUM MEDOCEF 2 g PULB. PT. SOL. INJ. 2g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 187,44 18,744000 13,932000 228,83 22,883000 18,828000

93 W44045001 J01DD12 CEFOPERAZONUM CEFOZON 500 mg PULB. PT. SOL. INJ. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. S/P-RF 1 3,88 3,880000 3,880000 5,24 5,240000 5,240000

94 W52795001 J01DD12 CEFOPERAZONUM CEFOZON 2 g PULB. PT. SOL. INJ./PERF. I.M./I.V. 2g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA A

20 ML CU PULB. PT. SOL. INJ./PERF. I.M./I.V.S/P-RF 1 11,61 11,610000 11,610000 15,69 15,690000 15,690000

95 W44061001 J01DD12 CEFOPERAZONUM CEFOZON 1 g PULB. PT. SOL. INJ./PERF.I.M./I.V. 1g E.I.P.I.CO. MED S.R.L. ROMANIA

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CU PULB. PT. SOL. INJ. I.M./PERF. I.V.

S/P-RF 1 7,04 7,040000 7,040000 9,51 9,510000 9,510000

96 W53787003 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF.

1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 50 FLAC. DIN STICLA INCOLORA

CONTINAND PULB. PT. SOL. INJ./PERF.S/P-RF 50 848,93 16,978600 16,978600 963,48 19,269600 19,269600

97 W53787002 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF.

1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA

CONTINAND PULB. PT. SOL. INJ./PERF.S/P-RF 10 180,16 18,016000 18,016000 219,94 21,994000 21,994000

98 W53787001 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF.

1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA

CONTINAND PULB. PT. SOL. INJ./PERF.S/P-RF 1 18,67 18,670000 18,670000 25,24 25,240000 22,273440

99 W53787004 J01DD62 COMBINATII (CEFOPERAZONUM+SULBACTAMUM) SULCEF 1000 mg/1000 mg PULB. PT. SOL. INJ./PERF.

1000mg/1000mg MEDOCHEMIE S.R.L. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA

CONTINAND PULB. PT. SOL. INJ./PERF. S 100 1.667,86 16,678600 16,678600 1.856,12 18,561200 18,561200

100 W13605001 J01DE02 CEFPIROMUM CEFROM (R) 1 g PULB. PT. SOL. INJ./PERF. 1g LAB. AVENTIS FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. INJ./PERF. S/P-

RF 1 59,93 59,930000 59,930000 75,78 75,780000 75,780000

101 W13606001 J01DE02 CEFPIROMUM CEFROM (R) 2 g PULB. PT. SOL. INJ./PERF. 2g LAB. AVENTIS FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. INJ./PERF. S/P-

RF 1 104,25 104,250000 104,250000 127,27 127,270000 127,270000

102 W55475002 J01DH02 MEROPENEMUM MERONEM IV 1 g PULB. PT. SOL. INJ. I.V./PERF. 1g ASTRAZENECA UK

LIMITEDMAREA BRITANIE

CUTIE CU 10 FLAC. DIN STICLA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ. I.V./PERF.

S 10 1.030,68 103,068000 63,118800 1.161,59 116,159000 73,377600

103 W55465002 J01DH02 MEROPENEMUM MERONEM IV 500 mg PULB. PT. SOL. INJ. I.V./PERF. 500mg ASTRAZENECA UK

LIMITEDMAREA BRITANIE

CUTIE CU 10 FLAC. DIN STICLA CU CAPACITATEA DE 20 ML PULB. PT. SOL. INJ. I.V./PERF.

S 10 539,60 53,960000 36,430800 626,31 62,631000 44,287200

104 W60705002 J01DH02 MEROPENEMUM MEROPENEM ZENTIVA 1000 mg PULB. PT. SOL. INJ. SAU PERF. 1000 mg ZENTIVA, K.S. REPUBLICA

CEHA

CUTIE CU 10 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 20 ML

PR 10 680,44 68,044000 63,118800 779,83 77,983000 73,377600

105 W60703002 J01DH02 MEROPENEMUM MEROPENEM ZENTIVA 500 mg PULB. PT. SOL. INJ. SAU PERF. 500 mg ZENTIVA, K.S. REPUBLICA

CEHA

CUTIE CU 10 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 20 ML

PR 10 361,24 36,124000 36,124000 431,90 43,190000 43,190000

106 W56827001 J01DH02 MEROPENEMUM LODITER 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg TERAPIA S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 40 ML CONTINAND PULB. PT. SOL. INJ./PERF.

PR 1 72,84 72,840000 63,118800 92,10 92,100000 73,377600

107 W61143002 J01DH02 MEROPENEMUM ARCHIFAR 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg MEDOCHEMIE ROMANIA

SRL ROMANIA

CUTIE CU 10 FLAC. DIN STICLA, CAPACITATEA 30 ML, DOP DIN CAUCIUC BROMOBUTILIC SIGILAT CU CAPSA AL CU PULB.PT.SOL.INJ./PERF.

PR 10 525,99 52,599000 52,599000 611,48 61,148000 61,148000

108 W58974002 J01DH02 MEROPENEMUM MEROPENEM ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE S.A. ROMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML SAU 30 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA DIN ALUMINIU PREVAZUTA CU DISC DIN MATERIAL PLASTIC

PRF 10 680,43 68,043000 63,118800 779,82 77,982000 73,377600

109 W56331002 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 1 g PULB. PT. SOL. INJ./PERF. 1g HOSPIRA UK LIMITED MAREA

BRITANIECUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 540,86 54,086000 54,086000 627,69 62,769000 62,769000

110 W56125002 J01DH02 MEROPENEMUM MEROPENEM KABI 1 g PULB. PT. SOL. INJ./PERF. 1g FRESENIUS KABI

ROMANIA SRL ROMANIACUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF.

S 10 680,43 68,043000 63,118800 779,82 77,982000 73,377600

111 W56826001 J01DH02 MEROPENEMUM LODITER 500 mg PULB. PT. SOL. INJ./PERF. 500mg TERAPIA S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CONTINAND PULB. PT. SOL. INJ./PERF.

PR 1 37,77 37,770000 36,430800 49,40 49,400000 44,287200

112 W58973002 J01DH02 MEROPENEMUM MEROPENEM ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA

PRF 10 361,24 36,124000 36,124000 431,90 43,190000 43,190000

113 W61142002 J01DH02 MEROPENEMUM ARCHIFAR 500 mg PULB. PT. SOL. INJ./PERF. 500mg MEDOCHEMIE ROMANIA

SRL ROMANIA

CUTIE CU 10 FLAC. DIN STICLA, CAPACITATEA 20 ML, DOP DIN CAUCIUC BROMOBUTILIC SIGILAT CU CAPSA AL CU PULB.PT.SOL.INJ./PERF.

PR 10 361,24 36,124000 36,124000 431,90 43,190000 43,190000

114 W56124002 J01DH02 MEROPENEMUM MEROPENEM KABI 500 mg PULB. PT. SOL. INJ./PERF. 500mg FRESENIUS KABI

ROMANIA SRL ROMANIACUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF.

PR 10 361,25 36,125000 36,125000 431,91 43,191000 43,191000

115 W56330002 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 500 mg PULB. PT. SOL. INJ./PERF. 500mg HOSPIRA UK LIMITED MAREA

BRITANIECUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 303,59 30,359000 30,359000 369,06 36,906000 36,906000

116 W54532001 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN KABI 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg

FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA

CU PULB. PT. SOL. PERF.S/P-RF 10 296,98 29,698000 29,698000 362,55 36,255000 36,255000

Pagina 4 din 87

Page 6: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

117 W54471007 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 30 ML PULB. PT. SOL. PERF.S/P-RF 1 30,31 30,310000 30,310000 39,65 39,650000 39,650000

118 W54471008 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 30 ML PULB. PT. SOL. PERF.S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

119 W54471006 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA

CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF.

S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

120 W54471005 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 100 ML PULB. PT. SOL. PERF.S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

121 W54471009 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA

CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF.

S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

122 W54471002 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 22 ML PULB. PT. SOL. PERF.S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

123 W54471003 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA

CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF.

S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

124 W61198003 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN ATB 500 mg/500 mg PULB. PT. SOL. PERF.

500mg/500mg ANTIBIOTICE S.A. ROMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA TIP III, CU CAPACITATEA DE 20 ML, CONTINANAD PULB. PT. SOL. PERF.

PR 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

125 W05741001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-

RF 20 5,71 0,285500 0,285500 7,72 0,386000 0,386000

126 W12479001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM CO - TRIM ELL COMPR. 400mg/80mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-

RF 20 5,21 0,260500 0,260500 7,04 0,352000 0,352000

127 W53671001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM BITRIM 400mg/80mg COMPR. 400mg/80mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-

RF 20 5,71 0,285500 0,285500 7,72 0,386000 0,386000

128 W05738001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM COMPR. 400mg/80mg

EGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,47 0,273500 0,273500 7,40 0,370000 0,370000

129 W44046001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM EPITRIM SUSP. ORALA 200mg/40mg /5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA BRUNA CU

MASURA DOZATOARE X 100 MLP-RF 1 3,52 3,520000 3,520000 4,76 4,760000 4,760000

130 W05739001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SUSP. ORALA 25mg/5mg/ml

EGIS PHARMACEUTICALS P.L.C.

UNGARIACUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE

P-RF 1 7,75 7,750000 7,750000 10,48 10,480000 10,480000

131 W05561001 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 1,5 Mil. UI COMPR. FILM. 1,5 M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 8 COMPR. FILM. P-RF 16 7,29 0,455625 0,455625 9,85 0,615625 0,615625

132 W13604002 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 3 Mil. UI COMPR. FILM. 3M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 10 18,91 1,891000 1,891000 25,56 2,556000 2,556000

133 W13604003 J01FA02 SPIRAMYCINUM ROVAMYCINE 3 Mil. UI COMPR. FILM. 3MilU.I. LABORATOIRES AVENTIS FRANTA CUTIE CU 1 BLIST. AL/PVC X 10 COMPR. FILM.

PRF 10 18,91 1,891000 1,891000 25,56 2,556000 2,556000

134 W58242002 J01FA09 CLARITHROMYCINUM CLAXIRIT 500 mg COMPR. CU ELIB. PREL. 500mg ACTAVIS GROUP PTC

EHF. ISLANDA CUTIE CU BLIST. PVC/PVDC//AL X 7 COMPR. CU ELIB. PREL.

PRF 7 23,71 3,387142 1,405714 32,05 4,578571 1,899428

135 W59000002 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. ELIB. PREL. 500mg

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR. ELIB. PREL.

PRF 6 21,73 3,621666 1,405714 29,37 4,895000 1,899428

136 W08490001 J01FA09 CLARITHROMYCINUM FROMILID 250 COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.

P-RF 14 12,35 0,882142 0,647142 16,69 1,192142 0,874285

137 W44093001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM.

P-RF 14 10,85 0,775000 0,647142 14,67 1,047857 0,874285

138 W58998015 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 250 mg COMPR. FILM. 250mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR)

PRF 14 8,39 0,599285 0,599285 11,34 0,810000 0,810000

139 W01326002 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 21,14 1,510000 0,647142 28,57 2,040714 0,874285

140 W14043001 J01FA09 CLARITHROMYCINUM KLERIMED (R) 250 COMPR. FILM. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM.

P-RF 14 12,35 0,882142 0,647142 16,69 1,192142 0,874285

141 W61223003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14

COMPR. FILM.PRF 14 7,55 0,539285 0,539285 10,20 0,728571 0,728571

142 W60253004 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM.

PRF 14 8,40 0,600000 0,600000 11,36 0,811428 0,811428

143 W44087001 J01FA09 CLARITHROMYCINUM KLABAX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM.

P-RF 14 23,73 1,695000 1,405714 32,08 2,291428 1,899428

144 W58999014 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. FILM. 500mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR)

PRF 14 18,22 1,301428 1,301428 24,62 1,758571 1,758571

145 W08491001 J01FA09 CLARITHROMYCINUM FROMILID 500 COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.

P-RF 14 24,13 1,723571 1,405714 32,62 2,330000 1,899428

146 W60254003 J01FA09 CLARITHROMYCINUM LEKOKLAR 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM.

PRF 14 24,13 1,723571 1,405714 32,62 2,330000 1,899428

147 W54044001 J01FA09 CLARITHROMYCINUM ROCLARIN 500 mg COMPR. FILM. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 20 33,14 1,657000 1,405714 43,35 2,167500 1,899428

148 W56269001 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-

RF 20 40,76 2,038000 1,405714 53,31 2,665500 1,899428

149 W61224003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14

COMPR. FILM.PRF 14 16,40 1,171428 1,171428 22,16 1,582857 1,582857

150 W14044001 J01FA09 CLARITHROMYCINUM KLERIMED (R) 500 COMPR. FILM. 500mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM.

P-RF 14 24,13 1,723571 1,405714 32,62 2,330000 1,899428

Pagina 5 din 87

Page 7: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

151 W44088001 J01FA09 CLARITHROMYCINUM KLABAX MR 500 mg COMPR. FILM. ELIB.MODIF. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC/PVDC-AL X 7 COMPR.

FILM. ELIB. PREL.P-RF 7 25,34 3,620000 1,405714 33,15 4,735714 1,899428

152 W13607002 J01FA09 CLARITHROMYCINUM KLACID SR COMPR. FILM. ELIB.PREL. 500mg ABBOTT LABORATORIES

LTD.MAREA BRITANIE

CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. FILM. ELIB. PREL.

P-RF 5 27,85 5,570000 1,405714 36,43 7,286000 1,899428

153 W41838002 J01FA09 CLARITHROMYCINUM FROMILID (R) UNO COMPR. FILM. ELIB.PREL. 500mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 COMPR.

FILM. ELIB. PREL.P-RF 7 20,78 2,968571 1,405714 28,09 4,012857 1,899428

154 W42258001 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA

CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP

P-RF 1 19,39 19,390000 16,812000 26,21 26,210000 22,728000

155 W44092001 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT.

60 ML SUSP . ORALAP-RF 1 14,01 14,010000 14,010000 18,94 18,940000 18,940000

156 W01327001 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA ITALIA

CUTIE X 1 FLACON PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML

P-RF 1 29,92 29,920000 29,920000 39,14 39,140000 39,140000

157 W01327002 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA ITALIA

CUTIE X 1 FLACON PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML

P-RF 1 18,11 18,110000 16,812000 24,48 24,480000 22,728000

158 W06981001 J01FA09 CLARITHROMYCINUM FROMILID (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. P-

RF 1 17,24 17,240000 16,812000 23,30 23,300000 22,728000

159 W44091002 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100

ML SUSP . ORALAP-RF 1 39,06 39,060000 39,060000 51,09 51,090000 51,090000

160 W58393002 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA

PRF 1 21,29 21,290000 21,290000 28,78 28,780000 28,780000

161 W44091001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60

ML SUSP . ORALAP-RF 1 23,44 23,440000 23,440000 31,68 31,680000 31,680000

162 W01329001 J01FA09 CLARITHROMYCINUM KLACID I.V. LIOF. PT. SOL. PERF. 500mg ABBOTT LABORATORIES

LTD. FRANTA CUTIE X 1 FLAC. LIOF. PT. SOL. PERF. S/P-RF 1 41,12 41,120000 41,120000 53,78 53,780000 53,780000

163 W42271001 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS. P-

RF 6 18,87 3,145000 3,145000 25,50 4,250000 4,250000

164 W00517001 J01FA10 AZITHROMYCINUM SUMAMED 250 mg CAPS. 250mg PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF 6 29,04 4,840000 3,774000 37,99 6,331666 5,100000

165 W00518001 J01FA10 AZITHROMYCINUM SUMAMED 125 mg COMPR. FILM. 125mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 6 COMPR. FILM. P-RF 6 18,76 3,126666 3,126666 25,36 4,226666 4,226666

166 W52838001 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 6 COMPR. FILM.

P-RF 6 18,88 3,146666 3,146666 25,52 4,253333 4,253333

167 W42879004 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 250 mg COMPRIMATE FILMATE COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. X 6 COMPR. FILM. P-

RF 6 37,31 6,218333 3,774000 48,80 8,133333 5,100000

168 W52838002 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 6 COMPR.FILM.

P-RF 6 18,88 3,146666 3,146666 25,52 4,253333 4,253333

169 W52840002 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR.FILM.

P-RF 3 18,97 6,323333 6,292000 25,64 8,546666 8,503999

170 W43486001 J01FA10 AZITHROMYCINUM AZIBIOT 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 18,98 6,326666 6,292000 25,65 8,550000 8,503999

171 W60406001 J01FA10 AZITHROMYCINUM AZITROMICINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 3 COMPR. FILM.

PRF 3 18,97 6,323333 6,292000 25,64 8,546666 8,503999

172 W57032001 J01FA10 AZITHROMYCINUM AZITROX (R) 500 COMPR. FILM. 500mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 16,37 5,456666 5,456666 22,13 7,376666 7,376666

173 W42878001 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 500 mg COMPRIMATE FILMATE COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 COMPR. FILM. P-

RF 3 37,31 12,436666 6,292000 48,80 16,266666 8,503999

174 W00519001 J01FA10 AZITHROMYCINUM SUMAMED 500 mg COMPR. FILM. 500mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 29,18 9,726666 6,292000 38,17 12,723333 8,503999

175 W60019004 J01FA10 AZITHROMYCINUM AZATRIL 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-PVC-AL/AL X 3

COMPR. FILM.PRF 3 15,73 5,243333 5,243333 21,26 7,086666 7,086666

176 W52840001 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM.

P-RF 3 18,97 6,323333 6,292000 25,64 8,546666 8,503999

177 W52841001 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM.

P-RF 3 34,11 11,370000 11,370000 44,61 14,870000 14,870000

178 W52841002 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR.FILM.

P-RF 3 34,11 11,370000 11,370000 44,61 14,870000 14,870000

179 W44152001 J01FA10 AZITHROMYCINUM SUMAMED (R) LIOF. PT. SOL. PERF. 500mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 5 FLAC. LIOF. PT. SOL. PERF. S/P-

RF 5 132,49 26,498000 26,498000 161,75 32,350000 32,350000

180 W53281001 J01FA10 AZITHROMYCINUM AZITROX 200 mg/5 ml PULB. + SOLV. SUSP. ORALA 200mg/5ml ZENTIVA S.A. ROMANIA

CUTIE X 1 FLAC. DIN PE CU PULB. PT. 15 ML SUSP. ORALA RECONSTITUITA + FLAC. CU SOLV. X 7,5 ML SOLV.

P-RF 1 12,10 12,100000 12,100000 16,36 16,360000 16,360000

181 W42901001 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA

CUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP

P-RF 1 16,61 16,610000 16,610000 22,45 22,450000 22,450000

182 W42877002 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 200 mg/5 ml PULB. PT. SUSP. ORALA 200 mg/5 ml SANDOZ SRL ROMANIA

CCUTIE X 1 FLAC. DIN PEID CONTINAD PULBERE PT. 20 ML SUSP. ORALA + SERINGA DOZATOARE DIN PE/PP

P-RF 1 26,27 26,270000 26,270000 34,36 34,360000 34,360000

183 W00520003 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA

CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE

P-RF 1 46,15 46,150000 46,150000 60,36 60,360000 60,360000

184 W00520002 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA

CUTIE X 1 FLAC. DIN PEID CU PULB. PT.15 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE

P-RF 1 18,63 18,630000 13,644000 25,18 25,180000 17,844000

Pagina 6 din 87

Page 8: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

185 W00520001 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA

CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE

P-RF 1 37,14 37,140000 37,140000 48,58 48,580000 48,580000

186 W03308001 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 40mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ.

P-RF 10 5,28 0,528000 0,528000 7,13 0,713000 0,713000

187 W03309002 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 80mg/2ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 50 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ.

P-RF/S

50 31,71 0,634200 0,600000 41,48 0,829600 0,811200

188 W03309001 J01GB03 GENTAMICINUM GENTAMICIN KRKA SOL. INJ. 80mg/2ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ.

P-RF 10 7,09 0,709000 0,600000 9,58 0,958000 0,811200

189 W08121001 J01GB03 GENTAMICINUM PAN - GENTAMICINE SOL.INJ. 80mg/2ml LAB. PANPHARMA FRANTA CUTIE X 10 FIOLE DIN STICLA INCOLORA X 2 ML SOL. INJ.

P-RF 10 5,00 0,500000 0,500000 6,76 0,676000 0,676000

190 W53277001 J01GB06 AMIKACINUM AMIKOZIT (R) 500 mg/2 ml SOL. INJ. 500mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA X 2 ML P-RF 1 5,15 5,150000 5,150000 6,96 6,960000 6,960000

191 W56957001 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 14,81 1,481000 1,008000 20,02 2,002000 1,363200

192 W07914001 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE

CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 8,40 0,840000 0,840000 11,36 1,136000 1,136000

193 W54037001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 28,52 2,852000 2,852000 37,31 3,731000 3,731000

194 W54037002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 20 51,89 2,594500 2,594500 65,61 3,280500 3,280500

195 W01273001 J01MA02 CIPROFLOXACINUM CIPRINOL 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM.

P-RF 10 5,05 0,505000 0,505000 6,83 0,683000 0,683000

196 W44077004 J01MA02 CIPROFLOXACINUM CIPROCIN 250 mg COMPR. FILM. 250mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM.

P-RF 10 5,05 0,505000 0,505000 6,83 0,683000 0,683000

197 W54038001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 4,85 0,485000 0,485000 6,56 0,656000 0,656000

198 W01271001 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

FILM.P-RF 20 9,10 0,455000 0,455000 12,30 0,615000 0,615000

199 W54038002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 20 9,10 0,455000 0,455000 12,30 0,615000 0,615000

200 W07862001 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 250mg RANBAXY UK LIMITED MAREA BRITANIE

CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM.

P-RF 10 5,13 0,513000 0,513000 6,93 0,693000 0,693000

201 W01288001 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 250 mg COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 5,05 0,505000 0,505000 6,83 0,683000 0,683000

202 W01271002 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR.

FILM.P-RF 10 5,05 0,505000 0,505000 6,83 0,683000 0,683000

203 W44076001 J01MA02 CIPROFLOXACINUM CIPROCIN 500 mg COMPR. FILM. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 9,78 0,978000 0,729600 13,22 1,322000 0,985800

204 W54039001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 6,83 0,683000 0,683000 9,23 0,923000 0,923000

205 W01274001 J01MA02 CIPROFLOXACINUM CIPRINOL 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM.

P-RF 10 9,78 0,978000 0,729600 13,22 1,322000 0,985800

206 W01272001 J01MA02 CIPROFLOXACINUM CUMINOL 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR.

FILM.P-RF 10 9,78 0,978000 0,729600 13,22 1,322000 0,985800

207 W54039002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 20 12,16 0,608000 0,608000 16,43 0,821500 0,821500

208 W12545001 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 9,78 0,978000 0,729600 13,22 1,322000 0,985800

209 W07863001 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 500mg RANBAXY UK LIMITED MAREA BRITANIE

CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM.

P-RF 10 6,50 0,650000 0,650000 8,78 0,878000 0,878000

210 W01289001 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 500 mg COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 9,78 0,978000 0,729600 13,22 1,322000 0,985800

211 W54040001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 750 mg COMPR. FILM. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 28,52 2,852000 2,852000 37,31 3,731000 3,731000

212 W42772001 J01MA02 CIPROFLOXACINUM CIPRINOL 750 mg COMPR. FILM. 750mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM.

P-RF 10 29,43 2,943000 2,943000 38,50 3,850000 3,850000

213 W57948001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB.PREL. 1000 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR.

FILM. ELIB. PREL.P-RF 7 66,99 9,570000 9,570000 84,70 12,100000 12,100000

214 W57949001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB.PREL. 500 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR.

FILM. ELIB. PREL.P-RF 3 20,44 6,813333 0,729600 27,63 9,210000 0,985800

215 W01275002 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF.

100mg/10ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 111,86 2,237200 2,237200 136,56 2,731200 2,731200

216 W60268001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ZENTIVA 10 mg/ml CONC. PT. SOL. PERF.

100mg/10ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA

PREVAZUTE CU INEL DE RUPERE X 10 MLS/P-RF 5 12,42 2,484000 2,484000 16,79 3,358000 3,277440

217 W01275001 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF.

100mg/10ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 10 ML S/P-

RF 5 12,42 2,484000 2,484000 16,79 3,358000 3,277440

218 W08223001 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 100mg/50ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA

X 50 ML SOL. PERF.S/P-RF 1 3,54 3,540000 2,684640 4,79 4,790000 3,277440

219 W08224001 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 200mg/100ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON, DIN STICLA INCOLORA

X 100 ML SOL. PERF.S/P-RF 1 7,09 7,090000 7,090000 9,58 9,580000 9,260640

220 W53353002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 100ML S 10 67,20 6,720000 6,720000 84,97 8,497000 8,497000

221 W53353003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 200ML S 10 126,50 12,650000 12,650000 154,43 15,443000 15,443000

222 W61489001 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 10 PUNGI DIN PVC PLASTICIZAT A CÂTE 100 ML SOL. PERF. PR 10 67,20 6,720000 6,720000 84,97 8,497000 8,497000

Pagina 7 din 87

Page 9: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

223 W61489002 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 50 PUNGI DIN PVC PLASTICIZAT A CÂTE 100 ML SOL. PERF. PR 50 319,00 6,380000 6,380000 385,86 7,717200 7,717200

224 W61489003 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 10 PUNGI DIN PVC PLASTICIZAT A CÂTE 200 ML SOL. PERF. PR 10 126,50 12,650000 12,650000 154,43 15,443000 15,443000

225 W61489004 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 30 PUNGI DIN PVC PLASTICIZAT A CÂTE 200 ML SOL. PERF. PR 30 372,00 12,400000 12,400000 443,63 14,787666 14,787666

226 W42193001 J01MA02 CIPROFLOXACINUM CIPRINOL (R) SOL. PERF. 400mg/200ml KRKA D.D. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 200 ML S/P-

RF 1 14,29 14,290000 14,290000 19,31 19,310000 17,745199

227 W52445001 J01MA03 PEFLOXACINUM PEFLOXACIN LAROPHARM COMPR. FILM. 400mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 20,61 2,061000 2,061000 27,86 2,786000 2,786000

228 W58303001 J01MA06 NORFLOXACINUM NORFLOXACIN HELCOR 400 mg COMPR. FILM. 400mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10

COMPR. FILM.P-RF 20 13,02 0,651000 0,651000 17,60 0,880000 0,880000

229 W54101001 J01MA06 NORFLOXACINUM NOR QUIN 400 mg COMPR. FILM. 400mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM.

P-RF/S

20 13,02 0,651000 0,651000 17,60 0,880000 0,880000

230 W41800001 J01MA06 NORFLOXACINUM NORFLOXACINA LPH 400 mg COMPR. FILM. 400mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 20 11,64 0,582000 0,582000 15,73 0,786500 0,786500

231 W07984001 J01MA06 NORFLOXACINUM NOLICIN 400 mg COMPR. FILM. 400mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.

P-RF 20 13,02 0,651000 0,651000 17,60 0,880000 0,880000

232 W52786004 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 250 mg COMPR. FILM. 250mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-

RF 7 12,88 1,840000 1,840000 17,41 2,487142 2,487142

233 W56992002 J01MA12 LEVOFLOXACINUM LEVOTOR 250 mg COMPR. FILM. 250mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-

RF 7 12,87 1,838571 1,838571 17,40 2,485714 2,485714

234 W59047002 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA MACLEODS 250 mg COMPR. FILM. 250mg MACLEODS PHARMA UK LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM.

PRF 10 17,49 1,749000 1,749000 23,64 2,364000 2,364000

235 W55699003 J01MA12 LEVOFLOXACINUM TAVANIC 250 mg COMPR. FILM. 250mg TERAPIA S.A. ROMANIA CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF 7 19,81 2,830000 2,098800 26,78 3,825714 2,836800

236 W56939002 J01MA12 LEVOFLOXACINUM FLERADAY 500 mg COMPR. FILM. 500 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/PVDC - AL X 7

COMPR. FILM.PRF 7 25,88 3,697142 3,697142 33,85 4,835714 4,835714

237 W52787004 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 1 BLIST. AL/PVC X 7 COMPR. FILM. P-

RF 7 25,89 3,698571 3,698571 33,86 4,837142 4,837142

238 W59048002 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA MACLEODS 500 mg COMPR. FILM. 500mg MACLEODS PHARMA UK LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM.

PRF 10 32,06 3,206000 3,206000 41,93 4,193000 4,193000

239 W55700002 J01MA12 LEVOFLOXACINUM TAVANIC 500 mg COMPR. FILM. 500mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF 7 39,82 5,688571 3,847200 52,08 7,440000 5,031600

240 W59048001 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA MACLEODS 500 mg COMPR. FILM. 500mg MACLEODS PHARMA UK LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR. FILM.

PRF 5 17,49 3,498000 3,498000 23,64 4,728000 4,728000

241 W56993002 J01MA12 LEVOFLOXACINUM LEVOTOR 500 mg COMPR. FILM. 500mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 7 COMPR. FILM. P-

RF 7 25,73 3,675714 3,675714 33,65 4,807142 4,807142

242 W55456003 J01MA12 LEVOFLOXACINUM EVOLOX 5 mg/ml SOL. PERF. 5mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 74,25 74,250000 74,250000 93,88 93,880000 93,880000

243 W54108003 J01MA12 LEVOFLOXACINUM LEVOFLOXACIN KABI 5 mg/ml SOL. PERF. 5mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA

CUTIE X 1 FLAC. PEJD KABIPAC X 100 ML CONTINAD 100 ML SOL. PERF. (500MG LEVOFLOXACINA)

S 1 74,25 74,250000 74,250000 93,88 93,880000 93,880000

244 W55456001 J01MA12 LEVOFLOXACINUM EVOLOX 5 mg/ml SOL. PERF. 5mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 37,79 37,790000 37,790000 49,43 49,430000 49,430000

245 W55702001 J01MA12 LEVOFLOXACINUM TAVANIC I.V. 500 mg SOL. PERF. 5mg/ml TERAPIA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML SOL. PERF.

P-RF/S

1 112,19 112,190000 88,920000 136,96 136,960000 112,428000

246 W55815004 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ACTAVIS 5 mg/ml SOL. PERF. 5mg/ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA X 100 ML

SOL. PERF. S 1 74,10 74,100000 74,100000 93,69 93,690000 93,690000

247 W59332001 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA AUROBINDO 400 mg COMPR. FILM. 400mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR.

FILM.PRF 5 30,78 6,156000 6,156000 40,26 8,052000 8,052000

248 W60545001 J01MA14 MOXIFLOXACINUM MOFIL 400 mg COMPR. FILM. 400mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 5 COMPR.

FILM.PRF 5 35,34 7,068000 7,068000 46,22 9,244000 9,244000

249 W60943001 J01MA14 MOXIFLOXACINUM MOFLAXA 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL

CONAINÂND 5 COMPRIMATE FILMATEPRF 5 38,76 7,752000 7,387200 50,70 10,140000 9,662400

250 W57939001 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg COMPR. FILM. 400mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. TRANSPARENT PP/AL X 5 COMPR. FILM.

P-RF 5 58,59 11,718000 7,387200 74,08 14,816000 9,662400

251 W60311001 J01MA14 MOXIFLOXACINUM MOFINACIN 400 mg COMPR. FILM. 400mg ALVOGEN IPCO S.A.R.L LUXEMBURG

CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM

PRF 5 42,18 8,436000 7,387200 55,17 11,034000 9,662400

252 W57938004 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg/250 ml SOL. PERF. 400mg/250ml BAYER PHARMA AG GERMANIA CUTIE X 5 FLACOANE DIN STICLA X 250 ML S 5 594,69 118,938000 98,640000 686,36 137,272000 124,728000

253 W60727001 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA KABI 400 mg/250 ml SOL. PERF. 400mg/250ml

FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPACK) A 250

ML SOL. PERF. (400 MG MOXIFLOXACINA) PR 1 82,20 82,200000 82,200000 103,94 103,940000 103,940000

254 W43348001 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 1g TEVA PHARM. WORKS

PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF.

S/P-RF 1 48,56 48,560000 48,560000 63,52 63,520000 63,520000

255 W43347001 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 500mg TEVA PHARM. WORKS

PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF.

S/P-RF 1 24,28 24,280000 24,280000 32,82 32,820000 32,820000

256 W56449002 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 1000 mg PULB. PT. SOL. PERF. 1000mg PHARMASWISS CESKA

REPUBLIKA S.R.O.REPUBLICA CEHA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 456,00 45,600000 45,600000 535,19 53,519000 53,519000

257 W56448002 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 500 mg PULB. PT. SOL. PERF. 500mg PHARMASWISS CESKA

REPUBLIKA S.R.O.REPUBLICA CEHA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 234,30 23,430000 23,430000 286,03 28,603000 28,603000

Pagina 8 din 87

Page 10: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

258 W57042001 J01XA01 VANCOMYCINUM VANCOMICINA KABI 1000 mg PULB. PT.CONC. PT.SOL. PERF. 1000mg FRESENIUS KABI

ROMANIA SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P

PR 1 48,39 48,390000 48,390000 63,30 63,300000 63,300000

259 W57041001 J01XA01 VANCOMYCINUM VANCOMICINA KABI 500 mg PULB. PT.CONC. PT.SOL. PERF. 500mg FRESENIUS KABI

ROMANIA SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P

PR 1 24,17 24,170000 24,170000 32,67 32,670000 32,670000

260 W06051001 J01XA01 VANCOMYCINUM EDICIN PULB.LIOF.PT.SOL.PERF./INJ 1g LEK PHARMACEUTICALS

D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. LIOF. PT. SOL. PERF./INJ.

S/P-RF 1 56,90 56,900000 54,720000 71,94 71,940000 64,222800

261 W13105001 J01XA02 TEICOPLANINUM TARGOCID (R) 400 mg LIOF. + SOLV. PT. SOL. INJ. 400mg AVENTIS PHARMA LTD. MAREA

BRITANIE CUTIE X 1 FLAC. LIOF. + O FIOLA SOLV. P-RF 1 109,84 109,840000 109,840000 134,09 134,090000 134,090000

262 W52501003 J01XB01 COLISTINUM COLISTINA ANTIBIOTICE 1000000 UI PULB. PT. SOL. INJ./PERF. 1000000ui ANTIBIOTICE SA ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA

CU PULB. PT. SOL. INJ./PERF. S 10 173,48 17,348000 17,348000 211,79 21,179000 21,179000

263 W53689002 J01XD01 METRONIDAZOLUM METRONIDAZOL ARENA 250 mg (J01XD01) COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 5,71 0,190333 0,190333 7,72 0,257333 0,257333

264 W08257001 J01XD01 METRONIDAZOLUM FLAGYL ( vezi J01XD01) COMPR. FILM. 250mg LABORATOIRE AVENTIS FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.

P-RF 20 5,25 0,262500 0,228400 7,09 0,354500 0,308800

265 W42138002 J01XD01 METRONIDAZOLUM METRONIDAZOL B 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 77,74 6,478333 6,478333 98,29 8,190833 8,190833

266 W42138001 J01XD01 METRONIDAZOLUM METRONIDAZOL B 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML S/P-RF 1 6,59 6,590000 6,590000 8,91 8,910000 8,910000

267 W42139002 J01XD01 METRONIDAZOLUM METRONIDAZOL A 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 79,29 6,607500 6,607500 100,25 8,354166 8,354166

268 W42139001 J01XD01 METRONIDAZOLUM METRONIDAZOL A 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML S/P-RF 1 6,74 6,740000 6,740000 9,11 9,110000 9,110000

269 W08927001 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA X

100 ML SOL. PERF.S/P-RF 10 37,40 3,740000 3,740000 48,92 4,892000 4,892000

270 W08927003 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. DIN PEJD X 100 ML SOL.

PERF.S/P-RF 20 228,10 11,405000 4,437600 278,47 13,923500 5,804400

271 W08927002 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN PEJD X 100 ML SOL.

PERF.S/P-RF 10 36,98 3,698000 3,698000 48,37 4,837000 4,837000

272 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-

RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

273 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML

P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

274 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIA10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA

PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

275 W60604004 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 10 PUNGI DIN PP TRANSPARENTA PANA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI INVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINAND FIECARE 300 ML SOL. PERF.

PR 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

276 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

277 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

278 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF.

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

279 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,615428 25,61 6,402500 4,887428

280 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-

RF 16 65,37 4,085625 3,615428 82,66 5,166250 4,887428

281 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 21,09 3,012857 3,012857 28,51 4,072857 4,072857

282 W43597001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6,98 3,490000 3,490000 9,43 4,715000 4,715000

283 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 23,31 3,330000 3,330000 31,51 4,501428 4,501428

284 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,340000 14,58 14,580000 7,212000

285 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,340000 9,68 9,680000 7,212000

286 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

Pagina 9 din 87

Page 11: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

287 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 6,07 6,070000 5,340000 8,20 8,200000 7,212000

288 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 8,90 8,900000 5,340000 12,03 12,030000 7,212000

289 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

290 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PR

F 1 9,57 9,570000 5,340000 12,94 12,940000 7,212000

291 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

292 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,340000 9,03 9,030000 7,212000

293 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC

TRANSPARENT/PVDC-AL X 1 CAPS.PRF 1 4,45 4,450000 4,450000 6,01 6,010000 6,010000

294 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PR

F 1 7,44 7,440000 5,340000 10,06 10,060000 7,212000

295 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 18,56 18,560000 5,340000 25,08 25,080000 7,212000

296 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS.

P-RF 1 13,95 13,950000 5,340000 18,86 18,860000 7,212000

297 W54835003 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-

RF 4 48,24 12,060000 5,340000 63,10 15,775000 7,212000

298 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-

RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

299 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 30,10 4,300000 4,300000 39,37 5,624285 5,624285

300 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,777714 19,58 2,797142 2,403428

301 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 43,23 6,175714 1,777714 56,54 8,077142 2,403428

302 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,777714 19,12 2,731428 2,403428

303 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

304 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 12,35 1,764285 1,764285 16,69 2,384285 2,384285

305 W52225001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-

RF 7 11,66 1,665714 1,665714 15,76 2,251428 2,251428

306 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

307 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS.

P-RF 7 21,91 3,130000 1,777714 29,61 4,230000 2,403428

308 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,777714 41,93 5,990000 2,403428

309 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 10,37 1,481428 1,481428 14,02 2,002857 2,002857

310 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

311 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE CU 1 FLAC. PEID, DE CAPACITATE 60ML + 1 LINGURITA DOZATOARE A 5 ML, CU PULB. PT. 35 ML SUSP.O

PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

312 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF.

PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

313 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF.

PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

314 W60056001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

315 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

316 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

317 W56963002 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL

S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

318 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100

ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

319 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200

ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

Pagina 10 din 87

Page 12: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

320 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF.

PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

321 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML

SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,179000

322 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML

S/PR-F 1 35,03 35,030000 20,737200 45,82 45,820000 25,316400

323 W52343006 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-

RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

324 W59235001 J02AC02 ITRACONAZOLUM ITRACONAZOL ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

325 W53958001 J02AC02 ITRACONAZOLUM MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 5 CAPS. P-

RF 15 40,18 2,678666 2,678666 52,55 3,503333 3,503333

326 W43051001 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

327 W03837002 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5

CAPS.P-RF 15 60,84 4,056000 3,214399 76,92 5,128000 4,204000

328 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-

RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

329 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-

RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

330 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA

BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

331 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA

P-RF 1 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

332 W60913001 J02AC04 POSACONAZOLUM** NOXAFIL 100mg CAPS. GASTROREZ. 100mg MERCK SHARP & DOHME

LTD.MAREA BRITANIE

CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE PR 24 3.330,00 138,750000 138,750000 3.667,85 152,827083 152,827083

333 W58194001 J02AC04 POSACONAZOLUM** NOXAFIL 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 105ML SUSP. ORALA

P-RF/R

1 2.488,19 2.488,190000 2.488,190000 2.750,28 2.750,280000 2.750,280000

334 W06665001 J02AX04 CASPOFUNGINUM** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME MAREA

BRITANIECUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.202,39 1.202,390000 1.202,390000 1.348,76 1.348,760000 1.348,760000

335 W06670001 J02AX04 CASPOFUNGINUM** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME MAREA

BRITANIECUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.560,14 1.560,140000 1.560,140000 1.738,70 1.738,700000 1.738,700000

336 W55841001 J02AX06 ANIDULAFUNGINUM ECALTA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg PFIZER LIMITED MAREA

BRITANIECUTIE X 1FLAC.DIN STICLA A 30ML X 100MG PULB. S 1 1.458,70 1.458,700000 1.458,700000 1.628,13 1.628,130000 1.628,130000

337 W58576002 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 100 mg COMPR. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 150 BLIST. PVC/AL X 10 COMPR. PR 1.500 159,50 0,106333 0,106333 194,72 0,129813 0,129813

338 W58577002 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 300 mg COMPR. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. PVC/AL X 10 COMPR. S/P-RF 1.500 395,00 0,263333 0,263333 468,70 0,312466 0,312466

339 W60582001 J04AC01 ISONIAZIDUM ISONIAZID SIROP 100mg/5ml CN UNIFARM S.A. ROMANIA CUTIE X 1 FLAC. X 200 ML SIROP PR 1 29,01 29,010000 29,010000 37,95 37,950000 37,950000340 W60594001 J04AC01 ISONIAZIDUM BITUB SOL INJ. 100mg/ml CN UNIFARM S.A. ROMANIA CUTIE CU 10 FIOLE A 5ML PR 10 14,16 1,416000 1,416000 19,14 1,914000 1,914000

341 W60213002 J04AK01 PYRAZINAMIDUM PIRAZINAMIDA ATB 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 150 BLIST. PVC/AL X 10 COMPR. PR 1.500 434,58 0,289720 0,289720 511,84 0,341226 0,341226

342 W53682002 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 3,54 0,177000 0,177000 4,79 0,239500 0,239500

343 W59648001 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 5,54 0,277000 0,277000 7,49 0,374500 0,374500

344 W59648003 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN PE X 50 CAPS. PRF 50 13,72 0,274400 0,274400 18,54 0,370800 0,370800

345 W42943002 J04AK02 ETHAMBUTOLUM ETAMBUTOL 250 mg COMPR. FILM. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1.500 314,54 0,209693 0,209693 381,00 0,254000 0,254000

346 W42861002 J04AK02 ETHAMBUTOLUM ETAMBUTOL 400 mg COMPR. FILM. 400mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1.500 485,00 0,323333 0,323333 566,80 0,377866 0,377866

347 W60583001 J04AK02 ETHAMBUTOLUM INBUTOL SOL INJ. 100mg/ml CN UNIFARM S.A. ROMANIA FLAC. X 10 ML SOL. INJ PR 1 15,55 15,550000 15,550000 21,02 21,020000 21,020000

348 W14071002 J04AM02 COMBINATII (RIFAMPICINUM+IZONIAZIDUM) SINERDOL ISO CAPS. 300mg+150mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1.000 580,00 0,580000 0,580000 670,35 0,670350 0,670350

349 W53675003 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS.P-RF/S

1.000 704,14 0,704140 0,613200 805,66 0,805660 0,805660

350 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-

RF 20 15,85 0,792500 0,613200 21,42 1,071000 0,828600

351 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 15,85 0,792500 0,613200 21,42 1,071000 0,828600

352 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14,97 0,748500 0,613200 20,23 1,011500 0,828600

353 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 14,41 1,441000 1,441000 19,48 1,948000 1,948000

354 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 10,22 0,511000 0,511000 13,81 0,690500 0,690500

355 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

356 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PR

F 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

357 W13972001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-

RF 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

358 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12,69 0,634500 0,613200 17,15 0,857500 0,828600

Pagina 11 din 87

Page 13: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

359 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 20,11 2,011000 1,729200 27,18 2,718000 2,337600

360 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL.

INJ./PERF.S/P-RF 5 231,79 46,358000 46,358000 282,97 56,594000 56,594000

361 W60057003 J05AB04 RIBAVIRINUM REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC )

P-RF/R

140 1.085,34 7,752428 7,752428 1.221,17 8,722642 8,722642

362 W53326004 J05AB04 RIBAVIRINUM COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM.P-RF/R

168 2.406,37 14,323630 9,302914 2.661,10 15,839880 10,467170

363 W51337001 J05AB06 GANCICLOVIRUM CYMEVENE LIOF. PT. SOL. INJ. 500mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 87,17 87,170000 87,170000 110,22 110,220000 110,220000

364 W61213001 J05AB06 GANCICLOVIRUM CYMEVENE 500 mg PULB. PT. SOL. PERF. 500mg ROCHE ROMANIA S.R.L. ROMANIA

CUTIE CU 1 FLAC. MULTIDOZA DIN STICLA INCOLORA CONTINAND 10 ML PULB. PT. SOL. PERF.

PR 1 87,17 87,170000 87,170000 110,22 110,220000 110,220000

365 W58707001 J05AB11 VALACYCLOVIRUM VALTREX 500 mg COMPR. FILM. 500 mg THE WELLCOME FOUNDATION LTD.

MAREA BRITANIE

CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM.

PRF 10 43,54 4,354000 3,396000 56,95 5,695000 4,441200

366 W60087001 J05AB11 VALACYCLOVIRUM VALACICLOVIR ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC ALB OPAC/AL X 10 COMPR. FILM.

PRF 10 28,30 2,830000 2,830000 37,01 3,701000 3,701000

367 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM.

PRF 60 3.171,52 52,858666 52,858666 3.495,11 58,251833 58,251833

368 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 63,430399 5.338,93 88,982166 69,902200

369 W12651002 J05AB15 BRIVUDINUM BRIVAL 125mg COMPR. 125mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 BLIST. PVC/AL X 7 COMPR. P-

RF 7 272,43 38,918571 38,918571 332,58 47,511428 47,511428

370 W42514001 J05AE01 SAQUINAVIRUM INVIRASE 500 mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 1 FLAC. PEID X 120 COMPR. FILM.

P-RF/R

120 1.013,90 8,449166 8,449166 1.143,30 9,527500 9,527500

371 W59955001 J05AE03 RITONAVIRUM** NORVIR 100 mg COMPR. FILM. 100mg ABBVIE LTD MAIDENHEAD

MAREA BRITANIE CUTIE X 1 FLAC. PEID X 30 COMPR.FILM.

P-RF/R

30 93,39 3,113000 3,113000 118,08 3,936000 3,936000

372 W55487001 J05AE03 RITONAVIRUM** NORVIR 100 mg COMPR. FILM. 100mg ABBOTT LABORATORIES LTD.

MAREA BRITANIE CUTIE X 1 FLAC. PEID X 30 COMPR.FILM.

P-RF/R

30 93,39 3,113000 3,113000 118,08 3,936000 3,936000

373 W59948001 J05AE06 LOPINAVIRUM+RITONAVIRUM** KALETRA 200mg/50mg COMPR. FILM. 200mg/50mg

ABBVIE LTD MAIDENHEAD

MAREA BRITANIE

CUTIE X 1 FLAC. DIN PEID X 120 COMPR. FILM. PR 120 1.401,42 11,678500 11,678500 1.565,70 13,047500 13,047500

374 W43277001 J05AE06 LOPINAVIRUM+RITONAVIRUM** KALETRA 200mg/50mg COMPR. FILM. 200mg/50mg

ABBOTT LABORATORIES LTD.

MAREA BRITANIE

CUTIE X 1 FLAC. DIN PEID X 120 COMPR. FILM.

P-RF/R

120 1.401,42 11,678500 11,678500 1.565,70 13,047500 13,047500

375 W59947002 J05AE06 LOPINAVIRUM+RITONAVIRUM** KALETRA 80mg/ml+20mg/ml SOL. ORALA 80mg/ml+20mg/ml

ABBVIE LTD MAIDENHEAD

MAREA BRITANIE

CUTIE X 5 FLAC. MULTIDOZA DIN TPE X 60 ML + 5 SERINGI GRADATE A 5 ML PR 5 1.177,17 235,434000 235,434000 1.321,27 264,254000 264,254000

376 W41772001 J05AE07 FOSAMPRENAVIRUM** TELZIR 700mg COMPR. FILM. 700mg GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 1 FLAC. DIN HDPE X 60 COMPR. FILM. PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII

P-RF/R

60 1.219,58 20,326333 20,326333 1.367,49 22,791500 22,791500

377 W41773001 J05AE07 FOSAMPRENAVIRUM** TELZIR 50mg/ml SUSP. ORALA 50mg/ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 1 FLAC. DIN HDPE X 225 ML SUSP. ORALA PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII +

P-RF/R

1 384,56 384,560000 384,560000 457,32 457,320000 457,320000

378 W14087002 J05AE08 ATAZANAVIRUM REYATAZ 150 mg CAPS. 150mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 60 CAPS. (BLIST. AL/AL 6X1)

P-RF/R

60 1.579,88 26,331333 26,331333 1.760,22 29,337000 29,337000

379 W53181001 J05AE08 ATAZANAVIRUM REYATAZ 300 mg CAPS. 300mg BRISTOL-MYERS SQUIBB PHARMA EEIG

MAREA BRITANIE CUTIE X 1 FLAC. PEID X 30 CAPS.

P-RF/R

30 1.691,40 56,380000 56,380000 1.881,78 62,726000 62,726000

380 W53878001 J05AE10 DARUNAVIRUM** PREZISTA 400mg COMPR. FILM. 400mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR.

FILM.

P-RF/R

60 2.015,15 33,585833 33,585833 2.234,67 37,244500 37,244500

381 W53877001 J05AE10 DARUNAVIRUM** PREZISTA 600mg COMPR. FILM. 600mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. DIN PEID X 60 COMPR.

FILM.

P-RF/R

60 2.841,59 47,359833 47,359833 3.135,49 52,258166 52,258166

382 W06151002 J05AF01 ZIDOVUDINUM RETROVIR (R) CAPS. 100mg VIIV HEALTHCARE UK LIMITED UK CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-

RF 100 354,20 3,542000 3,542000 424,23 4,242300 4,242300

383 W60312001 J05AF01 ZIDOVUDINUM RETROVIR 10 mg/ml SOL. ORALA 10mg/ml VIIV HEALTHCARE UK LIMITED

MAREA BRITANIE

CUTIE CU 1 FLACON DIN STICLA BRUNA X 200 ML SOL. ORALA + 1 ADAPTOR DE DOZARE + 1 SERINGA PT. ADM. ORALA DE 10 ML

PRF 1 42,89 42,890000 42,890000 56,10 56,100000 56,100000

384 W10724001 J05AF02 DIDANOSINUM VIDEX EC 250 mg CAPS. GASTROREZ. 250mg BRISTOL MYERS SQUIBB

KFT UNGARIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. S/P-RF 30 421,93 14,064333 14,064333 498,05 16,601666 16,601666

385 W10725001 J05AF02 DIDANOSINUM VIDEX EC 400 mg CAPS. GASTROREZ. 400mg BRISTOL MYERS SQUIBB

KFT UNGARIA CUTIE X 3 BLIST. X 10 CAPS. GASTROREZ. S/P-RF 30 657,08 21,902666 21,902666 754,37 25,145666 25,145666

386 W12057001 J05AF04 STAVUDINUM ZERIT 30 mg CAPS. 30mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 4 BLIST. ACLAR/AL X 14 CAPS.

P-RF/R

56 487,42 8,703928 8,703928 569,44 10,168571 10,168571

387 W12056001 J05AF04 STAVUDINUM ZERIT 40 mg CAPS. 40mg BRISTOL-MYERS SQUIBB MAREA BRITANIE CUTIE X 4 BLIST. ACLAR/AL X 14 CAPS.

P-RF/R

56 502,69 8,976607 8,976607 586,08 10,465714 10,465714

388 W55473003 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA PHARMA B.V. 150 mg COMPR. FILM. 150 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPR. FILM.

P-RF/R

60 319,27 5,321166 5,321166 386,16 6,436000 6,436000

Pagina 12 din 87

Page 14: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

389 W59320003 J05AF05 LAMIVUDINUM LAMIVUDINA AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 FLAC. PVC-ACLAR/AL X 60

COMPR. FILM. PR 60 319,27 5,321166 5,321166 386,16 6,436000 6,436000

390 W03923002 J05AF05 LAMIVUDINUM EPIVIR 150mg COMPR. FILM. 150mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILM.

P-RF/R

60 476,54 7,942333 6,385399 557,58 9,293000 7,723200

391 W55474002 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA PHARMA B.V. 300 mg COMPR. FILM. 300 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM.

P-RF/R

30 319,27 10,642333 10,642333 386,16 12,872000 12,872000

392 W03924002 J05AF05 LAMIVUDINUM EPIVIR 10mg/ml SOL. ORALA 10mg/ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 1 FLACON PEID X 240ML SOL. ORALA + 1 SERINGA DOZATOARE + 1 ADAPTOR

P-RF/R

1 131,82 131,820000 131,820000 160,92 160,920000 160,920000

393 W12820001 J05AF06 ABACAVIRUM ZIAGEN 300 mg COMPR. FILM. 300mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 60 COMPR. FILM.

P-RF/R

60 787,53 13,125500 13,125500 896,56 14,942666 14,942666

394 W07524001 J05AF06 ABACAVIRUM ZIAGEN 20 mg/ml SOL. ORALA 20mg/ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 1 FLACON PEID X 240 ML SOL. ORALA + SERINGA DOZATOARE PP X 10 ML + ADAPTOR PE

P-RF/R

1 209,91 209,910000 209,910000 256,26 256,260000 256,260000

395 W60828015 J05AF07 TENOFOVIRUM DISOPROXIL FUMARATE TENOFOVIR DISOPROXIL TEVA 245 mg COMPR. FILM. 245mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA

CUTIE CU 1 FLAC. DIN PEÎD CU CAPAC CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM.

PR 30 723,56 24,118666 24,118666 826,83 27,561000 27,561000

396 W51800001 J05AF07 TENOFOVIRUM DISOPROXIL FUMARATE VIREAD 245mg COMPR. FILM. 245mg GILEAD SCIENCE INTERNATIONAL LIMITED

MAREA BRITANIE

CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM

P-RF/R

30 1.097,01 36,567000 28,942399 1.233,89 41,129666 33,073200

397 W51482001 J05AF09 EMTRICITABINUM EMTRIVA 200mg CAPS. 200mg GILEAD SCIENCE INTERNATIONAL LIMITED

MAREA BRITANIE CUTIE X 1 FLAC. DIN PEID X 30 CAPS.

P-RF/R

30 656,22 21,874000 21,874000 753,43 25,114333 25,114333

398 W59667002 J05AG01 NEVIRAPINUM NEVIRAPINA SANDOZ 200 mg COMPR. 200mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 60 COMPR. PR 60 327,53 5,458833 5,458833 395,16 6,586000 6,586000

399 W59595001 J05AG01 NEVIRAPINUM NEVIRAPINA TEVA 200mg COMPR. 200mg TEVA PHARMA B.V. OLANDA BLISTERE DIN PVC/PE/PVDC - AL X 60 COMP.

P-RF/R

60 416,84 6,947333 6,550600 492,51 8,208500 7,903200

400 W57323001 J05AG01 NEVIRAPINUM VIRAMUNE 400mg COMPR. ELIB. PREL. 400mg

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA CUTIE CU UN FLACON DIN PEID X 30 COMPR. CU ELIB. PRELUNGITA PR 30 966,78 32,226000 32,226000 1.091,94 36,398000 36,398000

401 W13091001 J05AG01 NEVIRAPINUM VIRAMUNE 50mg/5ml SUSP. ORALA 50mg/5mlBOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIACUTIE X 1 FLACON PEID X 240 ML + O SERINGA X 5 ML + UN DISPOZITIV DE ADAPTARE A SERINGII LA FLACON

PR 1 186,84 186,840000 186,840000 228,10 228,100000 228,100000

402 W12025001 J05AG03 EFAVIRENZUM STOCRIN 600 mg COMPR. FILM. 600mg MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. PREVAZUT CU UN SIST. DE INCHIDERE SECURIZAT PT. COPII

P-RF/R

30 67,45 2,248333 2,248333 85,28 2,842666 2,842666

403 W53549001 J05AG04 ETRAVIRINUM INTELENCE COMPR. 100mg JANSSEN-CILAG INTERNATIONAL NV BELGIA CUTIE X 1 FLAC. PEID X 120 COMPR.

P-RF/R

120 1.947,00 16,225000 16,225000 2.160,38 18,003166 18,003166

404 W56750001 J05AR01 COMBINATII (LAMIVUDINUM+ZIDOVUDINUM)** LAMIVUDINA/ZIDOVUDINA TEVA COMPR. FILM. 150 mg/300 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN OPA/AL/PVC X 60

COMPRIMATE FILMATEP-RF 60 677,93 11,298833 9,408000 777,10 12,951666 11,017800

405 W02028001 J05AR01 COMBINATII (LAMIVUDINUM+ZIDOVUDINUM)** COMBIVIR 150mg/300mg COMPR. FILM. 150mg/300mg GLAXO GROUP LTD. MAREA

BRITANIE CUTIE X 6 BLIST. X 10 COMPR. FILM.P-RF/R

60 1.026,84 17,114000 9,408000 1.157,41 19,290166 11,017800

406 W59832001 J05AR01 COMBINATII (LAMIVUDINUM+ZIDOVUDINUM)** LAMIVUDINA/ZIDOVUDINA AUROBINDO 150 mg/300 mg COMPR. FILM. 150mg/300

mgAUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 60

COMPR. FILM. PR 60 470,40 7,840000 7,840000 550,89 9,181500 9,181500

407 W42301001 J05AR02 ABACAVIRUM+LAMIVUDINUM** KIVEXA 600mg/300mg COMPR. FILM. 600mg/300mg GLAXO GROUP LTD. MAREA

BRITANIECUTIE X 30 COMPR. FILM.( BLIST.ALB-OPACPVC-PVDC/AL )

P-RF/R

30 1.328,77 44,292333 44,292333 1.486,51 49,550333 49,550333

408 W08336004 J05AR04 ABACAVIRUM+LAMIVUDINUM+ZIDOVUDINUM** TRIZIVIR 300mg/150mg/300mg COMPR. FILM. 300mg/150mg/300mg GLAXO GROUP LTD. MAREA

BRITANIECUTIE X 60 COMPR. FILM. (BLIST. OPACE DIN PVC/ACLAR)

P-RF/R

60 1.675,67 27,927833 27,927833 1.864,63 31,077166 31,077166

409 W08336001 J05AR04 ABACAVIRUM+LAMIVUDINUM+ZIDOVUDINUM** TRIZIVIR 300mg/150mg/300mg COMPR. FILM. 300mg/150mg/300mg GLAXO GROUP LTD. MAREA

BRITANIECUTIE X, 1 FLAC. DIN PEID X 60 COMPR. FILM.

P-RF/R

60 1.675,67 27,927833 27,927833 1.864,63 31,077166 31,077166

410 W13961001 J05AX07 ENFUVIRTIDUM** FUZEON 90mg/ml PULB. + SOLV. PT. SOL. INJ. 90mg/ml ROCHE REGISTRATION

LTD.MAREA BRITANIE

CUTIE X 60 FLAC. PULB. PT. SOL. INJ. + 60 FLAC. SOLV. + 60 SERINGI X 3 ML + 60 SERINGI X 1 ML, 180 T

P-RF/R

60 6.090,78 101,513000 101,513000 6.677,11 111,285166 111,285166

411 W52764001 J05AX08 RALTEGRAVIRUM ISENTRESS 400mg COMPR. FILM. 400 mg MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 1 FLAC. PEID X 60 COMPR. FILMATE

P-RF/R

60 3.480,67 58,011166 58,011166 3.832,08 63,868000 63,868000

412 W61477003 J05AX09 MARAVIROCUM CELSENTRI 150mg COMPR. FILM. 150mg VIIV HEALTHCARE UK LIMITED

MAREA BRITANIE CUTIE X 60 COMPR. FILM.( BLIST. PVC/AL) PR 60 2.495,56 41,592666 41,592666 2.758,31 45,971833 45,971833

413 W61478003 J05AX09 MARAVIROCUM CELSENTRI 300mg COMPR. FILM. 300mg VIIV HEALTHCARE UK LIMITED

MAREA BRITANIE CUTIE X 60 COMPR. FILM.( BLIST. PVC/AL) PR 60 2.495,56 41,592666 41,592666 2.758,31 45,971833 45,971833

414 W60635001 J05AX12 DOLUTEGRAVIRUM** TIVICAY 50mg COMPR. FILM. 50mg VIIV HEALTHCARE UK LIMITED

MAREA BRITANIE

FLACOANE PEID X 30 COMPRIMATE FILMATE, INCHISE CU CAPAC CU FILET DIN POLIPROPILENA SI SIGILIU CU LINIE DE INDUCTIE CU O FATA DIN POLIETILENA

PR 30 2.832,00 94,400000 94,400000 3.125,03 104,167666 104,167666

415 W54752003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 1.714,69 1.714,690000 1.714,690000 1.907,17 1.907,170000 1.907,170000

416 W54752004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. S 1 3.437,56 3.437,560000 3.437,560000 3.785,10 3.785,100000 3.785,100000

417 W54752002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 881,87 881,870000 881,870000 999,39 999,390000 999,390000

418 W54752001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 379,02 379,020000 379,020000 451,28 451,280000 451,280000

Pagina 13 din 87

Page 15: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

419 W51530003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL.

PERF.(5G/50ML) S 1 925,45 925,450000 909,000000 1.046,89 1.046,890000 1.036,596000

420 W51530004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL.

PERF.(10G/100ML) S 1 1.857,75 1.857,750000 1.782,000000 2.063,10 2.063,100000 1.988,160000

421 W51530006 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL.

PERF.(30G/300ML) S 1 5.558,99 5.558,990000 5.558,990000 6.097,46 6.097,460000 6.097,460000

422 W51530005 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL.

PERF.(20G/200ML) S 1 3.821,35 3.821,350000 3.821,350000 4.203,43 4.203,430000 4.203,430000

423 W51530001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL.

PERF.(1G/10ML) S 1 202,26 202,260000 202,260000 246,92 246,920000 246,920000

424 W43965001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.485,00 1.485,000000 1.485,000000 1.656,80 1.656,800000 1.656,800000

425 W43962001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 197,39 197,390000 197,390000 240,98 240,980000 240,980000

426 W43963001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 393,75 393,750000 393,750000 467,34 467,340000 467,340000

427 W59114003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 100 ML

SOL. PERF.PRF 1 882,14 882,140000 882,140000 999,68 999,680000 999,680000

428 W59114001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 20 ML SOL.

PERF.PRF 1 187,48 187,480000 187,480000 228,87 228,870000 228,870000

429 W59114004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 200 ML

SOL. PERF.PRF 1 1.734,28 1.734,280000 1.734,280000 1.928,52 1.928,520000 1.928,520000

430 W59114002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 50 ML SOL.

PERF.PRF 1 456,06 456,060000 456,060000 535,26 535,260000 535,260000

431 W52560001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 10 ML SOL. PERF. S 1 102,55 102,550000 102,550000 125,19 125,190000 125,190000

432 W13462001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 50 ML S 1 465,59 465,590000 465,590000 545,64 545,640000 545,640000

433 W13462003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 200 ML S 1 1.772,34 1.772,340000 1.772,340000 1.970,00 1.970,000000 1.970,000000

434 W13462002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 100 ML S 1 882,13 882,130000 882,130000 999,67 999,670000 999,670000

435 W43964001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 757,50 757,500000 757,500000 863,83 863,830000 863,830000

436 W59944001 J06BB16 PALIVIZUMABUM** SYNAGIS 50 mg PULB. + SOLV. PT. SOL. INJ. 50mg ABBVIE LTD

MAIDENHEADMAREA BRITANIE

CUTIE X 1 FLAC. PULB. PT. SOL. INJ. + FIOLA X 1 ML SOLV.

P-RF 1 1.853,66 1.853,660000 1.853,660000 2.058,64 2.058,640000 2.058,640000

437 W51424001 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML

S/P-RF 1 267,05 267,050000 194,520000 326,02 326,020000 237,468000

438 W51423001 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML

S/P-RF 1 436,57 436,570000 313,092000 514,01 514,010000 382,224000

439 W53892001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 30MU/0,5mlSOL. INJ. /PERF. IN SERINGA PREUMPLUTA

60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

1 162,10 162,100000 162,100000 197,89 197,890000 197,890000

440 W53893001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 48MU/0,5mlSOL. INJ. /PERF. IN SERINGA PREUMPLUTA

96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

1 260,91 260,910000 260,910000 318,52 318,520000 318,520000

441 W55756002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 12 MU/0,2ml SOL. INJ./PERF. 120µg/0,2ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,2ML SOL. INJ. SAU PERF.

P-RF 5 418,45 83,690000 83,690000 494,26 98,852000 98,852000

442 W53520001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0,5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML

SOL. INJ. SAU PERF.

S/P-RF/R

1 214,16 214,160000 194,520000 261,45 261,450000 237,468000

443 W55757002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.

P-RF 5 1.001,12 200,224000 194,520000 1.129,37 225,874000 225,874000

444 W53523001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0,8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML

SOL. INJ. SAU PERF.

S/P-RF/R

1 355,90 355,900000 313,092000 426,08 426,080000 382,224000

445 W55758002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.

P-RF 5 1.656,30 331,260000 313,092000 1.843,52 368,704000 368,704000

446 W54015001 P01BC02 MEFLOQUINUM4) ELOQUINE 250 mg COMPR. 250mg CN UNIFARM ROMANIA CUTIE X 10 BLIST. X 10 COMPR. X 100 140,58 1,405800 1,405800 171,62 1,716200 1,716200

447 W12757001 S01AA23 NETILMICINUM NETTACIN (R) PIC. OFT., SOL 0,3% S.I.F.I. SPA ITALIA CUTIE X 1 FLACON X 5ML P-RF 1 10,49 10,490000 10,490000 14,18 14,180000 14,180000

448 W41510001 S01AA23 NETILMICINUM NETTACIN (R) PICATURI OFT.-SOL. 0,3% S.I.F.I. SPA ITALIA

CUTIE X 3 FOLII TERMOSUDATE X 5 FLACOANE UNIDOZA DIN POLIETILENA X 0,3 ML

P-RF 15 21,41 1,427333 1,427333 28,94 1,929333 1,929333

449 W43512001 S01AA23 NETILMICINUM NETTAVISC 3mg/g UNG. OFT. 3mg/g S.I.F.I. SPA ITALIA CUTIE X 1 TUB DIN AL X 5 G UNGUENT OFTALMIC, PREV. CU APLICATOR

P-RF 1 24,05 24,050000 12,588000 32,50 32,500000 17,016000

450 W55950001 S01BA01 DEXAMETHASONUM OZURDEX IMPLANT 700 micrograme

ALLERGAN PHARMACEUTICALS IRELAND

IRLANDA

CUTIE X 1 IMPLANT STERIL DE TIP FILAMENT CU ELIBERARE PRELUNGITA X 700MCG DEXAMETAZONA DISPUS IN ACUL (OTEL INOXIDABIL) UNUI APLICATOR DE UNICA FOLOSINTA

P-RF 1 4.694,69 4.694,690000 4.694,690000 5.155,37 5.155,370000 5.155,370000

451 W55648002 S01BA01 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 1mg/ml PIC. OFT. SUSP. 1mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. DIN PEID X 10 ML PIC.

OFT., SUSPENSIEP-RF 1 7,49 7,490000 7,490000 10,12 10,120000 10,120000

452 W55648001 S01BA01 DEXAMETHASONUM DEXAMETAZONA ROMPHARM 1mg/ml PIC. OFT. SUSP. 1mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. DIN PEID X 5 ML PIC. OFT.,

SUSPENSIEP-RF 1 4,11 4,110000 4,110000 5,55 5,550000 5,550000

Pagina 14 din 87

Page 16: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

453 W02427001 S01BA01 DEXAMETHASONUM MAXIDEX (R) PICATURI OFT.-SUSP. 0,1% ALCON COUVREUR NV BELGIA CUTIE X 1 FLACON PICURATOR DIN PE X 5

MLP-RF 1 6,33 6,330000 4,932000 8,55 8,550000 6,660000

454 W51513001 S03AAN2 NORFLOXACINUM NORFLOX PICATURI OFT./AURIC.-SOL. 0,3% CIPLA (UK) LIMITED MAREA

BRITANIE CUTIE X 1 FLACON PEJD X 5 ML P-RF 1 3,52 3,520000 3,520000 4,76 4,760000 4,760000

P1: PROGRAMUL NATIONAL DE BOLI TRANSMISIBILE B) SUBPROGRAMUL DE TRATAMENT AL BOLNAVILOR CU TUBERCULOZA

1 W42822001 A11HA02 PYRIDOXINUM VITAMINA B6 250 mg COMPR. 250 mg ARENA GROUP SA ROMANIA CUTIE X 1 FLACON DIN PE X 20 COMPR. P-6L 20 6,74 0,337000 0,337000 9,11 0,455500 0,455500

2 W56760001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg COMPR. 250mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PE X 20 COMPR. P-6L 20 6,74 0,337000 0,337000 9,11 0,455500 0,455500

3 W56758001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 250 mg/5 ml SOL. INJ. 250mg/5ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 5 ML SOL. INJ.

P-RF 5 7,65 1,530000 1,530000 10,34 2,068000 2,068000

4 W56757001 A11HA02 PYRIDOXINUM VITAMINA B6 ZENTIVA 50 mg/2ml SOL. INJ. 50mg/2ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ.

P-RF 5 5,16 1,032000 1,032000 6,98 1,396000 1,396000

5 W12565003 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR.P-RF/S

1.000 44,43 0,044430 0,044430 58,12 0,058120 0,058120

6 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1,94 0,064666 0,053316 2,62 0,087333 0,069744

7 W13686002 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,74 0,091333 0,053316 3,71 0,123666 0,069744

8 W53341001 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-

RF 20 1,90 0,095000 0,053316 2,57 0,128500 0,069744

9 W05242001 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 1,96 0,098000 0,053316 2,65 0,132500 0,069744

10 W58242002 J01FA09 CLARITHROMYCINUM CLAXIRIT 500 mg COMPR. CU ELIB. PREL. 500mg ACTAVIS GROUP PTC

EHF. ISLANDA CUTIE CU BLIST. PVC/PVDC//AL X 7 COMPR. CU ELIB. PREL.

PRF 7 23,71 3,387142 1,405714 32,05 4,578571 1,899428

11 W59000002 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. ELIB. PREL. 500mg

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR. ELIB. PREL.

PRF 6 21,73 3,621666 1,405714 29,37 4,895000 1,899428

12 W08490001 J01FA09 CLARITHROMYCINUM FROMILID 250 COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.

P-RF 14 12,35 0,882142 0,647142 16,69 1,192142 0,874285

13 W44093001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM.

P-RF 14 10,85 0,775000 0,647142 14,67 1,047857 0,874285

14 W58998015 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 250 mg COMPR. FILM. 250mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR)

PRF 14 8,39 0,599285 0,599285 11,34 0,810000 0,810000

15 W01326002 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 21,14 1,510000 0,647142 28,57 2,040714 0,874285

16 W14043001 J01FA09 CLARITHROMYCINUM KLERIMED (R) 250 COMPR. FILM. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM.

P-RF 14 12,35 0,882142 0,647142 16,69 1,192142 0,874285

17 W61223003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14

COMPR. FILM.PRF 14 7,55 0,539285 0,539285 10,20 0,728571 0,728571

18 W60253004 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM.

PRF 14 8,40 0,600000 0,600000 11,36 0,811428 0,811428

19 W44087001 J01FA09 CLARITHROMYCINUM KLABAX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM.

P-RF 14 23,73 1,695000 1,405714 32,08 2,291428 1,899428

20 W58999014 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. FILM. 500mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR)

PRF 14 18,22 1,301428 1,301428 24,62 1,758571 1,758571

21 W08491001 J01FA09 CLARITHROMYCINUM FROMILID 500 COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.

P-RF 14 24,13 1,723571 1,405714 32,62 2,330000 1,899428

22 W60254003 J01FA09 CLARITHROMYCINUM LEKOKLAR 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM.

PRF 14 24,13 1,723571 1,405714 32,62 2,330000 1,899428

23 W54044001 J01FA09 CLARITHROMYCINUM ROCLARIN 500 mg COMPR. FILM. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 20 33,14 1,657000 1,405714 43,35 2,167500 1,899428

24 W56269001 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-

RF 20 40,76 2,038000 1,405714 53,31 2,665500 1,899428

25 W61224003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14

COMPR. FILM.PRF 14 16,40 1,171428 1,171428 22,16 1,582857 1,582857

26 W14044001 J01FA09 CLARITHROMYCINUM KLERIMED (R) 500 COMPR. FILM. 500mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM.

P-RF 14 24,13 1,723571 1,405714 32,62 2,330000 1,899428

27 W44088001 J01FA09 CLARITHROMYCINUM KLABAX MR 500 mg COMPR. FILM. ELIB.MODIF. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC/PVDC-AL X 7 COMPR.

FILM. ELIB. PREL.P-RF 7 25,34 3,620000 1,405714 33,15 4,735714 1,899428

28 W13607002 J01FA09 CLARITHROMYCINUM KLACID SR COMPR. FILM. ELIB.PREL. 500mg ABBOTT LABORATORIES

LTD.MAREA BRITANIE

CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. FILM. ELIB. PREL.

P-RF 5 27,85 5,570000 1,405714 36,43 7,286000 1,899428

29 W41838002 J01FA09 CLARITHROMYCINUM FROMILID (R) UNO COMPR. FILM. ELIB.PREL. 500mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 COMPR.

FILM. ELIB. PREL.P-RF 7 20,78 2,968571 1,405714 28,09 4,012857 1,899428

30 W42258001 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA

CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP

P-RF 1 19,39 19,390000 16,812000 26,21 26,210000 22,728000

31 W44092001 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT.

60 ML SUSP . ORALAP-RF 1 14,01 14,010000 14,010000 18,94 18,940000 18,940000

32 W01327001 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA ITALIA

CUTIE X 1 FLACON PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML

P-RF 1 29,92 29,920000 29,920000 39,14 39,140000 39,140000

33 W01327002 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA ITALIA

CUTIE X 1 FLACON PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML

P-RF 1 18,11 18,110000 16,812000 24,48 24,480000 22,728000

34 W06981001 J01FA09 CLARITHROMYCINUM FROMILID (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. P-

RF 1 17,24 17,240000 16,812000 23,30 23,300000 22,728000

35 W44091002 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100

ML SUSP . ORALAP-RF 1 39,06 39,060000 39,060000 51,09 51,090000 51,090000

Pagina 15 din 87

Page 17: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

36 W58393002 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA

PRF 1 21,29 21,290000 21,290000 28,78 28,780000 28,780000

37 W44091001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60

ML SUSP . ORALAP-RF 1 23,44 23,440000 23,440000 31,68 31,680000 31,680000

38 W01329001 J01FA09 CLARITHROMYCINUM KLACID I.V. LIOF. PT. SOL. PERF. 500mg ABBOTT LABORATORIES

LTD. FRANTA CUTIE X 1 FLAC. LIOF. PT. SOL. PERF. S/P-RF 1 41,12 41,120000 41,120000 53,78 53,780000 53,780000

39 W57336001 J01GA01 STREPTOMYCINUM STREPTOMICINA SULFAT BP PULB. PT. SOL. INJ. 1g ANTIBIOTICE S.A. ROMANIA CUTIE X 50 FL.PULB.PT. SOL.INJ. A 1 G PRF 50 139,72 2,794400 2,794400 170,57 3,411400 3,411400

40 W14119005 J01GA01 STREPTOMYCINUM STREVITAL 1 g PULB. PT. SOL. INJ. 1g ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA CONTINAND PULB. PT. SOL. INJ. S 100 277,91 2,779100 2,779100 339,27 3,392700 3,392700

41 W14119004 J01GA01 STREPTOMYCINUM STREVITAL 1 g PULB. PT. SOL. INJ. 1g ANTIBIOTICE SA ROMANIA CUTIE X 50 FLAC. DIN STICLA CONTINAND PULB. PT. SOL. INJ. S 50 139,72 2,794400 2,794400 170,57 3,411400 3,411400

42 W08827001 J01GB04 KANAMYCINUM PAN - KANAMYCINE PULB. PT. SOL. INJ. 1g LAB. PANPHARMA FRANTA CUTIE X 50 FLAC. X 1 GP-RF/S

50 81,11 1,622200 1,622200 102,56 2,051200 2,051200

43 W53277001 J01GB06 AMIKACINUM AMIKOZIT (R) 500 mg/2 ml SOL. INJ. 500mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 1 FLACON DIN STICLA X 2 ML P-RF 1 5,15 5,150000 5,150000 6,96 6,960000 6,960000

44 W56957001 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 14,81 1,481000 1,008000 20,02 2,002000 1,363200

45 W07914001 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE

CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 8,40 0,840000 0,840000 11,36 1,136000 1,136000

46 W54037001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 28,52 2,852000 2,852000 37,31 3,731000 3,731000

47 W54037002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 20 51,89 2,594500 2,594500 65,61 3,280500 3,280500

48 W01273001 J01MA02 CIPROFLOXACINUM CIPRINOL 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM.

P-RF 10 5,05 0,505000 0,505000 6,83 0,683000 0,683000

49 W44077004 J01MA02 CIPROFLOXACINUM CIPROCIN 250 mg COMPR. FILM. 250mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM.

P-RF 10 5,05 0,505000 0,505000 6,83 0,683000 0,683000

50 W54038001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 4,85 0,485000 0,485000 6,56 0,656000 0,656000

51 W01271001 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.

FILM.P-RF 20 9,10 0,455000 0,455000 12,30 0,615000 0,615000

52 W54038002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 20 9,10 0,455000 0,455000 12,30 0,615000 0,615000

53 W07862001 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 250mg RANBAXY UK LIMITED MAREA BRITANIE

CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM.

P-RF 10 5,13 0,513000 0,513000 6,93 0,693000 0,693000

54 W01288001 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 250 mg COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 5,05 0,505000 0,505000 6,83 0,683000 0,683000

55 W01271002 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR.

FILM.P-RF 10 5,05 0,505000 0,505000 6,83 0,683000 0,683000

56 W44076001 J01MA02 CIPROFLOXACINUM CIPROCIN 500 mg COMPR. FILM. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 9,78 0,978000 0,729600 13,22 1,322000 0,985800

57 W54039001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 6,83 0,683000 0,683000 9,23 0,923000 0,923000

58 W01274001 J01MA02 CIPROFLOXACINUM CIPRINOL 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM.

P-RF 10 9,78 0,978000 0,729600 13,22 1,322000 0,985800

59 W01272001 J01MA02 CIPROFLOXACINUM CUMINOL 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR.

FILM.P-RF 10 9,78 0,978000 0,729600 13,22 1,322000 0,985800

60 W54039002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 20 12,16 0,608000 0,608000 16,43 0,821500 0,821500

61 W12545001 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 9,78 0,978000 0,729600 13,22 1,322000 0,985800

62 W07863001 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 500mg RANBAXY UK LIMITED MAREA BRITANIE

CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM.

P-RF 10 6,50 0,650000 0,650000 8,78 0,878000 0,878000

63 W01289001 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 500 mg COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 9,78 0,978000 0,729600 13,22 1,322000 0,985800

64 W54040001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 750 mg COMPR. FILM. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 10 28,52 2,852000 2,852000 37,31 3,731000 3,731000

65 W42772001 J01MA02 CIPROFLOXACINUM CIPRINOL 750 mg COMPR. FILM. 750mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM.

P-RF 10 29,43 2,943000 2,943000 38,50 3,850000 3,850000

66 W57948001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB.PREL. 1000 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR.

FILM. ELIB. PREL.P-RF 7 66,99 9,570000 9,570000 84,70 12,100000 12,100000

67 W57949001 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB.PREL. 500 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR.

FILM. ELIB. PREL.P-RF 3 20,44 6,813333 0,729600 27,63 9,210000 0,985800

68 W01275002 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF.

100mg/10ml KRKA D.D. SLOVENIA CUTIE X 50 FIOLE X 10 ML S 50 111,86 2,237200 2,237200 136,56 2,731200 2,731200

69 W60268001 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ZENTIVA 10 mg/ml CONC. PT. SOL. PERF.

100mg/10ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA

PREVAZUTE CU INEL DE RUPERE X 10 MLS/P-RF 5 12,42 2,484000 2,484000 16,79 3,358000 3,277440

70 W01275001 J01MA02 CIPROFLOXACINUM CIPRINOL (R) CONC. PT. SOL. PERF.

100mg/10ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 10 ML S/P-

RF 5 12,42 2,484000 2,484000 16,79 3,358000 3,277440

71 W08223001 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 100mg/50ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA

X 50 ML SOL. PERF.S/P-RF 1 3,54 3,540000 2,684640 4,79 4,790000 3,277440

72 W08224001 J01MA02 CIPROFLOXACINUM CIPRINOL SOL. PERF. 200mg/100ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON, DIN STICLA INCOLORA

X 100 ML SOL. PERF.S/P-RF 1 7,09 7,090000 7,090000 9,58 9,580000 9,260640

Pagina 16 din 87

Page 18: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

73 W53353002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 100ML S 10 67,20 6,720000 6,720000 84,97 8,497000 8,497000

74 W53353003 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE X 10 PUNGI PVC PLASTIFIAT X 200ML S 10 126,50 12,650000 12,650000 154,43 15,443000 15,443000

75 W61489001 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 10 PUNGI DIN PVC PLASTICIZAT A CÂTE 100 ML SOL. PERF. PR 10 67,20 6,720000 6,720000 84,97 8,497000 8,497000

76 W61489002 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 50 PUNGI DIN PVC PLASTICIZAT A CÂTE 100 ML SOL. PERF. PR 50 319,00 6,380000 6,380000 385,86 7,717200 7,717200

77 W61489003 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 10 PUNGI DIN PVC PLASTICIZAT A CÂTE 200 ML SOL. PERF. PR 10 126,50 12,650000 12,650000 154,43 15,443000 15,443000

78 W61489004 J01MA02 CIPROFLOXACINUM CIPRO INF 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS SRL ROMANIA CUTIE CU 30 PUNGI DIN PVC PLASTICIZAT A CÂTE 200 ML SOL. PERF. PR 30 372,00 12,400000 12,400000 443,63 14,787666 14,787666

79 W42193001 J01MA02 CIPROFLOXACINUM CIPRINOL (R) SOL. PERF. 400mg/200ml KRKA D.D. SLOVENIA CUTIE X 1 FLACON DIN STICLA X 200 ML S/P-

RF 1 14,29 14,290000 14,290000 19,31 19,310000 17,745199

80 W59332001 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA AUROBINDO 400 mg COMPR. FILM. 400mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 5 COMPR.

FILM.PRF 5 30,78 6,156000 6,156000 40,26 8,052000 8,052000

81 W60545001 J01MA14 MOXIFLOXACINUM MOFIL 400 mg COMPR. FILM. 400mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PA/AL/PVC-AL X 5 COMPR.

FILM.PRF 5 35,34 7,068000 7,068000 46,22 9,244000 9,244000

82 W60943001 J01MA14 MOXIFLOXACINUM MOFLAXA 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN OPA-AL-PVC/AL

CONAINÂND 5 COMPRIMATE FILMATEPRF 5 38,76 7,752000 7,387200 50,70 10,140000 9,662400

83 W57939001 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg COMPR. FILM. 400mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. TRANSPARENT PP/AL X 5 COMPR. FILM.

P-RF 5 58,59 11,718000 7,387200 74,08 14,816000 9,662400

84 W60311001 J01MA14 MOXIFLOXACINUM MOFINACIN 400 mg COMPR. FILM. 400mg ALVOGEN IPCO S.A.R.L LUXEMBURG

CUTIE CU BLIST. OPA-AL-PVC/AL X 5 COMPR. FILM

PRF 5 42,18 8,436000 7,387200 55,17 11,034000 9,662400

85 W57938004 J01MA14 MOXIFLOXACINUM AVELOX® 400 mg/250 ml SOL. PERF. 400mg/250ml BAYER PHARMA AG GERMANIA CUTIE X 5 FLACOANE DIN STICLA X 250 ML S 5 594,69 118,938000 98,640000 686,36 137,272000 124,728000

86 W60727001 J01MA14 MOXIFLOXACINUM MOXIFLOXACINA KABI 400 mg/250 ml SOL. PERF. 400mg/250ml

FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPACK) A 250

ML SOL. PERF. (400 MG MOXIFLOXACINA) PR 1 82,20 82,200000 82,200000 103,94 103,940000 103,940000

87 W08238001 J04AB01 CICLOSERINUM HELPOCERIN CAPS. 250mg HELP PHARMACEUTICALS LTD. GRECIA CUTIE X 5 BLIST. X 10 CAPS. S/P-

RF 50 190,37 3,807400 3,807400 232,40 4,648000 4,648000

88 W52079002 J04AB01 CICLOSERINUM CICLOSERINA ANTIBIOTICE 250 mg CAPS. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 10 FOLII TERMOSUDATE DIN AL/AL X 10 CAPS.

P-RF 100 425,06 4,250600 4,250600 501,47 5,014700 5,014700

89 W41998002 J04AB02 RIFAMPICINUM SINERDOL 150 mg CAPS. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1.000 163,52 0,163520 0,163520 199,62 0,199620 0,19962090 W41999002 J04AB02 RIFAMPICINUM SINERDOL 300 mg CAPS. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR. S 1.000 530,00 0,530000 0,530000 615,85 0,615850 0,615850

91 W58576002 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 100 mg COMPR. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 150 BLIST. PVC/AL X 10 COMPR. PR 1.500 159,50 0,106333 0,106333 194,72 0,129813 0,129813

92 W58577002 J04AC01 ISONIAZIDUM IZONIAZIDA ATB 300 mg COMPR. 300mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. PVC/AL X 10 COMPR. S/P-RF 1.500 395,00 0,263333 0,263333 468,70 0,312466 0,312466

93 W60582001 J04AC01 ISONIAZIDUM ISONIAZID SIROP 100mg/5ml CN UNIFARM S.A. ROMANIA CUTIE X 1 FLAC. X 200 ML SIROP PR 1 29,01 29,010000 29,010000 37,95 37,950000 37,95000094 W60594001 J04AC01 ISONIAZIDUM BITUB SOL INJ. 100mg/ml CN UNIFARM S.A. ROMANIA CUTIE CU 10 FIOLE A 5ML PR 10 14,16 1,416000 1,416000 19,14 1,914000 1,914000

95 W55916001 J04AD01 PROTIONAMIDUM PETEHA 250 mg COMPR. FILM. 250 mg ANTIBIOTICE SA ROMANIA CUTIE X 10 BLISTERE X 10 COMPRIMATE FILMATE PR 100 98,56 0,985600 0,985600 124,62 1,246200 1,246200

96 W60213002 J04AK01 PYRAZINAMIDUM PIRAZINAMIDA ATB 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 150 BLIST. PVC/AL X 10 COMPR. PR 1.500 434,58 0,289720 0,289720 511,84 0,341226 0,341226

97 W53682002 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 3,54 0,177000 0,177000 4,79 0,239500 0,239500

98 W59648001 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 5,54 0,277000 0,277000 7,49 0,374500 0,374500

99 W59648003 J04AK02 ETHAMBUTOLUM ETAMBUTOL ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. DIN PE X 50 CAPS. PRF 50 13,72 0,274400 0,274400 18,54 0,370800 0,370800

100 W42943002 J04AK02 ETHAMBUTOLUM ETAMBUTOL 250 mg COMPR. FILM. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1.500 314,54 0,209693 0,209693 381,00 0,254000 0,254000

101 W42861002 J04AK02 ETHAMBUTOLUM ETAMBUTOL 400 mg COMPR. FILM. 400mg ANTIBIOTICE SA ROMANIA CUTIE X 150 BLIST. AL/PVC X 10 COMPR. FILM. S 1.500 485,00 0,323333 0,323333 566,80 0,377866 0,377866

102 W60583001 J04AK02 ETHAMBUTOLUM INBUTOL SOL INJ. 100mg/ml CN UNIFARM S.A. ROMANIA FLAC. X 10 ML SOL. INJ PR 1 15,55 15,550000 15,550000 21,02 21,020000 21,020000

103 W14071002 J04AM02 COMBINATII (RIFAMPICINUM+IZONIAZIDUM) SINERDOL ISO CAPS. 300mg+150mg ANTIBIOTICE SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS. S 1.000 580,00 0,580000 0,580000 670,35 0,670350 0,670350

P1: PROGRAMUL NATIONAL DE BOLI TRANSMISIBILEC) SUBPROGRAMUL DE SUPRAVEGHERE SI CONTROL AL BOLILOR TRANSMISIBILE PRIORITATRE PREV-TRAT GRIPEI

1 W08867001 J05AH01 ZANAMIVIRUM RELENZA 5 mg PULB. UNIDOZA DE INHALAT 5mg GLAXO GROUP LTD. MAREA

BRITANIE

CUTIE X 1 FLAC. X 5 BLIST. TIP ROTADISK X4 DOZE + DISPOZITIV DE ADMINISTRARE DISKHALER

P-RF 5 59,59 11,918000 11,918000 75,34 15,068000 15,068000

2 W52316001 J05AH02 OSELTAMIVIRUM TAMIFLU 30mg CAPS. 30mg ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1BLISTER PVC/PE/PVDC/ALX 10 CAPSULE

P-RF 10 37,94 3,794000 3,794000 49,62 4,962000 4,962000

3 W13633001 J05AH02 OSELTAMIVIRUM TAMIFLU 75 mg CAPS. 75mg ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1BLISTER PVC/PE/PVDC/AL X 10 CAPSULE

P-RF 10 60,15 6,015000 6,015000 76,06 7,606000 7,606000

P3: PROGRAMUL NATIONAL DE ONCOLOGIE1 W58800001 G03HA01 CYPROTERONUM ANDROCUR COMPR. 50mg BAYER PHARMA AG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-

RF 50 85,78 1,715600 1,715600 108,46 2,169200 2,169200

2 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-

RF 50 19,33 0,386600 0,386600 26,13 0,522600 0,522600

3 W52215001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. I.V. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S 1 11,76 11,760000 11,760000 15,89 15,890000 15,890000

4 W58866002 L01AA02 CHLORAMBUCILUM LEUKERAN COMPR. FILM. 2mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. X 25 COMPR. FILM. P-

RF 25 238,56 9,542400 9,542400 291,24 11,649600 11,649600

Pagina 17 din 87

Page 19: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

5 W58865001 L01AA03 MELPHALANUM ALKERAN 2 mg COMPR. FILM. 2mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 25

COMPR. FILM.P-RF 25 288,54 11,541600 11,541600 352,25 14,090000 14,090000

6 W60631001 L01AA03 MELPHALANUM ALKERAN 50 mg PULB+SOLV. PT. SOL. INJ./PERF. 50mg CN UNIFARM S.A. ROMANIA CUTIE CU 1 FIOLA PULB.+ 1 FIOLA

SOLVENT PR 1 654,63 654,630000 654,630000 751,70 751,700000 751,700000

7 W12497001 L01AA06 IFOSFAMIDUM HOLOXAN 1 g PULB. PT. SOL. PERF. 1g BAXTER ONCOLOGY

GMBH GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. PERF. S 1 92,66 92,660000 92,660000 117,16 117,160000 117,160000

8 W58856002 L01AB01 BUSULFANUM MYLERAN COMPR. FILM. 2mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100

COMPR. FILM.P-RF 100 1.028,76 10,287600 10,287600 1.159,50 11,595000 11,595000

9 W51454001 L01AB01 BUSULFANUM BUSILVEX 6mg/ml CONC. PT. SOL. PERF. 6mg/ml PIERRE FABRE

MEDICAMENT FRANTA CUTIE X 8 FLAC. X 10 ML CONC. PT. SOL. INJ. S 8 9.151,91 1.143,988750 1.143,988750 10.013,75 1.251,718750 1.251,718750

10 W59709001 L01AD02 LOMUSTINUM4) CECENU CAPS. 40mg CN UNIFARM S.A. ROMANIA CUTIE X 1 FLACON X 20 CAPSULE PR 20 1.858,81 92,940500 92,940500 2.064,26 103,213000 103,213000

11 W56780001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 100 mg CAPS. 100mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 393,55 78,710000 78,710000 467,12 93,424000 93,424000

12 W59705002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 100 mg CAPS. 100mg ROMASTRU TRADING SRL ROMANIA

CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL-COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS.

PR 5 393,55 78,710000 78,710000 467,12 93,424000 93,424000

13 W58092001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE SUN 100 mg CAPS. 100mgSUN PHARMACEUTICAL INDUSTRIES EUROPE B.V.

OLANDA CUTIE CU FLACON DIN STICLA BRUNA X 5 CAPSULE

PRF 5 675,04 135,008000 94,452000 773,95 154,790000 112,108800

14 W59451001 L01AX03 TEMOZOLOMIDUM** BLASTOMAT 100 mg CAPS. 100mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. PEID X 5 CAPS. PR

F 5 393,55 78,710000 78,710000 467,12 93,424000 93,424000

15 W59506001 L01AX03 TEMOZOLOMIDUM** NOGRON 100 mg CAPS. 100mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 393,55 78,710000 78,710000 467,12 93,424000 93,424000

16 W59705001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 100 mg CAPS. 100mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 393,55 78,710000 78,710000 467,12 93,424000 93,424000

17 W61245001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 100 mg CAPS. 100mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 393,55 78,710000 78,710000 467,12 93,424000 93,424000

18 W61245002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 100 mg CAPS. 100mg NEOLA PHARMA S.R.L. ROMANIA

CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL-COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS.

PR 5 393,55 78,710000 78,710000 467,12 93,424000 93,424000

19 W59614003 L01AX03 TEMOZOLOMIDUM** TEMODAL 100 mg CAPS. 100mg MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI

P-RF/R

5 589,30 117,860000 94,452000 680,49 136,098000 112,108800

20 W59699001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA GLENMARK 100 mg CAPS. 100mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 393,55 78,710000 78,710000 467,12 93,424000 93,424000

21 W55335001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE TEVA 100 mg CAPS. 100mg TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS.

P-RF/R

5 393,55 78,710000 78,710000 467,12 93,424000 93,424000

22 W56781001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 140 mg CAPS. 140mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 547,19 109,438000 109,438000 634,59 126,918000 126,918000

23 W58093001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE SUN 140 mg CAPS. 140mgSUN PHARMACEUTICAL INDUSTRIES EUROPE B.V.

OLANDA CUTIE CU FLACON DIN STICLA BRUNA X 5 CAPSULE

PRF 5 1.648,19 329,638000 131,325600 1.834,68 366,936000 152,301600

24 W59706001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 140 mg CAPS. 140mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 857,79 171,558000 131,325600 973,14 194,628000 152,301600

25 W59706002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 140 mg CAPS. 140mg ROMASTRU TRADING SRL ROMANIA

CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL-COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS.

PR 5 857,79 171,558000 131,325600 973,14 194,628000 152,301600

26 W59615003 L01AX03 TEMOZOLOMIDUM** TEMODAL 140mg CAPS. 140mg MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI

P-RF/R

5 825,68 165,136000 131,325600 938,14 187,628000 152,301600

27 W59507001 L01AX03 TEMOZOLOMIDUM** NOGRON 140 mg CAPS. 140mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 547,19 109,438000 109,438000 634,59 126,918000 126,918000

28 W56782001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 180 mg CAPS. 180mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 672,99 134,598000 134,598000 771,71 154,342000 154,342000

29 W59508001 L01AX03 TEMOZOLOMIDUM** NOGRON 180 mg CAPS. 180mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 672,99 134,598000 134,598000 771,71 154,342000 154,342000

30 W59616003 L01AX03 TEMOZOLOMIDUM** TEMODAL 180 mg CAPS. 180mg MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI

P-RF/R

5 1.019,21 203,842000 161,517600 1.149,09 229,818000 185,210400

31 W59704001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 20 mg CAPS. 20mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 92,91 18,582000 18,582000 117,48 23,496000 23,496000

32 W59704002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 20 mg CAPS. 20mg ROMASTRU TRADING SRL ROMANIA

CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL-COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS.

PR 5 92,91 18,582000 18,582000 117,48 23,496000 23,496000

33 W56779001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 20 mg CAPS. 20mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 92,91 18,582000 18,582000 117,48 23,496000 23,496000

Pagina 18 din 87

Page 20: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

34 W58091001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE SUN 20 mg CAPS. 20mgSUN PHARMACEUTICAL INDUSTRIES EUROPE B.V.

OLANDA CUTIE CU FLACON DIN STICLA BRUNA X 5 CAPSULE

PRF 5 141,91 28,382000 22,298400 173,24 34,648000 28,195200

35 W59450001 L01AX03 TEMOZOLOMIDUM** BLASTOMAT 20 mg CAPS. 20mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. PEID X 5 CAPS. PR

F 5 92,91 18,582000 18,582000 117,48 23,496000 23,496000

36 W59505001 L01AX03 TEMOZOLOMIDUM** NOGRON 20 mg CAPS. 20mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU 1 FLAC. PEID X 5 CAPS. PRF 5 92,91 18,582000 18,582000 117,48 23,496000 23,496000

37 W59617003 L01AX03 TEMOZOLOMIDUM** TEMODAL 20 mg CAPS. 20mg MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 5 CAPS. AMBALATE INDIVIDUAL IN PLICURI

P-RF/R

5 140,39 28,078000 22,298400 171,39 34,278000 28,195200

38 W55334001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE TEVA 20 mg CAPS. 20mg TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS.

P-RF/R

5 92,91 18,582000 18,582000 117,48 23,496000 23,496000

39 W61244001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 20 mg CAPS. 20mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 92,91 18,582000 18,582000 117,48 23,496000 23,496000

40 W61244002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 20 mg CAPS. 20mg NEOLA PHARMA S.R.L. ROMANIA

CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL-COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS.

PR 5 92,91 18,582000 18,582000 117,48 23,496000 23,496000

41 W59698001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA GLENMARK 20 mg CAPS. 20mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 92,91 18,582000 18,582000 117,48 23,496000 23,496000

42 W55336001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE TEVA 250 mg CAPS. 250mg TEVA PHARMA B.V. OLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 CAPS.

P-RF/R

5 1.557,48 311,496000 310,096800 1.735,81 347,162000 347,162000

43 W60017002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 250 mg CAPS. 250mg ROMASTRU TRADING SRL ROMANIA

CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL-COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS.

PR 5 1.557,47 311,494000 310,096800 1.735,80 347,160000 347,160000

44 W56783001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA HF 250 mg CAPS. 250mg STADA HEMOFARM SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 5 CAPS. PR 5 1.292,07 258,414000 258,414000 1.446,51 289,302000 289,302000

45 W58097001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDE SUN 250 mg CAPS. 250mgSUN PHARMACEUTICAL INDUSTRIES EUROPE B.V.

OLANDA CUTIE CU FLACON DIN STICLA BRUNA X 5 CAPSULE

PRF 5 2.539,46 507,892000 310,096800 2.806,17 561,234000 347,162400

46 W59454001 L01AX03 TEMOZOLOMIDUM** BLASTOMAT 250 mg CAPS. 250mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. PEID X 5 CAPS. PR

F 5 1.550,35 310,070000 310,070000 1.728,03 345,606000 345,606000

47 W59702001 L01AX03 TEMOZOLOMIDUM** TEMOZOLOMIDA GLENMARK 250 mg CAPS. 250mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 1.557,48 311,496000 310,096800 1.735,81 347,162000 347,162000

48 W60017001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 250 mg CAPS. 250mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 1.557,47 311,494000 310,096800 1.735,80 347,160000 347,160000

49 W61248001 L01AX03 TEMOZOLOMIDUM** BRASTORYN 250 mg CAPS. 250mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEID X 5 CAPS. PR 5 1.557,47 311,494000 310,096800 1.735,80 347,160000 347,160000

50 W61248002 L01AX03 TEMOZOLOMIDUM** BRASTORYN 250 mg CAPS. 250mg NEOLA PHARMA S.R.L. ROMANIA

CUTIE CU 5 PLICURI DIN HARTIE CU UN STRAT LINIAR DE POLIETILENA CU DENSITATE SCAZUTA (STRATUL EXTERIOR) SI AL-COPOLIMER ETILENA-ACID ACRILIC (STRATUL INTERIOR) X 1 CAPS.

PR 5 1.557,47 311,494000 310,096800 1.735,80 347,160000 347,160000

51 W59613001 L01AX03 TEMOZOLOMIDUM** TEMODAL 2,5mg/ml PULB. PT. SOL. PERF. 2,5mg/ml MERCK SHARP & DOHME MAREA

BRITANIE CUTIE X 1 FLAC. PULB. PT. SOL. PERF.P-RF/R

1 582,04 582,040000 582,040000 672,57 672,570000 672,570000

52 W56549001 L01AX04 DACARBAZINUM DACARBAZINE MEDAC 500 mg PULB. PT. SOL. INJ. 500mg CN UNIFARM S.A. ROMANIA CUTIE CU 1 FLAC.X 500MG PULB. PT. SOL. INJ.

PR/PRF

1 66,94 66,940000 66,940000 84,64 84,640000 84,640000

53 W58779001 L01AX04 DACARBAZINUM DACARBAZINA LIPOMED 200 mg PULB. PT. SOL. INJ./PERF. 200 mg LIPOMED GMBH GERMANIA

CUTIE CU 10 FLACOANE MONODOZA DIN STICLA BRUNA CU DOP DIN CAUCIUC BROMOBUTILIC CU SIGILIU DIN AL TIP FLIP-OFF CU CAPAC DIN PLASTIC DE CULOARE ROSIE CARE CONTIN PULB. PENTRU SOL. INJ. SAU PERF.

PR 10 730,98 73,098000 73,098000 834,92 83,492000 83,492000

54 W58569001 L01BA01 METHOTREXATUM METHOTREXATE PCH 10mg COMPR. 10mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 10COMPR. P6L 10 21,32 2,132000 2,132000 28,81 2,881000 2,881000

55 W58568001 L01BA01 METHOTREXATUM METHOTREXATE PCH 2,5mg COMPR. 2,5mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X30 COMPRIMATE P6L 30 16,00 0,533333 0,533333 21,62 0,720666 0,720666

56 W12735001 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 332,72 332,720000 332,720000 400,81 400,810000 400,810000

57 W04185002 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 197,47 39,494000 39,494000 241,07 48,214000 48,214000

58 W12733003 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 70,91 70,910000 70,910000 89,66 89,660000 89,660000

59 W59856001 L01BA01 METHOTREXATUM BENDATREXAT SOL INJ. 25mg/ml CN UNIFARM S.A. ROMANIA CUTIE CU 1 FLAC. X 2 ML PR 1 65,37 65,370000 65,370000 82,65 82,650000 82,650000

60 W04186001 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 17,62 1,762000 1,762000 23,82 2,382000 2,382000

61 W58316001 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ

PR 1 45,60 45,600000 45,600000 59,64 59,640000 59,640000

Pagina 19 din 87

Page 21: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

62 W58316010 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

PR 1 100,34 100,340000 100,340000 122,50 122,500000 122,500000

63 W58316004 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

PR 1 62,22 62,220000 62,220000 78,67 78,670000 78,670000

64 W58316007 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

PR 1 87,07 87,070000 87,070000 110,09 110,090000 110,090000

65 W53758006 L01BA01 METHOTREXATUM METOJECT 50mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

50mg/mlMEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIACUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

P-RF 1 62,22 62,220000 62,220000 78,67 78,670000 78,670000

66 W53758016 L01BA01 METHOTREXATUM METOJECT 50mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

50mg/mlMEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIACUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

P-RF 1 86,63 86,630000 86,630000 109,54 109,540000 109,540000

67 W53758001 L01BA01 METHOTREXATUM METOJECT 50mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

50mg/mlMEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIACUTIE X 1 SERINGA PREUMPLUTA X 0,15ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

P-RF 1 59,16 59,160000 54,720000 74,80 74,800000 71,568000

68 W53758021 L01BA01 METHOTREXATUM METOJECT 50mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

50mg/mlMEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIACUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

P-RF 1 101,74 101,740000 101,740000 124,21 124,210000 124,210000

69 W42003001 L01BA04 PEMETREXEDUM**** ALIMTA 500mg PULB. PT. CONC. PT. SOL. PERF. 500mg ELI LILLY NEDERLAND

BV OLANDA CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. S 1 4.944,17 4.944,170000 4.944,170000 5.537,28 5.537,280000 5.537,280000

70 W58868001 L01BB02 MERCAPTOPURINUM PURI - NETHOL COMPR. 50mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 25

COMPR.P-RF 25 300,20 12,008000 12,008000 365,37 14,614800 14,614800

71 W60721001 L01BB03 TIOGUANINUM THIOGUANIN ASPEN 40 mg COMPR. 40mg CN UNIFARM S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA CU 25 COMPR. PR 25 638,68 25,547200 25,547200 734,31 29,372400 29,372400

72 W58869001 L01BB03 TIOGUANINUM LANVIS COMPR. 40mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. X 25 COMPR. P-

RF 25 638,68 25,547200 25,547200 734,31 29,372400 29,372400

73 W44114001 L01BB04 CLADRIBINUM LITAK 2 mg/ml SOL. INJ. 2mg/ml LIPOMED GMBH GERMANIA CUTIE X 1 FLACON X 5 ML S 1 1.435,80 1.435,800000 1.435,800000 1.603,17 1.603,170000 1.603,170000

74 W56210002 L01BB05 FLUDARABINUM**** FLUDARA ORAL 10 mg COMPR. FILM. 10mg GENZYME EUROPE B.V. OLANDA CUTIE X 1 FLAC. DIN PE X 4 BLIST. AL/AL X 5 COMPR. FILM.

P-RF/S

20 1.094,66 54,733000 54,733000 1.231,33 61,566500 61,566500

75 W56211001 L01BB05 FLUDARABINUM FLUDARA LIOF. PT. SOL. INJ./PERF. 50mg GENZYME EUROPE B.V. OLANDA CUTIE X 5 FLAC. CU LIOF. PT. SOL.

INJ./PERF. S 5 513,08 102,616000 102,616000 597,41 119,482000 119,482000

76 W53700001 L01BB05 FLUDARABINUM FLUDARABINA ACTAVIS 25 mg/ml PULB. PT. SOL. INJ./PERF. 25mg/ml ACTAVIS S.R.L. ROMANIA

CUTIE X 1 FLAC. DIN STICLA INCOLORA (CAPACITATE 5ML) CU PULB. PT. SOL. INJ/PERF CONTINAND 50MG FLUDA

S 1 340,13 340,130000 123,139200 408,89 408,890000 143,378400

77 W53291005 L01BB06 CLOFARABINUM**** EVOLTRA 1mg/ml CONC. PT. SOL. PERF. 1mg/ml GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. CU CONC. PT. SOL. PERF. PR 1 6.346,63 6.346,630000 6.346,630000 6.955,99 6.955,990000 6.955,990000

78 W52264001 L01BB07 NELARABINUM**** ATRIANCE SOL. PERF. 5mg/ml GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 6 FLAC. X 50 ML S 6 7.484,57 1.247,428333 1.247,428333 8.196,34 1.366,056666 1.366,056666

79 W13946007 L01BC01 CYTARABINUM ALEXAN 20mg/ml SOL. INJ. 20mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FLACOANE DIN STICLA X 5 ML

SOL. INJ. S 10 97,56 9,756000 9,756000 123,36 12,336000 12,336000

80 W42933004 L01BC01 CYTARABINUM ALEXAN 50mg/ml SOL. INJ. 50mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 20 ML. SOL. INJ. S 1 76,34 76,340000 60,600000 96,52 96,520000 76,620000

81 W59016002 L01BC01 CYTARABINUM CITARABINA KABI 100 mg/ml SOL. INJ. SAU PERF. 100mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC BROMBUTILIC CU CAPSA DETASABILA DIN AL DE CULOARE ALBASTRA X 5 ML SOL. INJ. SAU PERF.

PR 1 25,25 25,250000 25,250000 33,03 33,030000 33,030000

82 W59016003 L01BC01 CYTARABINUM CITARABINA KABI 100 mg/ml SOL. INJ. SAU PERF. 100mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC BROMBUTILIC CU CAPSA DETASABILA DIN AL DE CULOARE ROSIE X 10 ML SOL. INJ. SAU PERF.

PR 1 50,50 50,500000 50,500000 63,85 63,850000 63,850000

83 W59016004 L01BC01 CYTARABINUM CITARABINA KABI 100 mg/ml SOL. INJ. SAU PERF. 100mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC BROMBUTILIC CU CAPSA DETASABILA DIN AL DE CULOARE GALBENA X 20 ML SOL. INJ. SAU PERF.

PR 1 99,23 99,230000 99,230000 125,47 125,470000 125,470000

84 W53814001 L01BC01 CYTARABINUM DEPOCYTE 50mg SUSP. INJ. 50mg PACIRA LIMITED MAREA BRITANIE

CUTIE X 1 FLAC. X 50MG SUSP.INJ. (MONODOZA 5ML) S 1 6.970,59 6.970,590000 6.970,590000 7.636,10 7.636,100000 7.636,100000

85 W43451005 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 20 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 13,64 13,640000 13,640000 18,44 18,440000 18,440000

86 W43451006 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 68,66 68,660000 68,660000 86,81 86,810000 86,810000

87 W43451001 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 5 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 6,32 6,320000 6,320000 8,54 8,540000 8,540000

88 W43451003 L01BC02 FLUOROURACILUM 5 - FLUOROURACIL EBEWE 50mg/ml CONC. PT. SOL. INJ./PERF. 50mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON DIN STICLA BRUNA X 10 ML CONCENTRAT PT. SOL. INJ./PERF. S 1 11,17 11,170000 11,170000 15,10 15,100000 15,100000

89 W60304001 L01BC02 FLUOROURACILUM FLUOROURACIL PCH 50 mg/ml SOL INJ. 50 mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA FLACON X 10ML SOLUTIE INJECTABILA PR 1 11,53 11,530000 11,530000 15,58 15,580000 15,580000

90 W60304002 L01BC02 FLUOROURACILUM FLUOROURACIL PCH 50 mg/ml SOL INJ. 50 mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA FLACON X 100ML SOLUTIE INJECTABILA PR 1 99,35 99,350000 82,392000 125,62 125,620000 104,172000

Pagina 20 din 87

Page 22: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

91 W59237013 L01BC05 GEMCITABINUM** GEMCITABINA EBEWE PHARMA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE CU UN FLAC. DIN STICLA INCOLORA CU INVELIS PROTECTOR ,,ONCO-SAFE" A 100 ML CONC. PT. SOL. PERF

S 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

92 W59237001 L01BC05 GEMCITABINUM** GEMCITABINA EBEWE PHARMA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE CU UN FLAC. DIN STICLA INCOLORA CU INVELIS PROTECTOR ,,ONCO-SAFE" A 20 ML CONC. PT. SOL. PERF.

S 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

93 W56583007 L01BC05 GEMCITABINUM** GEMSOL 40 mg/ml CONC. PT. SOL. PERF. 40 mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE CU 1 FLACOANE STICLA INCOLORA SIST. ,,ONCO-SAFE" A 25 ML CONC .SOL. PERF. X 1000 MG

PR 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

94 W56583009 L01BC05 GEMCITABINUM** GEMSOL 40 mg/ml CONC. PT. SOL. PERF. 40 mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE CU 1 FLACON STICLA INCOLORA SIST. ,,ONCO-SAFE" A 50 ML CONC .SOL. PERF. X 2000 MG

PR 1 367,76 367,760000 367,760000 439,01 439,010000 439,010000

95 W56583004 L01BC05 GEMCITABINUM** GEMSOL 40 mg/ml CONC. PT. SOL. PERF. 40 mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE CU 1 FLACON STICLA INCOLORA FARA SIST. ,,ONCO-SAFE" A 5 ML CONC .SOL. PERF. X 200 MG

PR 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

96 W59316002 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 25 ML X 1 G GEMCITABINA PR 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

97 W59316003 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML X 2 G GEMCITABINA PR 1 367,76 367,760000 367,760000 439,01 439,010000 439,010000

98 W56425003 L01BC05 GEMCITABINUM** GITRABIN 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml ACTAVIS GROUP PTC

EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 50 ML X 2 G GEMCITABINA PR 1 518,45 518,450000 440,400000 603,26 603,260000 525,816000

99 W59510001 L01BC05 GEMCITABINUM** GEMCITABINA KABI 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, PREVAZUT CU SIGILIU CU CAPSA DETASABILA DIN AL DE CULOARE VERDE, CU DISC DIN PP, A 200 MG/5 ML CONC. PT. SOL. PERF.

PR 1 41,04 41,040000 41,040000 53,68 53,680000 53,680000

100 W59510002 L01BC05 GEMCITABINUM** GEMCITABINA KABI 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, PREVAZUT CU SIGILIU CU CAPSA DETASABILA DIN AL DE CULOARE ALBASTRA, CU DISC DIN PP, A 1000 MG/25 ML CONC. PT. SOL. PERF.

PR 1 184,80 184,800000 184,800000 225,60 225,600000 225,600000

101 W59510003 L01BC05 GEMCITABINUM** GEMCITABINA KABI 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA, PREVAZUT CU SIGILIU CU CAPSA DETASABILA DIN AL DE CULOARE VIOLET, CU DISC DIN PP, A 2000 MG/50 ML CONC. PT. SOL. PERF.

PR 1 367,00 367,000000 367,000000 438,18 438,180000 438,180000

102 W56425001 L01BC05 GEMCITABINUM** GITRABIN 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml ACTAVIS GROUP PTC

EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 5 ML X 200 MG GEMCITABINA PR 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

103 W56425002 L01BC05 GEMCITABINUM** GITRABIN 40 mg/ml CONC. PT. SOL. PERF. 40mg/ml ACTAVIS GROUP PTC

EHF. ISLANDA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 25 ML X 1 G GEMCITABINA PR 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

104 W56246001 L01BC05 GEMCITABINUM** GEMZAR 1000 mg PULB. PT. SOL. PERF. 1000 mg LILLY FRANCE SAS FRANTA CUTIE X 1FLAC. DIN STICLA INCOLORA CU

PULB. PT. SOL. PERF. S 1 285,80 285,800000 217,632000 348,91 348,910000 265,680000

105 W56371001 L01BC05 GEMCITABINUM** GEMCITABINA ATB 1000 mg PULB. PT. SOL. PERF. 1000mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X

50 ML PULB. PT. SOL. PERF. PR 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

106 W55552001 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 1000 mg PULB. PT. SOL. PERF. 1000mg

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 1000 MG PULB. PT. SOL. PERF. S 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

107 W56150001 L01BC05 GEMCITABINUM** DAPLAX 1 g PULB. PT. SOL. PERF. 1g DR. REDDY'S

LABORATORIES ROMANIACUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. CONTINAND 1000MG GEMCITABINA

S 1 185,76 185,760000 185,760000 226,77 226,770000 226,770000

108 W55553001 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 2000 mg PULB. PT. SOL. PERF. 2000mg

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 2000 MG PULB. PT. SOL. PERF. S 1 367,77 367,770000 367,770000 439,02 439,020000 439,020000

109 W55551001 L01BC05 GEMCITABINUM** GEMCITABINA TEVA 200 mg PULB. PT. SOL. PERF. 200mg

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 MG PULB. PT. SOL. PERF. S 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

110 W56149001 L01BC05 GEMCITABINUM** DAPLAX 200 mg PULB. PT. SOL. PERF. 200mg DR. REDDY'S

LABORATORIES ROMANIACUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. CONTINAND 200MG GEMCITABINA

S 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

111 W56370001 L01BC05 GEMCITABINUM** GEMCITABINA ATB 200 mg PULB. PT. SOL. PERF. 200mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X

10 ML PULB. PT. SOL. PERF. PR 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

112 W03290001 L01BC05 GEMCITABINUM** GEMZAR (R) 200 mg PULB. PT. SOL. PERF. 200mg LILLY FRANCE SAS FRANTA CUTIE X 1 FLAC. PULB. PT. SOL. PERF. S 1 62,79 62,790000 49,248000 79,39 79,390000 64,416000

113 W54381002 L01BC05 GEMCITABINUM** GEMCIRENA 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml FRESENIUS KABI

ROMANIA SRL ROMANIACUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. CARE CONTINE 1000MG GEMCITABINA

S 1 181,36 181,360000 181,360000 221,40 221,400000 221,400000

114 W54381004 L01BC05 GEMCITABINUM** GEMCIRENA 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml FRESENIUS KABI

ROMANIA SRL ROMANIACUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 ML CU PULB. PT. SOL. PERF. CARE CONTINE 2000MG GEMCITABINA

S 1 368,80 368,800000 368,800000 440,14 440,140000 440,140000

115 W54270005 L01BC05 GEMCITABINUM** GEMCITABINE MYLAN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml MYLAN S.A.S. FRANTA

CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML PULB. PT SOL. PERF. CARE CONTINE 1000 MG GEMCITABINA

S 1 285,80 285,800000 217,632000 348,91 348,910000 265,680000

116 W54270001 L01BC05 GEMCITABINUM** GEMCITABINE MYLAN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml MYLAN S.A.S. FRANTA

CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML PULB. PT SOL. PERF. CARE CONTINE 200 MG GEMCITABINA

S 1 62,79 62,790000 49,248000 79,39 79,390000 64,416000

Pagina 21 din 87

Page 23: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

117 W55531004 L01BC05 GEMCITABINUM** GITRABIN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE X 1 FLAC. STICLA INCOLORA CU PULB. PT SOL. PERF. CARE CONTINE 2000MG GEMCITABINA

S 1 367,76 367,760000 367,760000 439,01 439,010000 439,010000

118 W55531002 L01BC05 GEMCITABINUM** GITRABIN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE X 1 FLAC. STICLA INCOLORA CU PULB. PT SOL. PERF. CARE CONTINE 200MG GEMCITABINA

S 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

119 W54381001 L01BC05 GEMCITABINUM** GEMCIRENA 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml FRESENIUS KABI

ROMANIA SRL ROMANIACUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML CU PULB. PT. SOL. PERF. CARE CONTINE 200MG GEMCITABINA

S 1 41,54 41,540000 41,540000 54,34 54,340000 54,340000

120 W55531003 L01BC05 GEMCITABINUM** GITRABIN 38 mg/ml PULB. PT. SOL. PERF. 38mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE X 1 FLAC. STICLA INCOLORA CU PULB. PT SOL. PERF. CARE CONTINE 1000MG GEMCITABINA

S 1 185,77 185,770000 185,770000 226,79 226,790000 226,790000

121 W58925005 L01BC06 CAPECITABINUM CAPECITABINA GLENMARK 150 mg COMPR. FILM. 150mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU 6 BLIST. PVC/PVDC-AL X 60 (6X10) COMPR. FILM. PR 60 101,61 1,693500 1,635199 124,04 2,067333 2,067333

122 W60217005 L01BC06 CAPECITABINUM ECANSYA 150mg COMPR. FILM. 150mg KRKA D.D. SLOVENIA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPRIMATE FILMATE PR 60 101,24 1,687333 1,635199 123,60 2,060000 2,060000

123 W59427001 L01BC06 CAPECITABINUM CAPECITABINA ZENTIVA 150 mg COMPR. FILM. 150mg ZENTIVA, K.S. REPUBLICA CEHA

CUTIE CU 6 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PR 60 101,61 1,693500 1,635199 124,05 2,067500 2,067500

124 W59385001 L01BC06 CAPECITABINUM XALVOBIN 150 mg COMPR. FILM. 150mg ALVOGEN IPCO S.AR.L. LUXEMBURG

CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. PR 60 134,21 2,236833 1,635199 163,84 2,730666 2,067600

125 W59385002 L01BC06 CAPECITABINUM XALVOBIN 150 mg COMPR. FILM. 150mg ALVOGEN IPCO S.AR.L. LUXEMBURG

CUTIE CU BLIST. PVC-PE-PVDC/AL X 60 COMPR. FILM. PR 60 134,21 2,236833 1,635199 163,84 2,730666 2,067600

126 W58925002 L01BC06 CAPECITABINUM CAPECITABINA GLENMARK 150 mg COMPR. FILM. 150mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU 6 BLIST. AL-AL X 60 (6X10) COMPR. FILM. PR 60 101,61 1,693500 1,635199 124,04 2,067333 2,067333

127 W59427002 L01BC06 CAPECITABINUM CAPECITABINA ZENTIVA 150 mg COMPR. FILM. 150mg ZENTIVA, K.S. REPUBLICA CEHA

CUTIE CU 6 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PR 60 101,61 1,693500 1,635199 124,05 2,067500 2,067500

128 W59654002 L01BC06 CAPECITABINUM ARXEDA 150 mg COMPR. FILM. 150mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 60

COMPR. FILM.PRF 60 101,61 1,693500 1,635199 124,04 2,067333 2,067333

129 W59873005 L01BC06 CAPECITABINUM CAPECITABINA SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ SRL ROMANIA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. PR 60 81,76 1,362666 1,362666 103,38 1,723000 1,723000

130 W08338001 L01BC06 CAPECITABINUM XELODA 150 mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 6 BLIST. DIN PVC/PE/PVDC X 10 COMPR. FILM.

P-RF/R

60 206,50 3,441666 1,635199 252,09 4,201500 2,067600

131 W59086001 L01BC06 CAPECITABINUM CAPECITABINA FRESENIUS KABI 150 mg COMPR. FILM. 150mg FRESENIUS KABI ONCOLOGY PLC

MAREA BRITANIE

CUTIE CU 6 BLIST. CU PERFORATIE DIN PVC-PVDC/AL X 10 COMPR. FILM. PR 60 91,84 1,530666 1,530666 116,12 1,935333 1,935333

132 W59654001 L01BC06 CAPECITABINUM ARXEDA 150 mg COMPR. FILM. 150mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60

COMPR. FILM.PRF 60 101,61 1,693500 1,635199 124,04 2,067333 2,067333

133 W60217002 L01BC06 CAPECITABINUM ECANSYA 150mg COMPR. FILM. 150mg KRKA D.D. SLOVENIA CUTIE CU BLIST. AL/AL X 60 COMPRIMATE FILMATE PR 60 101,24 1,687333 1,635199 123,60 2,060000 2,060000

134 W60278001 L01BC06 CAPECITABINUM CAPECITABINE TEVA 150 mg COMPR. FILM. 150mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PE/PVDC/AL X 60 COMPR. FILM. PR 60 81,76 1,362666 1,362666 103,38 1,723000 1,723000

135 W60218002 L01BC06 CAPECITABINUM ECANSYA 300mg COMPR. FILM. 300mg KRKA D.D. SLOVENIA CUTIE CU BLIST. AL/AL X 60 COMPRIMATE FILMATE PR 60 312,14 5,202333 5,202333 378,38 6,306333 6,306333

136 W60218005 L01BC06 CAPECITABINUM ECANSYA 300mg COMPR. FILM. 300mg KRKA D.D. SLOVENIA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPRIMATE FILMATE PR 60 312,14 5,202333 5,202333 378,38 6,306333 6,306333

137 W58926006 L01BC06 CAPECITABINUM CAPECITABINA GLENMARK 500 mg COMPR. FILM. 500mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU 12 BLIST. PVC/PVDC-AL X 120 (12X10) COMPR. FILM. PR 120 430,65 3,588750 3,588750 507,56 4,229666 4,229666

138 W59367001 L01BC06 CAPECITABINUM CAPECITABINA ACTAVIS 500 mg COMPR. FILM. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 120

COMPR. FILM. PR 120 580,39 4,836583 4,306500 670,78 5,589833 5,075599

139 W59874012 L01BC06 CAPECITABINUM CAPECITABINA SANDOZ 500 mg COMPR. FILM. 500mg SANDOZ SRL ROMANIA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 120 COMPR. FILM. PR 120 514,24 4,285333 4,285333 598,67 4,988916 4,988916

140 W59059006 L01BC06 CAPECITABINUM COLOXET 500 mg COMPR. FILM. 500mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU 12 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PR 120 624,00 5,200000 4,306500 718,31 5,985916 5,075599

141 W59386001 L01BC06 CAPECITABINUM XALVOBIN 500 mg COMPR. FILM. 500mg ALVOGEN IPCO S.AR.L. LUXEMBURG

CUTIE CU BLIST. PVC-PVDC/AL X 120 COMPR. FILM. PR 120 624,09 5,200750 4,306500 718,41 5,986750 5,075599

142 W59424002 L01BC06 CAPECITABINUM CEREX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 (12X10) COMPR. FILM. PR 120 971,30 8,094166 4,306500 1.096,87 9,140583 5,075599

143 W59059003 L01BC06 CAPECITABINUM COLOXET 500 mg COMPR. FILM. 500mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU 12 BLIST. AL/AL X 10 COMPR. FILM. PR 120 624,00 5,200000 4,306500 718,31 5,985916 5,075599

144 W59087001 L01BC06 CAPECITABINUM CAPECITABINA FRESENIUS KABI 500 mg COMPR. FILM. 500mg FRESENIUS KABI ONCOLOGY PLC

MAREA BRITANIE

CUTIE CU 12 BLIST. CU PERFORATIE DIN PVC-PVDC/AL X 10 COMPR. FILM. PR 120 580,00 4,833333 4,306500 670,35 5,586250 5,075599

145 W59655001 L01BC06 CAPECITABINUM ARXEDA 500 mg COMPR. FILM. 500mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 120

COMPR. FILM.PRF 120 624,00 5,200000 4,306500 718,31 5,985916 5,075599

146 W59424001 L01BC06 CAPECITABINUM CEREX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 120 (12X10) COMPR. FILM. PR 120 971,30 8,094166 4,306500 1.096,87 9,140583 5,075599

147 W59655002 L01BC06 CAPECITABINUM ARXEDA 500 mg COMPR. FILM. 500mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120

COMPR. FILM.PRF 120 624,00 5,200000 4,306500 718,31 5,985916 5,075599

148 W08339001 L01BC06 CAPECITABINUM XELODA 500 mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 12 BLIST. DIN PVC/PE/PVDC X 10 COMPR. FILM.

P-RF/R

120 1.275,41 10,628416 4,306500 1.428,35 11,902916 5,075599

149 W59428001 L01BC06 CAPECITABINUM CAPECITABINA ZENTIVA 500 mg COMPR. FILM. 500mg ZENTIVA, K.S. REPUBLICA CEHA

CUTIE CU 12 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PR 120 624,09 5,200750 4,306500 718,41 5,986750 5,075599

150 W59428002 L01BC06 CAPECITABINUM CAPECITABINA ZENTIVA 500 mg COMPR. FILM. 500mg ZENTIVA, K.S. REPUBLICA CEHA

CUTIE CU 12 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PR 120 624,09 5,200750 4,306500 718,41 5,986750 5,075599

151 W59386002 L01BC06 CAPECITABINUM XALVOBIN 500 mg COMPR. FILM. 500mg ALVOGEN IPCO S.AR.L. LUXEMBURG

CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 624,09 5,200750 4,306500 718,41 5,986750 5,075599

152 W58926003 L01BC06 CAPECITABINUM CAPECITABINA GLENMARK 500 mg COMPR. FILM. 500mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU 12 BLIST. AL-AL X 120 (12X10) COMPR. FILM. PR 120 430,65 3,588750 3,588750 507,56 4,229666 4,229666

Pagina 22 din 87

Page 24: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

153 W60219006 L01BC06 CAPECITABINUM ECANSYA 500mg COMPR. FILM. 500mg KRKA D.D. SLOVENIA CUTIE CU BLIST. PVC/PVDC/AL X 120 COMPRIMATE FILMATE PR 120 622,25 5,185416 4,306500 716,40 5,970000 5,075599

154 W60279001 L01BC06 CAPECITABINUM CAPECITABINE TEVA 500 mg COMPR. FILM. 500mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PE/PVDC/AL X 120 COMPR. FILM. PR 120 514,24 4,285333 4,285333 598,67 4,988916 4,988916

155 W60219003 L01BC06 CAPECITABINUM ECANSYA 500mg COMPR. FILM. 500mg KRKA D.D. SLOVENIA CUTIE CU BLIST. AL/AL X 120 COMPRIMATE FILMATE PR 120 622,25 5,185416 4,306500 716,40 5,970000 5,075599

156 W60255001 L01BC06 CAPECITABINUM CAPECITABINA DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLISTERE PVC-PE-PVDC/AL-PET-

HARTIE X 120 COMPRIMATE FILMATE PR 120 624,08 5,200666 4,306500 718,40 5,986666 5,075599

157 W59587001 L01BC08 DECITABINUM**** DACOGEN PULB. PT. CONC. PT. SOL. PERF. 50mg JANSSEN CILAG

INTERNATIONALL NV BELGIA CUTIE CU 1 FL. DIN STICLA CE CONTINE 50MG DECITABINA PR 1 5.755,43 5.755,430000 5.755,430000 6.311,58 6.311,580000 6.311,580000

158 W59211001 L01CA01 VINBLASTINUM4) VINBLASTINA TEVA 1 mg/ml SOL INJ. 1mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 10 ML SOL. INJ. PR 1 29,63 29,630000 29,630000 38,75 38,750000 38,750000

159 W52220001 L01CA02 VINCRISTINUM SINDOVIN 1 mg LIOF. PT. SOL. INJ./PERF. I.V. 1mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT.

SOL. INJ./PERF. I.V. S 1 25,54 25,540000 25,540000 33,40 33,400000 33,400000

160 W42512002 L01CA04 VINORELBINUM NAVELBINE 20 mg CAPS. MOI 20mgPIERRE FABRE MEDICAMENT PRODUCTION

FRANTA CUTIE X 1 BLIST. PVC-PVDC/AL-PETP X 1 CAPS. MOALE

P-RF 1 195,08 195,080000 195,080000 238,15 238,150000 238,150000

161 W42513002 L01CA04 VINORELBINUM NAVELBINE 30 mg CAPS. MOI 30mgPIERRE FABRE MEDICAMENT PRODUCTION

FRANTA CUTIE X 1 BLIST. PVC-PVDC/AL-PETP X 1 CAPS. MOALE

P-RF 1 292,59 292,590000 292,590000 357,19 357,190000 357,190000

162 W43735002 L01CA04 VINORELBINUM VINORELBIN EBEWE 10 mg/ ml CONC. PT. SOL. INJ./PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL. INJ/PERF. S 1 352,01 352,010000 352,010000 421,84 421,840000 421,840000

163 W43735001 L01CA04 VINORELBINUM VINORELBIN EBEWE 10 mg/ ml CONC. PT. SOL. INJ./PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLAC. X 1 ML CONC. PT. SOL. INJ/PERF. S 1 72,14 72,140000 72,140000 91,21 91,210000 91,210000

164 W53906001 L01CA04 VINORELBINUM TELBINE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICAL

S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 1 ML CONC. PT. SOL. PERF. S 1 72,14 72,140000 72,140000 91,21 91,210000 91,210000

165 W52194001 L01CA04 VINORELBINUM VINORELBIN ACTAVIS 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 1 ML CONC. PT. SOL.

PERF. S 1 72,15 72,150000 72,150000 91,23 91,230000 91,230000

166 W53906003 L01CA04 VINORELBINUM TELBINE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml TEVA PHARMACEUTICAL

S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 352,01 352,010000 352,010000 421,84 421,840000 421,840000

167 W52194002 L01CA04 VINORELBINUM VINORELBIN ACTAVIS 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL.

PERF. S 1 448,89 448,890000 422,412000 527,44 527,440000 506,208000

168 W08035001 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 100mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 BLIST. PVC/A0-PVC-PVDC X 10

CAPS.P-RF 10 311,36 31,136000 31,136000 377,53 37,753000 37,753000

169 W08036001 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 50mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. PVC/AL-PVC-PVDC X 10

CAPS.P-RF 20 308,57 15,428500 15,428500 374,49 18,724500 18,724500

170 W52210001 L01CB01 ETOPOSIDUM SINTOPOZID 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA

X 5 ML CONC. PT. SOL. PERF. S 1 32,83 32,830000 32,830000 42,94 42,940000 42,940000

171 W03065001 L01CB01 ETOPOSIDUM ETOPOSID "EBEWE" 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 39,04 39,040000 38,352000 51,07 51,070000 50,172000

172 W52574001 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL. PERF. S 1 31,96 31,960000 31,960000 41,81 41,810000 41,810000

173 W60599002 L01CB01 ETOPOSIDUM ETOPOZIDA KABI 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU UN FLAC. DIN STICLA INCOLORA TIP I, CU CAPACITATEA DE 10 ML ÎNCHIS CU DOP DIN CAUCIUC BROMOBUTIL SI SIGILAT CU CAPSE DETASABILE DIN AL DE CULOARE ALBASTRA CONTINÂND 10 ML CONC. PENTRU SOL. PERF.

PR 1 61,04 61,040000 61,040000 77,18 77,180000 77,180000

174 W52574002 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. X 10 ML CONC. PT. SOL. PERF. S 1 61,07 61,070000 61,070000 77,22 77,220000 77,220000

175 W43372003 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 25 ML CONC. PT. SOL. PERF. S 1 832,08 832,080000 538,200000 945,12 945,120000 632,424000

176 W52212003 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X,

25 ML CONC. PT. SOL. PERF. S 1 559,41 559,410000 538,200000 647,91 647,910000 632,424000

177 W54978002 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLICA

CEHACUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 MG CONC. PT. SOL. PERF. S 1 356,96 356,960000 356,960000 427,24 427,240000 425,271000

178 W52058002 L01CD01 PACLITAXELUM** PACLITAXEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml PHARMEXPRESS S.R.L. ROMANIA CUTIE X 4 FLAC. X 16,7 ML S 4 1.265,52 316,380000 316,380000 1.417,57 354,392500 354,392500

179 W52212002 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

16,67 ML CONC. PT. SOL. PERF. S 1 356,99 356,990000 356,990000 427,27 427,270000 425,271000

180 W52212004 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

50 ML CONC. PT. SOL. PERF. S 1 1.100,68 1.100,680000 1.100,680000 1.237,89 1.237,890000 1.237,890000

181 W52212005 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

43,33 ML CONC. PT. SOL. PERF. S 1 909,41 909,410000 909,410000 1.029,41 1.029,410000 1.029,410000

182 W56078001 L01CD01 PACLITAXELUM** PACLITAXEL ACCORD 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ACCORD HEALTHCARE

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA A 5 ML CARE CONTINE 30 MG PACLITAXEL S 1 114,66 114,660000 114,660000 139,98 139,980000 132,744000

183 W52212001 L01CD01 PACLITAXELUM** SINDAXEL CONC. PT. SOL. PERF. 6mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 5

ML CONC. PT. SOL. PERF. S 1 114,95 114,950000 114,950000 140,33 140,330000 132,744000

184 W56078002 L01CD01 PACLITAXELUM** PACLITAXEL ACCORD 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ACCORD HEALTHCARE

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA A 16,7 ML CARE CONTINE 100 MG PACLITAXEL S 1 356,77 356,770000 356,770000 427,03 427,030000 425,271000

185 W54068003 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI

ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 16,7 ML CONC. PT. SOL. PERF. S 1 338,86 338,860000 338,860000 407,51 407,510000 407,510000

186 W54068007 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI

ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 25 ML CONC. PT. SOL. PERF. S 1 448,50 448,500000 448,500000 527,02 527,020000 527,020000

Pagina 23 din 87

Page 25: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

187 W52058003 L01CD01 PACLITAXELUM** PACLITAXEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml PHARMEXPRESS S.R.L. ROMANIA CUTIE X 1 FLAC. X 50 ML S 1 1.010,91 1.010,910000 1.010,910000 1.140,04 1.140,040000 1.140,040000

188 W56078003 L01CD01 PACLITAXELUM** PACLITAXEL ACCORD 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ACCORD HEALTHCARE

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA A 50 ML CARE CONTINE 300 MG PACLITAXEL S 1 1.100,51 1.100,510000 1.100,510000 1.237,71 1.237,710000 1.237,710000

189 W54978001 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLICA

CEHACUTIE CU 1 FLAC. DIN STICLA INCOLORA X 30 MG CONC. PT. SOL. PERF. S 1 114,92 114,920000 114,920000 140,30 140,300000 132,744000

190 W54978004 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLICA

CEHACUTIE CU 1 FLAC. DIN STICLA INCOLORA X 300 MG CONC. PT. SOL. PERF. S 1 1.100,65 1.100,650000 1.100,650000 1.237,86 1.237,860000 1.237,860000

191 W54978003 L01CD01 PACLITAXELUM** PACLITAXEL ARCHIE SAMUEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml ARCHIE SAMUEL S.R.O. REPUBLICA

CEHACUTIE CU 1 FLAC. DIN STICLA INCOLORA X 150 MG CONC. PT. SOL. PERF. S 1 559,30 559,300000 538,200000 647,79 647,790000 632,424000

192 W52058001 L01CD01 PACLITAXELUM** PACLITAXEL 6 mg/ml CONC. PT. SOL. PERF. 6mg/ml PHARMEXPRESS S.R.L. ROMANIA CUTIE X 10 FLAC. X 5 ML S 10 979,86 97,986000 97,986000 1.106,20 110,620000 110,620000

193 W54068005 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI

ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 ML CONC. PT. SOL. PERF. S 1 1.010,86 1.010,860000 1.010,860000 1.139,99 1.139,990000 1.139,990000

194 W43372004 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 50 ML CONC. PT. SOL. PERF. S 1 1.100,68 1.100,680000 1.100,680000 1.237,89 1.237,890000 1.237,890000

195 W43372002 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 16,6 ML CONC. PT. SOL. PERF. S 1 356,99 356,990000 356,990000 427,27 427,270000 425,271000

196 W43372001 L01CD01 PACLITAXELUM** PACLITAXEL EBEWE 6mg/ml CONC. PT. SOL. PERF. 6mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 114,95 114,950000 114,950000 140,33 140,330000 132,744000

197 W54068001 L01CD01 PACLITAXELUM** PACLITAXEL KABI 6mg/ml CONC. PT. SOL. PERF. 6mg/ml FRESENIUS KABI

ROMANIA SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. S 1 106,15 106,150000 106,150000 129,59 129,590000 129,590000

198 W12995001 L01CD02 DOCETAXELUM** TAXOTERE 20 mg CONC. + SOLV. PT. SOL. PERF. 20mg AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON X 0,5 ML CONC. SOL.

PERF. + 1 FLACON X 1,5 ML SOLV. S 1 227,82 227,820000 77,952000 278,12 278,120000 98,568000

199 W55406001 L01CD02 DOCETAXELUM** DOCETAXEL TEVA 20mg CONC. + SOLV. PT. SOL. PERF. 20mg TEVA PHARMA B.V. OLANDA

CUTIE X 1 FLAC. DIN STICLA INCOLORA X 0,5 ML CONCENTRAT PT. SOL.PERF.+1 FLAC.X1,5ML SOLV.

S 1 148,08 148,080000 77,952000 180,78 180,780000 98,568000

200 W55670001 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/0,5 ml CONC. + SOLV. PT. SOL. PERF. 20mg/0,5ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 BLIST. DIN POLISTIREN TERMOFORMAT CU 1 FLAC. DIN STICLA INCOLORA X 0,5 ML CONC. PT. SOL.

S 1 364,79 364,790000 77,952000 435,77 435,770000 98,568000

201 W55407001 L01CD02 DOCETAXELUM** DOCETAXEL TEVA 80mg CONC. + SOLV. PT. SOL. PERF. 80mg TEVA PHARMA B.V. OLANDA

CUTIE X 1 FLAC. DIN STICLA INCOLORA X 2 ML CONCENTRAT PT. SOL.PERF.+1 FLAC.X 6ML SOLV.

S 1 787,79 787,790000 307,296000 896,84 896,840000 375,144000

202 W12994001 L01CD02 DOCETAXELUM** TAXOTERE 80 mg CONC. + SOLV. PT. SOL. PERF. 80mg AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON X 2 ML CONC. SOL.

PERF. + 1 FLACON X 6 ML SOLV. S 1 1.043,54 1.043,540000 307,296000 1.175,61 1.175,610000 375,144000

203 W55671001 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 80 mg/2 ml CONC. + SOLV. PT. SOL. PERF. 80mg/2ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 BLIST. DIN POLISTIREN TERMOFORMAT CU 1 FLAC. DIN STICLA INCOLORA X 2 ML CONC. PT. SOL. PE

S 1 1.369,45 1.369,450000 307,296000 1.530,85 1.530,850000 375,144000

204 W55307002 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LIMITED MAREA

BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA IN FOLIE PROTECTOARE ONCO-TAIN X 2 ML CONC. PT. SOL. PERF.

S/P-RF 1 64,96 64,960000 64,960000 82,14 82,140000 82,140000

205 W55307004 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LIMITED MAREA

BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA IN FOLIE PROTECTOARE ONCO-TAIN X 8 ML CONC. PT. SOL. PERF.

S/P-RF 1 256,08 256,080000 256,080000 312,62 312,620000 312,620000

206 W55307006 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LIMITED MAREA

BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA IN FOLIE PROTECTOARE ONCO-TAIN X 16 ML CONC. PT. SOL. PERF.

S/P-RF 1 466,50 466,500000 466,500000 546,64 546,640000 546,640000

207 W55307001 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LTD MAREA

BRITANIECUTIE CU 1 FLAC. DIN STICLA INCOLORA X 2 ML CONC. PT. SOL. PERF.

S/P-RF 1 64,96 64,960000 64,960000 82,14 82,140000 82,140000

208 W57028007 L01CD02 DOCETAXELUM** DOCETAXEL EBEWE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 8 ML CONC. PT. SOL. PERF.

P-RF/R

1 924,39 924,390000 307,296000 1.045,74 1.045,740000 375,144000

209 W55307005 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LTD MAREA

BRITANIECUTIE CU 1 FLAC. DIN STICLA INCOLORA X 16 ML CONC. PT. SOL. PERF.

S/P-RF 1 466,50 466,500000 466,500000 546,64 546,640000 546,640000

210 W57028016 L01CD02 DOCETAXELUM** DOCETAXEL EBEWE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC ONCO-SAFE X 16 ML CONC. PT. SO

P-RF/R

1 1.542,65 1.542,650000 559,800000 1.719,64 1.719,640000 655,968000

211 W55307003 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml HOSPIRA UK LTD MAREA

BRITANIECUTIE CU 1 FLAC. DIN STICLA INCOLORA X 8 ML CONC. PT. SOL. PERF.

S/P-RF 1 256,08 256,080000 256,080000 312,62 312,620000 312,620000

212 W57028001 L01CD02 DOCETAXELUM** DOCETAXEL EBEWE 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 2 ML CONC. PT. SOL. PERF.

P-RF/R

1 261,95 261,950000 77,952000 319,79 319,790000 98,568000

213 W59128003 L01CD02 DOCETAXELUM** DOCETAXEL PFIZER 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIECUTIE CU 1 FLAC. DIN PP DE UNICA FOLOSINTA A 13 ML CONC. PT. SOL. PERF. PR 1 1.577,91 1.577,910000 1.577,910000 1.758,07 1.758,070000 1.758,070000

214 W59128001 L01CD02 DOCETAXELUM** DOCETAXEL PFIZER 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIECUTIE CU 1 FLAC. DIN PP DE UNICA FOLOSINTA A 2 ML CONC. PT. SOL. PERF. PR 1 261,95 261,950000 77,952000 319,79 319,790000 98,568000

215 W59128004 L01CD02 DOCETAXELUM** DOCETAXEL PFIZER 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIECUTIE CU 1 FLAC. DIN PP DE UNICA FOLOSINTA A 20 ML CONC. PT. SOL. PERF. PR 1 2.411,40 2.411,400000 2.411,400000 2.666,58 2.666,580000 2.666,580000

Pagina 24 din 87

Page 26: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

216 W59128002 L01CD02 DOCETAXELUM** DOCETAXEL PFIZER 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIECUTIE CU 1 FLAC. DIN PP DE UNICA FOLOSINTA A 8 ML CONC. PT. SOL. PERF. PR 1 924,39 924,390000 307,296000 1.045,74 1.045,740000 375,144000

217 W57271001 L01CD02 DOCETAXELUM** TAXOTERE 160 mg/8ml CONC. PT. SOL. PERF. 160 mg/8 ml AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON DIN STICLA CU 8 ML

CONC. PT. SOL. PERF.X 160MG PR 1 2.361,67 2.361,670000 559,800000 2.612,37 2.612,370000 655,968000

218 W59570001 L01CD02 DOCETAXELUM** DOCETAXEL KABI 120 mg/6 ml CONC. PT. SOL. PERF. 20 mg/1 ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FL DIN STICLA INCOLORA X 6 ML CONCENTRAT PENTRU SOL. PERFUZABILA

PR 1 1.359,59 1.359,590000 1.359,590000 1.520,11 1.520,110000 1.520,110000

219 W55044001 L01CD02 DOCETAXELUM** TAXOTERE 20 mg/1ml CONC. PT. SOL. PERF. 20mg/1ml AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON X 1 ML CONC. PT. SOL.

PERF. PR 1 287,07 287,070000 77,952000 350,45 350,450000 98,568000

220 W59877003 L01CD02 DOCETAXELUM** TOLNEXA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml KRKA, D.D., NOVO

MESTO SLOVENIA

CUTIE CU 1 FLAC. DIN STICLA, DE CAPACITATE 5 ML, PREVAZUT CU SIGILIU DIN AL CU CAPSA TIP FLIP-OFF DE CULOARE PORTOCALIE, A 8 ML CONC. PT. SOL. PERF. CARE CONTINE 160 MG DOCETAXEL

PR 1 566,74 566,740000 559,800000 655,90 655,900000 655,900000

221 W59571001 L01CD02 DOCETAXELUM** DOCETAXEL KABI 160 mg/8 ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FL DIN STICLA INCOLORA X 8 ML CONCENTRAT CE CONTINE 160 MG DOCETAXEL

PR 1 1.706,08 1.706,080000 559,800000 1.897,78 1.897,780000 655,968000

222 W55902001 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU 1 ML CONC. PT. SOL. PERF. CARE CONTINE 20 MG DOCETAX

PR 1 261,95 261,950000 77,952000 319,79 319,790000 98,568000

223 W55902002 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU 4 ML CONC. PT. SOL. PERF. CARE CONTINE 80 MG DOCETAX

PR 1 924,39 924,390000 307,296000 1.045,74 1.045,740000 375,144000

224 W59826001 L01CD02 DOCETAXELUM** DOCETAXEL KABI 20mg/ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE X 1 FLACON DIN STICLA X 1ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA X 20MG DOCETAXEL

PR 1 256,30 256,300000 77,952000 312,89 312,890000 98,568000

225 W59573001 L01CD02 DOCETAXELUM** DOCETAXEL KABI 80 mg/4 ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FL DIN STICLA INCOLORA X 4 ML CONCENTRAT CE CONTINE 80 MG DOCETAXEL

PR 1 916,40 916,400000 307,296000 1.037,03 1.037,030000 375,144000

226 W55902003 L01CD02 DOCETAXELUM** DOCETAXEL ACTAVIS 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU 7 ML CONC. PT. SOL. PERF. CARE CONTINE 140 MG DOCETA

PR 1 2.373,51 2.373,510000 2.373,510000 2.625,28 2.625,280000 2.625,280000

227 W59877002 L01CD02 DOCETAXELUM** TOLNEXA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml KRKA, D.D., NOVO

MESTO SLOVENIA

CUTIE CU 1 FLAC. DIN STICLA, DE CAPACITATE 5 ML, PREVAZUT CU SIGILIU DIN AL CU CAPSA TIP FLIP-OFF DE CULOARE ROSIE, A 4 ML CONC. PT. SOL. PERF. CARE CONTINE 80 MG DOCETAXEL

PR 1 309,04 309,040000 307,296000 375,00 375,000000 375,000000

228 W59877001 L01CD02 DOCETAXELUM** TOLNEXA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml KRKA, D.D., NOVO

MESTO SLOVENIA

CUTIE CU 1 FLAC. DIN STICLA, DE CAPACITATE 5 ML, PREVAZUT CU SIGILIU DIN AL CU CAPSA TIP FLIP-OFF DE CULOARE PORTOCALIE, A 1 ML CONC. PT. SOL. PERF. CARE CONTINE 20 MG DOCETAXEL

PR 1 77,91 77,910000 77,910000 98,51 98,510000 98,510000

229 W55045001 L01CD02 DOCETAXELUM** TAXOTERE 80 mg/4ml CONC. PT. SOL. PERF. 80mg/4ml AVENTIS PHARMA SA FRANTA CUTIE X 1 FLACON DIN STICLA X 4 ML

CONC. PT. SOL. PERF. PR 1 1.195,82 1.195,820000 307,296000 1.341,60 1.341,600000 375,144000

230 W57150001 L01CD02 DOCETAXELUM** TAXEGIS 20 mg CONC. SI SOLV. PT. SOL. PERF. 20mg

EGIS PHARMACEUTICALS P.L.C.

UNGARIA

CUTIE CU 1 BLIST. X 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CU 0,5 ML CONC. PT. SOL. PERF.+1 FLAC UNIDOZA CU 1,5 ML SOLV. PT. SOL. PERF

PR 1 148,08 148,080000 77,952000 180,78 180,780000 98,568000

231 W57152001 L01CD02 DOCETAXELUM** TAXEGIS 80 mg CONC. SI SOLV. PT. SOL. PERF. 80mg

EGIS PHARMACEUTICALS P.L.C.

UNGARIACUTIE CU 1 BLIST. X 1 FLAC. UNIDOZA DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CU 2 ML CONC. PT. SO

PR 1 787,78 787,780000 307,296000 896,83 896,830000 375,144000

232 W52365001 L01CX01 TRABECTEDINUM**** YONDELIS 0,25mg PULB. PT.CONC. PT.SOL. PERF. 0,25mg PHARMA MAR S.A. SPANIA CUTIE X 1 FLAC. CU PULB. PT. CONC. PT.

SOL. PERF. S 1 2.068,12 2.068,120000 2.068,120000 2.292,40 2.292,400000 2.292,400000

233 W52366001 L01CX01 TRABECTEDINUM**** YONDELIS 1mg PULB. PT.CONC. PT.SOL. PERF. 1mg PHARMA MAR S.A. SPANIA CUTIE X 1 FLAC. CU PULB. PT. CONC. PT.

SOL. PERF. S 1 7.697,96 7.697,960000 7.697,960000 8.428,94 8.428,940000 8.428,940000

234 W59712001 L01DA01 DACTINOMICINUM4) COSMEGEN LYOVAC 0,5 mg PULB. PT. SOL. INJ. 0,5mg CN UNIFARM S.A. ROMANIA CUTIE X 1 FLACON PULBERE LIOFILIZATA PENTRU SOLUTIE PERFUZABILA PR 1 128,87 128,870000 128,870000 157,32 157,320000 157,320000

235 W60643001 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X

5 ML CONC. PT. SOL. PERF. PR 1 27,42 27,420000 27,420000 35,86 35,860000 35,860000

236 W60643002 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X

10 ML CONC. PT. SOL. PERF. PR 1 66,23 66,230000 66,230000 83,74 83,740000 83,740000

237 W60643003 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X

25 ML CONC. PT. SOL. PERF. PR 1 101,03 101,030000 101,030000 123,34 123,340000 123,340000

238 W56397001 L01DB01 DOXORUBICINUM DOXORUBICINA ACCORD 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACCORD HEALTHCARE

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 5 ML CONC. PT. SOL. PERF. CONTINAND 10 MG DOXORUBICINA

PR 1 28,22 28,220000 28,220000 36,91 36,910000 36,910000

239 W58172001 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. A 5 ML CONC. PT. SOL. PERF. CARE CONTINE 10 MG DOXORUBICINA

PR 1 27,18 27,180000 27,180000 35,55 35,550000 35,550000

240 W57533002 L01DB01 DOXORUBICINUM DOXORUBICINA TEVA 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. CONC. PT. SOL. PERF. X 20 MG CLORHIDRAT DE DOXORUBICINA PR 1 63,03 63,030000 63,030000 79,70 79,700000 79,700000

Pagina 25 din 87

Page 27: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

241 W57533003 L01DB01 DOXORUBICINUM DOXORUBICINA TEVA 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. CONC. PT. SOL. PERF. X 50 MG CLORHIDRAT DE DOXORUBICINA PR 1 89,23 89,230000 89,230000 112,82 112,820000 112,820000

242 W56397002 L01DB01 DOXORUBICINUM DOXORUBICINA ACCORD 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACCORD HEALTHCARE

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 25 ML CONC. PT. SOL. PERF. CONTINAND 50 MG DOXORUBICINA

PR 1 89,23 89,230000 89,230000 112,82 112,820000 112,820000

243 W56397003 L01DB01 DOXORUBICINUM DOXORUBICINA ACCORD 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACCORD HEALTHCARE

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 100 ML CONC. PT. SOL. PERF. CONTINAND 200 MG DOXORUBICINA

PR 1 225,68 225,680000 225,680000 275,51 275,510000 275,510000

244 W58172003 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. A 10 ML CONC. PT. SOL. PERF. CARE CONTINE 20 MG DOXORUBICINA

PR 1 62,33 62,330000 62,330000 78,81 78,810000 78,810000

245 W56501003 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ROMASTRU TRADING

S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 25 ML CONC. PT. SOL. PERF. PR 1 101,03 101,030000 101,030000 123,34 123,340000 123,340000

246 W58172008 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. A 100 ML CONC. PT. SOL. PERF. CARE CONTINE 200 MG DOXORUBICINA

PR 1 269,92 269,920000 269,920000 329,52 329,520000 329,520000

247 W42736001 L01DB01 DOXORUBICINUM DOXORUBICIN "EBEWE" 2mg/ml CONC. PT. SOL. PERF. 2mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON X 5 ML CONC. PT. SOL. PERF. (10 MG DOXORUBICINA) S 1 28,22 28,220000 28,220000 36,91 36,910000 36,910000

248 W58281001 L01DB01 DOXORUBICINUM CAELYX 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml JANSSEN CILAG

INTERNATIONALL NV BELGIA CUTIE X 1 FLACON DIN STICLA X 10 ML S 1 1.445,08 1.445,080000 1.445,080000 1.613,29 1.613,290000 1.613,290000

249 W42736002 L01DB01 DOXORUBICINUM DOXORUBICIN "EBEWE" 2mg/ml CONC. PT. SOL. PERF. 2mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON X 25 ML CONC. PT. SOL. PERF. (50 MG DOXORUBICINA) S 1 110,17 110,170000 107,076000 134,49 134,490000 134,490000

250 W56501001 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ROMASTRU TRADING

S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 5 ML CONC. PT. SOL. PERF. PR 1 27,42 27,420000 27,420000 35,86 35,860000 35,860000

251 W56501002 L01DB01 DOXORUBICINUM DHARUXO 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ROMASTRU TRADING

S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 10 ML CONC. PT. SOL. PERF. PR 1 66,23 66,230000 66,230000 83,74 83,740000 83,740000

252 W58172005 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. A 25 ML CONC. PT. SOL. PERF. CARE CONTINE 50 MG DOXORUBICINA

PR 1 105,66 105,660000 105,660000 128,99 128,990000 128,990000

253 W58172006 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. A 50 ML CONC. PT. SOL. PERF. CARE CONTINE 100 MG DOXORUBICINA

PR 1 208,14 208,140000 208,140000 254,10 254,100000 254,100000

254 W58172007 L01DB01 DOXORUBICINUM DOXORUBICINA ACTAVIS 2 mg/ml CONC. PT. SOL. PERF. 2mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. A 75 ML CONC. PT. SOL. PERF. CARE CONTINE 150 MG DOXORUBICINA

PR 1 261,57 261,570000 261,570000 319,32 319,320000 319,320000

255 W60636001 L01DB01 DOXORUBICINUM MYOCET 50mg

PULB. + AMESTC. PT. CONC. PT.DISP.LIPOZOM.PT.PERF

50mg TEVA PHARMA B.V. OLANDA CUTIE X 2 SETURI X 3 FLAC. (1 FLAC PULB. + 1 FLAC.LIPOZOMI +1 FLAC. SOL.TAMP.) S 2 3.751,62 1.875,810000 1.875,810000 4.127,42 2.063,710000 2.063,710000

256 W52903002 L01DB01 DOXORUBICINUM SINDROXOCIN 2mg/ml PULB. PT. SOL. PERF. 2mg/ml ACTAVIS S.R.L ROMANIA

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML X 50 MG CLORHIDRAT DE DOXORUBICINA

S 1 105,66 105,660000 105,660000 128,99 128,990000 128,990000

257 W52903001 L01DB01 DOXORUBICINUM SINDROXOCIN 2mg/ml PULB. PT. SOL. PERF. 2mg/ml ACTAVIS S.R.L ROMANIA

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 8 ML CONTINAND 10 MG CLORHIDRAT DE DOXORUBICIN

S 1 27,18 27,180000 27,180000 35,55 35,550000 35,550000

258 W41876003 L01DB03 EPIRUBICINUM EPIRUBICIN "EBEWE" 2 mg/ml CONC. PT. SOL. INJ. 2mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 454,46 454,460000 260,400000 533,51 533,510000 317,892000

259 W41876001 L01DB03 EPIRUBICINUM EPIRUBICIN "EBEWE" 2 mg/ml CONC. PT. SOL. INJ. 2mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 48,67 48,670000 45,636000 63,66 63,660000 59,688000

260 W41876002 L01DB03 EPIRUBICINUM EPIRUBICIN "EBEWE" 2 mg/ml CONC. PT. SOL. INJ. 2mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON X 25 ML S 1 231,77 231,770000 231,770000 282,94 282,940000 282,940000

261 W52209001 L01DB03 EPIRUBICINUM EPISINDAN 10 mg LIOF. PT. SOL. INJ. 10mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. CU LIOF. PT. SOL. INJ. S 1 42,74 42,740000 42,740000 55,90 55,900000 55,900000

262 W52208001 L01DB03 EPIRUBICINUM EPISINDAN 50 mg LIOF. PT. SOL. INJ. 50mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. CU LIOF. PT. SOL. INJ. S 1 233,65 233,650000 233,650000 285,24 285,240000 285,240000

263 W60072003 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 25 ML SOL. INJ./PERF. X 50 MG EPIRUBICINA

S 1 198,48 198,480000 198,480000 242,30 242,300000 242,300000

264 W53860001 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 5 ML

SOL. INJ. /PERFZ. S 1 42,50 42,500000 42,500000 55,59 55,590000 55,590000

265 W53860002 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 10 ML

SOL. INJ. /PERFZ. S 1 83,38 83,380000 83,380000 105,42 105,420000 105,420000

266 W53860004 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 75 ML

SOL. INJ. /PERFZ. S 1 588,06 588,060000 588,060000 679,14 679,140000 679,140000

267 W53860005 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 100

ML SOL. INJ. /PERFZ. S 1 773,38 773,380000 476,772000 881,13 881,130000 565,464000

268 W55573003 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml ROMASTRU TRADING SRL ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 25 ML SOL. INJ./PERF. X 50 MG EPIRUBICINA

S 1 198,48 198,480000 198,480000 242,30 242,300000 242,300000

269 W60072002 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 10 ML SOL. INJ./PERF. X 20 MG EPIRUBICINA

S 1 80,83 80,830000 80,830000 102,20 102,200000 102,200000

Pagina 26 din 87

Page 28: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

270 W60072001 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 5 ML SOL. INJ./PERF. X 10 MG EPIRUBICINA

S 1 39,99 39,990000 39,990000 52,31 52,310000 52,310000

271 W53325003 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 25 ML SOL. INJ. X 50MG (50MG/25ML) S 1 197,39 197,390000 197,390000 240,97 240,970000 240,970000

272 W53325004 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 50 ML SOL. INJ. X 100MG (100MG/50ML) S 1 217,00 217,000000 217,000000 264,91 264,910000 264,910000

273 W53325005 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 100ML SOL. INJ. X 200MG (200MG/100ML) S 1 397,31 397,310000 397,310000 471,22 471,220000 471,220000

274 W55573001 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml ROMASTRU TRADING SRL ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 5 ML SOL. INJ./PERF. X 10 MG EPIRUBICINA

S 1 39,99 39,990000 39,990000 52,31 52,310000 52,310000

275 W53325002 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 10 ML SOL. INJ. X 20MG (20MG/10ML) S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

276 W53860003 L01DB03 EPIRUBICINUM EPIRUBICINA TEVA 2 mg/ml SOL. INJ./PERF. 2mg/ml TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA INCOLORA X 25 ML

SOL. INJ. /PERFZ. S 1 204,65 204,650000 204,650000 249,84 249,840000 249,840000

277 W55573002 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml ROMASTRU TRADING SRL ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 10 ML SOL. INJ./PERF. X 20 MG EPIRUBICINA

S 1 80,83 80,830000 80,830000 102,20 102,200000 102,200000

278 W55573004 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml ROMASTRU TRADING SRL ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 50 ML SOL. INJ./PERF. X 100 MG EPIRUBICINA

S 1 450,99 450,990000 260,400000 529,73 529,730000 317,892000

279 W55573005 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml ROMASTRU TRADING SRL ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 10 ML SOL. INJ./PERF. X 200 MG EPIRUBICINA

S 1 771,75 771,750000 476,772000 879,36 879,360000 565,464000

280 W53325001 L01DB03 EPIRUBICINUM EPIRUBICINA ACTAVIS 2mg/ml SOL. INJ./PERF. 2mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. A 5 ML SOL. INJ. X 10MG (10MG/5ML) S 1 38,03 38,030000 38,030000 49,74 49,740000 49,740000

281 W60072004 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 50 ML SOL. INJ./PERF. X 100 MG EPIRUBICINA

S 1 450,99 450,990000 260,400000 529,73 529,730000 317,892000

282 W60072005 L01DB03 EPIRUBICINUM ECCLEPIA 2 mg/ml SOL. INJ./PERF. 2mg/ml NEOLA PHARMA SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU 100 ML SOL. INJ./PERF. X 200 MG EPIRUBICINA

S 1 771,75 771,750000 476,772000 879,36 879,360000 565,464000

283 W03575001 L01DB06 IDARUBICINUM ZAVEDOS CAPS. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 1 CAPS. P-

RF 1 203,33 203,330000 203,330000 248,22 248,220000 248,220000

284 W03581001 L01DB06 IDARUBICINUM ZAVEDOS 5 mg PULB. PT. SOL. INJ. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 143,35 143,350000 143,350000 175,00 175,000000 175,000000

285 W42735002 L01DB07 MITOXANTRONUM** ONKOTRONE CONC. PT. SOL. INJ. 2mg/ml BAXTER ONCOLOGY

GMBH GERMANIA CUTIE X 1 FLACON X 10 ML CONC. PT. SOL. INJ. S 1 555,48 555,480000 555,480000 643,62 643,620000 643,620000

286 W58249002 L01DC01 BLEOMYCINUM SULFAS BLEOMYCIN MEDAC 15000 UI PULB. PT. SOL. INJ. 15000UIMEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML CU PULB. PT. SOL. INJ.

PR 1 105,44 105,440000 105,440000 128,72 128,720000 128,720000

287 W56664002 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 19,75 19,750000 19,750000 26,70 26,700000 26,700000

288 W56664003 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 35,38 35,380000 35,380000 46,28 46,280000 46,280000

289 W56664001 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 20 ML CONC. PT. SOL. PERF. PR 1 11,00 11,000000 11,000000 14,87 14,870000 14,868000

290 W56665003 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 67,91 67,910000 67,910000 85,86 85,860000 85,860000

291 W56665002 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 35,38 35,380000 35,380000 46,28 46,280000 46,280000

292 W01315001 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 10 mg/20 ml CONC. PT. SOL. PERF. 10mg/20ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON X 20 ML CONC. PT. SOL. PERF. S 1 9,17 9,170000 9,170000 12,39 12,390000 12,390000

293 W52187002 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 50 ML X 50 MG CONC.

SOL. PERF. S 1 48,45 48,450000 37,884000 63,37 63,370000 49,560000

294 W52187001 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 10 ML X 10 MG CONC.

SOL. PERF. S 1 18,81 18,810000 11,004000 25,42 25,420000 14,868000

295 W01316001 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 25 mg/50 ml CONC. PT. SOL. PERF. 25mg/50ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML COND. PT. SOL. PERF. S 1 22,06 22,060000 22,060000 29,81 29,810000 29,810000

296 W01317001 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 50 mg/100 ml CONC. PT. SOL. PERF.

50mg/100ml

EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 100 ML CONC. PT.

SOL. PERF. S 1 31,57 31,570000 31,570000 41,30 41,300000 41,300000

297 W53000002 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA

X 15 ML CONC. PT. SOL. PERF. S 1 50,00 50,000000 50,000000 63,22 63,220000 63,220000

298 W58740004 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE GALBENA X 60 ML CONC. PT. SOL. PERF. X 600 MG CARBOPLATINA

PR 1 174,90 174,900000 174,900000 213,52 213,520000 213,520000

299 W13052001 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 15 ML CONC. PT. SOL. PERF. S 1 62,52 62,520000 56,904000 79,05 79,050000 74,436000

300 W52579002 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 15 ML CONC. PT. SOL. PERF. S 1 47,45 47,450000 47,450000 62,06 62,060000 62,060000

Pagina 27 din 87

Page 29: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

301 W52579003 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 45 ML CONC. PT. SOL. PERF. S 1 132,81 132,810000 132,810000 162,14 162,140000 162,140000

302 W53000003 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA

X 45 ML CONC. PT. SOL. PERF. S 1 133,04 133,040000 133,040000 162,41 162,410000 162,410000

303 W13052003 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 45 ML CONC. PT. SOL. PERF. S 1 178,07 178,070000 158,400000 217,39 217,390000 193,380000

304 W13052002 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 5 ML CONC. PT. SOL. PERF. S 1 21,86 21,860000 21,624000 29,55 29,550000 29,220000

305 W53000001 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA

X 5 ML CONC. PT. SOL. PERF. S 1 18,05 18,050000 18,050000 24,39 24,390000 24,390000

306 W58740001 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE VERDE X 5 ML CON. PT. SOL. PERF. X 50 MG CARBOPLATINA

PR 1 18,02 18,020000 18,020000 24,35 24,350000 24,350000

307 W58740002 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ALBASTRA X 15 ML CONC. PT. SOL. PERF. X 150 MG CARBOPLATINA

PR 1 47,42 47,420000 47,420000 62,03 62,030000 62,030000

308 W58740003 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ROSIE X 45 ML CON. PT. SOL. PERF. X 450 MG CARBOPLATINA

PR 1 132,00 132,000000 132,000000 161,15 161,150000 161,150000

309 W57278010 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml CONC. PT. SOL. PERF. 5 mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU INVELIS DE PROTECTIE (ONCO-SAFE) X 40 ML CONC. PT. SOL. PERF

PR 1 1.396,48 1.396,480000 143,700000 1.560,32 1.560,320000 175,428000

310 W57278002 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml CONC. PT. SOL. PERF. 5 mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU INVELIS DE PROTECTIE (ONCO-SAFE) X 10 ML CONC. PT. SOL. PERF

PR 1 264,15 264,150000 37,236000 322,48 322,480000 48,708000

311 W57278008 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml CONC. PT. SOL. PERF. 5 mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU INVELIS DE PROTECTIE (ONCO-SAFE) X 20 ML CONC. PT. SOL. PERF

PR 1 523,31 523,310000 73,152000 608,56 608,560000 92,496000

312 W57175003 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. DIN STICLA INCOLORA A 40 ML CONC. PT. SOL. PERF. CARE CONTINE 200 MG OXALIPLATINA

PR 1 1.396,51 1.396,510000 143,700000 1.560,35 1.560,350000 175,428000

313 W55804002 L01XA03 OXALIPLATINUM OXALIPLATIN ACCORD 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACCORD HEALTHCARE

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 20 ML CONC. PT. SOL. PERF. X 100 MG OXALIPLATINA

S 1 615,78 615,780000 73,152000 709,35 709,350000 92,496000

314 W56696001 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC A 10 ML CONC. PT. SOL. PERF. CONTINAND 50 MG OXALIPLATINA

PR 1 31,03 31,030000 31,030000 40,59 40,590000 40,590000

315 W56696002 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC A 20 ML CONC. PT. SOL. PERF. CONTINAND 100 MG OXALIPLATINA

PR 1 60,96 60,960000 60,960000 77,08 77,080000 77,080000

316 W57175002 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. DIN STICLA INCOLORA A 20 ML CONC. PT. SOL. PERF. CARE CONTINE 100 MG OXALIPLATINA

PR 1 615,78 615,780000 73,152000 709,35 709,350000 92,496000

317 W54318002 L01XA03 OXALIPLATINUM OXALIPLATINA TEVA 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML CONC. PT. SOL. PERF. PR 1 165,76 165,760000 37,236000 202,36 202,360000 48,708000

318 W54318003 L01XA03 OXALIPLATINUM OXALIPLATINA TEVA 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 20 ML CONC. PT. SOL. PERF. PR 1 331,41 331,410000 73,152000 399,39 399,390000 92,496000

319 W42983001 L01XA03 OXALIPLATINUM ELOXATIN 5mg/ml CONC. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS

FRANCE FRANTA CUTIE X 1 FLACON X 50 MG/10 ML CONC. PT. SOL. PERF. S 1 255,01 255,010000 37,236000 311,32 311,320000 48,708000

320 W56696005 L01XA03 OXALIPLATINUM OXALIPLATIN KABI 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU FOLIE PROTECTOARE DIN PLASTIC A 40 ML CONC. PT. SOL. PERF. CONTINAND 200 MG OXALIPLATINA

PR 1 119,75 119,750000 119,750000 146,19 146,190000 146,190000

321 W42983003 L01XA03 OXALIPLATINUM ELOXATIN 5mg/ml CONC. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS

FRANCE FRANTA CUTIE X 1 FLACON X 200 MG/40 ML CONC. PT. SOL. PERF. S 1 957,36 957,360000 143,700000 1.081,67 1.081,670000 175,428000

322 W57175001 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CONC. PT. SOL. PERF. CARE CONTINE 50 MG OXALIPLATINA

PR 1 322,26 322,260000 37,236000 389,41 389,410000 48,708000

323 W60404003 L01XA03 OXALIPLATINUM OXALIPLATIN HAEMATO 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml HAEMATO PHARM AG GERMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA DE CAPACITATE DE 40 ML X 200 MG OXALIPLATINA

PR 1 632,78 632,780000 143,700000 727,88 727,880000 175,428000

Pagina 28 din 87

Page 30: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

324 W42983002 L01XA03 OXALIPLATINUM ELOXATIN 5mg/ml CONC. PT. SOL. PERF. 5mg/ml SANOFI-AVENTIS

FRANCE FRANTA CUTIE X 1 FLACON X 100 MG/20 ML CONC. PT. SOL. PERF. S 1 493,70 493,700000 73,152000 576,28 576,280000 92,496000

325 W55804001 L01XA03 OXALIPLATINUM OXALIPLATIN ACCORD 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ACCORD HEALTHCARE

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA A 10 ML CONC. PT. SOL. PERF. X 50 MG OXALIPLATINA

S 1 322,25 322,250000 37,236000 389,40 389,400000 48,708000

326 W60404001 L01XA03 OXALIPLATINUM OXALIPLATIN HAEMATO 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml HAEMATO PHARM AG GERMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA DE CAPACITATE DE 10 ML X 50 MG OXALIPLATINA

PR 1 165,76 165,760000 37,236000 202,36 202,360000 48,708000

327 W60404002 L01XA03 OXALIPLATINUM OXALIPLATIN HAEMATO 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml HAEMATO PHARM AG GERMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA DE CAPACITATE DE 20 ML X 100 MG OXALIPLATINA

PR 1 331,41 331,410000 73,152000 399,39 399,390000 92,496000

328 W52195002 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml LIOF. PT. SOL. PERF. 5mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 100 MG LIOF. PT. SOL.

PERF. S 1 615,78 615,780000 73,152000 709,35 709,350000 92,496000

329 W52195001 L01XA03 OXALIPLATINUM OXALIPLATIN ACTAVIS 5 mg/ml LIOF. PT. SOL. PERF. 5mg/ml ACTAVIS S.R.L. ROMANIA CUTIE 1 FLAC. X 50 MG LIOF. PT. SOL.

PERF. S 1 322,26 322,260000 37,236000 389,41 389,410000 48,708000

330 W52468002 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml PULB. PT. SOL. PERF. 5mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE X 1 FLAC. DIN STICLA INCOLORA CU SUPORT TRANSPARENT DIN PLASTIC (ONKO-SAFE) X 100 MG OXALIPLAT

PR 1 871,57 871,570000 73,152000 988,16 988,160000 92,496000

331 W52977002 L01XA03 OXALIPLATINUM OXALIPLATIN STADA 5 mg/ml PULB. PT. SOL. PERF. 5mg/ml STADA ARZNEIMITTEL

AG GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 100 MG OXALIPLATINA PR 1 302,25 302,250000 73,152000 367,60 367,600000 92,496000

332 W52468001 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml PULB. PT. SOL. PERF. 5mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE X 1 FLAC. DIN STICLA INCOLORA CU SUPORT TRANSPARENT DIN PLASTIC (ONKO-SAFE) X 50 MG OXALIPLATI

PR 1 457,29 457,290000 37,236000 536,60 536,600000 48,708000

333 W54761001 L01XA03 OXALIPLATINUM REZIDOL 5 mg/ml PULB. PT. SOL. PERF. 5mg/ml

EGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 MG OXALIPLATINA S 1 165,75 165,750000 37,236000 202,35 202,350000 48,708000

334 W54761002 L01XA03 OXALIPLATINUM REZIDOL 5 mg/ml PULB. PT. SOL. PERF. 5mg/ml

EGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 MG OXALIPLATINA S 1 331,40 331,400000 73,152000 399,38 399,380000 92,496000

335 W52977001 L01XA03 OXALIPLATINUM OXALIPLATIN STADA 5 mg/ml PULB. PT. SOL. PERF. 5mg/ml STADA ARZNEIMITTEL

AG GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50 MG OXALIPLATINA PR 1 144,33 144,330000 37,236000 176,20 176,200000 48,708000

336 W52468003 L01XA03 OXALIPLATINUM OXALIPLATIN EBEWE 5mg/ml PULB. PT. SOL. PERF. 5mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIACUTIE X 1 FLAC. DIN STICLA INCOLORA CU SUPORT TRANSPARENT DIN PLASTIC (ONKO-SAFE) X 150 MG OXALIPLAT

PR 1 1.609,04 1.609,040000 1.609,040000 1.792,01 1.792,010000 1.792,010000

337 W59766001 L01XB01 PROCARBAZINUM4) NATULAN CAPS. 50 mg CN UNIFARM S.A. ROMANIA CUTIE X 50CAPSULE PRF 50 669,00 13,380000 13,380000 767,36 15,347200 15,347200

338 W07199001 L01XC02 RITUXIMABUM**** MABTHERA 100 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION

LTD.MAREA BRITANIE CUTIE X 2 FLACOANE X 10 ML S 2 2.221,55 1.110,775000 1.110,775000 2.459,64 1.229,820000 1.229,820000

339 W07200001 L01XC02 RITUXIMABUM**** MABTHERA 500 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION

LTD.MAREA BRITANIE

CUTIE X 1 FLACON X 50 ML(500MG RITUXIMAB IN 50ML- 10MG/ML) S 1 5.509,03 5.509,030000 5.509,030000 6.043,00 6.043,000000 6.043,000000

340 W07881001 L01XC03 TRASTUZUMABUM**** HERCEPTIN 150mg PULB. PT. CONC. PT. SOL. PERF. 150mg ROCHE REGISTRATION

LTD.MAREA BRITANIE

CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. PR 1 2.621,74 2.621,740000 2.621,740000 2.895,85 2.895,850000 2.895,850000

341 W60341001 L01XC03 TRASTUZUMABUM**** HERCEPTIN 600mg/5ml SOL. INJ. 600mg/5ml ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE CU UN FLACON DE 6 ML DIN STICLA TRANSPARENTA CU DOP CONTINAND 5ML SOLUTIE (600 MG TRASTUZUMAB)

S 1 8.534,12 8.534,120000 8.534,120000 9.340,35 9.340,350000 9.340,350000

342 W52549002 L01XC06 CETUXIMABUM**** ERBITUX 5mg/ml SOL. PERF. 5mg/ml MERCK KGAA GERMANIA CUTIE X 1 FLAC. DIN STICLA X 20 ML SOL. PERF. S 1 871,19 871,190000 871,190000 987,75 987,750000 987,750000

343 W42165001 L01XC07 BEVACIZUMABUM**** AVASTIN 25mg/ml CONC. PT. SOL. PERF. 25mg/ml ROCHE REGISTRATION

LTD.MAREA BRITANIE

CUTIE X 1 FLAC. DIN STICLA X 4 ML CONC. PT. SOL. PERF. S 1 1.332,54 1.332,540000 1.332,540000 1.490,62 1.490,620000 1.490,620000

344 W42165002 L01XC07 BEVACIZUMABUM**** AVASTIN 25mg/ml CONC. PT. SOL. PERF. 25mg/ml ROCHE REGISTRATION

LTD.MAREA BRITANIE

CUTIE X 1 FLAC. DIN STICLA X 16 ML CONC.PT. SOL. PERF. S 1 5.246,58 5.246,580000 5.246,580000 5.756,93 5.756,930000 5.756,930000

345 W57375001 L01XC10 OFATUMUMAB**** ARZERRA 1000mg CONC. PT. SOL. PERF. 20mg/ml GLAXO GROUP LTD. MAREA

BRITANIE

CUTIE CU 1 FLACON DIN STICLA X 50 ML CONCENTRAT PT. SOL. PERF. (1000MG OFATUMUMAB)+2 SETURI DE EXTEN

S 1 8.805,58 8.805,580000 8.805,580000 9.636,25 9.636,250000 9.636,250000

346 W59881004 L01XE01 IMATINIBUM**** EGITINID 100 mg CAPS. 100mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU BLIST. PA-AL-PVC/AL X 120 CAPS. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

347 W59827004 L01XE01 IMATINIBUM**** IMATINIB ACTAVIS 100 mg CAPS. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTER DIN AL/PVC/ACLAR X

120 CAPSULE PR 120 5.269,99 43,916583 43,916583 5.782,45 48,187083 48,187083

348 W06844004 L01XE01 IMATINIBUM**** GLIVEC 100 mg CAPS. 100mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE CUTIE X 120 CAPS. PR 120 8.091,78 67,431500 52,699900 8.858,20 73,818333 57,824500

349 W59679004 L01XE01 IMATINIBUM**** NIBIX 100 mg CAPS. 100mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 120 CAPS. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

350 W59589001 L01XE01 IMATINIBUM**** IMATINIB TEVA 100 mg COMPR. FILM. 100mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. OPA/AL/PVC/AL A CATE 120 X 1 COMPRIMAT PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

351 W59937006 L01XE01 IMATINIBUM**** NEOXELL 100 mg COMPR. FILM. 100mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120

COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

352 W59541007 L01XE01 IMATINIBUM**** IMATINIB GLENMARK 100 mg COMPR. FILM. 100mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

353 W59852005 L01XE01 IMATINIBUM**** MEAXIN 100 mg COMPR. FILM. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 120

COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

354 W59852011 L01XE01 IMATINIBUM**** MEAXIN 100 mg COMPR. FILM. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120

COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

355 W61215006 L01XE01 IMATINIBUM**** NEOXELL 100 mg COMPR. FILM. 100mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

356 W59486006 L01XE01 IMATINIBUM**** IMAKREBIN 100 mg COMPR. FILM. 100mg ALVOGEN IPCO S.AR.L. LUXEMBURG

CUTIE CU BLIST. PVC-PE-PVDC/AL X 120 COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

357 W59500004 L01XE01 IMATINIBUM**** IMATINIB ZENTIVA 100 mg COMPR. FILM. 100mg ZENTIVA, K.S. REPUBLICA CEHA

CUTIE CU 12 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PR 120 5.270,15 43,917916 43,917916 5.782,62 48,188500 48,188500

Pagina 29 din 87

Page 31: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

358 W59590001 L01XE01 IMATINIBUM**** IMATINIB TEVA 400 mg COMPR. FILM. 400 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. OPA/AL/PVC/AL A CATE 30 X 1 COMPRIMAT PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

359 W59936003 L01XE01 IMATINIBUM**** NEOXELL 400 mg COMPR. FILM. 400mg ROMASTRU TRADING SRL ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30

COMPR. FILM. PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

360 W59487003 L01XE01 IMATINIBUM**** IMAKREBIN 400 mg COMPR. FILM. 400mg ALVOGEN IPCO S.AR.L. LUXEMBURG

CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

361 W59542002 L01XE01 IMATINIBUM**** IMATINIB GLENMARK 400 mg COMPR. FILM. 400mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

362 W59853002 L01XE01 IMATINIBUM**** MEAXIN 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30

COMPR. FILM. PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

363 W59853006 L01XE01 IMATINIBUM**** MEAXIN 400 mg COMPR. FILM. 400mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30

COMPR. FILM. PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

364 W61216006 L01XE01 IMATINIBUM**** NEOXELL 400 mg COMPR. FILM. 400mg NEOLA PHARMA SRL ROMANIA CUTIE X BLISTERE PVC-PE-PVDC/AL X 30 COMPRIMATE FILMATE PR 30 5.270,15 175,671666 175,671666 5.782,62 192,754000 192,754000

365 W42501001 L01XE03 ERLOTINIBUM**** TARCEVA 100 mg COMPR. FILM. 100mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 30 COMPR. FILM., (BLIST. AL/PVC)

P-RF/R

30 6.304,73 210,157666 210,157666 6.910,31 230,343666 230,343666

366 W42502001 L01XE03 ERLOTINIBUM**** TARCEVA 150 mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 30 COMPR. FILM. (BLIST. AL/PVC)

P-RF/R

30 8.391,10 279,703333 279,703333 9.184,46 306,148666 306,148666

367 W43546001 L01XE04 SUNITINIBUM**** SUTENT 12,5 mg CAPS. 12,5mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 CAPS.

P-RF/R

30 4.552,93 151,764333 151,764333 5.000,85 166,695000 166,695000

368 W43556001 L01XE04 SUNITINIBUM**** SUTENT 25mg CAPS. 25mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 CAPS.

P-RF/R

30 9.072,02 302,400666 302,400666 9.926,67 330,889000 330,889000

369 W43557001 L01XE04 SUNITINIBUM**** SUTENT 50 mg CAPS. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 1 FLACON DIN PEID X 30 CAPS.

P-RF/R

30 18.082,13 602,737666 602,737666 19.747,70 658,256666 658,256666

370 W54280001 L01XE05 SORAFENIBUM**** NEXAVAR 200 mg COMPR. FILM. 200mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 4 BLIST. AL/PP X 28 COMPR.FILM.

P-RF/R

112 14.588,00 130,250000 130,250000 15.939,09 142,313303 142,313303

371 W54613001 L01XE06 DASATINIBUM**** SPRYCEL 100mg COMPR. FILM. 100 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE

CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM.

P-RF/R

30 16.311,93 543,731000 543,731000 17.818,18 593,939333 593,939333

372 W51768001 L01XE06 DASATINIBUM**** SPRYCEL 20mg COMPR. FILM. 20 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE

CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM.

P-RF/R

60 7.697,81 128,296833 128,296833 8.428,77 140,479500 140,479500

373 W51769001 L01XE06 DASATINIBUM**** SPRYCEL 50mg COMPR. FILM. 50 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE

CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM.

P-RF/R

60 15.365,65 256,094166 256,094166 16.786,73 279,778833 279,778833

374 W51770001 L01XE06 DASATINIBUM**** SPRYCEL 70mg COMPR. FILM. 70 mg BRISTOL-MYERS SQUIBB MAREA BRITANIE

CUTIE X 1 FLAC. DIN PEID X 60 COMPR. FILM.

P-RF/R

60 15.365,65 256,094166 256,094166 16.786,73 279,778833 279,778833

375 W56489002 L01XE08 NILOTINIBUM**** TASIGNA CAPS. 150mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE 4 CUTII X 28 CAPS.(BLIST. PVC/PVDC/AL)

P-RF/R

112 11.165,63 99,693125 99,693125 12.208,70 109,006250 109,006250

376 W56489001 L01XE08 NILOTINIBUM**** TASIGNA CAPS. 150mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE CUTIE X 28 CAPS.(BLIST. PVC/PVDC/AL)

P-RF/R

28 2.813,91 100,496785 100,496785 3.105,32 110,904285 110,904285

377 W52708003 L01XE08 NILOTINIBUM**** TASIGNA CAPS. 200mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE CUTIE X 28 CAPS.(BLIST. PVC/PVDC/AL) PR 28 3.828,97 136,748928 136,748928 4.211,73 150,418928 150,418928

378 W52708002 L01XE08 NILOTINIBUM**** TASIGNA CAPS. 200mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE 4 CUTII X 28 CAPS.(BLIST. PVC/PVDC/AL) PR 112 15.225,88 135,945357 135,945357 16.634,38 148,521250 148,521250

379 W52721001 L01XE09 TEMSIROLIMUSUM TORISEL 25mg/ml CONC. + SOLV. PT. SOL. PERF. 25mg/ml WYETH EUROPA

LIMITEDMAREA BRITANIE

CUTIE X 1 FLAC. X 1,2ML CONCENTRAT + 1 FLAC. X 1,8 SOLVENT S 1 3.737,17 3.737,170000 3.737,170000 4.111,67 4.111,670000 4.111,670000

380 W59310001 L01XE18 RUXOLITINIBUM**** JAKAVI COMPR. 15 mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

FLACON DIN PEÎD, CU GARNITURA ETANSA SI SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, CONTINÂND 60

PR 60 17.353,45 289,224166 289,224166 18.953,43 315,890500 315,890500

381 W59311001 L01XE18 RUXOLITINIBUM**** JAKAVI COMPR. 20 mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

FLACON DIN PEÎD, CU GARNITURA ETANSA SI SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, CONTINÂND 60

PR 60 17.353,45 289,224166 289,224166 18.953,43 315,890500 315,890500

382 W59309001 L01XE18 RUXOLITINIBUM**** JAKAVI COMPR. 5 mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

FLACON DIN PEÎD, CU GARNITURA ETANSA SI SISTEM DE ÎNCHIDERE SECURIZAT PENTRU COPII, CONTINÂND 60

PR 60 8.622,14 143,702333 143,702333 9.436,29 157,271500 157,271500

383 W10506001 L01XX02 ASPARAGINAZUM ASPARAGINASE 10000 MEDAC LIOF. PT. SOL. INJ./PERF. 10000ui

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIA CUTIE X 1 FLAC. DIN STICLA X 10 000 UI LIOF. PT. SOL. INJ./PERF. S 1 314,90 314,900000 314,900000 381,39 381,390000 381,390000

384 W10508001 L01XX02 ASPARAGINAZUM ASPARAGINASE 5000 MEDAC LIOF. PT. SOL. INJ./PERF. 5000ui

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIA CUTIE X 1 FLAC. DIN STICLA X 5000 UI LIOF.PT. SOL. INJ./PERF. S 1 262,42 262,420000 262,420000 320,36 320,360000 320,360000

385 W03542001 L01XX05 HYDROXYCARBAMIDUM HYDREA CAPS. 500mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100

CAPS.P-RF 100 65,72 0,657200 0,657200 83,10 0,831000 0,831000

386 W54018001 L01XX14 TRETINOINUM4) VESANOID 10 mg CAPS. MOI 10mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 100 CAPS. MOI PRF 100 625,29 6,252900 6,252900 719,72 7,197200 7,197200

387 W53177001 L01XX17 TOPOTECAMUM HYCAMTIN 1 mg CAPS. 1mg SMITHKLINE BEECHAM PLC

MAREA BRITANIE CUTIE X BLIST. PVC/PCTFE/AL X 10 CAPS. P-

RF 10 1.582,86 158,286000 158,286000 1.763,47 176,347000 176,347000

388 W54750001 L01XX17 TOPOTECAMUM TOPOTECAN TEVA 1 mg/1ml CONC. PT. SOL. PERF. 1mg/1ml TEVA PHARMA B.V. OLANDA CUTIE X 1 FLACON DIN STICLA

TRANSPARENTA A 1ML

P-RF/R

1 170,26 170,260000 170,260000 207,85 207,850000 207,850000

Pagina 30 din 87

Page 32: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

389 W56261007 L01XX17 TOPOTECAMUM TOPOTECAN EBEWE 1 mg/ml CONC. PT. SOL. PERF. 1mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 4 ML CONC. PT. SOL. PERF. PR 1 649,10 649,100000 649,100000 745,67 745,670000 745,670000

390 W54751001 L01XX17 TOPOTECAMUM TOPOTECAN TEVA 4 mg/4ml CONC. PT. SOL. PERF. 4mg/4ml TEVA PHARMA B.V. OLANDA CUTIE X 1 FLACON DIN STICLA

TRANSPARENTA A 4ML

P-RF/R

1 649,09 649,090000 649,090000 745,66 745,660000 745,660000

391 W57231001 L01XX17 TOPOTECAMUM TOPOTECAN ATB 1 mg PULB. PT. CONC. PT. SOL. PERF. 1mg ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML X 1 MG TOPOTECAN

PR 1 170,26 170,260000 170,260000 207,85 207,850000 207,850000

392 W55110001 L01XX17 TOPOTECAMUM TOPOTECAN ACCORD 4 mg PULB. PT. CONC. PT. SOL. PERF. 4mg ACCORD HEALTHCARE

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. CONC. PT. SOL. PERF. S 1 647,70 647,700000 647,700000 744,14 744,140000 744,140000

393 W57232001 L01XX17 TOPOTECAMUM TOPOTECAN ATB 4 mg PULB. PT. CONC. PT. SOL. PERF. 4mg ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML X 4 MG TOPOTECAN

PR 1 649,09 649,090000 649,090000 745,66 745,660000 745,660000

394 W56744001 L01XX17 TOPOTECAMUM POTACTASOL 4mg PULB. PT. CONC. PT. SOL. PERF. 4mg ACTAVIS GROUP PTC

EHF. ISLANDACUTIE CU 1FL DIN STICLA X 4 MG PULBERE PENTRU CONCENTRAT PENTRU SOLU_IE PERFUZABILA

PR 1 649,10 649,100000 649,100000 745,67 745,670000 745,670000

395 W05958002 L01XX17 TOPOTECAMUM HYCAMTIN 4 mg PULB.CONC.SOL.PERF. 4mg SMITHKLINE BEECHAM

PLCMAREA BRITANIE

CUTIE X 1 FLAC. PULB. PT. CONC. PT. SOL. PERF. S 1 982,46 982,460000 777,240000 1.109,03 1.109,030000 892,968000

396 W52206001 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 2 ML

CONC. PT. SOL. INJ. S 1 163,74 163,740000 163,740000 199,89 199,890000 199,890000

397 W52802003 L01XX19 IRINOTECANUM CAMPTO CONC. PT. SOL. PERF. 20mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIECUTIE X 1 FLAC. DIN PP X 5 ML CONC. PT. SOL. PERF. S 1 639,39 639,390000 196,188000 735,09 735,090000 239,508000

398 W52802004 L01XX19 IRINOTECANUM CAMPTO CONC. PT. SOL. PERF. 20mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIECUTIE X 1 FLAC. DIN PP X 15 ML CONC. PT. SOL. PERF. S 1 2.129,33 2.129,330000 1.554,888000 2.359,12 2.359,120000 1.740,612000

399 W57602002 L01XX19 IRINOTECANUM LUDIRADOL 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml

EGIS PHARMACEUTICALS P.L.C.

UNGARIACUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 6 ML X 100 MG IRINOTECAN

PR 1 355,85 355,850000 196,188000 426,03 426,030000 239,508000

400 W52206004 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 15

ML CONC. PT. SOL.PERF. S 1 1.295,74 1.295,740000 1.295,740000 1.450,51 1.450,510000 1.450,510000

401 W54336001 L01XX19 IRINOTECANUM IRINOTECAN MEDAC 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA BRUNA X 2 ML CONC. PR. SOL. PERF. S 1 167,11 167,110000 167,110000 204,01 204,010000 204,010000

402 W54336002 L01XX19 IRINOTECANUM IRINOTECAN MEDAC 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA BRUNA X 5 ML CONC. PR. SOL. PERF. S 1 426,18 426,180000 196,188000 502,69 502,690000 239,508000

403 W54336003 L01XX19 IRINOTECANUM IRINOTECAN MEDAC 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA BRUNA X 15 ML CONC. PR. SOL. PERF. S 1 1.394,57 1.394,570000 1.394,570000 1.558,23 1.558,230000 1.558,230000

404 W55816021 L01XX19 IRINOTECANUM IRINOTECAN EBEWE 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA

CUTIE X 1 FLACON DIN STICLA BRUNA, CU DOP CAUCIUC FARA PLASTIC DE PROTECTIE TIP ONCO-SAFE A 15ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA CARE CONTINE 300MG CLORHIDRAT DE IRINOTECAN TRIHIDRAT

S 1 1.345,75 1.345,750000 1.345,750000 1.505,02 1.505,020000 1.505,020000

405 W54854002 L01XX19 IRINOTECANUM IRINOTECAN STADA 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml STADA ARZNEIMITTEL

AG GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA A 5 ML CONC. PT. SOL. PERF. X 100 MG S 1 163,49 163,490000 163,490000 199,59 199,590000 199,590000

406 W55816015 L01XX19 IRINOTECANUM IRINOTECAN EBEWE 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA

CUTIE X 1 FLACON DIN STICLA BRUNA, CU DOP DIN CAUCIUC FARA PLASTIC DE PROTECTIE TIP "ONCO-SAFE", A 5ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA CARE CONTINE 100MG CLORHIDRAT DE IRINOTECAN TRIHIDRAT

S 1 416,85 416,850000 196,188000 492,52 492,520000 239,508000

407 W52206003 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 25

ML CONC. PT. SOL. INJ. S 1 2.010,90 2.010,900000 2.010,900000 2.230,03 2.230,030000 2.230,030000

408 W53956001 L01XX19 IRINOTECANUM IRINOTECAN HOSPIRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml HOSPIRA UK LIMITED MAREA

BRITANIECUTIE X 1 FLAC. STICLA BRUNA X 2 ML CONC. PT. SOL. PERF. S 1 152,48 152,480000 152,480000 186,15 186,150000 186,150000

409 W52206002 L01XX19 IRINOTECANUM IRINOTESIN 20mg/ml CONC. PT. SOL. PERF. 20mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 5 ML

CONC. PT. SOL. INJ. S 1 402,16 402,160000 196,188000 476,50 476,500000 239,508000

410 W53956003 L01XX19 IRINOTECANUM IRINOTECAN HOSPIRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml HOSPIRA UK LIMITED MAREA

BRITANIECUTIE X 1 FLAC. STICLA BRUNA X 25 ML CONC. PT. SOL. PERF. S 1 1.753,18 1.753,180000 1.753,180000 1.949,12 1.949,120000 1.949,120000

411 W53956002 L01XX19 IRINOTECANUM IRINOTECAN HOSPIRA 20mg/ml CONC. PT. SOL. PERF. 20mg/ml HOSPIRA UK LIMITED MAREA

BRITANIECUTIE X 1 FLAC. STICLA BRUNA X 5 ML CONC. PT. SOL. PERF. S 1 374,64 374,640000 196,188000 446,51 446,510000 239,508000

412 W58369002 L01XX19 IRINOTECANUM IRINOTECAN ATB 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA BRUNA CU CAPACITATEA DE 5 ML X 5 ML CONC. PT. SOL. PERF. INCHIS CU DOP D

PR 1 426,10 426,100000 196,188000 502,60 502,600000 239,508000

413 W51535001 L01XX23 MITOTANUM LYSODREN 500mg COMPR. 500mg LABORATOIRE HRA PHARMA FRANTA CUTIE X 1 FLAC. DIN PEID X 100 COMPR.

P-RF/R

100 2.567,46 25,674600 25,674600 2.836,68 28,366800 28,366800

414 W42249001 L01XX32 BORTEZOMIBUM**** VELCADE 3,5 mg PULB. PT. SOL. INJ. 3,5mg JANSSEN-CILAG INTERNATIONAL NV BELGIA

CUTIE X 1 FLAC. X 10ML X 3,5 MG PULB. PT. SOL. INJ., INTRODUS INTR-UN BLISTER TRANSPARENT

P-RF/R

1 4.587,17 4.587,170000 4.587,170000 5.038,17 5.038,170000 5.038,170000

415 W52184001 L02AB01 MEGESTROLUM MEGESIN 160 mg COMPR. 160mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.

P-RF 30 97,75 3,258333 3,258333 123,59 4,119666 4,119666

416 W07196002 L02AE02 LEUPRORELINUM** LUCRIN DEPOT 11,25mgLIOF.+ SOLV. PT. SUSP. INJ. ELIB. PREL.

11,25mg ABBOTT LABORATORIES LTD. SPANIA

CUTIE X 1 KIT X 1 FLAC. CU LIOFILIZAT (MICROSFERE) + 1 FIOLA X 2 ML SOLV. + 1 SERINGA + 2 ACE SI TA

S/P-RF 1 525,01 525,010000 525,010000 610,41 610,410000 610,410000

417 W07197002 L02AE02 LEUPRORELINUM** LUCRIN DEPOT 3,75mgLIOF.+ SOLV. PT. SUSP. INJ. ELIB. PREL.

3,75mg ABBOTT LABORATORIES LTD. SPANIA

CUTIE X 1 KIT X 1 FLAC. CU LIOFILIZAT (MICROSFERE) + 1 FIOLA X 2 ML SOLV. + 1 SERINGA SI TAMPON IMB

S/P-RF 1 194,95 194,950000 194,950000 237,99 237,990000 237,990000

Pagina 31 din 87

Page 33: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

418 W43179004 L02AE02 LEUPRORELINUM** ELIGARD 22,5 mg PULB+SOLV.PT.SOL.INJ 22,5mg ASTELLAS PHARMA

EUROPE BV OLANDACUTIE X 1 SET X 2 SERINGI DIN PP PREUMPLUTE (O SERINGA A SI O SERINGA B), IN TAVI TERMOFORMATE

S 1 736,20 736,200000 736,200000 840,61 840,610000 840,610000

419 W52321002 L02AE02 LEUPRORELINUM** ELIGARD 45 mg PULB+SOLV.PT.SOL.INJ 45mg ASTELLAS PHARMA

EUROPE BV OLANDA

O CUTIE X 1 SET X 2 TAVITE TERMOFORMATE CE CONTIN 2 SERINGI PREUMPLUTE (O SERINGA A SI O SERINGA B)

S 1 2.030,80 2.030,800000 2.030,800000 2.251,73 2.251,730000 2.251,730000

420 W43178003 L02AE02 LEUPRORELINUM** ELIGARD 7,5 mg PULB+SOLV.PT.SOL.INJ 7,5mg ASTELLAS PHARMA

EUROPE BV OLANDACUTIE X 1 SET X 2 SERINGI DIN PP PREUMPLUTE (O SERINGA A SI O SERINGA B), IN TAVI TERMOFORMATE

S 1 257,84 257,840000 257,840000 314,77 314,770000 314,770000

421 W60959002 L02AE02 LEUPRORELINUM** LUCRIN DEPOT 11,25mg PULB. PT. SUSP. INJ. CU ELIB. PREL. 11,25mg ABBVIE FARMACEUTICA

S.L.U. SPANIA

CUTIE CU1 KIT CU 1 FLAC. DIN STICLA INCOLORA,O FIOLA DIN STICLA INCOLORA CU PUNCT DE RUPERE A 2 ML SOLV,O SERINGA STERILA,APIROGENA DE UNICA FOLOSINTA A 2,5 ML,2 ACE(23G 1½)STERILE,DE UNICA FOLOSINTA SI 1 TAMPON IMBIBAT CU ALCOOL IZOPROPILIC70%.

PR/PRF

1 525,01 525,010000 525,010000 610,41 610,410000 610,410000

422 W60960002 L02AE02 LEUPRORELINUM** LUCRIN DEPOT 3,75mg PULB. PT. SUSP. INJ. CU ELIB. PREL. 3,75mg ABBVIE FARMACEUTICA

S.L.U. SPANIA

CUTIE CU1 KIT CU 1 FLAC. DIN STICLA INCOLORA,O FIOLA DIN STICLA INCOLORA CU PUNCT DE RUPERE A 2 ML SOLV,O SERINGA STERILA,APIROGENA DE UNICA FOLOSINTA A 2,5 ML,2 ACE(22G 1½)STERILE,DE UNICA FOLOSINTA SI 1 TAMPON IMBIBAT CU ALCOOL IZOPROPILIC70%.

PR/PRF

1 194,95 194,950000 194,950000 237,99 237,990000 237,990000

423 W10731001 L02AE03 GOSERELINUM** ZOLADEX LA 10,8 mg IMPLANT 10,8 mg ASTRAZENECA UK LTD. MAREA BRITANIE

CUTIE X 1 PLIC DIN PET-AL-PE X 1 SERINGA PREUMPLUTA CU 10,8 MG IMPLANT+AC DIN INOX CU SIST. DE PROT

S 1 1.040,75 1.040,750000 1.040,750000 1.172,57 1.172,570000 1.172,570000

424 W10173001 L02AE03 GOSERELINUM** ZOLADEX (R) IMPLANT 3,6mg ASTRAZENECA UK LTD. MAREA BRITANIE

CUTIE X 1 PLIC X 1 SERINGA PRE-UMPLUTA X 3,6 MG

S/P-RF 1 365,48 365,480000 365,480000 436,52 436,520000 436,520000

425 W55725001 L02AE04 TRIPTORELINUM** DIPHERELINE 0,1 mg LIOF. + SOLV. PT. SOL. INJ. 0,1mg IPSEN PHARMA FRANTA CUTIE X 7 FLAC. CU LIOF. PT. SOL. INJ. + 7

FIOLE X 1 ML SOLV.S/P-RF 7 110,27 15,752857 15,752857 134,62 19,231428 19,231428

426 W55726001 L02AE04 TRIPTORELINUM** DIPHERELINE PR 11,25 mgPULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

11,25mg IPSEN PHARMA FRANTA

CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU 1 SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE

S/P-RF 1 1.051,98 1.051,980000 1.051,980000 1.184,81 1.184,810000 1.184,810000

427 W55727001 L02AE04 TRIPTORELINUM** DIPHERELINE 3,75 mgPULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

3,75mg IPSEN PHARMA FRANTA

CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA X 2 ML SOLV. + 1 BLIST. CU O SERINGA X 3 ML + 1 BLIST. CU 2 ACE STERILE

S/P-RF 1 369,20 369,200000 369,200000 440,58 440,580000 440,580000

428 W58059002 L02AE04 TRIPTORELINUM** GONAPEPTYL ZILNIC 0,1 mg/ml SOL. INJ. 0,1mg/ml FERRING GMBH GERMANIA CUTIE X 28 SERINGI PREUMPLUTE DIN STICLA INCOLORA X 1 ML SOL. INJ

S/P-RF 28 543,42 19,407857 18,903428 630,48 22,517142 22,517142

429 W53654002 L02BA01 TAMOXIFENUM TAMOXIFEN SANDOZ 10 mg COMPR. FILM. 10mg HEXAL AG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM.P-RF/S

100 39,78 0,397800 0,397800 52,03 0,520300 0,520300

430 W51514001 L02BA03 FULVESTRANTUM** FASLODEX 250mg SOL. INJ. 250mg/5ml ASTRAZENECA UK LTD. MAREA BRITANIE

CUTIE X 1 SERINGA PREUMPLUTA X 5 ML + 1 AC

P-RF 1 1.551,89 1.551,890000 1.551,890000 1.729,71 1.729,710000 1.729,710000

431 W52204001 L02BB01 FLUTAMIDUM FLUTASIN 250 mg COMPR. 250mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. STICLA BRUNA X 30 COMPR.

P-RF 30 30,83 1,027666 1,027666 40,32 1,344000 1,344000

432 W03217002 L02BB01 FLUTAMIDUM FLUTAN COMPR. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-RF 100 113,97 1,139700 1,139700 139,14 1,391400 1,391400

433 W55157001 L02BB03 BICALUTAMIDUM YONISTIB 150 mg COMPR. FILM. 150mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14

COMPR. FILM.P-6L 28 394,41 14,086071 14,086071 468,06 16,716428 16,716428

434 W58040001 L02BB03 BICALUTAMIDUM BICALUTAMIDA ALVOGEN 150 mg COMPR. FILM. 150mg ALVOGEN ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14

COMPR. FILMP6L 28 381,97 13,641785 13,641785 454,50 16,232142 16,232142

435 W12048001 L02BB03 BICALUTAMIDUM CASODEX 150 mg COMPR. FILM. 150mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM. P-

6L 28 590,67 21,095357 15,280285 681,98 24,356428 18,290570

436 W54719007 L02BB03 BICALUTAMIDUM BICALUTAMIDA SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU BLISTERE PVC-ACLAR/AL X 30 COMPR. FILM.

P-6L 30 415,88 13,862666 13,862666 491,46 16,382000 16,382000

437 W61109001 L02BB03 BICALUTAMIDUM YONISTIB 150 mg COMPR. FILM. 150mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.

P-6L 28 394,41 14,086071 14,086071 468,06 16,716428 16,716428

438 W53572001 L02BB03 BICALUTAMIDUM BICALUTAMID TERAPIA 150 mg COMPR. FILM. 150mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM.

P-6L 28 356,54 12,733571 12,733571 426,78 15,242142 15,242142

439 W58725001 L02BB03 BICALUTAMIDUM BICALUTAMIDA RANBAXY 50 mg COMPR. FILM. 50 mg RANBAXY (U.K.) LIMITED MAREA BRITANIE

CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR.FILM.

P6L 28 168,59 6,021071 5,983999 205,82 7,350714 7,305199

440 W58725009 L02BB03 BICALUTAMIDUM BICALUTAMIDA RANBAXY 50 mg COMPR. FILM. 50 mg RANBAXY (U.K.) LIMITED MAREA BRITANIE

CUTIE CU 1 FLAC. PEID CU CAPAC PP X 28 COMPR.FILM.

P6L 28 168,59 6,021071 5,983999 205,82 7,350714 7,305199

441 W56707002 L02BB03 BICALUTAMIDUM BICALUTAMIDA KABI 50 mg COMPR. FILM. 50 mg FRESENIUS KABI ONCOLOGY PLC

MAREA BRITANIE

CUTIE CU BLIST. PVC/AL X 28 (2X14) COMPR. FILM.

P6L 28 140,25 5,008928 5,008928 171,22 6,115000 6,115000

442 W53339003 L02BB03 BICALUTAMIDUM BICALUTAMIDA SANDOZ 50 mg COMPR. FILM. 50mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

P-6L 30 149,60 4,986666 4,986666 182,63 6,087666 6,087666

443 W54851001 L02BB03 BICALUTAMIDUM CALUMID COMPR. FILM. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVDC-PVC X 15

COMPR. FILM.P-6L 30 200,69 6,689666 5,983999 245,00 8,166666 7,305199

444 W10174001 L02BB03 BICALUTAMIDUM CASODEX 50 mg COMPR. FILM. 50mg ASTRAZENECA UK LTD. MAREA BRITANIE

CUTIE X 2 BLIST. TIP CALENDAR AL/PVC X 14 COMPR. FILM.

P-6L 28 288,09 10,288928 5,983999 351,70 12,560714 7,305199

Pagina 32 din 87

Page 34: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

445 W56520001 L02BB03 BICALUTAMIDUM BICALUTAMIDA ATB 50 mg COMPR. FILM. 50mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. PR 30 179,30 5,976666 5,976666 218,89 7,296333 7,296333

446 W55156001 L02BB03 BICALUTAMIDUM YONISTIB 50 mg COMPR. FILM. 50mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14

COMPR. FILM.P-6L 28 167,54 5,983571 5,983571 204,53 7,304642 7,304642

447 W58039001 L02BB03 BICALUTAMIDUM BICALUTAMIDA ALVOGEN 50 mg COMPR. FILM. 50mg ALVOGEN ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14

COMPR. FILMP6L 28 152,77 5,456071 5,456071 186,50 6,660714 6,660714

448 W61108001 L02BB03 BICALUTAMIDUM YONISTIB 50 mg COMPR. FILM. 50mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM.

P-6L 28 167,54 5,983571 5,983571 204,53 7,304642 7,304642

449 W56123003 L02BB03 BICALUTAMIDUM BICALUTAMIDA ACCORD 50 mg COMPR. FILM. 50mg ACCORD HEALTHCARE LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM.

P-6L 28 141,19 5,042500 5,042500 172,37 6,156071 6,156071

450 W53266005 L02BG03 ANASTROZOLUM EGISTROZOL 1 mg COMPR. FILM. 1mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU, BLIST. PVC-PE- PVDC/AL X 30 COMPR.FILM. PR 30 113,17 3,772333 3,461142 138,16 4,605333 4,324200

451 W53147004 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 50 COMPR. FILM. PR 50 169,90 3,398000 3,398000 207,42 4,148400 4,148400

452 W56262002 L02BG03 ANASTROZOLUM OZOLAN 1 mg COMPR. FILM. 1mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. P-

6L 28 95,20 3,400000 3,400000 120,37 4,298928 4,298928

453 W53147008 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 300 COMPR. FILM. PR 300 956,79 3,189300 3,189300 1.081,05 3,603500 3,603500

454 W54874003 L02BG03 ANASTROZOLUM ANASTRAZE 1 mg COMPR. FILM. 1mg SANDOZ SRL ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM.

P-6L 28 94,64 3,380000 3,380000 119,66 4,273571 4,273571

455 W53147002 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. PR 28 96,88 3,460000 3,460000 122,50 4,375000 4,324200

456 W53147003 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 30 COMPR. FILM. PR 30 103,80 3,460000 3,460000 126,72 4,224000 4,224000

457 W57886001 L02BG03 ANASTROZOLUM ANASTROZOL KABI 1 mg COMPR. FILM. 1mg FRESENIUS KABI ONCOLOGY PLC

MAREA BRITANIE

CUTIE CU BLIST. PVC/AL X 14 (1X14) COMPR. FILM.

P6L 14 40,38 2,884285 2,884285 52,82 3,772857 3,772857

458 W53147001 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 20 COMPR. FILM. PR 20 69,20 3,460000 3,460000 87,50 4,375000 4,324200

459 W53147005 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 84 COMPR. FILM. PR 84 285,45 3,398214 3,398214 348,48 4,148571 4,148571

460 W53147006 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 98 COMPR. FILM. PR 98 332,75 3,395408 3,395408 400,85 4,090306 4,090306

461 W58828003 L02BG03 ANASTROZOLUM ELOZA 1 mg COMPR. FILM. 1mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA CUTIE X BLIST. PVC/AL X 30 COMPR. FILM. PR 30 91,40 3,046666 3,046666 115,56 3,852000 3,852000

462 W53266010 L02BG03 ANASTROZOLUM EGISTROZOL 1 mg COMPR. FILM. 1mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU, BLIST. PVC-PE- PVDC/AL X 90 COMPR.FILM. PR 90 338,63 3,762555 3,461142 407,26 4,525111 4,324200

463 W56083001 L02BG03 ANASTROZOLUM ANASTROZOL ATB 1 mg COMPR. FILM. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM.

P -6L 30 91,40 3,046666 3,046666 115,56 3,852000 3,852000

464 W61107001 L02BG03 ANASTROZOLUM KYARESTA 1 mg COMPR. FILM. 1mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL A CATE 14 COMPR. FILM.

P-6L 28 95,19 3,399642 3,399642 120,36 4,298571 4,298571

465 W56267005 L02BG03 ANASTROZOLUM ANASTROZOL TEVA 1 mg COMPR. FILM. 1mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

P-6L 30 91,46 3,048666 3,048666 115,64 3,854666 3,854666

466 W55859001 L02BG03 ANASTROZOLUM KYARESTA 1 mg COMPR. FILM. 1mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 14 COMPR.

FILM.P-6L 28 95,19 3,399642 3,399642 120,36 4,298571 4,298571

467 W53147007 L02BG03 ANASTROZOLUM ANASTROZOL TERAPIA 1 mg COMPR. FILM. 1mg TERAPIA SA ROMANIA CUTIE X BLIST. PVC/AL X 100 COMPR. FILM. PR 100 338,93 3,389300 3,389300 407,58 4,075800 4,075800

468 W53245005 L02BG03 ANASTROZOLUM ENZAMIDEX 1mg COMPR. FILM. 1mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30

COMPR. FILM. PR 30 91,46 3,048666 3,048666 115,64 3,854666 3,854666

469 W00468001 L02BG03 ANASTROZOLUM ARIMIDEX 1 mg COMPR. FILM. 1mg ASTRAZENECA UK LTD. MAREA BRITANIE

CUTIE X 2 BLIST. TIP CALENDAR AL/PVC X 14 COMPR. FILM.

P-6L 28 128,99 4,606785 3,461142 157,47 5,623928 4,324200

470 W56632005 L02BG04 LETROZOLUM LETROZOL TERAPIA 2,5 mg COMPR. FILM. 2,5 mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/PE/PVDC - AL X 30 COMPR. FILM.

P6L 30 198,16 6,605333 2,607199 241,92 8,064000 3,296800

471 W55679004 L02BG04 LETROZOLUM LETROZOL SANOFI-AVENTIS 2,5 mg COMPR. FILM. 2,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR.

FILM.P-6L 30 165,05 5,501666 2,607199 201,49 6,716333 3,296800

472 W56502003 L02BG04 LETROZOLUM LETROZOL STADA 2,5 mg COMPR. FILM. 2,5mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU BLIST. PVC/AL X 100 (10X10)

COMPR. FILM.P6L 100 280,55 2,805500 2,607199 342,50 3,425000 3,296800

473 W55449003 L02BG04 LETROZOLUM LEZRA 2,5 mg COMPR. FILM. 2,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR.

FILM.P-6L 30 77,28 2,576000 2,576000 97,71 3,257000 3,257000

474 W53743003 L02BG04 LETROZOLUM ETRUZIL 2,5 mg COMPR. FILM. 2,5mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU BLIST. DIN PVC/AL X 30 COMPR. FILM.

P-6L 30 77,84 2,594666 2,594666 98,42 3,280666 3,280666

475 W55367002 L02BG04 LETROZOLUM ZEQUIPRA 2,5 mg COMPR. FILM. 2,5mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU BLIST. AL-PVC/PVC-PE-PVDC X

30 COMPR. FILM.P-6L 30 78,22 2,607333 2,607199 98,90 3,296666 3,296666

476 W53124002 L02BG04 LETROZOLUM LETROZOL TEVA 2,5 mg COMPR. FILM. 2,5mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

P-6L 30 228,64 7,621333 2,607199 279,12 9,304000 3,296800

477 W58927003 L02BG04 LETROZOLUM LETROZOL POLIPHARMA 2,5 mg COMPR. FILM. 2,5mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR.

FILM.P6L 30 164,45 5,481666 2,607199 200,76 6,692000 3,296800

478 W55787007 L02BG04 LETROZOLUM ELOZORA 2,5 mg COMPR. FILM. 2,5mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

P-6L 30 96,38 3,212666 2,607199 121,86 4,062000 3,296800

479 W58106004 L02BG04 LETROZOLUM TROZEL 2,5 mg COMPR. FILM. 2,5mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM.

P-6L 30 73,81 2,460333 2,460333 93,32 3,110666 3,110666

480 W56911001 L02BG04 LETROZOLUM LETROZOL ATB 2,5 mg COMPR. FILM. 2,5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVDC-PE-PVC/AL X 10 COMPR. FILM.

P6L 30 74,74 2,491333 2,491333 94,50 3,150000 3,150000

481 W53742003 L02BG04 LETROZOLUM ZOTROL 2,5 mg COMPR. FILM. 2,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC/AL X 30 COMPR. FILM.

P-6L 30 164,45 5,481666 2,607199 200,76 6,692000 3,296800

Pagina 33 din 87

Page 35: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

482 W59547004 L02BG04 LETROZOLUM LORTANDA 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30

COMPR. FILM.P6L 30 65,18 2,172666 2,172666 82,42 2,747333 2,747333

483 W51409001 L02BG04 LETROZOLUM FEMARA 2,5 mg COMPR. FILM. 2,5mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10

COMPR.P-6L 30 473,58 15,786000 2,607199 554,35 18,478333 3,296800

484 W55646003 L02BG04 LETROZOLUM LETROZOL ALVOGEN 2,5 mg COMPR. FILM. 2,5mg ALVOGEN IPCO S.A.R.L LUXEMBURG

CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM.

P-6L 30 78,21 2,607000 2,607000 98,89 3,296333 3,296333

485 W57606001 L02BG04 LETROZOLUM LETROZOL KABI 2,5 mg COMPR. FILM. 2,5mg FRESENIUS KABI ONCOLOGY PLC

MAREA BRITANIE

CUTIE CU BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM.

P6L 10 72,53 7,253000 2,607199 91,71 9,171000 3,296800

486 W57212004 L02BG06 EXEMESTANUM AROSTANIL 25 mg COMPR. FILM. 25 mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

PRF 30 154,58 5,152666 2,705200 188,71 6,290333 3,420400

487 W57688004 L02BG06 EXEMESTANUM EXEMESTAN MEDISON PHARMA 25 mg COMPR. FILM. 25mg MEDISON PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM.

PRF 30 201,50 6,716666 2,705200 245,99 8,199666 3,420400

488 W59268003 L02BG06 EXEMESTANUM ESCEPRAN 25 mg COMPR. FILM. 25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

P-RF 30 67,63 2,254333 2,254333 85,51 2,850333 2,850333

489 W57021003 L02BG06 EXEMESTANUM EXEMESTAN TERAPIA 25 mg COMPR. FILM. 25mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. FILM.

PRF 30 185,48 6,182666 2,705200 226,44 7,548000 3,420400

490 W57409001 L02BG06 EXEMESTANUM XANEPRA 25 mg COMPR. FILM. 25mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10

COMPR. FILMPRF 30 81,15 2,705000 2,705000 102,61 3,420333 3,420333

491 W57409002 L02BG06 EXEMESTANUM XANEPRA 25 mg COMPR. FILM. 25mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10

COMPR. FILMPRF 30 81,15 2,705000 2,705000 102,61 3,420333 3,420333

492 W59431001 L02BG06 EXEMESTANUM EXEMESTAN POLIPHARMA 25 mg COMPR. FILM. 25mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10

COMPR. FILM.PRF 30 154,58 5,152666 2,705200 188,71 6,290333 3,420400

493 W55664004 L02BG06 EXEMESTANUM EXEMESTAN TEVA 25 mg COMPR. FILM. 25mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM

P-RF 30 81,15 2,705000 2,705000 102,61 3,420333 3,420333

494 W55874002 L02BG06 EXEMESTANUM EXEMESTAN GLENMARK 25mg COMPR. FILM. 25mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

P-RF 30 81,15 2,705000 2,705000 102,61 3,420333 3,420333

495 W55888004 L02BG06 EXEMESTANUM EXEMESTAN ACCORD 25 mg COMPR. FILM. 25mg ACCORD HEALTHCARE LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

P-RF 30 201,38 6,712666 2,705200 245,85 8,195000 3,420400

496 W56479002 L02BG06 EXEMESTANUM EXEMESTAN ALVOGEN 25 mg COMPR. FILM. 25mg ALVOGEN IPCO S.A.R.L LUXEMBURG

CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM.

P-RF 30 81,15 2,705000 2,705000 102,61 3,420333 3,420333

497 W57687007 L02BG06 EXEMESTANUM INPLAVIA 25 mg COMPR. FILM. 25mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. UNIDOZA PVC-PVDC/AL X

30 (30X1) COMPR. FILM.PRF 30 176,84 5,894666 2,705200 215,89 7,196333 3,420400

498 W55665004 L02BG06 EXEMESTANUM EXESTRALAN 25 mg COMPR. FILM. 25mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 30

COMPR. FILM.P-RF 30 185,49 6,183000 2,705200 226,45 7,548333 3,420400

499 W61219002 L02BG06 EXEMESTANUM XANEPRA 25 mg COMPR. FILM. 25mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM

PRF 30 81,15 2,705000 2,705000 102,61 3,420333 3,420333

500 W61219001 L02BG06 EXEMESTANUM XANEPRA 25 mg COMPR. FILM. 25mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM

PRF 30 81,15 2,705000 2,705000 102,61 3,420333 3,420333

501 W08074001 L02BG06 EXEMESTANUM AROMASIN 25 mg DRAJ. 25mg PFIZER EUROPE MA EEIG MAREA BRITANIE

CUTIE X 2 BLIST. PVC-PVDC/PVC-AL X 15 DRAJ.

P-RF 30 310,19 10,339666 2,705200 376,26 12,542000 3,420400

502 W51424001 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML

S/P-RF 1 267,05 267,050000 194,520000 326,02 326,020000 237,468000

503 W51423001 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML

S/P-RF 1 436,57 436,570000 313,092000 514,01 514,010000 382,224000

504 W53892001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 30MU/0,5mlSOL. INJ. /PERF. IN SERINGA PREUMPLUTA

60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

1 162,10 162,100000 162,100000 197,89 197,890000 197,890000

505 W53893001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 48MU/0,5mlSOL. INJ. /PERF. IN SERINGA PREUMPLUTA

96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

1 260,91 260,910000 260,910000 318,52 318,520000 318,520000

506 W55756002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 12 MU/0,2ml SOL. INJ./PERF. 120µg/0,2ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,2ML SOL. INJ. SAU PERF.

P-RF 5 418,45 83,690000 83,690000 494,26 98,852000 98,852000

507 W53520001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0,5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML

SOL. INJ. SAU PERF.

S/P-RF/R

1 214,16 214,160000 194,520000 261,45 261,450000 237,468000

508 W55757002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.

P-RF 5 1.001,12 200,224000 194,520000 1.129,37 225,874000 225,874000

509 W53523001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0,8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML

SOL. INJ. SAU PERF.

S/P-RF/R

1 355,90 355,900000 313,092000 426,08 426,080000 382,224000

510 W55758002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.

P-RF 5 1.656,30 331,260000 313,092000 1.843,52 368,704000 368,704000

511 W51563003 L03AA13 PEGFILGRASTIMUM*** NEULASTA 6mg SOL. INJ. 6 mg AMGEN EUROPE B.V. OLANDACUTIE CU 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. IN BLISTER, CU PROTECTIE A ACULUI

PR 1 3.307,67 3.307,670000 3.307,670000 3.643,51 3.643,510000 3.643,510000

512 W51563001 L03AA13 PEGFILGRASTIMUM*** NEULASTA 6mg SOL. INJ. 6mg AMGEN EUROPE B.V. OLANDA CUTIE X BLISTER X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR 1 3.307,67 3.307,670000 3.307,670000 3.643,51 3.643,510000 3.643,510000

513 W51327001 L03AB04 INTERFERONUM ALFA 2A*** ROFERON A SOL. INJ. 3Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML + AC STERIL PR 1 69,15 69,150000 69,150000 87,43 87,430000 87,430000

514 W51329001 L03AB04 INTERFERONUM ALFA 2A*** ROFERON A SOL. INJ. 9Mui/0,5ml ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML SOL. INJ. + AC STERIL PR 1 140,84 140,840000 140,840000 171,94 171,940000 171,940000

515 W59599002 L03AB05 INTERFERONUM ALFA 2B*** INTRON A 18 milioane U.I. SOL. INJ. PEN MULTIDOZA

18 milioane U.I. MERCK SHARP & DOHME MAREA

BRITANIE

CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML SOL. INJ. + 12 ACE + 12 TAMPOANE DEZINFECTANTE

P-RF/R

1 363,48 363,480000 363,480000 434,34 434,340000 434,340000

516 W59600001 L03AB05 INTERFERONUM ALFA 2B*** INTRON A 30 milioane U.I. SOL. INJ. PEN MULTIDOZA

30 milioane U.I. MERCK SHARP & DOHME MAREA

BRITANIE

CUTIE X 1 STILOU INJECTOR (PEN) X 1,2 ML + 12 ACE + 12 TAMPOANE DEZINFECTANTE

P-RF/R

1 621,78 621,780000 621,780000 715,89 715,890000 715,890000

Pagina 34 din 87

Page 36: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

517 W57665001 M05BA02 ACIDUM CLODRONICUM** BONEFOS® 800 mg COMPR. FILM. 800mg BAYER OY FINLANDA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM.

P-6L 60 586,00 9,766666 9,766666 676,89 11,281500 11,281500

518 W52199001 M05BA02 ACIDUM CLODRONICUM** SINDRONAT (R) 300 mg/5 ml CONC. PT. SOL. PERF. 300mg/5ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA X 5 ML S 1 20,75 20,750000 20,750000 28,04 28,040000 28,040000

519 W58123007 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml

CHIESI PHARMACEUTICALS GMBH

AUSTRIA CUTIE X 1 FIOLA PE X 4 ML S/P-RF 1 361,86 361,860000 285,384000 432,58 432,580000 348,396000

520 W58123005 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml

CHIESI PHARMACEUTICALS GMBH

AUSTRIA CUTIE X 1 FIOLA PE X 1 ML S/P-RF 1 102,98 102,980000 102,980000 125,72 125,720000 125,720000

521 W58123006 M05BA03 ACIDUM PAMIDRONICUM** PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml

CHIESI PHARMACEUTICALS GMBH

AUSTRIA CUTIE X 1 FIOLA PE X 2 ML S/P-RF 1 158,95 158,950000 158,950000 194,05 194,050000 194,050000

522 W07918001 M05BA03 ACIDUM PAMIDRONICUM** AREDIA (R) 15 mg LIOF.+ SOLV. PT. SOL. PERF. 15mg NOVARTIS PHARMA

GMBH GERMANIACUTIE X 4 FLAC. DIN STICLA X 15 MG LIOF. PT. SOL. PERF. + 4 FIOLE DIN STICLA X 5 ML SOLV.

S/P-RF 4 595,85 148,962500 123,576000 687,63 171,907500 150,864000

523 W57926001 M05BA03 ACIDUM PAMIDRONICUM** PAMIRED 30mg pulbere pentru solutie perfuzabila

PULB. PT. SOL. PERF. 30mg DR. REDDY'S

LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 MG LIOF. PT. SOL. PERF. I.V. PR 1 152,87 152,870000 152,870000 186,63 186,630000 186,630000

524 W57925001 M05BA03 ACIDUM PAMIDRONICUM** PAMIRED 60mg pulbere pentru solutie perfuzabila

PULB. PT. SOL.PERF. 60mg DR. REDDY'S

LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 60 MG LIOF. PT. SOL. PERF. I.V. PR 1 237,82 237,820000 237,820000 290,33 290,330000 290,330000

525 W60664001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 1

COMPR. FILM.P6L 1 29,66 29,660000 29,660000 38,80 38,800000 38,800000

526 W56748001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 50 mg COMPR. FILM. 50 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 28 COMPRIMATE FILMATE PR 28 637,14 22,755000 22,269428 732,63 26,165357 25,908857

527 W57730004 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC SANDOZ 50 mg COMPR. FILM. 50 mgSANDOZ PHARMACEUTICALS GMBH

GERMANIA CUTIE CU BLIST. DIN PA/AL/PVC/AL CU 28 COMPRIMATE FILMATE PR 28 519,62 18,557857 18,557857 604,54 21,590714 21,590714

528 W57712001 M05BA06 ACIDUM IBANDRONICUM** HOLMEVIS 50 mg COMPR. FILM. 50mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. PR 28 637,16 22,755714 22,269428 732,65 26,166071 25,908857

529 W59829025 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC GLENMARK 50 mg COMPR. FILM. 50mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU BLIST. PVC/PVDC-AL X 28 COMPR. FILM. PR 28 562,00 20,071428 20,071428 650,73 23,240357 23,240357

530 W41499001 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 50mg COMPR. FILM. 50mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X BLIST. AL/PVC X 28 COMPR. FILM. S 28 964,08 34,431428 22,269428 1.089,00 38,892857 25,908857

531 W56932004 M05BA06 ACIDUM IBANDRONICUM** IASIBON 50 mg COMPR. FILM. 50mg PHARMATHEN S.A. GRECIA CUTIE CU BLIST. PA/ALL/PVC/ALU X 28 COMPR. FILM PR 28 629,47 22,481071 22,269428 724,27 25,866785 25,866785

532 W58937001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 6 mg CONC. PT. SOL. PERF. 6mg

TEVA PHARMACEUTICALS S.R.L.

ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC SI CAPSA DE CULOARE TURCOAZ (ALBASTRU VERZUI) X 6 ML CONC. PT. SOL. PERF.

PR 1 596,39 596,390000 596,390000 688,22 688,220000 688,220000

533 W41498001 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml ROCHE REGISTRATION

LTD.MAREA BRITANIE

CUTIE X 1 FLACON X 6 ML CONC. PT. SOL. PERF. S 1 901,37 901,370000 715,668000 1.020,64 1.020,640000 825,864000

534 W56933001 M05BA06 ACIDUM IBANDRONICUM** IASIBON 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml PHARMATHEN S.A. GRECIA CUTIE CU 1 FLAC. DIN STICLA X 6ML CONC.

PT. SOL. PERF. PR 1 596,39 596,390000 596,390000 688,22 688,220000 688,220000

535 W59742004 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC TEVA 4 mg/5 ml CONC. PT. SOL. PERF. 4 mg/5 ml TEVA PHARMA B.V. OLANDA

CUTIE X 1 FLACON DIN STICLA CU 5ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA

PR 1 377,14 377,140000 356,400000 449,23 449,230000 435,096000

536 W59137001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/100 ml CONC. PT. SOL. PERF. 4mg/100ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 100 ML CONC. PT. SOL. PERF.

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

537 W59136001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 5 ML CONC. PT. SOL. PERF.

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

538 W59044001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC RICHTER 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml GEDEON RICHTER

ROMANIA SA ROMANIA

CUTIE X 1 FLACON TRANSPARENT, INCOLOR DIN POLIMER CICLO-OLEFENIC INCHIS CU DOP GRI INCHIS DIN CAUCIUC CU STRAT FLUOROPOLIMERIC, CAPSA DIN AL SI SISTEM "FLIP-OFF" DIN PLASTIC ROSU X 5ML CONC. PT. SOL. PERF.

PR 1 724,49 724,490000 356,400000 827,84 827,840000 435,096000

539 W59476002 M05BA08 ACIDUM ZOLEDRONICUM** ZOLACITOR 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml

CHIESI PHARMACEUTICALS GMBH

AUSTRIA CUTIE CU 4 FLAC., DE CAPACITATE DE 5 ML CARE CONTINE CONC. PT. SOL. PERF. PR 4 2.807,00 701,750000 356,400000 3.097,78 774,445000 435,096000

540 W59588001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC ACTAVIS 4mg/5ml CONC. PT. SOL. PERF. 4mg/5ml ACTAVIS GROUP PTC

EHF. ISLANDA

CUTIE X 1 FLACON PLASTIC TRANSPARENT, INCOLOR CU CAPACITATEA DE 5 ML CARE CONTINE CONC. PT. SOL. PER

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

541 W58621001 M05BA08 ACIDUM ZOLEDRONICUM** ZYOLIX 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml ROMASTRU TRADING

S.R.L. ROMANIA

CUTIE CU 1 FLAC. DIN COPOLIMER COCLOOLEFINIC, TRANSPARENT, INCOLOR, INCHIS CU DOP DIN CAUCIUC BROMOB

PR 1 459,66 459,660000 356,400000 539,18 539,180000 435,096000

542 W59167001 M05BA08 ACIDUM ZOLEDRONICUM** OSPORIL 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml

EGIS PHARMACEUTICALS P.L.C.

UNGARIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CARE CONTINE CONC. PT. SOL. PERF.

PR 1 676,71 676,710000 356,400000 775,76 775,760000 435,096000

Pagina 35 din 87

Page 37: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

543 W59840001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC HOSPIRA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml HOSPIRA UK LIMITED MAREA

BRITANIE

CUTIE X 1 FLACON CU CAPACITATE DE 5ML DIN PLASTIC CU DOP BROMOBUTIL, ACOPERIT CU UN STRAT DE FLUOROPOLIMER SI CAPAC DIN AL CU COMPONENTA "FLIP-OFF"

PR 1 364,11 364,110000 356,400000 435,03 435,030000 435,030000

544 W59914001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC PFIZER 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE CU 1 FLAC. DIN PP PREVAZUT CU CAPSA FLIP-OFF DIN AL CU CONC. PT. SOL. PERF.

PR 1 724,49 724,490000 356,400000 827,84 827,840000 435,096000

545 W59476001 M05BA08 ACIDUM ZOLEDRONICUM** ZOLACITOR 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml

CHIESI PHARMACEUTICALS GMBH

AUSTRIA CUTIE CU 1 FLAC., DE CAPACITATE DE 5 ML CARE CONTINE CONC. PT. SOL. PERF. PR 1 724,40 724,400000 356,400000 827,75 827,750000 435,096000

546 W59191004 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC TERAPIA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. TRANSPARENT DIN STICLA CU CAPACITATEA DE 6 ML INCHIS CU DOP DIN CAUCIUC DE CULOARE GRI SI SIGILAT CU CAPAC DIN AL, TIP "FLIP OFF" DE CULOARE GRI CARE CONTINE CONC. PT. SOL. PERF.

PR 1 724,49 724,490000 356,400000 827,84 827,840000 435,096000

547 W59090002 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC FRESENIUS KABI 4 mg/5 ml

CONC. PT. SOL. PERF. 4mg/5ml FRESENIUS KABI

ROMANIA SRL ROMANIA CUTIE CU 4 FLAC. DIN PP INCOLORA, INCHIS X 4 MG/5 ML CONC. PT. SOL. PERF. PR 4 1.417,59 354,397500 354,397500 1.583,33 395,832500 395,832500

548 W60216001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC MEDAC 4mg/5ml CONC. PT. SOL. PERF. 4mg/5ml

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIACUTIE X 1 FLACON DIN PLASTIC CU 5ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

549 W60989001 M05BA08 ACIDUM ZOLEDRONICUM** ZYOLIX 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml NEOLA PHARMA SRL ROMANIA

CUTIE CU 1 FLAC. DIN COPOLIMER COCLOOLEFINIC, TRANSPARENT, INCOLOR, INCHIS CU DOP DIN CAUCIUC BROMOBUTILIC, SIGILAT CU CAPSA DIN AL SI CAPAC TIP FLIP-OFF DIN PP CARE CONTINE 4 MG/5 ML CONC. PT. SOL. PERF.

PR 1 459,66 459,660000 356,400000 539,18 539,180000 435,096000

550 W58886001 M05BA08 ACIDUM ZOLEDRONICUM** DESINOBON 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml ALVOGEN IPCO S.A.R.L LUXEMBOU

RG

CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR DE 5 ML DIN COPOLIMER CICLOOLEFINIC CU DOP DE CAUCIUC SI CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" CARE CONTINE CONC. PT. SOL. PERF.

PR 1 452,56 452,560000 356,400000 531,44 531,440000 435,096000

551 W59889001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC POLIPHARMA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml POLIPHARMA

INDUSTRIES S.R.L. ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA SITRANSPARENTA, CAPACITATE 8,4 ML, A 5 ML CONC. PT. SOL. PERF.

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

552 W59520001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC DR. REDDY'S 4mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml DR. REDDY'S

LABORATORIES ROMANIACUTIE CU 1 FLAC. DIN STICLA CU CAPACITATEA DE 5 ML CU CONC. PT. SOL. PERF.

PR 1 297,00 297,000000 297,000000 362,58 362,580000 362,580000

553 W59889002 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC POLIPHARMA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml POLIPHARMA

INDUSTRIES S.R.L. ROMANIACUTIE CU 4 FLAC. DIN STICLA INCOLORA SITRANSPARENTA, CAPACITATE 8,4 ML, A 5 ML CONC. PT. SOL. PERF.

PR 4 1.418,88 354,720000 354,720000 1.584,73 396,182500 396,182500

554 W08426001 M05BA08 ACIDUM ZOLEDRONICUM** ZOMETA 4 mg PULB. + SOLV. SOL. PERF. 4mg NOVARTIS EUROPHARM

LTD.MAREA BRITANIE

CUTIE X 1 FLAC. 4MG PULB. PT. SOL. PERF. + 1 FIOLA X 5 ML SOLV. PR 1 1.098,45 1.098,450000 356,400000 1.235,46 1.235,460000 435,096000

555 W60382001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC HOSPIRA 4 mg/100 ml SOL. PERF. 4 mg/100 ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 1 PUNGA DIN POLIPROPILENA DE 100ML CU UN PORT "TWIST-OFF" DIN POLIPROPILENA CU CAPAC SI CU UN INVELIS DIN POLIESTER/POLIPROPILENA

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

556 W60543001 M05BA08 ACIDUM ZOLEDRONICUM** ZERLINDA 4 mg/100 ml SOL. PERF. 4mg/100ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 PUNGA A 100 ML SOL. PERF. PR 1 724,00 724,000000 356,400000 827,31 827,310000 435,096000

557 W60215001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC MEDAC 4mg/100ml SOL. PERF. 4mg/100mlMEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIA CUTIE X 1 FLACON DIN PLASTIC CU 100 ML SOLUTIE PERFUZABILA PR 1 522,14 522,140000 356,400000 607,28 607,280000 435,096000

558 W60980001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC DR. REDDY'S 4mg/100 ml SOL. PERF. 4mg/100ml DR. REDDY'S LABORATORIES ROMANIA

CUTIE CU 1 FLAC. DIN STICLA CU DOP DIN CAUCIUC CLOROBUTILIC, SIGILAT CU CAPSA DIN AL TIP "FLIP-OFF"A 100 ML SOL. PERF.

PR 1 297,00 297,000000 297,000000 362,58 362,580000 362,580000

559 W59355001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC ZENTIVA 4 mg/5 ml SOL. PERF. 4mg/5ml ZENTIVA, K.S. REPUBLICA CEHA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CARE CONTINE CONC. PT. SOL. PERF. PR 1 676,71 676,710000 356,400000 775,76 775,760000 435,096000

560 W04133001 V03AF01 MESNUM UROMITEXAN (R) 400 mg SOL. INJ. 400mg/4ml BAXTER ONCOLOGY GMBH GERMANIA

CUTIE X 3 SUPORTURI TERMOFORMATE DIN PLASTIC X 5 FIOLE DE STICLA INCOLORA X 4 ML

S 15 44,87 2,991333 2,991333 58,69 3,912666 3,912666

561 W00734001 V03AF03 CALCII FOLINAS CALCIUM FOLINAT "EBEWE" 15 mg CAPS. 15mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X1 FLAC. X 20 CAPS. P-

6L 20 29,11 1,455500 1,455500 38,08 1,904000 1,904000

562 W52217001 V03AF03 CALCII FOLINAS FOLCASIN (R) 100 mg/10 ml SOL. INJ. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON X 10 ML S/P-RF 1 29,47 29,470000 29,470000 38,55 38,550000 38,550000

563 W54980002 V03AF03 CALCII FOLINAS FOLINAT DE CALCIU TEVA 10 mg/ml SOL. INJ. 10mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLAC. X 10 ML SOL. INJ.P-RF/S

1 29,50 29,500000 29,500000 38,59 38,590000 38,590000

564 W00735001 V03AF03 CALCII FOLINAS CALCIUMFOLINAT "EBEWE" 10 mg/ml SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 3 ML P-

RF 5 50,23 10,046000 10,046000 63,51 12,702000 12,702000

565 W00735003 V03AF03 CALCII FOLINAS CALCIUMFOLINAT "EBEWE" 10 mg/ml SOL. INJ./PERF. 10mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 5 FIOLE X 10 ML P-

RF 5 142,16 28,432000 28,432000 173,55 34,710000 34,710000

566 W52219001 V03AF03 CALCII FOLINAS FOLCASIN (R) 3 mg/ml SOL. INJ./PERF. 3mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON X 10 ML S/P-RF 1 13,53 13,530000 12,055200 18,29 18,290000 15,242400

Pagina 36 din 87

Page 38: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

P4: PROGRAMUL NATIONAL DE BOLI NEUROLOGICE Subprogramul de tratament al sclerozei multiple

1 W42705001 L03AB07 INTERFERONUM BETA 1A**** AVONEX 30 mcg BIO-SET PULB. + SOLV. PT. SOL. INJ.

30mcg (6 mil. UI) BIOGEN IDEC LIMITED MAREA

BRITANIE

CUTIE X (1 FLAC. DIN STICLA X 30 MCG PULBERE + 1 SERINGA PRE-UMPLUTA + 1 ML SOLV. + 4 FIOLE PREVAZUT

P-RF/R

4 3.085,23 771,307500 771,307500 3.401,05 850,262500 850,262500

2 W08473003 L03AB07 INTERFERONUM BETA 1A**** REBIF 44 micrograme SOL. INJ. 44mcg SERONO EUROPE LTD. MAREA BRITANIE

CUTIE X 12 SERINGI PREUMPLUTE X 0,5ML SOL. INJ.

P-RF/R

12 4.183,50 348,625000 348,625000 4.598,17 383,180833 383,180833

3 W53186002 L03AB08 INTERFERONUM BETA 1-B**** EXTAVIA 250 mcg/ ml PULB+SOLV.PT.SOL.INJ 250mcg/ml NOVARTIS EUROPHARM

LTD.MAREA BRITANIE

CUTIE X 15 FLAC. CU PULBERE + 15 SERINGI PREUMPLUTE CU SOLVENT

P-RF/R

15 3.506,14 233,742666 233,742666 3.859,85 257,323333 257,323333

4 W52752007 L03AB08 INTERFERONUM BETA 1-B**** BETAFERON 250mcg/ml PULB. + SOLV. PT. SOL. INJ. 250mcg/ml BAYER SCHERING AG GERMANIA

CUTIE X 15 AMBALAJE MULTIPLE CE CONTIN FIECARE CATE 1 FLAC. CU PULB., O SERINGA PREUMPLUTA CU SOLV.

P-RF/P

15 3.301,14 220,076000 220,076000 3.636,40 242,426666 242,426666

5 W44044001 L03AX13 GLATIRAMER ACETAT**** COPAXONE SOL. INJ. 20mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIACUTIE X 28 BLIST. PVC X 1 SERINGA PREUMPLUTA X 1 ML PREVAZUTA CU AC FIX

S/P-RF 28 3.083,08 110,110000 110,110000 3.398,71 121,382500 121,382500

6 W51764001 L04AA23 NATALIZUMABUM**** TYSABRI 300mg CONC. PT. SOL. PERF. 20mg/ml ELAN PHARMA

INTERNATIONAL LTD IRLANDA CUTIE X 1 FLAC. X 15ML CONC. PT. SOL. PERF S 1 6.951,95 6.951,950000 6.951,950000 7.615,78 7.615,780000 7.615,780000

7 W56928001 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM.

S/P-RF 100 55,53 0,555300 0,555300 70,21 0,702100 0,702100

8 W56508002 L04AX01 AZATHIOPRINUM* IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR.

FILM. PR 100 62,39 0,623900 0,623900 78,89 0,788900 0,788900

P5: PROGRAMUL NATIONAL DE DIABET ZAHARAT Tratamentul medicamentos al bolnavilor cu diabet zaharat

1 W52999002 A10AB01 INSULINE UMANE HUMULIN R SOL. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 90,98 18,196000 18,196000 115,03 23,006000 23,006000

2 W52999001 A10AB01 INSULINE UMANE HUMULIN R SOL. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 1 FLAC. X 10 ML SOL. INJ. P-RF 1 43,32 43,320000 43,320000 56,66 56,660000 56,660000

3 W08452003 A10AB01 INSULINE UMANE INSUMAN RAPID 100UI/ml SOL. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS

DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SOL. INJ.

P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

4 W08451001 A10AB01 INSULINE UMANE INSUMAN RAPID 100UI/ml SOL. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS

DEUTSCHLAND GMBH GERMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA X 5 ML SOL. INJ.

P-RF 5 105,39 21,078000 21,078000 128,66 25,732000 25,732000

5 W53811003 A10AB01 INSULINE UMANE INSUMAN RAPID 100 UI/ml SoloStarSOL. INJ. IN STILOU INJECTOR PREUMPLUT

100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA

CUTIE X 5 STILOURI INJECTOARE X 1 CARTUS DIN STICLA INCOLORA X 3 ML SOL. INJ.

P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

6 W53873001 A10AB04 INSULINUM LISPRO** HUMALOG KWIKPEN100U/ml SOL. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-

URI) PRE-UMPLUTE X 3 ML SOL. INJ.P-RF 5 156,50 31,300000 30,950400 191,06 38,212000 37,785600

7 W52601001 A10AB04 INSULINUM LISPRO** HUMALOG 100 U/ml SOL. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 CARTUSE X 3 ML SOL.INJ. P-

RF 5 128,96 25,792000 25,792000 157,44 31,488000 31,488000

8 W07268001 A10AB05 INSULINUM ASPART** NOVORAPID PENFILL 100 U/ml SOL. INJ. IN CARTUS 100Uml NOVO NORDISK A/S DANEMAR

CA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 130,56 26,112000 26,112000 159,39 31,878000 31,878000

9 W41740004 A10AB06 INSULINUM GLULIZINA** APIDRA 100U/ml SOL. INJ. IN CARTUS 100U/ml SANOFI - AVENTIS

DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE X 3 ML SOL. INJ. P-RF 5 108,80 21,760000 21,760000 132,82 26,564000 26,564000

10 W52538004 A10AB06 INSULINUM GLULIZINA** APIDRA 100U/mlSOL. INJ. IN STILOU INJECTOR PREUMPLUT

100U/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA

CUTIE X 5 STILOURI INJECTOARE (PEN-URI) PREUMPLUTE (SOLOSTAR) X 3 ML SOL. INJ.

P-RF 5 108,80 21,760000 21,760000 132,82 26,564000 26,564000

11 W52986002 A10AC01 INSULINE UMANE HUMULIN N SUSP. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ.

P-RF 5 90,98 18,196000 18,196000 115,03 23,006000 23,006000

12 W52986001 A10AC01 INSULINE UMANE HUMULIN N SUSP. INJ. 100UI/ml LILLY FRANCE SAS FRANTA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10 ML SUSP. INJ.

P-RF 1 43,32 43,320000 43,320000 56,66 56,660000 56,660000

13 W08444003 A10AC01 INSULINE UMANE INSUMAN BASAL 100UI/ml SUSP. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS

DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ.

P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

14 W08381002 A10AC01 INSULINE UMANE INSUMAN BASAL 100UI/ml SUSP. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS

DEUTSCHLAND GMBH GERMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA X 5 ML SUSP. INJ.

P-RF 5 111,21 22,242000 22,242000 135,77 27,154000 27,154000

15 W53808003 A10AC01 INSULINE UMANE INSUMAN BASAL 100UI/ml SoloStarSUSP. INJ. IN STILOU INJECTOR PREUMPLUT

100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA

CUTIE X 5 STILOURI INJECTOARE X 1 CARTUS DIN STICLA INCOLORA X 3 ML SUSP. INJ.

P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

16 W53876001 A10AC04 INSULINUM LISPRO** HUMALOG BASAL KWIKPEN 100U/ml SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-

URI) X 3 ML SUSP. INJ.P-RF 5 156,50 31,300000 31,300000 191,06 38,212000 38,212000

17 W53106001 A10AD01 INSULINE UMANE HUMULIN M3 SUSP. INJ. 100ui/ml LILLY FRANCE S.A.S FRANTA CUTIE X 1 FLACON DIN STICLA INCOLORA X 10 ML SUSP. INJ.

P-RF 1 43,32 43,320000 43,320000 56,66 56,660000 56,660000

18 W53106002 A10AD01 INSULINE UMANE HUMULIN M3 SUSP. INJ. 100ui/ml LILLY FRANCE S.A.S FRANTA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ.

P-RF 5 90,98 18,196000 18,196000 115,03 23,006000 23,006000

19 W08449003 A10AD01 INSULINE UMANE INSUMAN COMB 50 100UI/ml SUSP. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS

DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ.

P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

20 W03703002 A10AD01 INSULINE UMANE MIXTARD 30 PENFILL 100 UI/ml SUSP. INJ. IN CARTUS 100UI/ml NOVO NORDISK A/S DANEMAR

CA CUTIE X 5 CARTUSE X 3 ML SUSP. INJ. P-RF 5 105,07 21,014000 19,502400 128,27 25,654000 24,660000

21 W08446003 A10AD01 INSULINE UMANE INSUMAN COMB 25 100UI/ml SUSP. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS

DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA INCOLORA X 3 ML SUSP. INJ.

P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

22 W08445002 A10AD01 INSULINE UMANE INSUMAN COMB 25 100UI/ml SUSP. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS

DEUTSCHLAND GMBH GERMANIA CUTIE X 5 FLACOANE DIN STICLA INCOLORA X 5 ML SUSP. INJ.

P-RF 5 137,51 27,502000 27,502000 167,87 33,574000 33,574000

23 W53810003 A10AD01 INSULINE UMANE INSUMAN COMB 25 100UI/ml SoloStarSUSP. INJ. IN STILOU INJECTOR PREUMPLUT

100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA

CUTIE X 5 STILOURI INJECTOARE X 1 CARTUS, DIN STICLA INCOLORA X 3 ML SUSP. INJ.

P-RF 5 81,26 16,252000 16,252000 102,75 20,550000 20,550000

24 W53875001 A10AD04 INSULINUM LISPRO** HUMALOG MIX50 KWIKPEN 100U/ml SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-

URI), PREUMPLUTE X 3 ML, SUSP. INJ.P-RF 5 156,50 31,300000 31,300000 191,06 38,212000 38,212000

25 W53874001 A10AD04 INSULINUM LISPRO** HUMALOG MIX25 KWIKPEN 100U/ml SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 STILOURI INJECTOARE (PEN-

URI), PREUMPLUTE X 3 ML, SUSP. INJ.P-RF 5 156,50 31,300000 31,300000 191,06 38,212000 38,212000

26 W52602001 A10AD04 INSULINUM LISPRO** HUMALOG MIX25 SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 CARTUSE X 3 ML SUSP.INJ. P-

RF 5 136,03 27,206000 27,206000 166,07 33,214000 33,214000

Pagina 37 din 87

Page 39: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

27 W03665001 A10AD04 INSULINUM LISPRO** HUMALOG MIX50 SUSP. INJ. 100U/ml ELI LILLY NEDERLAND BV OLANDA CUTIE X 5 CARTUSE X 3 ML SUSP. INJ. P-

RF 5 134,73 26,946000 26,946000 164,48 32,896000 32,896000

28 W08254001 A10AD05 INSULINUM ASPART** NOVOMIX 30 PENFILL 100 U/ml SUSP. INJ. IN CARTUS 100U/ml NOVO NORDISK A/S DANEMAR

CA CUTIE X 5 CARTUSE X 3 ML SUSP. INJ. P-RF 5 140,58 28,116000 28,116000 171,62 34,324000 34,324000

29 W08054002 A10AE04 INSULINUM GLARGINE** LANTUS 100UI/ml SOL. INJ. IN CARTUS 100UI/ml SANOFI - AVENTIS

DEUTSCHLAND GMBH GERMANIA CUTIE X 5 CARTUSE DIN STICLA X 3 ML SOL. INJ.

P-RF 5 203,05 40,610000 40,610000 247,88 49,576000 49,576000

30 W10010005 A10AE04 INSULINUM GLARGINE** LANTUS 100UI/ml SOL. INJ. IN FLACON 100UI/ml SANOFI - AVENTIS

DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLACON DIN STICLA X 10 ML SOL. INJ.

P-RF 1 146,86 146,860000 146,860000 179,29 179,290000 179,290000

31 W52628008 A10AE04 INSULINUM GLARGINE** LANTUS SoloStarSOL. INJ. IN STILOU INJECTOR PREUMPLUT

100UI/ml SANOFI - AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 5 STILOURI INJECTOARE (PEN-

URI) PREUMPLUTE X 3 MLP-RF 5 200,05 40,010000 40,010000 244,22 48,844000 48,844000

32 W41732002 A10AE05 INSULINUM DETEMIR** LEVEMIR PENFILL 100 U/ml SOL. INJ. IN CARTUS 100U/ml NOVO NORDISK A/S DANEMAR

CA CUTIE X 5 CARTUSE X 3 ML P-RF 5 245,54 49,108000 49,108000 299,76 59,952000 59,952000

33 W53953001 A10BA02 METFORMINUM METFORMIN ARENA 1000 MG COMPR. 1000mg ARENA GROUP S.A. ROMANIA CUTIE X 10 BLIST. AL/PVC X 5 COMPR. P-RF 50 6,30 0,126000 0,126000 8,52 0,170400 0,170400

34 W53953002 A10BA02 METFORMINUM METFORMIN ARENA 1000 MG COMPR. 1000mg ARENA GROUP S.A. ROMANIA FLACON DIN PE X 200 COMPR.P-RF/S

200 25,16 0,125800 0,125800 32,91 0,164550 0,164550

35 W53951003 A10BA02 METFORMINUM METFORMIN ARENA 500 MG COMPR. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. DIN PE X 60 COMPR. P-RF 60 3,58 0,059666 0,059666 4,84 0,080666 0,080666

36 W53952001 A10BA02 METFORMINUM METFORMIN ARENA 850 MG COMPR. 850mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 COMPR. P-RF 15 1,69 0,112666 0,112666 2,28 0,152000 0,152000

37 W43318002 A10BA02 METFORMINUM GLUCOPHAGE XR COMPR. ELIB. PREL. 500mg MERCK SANTE S.A.S. FRANTA CUTIE X 2 BLIST. AL/PVC-PVDC X 15

COMPR. ELIB. PREL.P-RF 30 11,34 0,378000 0,071599 15,33 0,511000 0,096799

38 W43318001 A10BA02 METFORMINUM GLUCOPHAGE XR COMPR. ELIB. PREL. 500mg MERCK SANTE S.A.S. FRANTA CUTIE X 3 BLIST. AL/PVC-PVDC X 10

COMPR. ELIB. PREL.P-RF 30 11,34 0,378000 0,071599 15,33 0,511000 0,096799

39 W59641002 A10BA02 METFORMINUM METFORMIN AUROBINDO 1000 mg COMPR. FILM. 1000mg AUROBINDO PHARMA LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

P6L 30 4,34 0,144666 0,144666 5,86 0,195333 0,195333

40 W56835001 A10BA02 METFORMINUM SERDENIS 1000 mg COMPR. FILM. 1000mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10

COMPR. FILM.P6L 30 4,38 0,146000 0,146000 5,92 0,197333 0,197333

41 W13583011 A10BA02 METFORMINUM GLUCOPHAGE 1000 mg COMPR. FILM. 1000mg MERCK SANTE FRANTA CUTIE CU BLIST. PVC/AL, X 60 COMPR. FILM.

P-6L 60 20,74 0,345666 0,150960 28,03 0,467166 0,197460

42 W56835002 A10BA02 METFORMINUM SERDENIS 1000 mg COMPR. FILM. 1000mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10

COMPR. FILM.P6L 60 8,75 0,145833 0,145833 11,83 0,197166 0,197166

43 W43828002 A10BA02 METFORMINUM METFOGAMMA 1000mg COMPR. FILM. 1000mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 8 BLIST. AL/PVC X 15 COMPR. FILM P6

L 120 15,93 0,132750 0,132750 21,53 0,179416 0,179416

44 W42349002 A10BA02 METFORMINUM SIOFOR 1000 COMPR. FILM. 1000mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 4 BLIST. PVC/AL X 15 COMPR.

FILM.P-RF 60 13,42 0,223666 0,150960 18,14 0,302333 0,197460

45 W56835003 A10BA02 METFORMINUM SERDENIS 1000 mg COMPR. FILM. 1000mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 9 BLIST. PVC-PVDC/AL X 10

COMPR. FILM.P6L 90 13,13 0,145888 0,145888 17,75 0,197222 0,197222

46 W59639003 A10BA02 METFORMINUM METFORMIN AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

P6L 30 2,55 0,085000 0,071599 3,45 0,115000 0,096799

47 W59639008 A10BA02 METFORMINUM METFORMIN AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM.

P6L 60 5,10 0,085000 0,071599 6,89 0,114833 0,096799

48 W13955001 A10BA02 METFORMINUM MEGUAN (R) 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10

COMPR. FILM.P6L 20 3,24 0,162000 0,071599 4,38 0,219000 0,096799

49 W42688001 A10BA02 METFORMINUM DIPIMET 500 mg COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 30 2,85 0,095000 0,071599 3,85 0,128333 0,096799

50 W56197002 A10BA02 METFORMINUM SIOFOR 850 mg COMPR. FILM. 850mg BERLIN-CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE CU 4 BLIST. AL/PVC X 15 COMPR.

FILM.P-6L 60 13,45 0,224166 0,121399 18,18 0,303000 0,164100

51 W56834001 A10BA02 METFORMINUM SERDENIS 850 mg COMPR. FILM. 850mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10

COMPR. FILM.P6L 30 3,64 0,121333 0,121333 4,92 0,164000 0,164000

52 W59640003 A10BA02 METFORMINUM METFORMIN AUROBINDO 850 mg COMPR. FILM. 850mg AUROBINDO PHARMA LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM.

P6L 30 3,60 0,120000 0,120000 4,87 0,162333 0,162333

53 W13873005 A10BA02 METFORMINUM GLUCOPHAGE 850 mg COMPR. FILM. 850mg MERCK SANTE FRANTA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. FILM.

P6L 100 18,70 0,187000 0,121399 25,27 0,252700 0,164100

54 W59640008 A10BA02 METFORMINUM METFORMIN AUROBINDO 850 mg COMPR. FILM. 850mg AUROBINDO PHARMA LIMITED

MAREA BRITANIE

CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM.

P6L 60 7,18 0,119666 0,119666 9,71 0,161833 0,161833

55 W14102001 A10BA02 METFORMINUM MEGUAN (R) 850 mg COMPR. FILM. 850mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10

COMPR. FILM.P6L 20 5,65 0,282500 0,121399 7,64 0,382000 0,164100

56 W56834002 A10BA02 METFORMINUM SERDENIS 850 mg COMPR. FILM. 850mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC-PVDC/AL X 10

COMPR. FILM.P6L 60 7,27 0,121166 0,121166 9,82 0,163666 0,163666

57 W08499004 A10BA02 METFORMINUM METFOGAMMA 850 mg COMPR. FILM. 850mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 12 BLIST. AL/PVC X 10 COMPR.

FILM.P6L 120 12,14 0,101166 0,101166 16,41 0,136750 0,136750

58 W56834003 A10BA02 METFORMINUM SERDENIS 850 mg COMPR. FILM. 850mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 9 BLIST. PVC-PVDC/AL X 10

COMPR. FILM.P6L 90 10,90 0,121111 0,121111 14,73 0,163666 0,163666

59 W53919001 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ATB 1,75 MG COMPR. 1,75 mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1,41 0,047000 0,047000 1,91 0,063666 0,063666

60 W41858004 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 1,75 mg COMPR. 1,75mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR.P-RF/S

1.000 55,56 0,055560 0,055560 70,25 0,070250 0,070250

61 W41858002 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 1,75 mg COMPR. 1,75mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. PEID X 100 COMPR.P-RF/S

100 8,60 0,086000 0,056400 11,62 0,116200 0,076399

62 W41858003 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 1,75 mg COMPR. 1,75mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1,52 0,050666 0,050666 2,05 0,068333 0,068333

63 W07202003 A10BB01 GLIBENCLAMIDUM MANINIL 1,75 mg COMPR. 1,75mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 FLAC. X 120 COMPR.

P-RF/S

120 8,75 0,072916 0,056400 11,82 0,098500 0,076399

64 W53920001 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ATB 3,5 MG COMPR. 3,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1,01 0,033666 0,033666 1,37 0,045666 0,045666

65 W41859004 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 3,5 mg COMPR. 3,5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR.P-RF/S

1.000 76,44 0,076440 0,040399 96,65 0,096650 0,054799

Pagina 38 din 87

Page 40: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

66 W41859002 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 3,5 mg COMPR. 3,5mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. PEID X 100 COMPR.P-RF/S

100 10,64 0,106400 0,040399 14,38 0,143800 0,054799

67 W07206003 A10BB01 GLIBENCLAMIDUM MANINIL 3,5 mg COMPR. 3,5mg BERLIN CHEMIE AG MENARINI GROUP GERMANIA CUTIE X 1 FLAC. X 120 COMPR.

P-RF/S

120 6,34 0,052833 0,040399 8,57 0,071416 0,054799

68 W41859003 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 3,5 mg COMPR. 3,5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 4,15 0,138333 0,040399 5,61 0,187000 0,054799

69 W53679003 A10BB01 GLIBENCLAMIDUM GLIBENCLAMID ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 4,24 0,141333 0,141333 5,73 0,191000 0,191000

70 W54934001 A10BB07 GLIPIZIDUM GLIPIZIDA ATB 5mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 11,49 0,383000 0,383000 15,53 0,517666 0,517666

71 W03348001 A10BB07 GLIPIZIDUM GLUCOTROL XL 10 mg COMPR. FILM. ELIB.MODIF. 10mg PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 FLAC. DIN PEID, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 30 COMPR. FILM. CU E

P-RF 30 35,35 1,178333 1,178333 46,24 1,541333 1,541333

72 W03349001 A10BB07 GLIPIZIDUM GLUCOTROL XL 5mg COMPR. FILM. ELIB.MODIF. 5mg PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 FLAC. DIN PEID PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII X 30 COMPR. FILM. CU EL

P-RF 30 17,67 0,589000 0,459600 23,88 0,796000 0,621199

73 W03352001 A10BB08 GLIQUIDONUM GLURENORM COMPR. 30mgBOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-RF 60 20,38 0,339666 0,339666 27,55 0,459166 0,459166

74 W42334001 A10BB09 GLICLAZIDUM ESQUEL (R) 80 mg COMPR. 80mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 15 COMPR. P6

L 30 9,71 0,323666 0,323666 13,13 0,437666 0,437666

75 W59674016 A10BB09 GLICLAZIDUM GLYCLADA 60 mg COMPR. CU ELIB. MODIF. 60mg KRKA, D.D., NOVO

MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. CU ELIB. MODIF.

PRF 60 21,90 0,365000 0,365000 29,60 0,493333 0,493333

76 W59674006 A10BB09 GLICLAZIDUM GLYCLADA 60 mg COMPR. CU ELIB. MODIF. 60mg KRKA, D.D., NOVO

MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. CU ELIB. MODIF.

PRF 60 21,90 0,365000 0,365000 29,60 0,493333 0,493333

77 W55137009 A10BB09 GLICLAZIDUM DIAPREL MR 60 mg COMPR. ELIB. MODIF. 60mg LES LABORATOIRES

SERVIER FRANTA CUTIE CU BLIST. PVC/AL X 60 COMPR. CU ELIB. MODIF.

P-RF 60 34,89 0,581500 0,438000 45,64 0,760666 0,592000

78 W61093003 A10BB09 GLICLAZIDUM GLICLAZIDA ZENTIVA 60 mg COMPR. ELIB. MODIF. 60mg ZENTIVA, K.S. REPUBLICA

CEHACUTIE CU BLIST. PVC-PVDC/AL X 90 COMPR. ELIB. MODIF.

PRF 90 34,02 0,378000 0,378000 44,50 0,494444 0,494444

79 W57919001 A10BB09 GLICLAZIDUM GLICLAZIDA ATB 30 mg COMPR. ELIB. PREL. 30mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB.

PREL.P-RF 30 6,02 0,200666 0,200666 8,14 0,271333 0,271333

80 W54001003 A10BB09 GLICLAZIDUM GLYCLADA 30 mg COMPR. ELIB. PREL. 30mg KRKA SLOVENIA CUTIE X 4 BLIST. PVC/AL X 15 COMPR. CU

ELIB. PREL.P-6L 60 12,10 0,201666 0,201666 16,36 0,272666 0,272666

81 W54001004 A10BB09 GLICLAZIDUM GLYCLADA 30 mg COMPR. ELIB. PREL. 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 6 BLIST. PVC/AL X 10 COMPR. CU

ELIB. PREL.P-6L 60 12,10 0,201666 0,201666 16,36 0,272666 0,272666

82 W55760001 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ATB 1 mg COMPR. 1mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 3,08 0,102666 0,102666 4,16 0,138666 0,138666

83 W57489005 A10BB12 GLIMEPIRIDUM AMARYL 1mg COMPR. 1mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-

RF 30 3,64 0,121333 0,121333 4,92 0,164000 0,164000

84 W43299001 A10BB12 GLIMEPIRIDUM MEGLIMID 1 mg COMPR. 1mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 6,73 0,224333 0,123199 9,09 0,303000 0,166399

85 W55761001 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ATB 2 mg COMPR. 2mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 5,08 0,169333 0,158800 6,87 0,229000 0,214399

86 W44007003 A10BB12 GLIMEPIRIDUM GLIMEPIRIDE 2 mg COMPR. 2mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 3,97 0,132333 0,132333 5,36 0,178666 0,178666

87 W57490004 A10BB12 GLIMEPIRIDUM AMARYL 2 mg COMPR. 2mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-

RF 30 6,10 0,203333 0,158800 8,24 0,274666 0,214399

88 W43300001 A10BB12 GLIMEPIRIDUM MEGLIMID 2 mg COMPR. 2mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 13,35 0,445000 0,158800 18,04 0,601333 0,214399

89 W57492004 A10BB12 GLIMEPIRIDUM AMARYL 3 mg COMPR. 3mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-

RF 30 11,31 0,377000 0,294000 15,28 0,509333 0,397600

90 W43301001 A10BB12 GLIMEPIRIDUM MEGLIMID 3 mg COMPR. 3mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 18,49 0,616333 0,294000 24,99 0,833000 0,397600

91 W44010003 A10BB12 GLIMEPIRIDUM GLIMEPIRIDE 3 mg COMPR. 3mg ACTAVIS GROUP HF. ISLANDA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-RF 30 7,35 0,245000 0,245000 9,94 0,331333 0,331333

92 W55762001 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ATB 3 mg COMPR. 3mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 9,43 0,314333 0,294000 12,74 0,424666 0,397600

93 W53365002 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ACCORD 4mg COMPR. 4mg ACCORD HEALTHCARE LIMITED

MAREA BRITANIE

CUTIE CU, BLIST. PVC-PVDC/AL X 30 COMPR.

P-6L 30 10,64 0,354666 0,354666 14,38 0,479333 0,479333

94 W55763001 A10BB12 GLIMEPIRIDUM GLIMEPIRIDA ATB 4 mg COMPR. 4mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. P-RF 30 10,62 0,354000 0,354000 14,36 0,478666 0,478666

95 W57494004 A10BB12 GLIMEPIRIDUM AMARYL 4 mg COMPR. 4mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-

RF 30 11,61 0,387000 0,387000 15,69 0,523000 0,523000

96 W57495004 A10BB12 GLIMEPIRIDUM AMARYL 6 mg COMPR. 6mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. P-

RF 30 19,08 0,636000 0,636000 25,79 0,859666 0,859666

97 W42117002 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) BIDIAB 400 mg/2,5 mg CAPS. 400mg+2,5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 5 CAPS.

P-RF/S

500 178,17 0,356340 0,356340 217,51 0,435020 0,435020

98 W42117001 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) BIDIAB 400 mg/2,5 mg CAPS. 400mg+2,5mg ARENA GROUP SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 5 CAPS. P-

RF 20 7,63 0,381500 0,381199 10,31 0,515500 0,515200

99 W10546002 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLIBOMET (R) COMPR. FILM. 400mg/2,5mg LAB. GUIDOTTI SPA ITALIA CUTIE X 3 BLIST. X 20 COMPR. FILM. P-

RF 60 19,06 0,317666 0,317666 25,76 0,429333 0,429333

100 W13594002 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLUCOVANCE (R) 500 mg/2,5 mg COMPR. FILM. 500mg/2,5mg MERCK SANTE FRANTA CUTIE X 4 BLIST. X 15 COMPR. FILM. P6

L 60 20,35 0,339166 0,339166 27,50 0,458333 0,458333

101 W13594006 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLUCOVANCE® 500 mg/2,5 mg COMPR. FILM. 500mg/2,5mg MERCK SANTE FRANTA CUTIE X 3 BLIST. PVC/AL X 20 COMPR.

FILM.P6L 60 20,35 0,339166 0,339166 27,50 0,458333 0,458333

102 W13595006 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLUCOVANCE® 500 mg/5 mg COMPR. FILM. 500mg/5mg MERCK SANTE FRANTA CUTIE X 3 BLIST. PVC/AL X 20 COMPR. FILM.

P6L 60 20,35 0,339166 0,339166 27,50 0,458333 0,458333

103 W13595002 A10BD02 COMBINATII (METFORMINUM+GLIBENCLAMIDUM) GLUCOVANCE (R) 500 mg/5 mg COMPR. FILM. 500mg/5mg MERCK SANTE FRANTA CUTIE X 4 BLIST. X 15 COMPR. FILM. P6L 60 20,35 0,339166 0,339166 27,50 0,458333 0,458333

Pagina 39 din 87

Page 41: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

104 W52765005 A10BD05 COMBINATII ( PIOGLITAZONUM + METFORMINUM)*** COMPETACT COMPR. FILM. 15mg/850m

g

TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD

MAREA BRITANIE CUTIE X 56 COMPR. FILM. ( BLIST. AL/AL ) P-

RF 56 159,72 2,852142 2,852142 194,99 3,481964 3,481964

105 W53295002 A10BD07 COMBINATII ( SITAGLIPTINUM+METFORMINUM)*** JANUMET 50 mg/1000 mg COMPR. FILM. 50mg/1000mg MERCK SHARP & DOHME MAREA

BRITANIECUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM.

P-RF 28 77,39 2,763928 2,763928 97,85 3,494642 3,494642

106 W58716003 A10BD10 COMBINATII ( SAXAGLIPTINUM + METFORMINUM)***KOMBOGLYZE 2,5/1000mg COMPR. FILM. 2,5mg+1000mg

BRISTOL-MYERS SQUIBB/ASTRAZENECA EEIG

MAREA BRITANIE

CUTIE CU BLIST. AL/AL NEPERFORATE CU 60 COMPR.FILM.

P-RF 60 168,58 2,809666 2,809666 205,80 3,430000 3,430000

107 W57947002 A10BF01 ACARBOSUM GLUCOBAY® 100 COMPR. 100mg BAYER PHARMA AG GERMANIA CUTIE X 8 BLIST. AL/PP X 15 COMPR. P-RF 120 51,89 0,432416 0,432416 65,61 0,546750 0,546750

108 W57946002 A10BF01 ACARBOSUM GLUCOBAY® 50 COMPR. 50mg BAYER PHARMA AG GERMANIA CUTIE X 8 BLIST. AL/PP X 15 COMPR. P-RF 120 39,95 0,332916 0,332916 52,25 0,435416 0,435416

109 W58660003 A10BG03 PIOGLITAZONUM*** ZIPION 15 mg COMPR. 15 mg ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.

PRF 30 56,24 1,874666 1,465600 71,11 2,370333 1,916800

110 W58503002 A10BG03 PIOGLITAZONUM*** GLIDIPION 15 mg COMPR. 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR.

(BLIST. TIP CALENDAR)PRF 28 34,20 1,221428 1,221428 44,73 1,597500 1,597500

111 W58030002 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA TORRENT 15 mg COMPR. 15mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-AL X 30

COMPR.PRF 30 43,89 1,463000 1,463000 57,41 1,913666 1,913666

112 W58446003 A10BG03 PIOGLITAZONUM*** LISPECIP 15 mg COMPR. 15mg ALVOGEN IPCO S.A.R.L LUXEMBURG

CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR.

PRF 30 40,47 1,349000 1,349000 52,93 1,764333 1,764333

113 W60060001 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA POLIPHARMA 15 mg COMPR. 15mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10

COMPR.P6L 30 36,64 1,221333 1,221333 47,92 1,597333 1,597333

114 W08069002 A10BG03 PIOGLITAZONUM*** ACTOS 15mg COMPR. 15mg

TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD

MAREA BRITANIE CUTIE X 28 COMPR. (BLIST. AL/AL) P-

RF 28 100,29 3,581785 1,465600 122,43 4,372500 1,916800

115 W58686003 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA AUROBINDO 15 mg COMPR. 15mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. DIN POLIAMIDA/AL/PVC X

30 COMPR.PRF 30 64,41 2,147000 1,465600 81,44 2,714666 1,916800

116 W58661003 A10BG03 PIOGLITAZONUM*** ZIPION 30 mg COMPR. 30 mg ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.

PRF 30 84,33 2,811000 2,811000 106,63 3,554333 3,554333

117 W58031002 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA TORRENT 30 mg COMPR. 30mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-AL X 30

COMPR.PRF 30 86,35 2,878333 2,878333 109,18 3,639333 3,639333

118 W58687003 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA AUROBINDO 30 mg COMPR. 30mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. DIN POLIAMIDA/AL/PVC X

30 COMPR.PRF 30 98,49 3,283000 2,880000 124,53 4,151000 3,641570

119 W58447003 A10BG03 PIOGLITAZONUM*** LISPECIP 30 mg COMPR. 30mg ALVOGEN IPCO S.A.R.L LUXEMBURG

CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR.

PRF 30 82,84 2,761333 2,761333 104,74 3,491333 3,491333

120 W58504002 A10BG03 PIOGLITAZONUM*** GLIDIPION 30 mg COMPR. 30mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR.

(BLIST. TIP CALENDAR)PRF 28 67,20 2,400000 2,400000 84,97 3,034642 3,034642

121 W60061001 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA POLIPHARMA 30 mg COMPR. 30mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10

COMPR.P6L 30 72,00 2,400000 2,400000 91,04 3,034666 3,034666

122 W08070003 A10BG03 PIOGLITAZONUM*** ACTOS 30mg COMPR. 30mg

TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD

MAREA BRITANIE CUTIE X 28 COMPR.(BLIST. AL/AL) P-

RF 28 150,92 5,390000 2,880000 184,24 6,580000 3,641570

123 W58662003 A10BG03 PIOGLITAZONUM*** ZIPION 45 mg COMPR. 45 mg ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.

PRF 30 143,75 4,791666 3,840000 175,49 5,849666 4,855200

124 W58688003 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA AUROBINDO 45 mg COMPR. 45mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. DIN POLIAMIDA/AL/PVC X

30 COMPR.PRF 30 130,18 4,339333 3,840000 158,92 5,297333 4,855200

125 W58448003 A10BG03 PIOGLITAZONUM*** LISPECIP 45 mg COMPR. 45mg ALVOGEN IPCO S.A.R.L LUXEMBURG

CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR.

PRF 30 116,90 3,896666 3,840000 142,71 4,757000 4,757000

126 W60062001 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA POLIPHARMA 45 mg COMPR. 45mg POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 3 BLIST. PA-AL-PVC/AL X 10

COMPR.P6L 30 96,00 3,200000 3,200000 121,38 4,046000 4,046000

127 W58505002 A10BG03 PIOGLITAZONUM*** GLIDIPION 45 mg COMPR. 45mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. AL/AL X 28 COMPR.

(BLIST. TIP CALENDAR)PRF 28 89,60 3,200000 3,200000 113,29 4,046071 4,046071

128 W08071002 A10BG03 PIOGLITAZONUM*** ACTOS 45mg COMPR. 45mg

TAKEDA GLOBAL RESEARCH AND DEVELOPMENT CENTRE LTD

MAREA BRITANIE CUTIE X 28 COMPR.(BLIST. AL/AL) P-

RF 28 206,41 7,371785 3,840000 251,99 8,999642 4,855200

129 W58032002 A10BG03 PIOGLITAZONUM*** PIOGLITAZONA TORRENT 45 mg COMPR. 45mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-AL X 30

COMPR.PRF 30 118,80 3,960000 3,840000 145,03 4,834333 4,834333

130 W51928002 A10BH01 SITAGLIPTINUM*** JANUVIA 100mg COMPR. FILM. 100mg MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 28 COMPR. FILM. (BLIST. PVC/PE/PVDC/AL)

P-RF 28 160,75 5,741071 5,741071 196,24 7,008571 7,008571

131 W54993009 A10BH03 SAXAGLIPTIN*** ONGLYZA COMPR. FILM. 5 mgBRISTOL-MYERS SQUIBB/ASTRAZENECA EEIG

MAREA BRITANIE

CUTIE CU BLISTER AL/AL PERFORAT 30 X1 COMPR.FILM.

P-RF 30 161,70 5,390000 5,390000 197,40 6,580000 6,580000

132 W56718002 A10BX02 REPAGLINIDUM RENEOS 0,5 mg COMPR. 0,5 mg ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU BLIST. OPA-AL-PVC/AL X 90 COMPR.

PRF 90 20,20 0,224444 0,224444 27,30 0,303333 0,303333

133 W56719002 A10BX02 REPAGLINIDUM RENEOS 1 mg COMPR. 1 mg ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU BLIST. OPA-AL-PVC/AL X 90 COMPR.

PRF 90 20,20 0,224444 0,224444 27,30 0,303333 0,303333

134 W56720002 A10BX02 REPAGLINIDUM RENEOS 2 mg COMPR. 2 mg ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 90 COMPR.

PRF 90 20,20 0,224444 0,224444 27,30 0,303333 0,303333

135 W57092001 A10BX04 EXENATIDUM*** BYDUREON 2 mgPULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

2 mg ELI LILLY NEDERLAND BV OLANDA

AMBALAJ CU 4 X 1 DISPOZITIV DE ADMINISTRAREA UNICA (1FL X2MG PULB.+1SERINGA PREUMPLUTAX0,65ML SOLVEN

PRF 4 380,67 95,167500 95,167500 453,08 113,270000 113,270000

136 W60301001 A10BX04 EXENATIDUM*** BYDUREON 2 mgPULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL.

2 mgBRISTOL-MYERS SQUIBB/ASTRAZENECA EEIG

MAREA BRITANIE

AMBALAJ CU 4 X 1 DISPOZITIV DE ADMINISTRAREA UNICA (1FL X2MG PULB.+1SERINGA PREUMPLUTAX0,65ML SOLVEN

PRF 4 380,67 95,167500 95,167500 453,08 113,270000 113,270000

137 W52269001 A10BX04 EXENATIDUM*** BYETTA 10mcg/dozaSOL. INJ. IN STILOU INJECTOR PREUMPLUT

10mcg/doza ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN)

PREUMPLUT (60 DOZE)P-RF 1 314,81 314,810000 314,810000 381,29 381,290000 381,290000

Pagina 40 din 87

Page 42: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

138 W60353001 A10BX04 EXENATIDUM*** BYETTA 10µg/dozaSOL. INJ. IN STILOU INJECTOR PREUMPLUT

10µg/dozaBRISTOL-MYERS SQUIBB/ASTRAZENECA EEIG

MAREA BRITANIE

CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT (60 DOZE)

P-RF 1 314,81 314,810000 314,810000 381,29 381,290000 381,290000

139 W52268001 A10BX04 EXENATIDUM*** BYETTA 5mcg/dozaSOL. INJ. IN STILOU INJECTOR PREUMPLUT

5mcg/doza ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN)

PREUMPLUT (60 DOZE)P-RF 1 303,47 303,470000 303,470000 368,93 368,930000 368,930000

140 W60352001 A10BX04 EXENATIDUM*** BYETTA 5µg/dozaSOL. INJ. IN STILOU INJECTOR PREUMPLUT

5µg/dozaBRISTOL-MYERS SQUIBB/ASTRAZENECA EEIG

MAREA BRITANIE

CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT (60 DOZE)

P-RF 1 303,47 303,470000 303,470000 368,93 368,930000 368,930000

141 W59381003 A10BX09 DAPAGLIFOZINUM*** FORXIGA 10 mg COMPR. FILM. 10mgBRISTOL-MYERS SQUIBB/ASTRAZENECA EEIG

MAREA BRITANIE

CUTIE CU BLIST. DIN ALU/ALU X 30X1 COMPR. FILM. (UNITATE DOZATA)

PRF 30 162,69 5,423000 5,423000 198,61 6,620333 6,620333

142 W61097002 A11DA03 BENFOTIAMINUM BENFOTIAMINA BIOMEDIAL 300 mg COMPR. FILM. 300mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10

COMPR. FILM.P6L 30 106,68 3,556000 3,556000 130,23 4,341000 4,341000

143 W41932004 A11DA03 BENFOTIAMINUM BENFOGAMMA DRAJ. 50mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-

6L 50 21,25 0,425000 0,425000 28,72 0,574400 0,574400

144 W01610002 A11DBN1 COMBINATII** MILGAMMA (R) N CAPS. MOIFARA CONCENTRATIE

WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 CAPS. MOIP-

6L 50 35,84 0,716800 0,716800 46,88 0,937600 0,937600

145 W01731002 A11DBN1 COMBINATII** MILGAMMA (R) (vezi B03BA51) DRAJ.FARA CONCENTRATIE

WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 BLIST. PVC/PVDC X 10 DRAJ. P-

6L 50 35,84 0,716800 0,716800 46,88 0,937600 0,937600

146 W41647001 A11DBN1 COMBINATII** MILGAMMA (R) NA SOL. INJ.FARA CONCENTRATIE

WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA

PREVAZUTE CU PUNCT DE RUPERE X 1 MLP-RF 5 13,70 2,740000 2,740000 18,52 3,704000 3,704000

147 W01611001 A11DBN1 COMBINATII** MILGAMMA (R) N SOL. INJ.FARA CONCENTRATIE

WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA

PREVAZUTE CU PUNCT DE RUPERE X 2 MLP-RF 5 13,70 2,740000 2,740000 18,52 3,704000 3,704000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.1: HEMOFILIE SI TALASEMIE

1 W56025001 B02BD02 FACTOR VIII DE COAGULARE** HAEMOCTIN SDH 1000 PULB+SOLV. PT. SOL. INJ. 100UI/ml BIOTEST PHARMA GMBH GERMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 FLAC. DIN STICLA INCOLORA CU 10 ML SOLV. PT. SOL. INJ. + 1 SERINGA DE UNICA FOLOSINTA + 1 CANULA DUBLA CU DOUA FILTRE SI 1 CANULA TIP FLUTURE

P-PR 1 1.734,00 1.734,000000 1.433,160000 1.928,21 1.928,210000 1.607,928000

2 W56024001 B02BD02 FACTOR VIII DE COAGULARE** HAEMOCTIN SDH 500 PULB+SOLV. PT. SOL. INJ. 50UI/ml BIOTEST PHARMA GMBH GERMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 FLAC. DIN STICLA INCOLORA CU 10 ML SOLV. PT. SOL. INJ. + 1 SERINGA DE UNICA FOLOSINTA + 1 CANULA DUBLA CU DOUA FILTRE SI 1 CANULA TIP FLUTURE

P-PR 1 882,00 882,000000 592,800000 999,53 999,530000 691,932000

3 W56023001 B02BD02 FACTOR VIII DE COAGULARE** HAEMOCTIN SDH 250 PULB+SOLV. PT. SOL. INJ. 50UI/ml BIOTEST PHARMA GMBH GERMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 FLAC. DIN STICLA INCOLORA CU 5 ML SOLV. PT. SOL. INJ. + 1 SERINGA DE UNICA FOLOSINTA + 1 CANULA DUBLA CU DOUA FILTRE SI 1 CANULA TIP FLUTURE

P-PR 1 456,00 456,000000 366,960000 535,19 535,190000 445,764000

4 W56663001 B02BD02 FACTOR VIII DE COAGULARE** OCTANATE 100 UI/ml PULB. + SOLV. PT. SOL. INJ. 100 UI/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE

CUTIE X 1 FLAC. X 1000 UI PULB. PT.SOL. INJ. + 1 FL. SOLVENT X 10ML + CUTIE CU SET DE RECONSTITUIRE

PR 1 1.194,30 1.194,300000 1.194,300000 1.339,94 1.339,940000 1.339,940000

5 W56662001 B02BD02 FACTOR VIII DE COAGULARE** OCTANATE 50 UI/ml PULB. + SOLV. PT. SOL. INJ. 50 UI/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE

CUTIE X 1 FLAC. CU 250 U.I. PULB. + 1 FL.SOLVENT X 5ML+ CUTIE CU SET DE RECONSTITUIRE SI ADM.

PR 1 305,80 305,800000 305,800000 371,47 371,470000 371,470000

6 W56662002 B02BD02 FACTOR VIII DE COAGULARE** OCTANATE 50 UI/ml PULB. + SOLV. PT. SOL. INJ. 50 UI/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE

CUTIE X 1 FLAC. CU 500 U.I. PULB. + 1 FL. SOLVENT X 10ML + CUTIE CU SET DE RECONSTITUIRE SI ADM.

PR 1 494,00 494,000000 494,000000 576,61 576,610000 576,610000

7 W61061001 B02BD02 MOROCTOCOG ALFA** REFACTO AF 1000UI PULB. + SOL. PT. SOL. INJ. 1000 UI PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STERIL DE PERF. + 1 PLASTURE + 1 TIFON

PR 1 2.226,90 2.226,900000 2.226,900000 2.465,47 2.465,470000 2.465,470000

8 W61062001 B02BD02 MOROCTOCOG ALFA** REFACTO AF 2000UI PULB. + SOL. PT. SOL. INJ. 2000 UI PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STERIL DE PERF. + 1 PLASTURE + 1 TIFON

PR 1 4.853,36 4.853,360000 4.853,360000 5.328,32 5.328,320000 5.328,320000

9 W61059001 B02BD02 MOROCTOCOG ALFA** REFACTO AF 250UI PULB. + SOL. PT. SOL. INJ. 250 UI PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STERIL DE PERF. + 1 PLASTURE + 1 TIFON

PR 1 599,90 599,900000 599,900000 692,04 692,040000 692,040000

10 W61060001 B02BD02 MOROCTOCOG ALFA** REFACTO AF 500UI PULB. + SOL. PT. SOL. INJ. 500 UI PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC.CU PULB. + 1 SERINGA PREUMPL. X 4 ML SOLV + 1 ADAPTOR + 2 TAMP.CU ALCOOL + 1 SET STERIL DE PERF. + 1 PLASTURE + 1 TIFON

PR 1 1.162,85 1.162,850000 1.162,850000 1.305,66 1.305,660000 1.305,660000

11 W54970001 B02BD02 OCTOCOG ALFA** RECOMBINATE 1000 UI PULB+SOLV. PT. SOL. INJ. 1000UI BAXTER AG AUSTRIA

CUTIE CU 1 FLAC. PULB.+1 FLAC. SOLV.+DISPOZITIV PT. RECONST. (BAXJECT II) +1 SERINGA +1 SET MINI-PERF.+ 2 TAMP. ALCOOL+2 PLAST.

S/P-RF 1 2.393,60 2.393,600000 2.393,600000 2.647,18 2.647,180000 2.647,180000

Pagina 41 din 87

Page 43: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

12 W59904001 B02BD02 OCTOCOG ALFA** RECOMBINATE 1000 UI/5 ml PULB+SOLV. PT. SOL. INJ. 1000UI/5ml BAXTER AG AUSTRIA

CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ., 1 FLAC CU 5 ML SOLV., 1 SERINGA DIN PLASTIC DE UNICA FOLOSINTA, 1 DISPOZITIV PT. RECONSTITUIRE (BAXJECT II), UN SET DE MINI-PERFUZARE STERIL, 2 TAMPOANE CU ALCOOL MEDICINAL SI 2 PLASTURI

PRF 1 2.393,60 2.393,600000 2.393,600000 2.647,18 2.647,180000 2.647,180000

13 W54968001 B02BD02 OCTOCOG ALFA** RECOMBINATE 250 UI PULB+SOLV. PT. SOL. INJ. 250UI BAXTER AG AUSTRIA

CUTIE CU 1 FLAC. PULB.+1 FLAC. SOLV.+DISPOZITIV PT. RECONST. (BAXJECT II) +1 SERINGA +1 SET MINI-PERF.+ 2 TAMP. ALCOOL+2 PLAST.

S/P-RF 1 620,90 620,900000 620,900000 714,93 714,930000 714,930000

14 W59902001 B02BD02 OCTOCOG ALFA** RECOMBINATE 250 UI/5 ml PULB+SOLV. PT. SOL. INJ. 250UI/5ml BAXTER AG AUSTRIA

CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SOL. INJ., 1 FLAC CU 5 ML SOLV., 1 SERINGA DIN PLASTIC DE UNICA FOLOSINTA, 1 DISPOZITIV PT. RECONSTITUIRE (BAXJECT II), UN SET DE MINI-PERFUZARE STERIL, 2 TAMPOANE CU ALCOOL MEDICINAL SI 2 PLASTURI

PRF 1 620,90 620,900000 620,900000 714,93 714,930000 714,930000

15 W54969001 B02BD02 OCTOCOG ALFA** RECOMBINATE 500 UI PULB+SOLV. PT. SOL. INJ. 500UI BAXTER AG AUSTRIA

CUTIE CU 1 FLAC. PULB.+1 FLAC. SOLV.+DISPOZITIV PT. RECONST. (BAXJECT II) +1 SERINGA +1 SET MINI-PERF.+ 2 TAMP. ALCOOL+2 PLAST.

S/P-RF 1 1.211,80 1.211,800000 1.211,800000 1.359,01 1.359,010000 1.359,010000

16 W51449001 B02BD02 OCTOCOG ALFA** ADVATE 1000UI PULB+SOLV.PT.SOL.INJ 1000UI BAXTER AG AUSTRIA

CUTIE X 1 FLAC. CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II

P-RF/R

1 2.482,35 2.482,350000 2.482,350000 2.743,92 2.743,920000 2.743,920000

17 W61172001 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 1000UI PULB+SOLV.PT.SOL.INJ 1000UI BAYER PHARMA AG GERMANIA

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTINE O TRUSA DE ADM.

PR 1 2.486,60 2.486,600000 2.486,600000 2.748,55 2.748,550000 2.748,550000

18 W51450001 B02BD02 OCTOCOG ALFA** ADVATE 1500UI PULB+SOLV.PT.SOL.INJ 1500UI BAXTER AG AUSTRIA

CUTIE X 1 FLAC. CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II

P-RF/R

1 3.996,10 3.996,100000 3.996,100000 4.393,90 4.393,900000 4.393,900000

19 W61175001 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 2000UI PULB+SOLV.PT.SOL.INJ 2000UI BAYER PHARMA AG GERMANIA

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 5,0ML SOL. + AMBALAJ SUPL. CE CONTINE O TRUSA DE ADM.

P-RF/R

1 4.943,22 4.943,220000 4.943,220000 5.426,27 5.426,270000 5.426,270000

20 W61168001 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 250UI PULB+SOLV.PT.SOL.INJ 250UI BAYER PHARMA AG GERMANIA

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTINE O TRUSA DE ADM.

P-RF/R

1 654,52 654,520000 654,520000 751,58 751,580000 751,580000

21 W51448001 B02BD02 OCTOCOG ALFA** ADVATE 500UI PULB+SOLV.PT.SOL.INJ 500 UI BAXTER AG AUSTRIA

CUTIE X 1 FLAC. CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II

P-RF/R

1 1.280,02 1.280,020000 1.280,020000 1.433,37 1.433,370000 1.433,370000

22 W61170001 B02BD02 OCTOCOG ALFA** KOGENATE BAYER 500UI PULB+SOLV.PT.SOL.INJ 500UI BAYER PHARMA AG GERMANIA

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 2,5ML SOL. + AMBALAJ SUPL. CE CONTINE O TRUSA DE ADM.

P-RF/R

1 1.269,02 1.269,020000 1.269,020000 1.421,38 1.421,380000 1.421,380000

23 W53183001 B02BD02 OCTOCOG ALFA** ADVATE 2000UI PULB+SOLV.PT.SOL.INJ. 2000 UI BAXTER AG AUSTRIA CUTIE X 1 FLAC CU PULB. + 1 FLAC. X 5 ML

SOLVENT + 1 DISPOZITIV BAXJECT II

P-RF/R

1 5.318,10 5.318,100000 5.318,100000 5.834,89 5.834,890000 5.834,890000

24 W51447001 B02BD02 OCTOCOG ALFA** ADVATE 250UI PULB+SOLV.PT.SOL.INJ. 250 UI BAXTER AG AUSTRIA

CUTIE X 1 FLAC CU PULB. + 1 FLAC. X 5 ML APA PT. SOL. INJ. + 1 DISPOZITIV BAXJECT II

P-RF/R

1 691,02 691,020000 691,020000 791,36 791,360000 791,360000

25 W53185001 B02BD02 OCTOCOG ALFA** ADVATE 3000UI PULB+SOLV.PT.SOL.INJ. 3000 UI BAXTER AG AUSTRIA CUTIE X 1 FLAC CU PULB. + 1 FLAC. X 5 ML

SOLVENT + 1 DISPOZITIV BAXJECT II

P-RF/R

1 7.962,15 7.962,150000 7.962,150000 8.716,90 8.716,900000 8.716,900000

26 W52173003 B02BD03 COMPLEX DE ANTIINHIBITORI AI COAGULARII** FEIBA NF 1000 U FEIBA PULB.+SOLV. PT. SOL. INJ. 1000 U BAXTER A.G. AUSTRIA

CUTIE X 1 FLACON FEIBA NF 1000U FEIBA PULB. PT. SOL. INJ. + 1 FLAC. CU SOLV. +1 DISP. BAXJECT II HI-FLOW1- FARA ACE PT. TRANSF. SI AMEST. MED. DIN 2 FLAC. INTR-O SER. DE UNICA FOLOS. +1AC DE UNICA FOLOS+1AC FLUTURE CU OPRITOR (SET. PT. INJ.)

PR 1 2.849,24 2.849,240000 2.849,240000 3.143,83 3.143,830000 3.143,830000

27 W52172002 B02BD03 COMPLEX DE ANTIINHIBITORI AI COAGULARII** FEIBA NF 500 U FEIBA PULB.+SOLV. PT. SOL. INJ. 500 U BAXTER A.G. AUSTRIA

CUTIE X 1 FLACON FEIBA NF 500U FEIBA PULB. PT. SOL. INJ. + 1 FLAC. CU SOLV. +1 DISP. BAXJECT II HI-FLOW1- FARA ACE PT. TRANSF. SI AMEST. MED. DIN 2 FLAC. INTR-O SER. DE UNICA FOLOS. +1AC DE UNICA FOLOS+1AC FLUTURE CU OPRITOR (SET. PT. INJ.)

PR 1 1.421,28 1.421,280000 1.421,280000 1.587,35 1.587,350000 1.587,350000

28 W58659001 B02BD04 FACTOR IX DE COAGULARE** BETAFACT 50 UI/ml PULB+SOLV. PT. SOL. INJ. 50 UI/ml LFB - BIOMEDICAMENTS FRANTA

CUTIE CU 1 FLAC. DIN STICLA CU PULB. (250 UI/5 ML) + 1 FLAC. STICLA X 5 ML SOLV. PT. SOL. INJ. + SISTEM DE TRANSFER SI 1 AC CU FILTRU

PR 1 487,95 487,950000 487,950000 570,02 570,020000 570,020000

29 W58659002 B02BD04 FACTOR IX DE COAGULARE** BETAFACT 50 UI/ml PULB+SOLV. PT. SOL. INJ. 50 UI/ml LFB - BIOMEDICAMENTS FRANTA

CUTIE CU 1 FLAC. DIN STICLA CU PULB. (500 UI/10 ML) + 1 FLAC. STICLA X 10 ML SOLV. PT. SOL. INJ. + SISTEM DE TRANSFER SI 1 AC CU FILTRU

PR 1 945,90 945,900000 931,200000 1.069,18 1.069,180000 1.060,788000

Pagina 42 din 87

Page 44: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

30 W56231001 B02BD04 FACTOR IX DE COAGULARE** OCTANINE F 1000 UI PULB. + SOLV. PT. SOL. PERF. 1000UI OCTAPHARMA (IP) LTD. MAREA

BRITANIE

CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF. + 1 FLAC. DIN STICLA CU 10 ML SOLV. PT. SOL. PERF.+ DISPOZITIV PT. RECONSTITUIRE SI ADM. CU 1 SET TRANSFER MIX2VIAL TM +1 SET DE PERFUZARE+1 SERINGA+2 TAMP. CU ALCOOL

S 1 1.474,14 1.474,140000 1.474,140000 1.644,96 1.644,960000 1.644,960000

31 W56230001 B02BD04 FACTOR IX DE COAGULARE** OCTANINE F 500 UI PULB. + SOLV. SOL. PERF. 500 UI OCTAPHARMA (IP) LTD. MAREA

BRITANIE

CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF. + 1 FLAC. DIN STICLA CU 5 ML SOLV. PT. SOL. PERF.+ DISPOZITIV PT. RECONSTITUIRE SI ADM. CU 1 AC CU CAP DUBLU+1 FILTRU PT. AC+1 SET DE PERFUZARE+1 SERINGA+2 TAMP. CU ALCOOL

S 1 776,00 776,000000 776,000000 883,99 883,990000 883,990000

32 W43970001 B02BD04 FACTOR IX DE COAGULARE** IMMUNINE 1200 UI PULB.+SOLV. PT. SOL. INJ./PERF. 1200UI BAXTER AG AUSTRIA

CUTIE X 1 FLAC. PULB. PT. SOL. INJ./ PERF. + 1 FLAC. X 10 ML SOLV. + 1 SET DE RECONSTITUIRE SI ADMI

S 1 1.685,69 1.685,690000 1.685,690000 1.875,55 1.875,550000 1.875,550000

33 W60173002 B02BD04 NONACOG ALPHA (FACTOR IX DE COAGULARE)** BENEFIX 1000UI PULB+SOLV.PT.SOL.INJ 1000UI PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF.

PR 1 2.519,23 2.519,230000 1.768,968000 2.784,11 2.784,110000 1.973,952000

34 W60172002 B02BD04 NONACOG ALPHA (FACTOR IX DE COAGULARE)** BENEFIX 2000UI PULB+SOLV.PT.SOL.INJ 2000UI PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF.

PR 1 5.008,50 5.008,500000 5.008,500000 5.497,42 5.497,420000 5.497,420000

35 W60175002 B02BD04 NONACOG ALPHA (FACTOR IX DE COAGULARE)** BENEFIX 250UI PULB+SOLV.PT.SOL.INJ 250UI PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF.

PR 1 712,99 712,990000 585,540000 815,31 815,310000 684,024000

36 W60174001 B02BD04 NONACOG ALPHA (FACTOR IX DE COAGULARE)** BENEFIX 500UI PULB+SOLV.PT.SOL.INJ 500UI PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. CU PULB. PT. SOL. INJ. + 1 SERINGA UMPLUTA. X 5ML SOL. INJ. + 1 SET STERIL DE PERF.

PR 1 1.262,20 1.262,200000 931,200000 1.413,95 1.413,950000 1.060,788000

37 W58455001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** WILATE 1000 1000 UI FVIII/1000 UI FVW PULB+SOLV. PT.

SOL. INJ

1000 UI FVIII/1000 UI FVW

OCTAPHARMA (IP) LTD. MAREA BRITANIE

CUTIE CU 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FLAC. CU SOLV. PT. SOL. INJ. + 1 SET DE ADMINISTRARE (1 SERINGA DE UNICA FOLOSINTA, 1 SET TRANSFER (MIX2VIAL), 1 SET DE PERFUZARE SI 2 TAMPOANE CU ALCOOL MEDICINAL)

PR 1 1.734,00 1.734,000000 1.734,000000 1.928,21 1.928,210000 1.928,210000

38 W58454001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** WILATE 500 500 UI FVIII/500 UI FVW PULB+SOLV. PT.

SOL. INJ

500 UI FVIII/500 UI FVW

OCTAPHARMA (IP) LTD. MAREA BRITANIE

CUTIE CU 1 FLAC. CU PULB. PT. SOL. INJ. + 1 FLAC. CU SOLV. PT. SOL. INJ. + 1 SET DE ADMINISTRARE (1 SERINGA DE UNICA FOLOSINTA, 1 SET TRANSFER (MIX2VIAL), 1 SET DE PERFUZARE SI 2 TAMPOANE CU ALCOOL MEDICINAL)

PR 1 882,00 882,000000 882,000000 999,53 999,530000 999,530000

39 W61007001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 1000 UI FVIII/750 UI FVW PULB.+SOLV. PT.

SOL. INJ.1000 UI /750 UI BAXTER AG AUSTRIA

CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (10ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE

PR 1 1.234,15 1.234,150000 1.234,150000 1.383,38 1.383,380000 1.383,380000

40 W58406001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 1000 UI PULB.+SOLV. PT.

SOL. INJ. 1000UI BAXTER AG AUSTRIA

CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (10ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE

PR 1 1.234,15 1.234,150000 1.234,150000 1.383,38 1.383,380000 1.383,380000

41 W61005001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 250 UI FVIII/190 UI FVW PULB.+SOLV. PT.

SOL. INJ.250 UI /190 UI BAXTER AG AUSTRIA

CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (5ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE

PR 1 299,32 299,320000 299,320000 365,41 365,410000 365,410000

42 W58404001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 250 UI PULB.+SOLV. PT.

SOL. INJ. 250UI BAXTER AG AUSTRIA

CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (5ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE

PR 1 299,32 299,320000 299,320000 365,41 365,410000 365,410000

43 W61006001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 500 UI FVIII/375 UI FVW PULB.+SOLV. PT.

SOL. INJ.500 UI /375 UI BAXTER AG AUSTRIA

CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (5ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE

PR 1 574,21 574,210000 574,210000 664,04 664,040000 664,040000

Pagina 43 din 87

Page 45: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

44 W58405001 B02BD06 FACTOR VIII DE COAGULARE SI FACTOR VON WILLEBRAND** IMMUNATE 500 UI PULB.+SOLV. PT.

SOL. INJ. 500UI BAXTER AG AUSTRIA

CUTIE CU 1 FLAC. MONODOZA CU PULB. PT. SOL. INJ. + 1 FLAC. MONODOZA CU SOLV. + 1 SET DE TRANSFER/FILTRU + 1 SERINGA DE UNICA FOLOSINTA (5ML) + 1 AC DE UNICA FOLOSINTA + 1 SET DE PERFUZIE

PR 1 574,21 574,210000 574,210000 664,04 664,040000 664,040000

45 W02408001 V03AC01 DEFEROXAMINUM**3) DESFERAL LIOF. PT. SOL. INJ./PERF. 500mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE X 10 FLAC. DIN STICLA X 500 MG LIOF. PT. SOL. INJ./PERF.

S/P-RF 10 110,64 11,064000 11,064000 135,07 13,507000 13,507000

46 W51484001 V03AC03 DEFERASIROXUM**** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) PR 28 687,54 24,555000 24,555000 787,57 28,127500 28,127500

47 W51485001 V03AC03 DEFERASIROXUM**** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 1.461,36 52,191428 52,191428 1.631,03 58,251071 58,251071

48 W51486001 V03AC03 DEFERASIROXUM**** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 2.660,12 95,004285 95,004285 2.937,68 104,917142 104,917142

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.2: EPIDERMOLIZA BULOASA

1 W53799002 D05BB02 ACITRETINUM NEOTIGASON 10 mg CAPS. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 CAPS. P-

RF 30 59,11 1,970333 1,970333 74,74 2,491333 2,491333

2 W54946001 D06AA04 TETRACYCLINUM TETRACICLINA ATB 30 mg/g UNGUENT 30mg/g ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 TUB AL X 12 G UNGUENT P-RF 1 5,70 5,700000 5,700000 7,70 7,700000 7,700000

3 W59985001 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g CREMA 20mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-

RF 1 8,83 8,830000 8,830000 11,94 11,940000 11,940000

4 W59986001 D06AX01 ACIDUM FUSIDICUM FUCIDIN 20 mg/g UNGUENT 20mg/g LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-

RF 1 9,09 9,090000 9,090000 12,28 12,280000 12,280000

5 W54309001 D06BA01 SULFADIAZINUM FLAMMAZINE CREMA 1% CN UNIFARM ROMANIA BORCAN X 500 G CREMA PRF 1 76,53 76,530000 76,530000 96,76 96,760000 96,760000

6 W60525001 D07CA01 COMBINATII (ACIDUM FUSIDICUM+HYDROCORTISONUM) FUCIDIN H CREMA

FARA CONCENTRATIE

LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-

RF 1 15,00 15,000000 15,000000 20,28 20,280000 20,280000

7 W59725001 D07CC01 BETAMETHASONUM+GENTAMICINUM+CLOTRIMAZOLUM TRESYL CREMA

FARA CONCENTRATIE

FITERMAN PHARMA S.R.L. ROMANIA

CUTIE CU 1 TUB DIN AL FILMAT LA INTERIOR CU LAC EPOXIFENOLIC X 15 G CREMA

P6L 1 7,33 7,330000 7,330000 9,91 9,910000 9,910000

8 W57219001 D07CC01 COMBINATII TRIDERM® CREMA 0,5mg+10mg+1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB AL X 15 G P-

RF 1 11,28 11,280000 11,280000 15,24 15,240000 15,240000

9 W57648001 D07CC01 COMBINATII DIPROGENTA 0,5 mg/1 mg pe gram CREMA 0,5mg/1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-

RF 1 9,26 9,260000 9,260000 12,51 12,510000 12,510000

10 W57224001 D07CC01 COMBINATII TRIDERM UNGUENT 0,5mg+10mg+1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-

RF 1 11,28 11,280000 11,280000 15,24 15,240000 15,240000

11 W57649001 D07CC01 COMBINATII DIPROGENTA 0,5 mg/1 mg pe gram UNGUENT 0,5mg/1mg/g MERCK SHARP & DOHME ROMANIA CUTIE X 1 TUB DIN AL X 15 G UNGUENT P-

RF 1 9,26 9,260000 9,260000 12,51 12,510000 12,510000

12 W59984001 D07CC01 COMBINATII (ACIDUM FUSIDICUM+ BETAMETHASONUM) FUCICORT 20 mg/1mg pe gram CREMA 20mg/1mg

pe gram LEO PHARMA A/S DANEMARCA CUTIE X 1 TUB DIN AL X 15 G CREMA P-

RF 1 15,88 15,880000 15,880000 21,46 21,460000 21,460000

13 W56910001 J01AA07 TETRACYCLINUM TETRACICLINA ATB 250 mg CAPS. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. PRF 20 4,79 0,239500 0,125304 6,47 0,323500 0,158448

14 W12701002 J01AA07 TETRACYCLINUM TETRACICLINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 50 BLIST., AL/PVC X 10 CAPS.P-RF/S

500 52,21 0,104420 0,104420 66,02 0,132040 0,132040

15 W12701001 J01AA07 TETRACYCLINUM TETRACICLINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 CAPS. P-RF 20 2,21 0,110500 0,110500 2,99 0,149500 0,149500

16 W12143001 N03AB02 PHENYTOINUM FENITOINA RICHTER 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-

6L 20 2,05 0,102500 0,102500 2,77 0,138500 0,138500

17 W55235001 N03AB02 PHENYTOINUM PHENHYDAN 250 mg/5 ml SOL. INJ. 250mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X

5 ML SOL. INJ.P-RF 5 53,57 10,714000 10,714000 67,73 13,546000 13,546000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.3: HIPERTENSIUNE PULMONARA

1 W43049001 C02KX01 BOSENTANUM** TRACLEER 125 mg COMPR. FILM. 125mg ACTELION REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 14 COMPR. FILM.

P-RF/R

56 9.529,79 170,174821 170,174821 10.425,63 186,171964 186,171964

2 W43048002 C02KX01 BOSENTANUM** TRACLEER 62,5 mg COMPR. FILM. 62,5mg ACTELION REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 14 COMPR. FILM.

P-RF/R

56 9.200,67 164,297678 164,297678 10.066,89 179,765892 179,765892

3 W52981002 C02KX02 AMBRISENTANUM** VOLIBRIS 10mg COMPR. FILM. 10mg GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 30 COMP. FILM (BLIST. PVC/PVDC/AL)

P-RF/R

30 8.848,19 294,939666 294,939666 9.682,69 322,756333 322,756333

4 W52980002 C02KX02 AMBRISENTANUM** VOLIBRIS 5mg COMPR. FILM. 5mg GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 30 COMP. FILM (BLIST. PVC/PVDC/AL)

P-RF/R

30 8.848,19 294,939666 294,939666 9.682,69 322,756333 322,756333

5 W42831001 G04BE03 SILDENAFILUM** REVATIO 20 mg COMPR. FILM. 20mg PFIZER LIMITED MAREA BRITANIE

CUTIE X 6 BLIST. AL/PVC X 15 COMPR. FILM. PR 90 1.873,53 20,817000 20,817000 2.080,30 23,114444 23,114444

6 W60083001 G04BE03 SILDENAFILUM** REVATIO 10mg/ml SUSP. ORALA 10mg/ml PFIZER LIMITED MAREA BRITANIE

CUTIE CU UN FLACON DIN STICLA BRUNA CE CONTINE 32,27 G DE PULBERE PENTRU SUSP. ORALA

PR 1 1.033,53 1.033,530000 1.033,530000 1.164,70 1.164,700000 1.164,700000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.4: MUCOVISCIDOZA

1 W56031002 A09AA02 PANCREATINUM** KREON 40000 CAPS. GASTROREZ. 400mg ABBOTT PRODUCTS

GMBH GERMANIA CUTIE X UN FLACON DIN PEID CU 50 CAPS. GASTROREZ.

P-6L 50 111,16 2,223200 2,223200 135,70 2,714000 2,714000

2 W58242002 J01FA09 CLARITHROMYCINUM CLAXIRIT 500 mg COMPR. CU ELIB. PREL. 500mg ACTAVIS GROUP PTC

EHF. ISLANDA CUTIE CU BLIST. PVC/PVDC//AL X 7 COMPR. CU ELIB. PREL.

PRF 7 23,71 3,387142 1,405714 32,05 4,578571 1,899428

3 W59000002 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. ELIB. PREL. 500mg

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR. ELIB. PREL.

PRF 6 21,73 3,621666 1,405714 29,37 4,895000 1,899428

Pagina 44 din 87

Page 46: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

4 W08490001 J01FA09 CLARITHROMYCINUM FROMILID 250 COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.

P-RF 14 12,35 0,882142 0,647142 16,69 1,192142 0,874285

5 W44093001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM.

P-RF 14 10,85 0,775000 0,647142 14,67 1,047857 0,874285

6 W58998015 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 250 mg COMPR. FILM. 250mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR)

PRF 14 8,39 0,599285 0,599285 11,34 0,810000 0,810000

7 W01326002 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 21,14 1,510000 0,647142 28,57 2,040714 0,874285

8 W14043001 J01FA09 CLARITHROMYCINUM KLERIMED (R) 250 COMPR. FILM. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM.

P-RF 14 12,35 0,882142 0,647142 16,69 1,192142 0,874285

9 W61223003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14

COMPR. FILM.PRF 14 7,55 0,539285 0,539285 10,20 0,728571 0,728571

10 W60253004 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM.

PRF 14 8,40 0,600000 0,600000 11,36 0,811428 0,811428

11 W44087001 J01FA09 CLARITHROMYCINUM KLABAX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM.

P-RF 14 23,73 1,695000 1,405714 32,08 2,291428 1,899428

12 W58999014 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. FILM. 500mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR)

PRF 14 18,22 1,301428 1,301428 24,62 1,758571 1,758571

13 W08491001 J01FA09 CLARITHROMYCINUM FROMILID 500 COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.

P-RF 14 24,13 1,723571 1,405714 32,62 2,330000 1,899428

14 W60254003 J01FA09 CLARITHROMYCINUM LEKOKLAR 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM.

PRF 14 24,13 1,723571 1,405714 32,62 2,330000 1,899428

15 W54044001 J01FA09 CLARITHROMYCINUM ROCLARIN 500 mg COMPR. FILM. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM.

P-RF 20 33,14 1,657000 1,405714 43,35 2,167500 1,899428

16 W56269001 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-

RF 20 40,76 2,038000 1,405714 53,31 2,665500 1,899428

17 W61224003 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14

COMPR. FILM.PRF 14 16,40 1,171428 1,171428 22,16 1,582857 1,582857

18 W14044001 J01FA09 CLARITHROMYCINUM KLERIMED (R) 500 COMPR. FILM. 500mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM.

P-RF 14 24,13 1,723571 1,405714 32,62 2,330000 1,899428

19 W44088001 J01FA09 CLARITHROMYCINUM KLABAX MR 500 mg COMPR. FILM. ELIB.MODIF. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC/PVDC-AL X 7 COMPR.

FILM. ELIB. PREL.P-RF 7 25,34 3,620000 1,405714 33,15 4,735714 1,899428

20 W13607002 J01FA09 CLARITHROMYCINUM KLACID SR COMPR. FILM. ELIB.PREL. 500mg ABBOTT LABORATORIES

LTD.MAREA BRITANIE

CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. FILM. ELIB. PREL.

P-RF 5 27,85 5,570000 1,405714 36,43 7,286000 1,899428

21 W41838002 J01FA09 CLARITHROMYCINUM FROMILID (R) UNO COMPR. FILM. ELIB.PREL. 500mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 COMPR.

FILM. ELIB. PREL.P-RF 7 20,78 2,968571 1,405714 28,09 4,012857 1,899428

22 W42258001 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA

CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP

P-RF 1 19,39 19,390000 16,812000 26,21 26,210000 22,728000

23 W44092001 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT.

60 ML SUSP . ORALAP-RF 1 14,01 14,010000 14,010000 18,94 18,940000 18,940000

24 W01327001 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA ITALIA

CUTIE X 1 FLACON PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML

P-RF 1 29,92 29,920000 29,920000 39,14 39,140000 39,140000

25 W01327002 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA ITALIA

CUTIE X 1 FLACON PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML

P-RF 1 18,11 18,110000 16,812000 24,48 24,480000 22,728000

26 W06981001 J01FA09 CLARITHROMYCINUM FROMILID (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. P-

RF 1 17,24 17,240000 16,812000 23,30 23,300000 22,728000

27 W44091002 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100

ML SUSP . ORALAP-RF 1 39,06 39,060000 39,060000 51,09 51,090000 51,090000

28 W58393002 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA

PRF 1 21,29 21,290000 21,290000 28,78 28,780000 28,780000

29 W44091001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60

ML SUSP . ORALAP-RF 1 23,44 23,440000 23,440000 31,68 31,680000 31,680000

30 W01329001 J01FA09 CLARITHROMYCINUM KLACID I.V. LIOF. PT. SOL. PERF. 500mg ABBOTT LABORATORIES

LTD. FRANTA CUTIE X 1 FLAC. LIOF. PT. SOL. PERF. S/P-RF 1 41,12 41,120000 41,120000 53,78 53,780000 53,780000

31 W52060001 J01GB01 TOBRAMYCINUM** TOBI (R) SOL. INHAL. 300mg/5ml NOVARTIS PHARMA GMBH GERMANIA

CUTIE X 4 PLICURI DIN AL; FIECARE PLIC CONTINE 7 FIOLE GEMENE DIN PEJD X 5 ML SOL. DE INHALAT PRIN N

P-RF 56 8.112,06 144,858214 144,858214 8.880,31 158,576964 158,576964

32 W61214001 R05CB13 DORNAZA ALFA** PULMOZYME 2500 U/2,5 mlSOL. DE INHALAT PRIN NEBULIZATOR

2500U/2,5ml ROCHE ROMANIA S.R.L. ROMANIA

CUTIE CU 6 FIOLE UNIDOZA, MONOBLOC, DIN PE X 2,5 ML SOL. INHAL. PRIN NEBULIZATOR, INTRODUSE INTR-O PUNGA DIN AL

PR 6 416,77 69,461666 69,461666 492,43 82,071666 82,071666

33 W51323001 R05CB13 DORNAZA ALFA** PULMOZYME SOL. INHAL. 1mg/ml ROCHE ROMANIA S.R.L. ROMANIACUTIE X 6 FIOLE UNIDOZA PE X 2,5 ML SOL.INHAL. PRIN NEBULIZATOR, INTRODUSE IN PUNGA AL

S/P-RF 6 416,77 69,461666 69,461666 492,43 82,071666 82,071666

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.5: BOLI NEUROLOGICE DEGENERATIVE/INFLAMATOR-IMUNEP6.5.1: TRATAMENTUL MEDICAMENTOS AL BOLNAVILOR CU BOLI NEUROLOGICE INFLAMATOR-IMUNE

1 W54752003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 1.714,69 1.714,690000 1.714,690000 1.907,17 1.907,170000 1.907,170000

2 W54752004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. S 1 3.437,56 3.437,560000 3.437,560000 3.785,10 3.785,100000 3.785,100000

3 W54752002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 881,87 881,870000 881,870000 999,39 999,390000 999,390000

Pagina 45 din 87

Page 47: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

4 W54752001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 379,02 379,020000 379,020000 451,28 451,280000 451,280000

5 W51530003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL.

PERF.(5G/50ML) S 1 925,45 925,450000 909,000000 1.046,89 1.046,890000 1.036,596000

6 W51530004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL.

PERF.(10G/100ML) S 1 1.857,75 1.857,750000 1.782,000000 2.063,10 2.063,100000 1.988,160000

7 W51530006 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL.

PERF.(30G/300ML) S 1 5.558,99 5.558,990000 5.558,990000 6.097,46 6.097,460000 6.097,460000

8 W51530005 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL.

PERF.(20G/200ML) S 1 3.821,35 3.821,350000 3.821,350000 4.203,43 4.203,430000 4.203,430000

9 W51530001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL.

PERF.(1G/10ML) S 1 202,26 202,260000 202,260000 246,92 246,920000 246,920000

10 W43965001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.485,00 1.485,000000 1.485,000000 1.656,80 1.656,800000 1.656,800000

11 W43962001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 197,39 197,390000 197,390000 240,98 240,980000 240,980000

12 W43963001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 393,75 393,750000 393,750000 467,34 467,340000 467,340000

13 W59114003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 100 ML

SOL. PERF.PRF 1 882,14 882,140000 882,140000 999,68 999,680000 999,680000

14 W59114001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 20 ML SOL.

PERF.PRF 1 187,48 187,480000 187,480000 228,87 228,870000 228,870000

15 W59114004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 200 ML

SOL. PERF.PRF 1 1.734,28 1.734,280000 1.734,280000 1.928,52 1.928,520000 1.928,520000

16 W59114002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 50 ML SOL.

PERF.PRF 1 456,06 456,060000 456,060000 535,26 535,260000 535,260000

17 W52560001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 10 ML SOL. PERF. S 1 102,55 102,550000 102,550000 125,19 125,190000 125,190000

18 W13462001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 50 ML S 1 465,59 465,590000 465,590000 545,64 545,640000 545,640000

19 W13462003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 200 ML S 1 1.772,34 1.772,340000 1.772,340000 1.970,00 1.970,000000 1.970,000000

20 W13462002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 100 ML S 1 882,13 882,130000 882,130000 999,67 999,670000 999,670000

21 W43964001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 757,50 757,500000 757,500000 863,83 863,830000 863,830000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.5: BOLI NEUROLOGICE DEGENERATIVE/INFLAMATOR-IMUNEP6.5.2: TRATAMENTUL MEDICAMENTOS AL BOLNAVILOR CU BOLI NEUROLOGICE DEGENERATIVE-SCLEROZA LATERALA AMIOTROFICA

1 W12590001 N07XX02 RILUZOLUM** RILUTEK 50 mg COMPR. FILM. 50mg AVENTIS PHARMA SA FRANTA CUTIE X 4 BLIST. X 14 COMPR. PR 56 535,66 9,565357 9,565357 622,02 11,107500 11,107500P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.5: BOLI NEUROLOGICE DEGENERATIVE/INFLAMATOR-IMUNEP6.5.3: Tratamentul medicamentos al bolnavilor cu polineuropatie familială amiloidă cu transtiretină

1 W59336001 N07XX08 TAFAMIDIS** VYNDAQEL CAPS. MOI 20mg PFIZER LIMITED MAREA BRITANIE

CUTIE CU 2 BLIST. PVC/AL A CATE 15 CAPSULE MOI PR 30 53.258,63 1.775,287666 1.775,287666 58.090,13 1.936,337666 1.936,337666

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.6: OSTEOGENEZA IMPERFECTA

1 W58123007 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml

CHIESI PHARMACEUTICALS GMBH

AUSTRIA CUTIE X 1 FIOLA PE X 4 ML S/P-RF 1 361,86 361,860000 285,384000 432,58 432,580000 348,396000

2 W58123005 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml

CHIESI PHARMACEUTICALS GMBH

AUSTRIA CUTIE X 1 FIOLA PE X 1 ML S/P-RF 1 102,98 102,980000 102,980000 125,72 125,720000 125,720000

3 W58123006 M05BA03 ACIDUM PAMIDRONICUM PAMIDRONAT TORREX CONC. PT. SOL. PERF. 15mg/ml

CHIESI PHARMACEUTICALS GMBH

AUSTRIA CUTIE X 1 FIOLA PE X 2 ML S/P-RF 1 158,95 158,950000 158,950000 194,05 194,050000 194,050000

4 W07918001 M05BA03 ACIDUM PAMIDRONICUM AREDIA (R) 15 mg LIOF.+ SOLV. PT. SOL. PERF. 15mg NOVARTIS PHARMA

GMBH GERMANIACUTIE X 4 FLAC. DIN STICLA X 15 MG LIOF. PT. SOL. PERF. + 4 FIOLE DIN STICLA X 5 ML SOLV.

S/P-RF 4 595,85 148,962500 123,576000 687,63 171,907500 150,864000

5 W57926001 M05BA03 ACIDUM PAMIDRONICUM PAMIRED 30mg pulbere pentru solutie perfuzabila

PULB. PT. SOL. PERF. 30mg DR. REDDY'S

LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 30 MG LIOF. PT. SOL. PERF. I.V. PR 1 152,87 152,870000 152,870000 186,63 186,630000 186,630000

6 W57925001 M05BA03 ACIDUM PAMIDRONICUM PAMIRED 60mg pulbere pentru solutie perfuzabila

PULB. PT. SOL.PERF. 60mg DR. REDDY'S

LABORATORIES ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 60 MG LIOF. PT. SOL. PERF. I.V. PR 1 237,82 237,820000 237,820000 290,33 290,330000 290,330000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.7: SINDROM PRADER WILLI

1 W07530001 H01AC01 SOMATROPINUM** ZOMACTON PULB. + SOLV. PT. SOL. INJ. 4mg (12ui) FERING GMBH GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1

FIOLA X 3,5 ML SOLV.P-RF 1 363,94 363,940000 363,940000 434,84 434,840000 434,840000

2 W05539002 H01AC01 SOMATROPINUM** GENOTROPIN (R) 16 ui (5,3 mg) PULB. + SOLV. PT. SOL. INJ.

5,3mg/ml (16ui) PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 CARTUS BICAMERAL MULTIDOZA CU PULB. SI SOLV. PT. SOL. INJ.

P-RF 1 474,75 474,750000 474,750000 555,63 555,630000 555,630000

3 W59825001 H01AC01 SOMATROPINUM** OMNITROPE 15mg/1,5ml SOL INJ. 15mg/1,5ml SANDOZ GMBH AUSTRIA CUTIE X 1 CARTUS X 1,5 ML SOL.INJ.PR/PRF

1 1.482,36 1.482,360000 1.482,360000 1.653,92 1.653,920000 1.653,920000

4 W52345001 H01AC01 SOMATROPINUM** OMNITROPE 3,3mg/ml SOL. INJ. 3,3mg/ml SANDOZ GMBH AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ.P-RF/R

1 409,15 409,150000 409,150000 484,12 484,120000 484,120000

5 W52346001 H01AC01 SOMATROPINUM** OMNITROPE 6,7mg/ml SOL. INJ. 6,7mg/ml SANDOZ GMBH AUSTRIA CUTIE X 1CARTUS X 1,5 ML SOL.INJ.P-RF/R

1 667,50 667,500000 667,500000 765,73 765,730000 765,730000

Pagina 46 din 87

Page 48: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

6 W54046001 H01AC01 SOMATROPINUM** NORDITROPIN SIMPLEXx 10 mg/1,5ml SOL. INJ. IN CARTUS 10mg/1,5ml NOVO NORDISK A/S DANEMAR

CACUTIE X 1 CARTUS DIN STICLA INCOLORA X 1,5 ML SOL. INJ.

P-RF 1 1.176,67 1.176,670000 801,000000 1.320,72 1.320,720000 918,876000

7 W55238001 H01AC01 SOMATROPINUM** NORDITROPIN FLEXPRO 10 mg/1,5 mlSOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT

10mg/1,5 ml NOVO NORDISK A/S DANEMARCA

CUTIE CU 1 STILOU INJECTOR (PEN) PREUMPLUT MULTI-DOZA ( CARTUS DIN STICLA INCOLORA X 1,5 ML SOL. INJ

P-RF 1 1.549,07 1.549,070000 801,000000 1.726,64 1.726,640000 918,876000

8 W55237001 H01AC01 SOMATROPINUM** NORDITROPIN FLEXPRO 5 mg/1,5 mlSOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT

5mg/1,5 ml NOVO NORDISK A/S DANEMARCA

CUTIE CU 1 STILOU INJECTOR (PEN) PREUMPLUT MULTI-DOZA ( CARTUS DIN STICLA INCOLORA X 1,5 ML SOL. INJ

P-RF 1 789,53 789,530000 490,980000 898,74 898,740000 580,944000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.8: BOALA FABRY

1 W08961001 A16AB04 AGALSIDASUM BETA** FABRAZYME 35 mg PULB. PT. CONC. PT. SOL. PERF. 35mg GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. CU PULB. PT. CONC. PT.

SOL. PERF. PR 1 13.797,28 13.797,280000 13.797,280000 15.077,20 15.077,200000 15.077,200000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.9: BOALA POMPE

1 W51536001 A16AB07 ALGLUCOSIDASUM ALPHA** MYOZYME 50mg PULB. PT. CONC. PT. SOL. PERF. 50mg GENZYME EUROPE B.V. OLANDA CUTIE X 1 FLAC. CU 50MG PULB. PT. CONC.

PT. SOL. PERF. PR 1 2.264,71 2.264,710000 2.264,710000 2.506,69 2.506,690000 2.506,690000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.10: TIROZINEMIE

1 W51629001 A16AX04 NITISINONUM ORFADIN 10mg CAPS. 10mg SWEDISH ORPHAN INTERNATIONAL AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 60 CAPS.

P-RF/R

60 12.802,92 213,382000 213,382000 13.993,35 233,222500 233,222500

2 W51622001 A16AX04 NITISINONUM ORFADIN 2mg CAPS. 2mg SWEDISH ORPHAN INTERNATIONAL AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 60 CAPS.

P-RF/R

60 3.522,06 58,701000 58,701000 3.877,20 64,620000 64,620000

3 W51627001 A16AX04 NITISINONUM ORFADIN 5mg CAPS. 5mg SWEDISH ORPHAN INTERNATIONAL AB SUEDIA CUTIE X 1 FLAC. DIN PEID X 60 CAPS.

P-RF/R

60 7.014,11 116,901833 116,901833 7.683,54 128,059000 128,059000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.12: MUCOPOLIZAHARIDOZĂ TIP II (SINDROM HUNTER)

1 W51481002 A16AB09 IDURSULFASUM** ELAPRASE 2mg/ml CONC. PT. SOL. PERF. 2mg/ml SHIRE HUMAN GENETIC

THERAPIES AB SUEDIA CUTIE X 4 FLAC. X 3 ML CONC. PT. SOL. PERF. S 4 49.871,94 12.467,985000 12.467,985000 54.398,63 13.599,657500 13.599,657500

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.13: MUCOPOLIZAHARIDOZĂ TIP I (SINDROM HURLER)

1 W42203001 A16AB05 LARONIDAZUM** ALDURAZYME 100UI/ml CONC. PT. SOL. PERF. 100UI/ml GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC. X 5 ML S 1 2.802,88 2.802,880000 2.802,880000 3.093,29 3.093,290000 3.093,290000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.15: Sindrom de imunodeficienţă primară

1 W54752003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 1.714,69 1.714,690000 1.714,690000 1.907,17 1.907,170000 1.907,170000

2 W54752004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. S 1 3.437,56 3.437,560000 3.437,560000 3.785,10 3.785,100000 3.785,100000

3 W54752002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 881,87 881,870000 881,870000 999,39 999,390000 999,390000

4 W54752001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 379,02 379,020000 379,020000 451,28 451,280000 451,280000

5 W51530003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL.

PERF.(5G/50ML) S 1 925,45 925,450000 909,000000 1.046,89 1.046,890000 1.036,596000

6 W51530004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL.

PERF.(10G/100ML) S 1 1.857,75 1.857,750000 1.782,000000 2.063,10 2.063,100000 1.988,160000

7 W51530006 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL.

PERF.(30G/300ML) S 1 5.558,99 5.558,990000 5.558,990000 6.097,46 6.097,460000 6.097,460000

8 W51530005 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL.

PERF.(20G/200ML) S 1 3.821,35 3.821,350000 3.821,350000 4.203,43 4.203,430000 4.203,430000

9 W51530001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL.

PERF.(1G/10ML) S 1 202,26 202,260000 202,260000 246,92 246,920000 246,920000

10 W43965001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.485,00 1.485,000000 1.485,000000 1.656,80 1.656,800000 1.656,800000

11 W43962001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 197,39 197,390000 197,390000 240,98 240,980000 240,980000

12 W43963001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 393,75 393,750000 393,750000 467,34 467,340000 467,340000

13 W59114003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 100 ML

SOL. PERF.PRF 1 882,14 882,140000 882,140000 999,68 999,680000 999,680000

14 W59114001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 20 ML SOL.

PERF.PRF 1 187,48 187,480000 187,480000 228,87 228,870000 228,870000

15 W59114004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 200 ML

SOL. PERF.PRF 1 1.734,28 1.734,280000 1.734,280000 1.928,52 1.928,520000 1.928,520000

16 W59114002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 50 ML SOL.

PERF.PRF 1 456,06 456,060000 456,060000 535,26 535,260000 535,260000

17 W52560001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 10 ML SOL. PERF. S 1 102,55 102,550000 102,550000 125,19 125,190000 125,190000

18 W13462001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 50 ML S 1 465,59 465,590000 465,590000 545,64 545,640000 545,640000

19 W13462003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 200 ML S 1 1.772,34 1.772,340000 1.772,340000 1.970,00 1.970,000000 1.970,000000

20 W13462002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 100 ML S 1 882,13 882,130000 882,130000 999,67 999,670000 999,670000

Pagina 47 din 87

Page 49: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

21 W43964001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 757,50 757,500000 757,500000 863,83 863,830000 863,830000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.16: Scleroza sistemică şi ulcere digitale evolutive

1 W43049001 C02KX01 BOSENTANUM** TRACLEER 125 mg COMPR. FILM. 125mg ACTELION REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 14 COMPR. FILM.

P-RF/R

56 9.529,79 170,174821 170,174821 10.425,63 186,171964 186,171964

2 W43048002 C02KX01 BOSENTANUM** TRACLEER 62,5 mg COMPR. FILM. 62,5mg ACTELION REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 14 COMPR. FILM.

P-RF/R

56 9.200,67 164,297678 164,297678 10.066,89 179,765892 179,765892

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.17: Purpura trombocitopenică imună cronică la adulţii splenectomizaţi şi nesplenectomizaţi

1 W53894001 B02BX04 ROMIPLOSTIMUM**** NPLATE 250mcg PULB. PT. SOL. INJ. 250mcg AMGEN EUROPE B.V. OLANDA CUTIE X 1 FLAC X 250MCG PULB. PT. SOL. INJ. S 1 2.905,50 2.905,500000 2.905,500000 3.205,15 3.205,150000 3.205,150000

2 W53895001 B02BX04 ROMIPLOSTIMUM**** NPLATE 500mcg PULB. PT. SOL. INJ. 500mcg AMGEN EUROPE B.V. OLANDA CUTIE X 1 FLAC X 500MCG PULB. PT. SOL. INJ. S 1 5.780,98 5.780,980000 5.780,980000 6.339,43 6.339,430000 6.339,430000

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.18: Pacienţi adulţi şi copii cu hiperfenilalaninemie diagnosticaţi cu fenilcetonurie sau deficit de tetrahidrobiopterină (BH4)

1 W57418002 A16AX07 SAPROPTERINUM**** KUVAN COMPR. SOLUBILE 100 mg MERCK SERONO EUROPE LIMITED

MAREA BRITANIE

CUTIE X FLAC. PEID X 120 COMPR. SOLUBILE PR 120 10.927,33 91,061083 91,061083 11.948,96 99,574666 99,574666

2 W57418001 A16AX07 SAPROPTERINUM**** KUVAN COMPR. SOLUBILE 100 mg MERCK SERONO EUROPE LIMITED

MAREA BRITANIE

CUTIE X FLAC. PEID X 30 COMPR. SOLUBILE PR 30 2.755,69 91,856333 91,856333 3.041,86 101,395333 101,395333

P6: PROGRAMUL NATIONAL DE DIAGNOSTIC SI TRATAMENT PENTRU BOLI RARE SI SEPSIS SEVER P6.19: Scleroză tuberoasă

1 W57284002 L01XE10 EVEROLIMUS**** VOTUBIA COMPR. 2,5 mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE CUTIE CU BLIST. PA/AL/PVC X 30 COMPR. PR 30 5.656,21 188,540333 188,540333 6.203,43 206,781000 206,781000

2 W57285001 L01XE10 EVEROLIMUS**** VOTUBIA COMPR. 5mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE CUTIE CU BLIST. PA/AL/PVC X 30 COMPR. PR 30 11.282,41 376,080333 376,080333 12.335,99 411,199666 411,199666

P7: PROGRAM NATIONAL DE BOLI ENDOCRINE Tratamentul medicamentos al bolnavilor cu osteoporoza, gusa datorata carentei de iod si proliferarii maligne

1 W00231001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,25 mcg CAPS. MOI 0,25mcgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. DIN PPID X 50 CAPS. MOI P-RF 50 21,46 0,429200 0,429200 29,01 0,580200 0,580200

2 W58167002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,25 mcg CAPS. MOI 0,25µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI

PRF 30 16,99 0,566333 0,515040 22,97 0,765666 0,696240

3 W44042001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,50 mcg CAPS. MOI 0,50mcgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. X 30 CAPS. MOI P-RF 30 23,23 0,774333 0,774333 31,40 1,046666 1,046666

4 W58168002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,5 mcg CAPS. MOI 0,5µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI

PRF 30 26,00 0,866666 0,866666 34,01 1,133666 1,133666

5 W55847001 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMAR

CACUTIE CU 10 FIOLE DIN STICLA BRUNA X 0,5 ML SOL. INJ. S 10 108,79 10,879000 10,879000 132,81 13,281000 13,281000

6 W55847002 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMAR

CACUTIE CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. S 10 203,78 20,378000 20,378000 248,78 24,878000 24,878000

7 W51334002 A11CC04 CALCITRIOLUM ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC X 20 CAPS. MOI. P-RF 100 53,88 0,538800 0,538800 68,12 0,681200 0,681200

8 W03025001 G03CA03 ESTRADIOLUM ESTREVA (R) GEL 0,1% LAB. THERAMEX MONACO CUTIE X 1 FLACON PE, INCHIS CU POMPA DOZATOARE X 50 G

P-6L 1 21,75 21,750000 21,750000 29,40 29,400000 29,400000

9 W55402001 G03CA03 ESTRADIOLUM OESTROGEL 0,6 mg/g GEL 0,6mg/g LABORATOIRES BESINS INTERNATIONAL FRANTA CUTIE CU 1 TUB AL X 80 G GEL +

DISPOZITIV DE DOZARE DIN POLISTIRENP-6L 1 12,29 12,290000 12,290000 16,61 16,610000 16,610000

10 W58804002 G03CA03 ESTRADIOLUM CLIMARA PLASTURE TRANSDERM. 50µg/24ore BAYER PHARMA AG GERMANIA CUTIE X 4 PLICURI X 1 PLASTURE

TRANSDERM.P-6L 4 22,11 5,527500 5,527500 29,89 7,472500 7,472500

11 W12902001 G03CX01 TIBOLONUM LIVIAL (R) 2,5 mg COMPR. 2,5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 28 COMPR. P-RF 28 57,59 2,056785 2,056785 72,82 2,600714 2,600714

12 W53455002 G03XC01 RALOXIFENUM EVISTA 60mg COMPR. FILM. 60mg DAIICHI SANKYO EUROPE GMBH GERMANIA CUTIE X 28 COMPR. FILM. (BLIST. ACLAR) P-

RF 28 98,84 3,530000 3,530000 124,97 4,463214 4,463214

13 W42160002 H01AB01 TIREOTROPINUM ALFA THYROGEN 0,9 mg PULB. PT. SOL. INJ. 0,9mg GENZYME EUROPE BV OLANDA CUTIE X 2 FLACOANE S 2 3.064,97 1.532,485000 1.532,485000 3.378,97 1.689,485000 1.689,485000

14 W04224001 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-

RF 50 24,13 0,482600 0,482600 32,62 0,652400 0,652400

15 W04222001 H02AB04 METHYLPREDNISOLONUM MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-

RF 20 21,94 1,097000 1,097000 29,65 1,482500 1,482500

16 W08307001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2

MLS/P-RF 1 6,52 6,520000 6,520000 8,81 8,810000 8,810000

17 W08310001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X

7,8 MLS/P-RF 1 22,95 22,950000 22,950000 31,02 31,020000 31,020000

18 W04237001 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV

P-RF 1 15,15 15,150000 15,150000 20,48 20,480000 20,480000

19 W57399001 H03AA01 LEVOTHYROXINUM EUTHYROX 100mcg COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 8,65 0,086500 0,067440 11,69 0,116900 0,091200

20 W59436009 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 100 micrograme COMPR. 100micrograme

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR.

P6L 100 5,62 0,056200 0,056200 7,60 0,076000 0,076000

21 W57399003 H03AA01 LEVOTHYROXINUM EUTHYROX 100µg COMPR. 100µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 8,65 0,086500 0,067440 11,69 0,116900 0,091200

Pagina 48 din 87

Page 50: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

22 W59437009 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 125 micrograme COMPR. 125micrograme

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR.

P6L 100 7,02 0,070200 0,070200 9,49 0,094900 0,094900

23 W59438009 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 150 micrograme COMPR. 150micrograme

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR.

P6L 100 8,43 0,084300 0,084300 11,40 0,114000 0,114000

24 W59439009 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 175 micrograme COMPR. 175micrograme

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR.

P6L 100 9,84 0,098400 0,098400 13,30 0,133000 0,133000

25 W57395001 H03AA01 LEVOTHYROXINUM EUTHYROX 200mcg COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-6L 100 17,86 0,178600 0,139440 24,14 0,241400 0,188400

26 W59440009 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 200 micrograme COMPR. 200micrograme

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR.

P6L 100 11,62 0,116200 0,116200 15,70 0,157000 0,157000

27 W57395002 H03AA01 LEVOTHYROXINUM EUTHYROX 200µg COMPR. 200µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-6L 100 17,86 0,178600 0,139440 24,14 0,241400 0,188400

28 W57396001 H03AA01 LEVOTHYROXINUM EUTHYROX 25mcg COMPR. 25mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 7,04 0,070400 0,054840 9,51 0,095100 0,074160

29 W59433009 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 25 micrograme COMPR. 25micrograme

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR.

P6L 100 4,57 0,045700 0,045700 6,18 0,061800 0,061800

30 W57396003 H03AA01 LEVOTHYROXINUM EUTHYROX 25µg COMPR. 25µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 7,04 0,070400 0,054840 9,51 0,095100 0,074160

31 W57398001 H03AA01 LEVOTHYROXINUM EUTHYROX 50mcg COMPR. 50mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-6L 100 6,12 0,061200 0,047760 8,27 0,082700 0,064560

32 W59434009 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 50 micrograme COMPR. 50micrograme

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR.

P6L 100 3,98 0,039800 0,039800 5,38 0,053800 0,053800

33 W57398002 H03AA01 LEVOTHYROXINUM EUTHYROX 50µg COMPR. 50µg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-6L 100 6,12 0,061200 0,047760 8,27 0,082700 0,064560

34 W59435009 H03AA01 LEVOTHYROXINUM LEVOTIROXINA TEVA 75 micrograme COMPR. 75micrograme

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR.

P6L 100 5,97 0,059700 0,059700 8,07 0,080700 0,080700

35 W54546003 H03BB02 THIAMAZOLUM THYROZOL 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM.

P-6L 50 15,54 0,310800 0,310800 21,00 0,420000 0,420000

36 W54545003 H03BB02 THIAMAZOLUM THYROZOL 20mg COMPR. FILM. 20mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM.

P-6L 50 18,88 0,377600 0,377600 25,52 0,510400 0,510400

37 W54547004 H03BB02 THIAMAZOLUM THYROZOL 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM.

P6L 100 22,83 0,228300 0,228300 30,86 0,308600 0,308600

38 W03843004 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. P-RF 100 9,12 0,091200 0,091200 12,33 0,123300 0,123300

39 W03843003 H03CA01 KALII IODIDUM JODID 100 COMPR. 100mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. AL/PP X 25 COMPR. P-RF 100 9,12 0,091200 0,091200 12,33 0,123300 0,123300

40 W03844003 H03CA01 KALII IODIDUM JODID 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PP/AL X 25 COMPR. P-RF 100 14,23 0,142300 0,142300 19,23 0,192300 0,192300

41 W03844004 H03CA01 KALII IODIDUM JODID 200 COMPR. 200mcg MERCK KGAA GERMANIA CUTIE X 4 BLIST. PVC/AL X 25 COMPR. P-RF 100 14,23 0,142300 0,142300 19,23 0,192300 0,192300

42 W55488001 H05AA02 TERIPARATIDUM** FORSTEO 20µg/80µl SOL. INJ. 20µg/80µl ELI LILLY NEDERLAND BV OLANDACUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 2,4 ML (28 DOZE X 20 ΜCG/80ΜCL)

P-RF 1 1.473,60 1.473,600000 1.473,600000 1.644,38 1.644,380000 1.644,380000

43 W08119001 H05BA01 CALCITONINUM (SOMON) NYLEX (R) SOL. INJ. 100UI/ml PROEL E.P. CORONIS SA GRECIA CUTIE X 5 FIOLE X 1ML P-RF 5 23,94 4,788000 4,788000 32,36 6,472000 6,472000

44 W00756001 H05BA01 CALCITONINUM (SOMON) MIACALCIC (R) SOL. INJ. 50ui/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE X 1 ML P-

RF 5 26,35 5,270000 5,270000 34,46 6,892000 6,892000

45 W54297001 M05BA04 ACIDUM ALENDRONICUM** TEVANAT 70 mg COMPR. 70 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-AL-OPA/AL X 4 COMPR.

P-6L 4 36,90 9,225000 5,337000 48,27 12,067500 7,212000

46 W60296004 M05BA04 ACIDUM ALENDRONICUM** FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L 2 28,39 14,195000 5,337000 37,13 18,565000 7,212000

47 W58352002 M05BA04 ACIDUM ALENDRONICUM** ACID ALENDRONIC AUROBINDO 70 mg COMPR. 70mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. TRANSPARENTE PVC-

ACLAR/AL X 4 COMPR.P6L 4 17,79 4,447500 4,447500 24,04 6,010000 6,010000

48 W56763003 M05BA04 ACIDUM ALENDRONICUM** ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 4 COMPR. FILM.

P-6L 4 36,67 9,167500 5,337000 47,97 11,992500 7,212000

49 W52948001 M05BA04 ACIDUM ALENDRONICUM** ALENDRONAT SANDOZ 70 mg COMPR. FILM. 70mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 2 COMPR. FILM

P-6L 2 9,49 4,745000 4,745000 12,82 6,410000 6,410000

50 W56763001 M05BA04 ACIDUM ALENDRONICUM** ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR. FILM.

P-6L 12 108,06 9,005000 5,337000 131,92 10,993333 7,212000

51 W56763002 M05BA04 ACIDUM ALENDRONICUM** ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 COMPR. FILM.

P-6L 2 18,33 9,165000 5,337000 24,78 12,390000 7,212000

52 W56749001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 150 mg COMPR. FILM. 150 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 1 COMPRIMAT FILMAT

P6L 1 46,96 46,960000 35,592000 61,42 61,420000 46,560000

53 W56947001 M05BA06 ACIDUM IBANDRONICUM** QUODIXOR 150 mg COMPR. FILM. 150mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU BLIST. PA-AL-PVC/AL X 1 COMPR.FILM.

P-6L 1 56,52 56,520000 35,592000 71,46 71,460000 46,560000

54 W55441001 M05BA06 ACIDUM IBANDRONICUM** OSSICA 150 mg COMPR. FILM. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM.

P-6L 1 36,32 36,320000 35,592000 47,51 47,510000 46,560000

55 W42716001 M05BA06 ACIDUM IBANDRONICUM** BONVIVA 150mg COMPR. FILM. 150mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 1 COMPR. FILM.( BLIST. AL/AL) P-

6L 1 70,97 70,970000 35,592000 89,74 89,740000 46,560000

56 W60664001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 1

COMPR. FILM.P6L 1 29,66 29,660000 29,660000 38,80 38,800000 38,800000

57 W57485004 M05BA06 ACIDUM IBANDRONICUM** OSAGRAND 150 mg COMPR. FILM. 150mg ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 COMPR. FILM.

P6L 1 29,66 29,660000 29,660000 38,80 38,800000 38,800000

58 W58574001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 BLIST. PA-AL-PVC/AL X 1 COMPR. FILM.

P6L 1 40,44 40,440000 35,592000 52,90 52,900000 46,560000

Pagina 49 din 87

Page 51: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

59 W56748001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 50 mg COMPR. FILM. 50 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 28 COMPRIMATE FILMATE PR 28 637,14 22,755000 22,269428 732,63 26,165357 25,908857

60 W57730004 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC SANDOZ 50 mg COMPR. FILM. 50 mgSANDOZ PHARMACEUTICALS GMBH

GERMANIA CUTIE CU BLIST. DIN PA/AL/PVC/AL CU 28 COMPRIMATE FILMATE PR 28 519,62 18,557857 18,557857 604,54 21,590714 21,590714

61 W57712001 M05BA06 ACIDUM IBANDRONICUM** HOLMEVIS 50 mg COMPR. FILM. 50mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE CU BLIST. PA/AL/PVC-AL X 28 COMPR. FILM. PR 28 637,16 22,755714 22,269428 732,65 26,166071 25,908857

62 W59829025 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC GLENMARK 50 mg COMPR. FILM. 50mgGLENMARK PHARMACEUTICALS S.R.O.

REPUBLICA CEHA

CUTIE CU BLIST. PVC/PVDC-AL X 28 COMPR. FILM. PR 28 562,00 20,071428 20,071428 650,73 23,240357 23,240357

63 W41499001 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 50mg COMPR. FILM. 50mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X BLIST. AL/PVC X 28 COMPR. FILM. S 28 964,08 34,431428 22,269428 1.089,00 38,892857 25,908857

64 W56932004 M05BA06 ACIDUM IBANDRONICUM** IASIBON 50 mg COMPR. FILM. 50mg PHARMATHEN S.A. GRECIA CUTIE CU BLIST. PA/ALL/PVC/ALU X 28 COMPR. FILM PR 28 629,47 22,481071 22,269428 724,27 25,866785 25,866785

65 W58937001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 6 mg CONC. PT. SOL. PERF. 6mg

TEVA PHARMACEUTICALS S.R.L.

ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC SI CAPSA DE CULOARE TURCOAZ (ALBASTRU VERZUI) X 6 ML CONC. PT. SOL. PERF.

PR 1 596,39 596,390000 596,390000 688,22 688,220000 688,220000

66 W41498001 M05BA06 ACIDUM IBANDRONICUM** BONDRONAT 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml ROCHE REGISTRATION

LTD.MAREA BRITANIE

CUTIE X 1 FLACON X 6 ML CONC. PT. SOL. PERF. S 1 901,37 901,370000 715,668000 1.020,64 1.020,640000 825,864000

67 W56933001 M05BA06 ACIDUM IBANDRONICUM** IASIBON 6mg/6ml CONC. PT. SOL. PERF. 6mg/6ml PHARMATHEN S.A. GRECIA CUTIE CU 1 FLAC. DIN STICLA X 6ML CONC.

PT. SOL. PERF. PR 1 596,39 596,390000 596,390000 688,22 688,220000 688,220000

68 W58935001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC TEVA 3 mgSOL INJ. IN SERINGA PREUMPLUTA

3mgTEVA PHARMACEUTICALS S.R.L.

ROMANIACUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. SI UN AC DE INJECTARE

P6L 1 232,02 232,020000 179,712000 283,25 283,250000 219,396000

69 W57932001 M05BA06 ACIDUM IBANDRONICUM** OSSICA 3 mgSOL INJ. IN SERINGA PREUMPLUTA

3mg GEDEON RICHTER ROMANIA SA ROMANIA

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. + 1 AC PT. INJECTIE

P6L 1 196,40 196,400000 179,712000 239,77 239,770000 219,396000

70 W57484001 M05BA06 ACIDUM IBANDRONICUM** OSAGRAND 3 mg/3 ml SOL. INJ. 3mg/3ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FIOLA DIN STICLA INCOLORA X 3 ML SOL. INJ.

P6L 1 222,35 222,350000 179,712000 271,45 271,450000 219,396000

71 W43328001 M05BA06 ACIDUM IBANDRONICUM** BONVIVA 3mg/3mlSOL. INJ. IN SERINGA PREUMPLUTA

1mg/1ml ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1 SERINGA PREUMPLUTA DIN STICLA X 3 ML SOL. INJ. + 1 AC

P-6L 1 354,51 354,510000 179,712000 424,57 424,570000 219,396000

72 W58778001 M05BA06 ACIDUM IBANDRONICUM** ACID IBANDRONIC ALVOGEN 3 mgSOL.INJ. IN SERINGA PREUMPLUTA

3 mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA SI 1 AC PT. INJECTARE X 3 ML SOL.INJ.

PR/PRF

1 149,76 149,760000 149,760000 182,83 182,830000 182,830000

73 W56198003 M05BA07 ACIDUM RISEDRONICUM** ACTONEL SAPTAMANAL 35 mg COMPR. FILM. 35mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR.

FILM.P-6L 4 32,87 8,217500 3,177000 43,00 10,750000 4,293000

74 W56414003 M05BA07 ACIDUM RISEDRONICUM** RISEDRONAT SODIC SANDOZ 35 mg COMPR. FILM. 35mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 4 COMPR. FILM. P6L 4 21,00 5,250000 3,177000 28,38 7,095000 4,293000

75 W60074002 M05BA07 ACIDUM RISEDRONICUM** RISEDRONAT SODIC ZENTIVA 35mg COMPR. FILM. 35mg ZENTIVA KS REPUBLICA CEHA

CUTIE X 1 BLISTER OPA-AL-PVC/AL X 4 COMPRIMATE FILMATE

P-6L 4 10,59 2,647500 2,647500 14,31 3,577500 3,577500

76 W55565003 M05BA07 ACIDUM RISEDRONICUM** OSODENS 35 mg COMPR. FILM. 35mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR. FILM.

P-6L 4 34,61 8,652500 3,177000 45,27 11,317500 4,293000

77 W61163003 M05BA07 ACIDUM RISEDRONICUM** ACTONEL SAPTAMANAL 35 mg COMPR. FILM. 35mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR.

FILM.P-6L 4 32,87 8,217500 3,177000 43,00 10,750000 4,293000

78 W53578003 M05BA07 ACIDUM RISEDRONICUM** RISEDRONAT TEVA 35 mg COMPR. FILM. 35mg TEVA PHARMACEUTICALS SRL ROMANIA CUTIE X BLIST. PVC-PVDC/AL X 4 COMPR.

FILM.P-6L 4 34,61 8,652500 3,177000 45,27 11,317500 4,293000

79 W54377002 M05BA07 ACIDUM RISEDRONICUM** LORINE 35mg COMPR. FILM. 35mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1BLIST. PVC- PVDC/AL X 4 COMPR. FILM.

P-6L 4 27,91 6,977500 3,177000 36,50 9,125000 4,293000

80 W59460003 M05BA07 ACIDUM RISEDRONICUM** RISEDRONAT AUROBINDO 35 mg COMPR. FILM. 35mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PE/PVDC-AL X 4

COMPR. FILM.P6L 4 10,59 2,647500 2,647500 14,31 3,577500 3,577500

81 W61164001 M05BA07 ACIDUM RISEDRONICUM** ACTONEL 75 mg COMPR. FILM. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR.

FILM.P6L 2 52,51 26,255000 26,255000 66,39 33,195000 33,195000

82 W54976001 M05BA07 ACIDUM RISEDRONICUM** ACTONEL 75 mg COMPR. FILM. 75mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR.

FILM.P-6L 2 52,51 26,255000 26,255000 66,39 33,195000 33,195000

83 W59742004 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC TEVA 4 mg/5 ml CONC. PT. SOL. PERF. 4 mg/5 ml TEVA PHARMA B.V. OLANDA

CUTIE X 1 FLACON DIN STICLA CU 5ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA

PR 1 377,14 377,140000 356,400000 449,23 449,230000 435,096000

84 W59137001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/100 ml CONC. PT. SOL. PERF. 4mg/100ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 100 ML CONC. PT. SOL. PERF.

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

85 W59136001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC SANDOZ 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR, DIN COPOLIMER CICLOOLEFINIC PREVAZUT CUC CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" X 5 ML CONC. PT. SOL. PERF.

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

86 W59044001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC RICHTER 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml GEDEON RICHTER

ROMANIA SA ROMANIA

CUTIE X 1 FLACON TRANSPARENT, INCOLOR DIN POLIMER CICLO-OLEFENIC INCHIS CU DOP GRI INCHIS DIN CAUCIUC CU STRAT FLUOROPOLIMERIC, CAPSA DIN AL SI SISTEM "FLIP-OFF" DIN PLASTIC ROSU X 5ML CONC. PT. SOL. PERF.

PR 1 724,49 724,490000 356,400000 827,84 827,840000 435,096000

87 W59476002 M05BA08 ACIDUM ZOLEDRONICUM** ZOLACITOR 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml

CHIESI PHARMACEUTICALS GMBH

AUSTRIA CUTIE CU 4 FLAC., DE CAPACITATE DE 5 ML CARE CONTINE CONC. PT. SOL. PERF. PR 4 2.807,00 701,750000 356,400000 3.097,78 774,445000 435,096000

Pagina 50 din 87

Page 52: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

88 W59588001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC ACTAVIS 4mg/5ml CONC. PT. SOL. PERF. 4mg/5ml ACTAVIS GROUP PTC

EHF. ISLANDA

CUTIE X 1 FLACON PLASTIC TRANSPARENT, INCOLOR CU CAPACITATEA DE 5 ML CARE CONTINE CONC. PT. SOL. PER

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

89 W58621001 M05BA08 ACIDUM ZOLEDRONICUM** ZYOLIX 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml ROMASTRU TRADING

S.R.L. ROMANIA

CUTIE CU 1 FLAC. DIN COPOLIMER COCLOOLEFINIC, TRANSPARENT, INCOLOR, INCHIS CU DOP DIN CAUCIUC BROMOB

PR 1 459,66 459,660000 356,400000 539,18 539,180000 435,096000

90 W59167001 M05BA08 ACIDUM ZOLEDRONICUM** OSPORIL 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml

EGIS PHARMACEUTICALS P.L.C.

UNGARIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 5 ML CARE CONTINE CONC. PT. SOL. PERF.

PR 1 676,71 676,710000 356,400000 775,76 775,760000 435,096000

91 W59840001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC HOSPIRA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml HOSPIRA UK LIMITED MAREA

BRITANIE

CUTIE X 1 FLACON CU CAPACITATE DE 5ML DIN PLASTIC CU DOP BROMOBUTIL, ACOPERIT CU UN STRAT DE FLUOROPOLIMER SI CAPAC DIN AL CU COMPONENTA "FLIP-OFF"

PR 1 364,11 364,110000 356,400000 435,03 435,030000 435,030000

92 W59914001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC PFIZER 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE CU 1 FLAC. DIN PP PREVAZUT CU CAPSA FLIP-OFF DIN AL CU CONC. PT. SOL. PERF.

PR 1 724,49 724,490000 356,400000 827,84 827,840000 435,096000

93 W59476001 M05BA08 ACIDUM ZOLEDRONICUM** ZOLACITOR 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml

CHIESI PHARMACEUTICALS GMBH

AUSTRIA CUTIE CU 1 FLAC., DE CAPACITATE DE 5 ML CARE CONTINE CONC. PT. SOL. PERF. PR 1 724,40 724,400000 356,400000 827,75 827,750000 435,096000

94 W59191004 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC TERAPIA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. TRANSPARENT DIN STICLA CU CAPACITATEA DE 6 ML INCHIS CU DOP DIN CAUCIUC DE CULOARE GRI SI SIGILAT CU CAPAC DIN AL, TIP "FLIP OFF" DE CULOARE GRI CARE CONTINE CONC. PT. SOL. PERF.

PR 1 724,49 724,490000 356,400000 827,84 827,840000 435,096000

95 W59090002 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC FRESENIUS KABI 4 mg/5 ml

CONC. PT. SOL. PERF. 4mg/5ml FRESENIUS KABI

ROMANIA SRL ROMANIA CUTIE CU 4 FLAC. DIN PP INCOLORA, INCHIS X 4 MG/5 ML CONC. PT. SOL. PERF. PR 4 1.417,59 354,397500 354,397500 1.583,33 395,832500 395,832500

96 W60216001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC MEDAC 4mg/5ml CONC. PT. SOL. PERF. 4mg/5ml

MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIACUTIE X 1 FLACON DIN PLASTIC CU 5ML CONCENTRAT PENTRU SOLUTIE PERFUZABILA

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

97 W60989001 M05BA08 ACIDUM ZOLEDRONICUM** ZYOLIX 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml NEOLA PHARMA SRL ROMANIA

CUTIE CU 1 FLAC. DIN COPOLIMER COCLOOLEFINIC, TRANSPARENT, INCOLOR, INCHIS CU DOP DIN CAUCIUC BROMOBUTILIC, SIGILAT CU CAPSA DIN AL SI CAPAC TIP FLIP-OFF DIN PP CARE CONTINE 4 MG/5 ML CONC. PT. SOL. PERF.

PR 1 459,66 459,660000 356,400000 539,18 539,180000 435,096000

98 W58886001 M05BA08 ACIDUM ZOLEDRONICUM** DESINOBON 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml ALVOGEN IPCO S.A.R.L LUXEMBOU

RG

CUTIE CU 1 FLAC. DIN PLASTIC TRANSPARENT, INCOLOR DE 5 ML DIN COPOLIMER CICLOOLEFINIC CU DOP DE CAUCIUC SI CAPAC DIN AL CU CAPSA TIP "FLIP-OFF" CARE CONTINE CONC. PT. SOL. PERF.

PR 1 452,56 452,560000 356,400000 531,44 531,440000 435,096000

99 W59889001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC POLIPHARMA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml POLIPHARMA

INDUSTRIES S.R.L. ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA SITRANSPARENTA, CAPACITATE 8,4 ML, A 5 ML CONC. PT. SOL. PERF.

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

100 W59520001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC DR. REDDY'S 4mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml DR. REDDY'S

LABORATORIES ROMANIACUTIE CU 1 FLAC. DIN STICLA CU CAPACITATEA DE 5 ML CU CONC. PT. SOL. PERF.

PR 1 297,00 297,000000 297,000000 362,58 362,580000 362,580000

101 W59889002 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC POLIPHARMA 4 mg/5 ml CONC. PT. SOL. PERF. 4mg/5ml POLIPHARMA

INDUSTRIES S.R.L. ROMANIACUTIE CU 4 FLAC. DIN STICLA INCOLORA SITRANSPARENTA, CAPACITATE 8,4 ML, A 5 ML CONC. PT. SOL. PERF.

PR 4 1.418,88 354,720000 354,720000 1.584,73 396,182500 396,182500

102 W08426001 M05BA08 ACIDUM ZOLEDRONICUM** ZOMETA 4 mg PULB. + SOLV. SOL. PERF. 4mg NOVARTIS EUROPHARM

LTD.MAREA BRITANIE

CUTIE X 1 FLAC. 4MG PULB. PT. SOL. PERF. + 1 FIOLA X 5 ML SOLV. PR 1 1.098,45 1.098,450000 356,400000 1.235,46 1.235,460000 435,096000

103 W60382001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC HOSPIRA 4 mg/100 ml SOL. PERF. 4 mg/100 ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 1 PUNGA DIN POLIPROPILENA DE 100ML CU UN PORT "TWIST-OFF" DIN POLIPROPILENA CU CAPAC SI CU UN INVELIS DIN POLIESTER/POLIPROPILENA

PR 1 377,22 377,220000 356,400000 449,32 449,320000 435,096000

104 W60543001 M05BA08 ACIDUM ZOLEDRONICUM** ZERLINDA 4 mg/100 ml SOL. PERF. 4mg/100ml ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 PUNGA A 100 ML SOL. PERF. PR 1 724,00 724,000000 356,400000 827,31 827,310000 435,096000

105 W60215001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC MEDAC 4mg/100ml SOL. PERF. 4mg/100mlMEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIA CUTIE X 1 FLACON DIN PLASTIC CU 100 ML SOLUTIE PERFUZABILA PR 1 522,14 522,140000 356,400000 607,28 607,280000 435,096000

106 W60980001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC DR. REDDY'S 4mg/100 ml SOL. PERF. 4mg/100ml DR. REDDY'S LABORATORIES ROMANIA

CUTIE CU 1 FLAC. DIN STICLA CU DOP DIN CAUCIUC CLOROBUTILIC, SIGILAT CU CAPSA DIN AL TIP "FLIP-OFF"A 100 ML SOL. PERF.

PR 1 297,00 297,000000 297,000000 362,58 362,580000 362,580000

107 W59355001 M05BA08 ACIDUM ZOLEDRONICUM** ACID ZOLEDRONIC ZENTIVA 4 mg/5 ml SOL. PERF. 4mg/5ml ZENTIVA, K.S. REPUBLICA CEHA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CARE CONTINE CONC. PT. SOL. PERF. PR 1 676,71 676,710000 356,400000 775,76 775,760000 435,096000

108 W42407001 M05BA08 ACIDUM ZOLEDRONICUM** ACLASTA 5mg/100ml SOL. PERF. 5mg/100ml NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 1 FLAC. X 100 ML + 1 CAPAC AL/PP CU COMPONENTA FLIP. PR 1 1.399,70 1.399,700000 1.399,700000 1.563,83 1.563,830000 1.563,830000

109 W42702002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)** FOSAVANCE 70mg/2800UI COMPR. 70mg/2800

UI MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.)

P-6L 4 71,05 17,762500 17,762500 89,84 22,460000 22,460000

110 W42702001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)** FOSAVANCE 70mg/2800UI COMPR. 70mg/2800

UI MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 2 COMPR. (1 PLIANT CU BLIST. AL/AL X 2 COMPR.)

P-6L 2 36,16 18,080000 18,080000 47,30 23,650000 23,650000

Pagina 51 din 87

Page 53: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

111 W52559001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)** FOSAVANCE 70mg/5600UI COMPR. 70mg/5600

UI MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 2 COMPR. (1 PLIANT CU BLIST. AL/AL X 2 COMPR.)

P-6L 2 36,16 18,080000 18,080000 47,30 23,650000 23,650000

112 W52559002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM)** FOSAVANCE 70mg/5600UI COMPR. 70mg/5600

UI MERCK SHARP & DOHME MAREA BRITANIE

CUTIE X 4 COMPR. (1 PLIANT CU BLIST. AL/AL X 4 COMPR.)

P-6L 4 71,05 17,762500 17,762500 89,84 22,460000 22,460000

113 W42094003 M05BX03 STRONTIUM RANELATUM OSSEOR 2 g GRAN. PT. SUSP. ORALA 2g LES LAB. SERVIER FRANTA CUTIE X 28 PLICURI HARTI-PE-AL/PE GRAN.

PT. SUSP. ORALAP-RF 28 143,02 5,107857 5,107857 174,60 6,235714 6,235714

V09FX03 NATRII IODIDUM (131I) V10XA01 NATRII IODIDUM (131I)

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.1: TRANSPLANT MEDULAR

1 W56153001 A04AA01 ONDANSETRONUM** OSETRON 4 mg COMPR. FILM. 4mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X

10 COMPR. FILM.P-RF 10 14,09 1,409000 1,409000 19,04 1,904000 1,904000

2 W56154001 A04AA01 ONDANSETRONUM** OSETRON 8 mg COMPR. FILM. 8mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. HARTIE/AL, PVDC/PVC X

10 COMPR. FILM.P-RF 10 24,64 2,464000 2,464000 33,31 3,331000 3,331000

3 W57423001 A04AA01 ONDANSETRONUM** OSETRON 4 mg SOLUTIE INJECTABILA SOL. INJ. 2mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE 1 BLIST. AL/PVC X 5 FIOLE X 2 ML

SOL. INJ.S/P-RF 5 17,60 3,520000 3,520000 23,79 4,758000 4,758000

4 W57424001 A04AA01 ONDANSETRONUM** OSETRON 8 mg SOLUTIE INJECTABILA SOL. INJ. 2mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. AL/PVC X 5 FIOLE X 4 ML

SOL. INJ.S/P-RF 5 33,45 6,690000 6,690000 43,75 8,750000 8,750000

5 W51505002 A04AA01 ONDANSETRONUM** EMESET 8 mg/4 ml SOL. INJ./PERF. 2mg/ml CIPLA (UK) LIMITED MAREA BRITANIE

CUTIE X 5 FIOLE STICLA + INEL RUPERE X 4ML SOL. INJ. / PERF.

S/P-RF 5 33,43 6,686000 6,686000 43,73 8,746000 8,746000

6 W51504002 A04AA01 ONDANSETRONUM** EMESET 4 mg/2 ml SOL. INJ./PERF. 2mg/ml CIPLA (UK) LIMITED MAREA BRITANIE

CUTIE X 5 FIOLE STICLA + INEL RUPERE X 2ML SOL. INJ/ PERF.

S/P-RF 5 17,60 3,520000 3,520000 23,79 4,758000 4,758000

7 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 56,54 1,130800 0,848200 71,49 1,429800 1,109400

8 W59934001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6

L 60 42,41 0,706833 0,706833 55,47 0,924500 0,924500

9 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 98,29 0,982900 0,848200 124,28 1,242800 1,109400

10 W00188001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 54,39 1,087800 0,848200 68,77 1,375400 1,109400

11 W53024004 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOCHOL 150 mg COMPR. 150mg ZAMBON S.P.A. ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-6L 60 41,43 0,690500 0,690500 54,19 0,903166 0,903166

12 W53025002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOCHOL 300 mg COMPR. 300mg ZAMBON S.P.A. ITALIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 27,43 1,371500 1,371500 35,88 1,794000 1,794000

13 W58710001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 25 COMPR.FILM.

P6L 50 111,83 2,236600 2,236600 136,52 2,730400 2,730400

14 W58710002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM.

P6L 100 219,67 2,196700 2,196700 268,17 2,681700 2,681700

15 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIACUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP

P6L 1 77,10 77,100000 77,100000 97,49 97,490000 97,490000

16 W54011001 B02AA02 ACIDUM TRANEXAMICUM4) EXACYL SOL. INJ. 500mg/5ml CN UNIFARM ROMANIA CUTIE X 5 FIOLE X 5ML SOL. INJ. X 5 9,47 1,894000 1,894000 12,80 2,560000 2,560000

17 W05892003 J01CR03 TICARCILLINUM + ACIDUM CLAVULANICUM TIMENTIN 3,2 g PULB. PT. SOL. INJ./PERF. 3,2g BEECHAM GROUP PLC MAREA

BRITANIECUTIE X 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF.

S/P-RF 10 212,62 21,262000 21,262000 259,57 25,957000 25,957000

18 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

19 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

20 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

21 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

22 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

23 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

24 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

25 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

26 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

27 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

28 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

Pagina 52 din 87

Page 54: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

29 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

30 W55475002 J01DH02 MEROPENEMUM MERONEM IV 1 g PULB. PT. SOL. INJ. I.V./PERF. 1g ASTRAZENECA UK

LIMITEDMAREA BRITANIE

CUTIE CU 10 FLAC. DIN STICLA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ. I.V./PERF.

S 10 1.030,68 103,068000 63,118800 1.161,59 116,159000 73,377600

31 W55465002 J01DH02 MEROPENEMUM MERONEM IV 500 mg PULB. PT. SOL. INJ. I.V./PERF. 500mg ASTRAZENECA UK

LIMITEDMAREA BRITANIE

CUTIE CU 10 FLAC. DIN STICLA CU CAPACITATEA DE 20 ML PULB. PT. SOL. INJ. I.V./PERF.

S 10 539,60 53,960000 36,430800 626,31 62,631000 44,287200

32 W60705002 J01DH02 MEROPENEMUM MEROPENEM ZENTIVA 1000 mg PULB. PT. SOL. INJ. SAU PERF. 1000 mg ZENTIVA, K.S. REPUBLICA

CEHA

CUTIE CU 10 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 20 ML

PR 10 680,44 68,044000 63,118800 779,83 77,983000 73,377600

33 W60703002 J01DH02 MEROPENEMUM MEROPENEM ZENTIVA 500 mg PULB. PT. SOL. INJ. SAU PERF. 500 mg ZENTIVA, K.S. REPUBLICA

CEHA

CUTIE CU 10 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 20 ML

PR 10 361,24 36,124000 36,124000 431,90 43,190000 43,190000

34 W56827001 J01DH02 MEROPENEMUM LODITER 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg TERAPIA S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 40 ML CONTINAND PULB. PT. SOL. INJ./PERF.

PR 1 72,84 72,840000 63,118800 92,10 92,100000 73,377600

35 W61143002 J01DH02 MEROPENEMUM ARCHIFAR 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg MEDOCHEMIE ROMANIA

SRL ROMANIA

CUTIE CU 10 FLAC. DIN STICLA, CAPACITATEA 30 ML, DOP DIN CAUCIUC BROMOBUTILIC SIGILAT CU CAPSA AL CU PULB.PT.SOL.INJ./PERF.

PR 10 525,99 52,599000 52,599000 611,48 61,148000 61,148000

36 W58974002 J01DH02 MEROPENEMUM MEROPENEM ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE S.A. ROMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML SAU 30 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA DIN ALUMINIU PREVAZUTA CU DISC DIN MATERIAL PLASTIC

PRF 10 680,43 68,043000 63,118800 779,82 77,982000 73,377600

37 W56331002 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 1 g PULB. PT. SOL. INJ./PERF. 1g HOSPIRA UK LIMITED MAREA

BRITANIECUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 540,86 54,086000 54,086000 627,69 62,769000 62,769000

38 W56125002 J01DH02 MEROPENEMUM MEROPENEM KABI 1 g PULB. PT. SOL. INJ./PERF. 1g FRESENIUS KABI

ROMANIA SRL ROMANIACUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF.

S 10 680,43 68,043000 63,118800 779,82 77,982000 73,377600

39 W56826001 J01DH02 MEROPENEMUM LODITER 500 mg PULB. PT. SOL. INJ./PERF. 500mg TERAPIA S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CONTINAND PULB. PT. SOL. INJ./PERF.

PR 1 37,77 37,770000 36,430800 49,40 49,400000 44,287200

40 W58973002 J01DH02 MEROPENEMUM MEROPENEM ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA, CU CAPACITATEA DE 20 ML CU DOP DIN CAUCIUC, SIGILAT CU CAPSA

PRF 10 361,24 36,124000 36,124000 431,90 43,190000 43,190000

41 W61142002 J01DH02 MEROPENEMUM ARCHIFAR 500 mg PULB. PT. SOL. INJ./PERF. 500mg MEDOCHEMIE ROMANIA

SRL ROMANIA

CUTIE CU 10 FLAC. DIN STICLA, CAPACITATEA 20 ML, DOP DIN CAUCIUC BROMOBUTILIC SIGILAT CU CAPSA AL CU PULB.PT.SOL.INJ./PERF.

PR 10 361,24 36,124000 36,124000 431,90 43,190000 43,190000

42 W56124002 J01DH02 MEROPENEMUM MEROPENEM KABI 500 mg PULB. PT. SOL. INJ./PERF. 500mg FRESENIUS KABI

ROMANIA SRL ROMANIACUTIE CU 10 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF.

PR 10 361,25 36,125000 36,125000 431,91 43,191000 43,191000

43 W56330002 J01DH02 MEROPENEMUM MEROPENEM HOSPIRA 500 mg PULB. PT. SOL. INJ./PERF. 500mg HOSPIRA UK LIMITED MAREA

BRITANIECUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PR 10 303,59 30,359000 30,359000 369,06 36,906000 36,906000

44 W54532001 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN KABI 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg

FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA

CU PULB. PT. SOL. PERF.S/P-RF 10 296,98 29,698000 29,698000 362,55 36,255000 36,255000

45 W54471007 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 30 ML PULB. PT. SOL. PERF.S/P-RF 1 30,31 30,310000 30,310000 39,65 39,650000 39,650000

46 W54471008 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 30 ML PULB. PT. SOL. PERF.S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

47 W54471006 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA

CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF.

S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

48 W54471005 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 100 ML PULB. PT. SOL. PERF.S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

49 W54471009 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA

CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF.

S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

50 W54471002 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 22 ML PULB. PT. SOL. PERF.S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

51 W54471003 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA

CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF.

S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

52 W61198003 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN ATB 500 mg/500 mg PULB. PT. SOL. PERF.

500mg/500mg ANTIBIOTICE S.A. ROMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA TIP III, CU CAPACITATEA DE 20 ML, CONTINANAD PULB. PT. SOL. PERF.

PR 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

53 W43348001 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 1g TEVA PHARM. WORKS

PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF.

S/P-RF 1 48,56 48,560000 48,560000 63,52 63,520000 63,520000

Pagina 53 din 87

Page 55: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

54 W43347001 J01XA01 VANCOMYCINUM VANCOMYCIN TEVA LIOF. PT. SOL. PERF. 500mg TEVA PHARM. WORKS

PRIVATE LTD. COMPANY UNGARIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF.

S/P-RF 1 24,28 24,280000 24,280000 32,82 32,820000 32,820000

55 W56449002 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 1000 mg PULB. PT. SOL. PERF. 1000mg PHARMASWISS CESKA

REPUBLIKA S.R.O.REPUBLICA CEHA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 456,00 45,600000 45,600000 535,19 53,519000 53,519000

56 W56448002 J01XA01 VANCOMYCINUM VANCOMICINA PHARMASWISS 500 mg PULB. PT. SOL. PERF. 500mg PHARMASWISS CESKA

REPUBLIKA S.R.O.REPUBLICA CEHA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. PERF. PR 10 234,30 23,430000 23,430000 286,03 28,603000 28,603000

57 W57042001 J01XA01 VANCOMYCINUM VANCOMICINA KABI 1000 mg PULB. PT.CONC. PT.SOL. PERF. 1000mg FRESENIUS KABI

ROMANIA SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P

PR 1 48,39 48,390000 48,390000 63,30 63,300000 63,300000

58 W57041001 J01XA01 VANCOMYCINUM VANCOMICINA KABI 500 mg PULB. PT.CONC. PT.SOL. PERF. 500mg FRESENIUS KABI

ROMANIA SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML CARE CONTINE PULB. PT. CONC. PT. SOL. P

PR 1 24,17 24,170000 24,170000 32,67 32,670000 32,670000

59 W06051001 J01XA01 VANCOMYCINUM EDICIN PULB.LIOF.PT.SOL.PERF./INJ 1g LEK PHARMACEUTICALS

D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. LIOF. PT. SOL. PERF./INJ.

S/P-RF 1 56,90 56,900000 54,720000 71,94 71,940000 64,222800

60 W13105001 J01XA02 TEICOPLANINUM TARGOCID (R) 400 mg LIOF. + SOLV. PT. SOL. INJ. 400mg AVENTIS PHARMA LTD. MAREA

BRITANIE CUTIE X 1 FLAC. LIOF. + O FIOLA SOLV. P-RF 1 109,84 109,840000 109,840000 134,09 134,090000 134,090000

61 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-

RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

62 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML

P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

63 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIA10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA

PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

64 W60604004 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 10 PUNGI DIN PP TRANSPARENTA PANA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI INVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINAND FIECARE 300 ML SOL. PERF.

PR 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

65 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

66 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

67 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF.

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

68 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,615428 25,61 6,402500 4,887428

69 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-

RF 16 65,37 4,085625 3,615428 82,66 5,166250 4,887428

70 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 21,09 3,012857 3,012857 28,51 4,072857 4,072857

71 W43597001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6,98 3,490000 3,490000 9,43 4,715000 4,715000

72 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 23,31 3,330000 3,330000 31,51 4,501428 4,501428

73 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,340000 14,58 14,580000 7,212000

74 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,340000 9,68 9,680000 7,212000

75 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

76 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 6,07 6,070000 5,340000 8,20 8,200000 7,212000

77 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 8,90 8,900000 5,340000 12,03 12,030000 7,212000

78 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

79 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PR

F 1 9,57 9,570000 5,340000 12,94 12,940000 7,212000

80 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

81 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,340000 9,03 9,030000 7,212000

82 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC

TRANSPARENT/PVDC-AL X 1 CAPS.PRF 1 4,45 4,450000 4,450000 6,01 6,010000 6,010000

83 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PR

F 1 7,44 7,440000 5,340000 10,06 10,060000 7,212000

84 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 18,56 18,560000 5,340000 25,08 25,080000 7,212000

85 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS.

P-RF 1 13,95 13,950000 5,340000 18,86 18,860000 7,212000

Pagina 54 din 87

Page 56: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

86 W54835003 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-

RF 4 48,24 12,060000 5,340000 63,10 15,775000 7,212000

87 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-

RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

88 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 30,10 4,300000 4,300000 39,37 5,624285 5,624285

89 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,777714 19,58 2,797142 2,403428

90 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 43,23 6,175714 1,777714 56,54 8,077142 2,403428

91 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,777714 19,12 2,731428 2,403428

92 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

93 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 12,35 1,764285 1,764285 16,69 2,384285 2,384285

94 W52225001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-

RF 7 11,66 1,665714 1,665714 15,76 2,251428 2,251428

95 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

96 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS.

P-RF 7 21,91 3,130000 1,777714 29,61 4,230000 2,403428

97 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,777714 41,93 5,990000 2,403428

98 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 10,37 1,481428 1,481428 14,02 2,002857 2,002857

99 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

100 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE CU 1 FLAC. PEID, DE CAPACITATE 60ML + 1 LINGURITA DOZATOARE A 5 ML, CU PULB. PT. 35 ML SUSP.O

PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

101 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF.

PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

102 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF.

PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

103 W60056001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

104 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

105 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

106 W56963002 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL

S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

107 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100

ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

108 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200

ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

109 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF.

PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

110 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML

SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,179000

111 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML

S/PR-F 1 35,03 35,030000 20,737200 45,82 45,820000 25,316400

112 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-

RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

113 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-

RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

114 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA

BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

115 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA

P-RF 1 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

116 W60913001 J02AC04 POSACONAZOLUM** NOXAFIL 100mg CAPS. GASTROREZ. 100mg MERCK SHARP & DOHME

LTD.MAREA BRITANIE

CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE PR 24 3.330,00 138,750000 138,750000 3.667,85 152,827083 152,827083

117 W58194001 J02AC04 POSACONAZOLUM** NOXAFIL 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 105ML SUSP. ORALA

P-RF/R

1 2.488,19 2.488,190000 2.488,190000 2.750,28 2.750,280000 2.750,280000

Pagina 55 din 87

Page 57: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

118 W06665001 J02AX04 CASPOFUNGINUM** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME MAREA

BRITANIECUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.202,39 1.202,390000 1.202,390000 1.348,76 1.348,760000 1.348,760000

119 W06670001 J02AX04 CASPOFUNGINUM** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME MAREA

BRITANIECUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.560,14 1.560,140000 1.560,140000 1.738,70 1.738,700000 1.738,700000

120 W53675003 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS.P-RF/S

1.000 704,14 0,704140 0,613200 805,66 0,805660 0,805660

121 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-

RF 20 15,85 0,792500 0,613200 21,42 1,071000 0,828600

122 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 15,85 0,792500 0,613200 21,42 1,071000 0,828600

123 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14,97 0,748500 0,613200 20,23 1,011500 0,828600

124 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 14,41 1,441000 1,441000 19,48 1,948000 1,948000

125 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 10,22 0,511000 0,511000 13,81 0,690500 0,690500

126 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

127 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PR

F 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

128 W13972001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-

RF 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

129 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12,69 0,634500 0,613200 17,15 0,857500 0,828600

130 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 20,11 2,011000 1,729200 27,18 2,718000 2,337600

131 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL.

INJ./PERF.S/P-RF 5 231,79 46,358000 46,358000 282,97 56,594000 56,594000

132 W58707001 J05AB11 VALACYCLOVIRUM VALTREX 500 mg COMPR. FILM. 500 mg THE WELLCOME FOUNDATION LTD.

MAREA BRITANIE

CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM.

PRF 10 43,54 4,354000 3,396000 56,95 5,695000 4,441200

133 W60087001 J05AB11 VALACYCLOVIRUM VALACICLOVIR ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC ALB OPAC/AL X 10 COMPR. FILM.

PRF 10 28,30 2,830000 2,830000 37,01 3,701000 3,701000

134 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM.

PRF 60 3.171,52 52,858666 52,858666 3.495,11 58,251833 58,251833

135 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 63,430399 5.338,93 88,982166 69,902200

136 W54752003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 1.714,69 1.714,690000 1.714,690000 1.907,17 1.907,170000 1.907,170000

137 W54752004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. S 1 3.437,56 3.437,560000 3.437,560000 3.785,10 3.785,100000 3.785,100000

138 W54752002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 881,87 881,870000 881,870000 999,39 999,390000 999,390000

139 W54752001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 379,02 379,020000 379,020000 451,28 451,280000 451,280000

140 W51530003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL.

PERF.(5G/50ML) S 1 925,45 925,450000 909,000000 1.046,89 1.046,890000 1.036,596000

141 W51530004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL.

PERF.(10G/100ML) S 1 1.857,75 1.857,750000 1.782,000000 2.063,10 2.063,100000 1.988,160000

142 W51530006 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL.

PERF.(30G/300ML) S 1 5.558,99 5.558,990000 5.558,990000 6.097,46 6.097,460000 6.097,460000

143 W51530005 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL.

PERF.(20G/200ML) S 1 3.821,35 3.821,350000 3.821,350000 4.203,43 4.203,430000 4.203,430000

144 W51530001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL.

PERF.(1G/10ML) S 1 202,26 202,260000 202,260000 246,92 246,920000 246,920000

145 W43965001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.485,00 1.485,000000 1.485,000000 1.656,80 1.656,800000 1.656,800000

146 W43962001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 197,39 197,390000 197,390000 240,98 240,980000 240,980000

147 W43963001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 393,75 393,750000 393,750000 467,34 467,340000 467,340000

148 W59114003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 100 ML

SOL. PERF.PRF 1 882,14 882,140000 882,140000 999,68 999,680000 999,680000

149 W59114001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 20 ML SOL.

PERF.PRF 1 187,48 187,480000 187,480000 228,87 228,870000 228,870000

150 W59114004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 200 ML

SOL. PERF.PRF 1 1.734,28 1.734,280000 1.734,280000 1.928,52 1.928,520000 1.928,520000

151 W59114002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 50 ML SOL.

PERF.PRF 1 456,06 456,060000 456,060000 535,26 535,260000 535,260000

152 W52560001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 10 ML SOL. PERF. S 1 102,55 102,550000 102,550000 125,19 125,190000 125,190000

153 W13462001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 50 ML S 1 465,59 465,590000 465,590000 545,64 545,640000 545,640000

154 W13462003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 200 ML S 1 1.772,34 1.772,340000 1.772,340000 1.970,00 1.970,000000 1.970,000000

155 W13462002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 100 ML S 1 882,13 882,130000 882,130000 999,67 999,670000 999,670000

Pagina 56 din 87

Page 58: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

156 W43964001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 757,50 757,500000 757,500000 863,83 863,830000 863,830000

157 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-

RF 50 19,33 0,386600 0,386600 26,13 0,522600 0,522600

158 W52215001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. I.V. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S 1 11,76 11,760000 11,760000 15,89 15,890000 15,890000

159 W58865001 L01AA03 MELPHALANUM ALKERAN 2 mg COMPR. FILM. 2mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 25

COMPR. FILM.P-RF 25 288,54 11,541600 11,541600 352,25 14,090000 14,090000

160 W60631001 L01AA03 MELPHALANUM ALKERAN 50 mg PULB+SOLV. PT. SOL. INJ./PERF. 50mg CN UNIFARM S.A. ROMANIA CUTIE CU 1 FIOLA PULB.+ 1 FIOLA

SOLVENT PR 1 654,63 654,630000 654,630000 751,70 751,700000 751,700000

161 W12497001 L01AA06 IFOSFAMIDUM HOLOXAN 1 g PULB. PT. SOL. PERF. 1g BAXTER ONCOLOGY

GMBH GERMANIA CUTIE X 1 FLAC. CU PULB. PT. SOL. PERF. S 1 92,66 92,660000 92,660000 117,16 117,160000 117,160000

162 W58856002 L01AB01 BUSULFANUM MYLERAN COMPR. FILM. 2mg ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100

COMPR. FILM.P-RF 100 1.028,76 10,287600 10,287600 1.159,50 11,595000 11,595000

163 W51454001 L01AB01 BUSULFANUM BUSILVEX 6mg/ml CONC. PT. SOL. PERF. 6mg/ml PIERRE FABRE

MEDICAMENT FRANTA CUTIE X 8 FLAC. X 10 ML CONC. PT. SOL. INJ. S 8 9.151,91 1.143,988750 1.143,988750 10.013,75 1.251,718750 1.251,718750

164 W58569001 L01BA01 METHOTREXATUM METHOTREXATE PCH 10mg COMPR. 10mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 10COMPR. P6L 10 21,32 2,132000 2,132000 28,81 2,881000 2,881000

165 W58568001 L01BA01 METHOTREXATUM METHOTREXATE PCH 2,5mg COMPR. 2,5mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X30 COMPRIMATE P6L 30 16,00 0,533333 0,533333 21,62 0,720666 0,720666

166 W12735001 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 332,72 332,720000 332,720000 400,81 400,810000 400,810000

167 W04185002 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 500 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 5 FIOLE X 5 ML S 5 197,47 39,494000 39,494000 241,07 48,214000 48,214000

168 W12733003 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 70,91 70,910000 70,910000 89,66 89,660000 89,660000

169 W59856001 L01BA01 METHOTREXATUM BENDATREXAT SOL INJ. 25mg/ml CN UNIFARM S.A. ROMANIA CUTIE CU 1 FLAC. X 2 ML PR 1 65,37 65,370000 65,370000 82,65 82,650000 82,650000

170 W04186001 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5 mg SOL. INJ. 5mg/ml EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 10 FIOLE X 1 ML S 10 17,62 1,762000 1,762000 23,82 2,382000 2,382000

171 W58316001 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 0,75 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJ

PR 1 45,60 45,600000 45,600000 59,64 59,640000 59,640000

172 W58316010 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

PR 1 100,34 100,340000 100,340000 122,50 122,500000 122,500000

173 W58316004 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

PR 1 62,22 62,220000 62,220000 78,67 78,670000 78,670000

174 W58316007 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

10mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA

CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA X 1,5 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE

PR 1 87,07 87,070000 87,070000 110,09 110,090000 110,090000

175 W53758006 L01BA01 METHOTREXATUM METOJECT 50mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

50mg/mlMEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIACUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

P-RF 1 62,22 62,220000 62,220000 78,67 78,670000 78,670000

176 W53758016 L01BA01 METHOTREXATUM METOJECT 50mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

50mg/mlMEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIACUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

P-RF 1 86,63 86,630000 86,630000 109,54 109,540000 109,540000

177 W53758001 L01BA01 METHOTREXATUM METOJECT 50mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

50mg/mlMEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIACUTIE X 1 SERINGA PREUMPLUTA X 0,15ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

P-RF 1 59,16 59,160000 54,720000 74,80 74,800000 71,568000

178 W53758021 L01BA01 METHOTREXATUM METOJECT 50mg/mlSOL. INJ. IN SERINGA PREUMPLUTA

50mg/mlMEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE

GERMANIACUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL

P-RF 1 101,74 101,740000 101,740000 124,21 124,210000 124,210000

179 W56210002 L01BB05 FLUDARABINUM FLUDARA ORAL 10 mg COMPR. FILM. 10mg GENZYME EUROPE B.V. OLANDA CUTIE X 1 FLAC. DIN PE X 4 BLIST. AL/AL X 5 COMPR. FILM.

P-RF/S

20 1.094,66 54,733000 54,733000 1.231,33 61,566500 61,566500

180 W56211001 L01BB05 FLUDARABINUM FLUDARA LIOF. PT. SOL. INJ./PERF. 50mg GENZYME EUROPE B.V. OLANDA CUTIE X 5 FLAC. CU LIOF. PT. SOL.

INJ./PERF. S 5 513,08 102,616000 102,616000 597,41 119,482000 119,482000

181 W53700001 L01BB05 FLUDARABINUM FLUDARABINA ACTAVIS 25 mg/ml PULB. PT. SOL. INJ./PERF. 25mg/ml ACTAVIS S.R.L. ROMANIA

CUTIE X 1 FLAC. DIN STICLA INCOLORA (CAPACITATE 5ML) CU PULB. PT. SOL. INJ/PERF CONTINAND 50MG FLUDA

S 1 340,13 340,130000 123,139200 408,89 408,890000 143,378400

182 W08035001 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 100mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 1 BLIST. PVC/A0-PVC-PVDC X 10

CAPS.P-RF 10 311,36 31,136000 31,136000 377,53 37,753000 37,753000

183 W08036001 L01CB01 ETOPOSIDUM VEPESID CAPS. MOI 50mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. PVC/AL-PVC-PVDC X 10

CAPS.P-RF 20 308,57 15,428500 15,428500 374,49 18,724500 18,724500

184 W52210001 L01CB01 ETOPOSIDUM SINTOPOZID 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA

X 5 ML CONC. PT. SOL. PERF. S 1 32,83 32,830000 32,830000 42,94 42,940000 42,940000

185 W03065001 L01CB01 ETOPOSIDUM ETOPOSID "EBEWE" 100 mg/5 ml CONC. PT. SOL. PERF. 100mg/5ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON X 5 ML S 1 39,04 39,040000 38,352000 51,07 51,070000 50,172000

186 W52574001 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. X 5 ML CONC. PT. SOL. PERF. S 1 31,96 31,960000 31,960000 41,81 41,810000 41,810000

187 W60599002 L01CB01 ETOPOSIDUM ETOPOZIDA KABI 20 mg/ml CONC. PT. SOL. PERF. 20mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU UN FLAC. DIN STICLA INCOLORA TIP I, CU CAPACITATEA DE 10 ML ÎNCHIS CU DOP DIN CAUCIUC BROMOBUTIL SI SIGILAT CU CAPSE DETASABILE DIN AL DE CULOARE ALBASTRA CONTINÂND 10 ML CONC. PENTRU SOL. PERF.

PR 1 61,04 61,040000 61,040000 77,18 77,180000 77,180000

Pagina 57 din 87

Page 59: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

188 W52574002 L01CB01 ETOPOSIDUM ETOPOSIDE - TEVA CONC. PT. SOL. PERF. 20mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. X 10 ML CONC. PT. SOL. PERF. S 1 61,07 61,070000 61,070000 77,22 77,220000 77,220000

189 W03575001 L01DB06 IDARUBICINUM ZAVEDOS CAPS. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 1 CAPS. P-

RF 1 203,33 203,330000 203,330000 248,22 248,220000 248,220000

190 W03581001 L01DB06 IDARUBICINUM ZAVEDOS 5 mg PULB. PT. SOL. INJ. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. S 1 143,35 143,350000 143,350000 175,00 175,000000 175,000000

191 W42735002 L01DB07 MITOXANTRONUM** ONKOTRONE CONC. PT. SOL. INJ. 2mg/ml BAXTER ONCOLOGY

GMBH GERMANIA CUTIE X 1 FLACON X 10 ML CONC. PT. SOL. INJ. S 1 555,48 555,480000 555,480000 643,62 643,620000 643,620000

192 W56664002 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 19,75 19,750000 19,750000 26,70 26,700000 26,700000

193 W56664003 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 35,38 35,380000 35,380000 46,28 46,280000 46,280000

194 W56664001 L01XA01 CISPLATINUM PLATOSIN 0,5 mg/ml CONC. PT. SOL. PERF. 0,5 mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 20 ML CONC. PT. SOL. PERF. PR 1 11,00 11,000000 11,000000 14,87 14,870000 14,868000

195 W56665003 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 100 ML CONC. PT. SOL. PERF. PR 1 67,91 67,910000 67,910000 85,86 85,860000 85,860000

196 W56665002 L01XA01 CISPLATINUM PLATOSIN 1 mg/ml CONC. PT. SOL. PERF. 1 mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 1 FLACON DIN STICLA BRUNA X 50 ML CONC. PT. SOL. PERF. PR 1 35,38 35,380000 35,380000 46,28 46,280000 46,280000

197 W01315001 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 10 mg/20 ml CONC. PT. SOL. PERF. 10mg/20ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON X 20 ML CONC. PT. SOL. PERF. S 1 9,17 9,170000 9,170000 12,39 12,390000 12,390000

198 W52187002 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 50 ML X 50 MG CONC.

SOL. PERF. S 1 48,45 48,450000 37,884000 63,37 63,370000 49,560000

199 W52187001 L01XA01 CISPLATINUM SINPLATIN 1 mg/1 ml CONC. PT. SOL. PERF. 1mg/1ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. X 10 ML X 10 MG CONC.

SOL. PERF. S 1 18,81 18,810000 11,004000 25,42 25,420000 14,868000

200 W01316001 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 25 mg/50 ml CONC. PT. SOL. PERF. 25mg/50ml EBEWE PHARMA GMBH

NFG. KG AUSTRIA CUTIE X 1 FLACON X 50 ML COND. PT. SOL. PERF. S 1 22,06 22,060000 22,060000 29,81 29,810000 29,810000

201 W01317001 L01XA01 CISPLATINUM CISPLATIN "EBEWE" 50 mg/100 ml CONC. PT. SOL. PERF.

50mg/100ml

EBEWE PHARMA GMBH NFG. KG AUSTRIA CUTIE X 1 FLACON X 100 ML CONC. PT.

SOL. PERF. S 1 31,57 31,570000 31,570000 41,30 41,300000 41,300000

202 W53000002 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA

X 15 ML CONC. PT. SOL. PERF. S 1 50,00 50,000000 50,000000 63,22 63,220000 63,220000

203 W58740004 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE GALBENA X 60 ML CONC. PT. SOL. PERF. X 600 MG CARBOPLATINA

PR 1 174,90 174,900000 174,900000 213,52 213,520000 213,520000

204 W13052001 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 15 ML CONC. PT. SOL. PERF. S 1 62,52 62,520000 56,904000 79,05 79,050000 74,436000

205 W52579002 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 15 ML CONC. PT. SOL. PERF. S 1 47,45 47,450000 47,450000 62,06 62,060000 62,060000

206 W52579003 L01XA02 CARBOPLATINUM CARBOPLATIN TEVA 10mg/ml CONC. PT. SOL. PERF. 10mg/ml

TEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 45 ML CONC. PT. SOL. PERF. S 1 132,81 132,810000 132,810000 162,14 162,140000 162,140000

207 W53000003 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA

X 45 ML CONC. PT. SOL. PERF. S 1 133,04 133,040000 133,040000 162,41 162,410000 162,410000

208 W13052003 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 45 ML CONC. PT. SOL. PERF. S 1 178,07 178,070000 158,400000 217,39 217,390000 193,380000

209 W13052002 L01XA02 CARBOPLATINUM CARBOPLATIN "EBEWE" 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml EBEWE PHARMA

GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON DIN STICLA X 5 ML CONC. PT. SOL. PERF. S 1 21,86 21,860000 21,624000 29,55 29,550000 29,220000

210 W53000001 L01XA02 CARBOPLATINUM CARBOPLATIN ACTAVIS 10mg/ml CONC. PT. SOL. PERF. 10mg/ml ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA INCOLORA

X 5 ML CONC. PT. SOL. PERF. S 1 18,05 18,050000 18,050000 24,39 24,390000 24,390000

211 W58740001 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE VERDE X 5 ML CON. PT. SOL. PERF. X 50 MG CARBOPLATINA

PR 1 18,02 18,020000 18,020000 24,35 24,350000 24,350000

212 W58740002 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ALBASTRA X 15 ML CONC. PT. SOL. PERF. X 150 MG CARBOPLATINA

PR 1 47,42 47,420000 47,420000 62,03 62,030000 62,030000

213 W58740003 L01XA02 CARBOPLATINUM CARBOPLATIN KABI 10 mg/ml CONC. PT. SOL. PERF. 10mg/ml FRESENIUS KABI

ONCOLOGY PLCMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU DOP DIN CAUCIUC FLUROTEC, SIGILAT CU CAPSA DIN AL DE CULOARE ROSIE X 45 ML CON. PT. SOL. PERF. X 450 MG CARBOPLATINA

PR 1 132,00 132,000000 132,000000 161,15 161,150000 161,150000

214 W07199001 L01XC02 RITUXIMABUM** MABTHERA 100 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION

LTD.MAREA BRITANIE CUTIE X 2 FLACOANE X 10 ML S 2 2.221,55 1.110,775000 1.110,775000 2.459,64 1.229,820000 1.229,820000

215 W07200001 L01XC02 RITUXIMABUM** MABTHERA 500 mg CONC. PT. SOL. PERF. 10mg/ml ROCHE REGISTRATION

LTD.MAREA BRITANIE

CUTIE X 1 FLACON X 50 ML(500MG RITUXIMAB IN 50ML- 10MG/ML) S 1 5.509,03 5.509,030000 5.509,030000 6.043,00 6.043,000000 6.043,000000

216 W51424001 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML

S/P-RF 1 267,05 267,050000 194,520000 326,02 326,020000 237,468000

Pagina 58 din 87

Page 60: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

217 W51423001 L03AA02 FILGRASTIMUM (G-CSF)** NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML

S/P-RF 1 436,57 436,570000 313,092000 514,01 514,010000 382,224000

218 W53892001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 30MU/0,5mlSOL. INJ. /PERF. IN SERINGA PREUMPLUTA

60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

1 162,10 162,100000 162,100000 197,89 197,890000 197,890000

219 W53893001 L03AA02 FILGRASTIMUM (G-CSF)** ZARZIO 48MU/0,5mlSOL. INJ. /PERF. IN SERINGA PREUMPLUTA

96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

1 260,91 260,910000 260,910000 318,52 318,520000 318,520000

220 W55756002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 12 MU/0,2ml SOL. INJ./PERF. 120µg/0,2ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,2ML SOL. INJ. SAU PERF.

P-RF 5 418,45 83,690000 83,690000 494,26 98,852000 98,852000

221 W53520001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0,5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML

SOL. INJ. SAU PERF.

S/P-RF/R

1 214,16 214,160000 194,520000 261,45 261,450000 237,468000

222 W55757002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.

P-RF 5 1.001,12 200,224000 194,520000 1.129,37 225,874000 225,874000

223 W53523001 L03AA02 FILGRASTIMUM (G-CSF)** TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0,8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML

SOL. INJ. SAU PERF.

S/P-RF/R

1 355,90 355,900000 313,092000 426,08 426,080000 382,224000

224 W55758002 L03AA02 FILGRASTIMUM (G-CSF)** NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.

P-RF 5 1.656,30 331,260000 313,092000 1.843,52 368,704000 368,704000

225 W54580001 L03AX16 PLERIXAFOR** MOZOBIL 20mg/ml SOL. INJ. 20 mg/ml GENZYME EUROPE B.V. OLANDA FLACON CU 1,2 ML SOL. X 20 MG/ML S 1 20.861,97 20.861,970000 20.861,970000 22.777,73 22.777,730000 22.777,730000

226 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS.

P-RF/R

100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

227 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM.

P-RF/R

50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

228 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

229 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

230 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR

F 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

231 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

232 W56643003 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X

100 CAPS.PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

233 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS.P-RF/R

100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

234 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM.

P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

235 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 100 133,10 1,331000 1,331000 162,49 1,624900 1,624900

236 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

237 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM.

P-RF/R

50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

238 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

239 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 50 133,10 2,662000 2,662000 162,49 3,249800 3,249800

240 W10576001 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR)

P-RF/R

30 489,29 16,309666 16,309666 571,48 19,049333 19,049333

241 W58975001 L04AB01 ETANERCEPTUM** ENBREL 10mg de uz pediatric PULB+SOLV. PT. SOL. INJ. 10mg PFIZER LIMITED MAREA

BRITANIE

CUTIE CU 4 FLACOANE CU PULBERE + 4 SERINGI PRE-UMPLUTE X 1ML APA + 4 ACE CU INJECTOARE DIN OTEL INOXIDABIL + 4 ADAPTOARE PENTRU FLACON + 8 TAMPOANE CU ALCOOL MEDICNAL

PR 4 722,92 180,730000 180,730000 826,13 206,532500 206,532500

242 W61297001 L04AB01 ETANERCEPTUM** ENBREL 25mg PULB. + SOLV. PT. SOL. INJ. 25mg PFIZER LIMITED MAREA

BRITANIE

CUTIE X 4 FLACOANE + 4 SERINGI PREUMPLUTE + 4 ACE + 4 ADAPTOARE PENTRU FLACOANE + 8 TAMPOANE CU ALCOOL

P-RF/R

4 1.748,78 437,195000 437,195000 1.944,32 486,080000 486,080000

243 W61299001 L04AB01 ETANERCEPTUM** ENBREL 25mgSOL. INJ. (INSERINGA PREUMPLUTA)

25mg PFIZER LIMITED MAREA BRITANIE

CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL

P-RF/R

4 1.722,63 430,657500 430,657500 1.915,82 478,955000 478,955000

244 W61300002 L04AB01 ETANERCEPTUM** ENBREL 50mgSOL. INJ. (INSERINGA PREUMPLUTA)

50mg PFIZER LIMITED MAREA BRITANIE

CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL

P-RF/R

4 3.432,11 858,027500 858,027500 3.779,16 944,790000 944,790000

245 W61303002 L04AB01 ETANERCEPTUM** ENBREL 50mgSOL. INJ. IN STILOU INJECTOR PREUMPLUT

50mg PFIZER LIMITED MAREA BRITANIE

CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL

P-RF/R

4 3.432,11 858,027500 858,027500 3.779,16 944,790000 944,790000

246 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

Pagina 59 din 87

Page 61: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

247 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

248 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

249 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

250 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

251 W56579003 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

252 W53729001 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 205,39 4,107800 4,107800 250,74 5,014800 5,014800

253 W59092001 L04AD02 TACROLIMUSUM** TRACSUS 0,5 mg CAPS. 0,5mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT

PRF 50 91,62 1,832400 1,832400 115,84 2,316800 2,316800

254 W55262007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS.

S/P-RF 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

255 W56580003 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

256 W59093001 L04AD02 TACROLIMUSUM** TRACSUS 1 mg CAPS. 1mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT

PRF 50 179,98 3,599600 3,599600 219,72 4,394400 4,394400

257 W53730001 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 363,74 7,274800 7,274800 434,63 8,692600 8,692600

258 W55263007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS.

S/P-RF 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

259 W53731001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 1.715,18 34,303600 34,303600 1.907,70 38,154000 38,154000

260 W51974002 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 204,92 4,098400 4,098400 250,17 5,003400 5,003400

261 W57352002 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 402,53 8,050600 8,050600 476,91 9,538200 9,538200

262 W51976002 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE, X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 1.865,58 37,311600 37,311600 2.071,63 41,432600 41,432600

263 W53732001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ASTELLAS PHARMA

EUROPE BV OLANDA CUTIE X 10 FIOLE X 1 ML S 10 1.545,19 154,519000 154,519000 1.722,41 172,241000 172,241000

264 W05960001 N02AX02 TRAMADOLUM MABRON 50 mg CAPS. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 2,85 0,285000 0,249000 3,85 0,385000 0,336600

265 W60291001 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-

RF 10 2,85 0,285000 0,249000 3,85 0,385000 0,336600

266 W60238002 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4,15 0,207500 0,207500 5,61 0,280500 0,280500

267 W12691002 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4,31 0,215500 0,215500 5,82 0,291000 0,291000

268 W41593001 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,67 0,283500 0,249000 7,67 0,383500 0,336600

269 W52049001 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6,66 0,333000 0,249000 9,00 0,450000 0,336600

270 W42440001 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,67 0,283500 0,249000 7,67 0,383500 0,336600

271 W42957001 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,67 0,283500 0,249000 7,67 0,383500 0,336600

272 W13507001 N02AX02 TRAMADOLUM TRAMADOLOR (R) 100 ID COMPR. ELIB. MODIF. 100mg HEXAL AG GERMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. MODIF. P-

RF 10 4,66 0,466000 0,466000 6,30 0,630000 0,630000

273 W41922002 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB.

PREL.P-RF 30 13,98 0,466000 0,466000 18,89 0,629666 0,629666

274 W60236002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB.

PREL.P-RF 30 13,98 0,466000 0,466000 18,89 0,629666 0,629666

275 W58072001 N02AX02 TRAMADOLUM TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg KRKA, D.D., NOVO

MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL.

PRF 30 13,99 0,466333 0,466333 18,91 0,630333 0,630333

276 W41923002 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB.

PREL.P-RF 30 20,38 0,679333 0,679333 27,55 0,918333 0,918333

277 W60237002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB.

PREL.P-RF 30 20,38 0,679333 0,679333 27,55 0,918333 0,918333

278 W58893002 N02AX02 TRAMADOLUM TRADOLAN RETARD 150 mg COMPR. ELIB. PREL. 150mg LANNACHER HEILMITTEL

GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF 30 24,72 0,824000 0,815200 33,41 1,113666 1,102000

279 W58894002 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg LANNACHER HEILMITTEL

GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF 30 26,22 0,874000 0,874000 34,30 1,143333 1,143333

Pagina 60 din 87

Page 62: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

280 W07784001 N02AX02 TRAMADOLUM TRADOLAN 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-

RF 30 7,88 0,262666 0,249000 10,65 0,355000 0,336600

281 W07473001 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. FILM. ELIB.PREL. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR.

FILM. CU ELIB. PREL.P-RF 10 7,17 0,717000 0,559200 9,69 0,969000 0,755599

282 W43360001 N02AX02 TRAMADOLUM TRAMADOL RETARD 150 mg COMPR. FILM. ELIB.PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

FILM. ELIB. PREL.P-RF 30 31,78 1,059333 0,815200 41,57 1,385666 1,102000

283 W05978001 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. FILM. ELIB.PREL. 150mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10

COMPR.FILM. CU ELIB. PREL.P-RF 10 16,30 1,630000 0,815200 22,03 2,203000 1,102000

284 W05979001 N02AX02 TRAMADOLUM TRAMAL RETARD 200 mg COMPR. FILM. ELIB.PREL. 200mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10

COMPR.FILM. ELIB. PREL.P-RF 10 20,85 2,085000 1,048800 28,18 2,818000 1,372000

285 W43361001 N02AX02 TRAMADOLUM TRAMADOL RETARD 200 mg COMPR. FILM. ELIB.PREL. 200mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.,

FILM. ELIB. PREL.P-RF 30 40,67 1,355666 1,048800 53,20 1,773333 1,372000

286 W60239001 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA

SLOVACACUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE

PRF 10 2,84 0,284000 0,249000 3,84 0,384000 0,336600

287 W60239003 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA

SLOVACACUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE

PRF 10 2,84 0,284000 0,249000 3,84 0,384000 0,336600

288 W05961001 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.

S/P-RF 5 7,27 1,454000 1,322640 9,83 1,966000 1,614720

289 W05961002 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.

S/P-RF 100 110,22 1,102200 1,102200 134,56 1,345600 1,345600

290 W05966001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 3,65 0,730000 0,730000 4,93 0,986000 0,986000

291 W05967001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 9,69 1,938000 1,322640 13,10 2,620000 1,614720

292 W05969001 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ. P-RF 5 4,13 0,826000 0,826000 5,58 1,116000 1,116000

293 W61214001 R05CB13 DORNAZA ALFA** PULMOZYME 2500 U/2,5 mlSOL. DE INHALAT PRIN NEBULIZATOR

2500U/2,5ml ROCHE ROMANIA S.R.L. ROMANIA

CUTIE CU 6 FIOLE UNIDOZA, MONOBLOC, DIN PE X 2,5 ML SOL. INHAL. PRIN NEBULIZATOR, INTRODUSE INTR-O PUNGA DIN AL

PR 6 416,77 69,461666 69,461666 492,43 82,071666 82,071666

294 W51323001 R05CB13 DORNAZA ALFA** PULMOZYME SOL. INHAL. 1mg/ml ROCHE ROMANIA S.R.L. ROMANIACUTIE X 6 FIOLE UNIDOZA PE X 2,5 ML SOL.INHAL. PRIN NEBULIZATOR, INTRODUSE IN PUNGA AL

S/P-RF 6 416,77 69,461666 69,461666 492,43 82,071666 82,071666

295 W51484001 V03AC03 DEFERASIROXUM** EXJADE 125mg COMPR. DISP. 125mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 28 COMPR. DISP.(BLIST. PVC/PE/PVDC/AL) PR 28 687,54 24,555000 24,555000 787,57 28,127500 28,127500

296 W51485001 V03AC03 DEFERASIROXUM** EXJADE 250mg COMPR. DISP. 250mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 1.461,36 52,191428 52,191428 1.631,03 58,251071 58,251071

297 W51486001 V03AC03 DEFERASIROXUM** EXJADE 500mg COMPR. DISP. 500mg NOVARTIS EUROPHARM LTD.

MAREA BRITANIE

CUTIE X 28 COMPR. DISP. ( PVC/PE/PVDC/AL) PR 28 2.660,12 95,004285 95,004285 2.937,68 104,917142 104,917142

298 W04133001 V03AF01 MESNUM UROMITEXAN (R) 400 mg SOL. INJ. 400mg/4ml BAXTER ONCOLOGY GMBH GERMANIA

CUTIE X 3 SUPORTURI TERMOFORMATE DIN PLASTIC X 5 FIOLE DE STICLA INCOLORA X 4 ML

S 15 44,87 2,991333 2,991333 58,69 3,912666 3,912666

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.2: TRANSPLANT DE CORD

1 W02947001 C01CA24 EPINEPHRINUM ADRENALINA 1 mg SOL. INJ. 1mg/ml TERAPIA SA ROMANIA CUTIE X 100 FIOLE X 1 ML S 100 151,25 1,512500 1,512500 184,65 1,846500 1,846500

2 W60389001 C01CA24 EPINEPHRINUM EPIPEN 150 micrograme SOL. INJ. IN STILOU PREUMPLUT 150mcg MEDA PHARMA GMBH &

CO KG GERMANIACUTIE CU 1 STILOU AUTOINJECTOR PREUMPLUT CU 2ML PENTRU O DOZA UNICA DE 0,3ML

PR 1 147,80 147,800000 147,800000 180,43 180,430000 180,430000

3 W60390001 C01CA24 EPINEPHRINUM EPIPEN 300 micrograme SOL. INJ. IN STILOU PREUMPLUT 300mcg MEDA PHARMA GMBH &

CO KG GERMANIACUTIE CU 1 STILOU AUTOINJECTOR PREUMPLUT CU 2ML PENTRU O DOZA UNICA DE 0,3ML

PR 1 147,80 147,800000 147,800000 180,43 180,430000 180,430000

4 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

5 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

6 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

7 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

8 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

9 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

10 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

11 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

Pagina 61 din 87

Page 63: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

12 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

13 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

14 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

15 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

16 W13676001 J01DD12 CEFOPERAZONUM MEDOCEF 1 g PULB. PT. SOL. INJ. 1g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 154,50 15,450000 8,448000 188,61 18,861000 11,412000

17 W13677001 J01DD12 CEFOPERAZONUM MEDOCEF 2 g PULB. PT. SOL. INJ. 2g MEDOCHEMIE LTD. CIPRU CUTIE X 10 FLAC. PULB. PT. SOL. INJ. S/P-RF 10 187,44 18,744000 13,932000 228,83 22,883000 18,828000

18 W44045001 J01DD12 CEFOPERAZONUM CEFOZON 500 mg PULB. PT. SOL. INJ. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. INJ. S/P-RF 1 3,88 3,880000 3,880000 5,24 5,240000 5,240000

19 W52795001 J01DD12 CEFOPERAZONUM CEFOZON 2 g PULB. PT. SOL. INJ./PERF. I.M./I.V. 2g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA A

20 ML CU PULB. PT. SOL. INJ./PERF. I.M./I.V.S/P-RF 1 11,61 11,610000 11,610000 15,69 15,690000 15,690000

20 W44061001 J01DD12 CEFOPERAZONUM CEFOZON 1 g PULB. PT. SOL. INJ./PERF.I.M./I.V. 1g E.I.P.I.CO. MED S.R.L. ROMANIA

CUTIE X 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 15 ML CU PULB. PT. SOL. INJ. I.M./PERF. I.V.

S/P-RF 1 7,04 7,040000 7,040000 9,51 9,510000 9,510000

21 W54532001 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN KABI 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg

FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA

CU PULB. PT. SOL. PERF.S/P-RF 10 296,98 29,698000 29,698000 362,55 36,255000 36,255000

22 W54471007 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 30 ML PULB. PT. SOL. PERF.S/P-RF 1 30,31 30,310000 30,310000 39,65 39,650000 39,650000

23 W54471008 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 30 ML PULB. PT. SOL. PERF.S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

24 W54471006 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA

CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 100 ML PULB. PT. SOL. PERF.

S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

25 W54471005 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 100 ML PULB. PT. SOL. PERF.S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

26 W54471009 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA

CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 30 ML PULB. PT. SOL. PERF.

S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

27 W54471002 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU

CAPACIT. DE 22 ML PULB. PT. SOL. PERF.S/P-RF 5 146,26 29,252000 29,252000 178,55 35,710000 35,710000

28 W54471003 J01DH51 IMIPENEMUM + CILASTATINUM CILOPEN 500mg/500mg PULB. PT. SOL. PERF.

500mg/500mg TERAPIA SA ROMANIA

CUTIE X 10 FLAC. DIN STICLA INCOLORA CU CAPACIT. DE 22 ML PULB. PT. SOL. PERF.

S/P-RF 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

29 W61198003 J01DH51 IMIPENEMUM + CILASTATINUM IMIPENEM/CILASTATIN ATB 500 mg/500 mg PULB. PT. SOL. PERF.

500mg/500mg ANTIBIOTICE S.A. ROMANIA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA TIP III, CU CAPACITATEA DE 20 ML, CONTINANAD PULB. PT. SOL. PERF.

PR 10 292,52 29,252000 29,252000 357,11 35,711000 35,711000

30 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-

RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

31 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML

P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

32 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIA10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA

PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

33 W60604004 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 10 PUNGI DIN PP TRANSPARENTA PANA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI INVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINAND FIECARE 300 ML SOL. PERF.

PR 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

34 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

35 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

36 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF.

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

37 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,615428 25,61 6,402500 4,887428

38 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-

RF 16 65,37 4,085625 3,615428 82,66 5,166250 4,887428

Pagina 62 din 87

Page 64: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

39 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 21,09 3,012857 3,012857 28,51 4,072857 4,072857

40 W43597001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6,98 3,490000 3,490000 9,43 4,715000 4,715000

41 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 23,31 3,330000 3,330000 31,51 4,501428 4,501428

42 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,340000 14,58 14,580000 7,212000

43 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,340000 9,68 9,680000 7,212000

44 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

45 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 6,07 6,070000 5,340000 8,20 8,200000 7,212000

46 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 8,90 8,900000 5,340000 12,03 12,030000 7,212000

47 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

48 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PR

F 1 9,57 9,570000 5,340000 12,94 12,940000 7,212000

49 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

50 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,340000 9,03 9,030000 7,212000

51 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC

TRANSPARENT/PVDC-AL X 1 CAPS.PRF 1 4,45 4,450000 4,450000 6,01 6,010000 6,010000

52 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PR

F 1 7,44 7,440000 5,340000 10,06 10,060000 7,212000

53 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 18,56 18,560000 5,340000 25,08 25,080000 7,212000

54 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS.

P-RF 1 13,95 13,950000 5,340000 18,86 18,860000 7,212000

55 W54835003 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-

RF 4 48,24 12,060000 5,340000 63,10 15,775000 7,212000

56 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-

RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

57 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 30,10 4,300000 4,300000 39,37 5,624285 5,624285

58 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,777714 19,58 2,797142 2,403428

59 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 43,23 6,175714 1,777714 56,54 8,077142 2,403428

60 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,777714 19,12 2,731428 2,403428

61 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

62 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 12,35 1,764285 1,764285 16,69 2,384285 2,384285

63 W52225001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-

RF 7 11,66 1,665714 1,665714 15,76 2,251428 2,251428

64 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

65 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS.

P-RF 7 21,91 3,130000 1,777714 29,61 4,230000 2,403428

66 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,777714 41,93 5,990000 2,403428

67 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 10,37 1,481428 1,481428 14,02 2,002857 2,002857

68 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

69 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE CU 1 FLAC. PEID, DE CAPACITATE 60ML + 1 LINGURITA DOZATOARE A 5 ML, CU PULB. PT. 35 ML SUSP.O

PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

70 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF.

PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

71 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF.

PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

72 W60056001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

Pagina 63 din 87

Page 65: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

73 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

74 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

75 W56963002 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL

S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

76 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100

ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

77 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200

ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

78 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF.

PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

79 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML

SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,179000

80 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML

S/PR-F 1 35,03 35,030000 20,737200 45,82 45,820000 25,316400

81 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-

RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

82 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-

RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

83 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA

BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

84 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA

P-RF 1 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

85 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM.

PRF 60 3.171,52 52,858666 52,858666 3.495,11 58,251833 58,251833

86 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 63,430399 5.338,93 88,982166 69,902200

87 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS.

P-RF/R

100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

88 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM.

P-RF/R

50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

89 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

90 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

91 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR

F 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

92 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

93 W56643003 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X

100 CAPS.PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

94 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS.P-RF/R

100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

95 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM.

P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

96 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 100 133,10 1,331000 1,331000 162,49 1,624900 1,624900

97 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

98 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM.

P-RF/R

50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

99 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

100 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 50 133,10 2,662000 2,662000 162,49 3,249800 3,249800

101 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

102 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

103 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

104 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

105 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

Pagina 64 din 87

Page 66: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

106 W56579003 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

107 W53729001 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 205,39 4,107800 4,107800 250,74 5,014800 5,014800

108 W59092001 L04AD02 TACROLIMUSUM** TRACSUS 0,5 mg CAPS. 0,5mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT

PRF 50 91,62 1,832400 1,832400 115,84 2,316800 2,316800

109 W55262007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS.

S/P-RF 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

110 W56580003 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

111 W59093001 L04AD02 TACROLIMUSUM** TRACSUS 1 mg CAPS. 1mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT

PRF 50 179,98 3,599600 3,599600 219,72 4,394400 4,394400

112 W53730001 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 363,74 7,274800 7,274800 434,63 8,692600 8,692600

113 W55263007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS.

S/P-RF 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

114 W53731001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 1.715,18 34,303600 34,303600 1.907,70 38,154000 38,154000

115 W51974002 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 204,92 4,098400 4,098400 250,17 5,003400 5,003400

116 W57352002 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 402,53 8,050600 8,050600 476,91 9,538200 9,538200

117 W51976002 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE, X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 1.865,58 37,311600 37,311600 2.071,63 41,432600 41,432600

118 W53732001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ASTELLAS PHARMA

EUROPE BV OLANDA CUTIE X 10 FIOLE X 1 ML S 10 1.545,19 154,519000 154,519000 1.722,41 172,241000 172,241000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.3: TRANSPLANT HEPATIC

1 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 56,54 1,130800 0,848200 71,49 1,429800 1,109400

2 W59934001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6

L 60 42,41 0,706833 0,706833 55,47 0,924500 0,924500

3 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 98,29 0,982900 0,848200 124,28 1,242800 1,109400

4 W00188001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 54,39 1,087800 0,848200 68,77 1,375400 1,109400

5 W53024004 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOCHOL 150 mg COMPR. 150mg ZAMBON S.P.A. ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-6L 60 41,43 0,690500 0,690500 54,19 0,903166 0,903166

6 W53025002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOCHOL 300 mg COMPR. 300mg ZAMBON S.P.A. ITALIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 27,43 1,371500 1,371500 35,88 1,794000 1,794000

7 W58710001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 25 COMPR.FILM.

P6L 50 111,83 2,236600 2,236600 136,52 2,730400 2,730400

8 W58710002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM.

P6L 100 219,67 2,196700 2,196700 268,17 2,681700 2,681700

9 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIACUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP

P6L 1 77,10 77,100000 77,100000 97,49 97,490000 97,490000

10 W13613002 B01AB05 ENOXAPARINUM CLEXANE 2000ui anti-Xa/0,2ml SOL. INJ. 2000ui anti-Xa/0,2ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML

SOL. INJ.

PR/PRF

10 49,00 4,900000 4,900000 64,09 6,409000 6,409000

11 W13612002 B01AB05 ENOXAPARINUM CLEXANE 4000ui anti-Xa/0,4ml SOL. INJ. 4000ui anti-Xa/0,4ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML

SOL. INJ.

PR/PRF

10 93,99 9,399000 9,399000 118,84 11,884000 11,884000

12 W13611002 B01AB05 ENOXAPARINUM CLEXANE 6000ui anti-Xa/0,6ml SOL. INJ. 6000ui anti-Xa/0,6ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML

SOL. INJ.

PR/PRF

10 118,32 11,832000 11,832000 144,45 14,445000 14,445000

13 W13610001 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000ui anti-Xa/0,8ml LAB. AVENTIS FRANTA CUTIE X 2 SERINGI PREUMPLUTE X 0,8 ML

SOL. INJ.

PR/PRF

2 30,69 15,345000 15,345000 40,14 20,070000 20,070000

14 W13610002 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti-Xa/0,8ml LABORATOIRE AVENTIS FRANTA

CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU A

PR/PRF

6 104,35 17,391666 17,391666 127,39 21,231666 21,231666

15 W58879001 B01AC11 ILOPROSTUM** ILOMEDIN 20 CONC. PT. SOL. PERF. 20µg/ml BAYER PHARMA AG GERMANIA CUTIE X 5 FIOLE STICLA INCOLORA X 1 ML

CONC. PT. SOL. PERF.S/P-RF 5 650,50 130,100000 130,100000 747,20 149,440000 149,440000

16 W51786004 B01AC11 ILOPROSTUM** VENTAVIS 10mcg/ml SOL. DE INHALAT PRIN NEBULIZ. 10mcg/ml BAYER SCHERING

PHARMA AG GERMANIA CUTIE X 30 FIOLE X 1 ML SOL. DE INHALAT PRIN NEBULIZ. S 30 1.947,00 64,900000 64,900000 2.160,38 72,012666 72,012666

17 W00257001 B01AD02 ALTEPLASUM** ACTILYSE PULB+SOLV. PT. SOL. INJ 50mg

BOEHRINGER INGELHEIM INTERNATIONAL GMBH

GERMANIA CUTIE X 1 FLAC. LIOF. PT. SOL. INJ. + 1 FLACON SOLV. + CANULA DE TRANSFER S 1 1.490,89 1.490,890000 1.490,890000 1.663,22 1.663,220000 1.663,220000

18 W54011001 B02AA02 ACIDUM TRANEXAMICUM4) EXACYL SOL. INJ. 500mg/5ml CN UNIFARM ROMANIA CUTIE X 5 FIOLE X 5ML SOL. INJ. X 5 9,47 1,894000 1,894000 12,80 2,560000 2,560000

Pagina 65 din 87

Page 67: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

19 W58726003 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUROCARD 50 mg/20 mg CAPS. 50mg/20

mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 23,29 0,776333 0,776333 31,48 1,049333 1,049333

20 W60585002 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIOCOR 50 mg/20 mg CAPS. 50mg/20mg SANIENCE S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6

L 30 23,29 0,776333 0,776333 31,48 1,049333 1,049333

21 W60585001 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIOCOR 50 mg/20 mg CAPS. 50mg/20mg SANIENCE S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P6

L 20 17,25 0,862500 0,862500 23,31 1,165500 1,165500

22 W07005001 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUREX 50 CAPS. 50mg/20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-

6L 20 17,25 0,862500 0,862500 23,31 1,165500 1,165500

23 W53832002 H01BA02 DESMOPRESSINUM DESMOPRESINA TEVA 0,2mg COMPR. 0,2mg TEVA PHARMACEUTICAL S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL- PVC/AL X 30

COMPR.P-RF 30 105,26 3,508666 3,508666 128,50 4,283333 4,283333

24 W53989001 H01BA02 DESMOPRESSINUM MINIRIN 0,2 mg COMPR. 0,2mg FERRING GMBH GERMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. P-RF 30 95,42 3,180666 3,180666 120,65 4,021666 4,021666

25 W53992002 H01BA02 DESMOPRESSINUM MINIRIN MELT 120 mcg LIOF. ORAL 120mcg FERRING GMBH GERMANIA CUTIE X 3 BLIST. AL/AL X 10 UNITATI DOZATE LIOF. ORAL

P-RF 30 149,92 4,997333 4,997333 183,02 6,100666 6,100666

26 W53991001 H01BA02 DESMOPRESSINUM MINIRIN MELT 60 mcg LIOF. ORAL 60mcg FERRING GMBH GERMANIA CUTIE X 1 BLIST AL/AL X 10 UNITATI DOZATE LIOF. ORAL

P-RF 10 26,04 2,604000 2,604000 34,06 3,406000 3,406000

27 W53991002 H01BA02 DESMOPRESSINUM MINIRIN MELT 60 mcg LIOF. ORAL 60mcg FERRING GMBH GERMANIA CUTIE X 3 BLIST AL/AL X 10 UNITATI DOZATE LIOF. ORAL

P-RF 30 76,73 2,557666 2,557666 97,02 3,234000 3,234000

28 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

29 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

30 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

31 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

32 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

33 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

34 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

35 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

36 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

37 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

38 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

39 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

40 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-

RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

41 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML

P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

42 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIA10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA

PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

43 W60604004 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 10 PUNGI DIN PP TRANSPARENTA PANA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI INVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINAND FIECARE 300 ML SOL. PERF.

PR 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

44 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

45 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

46 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF.

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

47 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-

RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

48 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-

RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

Pagina 66 din 87

Page 68: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

49 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA

BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

50 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA

P-RF 1 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

51 W06665001 J02AX04 CASPOFUNGINUM** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME MAREA

BRITANIECUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.202,39 1.202,390000 1.202,390000 1.348,76 1.348,760000 1.348,760000

52 W06670001 J02AX04 CASPOFUNGINUM** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME MAREA

BRITANIECUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.560,14 1.560,140000 1.560,140000 1.738,70 1.738,700000 1.738,700000

53 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM.

PRF 60 3.171,52 52,858666 52,858666 3.495,11 58,251833 58,251833

54 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 63,430399 5.338,93 88,982166 69,902200

55 W54188003 J06BB04 IMUNOGLOBULINA ANTI-HEPATITICA B** HEPATECT CP 50 UI/ml SOL. PERF. 50 UI/ ml BIOTEST PHARMA GMBH GERMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X 40 ML SOL. PERF. (2000UI) PR 1 2.935,32 2.935,320000 2.935,320000 3.237,65 3.237,650000 3.237,650000

56 W51424001 L03AA02 FILGRASTIMUM (G-CSF) NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML

S/P-RF 1 267,05 267,050000 194,520000 326,02 326,020000 237,468000

57 W51423001 L03AA02 FILGRASTIMUM (G-CSF) NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML

S/P-RF 1 436,57 436,570000 313,092000 514,01 514,010000 382,224000

58 W53892001 L03AA02 FILGRASTIMUM (G-CSF) ZARZIO 30MU/0,5mlSOL. INJ. /PERF. IN SERINGA PREUMPLUTA

60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

1 162,10 162,100000 162,100000 197,89 197,890000 197,890000

59 W53893001 L03AA02 FILGRASTIMUM (G-CSF) ZARZIO 48MU/0,5mlSOL. INJ. /PERF. IN SERINGA PREUMPLUTA

96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

1 260,91 260,910000 260,910000 318,52 318,520000 318,520000

60 W55756002 L03AA02 FILGRASTIMUM (G-CSF) NIVESTIM 12 MU/0,2ml SOL. INJ./PERF. 120µg/0,2ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,2ML SOL. INJ. SAU PERF.

P-RF 5 418,45 83,690000 83,690000 494,26 98,852000 98,852000

61 W53520001 L03AA02 FILGRASTIMUM (G-CSF) TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0,5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML

SOL. INJ. SAU PERF.

S/P-RF/R

1 214,16 214,160000 194,520000 261,45 261,450000 237,468000

62 W55757002 L03AA02 FILGRASTIMUM (G-CSF) NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.

P-RF 5 1.001,12 200,224000 194,520000 1.129,37 225,874000 225,874000

63 W53523001 L03AA02 FILGRASTIMUM (G-CSF) TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0,8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML

SOL. INJ. SAU PERF.

S/P-RF/R

1 355,90 355,900000 313,092000 426,08 426,080000 382,224000

64 W55758002 L03AA02 FILGRASTIMUM (G-CSF) NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.

P-RF 5 1.656,30 331,260000 313,092000 1.843,52 368,704000 368,704000

65 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS.

P-RF/R

100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

66 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM.

P-RF/R

50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

67 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

68 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

69 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR

F 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

70 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

71 W56643003 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X

100 CAPS.PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

72 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS.P-RF/R

100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

73 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM.

P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

74 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 100 133,10 1,331000 1,331000 162,49 1,624900 1,624900

75 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

76 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM.

P-RF/R

50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

77 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

78 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 50 133,10 2,662000 2,662000 162,49 3,249800 3,249800

79 W10576001 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR)

P-RF/R

30 489,29 16,309666 16,309666 571,48 19,049333 19,049333

80 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

Pagina 67 din 87

Page 69: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

81 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

82 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

83 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

84 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

85 W56579003 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

86 W53729001 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 205,39 4,107800 4,107800 250,74 5,014800 5,014800

87 W59092001 L04AD02 TACROLIMUSUM** TRACSUS 0,5 mg CAPS. 0,5mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT

PRF 50 91,62 1,832400 1,832400 115,84 2,316800 2,316800

88 W55262007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS.

S/P-RF 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

89 W56580003 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

90 W59093001 L04AD02 TACROLIMUSUM** TRACSUS 1 mg CAPS. 1mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT

PRF 50 179,98 3,599600 3,599600 219,72 4,394400 4,394400

91 W53730001 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 363,74 7,274800 7,274800 434,63 8,692600 8,692600

92 W55263007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS.

S/P-RF 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

93 W53731001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 1.715,18 34,303600 34,303600 1.907,70 38,154000 38,154000

94 W51974002 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 204,92 4,098400 4,098400 250,17 5,003400 5,003400

95 W57352002 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 402,53 8,050600 8,050600 476,91 9,538200 9,538200

96 W51976002 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE, X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 1.865,58 37,311600 37,311600 2.071,63 41,432600 41,432600

97 W53732001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ASTELLAS PHARMA

EUROPE BV OLANDA CUTIE X 10 FIOLE X 1 ML S 10 1.545,19 154,519000 154,519000 1.722,41 172,241000 172,241000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.4: TRANSPLANT RENAL combinat RINICHI si PANCREAS

1 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 56,54 1,130800 0,848200 71,49 1,429800 1,109400

2 W59934001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6

L 60 42,41 0,706833 0,706833 55,47 0,924500 0,924500

3 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 98,29 0,982900 0,848200 124,28 1,242800 1,109400

4 W00188001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 54,39 1,087800 0,848200 68,77 1,375400 1,109400

5 W53024004 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOCHOL 150 mg COMPR. 150mg ZAMBON S.P.A. ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-6L 60 41,43 0,690500 0,690500 54,19 0,903166 0,903166

6 W53025002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOCHOL 300 mg COMPR. 300mg ZAMBON S.P.A. ITALIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 27,43 1,371500 1,371500 35,88 1,794000 1,794000

7 W58710001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 25 COMPR.FILM.

P6L 50 111,83 2,236600 2,236600 136,52 2,730400 2,730400

8 W58710002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM.

P6L 100 219,67 2,196700 2,196700 268,17 2,681700 2,681700

9 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIACUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP

P6L 1 77,10 77,100000 77,100000 97,49 97,490000 97,490000

10 W00231001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,25 mcg CAPS. MOI 0,25mcgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. DIN PPID X 50 CAPS. MOI P-RF 50 21,46 0,429200 0,429200 29,01 0,580200 0,580200

11 W58167002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,25 mcg CAPS. MOI 0,25µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI

PRF 30 16,99 0,566333 0,515040 22,97 0,765666 0,696240

12 W44042001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,50 mcg CAPS. MOI 0,50mcgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. X 30 CAPS. MOI P-RF 30 23,23 0,774333 0,774333 31,40 1,046666 1,046666

13 W58168002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,5 mcg CAPS. MOI 0,5µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI

PRF 30 26,00 0,866666 0,866666 34,01 1,133666 1,133666

14 W55847001 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMAR

CACUTIE CU 10 FIOLE DIN STICLA BRUNA X 0,5 ML SOL. INJ. S 10 108,79 10,879000 10,879000 132,81 13,281000 13,281000

Pagina 68 din 87

Page 70: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

15 W55847002 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMAR

CACUTIE CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. S 10 203,78 20,378000 20,378000 248,78 24,878000 24,878000

16 W43774001 B01AB04 DALTEPARINUM FRAGMIN 10000 UI/0,4 ml SOL. INJ. 10000UI/0,4ml PFIZER EUROPE MA EEIG MAREA

BRITANIECUTIE X 5 BLIST. X 1 SERINGA X 0,4 ML SOL. INJ.

S/P-RF 5 103,19 20,638000 20,638000 125,97 25,194000 25,194000

17 W43775001 B01AB04 DALTEPARINUM FRAGMIN 12500 UI/0,5 ml SOL. INJ. 12500 UI/0,5ml PFIZER EUROPE MA EEIG MAREA

BRITANIECUTIE X 5 BLIST. X 1 SERINGA X 0,5 ML SOL. INJ.

S/P-RF 5 139,97 27,994000 27,994000 170,87 34,174000 34,174000

18 W52805003 B01AB04 DALTEPARINUM FRAGMIN15000 UI/0,6 ml SOL. INJ. 15000ui/0,6ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 5 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,6 ML SOL. INJ.

S/P-RF 5 169,45 33,890000 33,890000 206,87 41,374000 41,374000

19 W43776001 B01AB04 DALTEPARINUM FRAGMIN 18000 UI/0,72 ml SOL. INJ. 18000 UI/0,72ml PFIZER EUROPE MA EEIG MAREA

BRITANIECUTIE X 5 BLIST. X 1 SERINGA X 0,72 ML SOL. INJ.

S/P-RF 5 192,72 38,544000 38,544000 235,27 47,054000 47,054000

20 W52809004 B01AB04 DALTEPARINUM FRAGMIN 2500 UI/0,2 ml SOL. INJ. 2500ui/0,2ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,2 ML

S/P-RF 10 61,36 6,136000 6,136000 77,59 7,759000 7,759000

21 W52808004 B01AB04 DALTEPARINUM FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000ui/0,2ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,2 ML

S/P-RF 10 116,45 11,645000 11,645000 142,16 14,216000 14,216000

22 W52807002 B01AB04 DALTEPARINUM FRAGMIN 7500 UI/0,3 ml SOL. INJ. 7500ui/0,3ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA X 0,3 ML

S/P-RF 10 166,28 16,628000 16,628000 202,99 20,299000 20,299000

23 W13613002 B01AB05 ENOXAPARINUM CLEXANE 2000ui anti-Xa/0,2ml SOL. INJ. 2000ui anti-Xa/0,2ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML

SOL. INJ.

PR/PRF

10 49,00 4,900000 4,900000 64,09 6,409000 6,409000

24 W13612002 B01AB05 ENOXAPARINUM CLEXANE 4000ui anti-Xa/0,4ml SOL. INJ. 4000ui anti-Xa/0,4ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML

SOL. INJ.

PR/PRF

10 93,99 9,399000 9,399000 118,84 11,884000 11,884000

25 W13611002 B01AB05 ENOXAPARINUM CLEXANE 6000ui anti-Xa/0,6ml SOL. INJ. 6000ui anti-Xa/0,6ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML

SOL. INJ.

PR/PRF

10 118,32 11,832000 11,832000 144,45 14,445000 14,445000

26 W13610001 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000ui anti-Xa/0,8ml LAB. AVENTIS FRANTA CUTIE X 2 SERINGI PREUMPLUTE X 0,8 ML

SOL. INJ.

PR/PRF

2 30,69 15,345000 15,345000 40,14 20,070000 20,070000

27 W13610002 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti-Xa/0,8ml LABORATOIRE AVENTIS FRANTA

CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU A

PR/PRF

6 104,35 17,391666 17,391666 127,39 21,231666 21,231666

28 W42955001 H01CB02 OCTREOTIDUM** SANDOSTATIN LAR 20 mgPULB. + SOLV. PT. SUSP. INJ. (I.M.) CU ELIB. PRELU

20mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA

PREUMPLUTA X 2,5 ML SOLVENT + 2 ACES/P-RF 1 3.478,41 3.478,410000 3.478,410000 3.829,62 3.829,620000 3.829,620000

29 W42954001 H01CB02 OCTREOTIDUM** SANDOSTATIN LAR 10 mgPULB.+SOLV.PT.SUSP. INJ. (I.M.) CU ELIB. PRELUNG.

10mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULBERE + 1 SERINGA

PREUMPLUTA X 2,5 ML SOLVENT + 2 ACES/P-RF 1 2.167,33 2.167,330000 2.167,330000 2.400,54 2.400,540000 2.400,540000

30 W42956001 H01CB02 OCTREOTIDUM** SANDOSTATIN LAR 30 mgPULB.+SOLV.PT.SUSP. INJ. (I.M.) CU ELIB. PRELUNG.

30mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PULB. + 1 SERINGA

PREUMPLUTA X 2,5 ML SOLVENT + 2 ACES/P-RF 1 4.817,21 4.817,210000 4.817,210000 5.288,92 5.288,920000 5.288,920000

31 W59668002 H01CB02 OCTREOTIDUM** OCTREOTID KABI 0,1 mg/ml SOL INJ. 0,1mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 5 FLAC. DIN SICLA INCOLORA,

CU CAPACITATEA DE 2 ML X 1 ML SOL. INJ.PRF 5 75,49 15,098000 8,100000 95,45 19,090000 10,596000

32 W59079001 H01CB02 OCTREOTIDUM** SANDOSTATIN 0,1 mg/ml SOL. INJ. 0,1mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X

1 ML SOL. INJ. PR 5 33,75 6,750000 6,750000 44,15 8,830000 8,830000

33 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

34 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

35 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

36 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

37 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

38 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

39 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

40 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

41 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

Pagina 69 din 87

Page 71: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

42 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

43 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

44 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

45 W13105001 J01XA02 TEICOPLANINUM TARGOCID (R) 400 mg LIOF. + SOLV. PT. SOL. INJ. 400mg AVENTIS PHARMA LTD. MAREA

BRITANIE CUTIE X 1 FLAC. LIOF. + O FIOLA SOLV. P-RF 1 109,84 109,840000 109,840000 134,09 134,090000 134,090000

46 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-

RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

47 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML

P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

48 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIA10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA

PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

49 W60604004 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 10 PUNGI DIN PP TRANSPARENTA PANA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI INVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINAND FIECARE 300 ML SOL. PERF.

PR 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

50 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

51 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

52 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF.

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

53 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,615428 25,61 6,402500 4,887428

54 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-

RF 16 65,37 4,085625 3,615428 82,66 5,166250 4,887428

55 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 21,09 3,012857 3,012857 28,51 4,072857 4,072857

56 W43597001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6,98 3,490000 3,490000 9,43 4,715000 4,715000

57 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 23,31 3,330000 3,330000 31,51 4,501428 4,501428

58 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,340000 14,58 14,580000 7,212000

59 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,340000 9,68 9,680000 7,212000

60 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

61 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 6,07 6,070000 5,340000 8,20 8,200000 7,212000

62 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 8,90 8,900000 5,340000 12,03 12,030000 7,212000

63 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

64 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PR

F 1 9,57 9,570000 5,340000 12,94 12,940000 7,212000

65 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

66 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,340000 9,03 9,030000 7,212000

67 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC

TRANSPARENT/PVDC-AL X 1 CAPS.PRF 1 4,45 4,450000 4,450000 6,01 6,010000 6,010000

68 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PR

F 1 7,44 7,440000 5,340000 10,06 10,060000 7,212000

69 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 18,56 18,560000 5,340000 25,08 25,080000 7,212000

70 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS.

P-RF 1 13,95 13,950000 5,340000 18,86 18,860000 7,212000

71 W54835003 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-

RF 4 48,24 12,060000 5,340000 63,10 15,775000 7,212000

72 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-

RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

73 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 30,10 4,300000 4,300000 39,37 5,624285 5,624285

Pagina 70 din 87

Page 72: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

74 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,777714 19,58 2,797142 2,403428

75 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 43,23 6,175714 1,777714 56,54 8,077142 2,403428

76 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,777714 19,12 2,731428 2,403428

77 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

78 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 12,35 1,764285 1,764285 16,69 2,384285 2,384285

79 W52225001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-

RF 7 11,66 1,665714 1,665714 15,76 2,251428 2,251428

80 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

81 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS.

P-RF 7 21,91 3,130000 1,777714 29,61 4,230000 2,403428

82 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,777714 41,93 5,990000 2,403428

83 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 10,37 1,481428 1,481428 14,02 2,002857 2,002857

84 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

85 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE CU 1 FLAC. PEID, DE CAPACITATE 60ML + 1 LINGURITA DOZATOARE A 5 ML, CU PULB. PT. 35 ML SUSP.O

PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

86 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF.

PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

87 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF.

PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

88 W60056001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

89 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

90 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

91 W56963002 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL

S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

92 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100

ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

93 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200

ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

94 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF.

PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

95 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML

SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,179000

96 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML

S/PR-F 1 35,03 35,030000 20,737200 45,82 45,820000 25,316400

97 W52343006 J02AC02 ITRACONAZOLUM OMICRAL 100 mg CAPS. 100mg MEDICO UNO PHARMACEUTICAL SRL ROMANIA CUTIE X 3 BLIST. AL/AL X 5 CAPS. P-

RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

98 W59235001 J02AC02 ITRACONAZOLUM ITRACONAZOL ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

99 W53958001 J02AC02 ITRACONAZOLUM MICOGAL 100 mg CAPS. 100mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 5 CAPS. P-

RF 15 40,18 2,678666 2,678666 52,55 3,503333 3,503333

100 W43051001 J02AC02 ITRACONAZOLUM ITRACONAZOL 100 mg CAPS. 100mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 5 CAPS. P-RF 15 40,18 2,678666 2,678666 52,56 3,504000 3,504000

101 W03837002 J02AC02 ITRACONAZOLUM ORUNGAL CAPS. 100mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 5

CAPS.P-RF 15 60,84 4,056000 3,214399 76,92 5,128000 4,204000

102 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-

RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

103 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-

RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

104 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA

BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

105 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA

P-RF 1 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

106 W06665001 J02AX04 CASPOFUNGINUM** CANCIDAS 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg MERCK SHARP & DOHME MAREA

BRITANIECUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.202,39 1.202,390000 1.202,390000 1.348,76 1.348,760000 1.348,760000

Pagina 71 din 87

Page 73: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

107 W06670001 J02AX04 CASPOFUNGINUM** CANCIDAS 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg MERCK SHARP & DOHME MAREA

BRITANIECUTIE X 1 FLAC. PULB. PTR. CONC. PTR. SOL. PERF. S 1 1.560,14 1.560,140000 1.560,140000 1.738,70 1.738,700000 1.738,700000

108 W53675003 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS.P-RF/S

1.000 704,14 0,704140 0,613200 805,66 0,805660 0,805660

109 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-

RF 20 15,85 0,792500 0,613200 21,42 1,071000 0,828600

110 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 15,85 0,792500 0,613200 21,42 1,071000 0,828600

111 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14,97 0,748500 0,613200 20,23 1,011500 0,828600

112 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 14,41 1,441000 1,441000 19,48 1,948000 1,948000

113 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 10,22 0,511000 0,511000 13,81 0,690500 0,690500

114 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

115 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PR

F 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

116 W13972001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-

RF 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

117 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12,69 0,634500 0,613200 17,15 0,857500 0,828600

118 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 20,11 2,011000 1,729200 27,18 2,718000 2,337600

119 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL.

INJ./PERF.S/P-RF 5 231,79 46,358000 46,358000 282,97 56,594000 56,594000

120 W58707001 J05AB11 VALACYCLOVIRUM VALTREX 500 mg COMPR. FILM. 500 mg THE WELLCOME FOUNDATION LTD.

MAREA BRITANIE

CUTIE CU BLIST. DIN CLORURA DE POLIVINIL/AL X 10 COMPR.FILM.

PRF 10 43,54 4,354000 3,396000 56,95 5,695000 4,441200

121 W60087001 J05AB11 VALACYCLOVIRUM VALACICLOVIR ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC ALB OPAC/AL X 10 COMPR. FILM.

PRF 10 28,30 2,830000 2,830000 37,01 3,701000 3,701000

122 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM.

PRF 60 3.171,52 52,858666 52,858666 3.495,11 58,251833 58,251833

123 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 63,430399 5.338,93 88,982166 69,902200

124 W54752003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S 1 1.714,69 1.714,690000 1.714,690000 1.907,17 1.907,170000 1.907,170000

125 W54752004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 200 ML SOL. PERF. S 1 3.437,56 3.437,560000 3.437,560000 3.785,10 3.785,100000 3.785,100000

126 W54752002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 50 ML SOL. PERF. S 1 881,87 881,870000 881,870000 999,39 999,390000 999,390000

127 W54752001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM 10% SOL. PERF. 100 mg/ml OCTAPHARMA (IP)

LIMITEDMAREA BRITANIE

CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 20 ML SOL. PERF. S 1 379,02 379,020000 379,020000 451,28 451,280000 451,280000

128 W51530003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 50ML SOL.

PERF.(5G/50ML) S 1 925,45 925,450000 909,000000 1.046,89 1.046,890000 1.036,596000

129 W51530004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 100ML SOL.

PERF.(10G/100ML) S 1 1.857,75 1.857,750000 1.782,000000 2.063,10 2.063,100000 1.988,160000

130 W51530006 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 300ML SOL.

PERF.(30G/300ML) S 1 5.558,99 5.558,990000 5.558,990000 6.097,46 6.097,460000 6.097,460000

131 W51530005 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 200ML SOL.

PERF.(20G/200ML) S 1 3.821,35 3.821,350000 3.821,350000 4.203,43 4.203,430000 4.203,430000

132 W51530001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** KIOVIG 100mg/ml SOL. PERF. 100mg/ml BAXTER AG AUSTRIA CUTIE X 1 FLAC X 10ML SOL.

PERF.(1G/10ML) S 1 202,26 202,260000 202,260000 246,92 246,920000 246,920000

133 W43965001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 10g/200ml SOL. PERF. 10g/200ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

200 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 1.485,00 1.485,000000 1.485,000000 1.656,80 1.656,800000 1.656,800000

134 W43962001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 1g/20ml SOL. PERF. 1g/20ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

20 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 197,39 197,390000 197,390000 240,98 240,980000 240,980000

135 W43963001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 2,5g/50ml SOL. PERF. 2,5g/50ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

50 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 393,75 393,750000 393,750000 467,34 467,340000 467,340000

136 W59114003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 100 ML

SOL. PERF.PRF 1 882,14 882,140000 882,140000 999,68 999,680000 999,680000

137 W59114001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 20 ML SOL.

PERF.PRF 1 187,48 187,480000 187,480000 228,87 228,870000 228,870000

138 W59114004 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 200 ML

SOL. PERF.PRF 1 1.734,28 1.734,280000 1.734,280000 1.928,52 1.928,520000 1.928,520000

139 W59114002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** INTRATECT 50 g/l SOL. PERF. 50g/l BIOTEST PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA A 50 ML SOL.

PERF.PRF 1 456,06 456,060000 456,060000 535,26 535,260000 535,260000

140 W52560001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** FLEBOGAMMADIF 50mg/ml SOL. PERF. 50mg/ml INSTITUTO GRIFOLS S.A. SPANIA CUTIE X 1 FLAC. X 10 ML SOL. PERF. S 1 102,55 102,550000 102,550000 125,19 125,190000 125,190000

141 W13462001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 50 ML S 1 465,59 465,590000 465,590000 545,64 545,640000 545,640000

142 W13462003 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 200 ML S 1 1.772,34 1.772,340000 1.772,340000 1.970,00 1.970,000000 1.970,000000

143 W13462002 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** OCTAGAM SOL. PERF. 50mg/ml OCTAPHARMA (IP) LTD. MAREA

BRITANIE CUTIE X 1 FLACON X 100 ML S 1 882,13 882,130000 882,130000 999,67 999,670000 999,670000

Pagina 72 din 87

Page 74: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

144 W43964001 J06BA02 IMUNOGLOBULINA NORMALA PT. ADM. INTRAVASCULARA** IG VENA 5g/100ml SOL. PERF. 5g/100ml KEDRION SPA ITALIA CUTIE X 1 FLAC. DIN STICLA INCOLORA X

100 ML SOL. PERF. + 1 SET ADMINISTRARE S 1 757,50 757,500000 757,500000 863,83 863,830000 863,830000

145 W12490001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN (R) 50 mg DRAJ. 50mg BAXTER ONCOLOGY GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 DRAJ. P-

RF 50 19,33 0,386600 0,386600 26,13 0,522600 0,522600

146 W52215001 L01AA01 CYCLOPHOSPHAMIDUM ENDOXAN 200 mg PULB. PT. SOL. PERF./INJ. I.V. 200mg ACTAVIS S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. SOL. PERF./INJ S 1 11,76 11,760000 11,760000 15,89 15,890000 15,890000

147 W51424001 L03AA02 FILGRASTIMUM (G-CSF) NEUPOGEN (R) SOL. INJ. 30MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML

S/P-RF 1 267,05 267,050000 194,520000 326,02 326,020000 237,468000

148 W51423001 L03AA02 FILGRASTIMUM (G-CSF) NEUPOGEN (R) SOL. INJ. 48MU/0,5ml AMGEN EUROPE B.V. OLANDA CUTIE X 1 SERINGA PRE-UMPLUTA X 0,5 ML

S/P-RF 1 436,57 436,570000 313,092000 514,01 514,010000 382,224000

149 W53892001 L03AA02 FILGRASTIMUM (G-CSF) ZARZIO 30MU/0,5mlSOL. INJ. /PERF. IN SERINGA PREUMPLUTA

60MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

1 162,10 162,100000 162,100000 197,89 197,890000 197,890000

150 W53893001 L03AA02 FILGRASTIMUM (G-CSF) ZARZIO 48MU/0,5mlSOL. INJ. /PERF. IN SERINGA PREUMPLUTA

96MU/ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL

P-RF/R

1 260,91 260,910000 260,910000 318,52 318,520000 318,520000

151 W55756002 L03AA02 FILGRASTIMUM (G-CSF) NIVESTIM 12 MU/0,2ml SOL. INJ./PERF. 120µg/0,2ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,2ML SOL. INJ. SAU PERF.

P-RF 5 418,45 83,690000 83,690000 494,26 98,852000 98,852000

152 W53520001 L03AA02 FILGRASTIMUM (G-CSF) TEVAGRASTIM 30MUI/0,5ml SOL. INJ./PERF. 300mcg/0,5ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,5 ML

SOL. INJ. SAU PERF.

S/P-RF/R

1 214,16 214,160000 194,520000 261,45 261,450000 237,468000

153 W55757002 L03AA02 FILGRASTIMUM (G-CSF) NIVESTIM 30 MU/0,5 ml SOL. INJ./PERF. 300µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.

P-RF 5 1.001,12 200,224000 194,520000 1.129,37 225,874000 225,874000

154 W53523001 L03AA02 FILGRASTIMUM (G-CSF) TEVAGRASTIM 48MUI/0,8ml SOL. INJ./PERF. 480mcg/0,8ml TEVA GENERICS GMBH GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.8 ML

SOL. INJ. SAU PERF.

S/P-RF/R

1 355,90 355,900000 313,092000 426,08 426,080000 382,224000

155 W55758002 L03AA02 FILGRASTIMUM (G-CSF) NIVESTIM 48 MU/0,5 ml SOL. INJ./PERF. 480µg/0,5ml HOSPIRA UK LIMITED MAREA BRITANIE

CUTIE X 5 SERINGI PREUMPLUTE (STICLA) X 0,5 ML SOL. INJ. SAU PERF.

P-RF 5 1.656,30 331,260000 313,092000 1.843,52 368,704000 368,704000

156 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS.

P-RF/R

100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

157 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM.

P-RF/R

50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

158 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

159 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

160 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR

F 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

161 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

162 W56643003 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X

100 CAPS.PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

163 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS.P-RF/R

100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

164 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM.

P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

165 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 100 133,10 1,331000 1,331000 162,49 1,624900 1,624900

166 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

167 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM.

P-RF/R

50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

168 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

169 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 50 133,10 2,662000 2,662000 162,49 3,249800 3,249800

170 W10576001 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR)

P-RF/R

30 489,29 16,309666 16,309666 571,48 19,049333 19,049333

171 W13098001 L04AC02 BASILIXIMABUM** SIMULECT 20 mg LIOF. + SOLV. PT. SOL. INJ./PERF. 20mg NOVARTIS EUROPHARM

LTD.MAREA BRITANIE

CUTIE X 1 FLAC. CU LIOF.+ 1 FIOLA SOLV. APA PT. PREP. INJ. S 1 4.267,46 4.267,460000 4.267,460000 4.689,69 4.689,690000 4.689,690000

172 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

173 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

174 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

175 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

Pagina 73 din 87

Page 75: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

176 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

177 W56579003 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

178 W53729001 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 205,39 4,107800 4,107800 250,74 5,014800 5,014800

179 W59092001 L04AD02 TACROLIMUSUM** TRACSUS 0,5 mg CAPS. 0,5mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT

PRF 50 91,62 1,832400 1,832400 115,84 2,316800 2,316800

180 W55262007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS.

S/P-RF 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

181 W56580003 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

182 W59093001 L04AD02 TACROLIMUSUM** TRACSUS 1 mg CAPS. 1mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT

PRF 50 179,98 3,599600 3,599600 219,72 4,394400 4,394400

183 W53730001 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 363,74 7,274800 7,274800 434,63 8,692600 8,692600

184 W55263007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS.

S/P-RF 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

185 W53731001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 1.715,18 34,303600 34,303600 1.907,70 38,154000 38,154000

186 W51974002 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 204,92 4,098400 4,098400 250,17 5,003400 5,003400

187 W57352002 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 402,53 8,050600 8,050600 476,91 9,538200 9,538200

188 W51976002 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE, X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 1.865,58 37,311600 37,311600 2.071,63 41,432600 41,432600

189 W53732001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ASTELLAS PHARMA

EUROPE BV OLANDA CUTIE X 10 FIOLE X 1 ML S 10 1.545,19 154,519000 154,519000 1.722,41 172,241000 172,241000

190 W56928001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM.

S/P-RF 100 55,53 0,555300 0,555300 70,21 0,702100 0,702100

191 W56508002 L04AX01 AZATHIOPRINUM IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR.

FILM. PR 100 62,39 0,623900 0,623900 78,89 0,788900 0,788900

192 W54297001 M05BA04 ACIDUM ALENDRONICUM TEVANAT 70 mg COMPR. 70 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-AL-OPA/AL X 4 COMPR.

P-6L 4 36,90 9,225000 5,337000 48,27 12,067500 7,212000

193 W60296004 M05BA04 ACIDUM ALENDRONICUM FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L 2 28,39 14,195000 5,337000 37,13 18,565000 7,212000

194 W58352002 M05BA04 ACIDUM ALENDRONICUM ACID ALENDRONIC AUROBINDO 70 mg COMPR. 70mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. TRANSPARENTE PVC-

ACLAR/AL X 4 COMPR.P6L 4 17,79 4,447500 4,447500 24,04 6,010000 6,010000

195 W56763003 M05BA04 ACIDUM ALENDRONICUM ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 4 COMPR. FILM.

P-6L 4 36,67 9,167500 5,337000 47,97 11,992500 7,212000

196 W52948001 M05BA04 ACIDUM ALENDRONICUM ALENDRONAT SANDOZ 70 mg COMPR. FILM. 70mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. OPA-AL-PVC/AL X 2 COMPR. FILM

P-6L 2 9,49 4,745000 4,745000 12,82 6,410000 6,410000

197 W56763001 M05BA04 ACIDUM ALENDRONICUM ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR. FILM.

P-6L 12 108,06 9,005000 5,337000 131,92 10,993333 7,212000

198 W56763002 M05BA04 ACIDUM ALENDRONICUM ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 COMPR. FILM.

P-6L 2 18,33 9,165000 5,337000 24,78 12,390000 7,212000

199 W42905002 N02AB02 PETHIDINUM MIALGIN (R) 100 mg/2 ml SOL. INJ. 50mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA X 2 ML P-TS 5 6,92 1,384000 1,384000 9,35 1,870000 1,870000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.5: TRANSPLANT CELULE PANCREATICE

1 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-

RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

2 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML

P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

3 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIA10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA

PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

4 W60604004 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 10 PUNGI DIN PP TRANSPARENTA PANA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI INVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINAND FIECARE 300 ML SOL. PERF.

PR 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

5 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

Pagina 74 din 87

Page 76: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

6 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

7 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF.

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

8 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-

RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

9 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-

RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

10 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA

BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

11 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA

P-RF 1 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

12 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM.

PRF 60 3.171,52 52,858666 52,858666 3.495,11 58,251833 58,251833

13 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 63,430399 5.338,93 88,982166 69,902200

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.6: TRANSPLANT PULMONAR

1 W13613002 B01AB05 ENOXAPARINUM CLEXANE 2000ui anti-Xa/0,2ml SOL. INJ. 2000ui anti-Xa/0,2ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML

SOL. INJ.

PR/PRF

10 49,00 4,900000 4,900000 64,09 6,409000 6,409000

2 W13612002 B01AB05 ENOXAPARINUM CLEXANE 4000ui anti-Xa/0,4ml SOL. INJ. 4000ui anti-Xa/0,4ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML

SOL. INJ.

PR/PRF

10 93,99 9,399000 9,399000 118,84 11,884000 11,884000

3 W13611002 B01AB05 ENOXAPARINUM CLEXANE 6000ui anti-Xa/0,6ml SOL. INJ. 6000ui anti-Xa/0,6ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML

SOL. INJ.

PR/PRF

10 118,32 11,832000 11,832000 144,45 14,445000 14,445000

4 W13610001 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000ui anti-Xa/0,8ml LAB. AVENTIS FRANTA CUTIE X 2 SERINGI PREUMPLUTE X 0,8 ML

SOL. INJ.

PR/PRF

2 30,69 15,345000 15,345000 40,14 20,070000 20,070000

5 W13610002 B01AB05 ENOXAPARINUM CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti-Xa/0,8ml LABORATOIRE AVENTIS FRANTA

CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU A

PR/PRF

6 104,35 17,391666 17,391666 127,39 21,231666 21,231666

6 W54011001 B02AA02 ACIDUM TRANEXAMICUM4) EXACYL SOL. INJ. 500mg/5ml CN UNIFARM ROMANIA CUTIE X 5 FIOLE X 5ML SOL. INJ. X 5 9,47 1,894000 1,894000 12,80 2,560000 2,5600007 W02947001 C01CA24 EPINEPHRINUM ADRENALINA 1 mg SOL. INJ. 1mg/ml TERAPIA SA ROMANIA CUTIE X 100 FIOLE X 1 ML S 100 151,25 1,512500 1,512500 184,65 1,846500 1,846500

8 W60389001 C01CA24 EPINEPHRINUM EPIPEN 150 micrograme SOL. INJ. IN STILOU PREUMPLUT 150mcg MEDA PHARMA GMBH &

CO KG GERMANIACUTIE CU 1 STILOU AUTOINJECTOR PREUMPLUT CU 2ML PENTRU O DOZA UNICA DE 0,3ML

PR 1 147,80 147,800000 147,800000 180,43 180,430000 180,430000

9 W60390001 C01CA24 EPINEPHRINUM EPIPEN 300 micrograme SOL. INJ. IN STILOU PREUMPLUT 300mcg MEDA PHARMA GMBH &

CO KG GERMANIACUTIE CU 1 STILOU AUTOINJECTOR PREUMPLUT CU 2ML PENTRU O DOZA UNICA DE 0,3ML

PR 1 147,80 147,800000 147,800000 180,43 180,430000 180,430000

10 W55423001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

11 W55369001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 20 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

12 W55629002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 12 265,41 22,117500 22,117500 324,01 27,000833 27,000833

13 W54763001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 2g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

10 ML CU PULB. PT. SOL. INJ./PERF. S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

14 W55629001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 2 g/0,25 g PULB. PT. SOL. INJ./PERF. 2g/0,25g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 30 ML CU PULB. PT. SOL. INJ./PERF.

S 1 22,93 22,930000 22,930000 30,99 30,990000 30,990000

15 W54765001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILINA/TAZOBACTAM MYLAN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g MYLAN S.A.S. FRANTA CUTIE CU 1 FLAC. DIN STICLA INCOLORA A

50 ML CU PULB. PT. SOL. INJ./PERF. S 1 40,94 40,940000 40,940000 53,55 53,550000 53,550000

16 W55630001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

17 W55630002 J01CR05 PIPERACILLINUM + TAZOBACTAMUM ZOPECILIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ROMASTRU TRADING

SRL ROMANIACUTIE CU 12 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 12 460,81 38,400833 38,400833 540,43 45,035833 45,035833

18 W55370001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM BACTACIN 4 g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g TERAPIA SA ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 50 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

19 W55424001 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PERASIN 4g/0,5 g PULB. PT. SOL. INJ./PERF. 4g/0,5g ANTIBIOTICE S.A. ROMANIA

CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 48 ML CU PULB. PT. SOL. INJ./PERF.

S 1 40,93 40,930000 40,930000 53,53 53,530000 53,530000

20 W53595006 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 2g/0,25 g PULB. PT. SOL. PERF. 2g/0,25g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 386,57 38,657000 26,541000 459,51 45,951000 32,401000

Pagina 75 din 87

Page 77: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

21 W53596003 J01CR05 PIPERACILLINUM + TAZOBACTAMUM PIPERACILLIN/TAZOBACTAM KABI 4g/0.5g PULB. PT. SOL. PERF. 4g/0,5g S.C. FRESENIUS KABI

S.R.L. ROMANIA CUTIE CU 10 FLAC DIN STICLA INCOLORA X 50 ML CU PULB. PT. SOL. PERF. S 10 389,01 38,901000 38,901000 462,17 46,217000 46,217000

22 W52799001 J01XX08 LINEZOLIDUM ZYVOXID (R) COMPR. FILM. 600mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. X 10 COMPR. FILM. P-

RF 10 1.603,26 160,326000 160,326000 1.785,71 178,571000 178,571000

23 W52800001 J01XX08 LINEZOLIDUM ZYVOXID (R) GRAN. PT. SUSP. ORALA 100mg/5ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 FLACON X 66 G GRAN. PTR. 150 ML SUSP. + 1 LINGURITA DOZATOARE DUBLA X 2,5 ML/5 ML

P-RF 1 879,36 879,360000 879,360000 996,65 996,650000 996,650000

24 W57578002 J01XX08 LINEZOLIDUM LINEZOLID TEVA 2 mg/ml SOL. PERF. 2mg/mlTEVA PHARMACEUTICALS S.R.L.

ROMANIA10 PUNGI PT. PERFUZIE (DIN POLIMER MULTISTRAT) CU 1 PERFUZOR SAU 2 PERFUZOARE CU 300 ML SOL., ECHIPA

PRF 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

25 W60604004 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 10 PUNGI DIN PP TRANSPARENTA PANA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI INVELIS SUPLIMENTAR DIN FOLIE LAMINATA TRANSPARENTA CONTINAND FIECARE 300 ML SOL. PERF.

PR 10 1.052,62 105,262000 105,262000 1.185,51 118,551000 118,551000

26 W52801001 J01XX08 LINEZOLIDUM ZYVOXID (R) SOL. PERF. 2mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 10 PUNGI X 300 ML S 10 1.603,26 160,326000 126,314400 1.785,71 178,571000 142,261200

27 W60604001 J01XX08 LINEZOLIDUM PNEUMOLID 2 mg/ml SOL. PERF. 2mg/ml ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU O PUNGA DIN PP TRANSPARENTA PÂNA LA GALBUIE CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

28 W60734001 J01XX08 LINEZOLIDUM LINEZOLID SANDOZ 2 mg/ml SOL. PERF. 2mg/ml SANDOZ S.R.L. ROMANIA

CUTIE CU 1 PUNGA DIN PP INCOLORA PÂNA LA GALBUIE, CU 1 SAU 2 PERFUZOARE SI ÎNVELIS SUPLIMENTAR DIN FOLIE LAMINATA CARE CONTINE SOL. PERF.

PR 1 112,48 112,480000 112,480000 137,32 137,320000 137,320000

29 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,615428 25,61 6,402500 4,887428

30 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-

RF 16 65,37 4,085625 3,615428 82,66 5,166250 4,887428

31 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 21,09 3,012857 3,012857 28,51 4,072857 4,072857

32 W43597001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6,98 3,490000 3,490000 9,43 4,715000 4,715000

33 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 23,31 3,330000 3,330000 31,51 4,501428 4,501428

34 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,340000 14,58 14,580000 7,212000

35 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,340000 9,68 9,680000 7,212000

36 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

37 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 6,07 6,070000 5,340000 8,20 8,200000 7,212000

38 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 8,90 8,900000 5,340000 12,03 12,030000 7,212000

39 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

40 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PR

F 1 9,57 9,570000 5,340000 12,94 12,940000 7,212000

41 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

42 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,340000 9,03 9,030000 7,212000

43 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC

TRANSPARENT/PVDC-AL X 1 CAPS.PRF 1 4,45 4,450000 4,450000 6,01 6,010000 6,010000

44 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PR

F 1 7,44 7,440000 5,340000 10,06 10,060000 7,212000

45 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 18,56 18,560000 5,340000 25,08 25,080000 7,212000

46 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS.

P-RF 1 13,95 13,950000 5,340000 18,86 18,860000 7,212000

47 W54835003 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-

RF 4 48,24 12,060000 5,340000 63,10 15,775000 7,212000

48 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-

RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

49 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 30,10 4,300000 4,300000 39,37 5,624285 5,624285

50 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,777714 19,58 2,797142 2,403428

51 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 43,23 6,175714 1,777714 56,54 8,077142 2,403428

52 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,777714 19,12 2,731428 2,403428

53 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

Pagina 76 din 87

Page 78: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

54 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 12,35 1,764285 1,764285 16,69 2,384285 2,384285

55 W52225001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-

RF 7 11,66 1,665714 1,665714 15,76 2,251428 2,251428

56 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

57 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS.

P-RF 7 21,91 3,130000 1,777714 29,61 4,230000 2,403428

58 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,777714 41,93 5,990000 2,403428

59 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 10,37 1,481428 1,481428 14,02 2,002857 2,002857

60 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

61 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE CU 1 FLAC. PEID, DE CAPACITATE 60ML + 1 LINGURITA DOZATOARE A 5 ML, CU PULB. PT. 35 ML SUSP.O

PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

62 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF.

PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

63 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF.

PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

64 W60056001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

65 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

66 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

67 W56963002 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL

S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

68 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100

ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

69 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200

ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

70 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF.

PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

71 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML

SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,179000

72 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML

S/PR-F 1 35,03 35,030000 20,737200 45,82 45,820000 25,316400

73 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-

RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

74 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-

RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

75 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA

BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

76 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA

P-RF 1 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

77 W53675003 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS.P-RF/S

1.000 704,14 0,704140 0,613200 805,66 0,805660 0,805660

78 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-

RF 20 15,85 0,792500 0,613200 21,42 1,071000 0,828600

79 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 15,85 0,792500 0,613200 21,42 1,071000 0,828600

80 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14,97 0,748500 0,613200 20,23 1,011500 0,828600

81 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 14,41 1,441000 1,441000 19,48 1,948000 1,948000

82 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 10,22 0,511000 0,511000 13,81 0,690500 0,690500

83 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

84 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PR

F 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

85 W13972001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-

RF 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

Pagina 77 din 87

Page 79: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

86 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12,69 0,634500 0,613200 17,15 0,857500 0,828600

87 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 20,11 2,011000 1,729200 27,18 2,718000 2,337600

88 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL.

INJ./PERF.S/P-RF 5 231,79 46,358000 46,358000 282,97 56,594000 56,594000

89 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM.

PRF 60 3.171,52 52,858666 52,858666 3.495,11 58,251833 58,251833

90 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 63,430399 5.338,93 88,982166 69,902200

91 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS.

P-RF/R

100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

92 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM.

P-RF/R

50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

93 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

94 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

95 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR

F 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

96 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

97 W56643003 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X

100 CAPS.PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

98 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS.P-RF/R

100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

99 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM.

P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

100 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 100 133,10 1,331000 1,331000 162,49 1,624900 1,624900

101 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

102 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM.

P-RF/R

50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

103 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

104 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 50 133,10 2,662000 2,662000 162,49 3,249800 3,249800

105 W13098001 L04AC02 BASILIXIMABUM** SIMULECT 20 mg LIOF. + SOLV. PT. SOL. INJ./PERF. 20mg NOVARTIS EUROPHARM

LTD.MAREA BRITANIE

CUTIE X 1 FLAC. CU LIOF.+ 1 FIOLA SOLV. APA PT. PREP. INJ. S 1 4.267,46 4.267,460000 4.267,460000 4.689,69 4.689,690000 4.689,690000

106 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

107 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

108 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

109 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

110 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

111 W56928001 L04AX01 AZATHIOPRINUM IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM.

S/P-RF 100 55,53 0,555300 0,555300 70,21 0,702100 0,702100

112 W56508002 L04AX01 AZATHIOPRINUM IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR.

FILM. PR 100 62,39 0,623900 0,623900 78,89 0,788900 0,788900

113 W05960001 N02AX02 TRAMADOLUM MABRON 50 mg CAPS. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 2,85 0,285000 0,249000 3,85 0,385000 0,336600

114 W60291001 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-

RF 10 2,85 0,285000 0,249000 3,85 0,385000 0,336600

115 W60238002 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4,15 0,207500 0,207500 5,61 0,280500 0,280500

116 W12691002 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 4,31 0,215500 0,215500 5,82 0,291000 0,291000

117 W41593001 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,67 0,283500 0,249000 7,67 0,383500 0,336600

118 W52049001 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6,66 0,333000 0,249000 9,00 0,450000 0,336600

119 W42440001 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,67 0,283500 0,249000 7,67 0,383500 0,336600

Pagina 78 din 87

Page 80: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

120 W42957001 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,67 0,283500 0,249000 7,67 0,383500 0,336600

121 W13507001 N02AX02 TRAMADOLUM TRAMADOLOR (R) 100 ID COMPR. ELIB. MODIF. 100mg HEXAL AG GERMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. MODIF. P-

RF 10 4,66 0,466000 0,466000 6,30 0,630000 0,630000

122 W41922002 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB.

PREL.P-RF 30 13,98 0,466000 0,466000 18,89 0,629666 0,629666

123 W60236002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB.

PREL.P-RF 30 13,98 0,466000 0,466000 18,89 0,629666 0,629666

124 W58072001 N02AX02 TRAMADOLUM TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg KRKA, D.D., NOVO

MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL.

PRF 30 13,99 0,466333 0,466333 18,91 0,630333 0,630333

125 W41923002 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB.

PREL.P-RF 30 20,38 0,679333 0,679333 27,55 0,918333 0,918333

126 W60237002 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB.

PREL.P-RF 30 20,38 0,679333 0,679333 27,55 0,918333 0,918333

127 W58893002 N02AX02 TRAMADOLUM TRADOLAN RETARD 150 mg COMPR. ELIB. PREL. 150mg LANNACHER HEILMITTEL

GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF 30 24,72 0,824000 0,815200 33,41 1,113666 1,102000

128 W58894002 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg LANNACHER HEILMITTEL

GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL.

PRF 30 26,22 0,874000 0,874000 34,30 1,143333 1,143333

129 W07784001 N02AX02 TRAMADOLUM TRADOLAN 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-

RF 30 7,88 0,262666 0,249000 10,65 0,355000 0,336600

130 W07473001 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. FILM. ELIB.PREL. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR.

FILM. CU ELIB. PREL.P-RF 10 7,17 0,717000 0,559200 9,69 0,969000 0,755599

131 W43360001 N02AX02 TRAMADOLUM TRAMADOL RETARD 150 mg COMPR. FILM. ELIB.PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.

FILM. ELIB. PREL.P-RF 30 31,78 1,059333 0,815200 41,57 1,385666 1,102000

132 W05978001 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. FILM. ELIB.PREL. 150mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10

COMPR.FILM. CU ELIB. PREL.P-RF 10 16,30 1,630000 0,815200 22,03 2,203000 1,102000

133 W05979001 N02AX02 TRAMADOLUM TRAMAL RETARD 200 mg COMPR. FILM. ELIB.PREL. 200mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10

COMPR.FILM. ELIB. PREL.P-RF 10 20,85 2,085000 1,048800 28,18 2,818000 1,372000

134 W43361001 N02AX02 TRAMADOLUM TRAMADOL RETARD 200 mg COMPR. FILM. ELIB.PREL. 200mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.,

FILM. ELIB. PREL.P-RF 30 40,67 1,355666 1,048800 53,20 1,773333 1,372000

135 W60239001 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA

SLOVACACUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE

PRF 10 2,84 0,284000 0,249000 3,84 0,384000 0,336600

136 W60239003 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA

SLOVACACUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE

PRF 10 2,84 0,284000 0,249000 3,84 0,384000 0,336600

137 W05961001 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.

S/P-RF 5 7,27 1,454000 1,322640 9,83 1,966000 1,614720

138 W05961002 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ.

S/P-RF 100 110,22 1,102200 1,102200 134,56 1,345600 1,345600

139 W05966001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 3,65 0,730000 0,730000 4,93 0,986000 0,986000

140 W05967001 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 9,69 1,938000 1,322640 13,10 2,620000 1,614720

141 W05969001 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ. P-RF 5 4,13 0,826000 0,826000 5,58 1,116000 1,116000

P9: PROGRAM NATIONAL DE TRANSPLANT DE ORGANE, TESUTURI SI CELULE DE ORIGINE UMANA P9.7: TRATAMENTUL STARII POSTTRANSPLANT IN AMBULATORIU A PACIENTILOR TRANSPLANTATI

1 W00187001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 56,54 1,130800 0,848200 71,49 1,429800 1,109400

2 W59934001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6

L 60 42,41 0,706833 0,706833 55,47 0,924500 0,924500

3 W00187002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 98,29 0,982900 0,848200 124,28 1,242800 1,109400

4 W00188001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 54,39 1,087800 0,848200 68,77 1,375400 1,109400

5 W53024004 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOCHOL 150 mg COMPR. 150mg ZAMBON S.P.A. ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-6L 60 41,43 0,690500 0,690500 54,19 0,903166 0,903166

6 W53025002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOCHOL 300 mg COMPR. 300mg ZAMBON S.P.A. ITALIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 27,43 1,371500 1,371500 35,88 1,794000 1,794000

7 W58710001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 25 COMPR.FILM.

P6L 50 111,83 2,236600 2,236600 136,52 2,730400 2,730400

8 W58710002 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM.

P6L 100 219,67 2,196700 2,196700 268,17 2,681700 2,681700

9 W58363001 A05AA02 ACIDUM URSODEOXYCHOLICUM URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIACUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP

P6L 1 77,10 77,100000 77,100000 97,49 97,490000 97,490000

10 W04224001 H02AB04 METHYLPREDNISOLONUM MEDROL A 16 COMPR. 16mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 5 BLIST. A-PVC/PVC X 10 COMPR. P-

RF 50 24,13 0,482600 0,482600 32,62 0,652400 0,652400

11 W04222001 H02AB04 METHYLPREDNISOLONUM MEDROL 32 COMPR. 32mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL-PVC/PVC X 10 COMPR. P-

RF 20 21,94 1,097000 1,097000 29,65 1,482500 1,482500

12 W08307001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2

MLS/P-RF 1 6,52 6,520000 6,520000 8,81 8,810000 8,810000

13 W08310001 H02AB04 METHYLPREDNISOLONUM LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X

7,8 MLS/P-RF 1 22,95 22,950000 22,950000 31,02 31,020000 31,020000

Pagina 79 din 87

Page 81: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

14 W04237001 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV

P-RF 1 15,15 15,150000 15,150000 20,48 20,480000 20,480000

15 W12565003 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 COMPR.P-RF/S

1.000 44,43 0,044430 0,044430 58,12 0,058120 0,058120

16 W12565002 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 1,94 0,064666 0,053316 2,62 0,087333 0,069744

17 W13686002 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,74 0,091333 0,053316 3,71 0,123666 0,069744

18 W53341001 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-

RF 20 1,90 0,095000 0,053316 2,57 0,128500 0,069744

19 W05242001 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 1,96 0,098000 0,053316 2,65 0,132500 0,069744

20 W05741001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-

RF 20 5,71 0,285500 0,285500 7,72 0,386000 0,386000

21 W12479001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM CO - TRIM ELL COMPR. 400mg/80mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-

RF 20 5,21 0,260500 0,260500 7,04 0,352000 0,352000

22 W53671001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM BITRIM 400mg/80mg COMPR. 400mg/80mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-

RF 20 5,71 0,285500 0,285500 7,72 0,386000 0,386000

23 W05738001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM COMPR. 400mg/80mg

EGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 5,47 0,273500 0,273500 7,40 0,370000 0,370000

24 W44046001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM EPITRIM SUSP. ORALA 200mg/40mg /5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA BRUNA CU

MASURA DOZATOARE X 100 MLP-RF 1 3,52 3,520000 3,520000 4,76 4,760000 4,760000

25 W05739001 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SUSP. ORALA 25mg/5mg/ml

EGIS PHARMACEUTICALS P.L.C.

UNGARIACUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE

P-RF 1 7,75 7,750000 7,750000 10,48 10,480000 10,480000

26 W08372001 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 18,95 4,737500 3,615428 25,61 6,402500 4,887428

27 W42371002 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-

RF 16 65,37 4,085625 3,615428 82,66 5,166250 4,887428

28 W58225007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 21,09 3,012857 3,012857 28,51 4,072857 4,072857

29 W43597001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 6,98 3,490000 3,490000 9,43 4,715000 4,715000

30 W43597002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 23,31 3,330000 3,330000 31,51 4,501428 4,501428

31 W43288001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 10,79 10,790000 5,340000 14,58 14,580000 7,212000

32 W42693001 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 7,16 7,160000 5,340000 9,68 9,680000 7,212000

33 W08373001 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

34 W51994001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 6,07 6,070000 5,340000 8,20 8,200000 7,212000

35 W60221001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 8,90 8,900000 5,340000 12,03 12,030000 7,212000

36 W43598001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

37 W57430001 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PR

F 1 9,57 9,570000 5,340000 12,94 12,940000 7,212000

38 W57239001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 7,35 7,350000 5,340000 9,94 9,940000 7,212000

39 W53943002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 6,68 6,680000 5,340000 9,03 9,030000 7,212000

40 W58226001 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC

TRANSPARENT/PVDC-AL X 1 CAPS.PRF 1 4,45 4,450000 4,450000 6,01 6,010000 6,010000

41 W56446001 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PR

F 1 7,44 7,440000 5,340000 10,06 10,060000 7,212000

42 W03156001 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-

RF 1 18,56 18,560000 5,340000 25,08 25,080000 7,212000

43 W44089001 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS.

P-RF 1 13,95 13,950000 5,340000 18,86 18,860000 7,212000

44 W54835003 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-

RF 4 48,24 12,060000 5,340000 63,10 15,775000 7,212000

45 W52224001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-

RF 1 4,88 4,880000 4,880000 6,59 6,590000 6,590000

46 W43599002 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 30,10 4,300000 4,300000 39,37 5,624285 5,624285

47 W42321001 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,49 2,070000 1,777714 19,58 2,797142 2,403428

48 W03157001 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 43,23 6,175714 1,777714 56,54 8,077142 2,403428

49 W53942002 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 14,15 2,021428 1,777714 19,12 2,731428 2,403428

50 W57238001 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

Pagina 80 din 87

Page 82: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

51 W43596001 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 12,35 1,764285 1,764285 16,69 2,384285 2,384285

52 W52225001 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-

RF 7 11,66 1,665714 1,665714 15,76 2,251428 2,251428

53 W51993001 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-

RF 7 11,95 1,707142 1,707142 16,15 2,307142 2,307142

54 W44098001 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS.

P-RF 7 21,91 3,130000 1,777714 29,61 4,230000 2,403428

55 W43287001 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 32,06 4,580000 1,777714 41,93 5,990000 2,403428

56 W58224007 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC

TRANSPARENT/PVDC-AL X 7 CAPS.PRF 7 10,37 1,481428 1,481428 14,02 2,002857 2,002857

57 W08374001 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 16,69 2,384285 1,777714 22,56 3,222857 2,403428

58 W58322001 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA

BRITANIE

CUTIE CU 1 FLAC. PEID, DE CAPACITATE 60ML + 1 LINGURITA DOZATOARE A 5 ML, CU PULB. PT. 35 ML SUSP.O

PRF 1 23,46 23,460000 23,460000 31,71 31,710000 31,710000

59 W58456001 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 50 ML SOL. PERF.

PR 20 350,00 17,500000 17,500000 419,65 20,982500 20,982500

60 W58456002 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 20 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 100 ML SOL. PERF.

PR 20 630,00 31,500000 20,737200 724,85 36,242500 25,316400

61 W60056001 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 1 17,91 17,910000 17,910000 24,21 24,210000 24,210000

62 W57368003 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 2mg/ml SOL. PERF. 2mg/ml ARENA GROUP S.A. ROMANIA CUTIE X 1 FLAC. X 100 ML SOL. PERF. S 1 40,63 40,630000 20,737200 53,14 53,140000 25,316400

63 W60056005 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 2 mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 10 FLACOANE DIN STICLA INCOLORA A CATE 100 ML SOL. PERF. X 200 MG FLUCONAZOL

S 10 172,81 17,281000 17,281000 210,97 21,097000 21,097000

64 W56963002 J02AC01 FLUCONAZOLUM MYCOMAX INF 2mg/ml SOL. PERF. 2mg/ml ZENTIVA K.S. REPUBLICA CEHA

CUTIE CU 1 FLACON DIN STICLA INCOLORA A 200 ML SOL. PERF. X 400 MG FLUCONAZOL

S 1 88,14 88,140000 88,140000 111,45 111,450000 103,986000

65 W55502009 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 100

ML SOL. PERF. S 1 34,28 34,280000 20,737200 44,84 44,840000 25,316400

66 W55502017 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 200

ML SOL. PERF. S 1 81,95 81,950000 81,950000 103,62 103,620000 103,620000

67 W58456003 J02AC01 FLUCONAZOLUM FLUCONAZOL INFOMED 2 mg/ml SOL. PERF. 2mg/ml INFOMED FLUIDS S.R.L. ROMANIA

CUTIE CU 10 PUNGI DIN PVC (PREVAZUTE CU 2 TUBURI CONECTOARE, DOP AMBALATE INTR-UN FILM DIN PET/AL/PET/PP X 200 ML SOL. PERF.

PR 10 760,00 76,000000 76,000000 866,55 86,655000 86,655000

68 W55502001 J02AC01 FLUCONAZOLUM FLUCONAZOL KABI 2 mg/ml SOL. PERF. 2mg/ml FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. PEJD (KABIPAC) X 50 ML

SOL. PERF. S 1 18,84 18,840000 18,840000 25,47 25,470000 25,179000

69 W12072001 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML

S/PR-F 1 35,03 35,030000 20,737200 45,82 45,820000 25,316400

70 W08947008 J02AC03 VORICONAZOLUM** VFEND 200mg COMPR. FILM. 200mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28 COMPR. FILM. (BLIST.PVC/AL) P-

RF 28 3.559,23 127,115357 127,115357 3.917,72 139,918571 139,918571

71 W08946008 J02AC03 VORICONAZOLUM** VFEND 50mg COMPR. FILM. 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 28COMPR. FILM. ( BLIST. PVC/AL) P-

RF 28 912,09 32,574642 32,574642 1.032,33 36,868928 36,868928

72 W10489001 J02AC03 VORICONAZOLUM** VFEND 200mg PULB. PT. SOL. PERF. 200mg PFIZER LIMITED MAREA

BRITANIE CUTIE X 1 FLAC. UNIDOZA X 30ML P-RF 1 458,07 458,070000 458,070000 537,45 537,450000 537,450000

73 W41889001 J02AC03 VORICONAZOLUM** VFEND 40 mg/ml PULB. PT. SUSP. ORALA 40mg/ml PFIZER LIMITED MAREA

BRITANIE

CUTIE X 1 FLAC. PEID DE 100ML X 45 G PULB. PT. SUSP. ORALA + 1 MASURA DOZATOARE (23 ML) + 1 SERINGA

P-RF 1 2.203,52 2.203,520000 2.203,520000 2.439,99 2.439,990000 2.439,990000

74 W60913001 J02AC04 POSACONAZOLUM** NOXAFIL 100mg CAPS. GASTROREZ. 100mg MERCK SHARP & DOHME

LTD.MAREA BRITANIE

CUTIE CU BLIST. PVC/PCTF/AL X 24 COMPRIMATE GASTROREZISTENTE PR 24 3.330,00 138,750000 138,750000 3.667,85 152,827083 152,827083

75 W58194001 J02AC04 POSACONAZOLUM** NOXAFIL 40mg/ml SUSP. ORALA 40mg/ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 FLAC. X 105ML SUSP. ORALA

P-RF/R

1 2.488,19 2.488,190000 2.488,190000 2.750,28 2.750,280000 2.750,280000

76 W53675003 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 100 BLIST. AL/PVC X 10 CAPS.P-RF/S

1.000 704,14 0,704140 0,613200 805,66 0,805660 0,805660

77 W56038001 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-

RF 20 15,85 0,792500 0,613200 21,42 1,071000 0,828600

78 W53675001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 15,85 0,792500 0,613200 21,42 1,071000 0,828600

79 W42857001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 14,97 0,748500 0,613200 20,23 1,011500 0,828600

80 W53676001 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 14,41 1,441000 1,441000 19,48 1,948000 1,948000

81 W06667003 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 10,22 0,511000 0,511000 13,81 0,690500 0,690500

82 W53225001 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

Pagina 81 din 87

Page 83: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

83 W60558001 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PR

F 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

84 W13972001 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-

RF 20 12,75 0,637500 0,613200 17,23 0,861500 0,828600

85 W00044001 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 12,69 0,634500 0,613200 17,15 0,857500 0,828600

86 W06668003 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mgEGIS PHARMACEUTICALS P.L.C.

UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 20,11 2,011000 1,729200 27,18 2,718000 2,337600

87 W00058001 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL.

INJ./PERF.S/P-RF 5 231,79 46,358000 46,358000 282,97 56,594000 56,594000

88 W60756001 J05AB14 VALGANCICLOVIRUM** VALGANCICLOVIR TEVA 450 mg COMPR. FILM. 450mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU BLIST. PVC-ACLAR-PVC/AL X 60 COMPR. FILM.

PRF 60 3.171,52 52,858666 52,858666 3.495,11 58,251833 58,251833

89 W51832001 J05AB14 VALGANCICLOVIRUM** VALCYTE (R) 450 mg COMPR. FILM. 450mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. X 60 COMPR. FILM. P-RF 60 4.863,09 81,051500 63,430399 5.338,93 88,982166 69,902200

90 W55472002 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA 100 mg COMPR. FILM. 100 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM.

P-RF/R

30 159,00 5,300000 5,300000 194,11 6,470333 6,470333

91 W07518002 J05AF05 LAMIVUDINUM ZEFFIX 100 mg COMPR. FILM. 100mg GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 28 COMPR. FILM. (BLIST. PVC-AL/PVC-AL)

P-RF/R

28 228,32 8,154285 6,360000 278,73 9,954642 7,764400

92 W55473003 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA PHARMA B.V. 150 mg COMPR. FILM. 150 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 60 COMPR. FILM.

P-RF/R

60 319,27 5,321166 5,321166 386,16 6,436000 6,436000

93 W59320003 J05AF05 LAMIVUDINUM LAMIVUDINA AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 FLAC. PVC-ACLAR/AL X 60

COMPR. FILM. PR 60 319,27 5,321166 5,321166 386,16 6,436000 6,436000

94 W03923002 J05AF05 LAMIVUDINUM EPIVIR 150mg COMPR. FILM. 150mg GLAXO GROUP LTD. MAREA BRITANIE CUTIE X 1 FLAC. PEID X 60 COMPR. FILM.

P-RF/R

60 476,54 7,942333 6,385399 557,58 9,293000 7,723200

95 W55474002 J05AF05 LAMIVUDINUM LAMIVUDINE TEVA PHARMA B.V. 300 mg COMPR. FILM. 300 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM.

P-RF/R

30 319,27 10,642333 10,642333 386,16 12,872000 12,872000

96 W03924002 J05AF05 LAMIVUDINUM EPIVIR 10mg/ml SOL. ORALA 10mg/ml GLAXO GROUP LTD. MAREA BRITANIE

CUTIE X 1 FLACON PEID X 240ML SOL. ORALA + 1 SERINGA DOZATOARE + 1 ADAPTOR

P-RF/R

1 131,82 131,820000 131,820000 160,92 160,920000 160,920000

97 W04406001 L04AA06 MYCOPHENOLATUM** CELLCEPT 250mg CAPS. 250mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 10 BLIST. X 10 CAPS.

P-RF/R

100 452,86 4,528600 4,528600 531,77 5,317700 5,317700

98 W04407001 L04AA06 MYCOPHENOLATUM** CELLCEPT 500mg COMPR. FILM. 500mg ROCHE REGISTRATION LTD.

MAREA BRITANIE CUTIE X 5 BLIST. X 10 COMPR. FILM.

P-RF/R

50 452,86 9,057200 9,057200 531,77 10,635400 10,635400

99 W42264003 L04AA06 MYCOPHENOLATUM** MYFORTIC 180 mg COMPR. FILM. GASTROREZ. 180mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 557,65 4,647083 4,647083 645,99 5,383250 5,383250

100 W42265003 L04AA06 MYCOPHENOLATUM** MYFORTIC 360 mg COMPR. FILM. GASTROREZ. 360mg NOVARTIS PHARMA

GMBH GERMANIA CUTIE PLIANTA X 12 BLIST. PA-AL-PVC/AL X 10 COMPR. FILM. GASTROREZ.

S/P-RF 120 1.041,93 8,682750 8,682750 1.173,85 9,782083 9,782083

101 W56643001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR

F 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

102 W56657001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 250 mg CAPS. 250 mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 100 CAPS. PR 100 291,62 2,916200 2,916200 356,01 3,560100 3,560100

103 W56643003 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 250 mg CAPS. 250 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLACON PEID CU CAPAC PP X

100 CAPS.PRF 100 162,65 1,626500 1,626500 198,56 1,985600 1,985600

104 W52877001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 250mg CAPS. 250mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 100 CAPS.P-RF/R

100 302,31 3,023100 3,023100 367,67 3,676700 3,676700

105 W56003001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL SANDOZ 500 mg COMPR. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 50 COMPR. FILM.

P-RF 50 227,17 4,543400 4,543400 277,33 5,546600 5,546600

106 W58520001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 250 mg COMPR. FILM. 250mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 10 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 100 133,10 1,331000 1,331000 162,49 1,624900 1,624900

107 W56644001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL STADA 500 mg COMPR. FILM. 500 mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.PRF 50 160,05 3,201000 3,201000 195,39 3,907800 3,907800

108 W52876001 L04AA06 MYCOPHENOLATUM MOFETILUM** MYFENAX 500mg COMPR. FILM. 500mg TEVA PHARMA BV OLANDA CUTIE X BLIST. PVC/PVDC/AL X 50 COMPR. FILM.

P-RF/R

50 302,31 6,046200 6,046200 367,67 7,353400 7,353400

109 W55987001 L04AA06 MYCOPHENOLATUM MOFETILUM** MICOFENOLAT MOFETIL DR. REDDY'S 500 mg COMPR. FILM. 500mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 50

COMPR. FILM.P-RF 50 272,59 5,451800 5,451800 332,78 6,655600 6,655600

110 W58523001 L04AA06 MYCOPHENOLATUM MOFETILUM** SUPREPHEN 500 mg COMPR. FILM. 500mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC-PCTFE-PE/AL X 10

COMPR. FILM.PRF 50 133,10 2,662000 2,662000 162,49 3,249800 3,249800

111 W10576001 L04AA10 SIROLIMUS** RAPAMUNE 1mg DRAJ. 1mg WYETH EUROPA LTD. MAREA BRITANIE CUTIE X 30 DRAJ. (BLIST. PVC/PE /ACLAR)

P-RF/R

30 489,29 16,309666 16,309666 571,48 19,049333 19,049333

112 W58368003 L04AD01 CICLOSPORINUM EQUORAL® 100 mg CAPS. MOI 100mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 251,97 5,039400 5,039400 307,60 6,152000 6,152000

113 W58149003 L04AD01 CICLOSPORINUM EQUORAL® 25 mg CAPS. MOI 25mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 59,45 1,189000 1,189000 75,17 1,503400 1,503400

114 W51399001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 112,48 2,249600 2,249600 137,32 2,746400 2,746400

Pagina 82 din 87

Page 84: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

115 W58367003 L04AD01 CICLOSPORINUM EQUORAL® 50 mg CAPS. MOI 50mg TEVA CZECH INDUSTRIES S.R.O. CEHIA CUTIE X 5 BLIST. X 10 CAPS. MOI S/P-

RF 50 120,89 2,417800 2,417800 147,58 2,951600 2,951600

116 W51398001 L04AD01 CICLOSPORINUM SANDIMMUN NEORAL (R) CAPS. MOI 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 BLIST. X 5 CAPS. MOI S/P-

RF 50 239,32 4,786400 4,786400 292,16 5,843200 5,843200

117 W56579003 L04AD02 TACROLIMUSUM** TACNI 0,5 mg CAPS. 0,5 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI DE AL A CATE 10 CAPSULE PR 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

118 W53729001 L04AD02 TACROLIMUSUM** PROGRAF (R) 0,5 mg CAPS. 0,5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 205,39 4,107800 4,107800 250,74 5,014800 5,014800

119 W59092001 L04AD02 TACROLIMUSUM** TRACSUS 0,5 mg CAPS. 0,5mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT

PRF 50 91,62 1,832400 1,832400 115,84 2,316800 2,316800

120 W55262007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 0,5 mg CAPS. 0,5mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS.

S/P-RF 50 133,49 2,669800 2,669800 162,97 3,259400 3,259400

121 W56580003 L04AD02 TACROLIMUSUM** TACNI 1 mg CAPS. 1 mgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE CU 5 BLIST. PVC/PVDC/AL IN PUNGI AL A CATE 10 CAPSULE PR 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

122 W59093001 L04AD02 TACROLIMUSUM** TRACSUS 1 mg CAPS. 1mg ALVOGEN IPCO S.AR.L LUXEMBURG

CUTIE CU 5 BLIST. PVC/PVDC-AL X 10 CAPS. IN PUNGI DIN AL PREVAZUTE CU DESICANT

PRF 50 179,98 3,599600 3,599600 219,72 4,394400 4,394400

123 W53730001 L04AD02 TACROLIMUSUM** PROGRAF (R) 1 mg CAPS. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 363,74 7,274800 7,274800 434,63 8,692600 8,692600

124 W55263007 L04AD02 TACROLIMUSUM** TACROLIMUS SANDOZ 1 mg CAPS. 1mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL IN PUNGI DE AL TRIPLU LAMINAT X 50 CAPS.

S/P-RF 50 238,62 4,772400 4,772400 291,31 5,826200 5,826200

125 W53731001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg CAPS. 5mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 PUNGA DE AL INCHISA ETANS X

5 BLIST. X 10 CAPS. + 1 PLIC CU DESICANTS/P-RF 50 1.715,18 34,303600 34,303600 1.907,70 38,154000 38,154000

126 W51974002 L04AD02 TACROLIMUSUM** ADVAGRAF 0,5mg CAPS. ELIB. PREL. 0,5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 204,92 4,098400 4,098400 250,17 5,003400 5,003400

127 W57352002 L04AD02 TACROLIMUSUM** ADVAGRAF 1mg CAPS. ELIB. PREL. 1mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 402,53 8,050600 8,050600 476,91 9,538200 9,538200

128 W51976002 L04AD02 TACROLIMUSUM** ADVAGRAF 5mg CAPS. ELIB. PREL. 5mg ASTELLAS PHARMA EUROPE B.V. OLANDA CUTIE, X 50 CAPS. ELIB. PREL. ( BLIST. PVC-

PVDC/AL)

P-RF/R

50 1.865,58 37,311600 37,311600 2.071,63 41,432600 41,432600

129 W53732001 L04AD02 TACROLIMUSUM** PROGRAF (R) 5 mg/ml CONC. PT. SOL. PERF. 5mg/ml ASTELLAS PHARMA

EUROPE BV OLANDA CUTIE X 10 FIOLE X 1 ML S 10 1.545,19 154,519000 154,519000 1.722,41 172,241000 172,241000

130 W56928001 L04AX01 AZATHIOPRINUM* IMURAN® COMPR. FILM. 50mg ASPEN EUROPE GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 COMPR. FILM.

S/P-RF 100 55,53 0,555300 0,555300 70,21 0,702100 0,702100

131 W56508002 L04AX01 AZATHIOPRINUM* IMMUNOPRIN 75 mg COMPR. FILM. 75mg EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE CU 1 FLAC. PEID X 100 COMPR.

FILM. PR 100 62,39 0,623900 0,623900 78,89 0,788900 0,788900

Pentru următoarele DCI-uri: VORICONAZOLUM si VALGANCICLOVIRUM prescrierea şi eliberarea medicamentelor se fac numai cu aprobarea Agenţiei Naţionale de Transplant

P10: PROGRAM NATIONAL DE SUPLEERE A FUNCTIEI RENALE LA BOLNAVII CU INSUFICIENTA RENALA CRONICA

1 W00231001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,25 mcg CAPS. MOI 0,25mcgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. DIN PPID X 50 CAPS. MOI P-RF 50 21,46 0,429200 0,429200 29,01 0,580200 0,580200

2 W58167002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,25 mcg CAPS. MOI 0,25µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI

PRF 30 16,99 0,566333 0,515040 22,97 0,765666 0,696240

3 W44042001 A11CC03 ALFACALCIDOLUM ALPHA D3 0,50 mcg CAPS. MOI 0,50mcgTEVA PHARMACEUTICALS S.R.L.

ROMANIA CUTIE X 1 FLAC. X 30 CAPS. MOI P-RF 30 23,23 0,774333 0,774333 31,40 1,046666 1,046666

4 W58168002 A11CC03 ALFACALCIDOLUM ALFACALCIDOL SANDOZ 0,5 mcg CAPS. MOI 0,5µg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 30 CAPS. MOI

PRF 30 26,00 0,866666 0,866666 34,01 1,133666 1,133666

5 W55847001 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMAR

CACUTIE CU 10 FIOLE DIN STICLA BRUNA X 0,5 ML SOL. INJ. S 10 108,79 10,879000 10,879000 132,81 13,281000 13,281000

6 W55847002 A11CC03 ALFACALCIDOLUM ONE-ALPHA 2 micrograme/ml SOL. INJ. 2micrograme/ml LEO PHARMA A/S DANEMAR

CACUTIE CU 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. S 10 203,78 20,378000 20,378000 248,78 24,878000 24,878000

7 W51334002 A11CC04 CALCITRIOLUM** ROCALTROL CAPS. MOI 0,25mcg ROCHE ROMANIA S.R.L. ROMANIA CUTIE CU 5 BLIST. AL/PVC X 20 CAPS. MOI. P-RF 100 53,88 0,538800 0,538800 68,12 0,681200 0,681200

8 W59962001 B01AB01 HEPARINUM** HEPARINA POLIPHARMA SOL. INJ. 5000UI/ml POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X

1 ML SOLUTIE INJECTABILA PR 5 64,90 12,980000 12,980000 82,06 16,412000 16,412000

9 W03447001 B01AB01 HEPARINUM** HEPARINE SODIQUE PANPHARMA SOL. INJ. 5000ui/ml LAB. PANPHARMA FRANTA CUTIE X 10 FLACOANE DIN STICLA INCOLORA X 5 ML SOL. INJ. S 10 104,96 10,496000 10,496000 128,14 12,814000 12,814000

10 W59962002 B01AB01 HEPARINUM** HEPARINA POLIPHARMA SOL. INJ. 5000UI/ml POLIPHARMA INDUSTRIES S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA INCOLORA

X 5 ML SOLUTIE INJECTABILA PR 10 142,47 14,247000 12,595200 173,93 17,393000 15,376800

11 W13613002 B01AB05 ENOXAPARINUM** CLEXANE 2000ui anti-Xa/0,2ml SOL. INJ. 2000ui anti-Xa/0,2ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,2 ML

SOL. INJ.

PR/PRF

10 49,00 4,900000 4,900000 64,09 6,409000 6,409000

12 W13612002 B01AB05 ENOXAPARINUM** CLEXANE 4000ui anti-Xa/0,4ml SOL. INJ. 4000ui anti-Xa/0,4ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0.4 ML

SOL. INJ.

PR/PRF

10 93,99 9,399000 9,399000 118,84 11,884000 11,884000

13 W13611002 B01AB05 ENOXAPARINUM** CLEXANE 6000ui anti-Xa/0,6ml SOL. INJ. 6000ui anti-Xa/0,6ml LAB. AVENTIS FRANTA CUTIE X 10 SERINGI PREUMPLUTE X 0,6 ML

SOL. INJ.

PR/PRF

10 118,32 11,832000 11,832000 144,45 14,445000 14,445000

Pagina 83 din 87

Page 85: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

14 W13610001 B01AB05 ENOXAPARINUM** CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000ui anti-Xa/0,8ml LAB. AVENTIS FRANTA CUTIE X 2 SERINGI PREUMPLUTE X 0,8 ML

SOL. INJ.

PR/PRF

2 30,69 15,345000 15,345000 40,14 20,070000 20,070000

15 W13610002 B01AB05 ENOXAPARINUM** CLEXANE 8000ui anti-Xa/0,8ml SOL. INJ. 8000UI anti-Xa/0,8ml LABORATOIRE AVENTIS FRANTA

CUTIE CU 6 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU A

PR/PRF

6 104,35 17,391666 17,391666 127,39 21,231666 21,231666

16 W55557001 B01AB06 NADROPARINUM** FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml SOL. INJ. 2850 ui AFXa/0,3ml

GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE

MAREA BRITANIE

CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,3 ML SOL. INJ.

S/P-RF 10 49,12 4,912000 4,912000 64,25 6,425000 6,425000

17 W61290001 B01AB06 NADROPARINUM** FRAXIPARINE 2850 UI anti-factor Xa/0,3 ml SOL. INJ. 2850 ui AFXa/0,3ml

ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN

STICLA X 0,3 ML SOL. INJ.S/P-RF 10 49,12 4,912000 4,912000 64,25 6,425000 6,425000

18 W55558001 B01AB06 NADROPARINUM** FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml

GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE

MAREA BRITANIE

CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,4 ML SOL. INJ.

S/P-RF 10 64,77 6,477000 6,477000 81,89 8,189000 8,189000

19 W61293001 B01AB06 NADROPARINUM** FRAXIPARINE 3800 UI anti-factor Xa/0,4 ml SOL. INJ. 3800 ui AFXa/0,4ml

ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN

STICLA X 0,4 ML SOL. INJ.S/P-RF 10 64,77 6,477000 6,477000 81,89 8,189000 8,189000

20 W61291001 B01AB06 NADROPARINUM** FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml

ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN

STICLA X 0,6 ML SOL. INJ.S/P-RF 10 104,10 10,410000 10,410000 127,08 12,708000 12,708000

21 W55559001 B01AB06 NADROPARINUM** FRAXIPARINE 5700 UI anti-factor Xa/0,6 ml SOL. INJ. 5700 ui AFXa/0,6ml

GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE

MAREA BRITANIE

CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,6 ML SOL. INJ.

S/P-RF 10 104,10 10,410000 10,410000 127,08 12,708000 12,708000

22 W55560001 B01AB06 NADROPARINUM** FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8ml

GLAXO GROUP LIMITED/GLAXO WELLCOME HOUSE

MAREA BRITANIE

CUTIE CU 10 SERINGI PREUMPLUTE DIN STICLA X 0,8 ML SOL. INJ.

S/P-RF 10 126,46 12,646000 12,646000 154,38 15,438000 15,438000

23 W61292001 B01AB06 NADROPARINUM** FRAXIPARINE 7600 UI anti-factor Xa/0,8 ml SOL. INJ. 7600 ui AFXa/0,8ml

ASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 SERINGI PREUMPLUTE DIN

STICLA X 0,8 ML SOL. INJ.S/P-RF 10 126,46 12,646000 12,646000 154,38 15,438000 15,438000

24 W55414002 B01AB06 NADROPARINUM** FRAXIPARINE 9500 UI anti-factor Xa/1 ml multidoza SOL. INJ. 9500 UI

AFXa/1 ml GLAXO GROUP LIMITED MAREA BRITANIE

CUTIE CU 10 FLAC. DIN STICLA INCOLORA, MULTIDOZA X 5 ML SOL. INJ. S 10 759,56 75,956000 75,956000 866,07 86,607000 86,607000

25 W61289002 B01AB06 NADROPARINUM** FRAXIPARINE 9500 UI anti-factor Xa/1 ml multidoza SOL. INJ. 9500 UI

AFXa/1 mlASPEN PHARMA TRADING LIMITED IRLANDA CUTIE CU 10 FLAC. DIN STICLA INCOLORA,

MULTIDOZA X 5 ML SOL. INJ. S 10 759,56 75,956000 75,956000 866,07 86,607000 86,607000

26 W59473001 B01AB10 TINZAPARINUM** INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN FLACOANE

10000UI anti-XA/ml LEO PHARMA A/S DANEMAR

CA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (20000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULO

PR/PRF

10 439,68 43,968000 43,968000 517,40 51,740000 51,740000

27 W59475001 B01AB10 TINZAPARINUM** INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN FLACOANE

20000 UI anti-Xa/ml LEO PHARMA A/S DANEMAR

CA

CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (40000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULO

PR/PRF

10 965,50 96,550000 96,550000 1.090,55 109,055000 109,055000

28 W59472003 B01AB10 TINZAPARINUM** INNOHEP 10000 UI ANTI-XA/mlSOL. INJ. IN SERINGI PREUMPLUTE

10000UI anti-XA/ml LEO PHARMA A/S DANEMAR

CA

CUTIE CU 10 SERINGI PREUMPLUTE X 0.35 ML (3500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC VERDE

PR/PRF

10 97,33 9,733000 9,733000 123,06 12,306000 12,306000

29 W59472004 B01AB10 TINZAPARINUM** INNOHEP 10000 UI ANTI-XA/mlSOL. INJ. IN SERINGI PREUMPLUTE

10000UI anti-XA/ml LEO PHARMA A/S DANEMAR

CA

CUTIE CU 10 SERINGI PREUMPLUTE X 0.45 ML (4500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT.

PR/PRF

10 127,04 12,704000 12,704000 155,09 15,509000 15,509000

30 W59474003 B01AB10 TINZAPARINUM** INNOHEP 20000 UI ANTI-Xa/mlSOL. INJ. IN SERINGI PREUMPLUTE

20000UI anti-Xa/ml LEO PHARMA A/S DANEMAR

CA

CUTIE CU 2 SERINGI PREUMPLUTE X 0,90 ML (18000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT.

PR/PRF

2 95,03 47,515000 47,515000 120,16 60,080000 60,080000

31 W59474001 B01AB10 TINZAPARINUM** INNOHEP 20000 UI ANTI-Xa/mlSOL. INJ. IN SERINGI PREUMPLUTE

20000UI anti-Xa/ml LEO PHARMA A/S DANEMAR

CA

CUTIE CU 2 SERINGI PREUMPLUTE X 0,50 ML (10000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT.

PR/PRF

2 58,25 29,125000 29,125000 73,65 36,825000 36,825000

32 W59474002 B01AB10 TINZAPARINUM** INNOHEP 20000 UI ANTI-Xa/mlSOL. INJ. IN SERINGI PREUMPLUTE

20000UI anti-Xa/ml LEO PHARMA A/S DANEMAR

CA

CUTIE CU 2 SERINGI PREUMPLUTE X 0,70 ML (14000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT.

PR/PRF

2 77,76 38,880000 38,880000 98,32 49,160000 49,160000

33 W51230001 B03AC02 COMPLEX DE HIDROXID DE FER (III) SUCROZA VENOFER (R) SOL. INJ./PERF. 20mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 5 FIOLE X 5 ML S/P-RF 5 122,68 24,536000 24,536000 149,77 29,954000 29,954000

34 W52289002 B03XA01 EPOETINUM ALFA** BINOCRIT 10000UI/1,0mlSOL. INJ. IN SERINGA PREUMPLUTA

10000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML

SOL. INJ.

S/P-RF/R

6 1.550,81 258,468333 258,468333 1.728,54 288,090000 288,090000

35 W52282002 B03XA01 EPOETINUM ALFA** BINOCRIT 1000UI/0,5mlSOL. INJ. IN SERINGA PREUMPLUTA

1000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML

SOL. INJ.

S/P-RF/R

6 178,92 29,820000 29,820000 218,42 36,403333 36,403333

36 W52283002 B03XA01 EPOETINUM ALFA** BINOCRIT 2000UI/1,0mlSOL. INJ. IN SERINGA PREUMPLUTA

2000UI/1,0ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 1ML

SOL. INJ.

S/P-RF/R

6 355,67 59,278333 59,278333 425,83 70,971666 70,971666

37 W55046001 B03XA01 EPOETINUM ALFA** BINOCRIT 30000UI/0,75mlSOL. INJ. IN SERINGA PREUMPLUTA

30000UI/0,75ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X

0,75ML SOL. INJ.

P-RF/R

1 688,15 688,150000 688,150000 788,23 788,230000 788,230000

38 W52284002 B03XA01 EPOETINUM ALFA** BINOCRIT 3000UI/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

3000UI/0,3ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML

SOL. INJ.

S/P-RF/R

6 518,88 86,480000 86,480000 603,73 100,621666 100,621666

Pagina 84 din 87

Page 86: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

39 W57497004 B03XA01 EPOETINUM ALFA** EPREX 40000 UI/mlSOL. INJ. IN SERINGA PREUMPLUTA

40 000UI/ml JOHNSON & JOHNSON D.O.O. SLOVENIA CUTIE CU 1 SERINGA PREUMPLUTA X 1 ML

SOL. INJ.S/P-RF 1 1.206,71 1.206,710000 1.052,784000 1.353,47 1.353,470000 1.193,316000

40 W55048001 B03XA01 EPOETINUM ALFA** BINOCRIT 40000 UI/1 mlSOL. INJ. IN SERINGA PREUMPLUTA

40000 UI/1 ml SANDOZ GMBH AUSTRIA CUTIE X 1 SERINGA PREUMPLUTA X 1ML

SOL. INJ.

P-RF/R

1 877,32 877,320000 877,320000 994,43 994,430000 994,430000

41 W52285002 B03XA01 EPOETINUM ALFA** BINOCRIT 4000UI/0,4mlSOL. INJ. IN SERINGA PREUMPLUTA

4000UI/0,4ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML

SOL. INJ.

S/P-RF/R

6 682,04 113,673333 113,673333 781,57 130,261666 130,261666

42 W52286002 B03XA01 EPOETINUM ALFA** BINOCRIT 5000UI/0,5mlSOL. INJ. IN SERINGA PREUMPLUTA

5000UI/0,5ml SANDOZ GMBH AUSTRIA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML

SOL. INJ.

S/P-RF/R

6 845,15 140,858333 140,858333 959,37 159,895000 159,895000

43 W07740002 B03XA01 EPOETINUM BETA** NEORECORMON 10000UI/0,6mlSOL. INJ. IN SERINGA PREUMPLUTA

10000UI/0,6ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 6 SERINGI PREUMPLUTE X 0,6 ML SOL. INJ. + 6 ACE

S/P-RF/R

6 2.117,84 352,973333 352,973333 2.346,60 391,100000 391,100000

44 W07741002 B03XA01 EPOETINUM BETA** NEORECORMON 2000UI/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

2000UI/0,3ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. X 6 ACE

S/P-RF/R

6 447,82 74,636666 74,636666 526,27 87,711666 87,711666

45 W42097001 B03XA01 EPOETINUM BETA** NEORECORMON 30000UI/0,6mlSOL. INJ. IN SERINGA PREUMPLUTA

30000 UI/0,6ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1 SERINGA PRE-UMPLUTA X 0,6 ML + 1 AC

S/P-RF/R

1 1.042,55 1.042,550000 1.042,550000 1.174,53 1.174,530000 1.174,530000

46 W07742002 B03XA01 EPOETINUM BETA** NEORECORMON 4000UI/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

4000UI/0,3ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE

S/P-RF/R

6 865,04 144,173333 144,173333 981,05 163,508333 163,508333

47 W07744002 B03XA01 EPOETINUM BETA** NEORECORMON 5000UI/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

5000UI/0,3ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 6 SERINGI PREUMPLUTE X 0,3 ML SOL. INJ. + 6 ACE

S/P-RF/R

6 1.073,53 178,921666 178,921666 1.208,30 201,383333 201,383333

48 W60969001 B03XA01 EPOETINUM ZETA** RETACRIT 10000UI/1,0mlSOL. INJ. IN SERINGA PREUMPLUTA

10000UI/1,0ml HOSPIRA UK LIMITED MAREA

BRITANIECUTIE X 1 SERINGA PREUMPLUTA X 1ML SOL. INJ. PR 1 180,07 180,070000 180,070000 219,83 219,830000 219,830000

49 W52733002 B03XA01 EPOETINUM ZETA** RETACRIT 10000UI/1,0mlSOL. INJ. IN SERINGA PREUMPLUTA

10000UI/1,0ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 1ML

SOL. INJ.

S/P-RF/R

6 1.012,10 168,683333 168,683333 1.141,34 190,223333 190,223333

50 W60963001 B03XA01 EPOETINUM ZETA** RETACRIT 1000UI/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

1000UI/0,3ml HOSPIRA UK LIMITED MAREA

BRITANIECUTIE X 1 SERINGA PREUMPLUTA X 0,3ML SOL. INJ. PR 1 8,03 8,030000 8,030000 10,85 10,850000 10,850000

51 W52728002 B03XA01 EPOETINUM ZETA** RETACRIT 1000UI/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

1000UI/0,3ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,3ML

SOL. INJ.

S/P-RF/R

6 48,15 8,025000 8,025000 62,98 10,496666 10,496666

52 W52732001 B03XA01 EPOETINUM ZETA** RETACRIT 20000UI/0,5mlSOL. INJ. IN SERINGA PREUMPLUTA

20000UI/0,5ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 0,5ML

SOL. INJ.

S/P-RF/R

1 370,80 370,800000 370,800000 442,32 442,320000 442,320000

53 W52732002 B03XA01 EPOETINUM ZETA** RETACRIT 20000UI/0,5mlSOL. INJ. IN SERINGA PREUMPLUTA

20000UI/0,5ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML

SOL. INJ.

S/P-RF/R

6 2.074,80 345,800000 345,800000 2.299,68 383,280000 383,280000

54 W60964001 B03XA01 EPOETINUM ZETA** RETACRIT 2000UI/0,6mlSOL. INJ. IN SERINGA PREUMPLUTA

2000UI/0,6ml HOSPIRA UK LIMITED MAREA

BRITANIECUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR 1 38,85 38,850000 38,850000 50,82 50,820000 50,820000

55 W52727002 B03XA01 EPOETINUM ZETA** RETACRIT 2000UI/0,6mlSOL. INJ. IN SERINGA PREUMPLUTA

2000UI/0,6ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML

SOL. INJ.

S/P-RF/R

6 224,93 37,488333 37,488333 274,59 45,765000 45,765000

56 W52731001 B03XA01 EPOETINUM ZETA** RETACRIT 30000UI/0,75mlSOL. INJ. IN SERINGA PREUMPLUTA

30000UI/0,75ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X

0,75ML SOL. INJ.

S/P-RF/R

1 541,20 541,200000 541,200000 628,06 628,060000 628,060000

57 W52731002 B03XA01 EPOETINUM ZETA** RETACRIT 30000UI/0,75mlSOL. INJ. IN SERINGA PREUMPLUTA

30000UI/0,75ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,75ML

SOL. INJ.

S/P-RF/R

6 3.097,20 516,200000 516,200000 3.414,10 569,016666 569,016666

58 W60965001 B03XA01 EPOETINUM ZETA** RETACRIT 3000UI/0,9mlSOL. INJ. IN SERINGA PREUMPLUTA

3000UI/0,9ml HOSPIRA UK LIMITED MAREA

BRITANIECUTIE X 1 SERINGA PREUMPLUTA X 0,9ML SOL. INJ. PR 1 57,25 57,250000 57,250000 72,39 72,390000 72,390000

59 W52729002 B03XA01 EPOETINUM ZETA** RETACRIT 3000UI/0,9mlSOL. INJ. IN SERINGA PREUMPLUTA

3000UI/0,9ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,9ML

SOL. INJ.

S/P-RF/R

6 336,72 56,120000 56,120000 405,17 67,528333 67,528333

60 W52730002 B03XA01 EPOETINUM ZETA** RETACRIT 40000UI/1,0mlSOL. INJ. IN SERINGA PREUMPLUTA

40000UI/1,0ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 1ML

SOL. INJ.

S/P-RF/R

6 4.119,59 686,598333 686,598333 4.528,51 754,751666 754,751666

Pagina 85 din 87

Page 87: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

61 W52730001 B03XA01 EPOETINUM ZETA** RETACRIT 40000UI/1,0mlSOL. INJ. IN SERINGA PREUMPLUTA

40000UI/1,0ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 1 SERINGA PREUMPLUTA X 1ML

SOL. INJ.

S/P-RF/R

1 711,60 711,600000 711,600000 813,79 813,790000 813,790000

62 W52737002 B03XA01 EPOETINUM ZETA** RETACRIT 4000UI/0,4mlSOL. INJ. IN SERINGA PREUMPLUTA

4000UI/0,4ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,4ML

SOL. INJ.

S/P-RF/R

6 438,96 73,160000 73,160000 516,62 86,103333 86,103333

63 W60973001 B03XA01 EPOETINUM ZETA** RETACRIT 4000UI/0,4mlSOL. INJ. IN SERINGA PREUMPLUTA

4000UI/0,4ml HOSPIRA UK LIMITED MAREA

BRITANIECUTIE X 1 SERINGA PREUMPLUTA X 0,4ML SOL. INJ. PR 1 76,34 76,340000 76,340000 96,52 96,520000 96,520000

64 W52736002 B03XA01 EPOETINUM ZETA** RETACRIT 5000UI/0,5mlSOL. INJ. IN SERINGA PREUMPLUTA

5000UI/0,5ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,5ML

SOL. INJ.

S/P-RF/R

6 541,20 90,200000 90,200000 628,06 104,676666 104,676666

65 W60972001 B03XA01 EPOETINUM ZETA** RETACRIT 5000UI/0,5mlSOL. INJ. IN SERINGA PREUMPLUTA

5000UI/0,5ml HOSPIRA UK LIMITED MAREA

BRITANIECUTIE X 1 SERINGA PREUMPLUTA X 0,5ML SOL. INJ. PR 1 95,42 95,420000 95,420000 120,65 120,650000 120,650000

66 W52735002 B03XA01 EPOETINUM ZETA** RETACRIT 6000UI/0,6mlSOL. INJ. IN SERINGA PREUMPLUTA

6000UI/0,6ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,6ML

SOL. INJ.

S/P-RF/R

6 643,44 107,240000 107,240000 739,50 123,250000 123,250000

67 W60971001 B03XA01 EPOETINUM ZETA** RETACRIT 6000UI/0,6mlSOL. INJ. IN SERINGA PREUMPLUTA

6000UI/0,6ml HOSPIRA UK LIMITED MAREA

BRITANIECUTIE X 1 SERINGA PREUMPLUTA X 0,6ML SOL. INJ. PR 1 112,47 112,470000 112,470000 137,30 137,300000 137,300000

68 W60970001 B03XA01 EPOETINUM ZETA** RETACRIT 8000UI/0,8mlSOL. INJ. IN SERINGA PREUMPLUTA

8000UI/0,8ml HOSPIRA UK LIMITED MAREA

BRITANIECUTIE X 1 SERINGA PREUMPLUTA X 0,8ML SOL. INJ. PR 1 154,75 154,750000 154,750000 188,92 188,920000 188,920000

69 W52734002 B03XA01 EPOETINUM ZETA** RETACRIT 8000UI/0,8mlSOL. INJ. IN SERINGA PREUMPLUTA

8000UI/0,8ml

HOSPIRA ENTERPRISES B.V. OLANDA CUTIE X 6 SERINGI PREUMPLUTE X 0,8ML

SOL. INJ.

S/P-RF/R

6 847,92 141,320000 141,320000 962,38 160,396666 160,396666

70 W41530002 B03XA02 DARBEPOETINUM ALFA** ARANESP 100mcg/0,5mlSOL. INJ. IN SERINGA PREUMPLUTA

100mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X

0,5 ML

P-RF/R

4 2.876,01 719,002500 719,002500 3.173,01 793,252500 793,252500

71 W41522002 B03XA02 DARBEPOETINUM ALFA** ARANESP 10mcg/0,4mlSOL. INJ. IN SERINGA PREUMPLUTA

10mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X

0,4 ML

P-RF/R

4 324,23 81,057500 81,057500 391,56 97,890000 97,890000

72 W41531002 B03XA02 DARBEPOETINUM ALFA** ARANESP 150mcg/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

150mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE, A 1 ML X

0,3 ML

P-RF/R

4 4.284,58 1.071,145000 1.071,145000 4.708,35 1.177,087500 1.177,087500

73 W41524002 B03XA02 DARBEPOETINUM ALFA** ARANESP 20mcg/0,5mlSOL. INJ. IN SERINGA PREUMPLUTA

20mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X

0,5 ML

P-RF/R

4 609,62 152,405000 152,405000 702,64 175,660000 175,660000

74 W41532001 B03XA02 DARBEPOETINUM ALFA** ARANESP 300mcg/0,6mlSOL. INJ. IN SERINGA PREUMPLUTA

300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X

0,6 ML

P-RF/R

1 1.991,25 1.991,250000 1.991,250000 2.208,61 2.208,610000 2.208,610000

75 W41525002 B03XA02 DARBEPOETINUM ALFA** ARANESP 30mcg/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

30mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X

0,3 ML

P-RF/R

4 891,12 222,780000 222,780000 1.009,47 252,367500 252,367500

76 W41526002 B03XA02 DARBEPOETINUM ALFA** ARANESP 40mcg/0,4mlSOL. INJ. IN SERINGA PREUMPLUTA

40mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X

0,4 ML

P-RF/R

4 1.175,04 293,760000 293,760000 1.318,95 329,737500 329,737500

77 W41533001 B03XA02 DARBEPOETINUM ALFA** ARANESP 500mcg/mlSOL. INJ. IN SERINGA PREUMPLUTA

500mcg/ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 1 ML

P-RF/R

1 3.298,77 3.298,770000 3.298,770000 3.633,81 3.633,810000 3.633,810000

78 W41527002 B03XA02 DARBEPOETINUM ALFA** ARANESP 50mcg/0,5mlSOL. INJ. IN SERINGA PREUMPLUTA

50mcg/0,5ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X

0,5 ML

P-RF/R

4 1.457,44 364,360000 364,360000 1.626,76 406,690000 406,690000

79 W41528002 B03XA02 DARBEPOETINUM ALFA** ARANESP 60mcg/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

60mcg/0,3ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X

0,3 ML

P-RF/R

4 1.742,22 435,555000 435,555000 1.937,17 484,292500 484,292500

80 W41529002 B03XA02 DARBEPOETINUM ALFA** ARANESP 80mcg/0,4mlSOL. INJ. IN SERINGA PREUMPLUTA

80mcg/0,4ml AMGEN EUROPE BV OLANDA CUTIE X 4 SERINGI PREUMPLUTE A 1 ML X

0,4 ML

P-RF/R

4 2.309,91 577,477500 577,477500 2.555,95 638,987500 638,987500

81 W52309001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 100mcg/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

100mcg/0,3ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 MLSOL. INJ.

S/P-RF/R

1 991,26 991,260000 991,260000 1.118,62 1.118,620000 1.118,620000

82 W53532001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 120mcg/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

120mcg/0,3ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 MLSOL. INJ.

S/P-RF/R

1 1.145,31 1.145,310000 1.145,310000 1.286,54 1.286,540000 1.286,540000

83 W52310001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 150mcg/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

150mcg/0,3ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 MLSOL. INJ.

S/P-RF/R

1 1.471,92 1.471,920000 1.471,920000 1.642,54 1.642,540000 1.642,540000

84 W52311001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 200mcg/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

200mcg/0,3ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 MLSOL. INJ.

S/P-RF/R

1 1.952,55 1.952,550000 1.952,550000 2.166,43 2.166,430000 2.166,430000

Pagina 86 din 87

Page 88: Lista medicamentelor valabila din 01.04.2015.pdf

Nr.crt Cod CIM

Grupa terapeutic

aDenumire generica Denumire comerciala Forma farmaceutica Concentratie

/ U.T. Firma Tara Ambalaj

Pres

crip

tie cant/ambala

j

Pret cu ridicata

maximal / ambalaj

Pret cu ridicata maximal / U.T.

Pret cu ridicata maximal de

decontare / U.T.

Pret cu amanuntul maximal / ambalaj

Pret cu amanuntul

maximal / U.T.

Pret de decontare / U.T.

85 W52312001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 250mcg/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

250mcg/0,3ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 MLSOL. INJ.

S/P-RF/R

1 2.399,00 2.399,000000 2.399,000000 2.653,06 2.653,060000 2.653,060000

86 W53529001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 30mcg/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

30mcg/0,3ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 MLSOL. INJ.

S/P-RF/R

1 317,25 317,250000 317,250000 383,95 383,950000 383,950000

87 W53533001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 360mcg/0,6mlSOL. INJ. IN SERINGA PREUMPLUTA

360mcg/0,6ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1 SERINGA PREUMPLUTA, X 0,6ML SOL. INJ.

S/P-RF/R

1 3.070,88 3.070,880000 3.070,880000 3.385,41 3.385,410000 3.385,410000

88 W52307001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 50 mcg/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

50 mcg/0,3ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 MLSOL. INJ.

S/P-RF/R

1 510,66 510,660000 510,660000 594,77 594,770000 594,770000

89 W52308001 B03XA03 METOXI-POLIETILENGLICOL EPOETINA BETA** MIRCERA 75mcg/0,3mlSOL. INJ. IN SERINGA PREUMPLUTA

75mcg/0,3ml

ROCHE REGISTRATION LTD.

MAREA BRITANIE

CUTIE X 1 SERINGA PREUMPLUTA, X 0,3 MLSOL. INJ.

S/P-RF/R

1 750,96 750,960000 750,960000 856,70 856,700000 856,700000

90 W43185002 H05BX01 CINACALCETUM**** MIMPARA 30 mg COMPR. FILM. 30mg AMGEN EUROPE B.V. OLANDA CUTIE X 2 BLIST. ACLAR-PVC-PVAC/AL X 14 COMPR. FILM.

P-RF 28 754,12 26,932857 26,932857 860,14 30,719285 30,719285

91 W43186002 H05BX01 CINACALCETUM**** MIMPARA 60 mg COMPR. FILM. 60mg AMGEN EUROPE B.V. OLANDA CUTIE X 2 BLIST. ACLAR-PVC-PVAC/AL X 14 COMPR. FILM.

P-RF 28 1.383,17 49,398928 49,398928 1.545,81 55,207500 55,207500

92 W43187002 H05BX01 CINACALCETUM**** MIMPARA 90 mg COMPR. FILM. 90mg AMGEN EUROPE B.V. OLANDA CUTIE X 2 BLIST. ACLAR-PVC-PVAC/AL X 14 COMPR. FILM.

P-RF 28 1.967,81 70,278928 70,278928 2.183,07 77,966785 77,966785

93 W60920002 H05BX02 PARICALCITOLUM** ZEMPLAR 1µg CAPS. MOI 1µg ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL

X 7 CAPS. MOIP-RF 28 229,10 8,182142 8,182142 279,68 9,988571 9,988571

94 W52425002 H05BX02 PARICALCITOLUM** ZEMPLAR 2mcg CAPS. MOI 2mcg ABBOTT LABORATORIES S.A. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL

X 7 CAPS.P-RF 28 395,68 14,131428 14,131428 469,44 16,765714 16,765714

95 W60921002 H05BX02 PARICALCITOLUM** ZEMPLAR 2µg CAPS. MOI 2µg ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE X 4 BLIST. PVC/FLUOROPOLIMER/AL

X 7 CAPS.P-RF 28 395,68 14,131428 14,131428 469,44 16,765714 16,765714

96 W42936001 H05BX02 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 mcg/ml ABBOTT LABORATORIES S.A. SPANIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S 5 188,23 37,646000 37,646000 229,79 45,958000 45,958000

97 W60961001 H05BX02 PARICALCITOLUM** ZEMPLAR SOL. INJ. 5 µg/ml ABBVIE FARMACEUTICA S.L.U. SPANIA CUTIE X 5 FIOLE X 1 ML SOL. INJ. S 5 188,23 37,646000 37,646000 229,79 45,958000 45,958000

98 W08985002 V03AE02 SEVELAMER** RENAGEL 800mg COMPR. FILM. 800mg GENZYME EUROPE BV OLANDA CUTIE X 1 FLAC.PEID. X 180 COMPR. FILM. P-RF 180 625,88 3,477111 3,477111 720,36 4,002000 4,002000

P11: PROGRAM NATIONAL DE SANATATE MINTALASUBPROGRAMUL TRATAMENTUL TOXICODEPENDENTELOR

1 W60453003 N07BB04 NALTREXONUM NALTREXONA TORREX 50 mg COMPR. FILM. 50mgCHIESI PHARMACEUTICALS GMBH

AUSTRIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.

PRF 28 215,60 7,700000 7,700000 263,20 9,400000 9,400000

2 W51921003 N07BC02 METHADONUM SINTALGON 2,5 mg COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 COMPR. P-TS 50 18,06 0,361200 0,361200 24,41 0,488200 0,488200

3 W55532001 N07BC02 METHADONUM METADON BIOEEL 20 mg COMPR. 20mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 COMPR.

P-TS 20 18,61 0,930500 0,930500 25,16 1,258000 1,258000

4 W55532002 N07BC02 METHADONUM METADON BIOEEL 20 mg COMPR. 20mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC-PVDC X 10 COMPR.

P-TS 50 46,54 0,930800 0,930800 60,88 1,217600 1,217600

5 W55533001 N07BC02 METHADONUM METADON BIOEEL 5 mg COMPR. 5mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC-PVDC X 10 COMPR.

P-TS 20 4,65 0,232500 0,232500 6,29 0,314500 0,314500

6 W55533002 N07BC02 METHADONUM METADON BIOEEL 5 mg COMPR. 5mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC-PVDC X 10 COMPR.

P-TS 50 11,63 0,232600 0,232600 15,72 0,314400 0,314400

7 W58160001 N07BC51 COMBINATII ( BUPRENORPHINUM + NALAXONE) SUBOXONE 2mg/0,5mg COMPR. SUBLING. 2mg/0,5mgRECKITT BENCKISER HEALTHCARE INTERNATIONAL LTD.

MAREA BRITANIE

CUTIE X 7 COMPR. SUBLING. ( BLIST.NYLON/AL/PVC)

P-TS; S

7 18,31 2,615714 2,615714 24,75 3,535714 3,535714

8 W58161001 N07BC51 COMBINATII ( BUPRENORPHINUM + NALAXONE) SUBOXONE 8mg/2mg COMPR. SUBLING. 8mg/2mgRECKITT BENCKISER HEALTHCARE INTERNATIONAL LTD.

MAREA BRITANIE

CUTIE X 7 COMPR. SUBLING. ( BLIST.NYLON/AL/PVC)

P-TS; S

7 55,36 7,908571 7,908571 70,00 10,000000 10,000000

Medicamentele corespunzatoare DCI-urilor notate cu (4) se importa cu avizul Ministerului Sanatatii;

Medicamentele din această sublistă se eliberează atât prin farmacii cu circuit închis cât și prin farmacii cu circuit deschis pe bază de prescripție medicală cu reținere în farmacie (P-RF).

NOTA:

- Tratamentul cu medicamentele corespunzătoare DCI-urilor notate cu (*) se inițiaza de medicul de specialitate in limita competenței și poate fi prescris în continuare de medicul de familie pe baza scrisorii medicale emise de medicul de specialitate; - Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (**) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS; - Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (***) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la nivelul Caselor Judetene de Asigurari de Sanatate;

- Tratamentul cu medicamentele corespunzatoare DCI-urilor notate cu (****) se efectueaza pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale MS si cu aprobarea comisiilor de la nivelul Casei Nationale de Asigurari de Sanatate;

Medicamentul corespunzator DCI-ului notat cu (3) se livreaza impreuna cu solvent;

Pagina 87 din 87

Page 89: Lista medicamentelor valabila din 01.04.2015.pdf
Page 90: Lista medicamentelor valabila din 01.04.2015.pdf
Page 91: Lista medicamentelor valabila din 01.04.2015.pdf

ANEXA 1

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti

1 A02BA02 RANITIDINUM RANITIDIN ARENA 150mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 4,55 0,227500 0,194850 0,1753652 A02BA02 RANITIDINUM RANITIDINA 150 mg COMPR. 150mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,56 0,228000 0,194850 0,1753653 A02BA02 RANITIDINUM RANITIDIN COMPR. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,55 0,227500 0,194850 0,1753654 A02BA02 RANITIDINUM ZANTAC 150 mg COMPR. FILM. 150mg GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 10 COMPR. FILM. P-6L 20 7,01 0,350500 0,194850 0,1753655 A02BA02 RANITIDINUM RANITIDINA LPH 150 mg COMPR. FILM. 150mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 4,56 0,228000 0,194850 0,1753656 A02BA02 RANITIDINUM RANITIDINA ATB 150 MG COMPR. FILM. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 4,55 0,227500 0,194850 0,1753657 A02BA02 RANITIDINUM RANITIDINA ATB 300 mg COMPR. FILM. 300mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 8,66 0,433000 0,389700 0,3507308 A02BA02 RANITIDINUM ARNETIN SOL. INJ. 25mg/ml MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE X 2 ML P-RF 5 12,67 2,534000 1,678945 1,5110509 A02BA03 FAMOTIDINUM FAMODIN 20 mg COMPR. FILM. 20mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 8,89 0,296333 0,194850 0,175365

10 A02BA03 FAMOTIDINUM FAMOTIDINA ZENTIVA 20mg COMPR. FILM. 20mg ZENTIVA S.A ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 5,86 0,195333 0,194850 0,17536511 A02BA03 FAMOTIDINUM QUAMATEL 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 9,45 0,337500 0,194850 0,17536512 A02BA03 FAMOTIDINUM FAMOTIDINA ZENTIVA 40 mg COMPR. FILM. 40mg ZENTIVA S.A ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 7,72 0,257333 0,257333 0,23159913 A02BA03 FAMOTIDINUM FAMODIN 40 mg COMPR. FILM. 40mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 12,31 0,410333 0,389700 0,35073014 A02BA03 FAMOTIDINUM QUAMATEL 20 mg PULB+SOLV. PT. SOL. INJ./PERF. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERFUZ. + 5 FIOLE DIN STCLA INCOLORA X 5 S/P-RF 5 24,64 4,928000 4,928000 4,43520015 A02BA04 NIZATIDINUM NIZATIDIN VIM SPECTRUM 150 mg CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 18,23 0,911500 0,194850 0,17536516 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 10 mg CAPS. GASTROREZ. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ. P6L 14 4,61 0,329285 0,321300 0,28917017 A02BC01 OMEPRAZOLUM ULTOP CAPS. GASTROREZ. 20mg KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PE X 14 CAPS. GASTROREZ. P-6L 14 14,45 1,032142 0,642600 0,57834018 A02BC01 OMEPRAZOLUM OMEPRAZOL 20 mg CAPS. GASTROREZ. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ. P-6L 14 9,24 0,660000 0,642600 0,57834019 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 20 12,80 0,640000 0,640000 0,57600020 A02BC01 OMEPRAZOLUM OMERAN 20 CAPS. GASTROREZ. 20mg EUROPHARM SA ROMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L 28 21,42 0,765000 0,642600 0,57834021 A02BC01 OMEPRAZOLUM OMEPRAZOL 20 mg CAPS. GASTROREZ. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 22,68 0,756000 0,642600 0,57834022 A02BC01 OMEPRAZOLUM OMEPRAZOL TERAPIA 20 mg CAPS. GASTROREZ. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 22,53 0,751000 0,642600 0,57834023 A02BC01 OMEPRAZOLUM OMEPRAZOL ARENA 20 mg CAPS. GASTROREZ. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 22,02 0,734000 0,642600 0,57834024 A02BC01 OMEPRAZOLUM OMEPRAZOL FARMEX 20 mg CAPS. GASTROREZ. 20mg FARMEX COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 20,85 0,695000 0,642600 0,57834025 A02BC01 OMEPRAZOLUM NOVOGAST 20 mg CAPS. GASTROREZ. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR. P-6L 20 16,95 0,847500 0,642600 0,57834026 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. PVC/AL X 10CAPS. GASTROREZ P-6L 10 6,49 0,649000 0,642600 0,57834027 A02BC01 OMEPRAZOLUM OMEPRAZOL ROMPHARM 20 mg CAPS. GASTROREZ. 20mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 22,16 0,738666 0,642600 0,57834028 A02BC01 OMEPRAZOLUM ORTANOL 20 mg CAPS. GASTROREZ. 20mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE CU 2 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L 14 8,07 0,576428 0,576428 0,51878529 A02BC01 OMEPRAZOLUM HELICID 20 CAPS. GASTROREZ. 20mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA X 14 CAPS. GASTROREZ. P-6L 14 10,06 0,718571 0,642600 0,57834030 A02BC01 OMEPRAZOLUM HELICID 20 CAPS. GASTROREZ. 20mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ. P-6L 28 18,38 0,656428 0,642600 0,57834031 A02BC01 OMEPRAZOLUM OMEZ 20mg CAPS. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P-6L 30 21,42 0,714000 0,642600 0,57834032 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 20 mg CAPS. GASTROREZ. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 28 CAPS. GASTROREZ. P6L 28 8,94 0,319285 0,319285 0,28735633 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 14 10,71 0,765000 0,642600 0,57834034 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg ROMASTRU TRADING S.R.L. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 28 21,42 0,765000 0,642600 0,57834035 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 28 21,42 0,765000 0,667574 0,60081636 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 14 10,71 0,765000 0,667574 0,60081637 A02BC01 OMEPRAZOLUM OMEPRAZOL ATB 20 mg CAPS. GASTROREZ. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR. P-6L 20 16,95 0,847500 0,642600 0,57834038 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA X 28 CAPS. GASTROREZ. P-6L 28 18,38 0,656428 0,642600 0,57834039 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 20 mg CAPS. GASTROREZ. 20mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 2 BLISTERE DIN OPA-AL-PEÎD-PE-DESICANT-PEÎD/AL A CATE 14 CAPSULE GASTROREZISTENTE P6L 28 18,38 0,656428 0,656428 0,59078540 A02BC01 OMEPRAZOLUM ORTANOL 40 mg CAPS. GASTROREZ. 40mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 7 CAPS. GASTROREZ. P-6L 7 8,03 1,147142 1,147142 1,03242741 A02BC01 OMEPRAZOLUM OMEPRAZOL AUROBINDO 40 mg CAPS. GASTROREZ. 40mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PA/AL/PVC/HARTIE/AL X 14 CAPS. GASTROREZ. P6L 14 12,76 0,911428 0,911428 0,820285

SUBLISTA A - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA CONFORMDENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU CONTRIBUTIE PERSONALA DIN HG NR. 720/2008 CU COMPLETARILE SI

MODIFICARILE ULTERIOARE VALABILA INCEPAND CU 1 APRILIE 2015

Pagina 1 din 27

Page 92: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti42 A02BC01 OMEPRAZOLUM LOSEC MUPS 10 mg COMPR. GASTROREZ. 10mg ASTRAZENECA AB SUEDIA CUTIE CU 1 FLAC. PEID X 14 COMPR. GASTROREZ. P6L 14 33,19 2,370714 0,321300 0,28917043 A02BC01 OMEPRAZOLUM OMEDAR 20 mg COMPR. GASTROREZ. 20mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. DE STICLA BRUNA X 28 COMPR. FILM. GASTROREZ. P-6L 28 14,45 0,516071 0,516071 0,46446344 A02BC01 OMEPRAZOLUM LOSEC MUPS 20 mg COMPR. GASTROREZ. 20mg ASTRAZENECA AB SUEDIA CUTIE CU 1 FLAC. PEID X 7 COMPR. GASTROREZ. P6L 7 24,96 3,565714 0,642600 0,57834045 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 40 mg PULB. PT. SOL. PERF. 40mg ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA CU LIOF. PT. SOL. PERF. S/P-RF 1 16,22 16,220000 16,220000 14,59800046 A02BC01 OMEPRAZOLUM HELICID 40 INF PULB. PT. SOL. PERF. FARA CONCENTRATIE ZENTIVA K.S. CEHIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. SOL. PERF. S/P-RF 1 16,22 16,220000 16,220000 14,59800047 A02BC03 LANSOPRAZOLUM LEVANT 15 mg CAPS. GASTROREZ. 15mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 6,56 0,468571 0,321300 0,28917048 A02BC03 LANSOPRAZOLUM LANZUL CAPS. GASTROREZ. 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 7 CAPS. GASTROREZ. P-6L 14 13,13 0,937857 0,642600 0,57834049 A02BC03 LANSOPRAZOLUM LEVANT 30 mg CAPS. GASTROREZ. 30mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 11,36 0,811428 0,642600 0,57834050 A02BC03 LANSOPRAZOLUM LANZAP 30mg CAPS. GASTROREZ. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L 20 16,66 0,833000 0,642600 0,57834051 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE X 3 BLIST. X 10 CAPS. ELIB. PREL. P-6L 30 25,07 0,835666 0,835666 0,75209952 A03AA04 MEBEVERINUM DUSPATALIN 200 mg CAPS. ELIB. PREL. 200mg ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA CUTIE X 2 BLIST. X 15 CAPS. ELIB. PREL. P-6L 30 25,07 0,835666 0,835666 0,75209953 A03AA04 MEBEVERINUM COLOSPASMIN DRAJ. 100mg E.I.P.I.CO. MED SRL ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 DRAJ. P-6L 20 9,03 0,451500 0,417833 0,37604954 A03AA05 TRIMEBUTINUM TRIMEBUTIN 100 COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 11,12 0,370666 0,370665 0,33359855 A03AA05 TRIMEBUTINUM COLPERIN 100 mg COMPR. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 11,12 0,370666 0,370665 0,33359856 A03AA05 TRIMEBUTINUM DEBRIDAT 100 mg COMPR. FILM. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 17,13 0,571000 0,370665 0,33359857 A03AA05 TRIMEBUTINUM DEBRIDAT 200 mg COMPR. FILM. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 33,61 1,120333 0,741334 0,66720058 A03AA05 TRIMEBUTINUM IBUTIN (R) 300 mg COMPR. FILM. ELIB. PREL. 300mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 36,01 1,800500 1,112002 1,00080159 A03AA05 TRIMEBUTINUM DEBRIDAT GRAN. PT. SUSP. ORALA 24mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 152,5 G GRANULE PT. 250ML SUSP. + MASURA DOZATOARE P-6L 1 12,05 12,050000 12,050000 10,84500060 A03AA05 TRIMEBUTINUM DEBRIDAT GRAN. PT. SUSP. ORALA 24mg/5ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA X 76,25 G GRANULE PT. 125ML SUSP. + MASURA DOZATOARE P-6L 1 10,05 10,050000 6,328125 5,69531261 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINA ARENA 100 mg COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,42 0,221000 0,193837 0,17445362 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINA FARMACOM 200 mg COMPR. 200 mg FARMACOM S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 8,54 0,427000 0,387675 0,34890763 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 4,01 0,100250 0,090225 0,08120264 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 5,67 0,141750 0,090225 0,08120265 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID ARENA 10 mg COMPR. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 4 BLIST. PVC/AL A CATE 10 COMPR. P6L 40 4,01 0,100250 0,090225 0,08120266 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID BIOFARM 1mg/5ml SIROP 1mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA X 100 ML SIROP + MASURA DOZATOARE P-RF 1 8,69 8,690000 8,690000 7,82100067 A03FA01 METOCLOPRAMIDUM METOCLOPRAMID 10 mg SOL. INJ. 5mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 MLP-RF 5 13,22 2,644000 2,644000 2,37960068 A03FA03 DOMPERIDONUM MOTILIUM 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 12,31 1,231000 0,090225 0,08120269 A03FA03 DOMPERIDONUM OROPERIDYS 10 mg COMPR. ORODISPERSABILE 10mg PIERRE FABRE MEDICAMENT PRODUCTION FRANTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. ORODISP. P6L 30 25,07 0,835666 0,090225 0,08120270 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 4 BLIST. AL/PVC X 25 CAPS. P6L 100 124,28 1,242800 1,242800 1,11852071 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK (R) CAPS. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 25 CAPS. P-6L 50 71,49 1,429800 1,340850 1,20676572 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOSAN CAPS. 250mg PRO. MED. CS PRAHA AS CEHIA CUTIE X 5 BLIST. AL/PVC X 10 CAPS. P-6L 50 68,77 1,375400 1,340850 1,20676573 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOROM 250 mg CAPS. 250mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 CAPS. P6L 60 55,47 0,924500 0,924500 0,83205074 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOCHOL 150 mg COMPR. 150mg ZAMBON S.P.A. ITALIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. P-6L 60 54,19 0,903166 0,804510 0,72405975 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOCHOL 300 mg COMPR. 300mg ZAMBON S.P.A. ITALIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 35,88 1,794000 1,609021 1,44811876 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L 50 136,52 2,730400 2,681700 2,41353077 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK 500 mg COMPR. FILM. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR.FILM. P6L 100 268,17 2,681700 2,681700 2,41353078 A05AA02 ACIDUM URSODEOXYCHOLICUM* URSOFALK 250 mg/5 ml SUSP. ORALA 250mg/5ml DR. FALK PHARMA GMBH GERMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 250 ML SUSP. ORALA+1LINGURITA DOZATOARE DIN PP P6L 1 97,49 97,490000 67,042564 60,33830779 A06AD11 LACTULOSUM DUPHALAC (R) LICHID ORAL 66,7% ABBOTT HEALTHCARE PRODUCTS B.V. OLANDA FLACON DIN PEID PREVAZUT CU MASURA DOZATOARE X 200 ML P6L 1 10,37 10,370000 6,899858 6,20987280 A06AD11 LACTULOSUM LACTULOSE SIROP 65% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 300 ML P-6L 1 10,42 10,420000 10,085999 9,07739981 A06AD11 LACTULOSUM LACTULOSE SIROP 65% E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON X 100 ML P-6L 1 3,47 3,470000 3,361999 3,02579982 A06AD11 LACTULOSUM LACTULOSE-MIP 650 mg/ml SIROP 650mg/ml MIP PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 500 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L 1 17,23 17,230000 16,809999 15,12899983 A06AD11 LACTULOSUM LACTULOSE-MIP 650 mg/ml SIROP 650mg/ml MIP PHARMA GMBH GERMANIA CUTIE X 1 FLAC. PET DE CULOARE BRUNA X 1000 ML SIROP + 1 MASURA DOZATOARE DIN PP P-6L 1 33,34 33,340000 33,340000 30,00600084 A06AD11 LACTULOSUM LACTULAK 660 mg/ml SOL. ORALA 660 mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE X 1 FLAC. PEID X 200 ML SOL. ORALA SI O LINGURITA DOZATOARE P-6L 1 6,73 6,730000 6,730000 6,05700085 A07AA02 NYSTATINUM NISTATINA COMPR. FILM. 500.000ui ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 9,24 0,462000 0,461999 0,41579986 A07EC01 SULFASALAZINUM SULFASALAZIN EN COMPR. FILM. GASTROREZ. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 50 28,24 0,564800 0,564800 0,50832087 A07EC01 SULFASALAZINUM SALAZIDIN GR 500 mg COMPR. GASTROREZ. 500mg AC HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. GASTROREZ. P6L 50 28,20 0,564000 0,564000 0,50760088 A07EC02 MESALAZINUM** PENTASA 1 g COMPR. CU ELIB. PREL. 1g FERRING GMBH GERMANIA CUTIE CU 6 BLIST. AL/AL X 10 COMPR. CU ELIB. PREL. P6L 60 197,11 3,285166 1,611998 1,45079889 A07EC02 MESALAZINUM** PENTASA 500mg COMPR. ELIB. PREL. 500mg FERRING GMBH GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 100 143,02 1,430200 0,805999 0,72539990 A07EC02 MESALAZINUM** SALOFALK 250 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 67,24 0,672400 0,402998 0,362698

Pagina 2 din 27

Page 93: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti91 A07EC02 MESALAZINUM** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 100 120,94 1,209400 0,805999 0,72539992 A07EC02 MESALAZINUM** SALOFALK 500 mg COMPRIMATE GASTROREZISTENTE COMPR. GASTROREZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. GASTROREZ. P-6L 50 73,85 1,477000 0,805999 0,72539993 A07EC02 MESALAZINUM** MESALAZINA DUO 400 mg COMPR. GASTROREZISTENTE 400mg DUO FARMACEUTICI S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 60 46,88 0,781333 0,644798 0,58031894 A07EC02 MESALAZINUM** MESALAZINA SOFARFARM 400 mg COMPR. GASTROREZISTENTE 400mg SOFARFARM S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 60 46,88 0,781333 0,644798 0,58031895 A07EC02 MESALAZINUM** MESALAZINA DUO 800 mg COMPR. GASTROREZISTENTE 800mg DUO FARMACEUTICI S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 60 89,05 1,484166 1,289599 1,16063996 A07EC02 MESALAZINUM** MESALAZINA DUO 800 mg COMPR. GASTROREZISTENTE 800mg DUO FARMACEUTICI S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 90 128,96 1,432888 1,289599 1,16063997 A07EC02 MESALAZINUM** MESALAZINA SOFARFARM 800 mg COMPR. GASTROREZISTENTE 800mg SOFARFARM S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 60 89,05 1,484166 1,289599 1,16063998 A07EC02 MESALAZINUM** MESALAZINA SOFARFARM 800 mg COMPR. GASTROREZISTENTE 800mg SOFARFARM S.R.L. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 15 COMPR. GASTROREZISTENTE P6L 90 128,96 1,432888 1,289599 1,16063999 A07EC02 MESALAZINUM** PENTASA 1000mg SUPOZ. 1000mg FERRING GMBH GERMANIA CUTIE X 4 BLIST. AL X 7 SUPOZ. + CUTIE PLASTIC X 28 CAUCIURI DE PROTECTIE A DEGETULUI P-6L 28 173,80 6,207142 6,207142 5,586427100 A07EC02 MESALAZINUM** SALOFALK 1 g SUPOZ. 1g DR. FALK PHARMA GMBH GERMANIA CUTIE CU FOLII TERMOSUDATE PVC/PE X 30 SUPOZ. P6L 30 223,62 7,454000 6,207142 5,586427101 A07EC02 MESALAZINUM** SALOFALK (R) 250 mg SUPOZ. 250mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 21,74 2,174000 1,551780 1,396602102 A07EC02 MESALAZINUM** SALOFALK (R) 500 mg SUPOZ. 500mg DR. FALK PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 36,00 3,600000 3,103571 2,793213103 A07EC02 MESALAZINUM** SALOFALK 4 g/ 60 ml SUSP. RECTALA 4g/60ml DR. FALK PHARMA GMBH GERMANIA CUTIE X 7 BLIST. AL/PE CONTINAND FIECARE CATE 1 FLACON UNIDOZA X 60 ML SUSPENSIE RECTALA + APLICA P-6L 7 169,61 24,230000 24,230000 21,807000104 B01AA07 ACENOCUMAROLUM TROMBOSTOP 2 mg COMPR. 2mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 6,53 0,217666 0,181166 0,163049105 B01AA07 ACENOCUMAROLUM SINTROM 4 mg COMPR. 4mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 6,76 0,338000 0,338000 0,304200106 B01AC05 TICLOPIDINUM1) TICLODIN COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-RF 20 35,53 1,776500 0,602517 0,542265107 B01AC05 TICLOPIDINUM1) IPATON COMPR. FILM. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/ PVC X 10 COMPR.FILM. P-RF 20 33,37 1,668500 0,602517 0,542265108 B02BA01 PHYTOMENADIONUM FITOMENADION 10 mg/ml SOL. INJ. 10mg/ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE PREVAZUTE CU PUNCT DE RUPERE X 1 ML S/P-RF 5 16,10 3,220000 3,220000 2,898000109 B03AA07 FERROSI SULFAS FERROGRADUMET (R) COMPR. ELIB. PREL. 105mg TEOFARMA SRL ITALIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 30 8,58 0,286000 0,286000 0,257400110 B03AA07 FERROSI SULFAS TARDYFERON 80 mg DRAJ. ELIB. PREL. 80mg LAB. PIERRE FABRE FRANTA CUTIE X 3 BLIST. AL/PVDC-PE-PVC X 10 DRAJ. ELIB. PREL. P-6L 30 12,08 0,402666 0,232091 0,208881111 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT MALTOFER COMPR. MAST. 100mg VIFOR FRANCE S.A. FRANTA CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. MASTIC. P-6L 30 21,49 0,716333 0,644699 0,580229112 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FER ROMPHARM 50 mg/ml PIC. ORALE, SOL. 50mg/ml ROMPHARM COMPANY SRL ROMANIA CUTIE CU 1 FLAC. PEID + APLICATOR PT. PICURARE DIN PEJD X 30 ML PIC. ORALE, SOL. P6L 1 8,78 8,780000 8,780000 7,902000113 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERGLUROM FORTE 50 mg/ml PICATURI ORALE, SOL. 50mg/ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 ML PICATURI ORALE, SOLUTIE P-6L 1 8,81 8,810000 8,809999 7,928999114 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERRUM HAUSMANN (R) PICATURI ORALE-SOL. 50mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON CU PICURATOR X 30 ML P-6L 1 13,53 13,530000 8,809999 7,928999115 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERRUM HAUSMANN (R) SIROP 10mg/ml VIFOR FRANCE S.A. FRANTA CUTIE X 1 FLACON X 150 ML + O MASURA DOZATOARE P-6L 1 15,39 15,390000 8,809999 7,928999116 B03AB05 COMPLEX DE HIDROXID DE FER (III) POLIMALTOZAT FERGLUROM 50mg/5ml SIROP 50mg/5ml BIOFARM S.A. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 100 ML SIROP + MASURA DOZATOARE GRADATA DE LA 2,5 - 20 ML P-6L 1 10,06 10,060000 5,873333 5,285999117 B03AEN1 COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM) SORBIFER DURULES COMPR. FILM. 100mg+60mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. FILM. P-6L 50 14,85 0,297000 0,297000 0,267300118 B03BB01 ACIDUM FOLICUM ACIFOL 5 mg COMPR. FILM. 5mg ZENTIVA S.A. ROMANIA CUTIE X 1 FLAC. DIN PEID X 30 COMPR. FILM. P-6L 30 7,40 0,246666 0,246666 0,221999119 C01AA05 DIGOXINUM DIGOXIN ZENTIVA 0,25 mg COMPR. 0,25mg ZENTIVA S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 3,34 0,133600 0,133600 0,120240120 C01AA05 DIGOXINUM DIGOXIN 0,5 mg/2 ml SOL. INJ. 0,5mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE X 2 ML SOL. INJ. S/P-RF 5 7,97 1,594000 1,594000 1,434600121 C01AA05 DIGOXINUM DIGOXIN ZENTIVA 0,5 mg/2ml SOL. INJ. 0,5mg/2ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA CU INEL DE RUPERE SAU CU PUNCT DE RUPERE SAU CU INEL DE RUPERE SI DOUA INELE (ROSU SI PORTOCALIU)X 2 ML SOL. INJ. S/P-RF 5 7,97 1,594000 1,594000 1,434600122 C01BA01 CHINIDINI SULFAS CHINIDINA ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. PEID X 20 COMPR. P-RF 20 12,37 0,618500 0,617975 0,556177123 C01BA01 CHINIDINI SULFAS CHINIDINA ARENA 200 mg COMPR. 200mg ARENA GROUP S.A. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 13,25 0,662500 0,617975 0,556177124 C01BA01 CHINIDINI SULFAS CHINIDINA ARENA 200 mg COMPR. 200mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 19,26 0,642000 0,617975 0,556177125 C01BA01 CHINIDINI SULFAS CHINIDINA ARENA 200 mg COMPR. 200mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. PRF 50 30,82 0,616400 0,616400 0,554760126 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 8,03 0,401500 0,362325 0,326092127 C01BC03 PROPAFENONUM PROPAFENONA ARENA 150 mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-RF 100 36,25 0,362500 0,362325 0,326092128 C01BC03 PROPAFENONUM RYTMONORM (R) COMPR. FILM. 150mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 50 32,02 0,640400 0,362325 0,326092129 C01BC03 PROPAFENONUM PROPAFENON AL 150 COMPR. FILM. 150mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 2 BLIST. X 25 COMPR. FILM. P-RF 50 18,71 0,374200 0,362325 0,326092130 C01BC03 PROPAFENONUM PROPAFENON AL 150 COMPR. FILM. 150mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 1 BLIST. X 20 COMPR. FILM. P-RF 20 7,49 0,374500 0,362325 0,326092131 C01BC03 PROPAFENONUM PROPAFENON AL 150 COMPR. FILM. 150mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM. P-RF 100 34,95 0,349500 0,349500 0,314550132 C01BC03 PROPAFENONUM PROPAFENON SANDOZ 150 mg COMPR. FILM. 150mg HEXAL AG GERMANIA CUTIE X 5 BLIST. AL/PP X 10 COMPR. FILM. P-RF 50 18,09 0,361800 0,361800 0,325620133 C01BC03 PROPAFENONUM PROPANORM 300 mg COMPR. FILM. 300mg PRO. MED. CS PRAHA CEHIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 50 40,30 0,806000 0,724650 0,652185134 C01BC03 PROPAFENONUM RYTMONORM SOL. INJ. 70mg/20ml ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 20 ML SOL. INJ. P-RF 5 36,79 7,358000 7,358000 6,622200135 C01BD01 AMIODARONUM AMIODARONA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 9,01 0,300333 0,272333 0,245099136 C01BD01 AMIODARONUM AMIODARONA ARENA 200 MG COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 7,33 0,244333 0,244333 0,219899137 C01BD01 AMIODARONUM CORDARONE 200 mg COMPR. DIVIZ. 200mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. DIVIZ. P-RF 30 13,87 0,462333 0,272333 0,245099138 C01DA02 NITROGLYCERINUM NITROMINT 2,6 mg COMPR. ELIB. PREL. 2,6mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 60 COMPR. ELIB. PREL. P-6L 60 11,42 0,190333 0,150805 0,135724139 C01DA02 NITROGLYCERINUM NITROGLICERINA 0,5 mg COMPR. SUBLING. 0,5mg ZENTIVA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. SUBLINGUALE P-6L 20 3,87 0,193500 0,102412 0,092170

Pagina 3 din 27

Page 94: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti140 C01DA02 NITROGLYCERINUM NITRODERM (R) TTS 5 SIST. TERAP. TRANSDERM. 25mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 10 PLICURI X 1 SIST. TERAPEUTIC TRANSDERMIC P-6L 10 18,47 1,847000 1,847000 1,662300141 C01DA02 NITROGLYCERINUM NITROMINT SPRAY SUBLINGUAL 0,4mg/doza EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON X 10G (180 DOZE) SPRAY SUBLINGUAL P-6L 1 12,56 12,560000 12,560000 11,304000142 C01DA08 ISOSORBIDI DINITRAS ISOSORBIDE DINITRATE 10 mg COMPR. 10mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 3, BLIST. AL/PVC X 20 COMPR. P-6L 60 2,14 0,035666 0,035666 0,032099143 C01DA08 ISOSORBIDI DINITRAS ISODINIT(R) RETARD COMPR. ELIB. PREL. 20mg PHARMAKI GENERICS LIMITED MAREA BRITANIE CUTIE X 6 BLIST. X 10 COMPR. ELIB. PREL. P-6L 60 3,94 0,065666 0,065666 0,059099144 C01DA14 ISOSORBIDI MONONITRAS OLICARD 40 mg RETARD CAPS. ELIB. PREL. 40mg ABBOTT PRODUCTS GMBH GERMANIA CUTIE X 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L 20 12,02 0,601000 0,290010 0,261009145 C01DA14 ISOSORBIDI MONONITRAS MONO ROM SR 40 mg CAPS. ELIB. PREL. 40mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 20 11,86 0,593000 0,290010 0,261009146 C01DA14 ISOSORBIDI MONONITRAS MONO ROM SR 60 mg CAPS. ELIB. PREL. 60mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 20 18,49 0,924500 0,435016 0,391514147 C01DA14 ISOSORBIDI MONONITRAS MONONITRON (R) EP 60 mg COMPR. FILM. ELIB. PREL. 60mg ZENTIVA S.A ROMANIA CUTIE X 4 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 40 36,41 0,910250 0,435016 0,391514148 C01EA01 ALPROSTADILUM*** PRIDAX 20mcg CONC. PT. SOL. PERF. 20mcg GEBRO PHARMA GMBH AUSTRIA CUTIE X 5 FLAC. X 1 ML CONC. PT. SOL. PERF S/P-RF 5 328,95 65,790000 55,530750 49,977675149 C01EA01 ALPROSTADILUM*** VASAPROSTAN 20 LIOF. PT. SOL. PERF. 20µg UCB PHARMA GMBH GERMANIA CUTIE X 10 FIOLE X 5 ML LIOF. PT. SOL. PERF. PRF 10 521,11 52,111000 52,111000 46,899900150 C01EB15 TRIMETAZIDINUM TRIMETAZIDIN VIM SPECTRUM 20 mg CAPS. 20mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 CAPS. P-6L 30 7,61 0,253666 0,253666 0,228299151 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA ATB 35 mg COMPR. CU ELIB. PREL. 35mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. CU ELIB. PREL. P6L 30 16,72 0,557333 0,443915 0,399523152 C01EB15 TRIMETAZIDINUM APSTAR 35 mg COMPR. ELIB. PREL. 35mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC-ACLAR/AL X 60 COMPR. ELIB. PREL. P6L 60 33,41 0,556833 0,443915 0,399523153 C01EB15 TRIMETAZIDINUM TRIMELUZINE 35 mg COMPR. ELIB. PREL. 35mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 60 COMPR. ELIB. PREL. P6L 60 26,64 0,444000 0,443915 0,399523154 C01EB15 TRIMETAZIDINUM MODUXIN MR 35 mg COMPR. ELIB. PREL. 35mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. AL/PVC X 30 COMPR. CU ELIB. PRELUNG. P6L 30 16,56 0,552000 0,443915 0,399523155 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA TEVA 35 mg COMPR. ELIB. PREL. 35mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. ELIB. PREL. P6L 60 23,56 0,392666 0,392666 0,353399156 C01EB15 TRIMETAZIDINUM MODUXIN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 7,61 0,253666 0,253666 0,228299157 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH (R) 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. FILM. P-6L 60 15,24 0,254000 0,253666 0,228299158 C01EB15 TRIMETAZIDINUM PREDUCTAL 20 mg COMPR. FILM. 20mg LES LABORATOIRES SERVIER FRANTA CUTIE CU 2 BLIST. PVC/AL X 30 COMPR. FILM. P-6L 60 23,44 0,390666 0,253666 0,228299159 C01EB15 TRIMETAZIDINUM DILATAN 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 7,61 0,253666 0,253666 0,228299160 C01EB15 TRIMETAZIDINUM PREDUCTAL MR 35 mg COMPR. FILM. ELIB. MODIF. 35mg LES LAB. SERVIER IND. FRANTA CUTIE X 2 BLIST. AL/PVC X 30 COMPR. FILM. ELIB. MODIF. P-6L 60 49,74 0,829000 0,443915 0,399523161 C01EB15 TRIMETAZIDINUM TRIMETAZIDINA LPH (R) 35 mg COMPR. FILM. ELIB. MODIF. 35mg LABORMED PHARMA SA ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. MODIF. P-6L 60 33,39 0,556500 0,443915 0,399523162 C01EB15 TRIMETAZIDINUM PREDUTRIM 20 mg/ml PIC. ORALE, SOL. 20mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID + APLICATOR PT. PICURARE DIN PEJD X 50 ML PIC. ORALE P6L 1 12,33 12,330000 12,330000 11,097000163 C02AB01 METHYLDOPUM DOPEGYT COMPR. 250mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 26,73 0,534600 0,534600 0,481140164 C02AC01 CLONIDINUM CLONIDINA SINTOFARM 0,15 mg COMPR. 0,15mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 12,00 0,240000 0,216642 0,194977165 C02AC01 CLONIDINUM CLONIDINA ARENA 0,15 mg COMPR. 0,15mg ARENA GROUP SA ROMANIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 12,34 0,246800 0,216642 0,194977166 C02AC01 CLONIDINUM CLONIDINA ARENA 0,15 mg COMPR. 0,15mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 COMPR. P6L 50 12,33 0,246600 0,216642 0,194977167 C03AA03 HYDROCHLOROTHIAZIDUM NEFRIX 25 mg COMPR. 25mg ZENTIVA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-6L 25 4,18 0,167200 0,167200 0,150480168 C03BA11 INDAPAMIDUM SERDIMID 1,5 mg COMPR. CU ELIB. PREL. 1,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P6L 30 13,68 0,456000 0,343424 0,309081169 C03BA11 INDAPAMIDUM INDAPAMIDA SOPHARMA 1,5 mg COMPR. CU ELIB. PREL. 1,5mg SOPHARMA PLC BULGARIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 9,32 0,310666 0,310666 0,279599170 C03BA11 INDAPAMIDUM SERDIMID 2,5 mg COMPR. CU ELIB. PREL. 2,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 15 COMPR. CU ELIB. PREL. P6L 30 15,07 0,502333 0,502333 0,452099171 C03BA11 INDAPAMIDUM INDAPAMIDA TERAPIA 1,5 mg COMPR. CU ELIB. PRELUNGITA 1,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. CU ELIB. PREL. P-6L 30 13,30 0,443333 0,343424 0,309081172 C03BA11 INDAPAMIDUM INDAPAMIDA TERAPIA 2,5mg COMPR. CU ELIB. PRELUNGITA 2,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10COMPR. CU ELIB. PREL. P-6L 30 14,90 0,496666 0,496666 0,446999173 C03BA11 INDAPAMIDUM INDAPAMIDA MYLAN 1,5 mg COMPR. ELIB. PREL. 1,5 mg MYLAN S.A.S. FRANTA CUTIE CU BLIST DIN PVC/AL X 30 COMPR. ELIB. PREL. P-6L 30 12,60 0,420000 0,343424 0,309081174 C03BA11 INDAPAMIDUM TERTENSIF SR 1,5 mg COMPR. ELIB. PREL. 1,5mg LES LAB. SERVIER FRANTA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. ELIB. PREL. P-6L 30 21,05 0,701666 0,343424 0,309081175 C03BA11 INDAPAMIDUM INDAPAMID MCC 1,5 mg COMPR. ELIB. PREL. 1,5mg MAGISTRA C&C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. P-6L 30 13,68 0,456000 0,343424 0,309081176 C03BA11 INDAPAMIDUM IDUREN SR 1,5 mg COMPR. ELIB. PREL. 1,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. ELIB. PREL. P-6L 30 10,66 0,355333 0,343424 0,309081177 C03BA11 INDAPAMIDUM DIUREMID SR 1,5 mg COMPR. ELIB. PREL. 1,5mg GLENMARK PHARMACEUTICALS SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. P-6L 30 13,68 0,456000 0,343424 0,309081178 C03BA11 INDAPAMIDUM INDAPAMIDA TEVA 1,5 mg COMPR. ELIB. PREL. 1,5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. ELIB. PREL. P-6L 30 13,31 0,443666 0,343424 0,309081179 C03BA11 INDAPAMIDUM INDAPAMIDA SR TORRENT 1,5 mg COMPR. ELIB. PREL. 1,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P6L 30 13,68 0,456000 0,343424 0,309081180 C03BA11 INDAPAMIDUM INDAPAGAMMA 1,5 mg COMPR. ELIB. PREL. 1,5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. ELIB. PREL. P6L 30 12,62 0,420666 0,343424 0,309081181 C03BA11 INDAPAMIDUM INDAPAMID LPH (R) 2,5 mg COMPR. FILM. 2,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 15,07 0,502333 0,502333 0,452099182 C03BA11 INDAPAMIDUM INDAPAMID SR 1,5 mg LAROPHARM COMPR. FILM. ELIB. PREL. 1,5 mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 9,11 0,455500 0,343424 0,309081183 C03BA11 INDAPAMIDUM INDAPAMID LPH (R) 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 13,68 0,456000 0,343424 0,309081184 C03BA11 INDAPAMIDUM RAWEL SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 11,71 0,390333 0,343424 0,309081185 C03BA11 INDAPAMIDUM IMPAMID SR 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 15 COMPR. FILM. ELIB. PREL. P-6L 30 13,16 0,438666 0,343424 0,309081186 C03BA11 INDAPAMIDUM INDAPAMIDA ACTAVIS 1,5 mg COMPR. FILM. ELIB. PREL. 1,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. CU ELIB. PRELUNGITA P-6L 30 13,68 0,456000 0,343424 0,309081187 C03BA11 INDAPAMIDUM REDITENS SR 1.5 mg COMPR. FILM. ELIB. PREL. 1,5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 30 13,68 0,456000 0,343424 0,309081188 C03CA01 FUROSEMIDUM FUROSEMID MCC 40 mg COMPR. 40mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,02 0,151000 0,151000 0,135900

Pagina 4 din 27

Page 95: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti189 C03CA01 FUROSEMIDUM FUROSEMID SLAVIA COMPR. 40mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,02 0,151000 0,151000 0,135900190 C03CA01 FUROSEMIDUM FUROSEMID ZENTIVA COMPR. 40mg ZENTIVA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 20 COMPR. P-6L 20 6,02 0,301000 0,151250 0,136125191 C03CA01 FUROSEMIDUM FUROSEMID LPH 40 mg COMPR. 40mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,04 0,152000 0,151250 0,136125192 C03CA01 FUROSEMIDUM FUROSEMID ARENA 40 mg COMPR. 40mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6,02 0,301000 0,151250 0,136125193 C03CA01 FUROSEMIDUM FUROSEMID BIOEEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 5,42 0,271000 0,151250 0,136125194 C03CA01 FUROSEMIDUM FUROSEMID 20 mg/2 ml SOL. INJ. 10mg/ml ZENTIVA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. P-RF 5 6,07 1,214000 1,214000 1,092600195 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 28,51 0,950333 0,950333 0,855299196 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 25 mg CAPS. 25mg ARENA GROUP S.A. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. P-6L 50 16,07 0,321400 0,237583 0,213824197 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA LPH 25 mg CAPS. 25mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 6 BLIST. PVC/AL X 10 CAPS. P6L 60 19,46 0,324333 0,237583 0,213824198 C03DA01 SPIRONOLACTONUM VEROSPIRON CAPS. 50mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 16,72 0,557333 0,475166 0,427649199 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA ARENA 50 mg CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P-6L 30 16,24 0,541333 0,475166 0,427649200 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA BIOEEL 25 mg COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,30 0,215000 0,215000 0,193500201 C03DA01 SPIRONOLACTONUM SPIRONOLACTONA 25 mg COMPR. FILM. 25mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 17,83 0,356600 0,237583 0,213824202 C03DA01 SPIRONOLACTONUM ALSPIRON 25 mg COMPR. FILM. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 4,30 0,215000 0,215000 0,193500203 C03DA01 SPIRONOLACTONUM ALSPIRON 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 13,74 0,687000 0,475166 0,427649204 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUROCARD 50 mg/20 mg CAPS. 50mg/20 mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 31,48 1,049333 1,049333 0,944399205 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIUREX 50 CAPS. 50mg/20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 23,31 1,165500 1,049333 0,944399206 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIOCOR 50 mg/20 mg CAPS. 50mg/20mg SANIENCE S.R.L. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 31,48 1,049333 1,049333 0,944399207 C03EB01 COMBINATII (SPIRONOLACTONUM+FUROSEMIDUM) DIOCOR 50 mg/20 mg CAPS. 50mg/20mg SANIENCE S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P6L 20 23,31 1,165500 1,049333 0,944399208 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 10,25 0,512500 0,410800 0,369720209 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 20,54 0,410800 0,410800 0,369720210 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 33,83 0,676600 0,616200 0,554580211 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 100 65,38 0,653800 0,616200 0,554580212 C04AD03 PENTOXIFYLLINUM VASONIT RETARD 600 mg COMPR. ELIB. PREL. 600mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-6L 50 33,65 0,673000 0,616200 0,554580213 C04AD03 PENTOXIFYLLINUM ANGIOPENT 400 mg COMPR. FILM. ELIB. PREL. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 6,13 0,306500 0,306500 0,275850214 C04AD03 PENTOXIFYLLINUM PENTOXI RETARD 400 mg COMPR. FILM. ELIB. PREL. 400mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. ELIB. PREL. P-6L 20 17,21 0,860500 0,410800 0,369720215 C04AD03 PENTOXIFYLLINUM OXIFLUX 400 mg COMPR. FILM. ELIB. PREL. 400mg LABORMED PHARMA S.A. ROMANIA CUTIE X 6 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL P-6L 60 18,40 0,306666 0,306666 0,275999216 C04AD03 PENTOXIFYLLINUM ANGIOPENT 600 mg COMPR. FILM. ELIB. PREL. 600mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 16,46 0,823000 0,616200 0,554580217 C07AA05 PROPRANOLOLUM PROPRANOLOL EEL 10 mg COMPR. 10 mg BIO EEL S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 25 COMPR. P6L 50 3,25 0,065000 0,030296 0,027266218 C07AA05 PROPRANOLOLUM PROPRANOLOL 10 mg COMPR. 10mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 4,10 0,082000 0,030296 0,027266219 C07AA05 PROPRANOLOLUM PROPRANOLOL EEL 40 mg COMPR. 40mg BIO EEL SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 4,98 0,099600 0,099600 0,089640220 C07AA05 PROPRANOLOLUM PROPRANOLOL 40 mg COMPR. 40mg SINTOFARM SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 4,98 0,099600 0,099600 0,089640221 C07AA05 PROPRANOLOLUM PROPRANOLOL ARENA 40 mg COMPR. 40mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 4,98 0,099600 0,099600 0,089640222 C07AA05 PROPRANOLOLUM HEMANGIOL 3,75 mg/ml SOL. ORALA 3,75 mg/ml PIERRE FABRE DERMATOLOGIE FRANTA CUTIE X 1 FLACON DIN STICLA BRUNA X 120ML SOLUTIE ORALA PR/PRF 1 1.067,99 1.067,990000 1,363331 1,226997223 C07AA07 SOTALOLUM SOTALOL AL 160 COMPR. 160mg ALIUD PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 11,17 0,558500 0,484740 0,436266224 C07AA07 SOTALOLUM SOTALOL AL 160 COMPR. 160mg ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 26,93 0,538600 0,484740 0,436266225 C07AA07 SOTALOLUM SOTALOL AL 160 COMPR. 160mg ALIUD PHARMA GMBH GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-6L 100 54,63 0,546300 0,484740 0,436266226 C07AA07 SOTALOLUM DAROB (R) 80 mg COMPR. 80mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. AL/PVP X 10 COMPR. P-6L 20 10,06 0,503000 0,242370 0,218133227 C07AA07 SOTALOLUM SOTAGAMMA 80 COMPR. 80mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 100 39,32 0,393200 0,242370 0,218133228 C07AA07 SOTALOLUM SOTALOL AL 80 COMPR. 80mg ALIUD PHARMA GMBH GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 COMPR. P-6L 100 36,53 0,365300 0,242370 0,218133229 C07AA07 SOTALOLUM SOTALOL AL 80 COMPR. 80mg ALIUD PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 17,52 0,350400 0,242370 0,218133230 C07AB02 METOPROLOLUM BLOXAN COMPR. 100mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC/PVDC TRANSPARENT/AL X 10 COMPR. P-6L 30 14,05 0,468333 0,284849 0,256364231 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10,94 0,364666 0,284849 0,256364232 C07AB02 METOPROLOLUM EGILOK 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X, 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 6,56 0,328000 0,284849 0,256364233 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,12 0,237333 0,237333 0,213599234 C07AB02 METOPROLOLUM METOPROLOL LAROPHARM 100 mg COMPR. 100mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 5,86 0,293000 0,284849 0,256364235 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 9,49 0,316333 0,284849 0,256364236 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 15,12 0,504000 0,284849 0,256364237 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 100 mg COMPR. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 7,38 0,369000 0,284849 0,256364

Pagina 5 din 27

Page 96: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti238 C07AB02 METOPROLOLUM METOPROLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,01 0,233666 0,233666 0,210299239 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 8,09 0,404500 0,284849 0,256364240 C07AB02 METOPROLOLUM METOPROLOL AL 100 COMPR. 100mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 8,78 0,292666 0,284849 0,256364241 C07AB02 METOPROLOLUM EGILOK 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 1,90 0,095000 0,071212 0,064090242 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 1,90 0,095000 0,071212 0,064090243 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2,85 0,095000 0,071212 0,064090244 C07AB02 METOPROLOLUM METOPROLOL ARENA 25 MG COMPR. 25mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 2,85 0,095000 0,071212 0,064090245 C07AB02 METOPROLOLUM METOPROLOL LAROPHARM 50 mg COMPR. 50mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,51 0,175500 0,142424 0,128181246 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,27 0,175666 0,142424 0,128181247 C07AB02 METOPROLOLUM EGILOK 50 mg COMPR. 50mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 20 COMPR. P-6L 20 3,51 0,175500 0,142424 0,128181248 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,75 0,158333 0,142424 0,128181249 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,27 0,175666 0,142424 0,128181250 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,06 0,235333 0,142424 0,128181251 C07AB02 METOPROLOLUM METOPROLOL VIM SPECTRUM 50 mg COMPR. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,45 0,172500 0,142424 0,128181252 C07AB02 METOPROLOLUM METOPROLOL ARENA 50 MG COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,27 0,175666 0,142424 0,128181253 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,51 0,175500 0,142424 0,128181254 C07AB02 METOPROLOLUM METOPROLOL AL 50 COMPR. 50mg ALIUD PHARMA GMBH GERMANIA CUTIE X 3 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 30 4,39 0,146333 0,142424 0,128181255 C07AB02 METOPROLOLUM METOPROLOL RETARD 100 mg COMPR. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. CU ELIB. PREL. P-6L 20 11,12 0,556000 0,284849 0,256364256 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 100 mg COMPR. FILM. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 9,09 0,303000 0,284849 0,256364257 C07AB02 METOPROLOLUM METOPROLOL TARTRAT AUROBINDO 50 mg COMPR. FILM. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 5,24 0,174666 0,142424 0,128181258 C07AB02 METOPROLOLUM BETALOC (R) ZOK 100 mg COMPR. FILM. ELIB. PREL. 100mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 25,70 0,856666 0,284849 0,256364259 C07AB02 METOPROLOLUM BETALOC (R) ZOK 50 mg COMPR. FILM. ELIB. PREL. 50mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. X 30 COMPR. FILM. ELIB. PREL. P-6L 30 15,69 0,523000 0,142424 0,128181260 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mg COMPR.FILM.ELIB.MOD. 190mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 22,71 0,757000 0,541214 0,487092261 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR.FILM.ELIB.MOD. 47,5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 8,14 0,271333 0,135303 0,121772262 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR.FILM.ELIB.MOD. 95mg HEXAL AG GERMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 13,59 0,453000 0,270607 0,243546263 C07AB03 ATENOLOLUM ATENOCOR 100 mg COMPR. 100mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10,83 0,361000 0,361000 0,324900264 C07AB03 ATENOLOLUM ATENOLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10,57 0,352333 0,352333 0,317099265 C07AB03 ATENOLOLUM ATENOLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 7,04 0,352000 0,352000 0,316800266 C07AB03 ATENOLOLUM ATENOLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6,26 0,313000 0,313000 0,281700267 C07AB03 ATENOLOLUM ATENOLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,93 0,196500 0,196500 0,176850268 C07AB03 ATENOLOLUM ATENOLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,90 0,196666 0,196666 0,176999269 C07AB03 ATENOLOLUM ATENOCOR 50 mg COMPR. 50mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,35 0,178333 0,178333 0,160499270 C07AB03 ATENOLOLUM ATENOLOL ARENA 50 MG COMPR. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,56 0,178000 0,178000 0,160200271 C07AB03 ATENOLOLUM ATENOLOL 100 mg MEDO COMPR. FILM. 100mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 4,61 0,230500 0,230500 0,207450272 C07AB05 BETAXOLOLUM LOKREN 20 mg COMPR. FILM. 20mg SANOFI-AVENTIS FRANCE FRANTA CUTIE X 2 BLIST. AL/PVC X 14 COMPR.FILM. P-6L 28 9,61 0,343214 0,343214 0,308892273 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 4 BLIST. AL/PVC X 7 COMPR. FILM. P-6L 28 14,84 0,530000 0,427274 0,384546274 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. FILM. P-6L 30 15,89 0,529666 0,427274 0,384546275 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC, X 10 COMPR. FILM. P-6L 20 10,60 0,530000 0,427274 0,384546276 C07AB05 BETAXOLOLUM BETAC COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC, X 7 COMPR. FILM. P-6L 14 7,41 0,529285 0,427274 0,384546277 C07AB07 BISOPROLOLUM BISOPROLOL LPH 10mg COMPR. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 18,12 0,604000 0,427274 0,384546278 C07AB07 BISOPROLOLUM BISOBLOCK 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 16,18 0,539333 0,427274 0,384546279 C07AB07 BISOPROLOLUM BISOPROLOL LPH 5mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 8,55 0,285000 0,213637 0,192273280 C07AB07 BISOPROLOLUM BISOBLOCK 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 7,32 0,244000 0,213637 0,192273281 C07AB07 BISOPROLOLUM BOREZ 10 mg COMPR. FILM. 10 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 10,51 0,350333 0,350333 0,315299282 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 31,83 1,061000 0,427274 0,384546283 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L/S 100 49,43 0,494300 0,427274 0,384546284 C07AB07 BISOPROLOLUM BISOGAMMA (R) 10 COMPR. FILM. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 18,12 0,604000 0,427274 0,384546285 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 32,72 1,090666 0,427274 0,384546286 C07AB07 BISOPROLOLUM BISOTENS 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 18,12 0,604000 0,427274 0,384546

Pagina 6 din 27

Page 97: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti287 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L 30 13,67 0,455666 0,427274 0,384546288 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 32,72 1,090666 0,427274 0,384546289 C07AB07 BISOPROLOLUM SOBYC 10 mg COMPR. FILM. 10mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 10,05 0,335000 0,335000 0,301500290 C07AB07 BISOPROLOLUM BOREZ 2,5 mg COMPR. FILM. 2,5 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. PERFORATE PVC-TE-PVDC/AL X 10 COMPR. FILM. P6L 30 8,07 0,269000 0,106818 0,096136291 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 14,76 0,492000 0,106818 0,096136292 C07AB07 BISOPROLOLUM CONCOR COR 2,5 mg COMPR. FILM. 2,5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 14,76 0,492000 0,106818 0,096136293 C07AB07 BISOPROLOLUM SOBYC 2,5 mg COMPR. FILM. 2,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 6,04 0,201333 0,106818 0,096136294 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 16,33 0,544333 0,213637 0,192273295 C07AB07 BISOPROLOLUM BISOGAMMA (R) 5 COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. X 10 COMPR. FILM. P-6L 30 8,55 0,285000 0,213637 0,192273296 C07AB07 BISOPROLOLUM BISOGAMMA (R) 5 COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 4 BLIST. X 25 COMPR. FILM. P-6L 100 25,01 0,250100 0,213637 0,192273297 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. FILM. P-6L 30 22,31 0,743666 0,213637 0,192273298 C07AB07 BISOPROLOLUM BISOTENS 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 8,55 0,285000 0,213637 0,192273299 C07AB07 BISOPROLOLUM BISOPROLOL FUMARAT AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PA-PVC-AL/HARTIE-PE-AL X 30 COMPR. FILM. P6L 30 7,87 0,262333 0,213637 0,192273300 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 22,31 0,743666 0,213637 0,192273301 C07AB07 BISOPROLOLUM SOBYC 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P6L 30 6,04 0,201333 0,201333 0,181199302 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 12,5 mg COMPR. 12,5 mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 8,20 0,273333 0,273333 0,245999303 C07AG02 CARVEDILOLUM DILATREND (R) 12,5 mg COMPR. 12,5mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 29,94 1,069285 0,338699 0,304829304 C07AG02 CARVEDILOLUM CORYOL 12,5 mg COMPR. 12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 12,48 0,445714 0,338699 0,304829305 C07AG02 CARVEDILOLUM TALLITON (R) 12,5 mg COMPR. 12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 13,30 0,443333 0,338699 0,304829306 C07AG02 CARVEDILOLUM CARVEDILOL LPH 12,5 mg COMPR. 12,5mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 13,36 0,445333 0,338699 0,304829307 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 12,5mg COMPR. 12,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 6,72 0,336000 0,336000 0,302400308 C07AG02 CARVEDILOLUM GLADYCOR 12,5 mg COMPR. 12,5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 13,10 0,436666 0,338699 0,304829309 C07AG02 CARVEDILOLUM MIOCARVIL 12,5 mg COMPR. 12,5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 13,36 0,445333 0,338699 0,304829310 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 12,2 mg COMPR. 12,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 8,72 0,436000 0,338699 0,304829311 C07AG02 CARVEDILOLUM DILATREND (R) 25 mg COMPR. 25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 33,45 1,194642 0,677399 0,609659312 C07AG02 CARVEDILOLUM CORYOL 25 mg COMPR. 25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. P-6L 28 22,05 0,787500 0,677399 0,609659313 C07AG02 CARVEDILOLUM TALLITON (R) 25 mg COMPR. 25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 23,62 0,787333 0,677399 0,609659314 C07AG02 CARVEDILOLUM CARVEDILOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 23,62 0,787333 0,677399 0,609659315 C07AG02 CARVEDILOLUM GLADYCOR 25 mg COMPR. 25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 23,00 0,766666 0,677399 0,609659316 C07AG02 CARVEDILOLUM MIOCARVIL 25 mg COMPR. 25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 23,62 0,787333 0,677399 0,609659317 C07AG02 CARVEDILOLUM CARVEDILOL HELCOR 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 15,72 0,786000 0,677399 0,609659318 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 25 mg COMPR. 25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 9,18 0,306000 0,306000 0,275400319 C07AG02 CARVEDILOLUM DILATREND (R) 6,25 mg COMPR. 6,25mg ROCHE ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. OPA-AL-PVDC/AL X 14 COMPR. P-6L 28 16,46 0,587857 0,169349 0,152414320 C07AG02 CARVEDILOLUM CORYOL (R) COMPR. 6,25mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. OPA-AL-PVC/AL X 7 COMPR. P-6L 28 6,44 0,230000 0,169349 0,152414321 C07AG02 CARVEDILOLUM TALLITON 6,25 mg COMPR. 6,25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR. P-6L 30 6,89 0,229666 0,169349 0,152414322 C07AG02 CARVEDILOLUM CARVEDILOL LPH 6,25 mg COMPR. 6,25mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. P-6L 30 6,89 0,229666 0,169349 0,152414323 C07AG02 CARVEDILOLUM CARVEDILOL VIM SPECTRUM 6,25 mg COMPR. 6,25mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,56 0,228000 0,169349 0,152414324 C07AG02 CARVEDILOLUM GLADYCOR 6,25 mg COMPR. 6,25mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 6,70 0,223333 0,169349 0,152414325 C07AG02 CARVEDILOLUM MIOCARVIL 6,25 mg COMPR. 6,25mg SLAVIA PHARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 15 COMPR. P-6L 30 6,89 0,229666 0,169349 0,152414326 C07AG02 CARVEDILOLUM CARVEDILOL SANDOZ 6,25 mg COMPR. 6,25mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P6L 30 5,33 0,177666 0,169349 0,152414327 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 12,5mg COMPR. FILM. 12,5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 6,93 0,247500 0,247500 0,222750328 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 25mg COMPR. FILM. 25mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 7,70 0,275000 0,275000 0,247500329 C07AG02 CARVEDILOLUM CARVEDILOL AUROBINDO 6,25mg COMPR. FILM. 6,25mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P6L 28 4,85 0,173214 0,169349 0,152414330 C08CA01 AMLODIPINUM AMLODIPINA TEVA 10 mg COMPR. 10 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 11,53 0,384333 0,384333 0,345899331 C08CA01 AMLODIPINUM AMLOHEXAL 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L 30 19,28 0,642666 0,578249 0,520424332 C08CA01 AMLODIPINUM TENOX (R) 10 COMPR. 10mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 19,26 0,642000 0,578249 0,520424333 C08CA01 AMLODIPINUM AMLODIPINE MEDOCHEMIE 10 mg COMPR. 10mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 30 13,13 0,437666 0,437666 0,393899334 C08CA01 AMLODIPINUM CARDILOPIN 10 mg COMPR. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 30 19,28 0,642666 0,578249 0,520424335 C08CA01 AMLODIPINUM ALMACOR 10 mg COMPR. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 19,28 0,642666 0,578249 0,520424

Pagina 7 din 27

Page 98: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti336 C08CA01 AMLODIPINUM EPLODIN 10 mg COMPR. 10mg EXTRACTUMPHARMA UNGARIA CUTIE X 3 BLIST. PVC- PVDC/AL X 10 COMPR. P-6L 30 19,26 0,642000 0,578249 0,520424337 C08CA01 AMLODIPINUM AMLODIPINA LPH 10 mg COMPR. 10mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 19,28 0,642666 0,578249 0,520424338 C08CA01 AMLODIPINUM STAMLO M 10 mg COMPR. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 14 COMPR. P-6L 28 14,67 0,523928 0,523928 0,471535339 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 19,31 0,643666 0,578249 0,520424340 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 19,31 0,643666 0,578249 0,520424341 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 7,38 0,246000 0,246000 0,221400342 C08CA01 AMLODIPINUM RECOTENS 10 mg COMPR. 10mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 14,05 0,468333 0,468333 0,421499343 C08CA01 AMLODIPINUM AMLODIPIN VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L 20 12,85 0,642500 0,578249 0,520424344 C08CA01 AMLODIPINUM AMLODIPINA ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 12,85 0,642500 0,578249 0,520424345 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 10 mg COMPR. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 8,49 0,283000 0,283000 0,254700346 C08CA01 AMLODIPINUM NORVASC 10 mg COMPR. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 13,36 0,445333 0,445333 0,400799347 C08CA01 AMLODIPINUM AMLODIPINA HELCOR 10 mg COMPR. 10mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 12,87 0,643500 0,578249 0,520424348 C08CA01 AMLODIPINUM AMLODIPINA ARENA 10 mg COMPR. 10mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 19,28 0,642666 0,578249 0,520424349 C08CA01 AMLODIPINUM AMLODIPINA TEVA 5 mg COMPR. 5 mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 5,76 0,192000 0,192000 0,172800350 C08CA01 AMLODIPINUM AMLOHEXAL 5 mg COMPR. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC-COC-PVDC X 10 COMPR. P-6L 30 11,37 0,379000 0,289124 0,260211351 C08CA01 AMLODIPINUM TENOX (R) 5 COMPR. 5mg KRKA D.D. SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 11,40 0,380000 0,289124 0,260211352 C08CA01 AMLODIPINUM AMLODIPINE MEDOCHEMIE 5 mg COMPR. 5mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 30 7,81 0,260333 0,260333 0,234299353 C08CA01 AMLODIPINUM CARDILOPIN 5 mg COMPR. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PVDC X 10 COMPR. P-6L 30 11,37 0,379000 0,289124 0,260211354 C08CA01 AMLODIPINUM ALMACOR 5 mg COMPR. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 11,36 0,378666 0,289124 0,260211355 C08CA01 AMLODIPINUM EPLODIN 5 mg COMPR. 5mg EXTRACTUMPHARMA UNGARIA CUTIE X 3 BLIST. PVC- PVDC/AL X 10 COMPR. P-6L 30 11,37 0,379000 0,289124 0,260211356 C08CA01 AMLODIPINUM AMLODIPINA LPH 5 mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 11,37 0,379000 0,289124 0,260211357 C08CA01 AMLODIPINUM STAMLO M 5 mg COMPR. 5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 14 COMPR. P-6L 28 8,75 0,312500 0,289124 0,260211358 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 10,82 0,360666 0,289124 0,260211359 C08CA01 AMLODIPINUM AMLODIPINA TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. ACLAR-PVC/AL X 10 COMPR. P-6L 30 10,82 0,360666 0,289124 0,260211360 C08CA01 AMLODIPINUM AMLODIPINA AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. P6L 30 5,25 0,175000 0,175000 0,157500361 C08CA01 AMLODIPINUM RECOTENS 5 mg COMPR. 5mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 7,63 0,254333 0,254333 0,228899362 C08CA01 AMLODIPINUM AMLODIPIN VIM SPECTRUM 5 mg COMPR. 5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. P-6L 20 7,44 0,372000 0,289124 0,260211363 C08CA01 AMLODIPINUM AMLODIPINA ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 7,58 0,379000 0,289124 0,260211364 C08CA01 AMLODIPINUM AMLODIPINA ZENTIVA 5 mg COMPR. 5mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 4,10 0,136666 0,136666 0,122999365 C08CA01 AMLODIPINUM NORVASC 5 mg COMPR. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P6L 30 16,47 0,549000 0,289124 0,260211366 C08CA01 AMLODIPINUM AMLODIPINA HELCOR 5 mg COMPR. 5mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 8,63 0,431500 0,289124 0,260211367 C08CA01 AMLODIPINUM AMLODIPINA ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 7,89 0,263000 0,263000 0,236700368 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 10mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L 30 50,21 1,673666 0,578249 0,520424369 C08CA02 FELODIPINUM FELODIPIN AL 10 mg COMPR. ELIB. PREL. 10mg ALIUD PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 30 33,73 1,124333 0,578249 0,520424370 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 2,5mg ASTRAZENECA AB SUEDIA CUTIE 1 FLAC. DIN PE X 30 COMPR. ELIB. PREL. P-6L 30 22,26 0,742000 0,144562 0,130105371 C08CA02 FELODIPINUM FELODIPIN AL 2,5 mg COMPR. ELIB. PREL. 2,5mg ALIUD PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 30 14,47 0,482333 0,144562 0,130105372 C08CA02 FELODIPINUM PLENDIL COMPR. ELIB. PREL. 5mg ASTRAZENECA AB SUEDIA CUTIE X 1 FLAC. DIN PE X, 30 COMPR. ELIB. PREL. P-6L 30 28,37 0,945666 0,289124 0,260211373 C08CA02 FELODIPINUM FELODIPIN AL 5 mg COMPR. ELIB. PREL. 5mg ALIUD PHARMA GMBH & CO. KG GERMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. ELIB. PREL. P-6L 30 18,44 0,614666 0,289124 0,260211374 C08CA02 FELODIPINUM SISTAR 10 mg COMPR. FILM. ELIB. MODIF. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 30,42 1,014000 0,578249 0,520424375 C08CA02 FELODIPINUM SISTAR 2,5 mg COMPR. FILM. ELIB. MODIF. 2,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 14,47 0,482333 0,144562 0,130105376 C08CA02 FELODIPINUM SISTAR 5 mg COMPR. FILM. ELIB. MODIF. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-6L 30 18,43 0,614333 0,289124 0,260211377 C08CA02 FELODIPINUM AURONAL 10 mg COMPR. FILM. ELIB. PREL. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 42,57 1,419000 0,578249 0,520424378 C08CA02 FELODIPINUM FELODIPIN SANDOZ 10 mg COMPR. FILM. ELIB. PREL. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 30,52 1,017333 0,578249 0,520424379 C08CA02 FELODIPINUM AURONAL 2,5 mg COMPR. FILM. ELIB. PREL. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 16,47 0,549000 0,144562 0,130105380 C08CA02 FELODIPINUM AURONAL 5 mg COMPR. FILM. ELIB. PREL. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 3 BLIST. AL/PVC-PE-PVDC X 10 COMPR. ELIB. PREL. P-6L 30 26,66 0,888666 0,289124 0,260211381 C08CA02 FELODIPINUM FELODIPIN SANDOZ 5 mg COMPR. FILM. ELIB. PREL. 5mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 15,69 0,523000 0,289124 0,260211382 C08CA05 NIFEDIPINUM ADALAT CR 30 COMPR. ELIB. MODIF. 30mg BAYER PHARMA AG GERMANIA CUTIE X 2 BLIST. AL/PP X 14 COMPR. ELIB. MODIF. P-6L 28 29,88 1,067142 0,289124 0,260211383 C08CA05 NIFEDIPINUM NIFEDIPIN RETARD TERAPIA 20 mg COMPR. FILM. ELIB. PREL. 20mg TERAPIA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 10,80 0,216000 0,192749 0,173474384 C08DA01 VERAPAMILUM VERAPAMIL ARENA 40 mg CAPS. 40mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 3,33 0,111000 0,094589 0,085130

Pagina 8 din 27

Page 99: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti385 C08DA01 VERAPAMILUM VERAPAMIL ARENA 80 mg CAPS. 80mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. P6L 30 5,96 0,198666 0,189180 0,170262386 C08DA01 VERAPAMILUM CORDAMIL 40 mg COMPR. FILM. 40mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 3,33 0,111000 0,094589 0,085130387 C08DA01 VERAPAMILUM VERAPAMIL AL 80 COMPR. FILM. 80mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 10 BLIST. X 10 COMPR. FILM. P-6L 100 21,02 0,210200 0,189180 0,170262388 C08DA01 VERAPAMILUM VERAPAMIL AL 80 COMPR. FILM. 80mg ALIUD® PHARMA GMBH & CO.KG GERMANIA CUTIE X 5 BLIST. X 10 COMPR. FILM. P-6L 50 10,51 0,210200 0,189180 0,170262389 C08DA01 VERAPAMILUM CORDAMIL 80 mg COMPR. FILM. 80mg AC HELCOR SRL ROMANIA CUTIE X 3 BLIST. X 10 COMPR.FILM. P-6L 30 5,96 0,198666 0,189180 0,170262390 C08DA01 VERAPAMILUM ISOPTIN (R) 80 mg COMPR. FILM. 80mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 50 15,30 0,306000 0,189180 0,170262391 C08DA01 VERAPAMILUM ISOPTIN RR COMPR. FILM. ELIB. PREL. 240mg ABBOTT GMBH&CO.KG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 19,91 0,995500 0,567540 0,510786392 C08DA01 VERAPAMILUM VERAPAMIL 40 mg DRAJ. 40mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 DRAJ. P-6L 50 11,82 0,236400 0,094589 0,085130393 C08DA01 VERAPAMILUM VERAPAMIL 80 mg DRAJ. 80mg SANOFI-AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 25 DRAJ. P-6L 50 17,32 0,346400 0,189180 0,170262394 C08DB01 DILTIAZEMUM DILTIAZEM SR ROMPHARM 180 mg CAPS. ELIB. PREL. 180mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P6L 30 35,79 1,193000 0,805350 0,724815395 C08DB01 DILTIAZEMUM DILTIAZEM SR ROMPHARM 90 mg CAPS. ELIB. PREL. 90mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. DIN FOLIE DE PVC/PVDC/AL X 7 CAPS. ELIB. PREL. P6L 21 7,00 0,333333 0,333333 0,299999396 C08DB01 DILTIAZEMUM DILTIAZEM EIPICO 60 mg COMPR. 60mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 2, BLIST. AL/PVC X 10 COMPR. P-6L 20 5,39 0,269500 0,268450 0,241605397 C08DB01 DILTIAZEMUM DILTIAZEM LPH 60 mg COMPR. 60mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 5,39 0,269500 0,268450 0,241605398 C08DB01 DILTIAZEMUM DILTIAZEM ARENA 60 mg COMPR. 60mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. DIN AL/ PVC X 10COMPR. P-6L 50 13,37 0,267400 0,267400 0,240660399 C08DB01 DILTIAZEMUM DILTIAZEM BIOEEL 60 mg COMPR. 60mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. DIN AL/ PVC X 10 COMPR. P-6L 20 5,39 0,269500 0,268450 0,241605400 C08DB01 DILTIAZEMUM DILZEM 90 mg RETARD COMPR. FILM. ELIB. PREL. 90mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 30 15,38 0,512666 0,402675 0,362407401 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 12,5 mg COMPR. 12,5mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 3,41 0,113666 0,044550 0,040095402 C09AA01 CAPTOPRILUM CAPTOPRIL 25 mg COMPR. 25mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,10 0,136666 0,089100 0,080190403 C09AA01 CAPTOPRILUM CAPTOPRIL 25 EEL COMPR. 25mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,02 0,151000 0,089100 0,080190404 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 25 mg COMPR. 25mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2,28 0,114000 0,089100 0,080190405 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 25 mg COMPR. 25mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3,42 0,114000 0,089100 0,080190406 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3,42 0,114000 0,089100 0,080190407 C09AA01 CAPTOPRILUM CAPTOPRIL SINTOFARM 25 mg COMPR. 25mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,64 0,154666 0,089100 0,080190408 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 25 mg COMPR. 25mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2,28 0,114000 0,089100 0,080190409 C09AA01 CAPTOPRILUM CAPTOPRIL ARENA 50 mg COMPR. 50 mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2,67 0,133500 0,133500 0,120150410 C09AA01 CAPTOPRILUM CAPTOPRIL 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 6,67 0,222333 0,178200 0,160380411 C09AA01 CAPTOPRILUM CAPTOPRIL 50 EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 3,87 0,193500 0,178200 0,160380412 C09AA01 CAPTOPRILUM CAPTOPRIL - AC 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 2,67 0,133500 0,133500 0,120150413 C09AA01 CAPTOPRILUM CAPTOPRIL MCC 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,50 0,150000 0,150000 0,135000414 C09AA01 CAPTOPRILUM CAPTOPRIL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 3,93 0,131000 0,131000 0,117900415 C09AA02 ENALAPRILUM ENALAPRIL 10 mg COMPR. 10mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 4,39 0,219500 0,178200 0,160380416 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3,96 0,198000 0,178200 0,160380417 C09AA02 ENALAPRILUM ENALAPRIL LPH 10 mg COMPR. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 4,39 0,219500 0,178200 0,160380418 C09AA02 ENALAPRILUM ENAP 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 4,39 0,219500 0,178200 0,160380419 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 10 mg COMPR. 10mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/ AL X 10 COMPR. P-6L 20 4,39 0,219500 0,178200 0,160380420 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 10,52 0,375714 0,178200 0,160380421 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 7,30 0,365000 0,178200 0,160380422 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC, X 10 COMPR. P-6L 30 6,87 0,229000 0,178200 0,160380423 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. AL/PVC, X 10 COMPR. P-6L 50 11,25 0,225000 0,178200 0,160380424 C09AA02 ENALAPRILUM ENALAPRIL ARENA 10mg COMPR. 10mg ARENA GROUP SA ROMANIA CUTIE X 10 BLIST. AL/PVC, X 10 COMPR. P-6L 100 22,02 0,220200 0,178200 0,160380425 C09AA02 ENALAPRILUM ENALAPRIL VIM SPECTRUM 10 mg COMPR. 10mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 4,10 0,205000 0,178200 0,160380426 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 10 mg COMPR. 10mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 4,39 0,219500 0,178200 0,160380427 C09AA02 ENALAPRILUM ENALAPRIL 20 mg COMPR. 20mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 7,94 0,397000 0,356400 0,320760428 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 20 mg COMPR. 20mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 10,18 0,509000 0,356400 0,320760429 C09AA02 ENALAPRILUM ENALAPRIL LPH 20 mg COMPR. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 8,75 0,437500 0,356400 0,320760430 C09AA02 ENALAPRILUM ENAP 20 mg COMPR. 20mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 7,94 0,397000 0,356400 0,320760431 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 17,12 0,611428 0,356400 0,320760432 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 11,11 0,555500 0,356400 0,320760433 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. P-6L 30 11,12 0,370666 0,356400 0,320760

Pagina 9 din 27

Page 100: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti434 C09AA02 ENALAPRILUM ENALAPRIL ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. P-6L 50 16,43 0,328600 0,328600 0,295740435 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 20 mg COMPR. 20mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 7,92 0,396000 0,356400 0,320760436 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 20 mg COMPR. 20mg LAROPHARM SRL ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 7,94 0,397000 0,356400 0,320760437 C09AA02 ENALAPRILUM ENALAPRIL 5 mg COMPR. 5mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3,67 0,183500 0,089100 0,080190438 C09AA02 ENALAPRILUM ENALAPRIL SANDOZ 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 3,67 0,183500 0,089100 0,080190439 C09AA02 ENALAPRILUM ENAP 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 3,67 0,183500 0,089100 0,080190440 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. P-6L 28 7,87 0,281071 0,089100 0,080190441 C09AA02 ENALAPRILUM ENALAPRIL LPH (R) 5 mg COMPR. 5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/AL X 10 COMPR. P-6L 20 3,84 0,192000 0,089100 0,080190442 C09AA02 ENALAPRILUM ENALAPRIL TERAPIA 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 10 COMPR. P-6L 20 3,93 0,196500 0,089100 0,080190443 C09AA02 ENALAPRILUM ENALAPRIL ARENA 5 mg COMPR. 5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 5,58 0,186000 0,089100 0,080190444 C09AA02 ENALAPRILUM ENALAPRIL SLAVIA 5 mg COMPR. 5mg SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. P6L 20 3,67 0,183500 0,089100 0,080190445 C09AA02 ENALAPRILUM ENALAPRIL LAROPHARM 5 mg COMPR. 5mg LAROPHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 20 COMPR. P6L 20 3,67 0,183500 0,089100 0,080190446 C09AA02 ENALAPRILUM ENAP 1,25 mg/ml SOL. INJ./PERF. 1,25mg/ml KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ. PR/PRF 5 15,45 3,090000 3,090000 2,781000447 C09AA03 LISINOPRILUM RANOLIP COMPR. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 14,98 0,499333 0,178200 0,160380448 C09AA03 LISINOPRILUM LISIREN 10 mg COMPR. 10mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 10,74 0,537000 0,178200 0,160380449 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 10 mg COMPR. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 10,31 0,343666 0,178200 0,160380450 C09AA03 LISINOPRILUM LISIGAMMA 10 mg COMPR. 10mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 8,61 0,287000 0,178200 0,160380451 C09AA03 LISINOPRILUM LISINOPRIL 10 MEDO COMPR. 10mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 14,44 0,481333 0,178200 0,160380452 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 10 mg COMPR. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 12,87 0,429000 0,178200 0,160380453 C09AA03 LISINOPRILUM LISINOPRIL ATB 10 MG COMPR. 10mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 11,96 0,398666 0,178200 0,160380454 C09AA03 LISINOPRILUM TONOLYSIN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 15,47 0,552500 0,178200 0,160380455 C09AA03 LISINOPRILUM TONOLYSIN 2,5 mg COMPR. 2,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 8,75 0,312500 0,044550 0,040095456 C09AA03 LISINOPRILUM RANOLIP COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 23,11 0,770333 0,356400 0,320760457 C09AA03 LISINOPRILUM LISIREN 20 mg COMPR. 20mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 15,65 0,782500 0,356400 0,320760458 C09AA03 LISINOPRILUM LISINOPRIL SANDOZ 20 mg COMPR. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 15,05 0,501666 0,356400 0,320760459 C09AA03 LISINOPRILUM LISIGAMMA 20 mg COMPR. 20mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 12,93 0,431000 0,356400 0,320760460 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 20 mg COMPR. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 23,37 0,779000 0,356400 0,320760461 C09AA03 LISINOPRILUM LISINOPRIL ATB 20 MG COMPR. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 23,48 0,782666 0,356400 0,320760462 C09AA03 LISINOPRILUM TONOLYSIN 20 mg COMPR. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 22,90 0,817857 0,356400 0,320760463 C09AA03 LISINOPRILUM LISINOPRIL 20 MEDO COMPR. 20mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 2 BLIST. PVDC/AL X 10 COMPR. P-6L 20 14,44 0,722000 0,356400 0,320760464 C09AA03 LISINOPRILUM LISINOPRIL ATB 40 MG COMPR. 40mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 39,31 1,310333 0,712800 0,641520465 C09AA03 LISINOPRILUM RANOLIP COMPR. 5mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 7,64 0,254666 0,089100 0,080190466 C09AA03 LISINOPRILUM LISIGAMMA 5 mg COMPR. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 6,50 0,216666 0,089100 0,080190467 C09AA03 LISINOPRILUM LISINOPRIL 5 MEDO COMPR. 5mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 8,67 0,289000 0,089100 0,080190468 C09AA03 LISINOPRILUM LISINOPRIL ACTAVIS 5 mg COMPR. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 COMPR. P-6L 30 7,37 0,245666 0,089100 0,080190469 C09AA03 LISINOPRILUM TONOLYSIN 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 9,28 0,331428 0,089100 0,080190470 C09AA05 RAMIPRILUM VIVACE 10 mg COMPR. 10 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 9,23 0,329642 0,329642 0,296677471 C09AA05 RAMIPRILUM PIRAMIL 10 mg COMPR. 10mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 23,28 0,831428 0,712800 0,641520472 C09AA05 RAMIPRILUM RAMIPRIL-AC 10 mg COMPR. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 9,74 0,324666 0,324666 0,292199473 C09AA05 RAMIPRILUM AMPRIL 10 mg COMPR. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 24,93 0,831000 0,712800 0,641520474 C09AA05 RAMIPRILUM HARTIL 10 mg COMPR. 10mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 9,21 0,328928 0,328928 0,296035475 C09AA05 RAMIPRILUM ZENRA 10 COMPR. 10mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 9,23 0,329642 0,329642 0,296677476 C09AA05 RAMIPRILUM TRITACE 10 COMPR. 10mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 14,19 0,506785 0,506785 0,456106477 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L 28 9,49 0,338928 0,338928 0,305035478 C09AA05 RAMIPRILUM AMPRIGEN 10 mg COMPR. 10mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 24,04 0,801333 0,712800 0,641520479 C09AA05 RAMIPRILUM RAMIPRIL TEVA 10 mg COMPR. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. P6L 30 9,88 0,329333 0,329333 0,296399480 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 9,88 0,329333 0,329333 0,296399481 C09AA05 RAMIPRILUM RAMIRAN 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 9,88 0,329333 0,329333 0,296399482 C09AA05 RAMIPRILUM VIVACE 2,5 mg COMPR. 2,5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7COMPR. P-6L 28 4,65 0,166071 0,166071 0,149463

Pagina 10 din 27

Page 101: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti483 C09AA05 RAMIPRILUM PIRAMIL 2,5 mg COMPR. 2,5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 9,37 0,334642 0,178200 0,160380484 C09AA05 RAMIPRILUM RAMIPRIL-AC 2,5 mg COMPR. 2,5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 4,87 0,162333 0,162333 0,146099485 C09AA05 RAMIPRILUM AMPRIL 2,5 mg COMPR. 2,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 10,02 0,334000 0,178200 0,160380486 C09AA05 RAMIPRILUM HARTIL 2,5 mg COMPR. 2,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 4,62 0,165000 0,165000 0,148500487 C09AA05 RAMIPRILUM ZENRA 2,5 COMPR. 2,5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 4,65 0,166071 0,166071 0,149463488 C09AA05 RAMIPRILUM TRITACE(R) 2,5 COMPR. 2,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 7,15 0,255357 0,178200 0,160380489 C09AA05 RAMIPRILUM AMPRIGEN 2,5 mg COMPR. 2,5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 9,92 0,330666 0,178200 0,160380490 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 4,98 0,166000 0,166000 0,149400491 C09AA05 RAMIPRILUM RAMIRAN 2,5 mg COMPR. 2,5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 4,98 0,166000 0,166000 0,149400492 C09AA05 RAMIPRILUM VIVACE 5 mg COMPR. 5 mg ACTAVIS GROUP HF ISLANDA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 6,70 0,239285 0,239285 0,215356493 C09AA05 RAMIPRILUM PIRAMIL 5 mg COMPR. 5mg SANDOZ SRL ROMANIA CUTIE X 4 FOLII AL-LDPE/LDPE-AL X 7 COMPR. P-6L 28 10,17 0,363214 0,356400 0,320760494 C09AA05 RAMIPRILUM RAMIPRIL-AC 5 mg COMPR. 5mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 7,18 0,239333 0,239333 0,215399495 C09AA05 RAMIPRILUM AMPRIL 5 mg COMPR. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 10,85 0,361666 0,356400 0,320760496 C09AA05 RAMIPRILUM HARTIL 5 mg COMPR. 5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. AL/AL X 7 COMPR. P-6L 28 6,69 0,238928 0,238928 0,215035497 C09AA05 RAMIPRILUM ZENRA 5 COMPR. 5mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 6,70 0,239285 0,239285 0,215356498 C09AA05 RAMIPRILUM TRITACE® 5 COMPR. 5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. X 14 COMPR. P-6L 28 10,31 0,368214 0,356400 0,320760499 C09AA05 RAMIPRILUM RAMIPRIL AUROBINDO 5 mg COMPR. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. P-6L 28 7,10 0,253571 0,253571 0,228213500 C09AA05 RAMIPRILUM AMPRIGEN 5 mg COMPR. 5mg ALVOGEN IPCO S.A.R.L LUXEMBURG CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L 30 10,75 0,358333 0,356400 0,320760501 C09AA05 RAMIPRILUM RAMIPRIL TEVA 5 mg COMPR. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA/AL/PVC-AL X 30 COMPR. P6L 30 7,18 0,239333 0,239333 0,215399502 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P6L 30 7,18 0,239333 0,239333 0,215399503 C09AA05 RAMIPRILUM RAMIRAN 5 mg COMPR. 5mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 30 COMPR. P6L 30 7,18 0,239333 0,239333 0,215399504 C09AA06 QUINAPRILUM ACCUPRO 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL/PA X 10 COMPR. FILM. P-6L 30 11,69 0,389666 0,118799 0,106919505 C09AA06 QUINAPRILUM ACCUPRO (R) 20 COMPR. FILM. 20mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 16,75 0,558333 0,237599 0,213839506 C09AA06 QUINAPRILUM ACCUPRO (R) 5 COMPR. FILM. 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. AL/PA-AL-PVC X 10 COMPR. FILM. P-6L 30 8,20 0,273333 0,059399 0,053459507 C09AA09 FOSINOPRILUM MONOPRIL 10 mg COMPR. 10mg BRISTOL MYERS SQUIBB KFT UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 20,83 0,743928 0,118799 0,106919508 C09AA09 FOSINOPRILUM FOSYPRIL 10 mg COMPR. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. P-6L 30 14,51 0,483666 0,118799 0,106919509 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 10 mg COMPR. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 13,54 0,451333 0,118799 0,106919510 C09AA09 FOSINOPRILUM MONOPRIL 20 mg COMPR. 20mg BRISTOL-MYERS SQUIBB UNGARIA CUTIE X 2 BLIST. AL/PVC-PVDC X 14 COMPR. P-6L 28 28,58 1,020714 0,237599 0,213839511 C09AA09 FOSINOPRILUM FOSYPRIL 20 mg COMPR. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL-PVC-PA/AL, X 10 COMPR. P-6L 30 19,91 0,663666 0,237599 0,213839512 C09AA09 FOSINOPRILUM FOSINOPRIL AUROBINDO 20 mg COMPR. 20mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. P6L 30 18,58 0,619333 0,237599 0,213839513 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP HL COMPR. 10mg+12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 8,89 0,444500 0,412071 0,370863514 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP H COMPR. 10mg+25mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. AL/OPA-AL-PVC X 10 COMPR. P-6L 20 9,82 0,491000 0,412071 0,370863515 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) VIMAPRIL HL COMPR. 10mg/12.5mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST.OPA-AL-PVC/AL A CATE 10 CAPS. P-6L 30 8,88 0,296000 0,296000 0,266400516 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) VIMAPRIL H COMPR. 10mg/25mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST.OPA-AL-PVC/AL A CATE 10 CAPS. P-6L 30 11,82 0,394000 0,394000 0,354600517 C09BA02 COMBINATII (ENALAPRILUM+HYDROCHLOROTHIAZIDUM) ENAP (R) HL 20 mg/12,5 mg COMPR. 20 mg/12,5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 20 7,95 0,397500 0,397500 0,357750518 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) HARTIL HCT 2,5 mg/12,5mg COMPR. 2,5mg/12,5mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L 28 5,64 0,201428 0,201428 0,181285519 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) RAMIPRIL HCT-MEDOCHEMIE COMPR. 2,5mg/12,5mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 13,27 0,442333 0,412071 0,370863520 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) TRITACE 2,5 PLUS COMPR. 2,5mg/12,5mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 8,67 0,309642 0,309642 0,278677521 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) HARTIL HCT 5 mg/25mg COMPR. 5mg/25mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PCTFE/AL X 14 COMPR. P-6L 28 12,82 0,457857 0,412071 0,370863522 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) RAMIPRIL HCT-MEDOCHEMIE COMPR. 5mg/25mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 30 20,15 0,671666 0,412071 0,370863523 C09BA05 COMBINATII (RAMIPRILUM+HYDROCHLOROTHIAZIDUM) TRITACE 5 PLUS COMPR. 5mg/25mg SANOFI - AVENTIS ROMANIA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. P-6L 28 19,72 0,704285 0,412071 0,370863524 C09CA01 LOSARTANUM LODIAL 100mg COMPR. FILM. 100 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 2 BLIST. DIN PVC/AL X 15 COMPR. FILM. P6L 30 39,38 1,312666 1,042713 0,938441525 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 33,41 1,113666 1,042713 0,938441526 C09CA01 LOSARTANUM TALOSAN 100 mg COMPR. FILM. 100mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 33,41 1,113666 1,042713 0,938441527 C09CA01 LOSARTANUM LOZAP 100 COMPR. FILM. 100mg ZENTIVA A.S. SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 14,38 0,479333 0,479333 0,431399528 C09CA01 LOSARTANUM LORISTA 100 mg COMPR. FILM. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 32,76 1,170000 1,042713 0,938441529 C09CA01 LOSARTANUM LOSARTAN ZENTIVA 100 mg COMPR. FILM. 100mg ZENTIVA A.S. SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 14,38 0,479333 0,479333 0,431399530 C09CA01 LOSARTANUM LODIAL 50mg COMPR. FILM. 50 mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPR. FILM. P6L 30 19,23 0,641000 0,521356 0,469220531 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 17,92 0,597333 0,521356 0,469220

Pagina 11 din 27

Page 102: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti532 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 17,92 0,597333 0,521356 0,469220533 C09CA01 LOSARTANUM LOSARTAN FARMAL 50 mg COMPR. FILM. 50mg FARMAL INTERNATIONAL S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PE- PVDC/AL X 14 COMPR. FILM. P-6L 28 17,89 0,638928 0,521356 0,469220534 C09CA01 LOSARTANUM LOZAP 50 COMPR. FILM. 50mg ZENTIVA A.S. SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 7,75 0,258333 0,258333 0,232499535 C09CA01 LOSARTANUM COZAAR 50 mg COMPR. FILM. 50mg MERCK SHARP & DOHME ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 64,56 2,305714 0,521356 0,469220536 C09CA01 LOSARTANUM LORISTA 50 mg COMPR. FILM. 50mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 28 COMPR. FILM. P6L 28 18,00 0,642857 0,521356 0,469220537 C09CA01 LOSARTANUM LOSARTAN ZENTIVA 50 mg COMPR. FILM. 50mg ZENTIVA A.S. SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 7,75 0,258333 0,258333 0,232499538 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 10 mg COMPR. FILM. 10 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 8,75 0,312500 0,194193 0,174773539 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 10 mg COMPR. FILM. 10mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 9,37 0,312333 0,194193 0,174773540 C10AA01 SIMVASTATINUM ZEPLAN (R) 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM P-6L 28 8,75 0,312500 0,194193 0,174773541 C10AA01 SIMVASTATINUM ZOCOR 10 mg COMPR. FILM. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 13,45 0,480357 0,194193 0,174773542 C10AA01 SIMVASTATINUM SINTENAL 10 mg COMPR. FILM. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 9,35 0,311666 0,194193 0,174773543 C10AA01 SIMVASTATINUM VASILIP 10 mg COMPR. FILM. 10mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L 28 8,74 0,312142 0,194193 0,174773544 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 9,37 0,312333 0,194193 0,174773545 C10AA01 SIMVASTATINUM RANVOR 10 mg COMPR. FILM. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 4,24 0,302857 0,194193 0,174773546 C10AA01 SIMVASTATINUM RANVOR 10 mg COMPR. FILM. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. X 7 COMPR. FILM. P-6L 28 8,47 0,302500 0,194193 0,174773547 C10AA01 SIMVASTATINUM RANVOR 10 mg COMPR. FILM. 10mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 9,37 0,312333 0,194193 0,174773548 C10AA01 SIMVASTATINUM SIMVASTATINA SUN 10 mg COMPR. FILM. 10mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 3,98 0,142142 0,142142 0,127927549 C10AA01 SIMVASTATINUM SIMVACARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 4,01 0,143214 0,143214 0,128892550 C10AA01 SIMVASTATINUM SIMVASTATINA ALVOGEN 10 mg COMPR. FILM. 10mg ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 9,37 0,312333 0,194193 0,174773551 C10AA01 SIMVASTATINUM SIMGAL® 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 4,01 0,143214 0,143214 0,128892552 C10AA01 SIMVASTATINUM SIMVASTATINA TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 4,28 0,142666 0,142666 0,128399553 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 4,93 0,164333 0,164333 0,147899554 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 10 mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 9,35 0,311666 0,194193 0,174773555 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 8,81 0,293666 0,194193 0,174773556 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 20 mg COMPR. FILM. 20 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 16,55 0,591071 0,388386 0,349547557 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 20 mg COMPR. FILM. 20mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 17,75 0,591666 0,388386 0,349547558 C10AA01 SIMVASTATINUM ZEPLAN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM P-6L 28 16,56 0,591428 0,388386 0,349547559 C10AA01 SIMVASTATINUM ZOCOR 20 mg COMPR. FILM. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 14 12,74 0,910000 0,388386 0,349547560 C10AA01 SIMVASTATINUM ZOCOR 20 mg COMPR. FILM. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 28 25,45 0,908928 0,388386 0,349547561 C10AA01 SIMVASTATINUM SINTENAL 20 mg COMPR. FILM. 20mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 17,69 0,589666 0,388386 0,349547562 C10AA01 SIMVASTATINUM VASILIP 20 mg COMPR. FILM. 20mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L 28 16,55 0,591071 0,388386 0,349547563 C10AA01 SIMVASTATINUM SIMCOR 20 mg COMPR. FILM. 20mg ANTIBIOTICE SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 17,73 0,591000 0,388386 0,349547564 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 17,73 0,591000 0,388386 0,349547565 C10AA01 SIMVASTATINUM RANVOR 20 mg COMPR. FILM. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 7,90 0,564285 0,388386 0,349547566 C10AA01 SIMVASTATINUM RANVOR 20 mg COMPR. FILM. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. X 7 COMPR. FILM. P-6L 28 15,79 0,563928 0,388386 0,349547567 C10AA01 SIMVASTATINUM RANVOR 20 mg COMPR. FILM. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 14,05 0,468333 0,388386 0,349547568 C10AA01 SIMVASTATINUM SIMVASTATINA SUN 20 mg COMPR. FILM. 20mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 6,58 0,235000 0,235000 0,211500569 C10AA01 SIMVASTATINUM SIMVACARD 20 mg COMPR. FILM. 20mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 6,63 0,236785 0,236785 0,213106570 C10AA01 SIMVASTATINUM SIMVASTATINA ALVOGEN 20 mg COMPR. FILM. 20mg ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 16,84 0,561333 0,388386 0,349547571 C10AA01 SIMVASTATINUM SIMGAL® 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 6,63 0,236785 0,236785 0,213106572 C10AA01 SIMVASTATINUM SIMVASTATINA TEVA 20 mg COMPR. FILM. 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 7,10 0,236666 0,236666 0,212999573 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 11,16 0,372000 0,372000 0,334800574 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 20 mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 14,05 0,468333 0,388386 0,349547575 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 14,87 0,495666 0,388386 0,349547576 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 30 mg COMPR. FILM. 30mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 21,09 0,703000 0,582581 0,524322577 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 40 mg COMPR. FILM. 40 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 29,88 1,067142 0,776774 0,699096578 C10AA01 SIMVASTATINUM VASILIP (R) 40 mg COMPR. FILM. 40mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 7 COMPR. FILM P-6L 28 29,86 1,066428 0,776774 0,699096579 C10AA01 SIMVASTATINUM ZOCOR FORTE COMPR. FILM. 40mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 28 44,47 1,588214 0,776774 0,699096580 C10AA01 SIMVASTATINUM ZOCOR FORTE COMPR. FILM. 40mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 14 22,99 1,642142 0,776774 0,699096

Pagina 12 din 27

Page 103: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti581 C10AA01 SIMVASTATINUM ZEPLAN (R) 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 29,88 1,067142 0,776774 0,699096582 C10AA01 SIMVASTATINUM SINTENAL 40 mg COMPR. FILM. 40mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 31,99 1,066333 0,776774 0,699096583 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 40 mg COMPR. FILM. 40mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 31,99 1,066333 0,776774 0,699096584 C10AA01 SIMVASTATINUM SIMCOR 40 mg COMPR. FILM. 40mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 31,99 1,066333 0,776774 0,699096585 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 40 mg COMPR. FILM. 40mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 31,99 1,066333 0,776774 0,699096586 C10AA01 SIMVASTATINUM RANVOR 40 mg COMPR. FILM. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 2 BLIST. X 7 COMPR. FILM. P-6L 14 15,01 1,072142 0,776774 0,699096587 C10AA01 SIMVASTATINUM RANVOR 40 mg COMPR. FILM. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 23,14 0,771333 0,771333 0,694199588 C10AA01 SIMVASTATINUM SIMVASTATINA SUN 40 mg COMPR. FILM. 40mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 9,06 0,323571 0,323571 0,291213589 C10AA01 SIMVASTATINUM SIMVASTATINA ALVOGEN 40 mg COMPR. FILM. 40mg ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 23,14 0,771333 0,771333 0,694199590 C10AA01 SIMVASTATINUM SIMVACARD 40 mg COMPR. FILM. 40mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 9,12 0,325714 0,325714 0,293142591 C10AA01 SIMVASTATINUM SIMGAL® 40 mg COMPR. FILM. 40mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 9,12 0,325714 0,325714 0,293142592 C10AA01 SIMVASTATINUM SIMVASTATINA TEVA 40 mg COMPR. FILM. 40mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. P6L 30 9,77 0,325666 0,325666 0,293099593 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 40 mg COMPR. FILM. 40mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 17,72 0,590666 0,590666 0,531599594 C10AA01 SIMVASTATINUM SIMVASTATIN ACTAVIS 40 mg COMPR. FILM. 40mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 23,11 0,770333 0,770333 0,693299595 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 40 mg COMPR. FILM. 40mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 25,79 0,859666 0,776774 0,699096596 C10AA01 SIMVASTATINUM SIMVASTATIN ACCORD 80 mg COMPR. FILM. 80mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC- PE- PVDC /AL X 30 COMPR. FILM. P-6L 30 56,17 1,872333 1,553549 1,398194597 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 10 BLIST. X 10 COMPR. P-6L 100 67,59 0,675900 0,258924 0,233031598 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-6L 10 14,44 1,444000 0,258924 0,233031599 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. X 10 COMPR. P-6L 30 20,79 0,693000 0,258924 0,233031600 C10AA02 LOVASTATINUM LOVASTATINA ARENA 20 mg COMPR. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 25,87 0,862333 0,258924 0,233031601 C10AA02 LOVASTATINUM MEDOSTATIN 40 mg COMPR. 40mg MEDOCHEMIE LTD. CIPRU CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 47,66 1,588666 0,517849 0,466064602 C10AA03 PRAVASTATINUM PRAVATOR 20 mg COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. AL/PVC X 7 COMPR. P-6L 28 22,45 0,801785 0,388386 0,349547603 C10AA03 PRAVASTATINUM PRAVATOR 40 mg COMPR. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PE-AL-PVC/AL X 7 COMPR. P-6L 28 35,52 1,268571 0,776774 0,699096604 C10AB05 FENOFIBRATUM LIPOFIB 160 mg CAPS. 160mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 26,89 0,896333 0,799949 0,719954605 C10AB05 FENOFIBRATUM FENOLIP 160 mg CAPS. 160mg PHARMASWISS CESKA REPUBLIKA S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 30 CAPS. P6L 30 26,44 0,881333 0,799949 0,719954606 C10AB05 FENOFIBRATUM LIPIVIM CAPS. PULB. MICRONIZATA 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 26,43 0,881000 0,881000 0,792900607 C10AB05 FENOFIBRATUM LIPANTIL NANO 145 mg COMPR. FILM. 145mg LAB. FOURNIER S.A. FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 34,74 1,158000 0,724954 0,652458608 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. FILM. ELIB. MODIF. 160mg LAB. FOURNIER SA FRANTA CUTIE X 1 BLIST. PVC- PE-PVDC/AL X 10 COMPR. FILM. CU ELIB. MOD. P-6L 10 13,81 1,381000 0,799949 0,719954609 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. FILM. ELIB. MODIF. 160mg LAB. FOURNIER SA FRANTA CUTIE X 3 BLIST. PVC- PE-PVDC/AL X 10 COMPR. FILM. CU ELIB. MOD. P-6L 30 40,04 1,334666 0,799949 0,719954610 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 6,83 6,830000 6,455999 5,810399611 D06BB03 ACICLOVIRUM ACICLOVIR 50mg/g CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 15 G CREMA P-RF 1 7,60 7,600000 6,185250 5,566725612 D06BB03 ACICLOVIRUM ZOVIRAX CREMA 5% THE WELLCOME FOUNDATION LTD. MAREA BRITANIE CUTIE X 1 TUB X 5G CREMA P-RF 1 21,06 21,060000 2,061750 1,855575613 D06BB03 ACICLOVIRUM ACICLOVIR 50mg/g CREMA 5% GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 5 G CREMA P-RF 1 4,98 4,980000 2,061750 1,855575614 D06BB03 ACICLOVIRUM ACICLOVIR HYPERION CREMA 50mg/g HYPERION S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 7,33 7,330000 6,185250 5,566725615 D06BB03 ACICLOVIRUM ACICLOVIR TIS 50mg/g CREMA 50mg/g TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB DIN PEJD X 15 G CREMA P-RF 1 4,70 4,700000 4,700000 4,230000616 D06BB03 ACICLOVIRUM ACICLOVIR SLAVIA 50 mg/g CREMA 50mg/g SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA P-RF 1 6,72 6,720000 6,185250 5,566725617 D06BB03 ACICLOVIRUM ACICLOVIR TERAPIA 50 mg/g CREMA 50mg/g TERAPIA S.A. ROMANIA CUTIE CU 1 TUB DIN AL X 15 G CREMA PRF 1 6,72 6,720000 6,185250 5,566725618 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 15 G CREMA PRF 1 7,60 7,600000 6,185250 5,566725619 D06BB03 ACICLOVIRUM ACICLOVIR SLAVIA 50 mg/g CREMA 50mg/g SLAVIA PHARM S.R.L. ROMANIA CUTIE CU 1 TUB AL X 5 G CREMA P-RF 1 5,39 5,390000 2,061750 1,855575620 D06BB03 ACICLOVIRUM ACICLOVIR-RICHTER 50mg/g CREMA 50mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 TUB AL X 5 G CREMA PRF 1 4,98 4,980000 2,061750 1,855575621 D07AA02 HYDROCORTISONUM HIDROCORTIZON 1% UNGUENT 1% ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 7,40 7,400000 7,400000 6,660000622 D07AC01 BETAMETHASONUM EKARZIN 0,5MG/G CREMA 0,5mg/g ANTIBIOTICE S.A. ROMANIA CUTIE X 1 TUB DIN AL X 15 G CREMA P-RF 1 7,40 7,400000 7,400000 6,660000623 D07AC01 BETAMETHASONUM BETADERM 1 mg/g CREMA 1mg/g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 5,96 5,960000 3,570000 3,213000624 D07AC01 BETAMETHASONUM BETADERM 1mg/g UNGUENT 1mg/g E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 5,96 5,960000 3,570000 3,213000625 G01AF04 MICONAZOLUM GYNOZOL 200 CAPS. VAG. 200mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 2 BLIST. X 3 CAPS. VAG. MOI P-RF 6 5,96 0,993333 0,993333 0,893999626 G01AF04 MICONAZOLUM GYNOZOL 400 CAPS. VAG. 400mg PHARCO IMPEX 93 S.R.L. ROMANIA CUTIE X 1 BLIST. X 3 CAPS. VAG. MOI P-RF 3 5,72 1,906666 1,906666 1,715999627 G02AB03 ERGOMETRINUM MALEAT DE ERGOMETRINA ZENTIVA 0,2 mg/ml SOL. INJ. 0,2mg/ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL. INJ., CU INEL DE RUPERE P-RF 5 7,13 1,426000 1,426000 1,283400628 G03BA03 TESTOSTERONUM* UNDESTOR TESTOCAPS 40 mg CAPS. MOI 40mg N.V. ORGANON OLANDA CUTIE X 6 PLICURI DIN PES-AL-PE X 1 BLIST. AL/PVC X 10 CAPS. MOI P-RF 60 47,33 0,788833 0,788833 0,709949629 G03BA03 TESTOSTERONUM* ANDROGEL 50 mg GEL 50mg LAB. BESINS INTERNATIONAL FRANTA CUTIE X 30 PLICURI DIN FOLIE PET/AL/PE X 5 G GEL P-RF 30 223,35 7,445000 6,444749 5,800274

Pagina 13 din 27

Page 104: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti630 G03BA03 TESTOSTERONUM* TESTIM 50 mg GEL TRANSDERMIC 50mg FERRING GMBH GERMANIA CUTIE CU 30 TUBURI DIN AL X 5 G GEL TRANSDERMIC PR/PRF 30 183,34 6,111333 6,111333 5,500199631 G03BA03 TESTOSTERONUM* NEBIDO 1000 mg/4 ml SOL. INJ. 1000mg/4ml BAYER PHARMA AG GERMANIA CUTIE X 1 FIOLA X 4 ML SOL. INJ. S/P-RF 1 452,72 452,720000 452,720000 407,448000632 G03CA03 ESTRADIOLUM* ESTREVA (R) GEL 0,1% LAB. THERAMEX MONACO CUTIE X 1 FLACON PE, INCHIS CU POMPA DOZATOARE X 50 G P-6L 1 29,40 29,400000 9,998190 8,998371633 G03CA03 ESTRADIOLUM* OESTROGEL 0,6 mg/g GEL 0,6mg/g LABORATOIRES BESINS INTERNATIONAL FRANTA CUTIE CU 1 TUB AL X 80 G GEL + DISPOZITIV DE DOZARE DIN POLISTIREN P-6L 1 16,61 16,610000 9,598263 8,638436634 G03CA03 ESTRADIOLUM* CLIMARA PLASTURE TRANSDERM. 50µg/24ore BAYER PHARMA AG GERMANIA CUTIE X 4 PLICURI X 1 PLASTURE TRANSDERM. P-6L 4 29,89 7,472500 7,472500 6,725250635 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 1mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 10,18 0,339333 0,189482 0,170533636 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 1mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 10,18 0,339333 0,189482 0,170533637 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 17,07 0,569000 0,378964 0,341067638 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 2mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 17,07 0,569000 0,378964 0,341067639 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L 30 30,86 1,028666 0,757928 0,682135640 G04CAN1 DOXAZOSINUM KAMIREN (vezi G04CAN1) COMPR. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. PVC-PVDE/AL X 10 COMPR. P-6L 30 30,86 1,028666 0,757928 0,682135641 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL-PVDC X 14 COMPR. ELIB. PREL. P-6L 28 46,49 1,660357 0,757928 0,682135642 G04CAN1 DOXAZOSINUM CARDURA XL 4 mg (vezi G04CAN1) COMPR. ELIB. MODIF. 4mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. PVC-PVDC/AL-PVDC X 14 COMPR. ELIB. PREL. P-6L 28 46,49 1,660357 0,757928 0,682135643 G04CAN1 DOXAZOSINUM KAMIREN XL 4 mg (vezi C02CA04) COMPR. FILM. ELIB. PREL. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. CU ELIB. PREL. P-6L 30 37,34 1,244666 0,757928 0,682135644 G04CAN1 DOXAZOSINUM KAMIREN XL 4 mg (vezi C02CA04) COMPR. FILM. ELIB. PREL. 4mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. CU ELIB. PREL. P-6L 30 37,34 1,244666 0,757928 0,682135645 H02AB04 METHYLPREDNISOLONUM* LEMOD SOLU 125 mg LIOF. PT. SOL. INJ. 125mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 8,81 8,810000 8,282500 7,454250646 H02AB04 METHYLPREDNISOLONUM* LEMOD SOLU 500 mg LIOF. PT. SOL. INJ. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 7,8 ML S/P-RF 1 31,02 31,020000 31,020000 27,918000647 H02AB04 METHYLPREDNISOLONUM* SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV P-RF 1 20,48 20,480000 16,565000 14,908500648 H02AB07 PREDNISONUM PREDNISON MCC 5 mg COMPR. 5mg MAGISTRA C&C S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 2,65 0,132500 0,087333 0,078599649 H02AB07 PREDNISONUM PREDNISON ARENA 5 mg COMPR. 5mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 2,62 0,087333 0,087333 0,078599650 H02AB07 PREDNISONUM PREDNISON 5 mg COMPR. 5mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 3,71 0,123666 0,087333 0,078599651 H02AB07 PREDNISONUM PREDNISON - RICHTER 5 mg COMPR. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 2,57 0,128500 0,087333 0,078599652 H02AB09 HYDROCORTISONUM* HYDROCORTISONE ROUSSEL COMPR. 10mg CN UNIFARM ROMANIA CUTIE X 1 FLAC. 25 COMPR. PRF 25 12,20 0,488000 0,488000 0,439200653 H02AB09 HYDROCORTISONUM* HYDROCORTISONE SUCCINAT SODIC LIOF. + SOLV. PT. SOL. INJ. 100mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU LIOF. PT. SOL. INJ. + 1 FIOLA SOLV. X 2 ML S/P-RF 1 3,91 3,910000 3,527999 3,175199654 H02AB09 HYDROCORTISONUM* HIDROCORTIZON HF 500 mg PULB. + SOLV. PT. SOL. INJ./PERF. 500mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 20 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DIN ALUMINIU, CONTINAND PULB. PT. SOL. INJ./PERF. SI 1 FIOLA CU 4 ML SOLV. PR/PRF 1 11,91 11,910000 11,910000 10,719000655 H02AB09 HYDROCORTISONUM* HIDROCORTIZON HF 100 mg PULB. SI SOLV. PT. SOL. INJ./PERF. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA, CU CAPACITATEA DE 5 ML, INCHIS CU DOP DIN CAUCIUC GRI, ETANSAT CU CAPSA DE ALUMINIU, CONTINAND PULB. PT. SOL.INJ./PERF. SI O FIOLA CU 2 ML SOLV. PR/PRF 1 7,09 7,090000 3,527999 3,175199656 H02AB09 HYDROCORTISONUM* HIDROCORTIZON HEMISUCCINAT SOL. INJ. I.V. 25mg/5ml ZENTIVA S.A. ROMANIA CUTIE X 5 FIOLE X 1 ML SOL. A + 5 FIOLE X 4 ML SOL. B S/P-RF 5 21,33 4,266000 0,881999 0,793799657 J01AA02 DOXYCYCLINUM DOXICICLINA ATB 100 mg CAPS. 100 mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 4,01 0,401000 0,342900 0,308610658 J01AA02 DOXYCYCLINUM DOXICICLINA ARENA CAPS. 100mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,00 0,350000 0,342900 0,308610659 J01AA02 DOXYCYCLINUM DOXICICLINA SANDOZ 100 mg CAPS. 100mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3,61 0,361000 0,342900 0,308610660 J01AA02 DOXYCYCLINUM UNIDOX SOLUTAB COMPR. DISP. 100mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 1 BLIST. DIN AL/PVC X 10 COMPR.DISP. P-RF 10 6,83 0,683000 0,342900 0,308610661 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,95 0,297500 0,297500 0,267750662 J01CA04 AMOXICILLINUM AMOXICILINA ANTIBIOTICE 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6,93 0,346500 0,311849 0,280664663 J01CA04 AMOXICILLINUM OSPAMOX 250 mg CAPS. 250mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL-PVC/PVDC X 6 CAPS. P-RF/S 12 4,44 0,370000 0,311849 0,280664664 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 6,15 0,307500 0,307500 0,276750665 J01CA04 AMOXICILLINUM AMOXICILINA ANTIBIOTICE 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 5,86 0,586000 0,479374 0,431436666 J01CA04 AMOXICILLINUM AMOXICILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 5,92 0,592000 0,479374 0,431436667 J01CA04 AMOXICILLINUM AMOXICILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 8,81 0,440500 0,440500 0,396450668 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS. P-RF 10 5,69 0,569000 0,479374 0,431436669 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 4,92 0,492000 0,479374 0,431436670 J01CA04 AMOXICILLINUM OSPAMOX 1000 mg COMPR. FILM. 1000mg SANDOZ GMBH AUSTRIA CUTIE 2 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 12 11,63 0,969166 0,958749 0,862874671 J01CA04 AMOXICILLINUM OSPAMOX 500 mg COMPR. FILM. 500mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF 12 5,69 0,474166 0,474166 0,426749672 J01CA04 AMOXICILLINUM AMOXICILINA TERAPIA 1 g COMPR. PT. DISP. ORALA 1g TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 7 COMPR. PT. DISP. ORALA P-RF 21 19,41 0,924285 0,924285 0,831856673 J01CA04 AMOXICILLINUM DUOMOX 1000 mg COMPR. PT. DISPERSIE ORALA 1000mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 23,77 1,188500 0,958749 0,862874674 J01CA04 AMOXICILLINUM DUOMOX 250 mg COMPR. PT. DISPERSIE ORALA 250mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 10,12 0,506000 0,311849 0,280664675 J01CA04 AMOXICILLINUM DUOMOX 500 mg COMPR. PT. DISPERSIE ORALA 500mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 14,76 0,738000 0,479374 0,431436676 J01CA04 AMOXICILLINUM DUOMOX 750 mg COMPR. PT. DISPERSIE ORALA 750mg ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 19,75 0,987500 0,719061 0,647154677 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA CONTINAND 20 G PULB PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 5,73 5,730000 1,871099 1,683989678 J01CA04 AMOXICILLINUM OSPAMOX (R) 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 5,1 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 4,55 4,550000 1,871099 1,683989

Pagina 14 din 27

Page 105: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti679 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 250 mg/ 5 ml PULB. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. X 20 G PULB. PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE PE, CU GRADATII PT. 1,25 P-RF 1 4,88 4,880000 3,742199 3,367979680 J01CA04 AMOXICILLINUM OSPAMOX 250 mg/5 ml PULB. PT. SUSP. ORALA 250mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 6,6 G PULB. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 4,88 4,880000 3,742199 3,367979681 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 1000 COMPR. FILM. 1000000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 3,47 0,289166 0,289166 0,260249682 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN® 1500 COMPR. FILM. 1500000ui SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. AL/PVC-PVDC X 6 COMPR. FILM. P-RF 12 6,10 0,508333 0,440718 0,396646683 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN (R) 500 COMPR. FILM. 500000ui SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. AL/PVC-PVDC X 12 COMPR. FILM. P-RF 12 2,62 0,218333 0,146906 0,132215684 J01CE02 PHENOXYMETHYLPENICILLINUM OSPEN 400.000 U.I./5 ml SUSP. ORALA 400.000U.I./5ml SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 60 ML SUSP. ORALA CU CAPAC SI LINGURITA DOZATOARE P-RF 1 8,63 8,630000 0,195874 0,176286685 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M. P-RF 1 5,39 5,390000 4,338799 3,904919686 J01CE08 BENZATHINI BENZYLPENICILLINUM MOLDAMIN 1200000 UI PULB. PT. SUSP. INJ. 1200000UI ANTIBIOTICE S.A. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SUSP. INJ. I.M. S/P-RF 100 451,96 4,519600 4,338799 3,904919687 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,10 0,355000 0,296110 0,266499688 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,55 0,377500 0,296110 0,266499689 J01CF04 OXACILLINUM OXACILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,70 0,385000 0,296110 0,266499690 J01CF04 OXACILLINUM OXACILINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 7,50 0,750000 0,592220 0,532998691 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 6,19 0,619000 0,592220 0,532998692 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 11,17 0,558500 0,558500 0,502650693 J01CF04 OXACILLINUM OXACILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 7,04 0,704000 0,592220 0,532998694 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 1 5,33 5,330000 5,117650 4,605885695 J01CF04 OXACILLINUM OXACILINA ATB 1000 mg PULB. PT. SOL. INJ./PERF. 1000mg ANTIBIOTICE SA ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 100 448,06 4,480600 4,480600 4,032540696 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 1 4,92 4,920000 2,558825 2,302942697 J01CF04 OXACILLINUM OXACILINA ATB 500 mg PULB. PT. SOL. INJ./PERF. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. PRF 100 418,89 4,188900 2,558825 2,302942698 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 500 mg PULB. PT. SOL. INJ./PERF. I.M./I.V. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF/S 100 418,89 4,188900 2,558825 2,302942699 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 500 mg PULB. PT. SOL. INJ./PERF. I.M./I.V. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF 1 4,92 4,920000 2,558825 2,302942700 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 1 g PULB. PT. SOL. INJ./PERF.I.M./I.V. 1g ANTIBIOTICE SA ROMANIA CUTIE X 100 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF/S 100 448,06 4,480600 4,480600 4,032540701 J01CF04 OXACILLINUM OXACILINA ANTIBIOTICE 1 g PULB. PT. SOL. INJ./PERF.I.M./I.V. 1g ANTIBIOTICE SA ROMANIA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ./PERF. I.M./I.V. P-RF 1 5,33 5,330000 5,117650 4,605885702 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN SR 1000 mg/62,5 mg COMPR. ELIB. PREL. 1000mg/62,5mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE CU 7 BLIST. AL/PVC-AL X 4 COMPR. ELIB. PREL. P-RF 28 44,84 1,601428 1,548214 1,393392703 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 1000 mg COMPR. FILM. 1000mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 2 BLIST. AL/AL X 7 COMPR.FILM. P-RF 14 39,13 2,795000 1,354687 1,219218704 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM ENHANCIN 500 mg/125mg COMPR. FILM. 500 mg/125 mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 4 FOLII AL-PEJD X 7 COMPR. FILM. P-RF 28 33,07 1,181071 0,774107 0,696696705 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 500/125 mg COMPR. FILM. 500/125mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 10,83 0,773571 0,773571 0,696213706 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 500 mg/125 mg COMPR. FILM. 500mg/125mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE CU 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTO P-RF 14 15,32 1,094285 0,774107 0,696696707 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 500 mg/125 mg COMPR. FILM. 500mg/125mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 9,95 0,710714 0,710714 0,639642708 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2 x 625 mg COMPR. FILM. 625mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 14 COMPR. FILM. P-RF 14 28,06 2,004285 0,774107 0,696696709 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXIPLUS 875 mg/125 mg COMPR. FILM. 875mg/125mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 18,97 1,355000 1,354687 1,219218710 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN 875 mg/125 mg COMPR. FILM. 875mg/125mg BEECHAM GROUP PLC MAREA BRITANIE CUTIE CU 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM., FIECARE BLISTER FIIND INTRODUS INTR-O PUNGA PROTECTO P-RF 14 26,35 1,882142 1,354687 1,219218711 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 875 mg/125 mg COMPR. FILM. 875mg/125mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 17,12 1,222857 1,222857 1,100571712 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 1000 mg COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE 1000mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 25,07 1,790714 1,354687 1,219218713 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV QUICKTAB 625 mg COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE 625mg BIOMEDIAL PHARMA S.R.L. ROMANIA CUTIE X 7 BLIST. AL/AL X 2 COMPR. PT. DISPERSIE ORALA/ORODISPERSABILE P-RF 14 16,53 1,180714 0,774107 0,696696714 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV 156,25 mg/5 ml PULB. PT. SUSP. ORALA 125mg+31,25/5ml MEDOCHEMIE LTD. CIPRU CUTIE X 1 FLAC. CU PULB. PT. 100ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 14,90 14,900000 5,815178 5,233660715 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 156,25mg/5ml PULB. PT. SUSP. ORALA 156,25mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 MG PULB. PT. 100 ML SUSP. ORALA P-RF 1 11,69 11,690000 5,815178 5,233660716 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM MEDOCLAV FORTE 312,5mg/5ml PULB. PT. SUSP. ORALA 250mg+62,5mg/5ml MEDOCHEMIE LTD. CIPRU CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 100 ML SUSP. P-RF 1 22,11 22,110000 11,630357 10,467321717 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2x PULB. PT. SUSP. ORALA 400mg+57mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 35 ML SUSP.ORALA + SERINGA DOZATOARE P-RF 1 6,46 6,460000 6,460000 5,814000718 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 2x PULB. PT. SUSP. ORALA 400mg+57mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU PULB. PT. 70 ML SUSP.ORALA + SERINGA DOZATOARE P-RF 1 12,93 12,930000 12,930000 11,637000719 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOXICILINA/ACID CLAVULANIC AUROBINDO 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 FLAC. PEID CARE CONTINE PULB. PT. SUSP. ORALA PT. OBTINEREA A 35 ML SUSP. RECONSTITUITA + 1 SERINGA DE POLISTIREN CU GRADATII LA INTERVALE DE 0,5 ML PRF 1 6,47 6,470000 6,470000 5,823000720 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + 1 SERINGA PT. ADM. ORALA P-RF 1 9,95 9,950000 6,513000 5,861700721 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 35 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 9,95 9,950000 6,513000 5,861700722 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN BIS 400 mg/57 mg/5 ml PULB. PT. SUSP. ORALA 400mg/57mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. 70 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 19,89 19,890000 13,026000 11,723400723 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AUGMENTIN (R) ES PULB. PT. SUSP. ORALA 600 mg/42,9mg/5ml SMITHKLINE BEECHAM PLC MAREA BRITANIE CUTIE X 1 FLACON DIN STICLA CU PULB. PT. 100 ML SUSP. ORALA + 1 MASURA DOZATOARE P-RF 1 34,30 34,300000 27,912857 25,121571724 J01CR02 AMOXICILLINUM + ACIDUM CLAVULANICUM AMOKSIKLAV 312,5mg/5ml PULB. PT.SUSP. ORALA 312,5mg/5ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. DIN STICLA BRUNA CU 25 G PULB. PT. 100 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 24,02 24,020000 11,630357 10,467321725 J01DB01 CEFALEXINUM CEFALEXINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 11,91 0,595500 0,450900 0,405810726 J01DB01 CEFALEXINUM CEFALEXINA ATB 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 12,02 0,601000 0,450900 0,405810727 J01DB01 CEFALEXINUM OSPEXIN (R) 250 mg CAPS. 250mg SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 CAPS. P-RF 12 7,15 0,595833 0,450900 0,405810

Pagina 15 din 27

Page 106: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti728 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ 250 mg CAPSULE CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 5,98 0,598000 0,450900 0,405810729 J01DB01 CEFALEXINUM CEFALEXINA ATB 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 10,51 1,051000 0,901800 0,811620730 J01DB01 CEFALEXINUM CEFALEXINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 9,00 0,900000 0,900000 0,810000731 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ CAPS. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 10,02 1,002000 0,901800 0,811620732 J01DB01 CEFALEXINUM OSPEXIN 1000 mg COMPR. FILM. 1000mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM. P-RF 12 15,79 1,315833 1,315833 1,184249733 J01DB01 CEFALEXINUM OSPEXIN 500 mg COMPR. FILM. 500mg SANDOZ GMBH AUSTRIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR.FILM. P-RF 12 11,88 0,990000 0,901800 0,811620734 J01DB01 CEFALEXINUM KEFLEX (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 6,19 6,190000 5,136250 4,622625735 J01DB01 CEFALEXINUM OSPEXIN (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 33 G GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA PP P-RF 1 7,61 7,610000 5,136250 4,622625736 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ 125 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 6,93 6,930000 5,136250 4,622625737 J01DB01 CEFALEXINUM KEFLEX (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 10,48 10,480000 10,272500 9,245250738 J01DB01 CEFALEXINUM CEFALEXIN SANDOZ 250 mg/5 ml GRANULE PENTRU SUSPENSIE ORALA GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 33 G PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 9,65 9,650000 9,650000 8,685000739 J01DB01 CEFALEXINUM OSPEXIN (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ GMBH AUSTRIA CUTIE X 1 FLAC. X 33G GRANULE PT. 60ML SUSP.+ LINGURITA DOZATOARE X 5ML P-RF 1 9,63 9,630000 9,630000 8,667000740 J01DB05 CEFADROXILUM CEXYL 250 mg CAPS. 250mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 18,55 1,855000 0,450900 0,405810741 J01DB05 CEFADROXILUM CEXYL 500 mg CAPS. 500mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 13,45 1,345000 0,901800 0,811620742 J01DB05 CEFADROXILUM CEFORAN 500 mg CAPS. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 13,02 1,302000 0,901800 0,811620743 J01DB05 CEFADROXILUM CEXYL 1000 mg COMPR. FILM. 1000mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. PVC/PVDC X 10. COMPR. FILM. P-RF 10 26,15 2,615000 1,803600 1,623240744 J01DB05 CEFADROXILUM CEXYL 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. CU GRAN PENTRU 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 12,05 12,050000 5,136250 4,622625745 J01DB05 CEFADROXILUM CEXYL 250 mg/5 ml GRAN. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. CU GRAN. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 22,42 22,420000 10,272500 9,245250746 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 14,28 1,428000 1,355400 1,219860747 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 250 mg COMPR. 250mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 14,28 1,428000 1,355400 1,219860748 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 250 mg COMPR. 250mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. PRF 10 10,80 1,080000 1,080000 0,972000749 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-AL-PA/AL X 10 COMPR. P-RF 10 30,12 3,012000 2,710800 2,439720750 J01DC02 CEFUROXIMUM CEFUROXIMA ANTIBIOTICE 500 mg COMPR. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 10 COMPR. P-RF 10 30,12 3,012000 2,710800 2,439720751 J01DC02 CEFUROXIMUM CEFUROXIMA AUROBINDO 500 mg COMPR. 500mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 10 COMPR. PRF 10 17,97 1,797000 1,797000 1,617300752 J01DC02 CEFUROXIMUM ZINNAT (R) 125 mg COMPR. FILM. 125mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 15,13 1,513000 1,324500 1,192050753 J01DC02 CEFUROXIMUM ZINNAT (R) 250 mg COMPR. FILM. 250mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X, 10 COMPR.FILM P-RF 10 16,61 1,661000 1,355400 1,219860754 J01DC02 CEFUROXIMUM ZINNAT (R) 500 mg COMPR. FILM. 500mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR.FILM P-RF 10 27,64 2,764000 2,710800 2,439720755 J01DC02 CEFUROXIMUM ZINNAT GRAN. PT. SUSP. ORALA 125mg/5ml GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA BRUNA CU GRANULE PT 50 ML SUSP. ORALA + PAHAR MENZURA A 20 ML SI LINGURIT P-RF 1 19,41 19,410000 13,245000 11,920500756 J01DC02 CEFUROXIMUM AXYCEF (R) 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PULB. PT. 70 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 17,66 17,660000 17,660000 15,894000757 J01DC04 CEFACLORUM CECLODYNE 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 16,07 1,607000 0,677700 0,609930758 J01DC04 CEFACLORUM CEFACLOR ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 15,16 1,516000 0,677700 0,609930759 J01DC04 CEFACLORUM CLORACEF (R) 250 CAPS. 250mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. X 8 CAPS. P-RF 16 21,40 1,337500 0,677700 0,609930760 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250 mg CAPS. 250mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 13,81 0,920666 0,677700 0,609930761 J01DC04 CEFACLORUM CECLODYNE FORTE 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 CAPS. P-RF 10 29,55 2,955000 1,355400 1,219860762 J01DC04 CEFACLORUM CLORACEF (R) FORTE 500 CAPS. 500mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. X 8 CAPS. P-RF 16 28,55 1,784375 1,355400 1,219860763 J01DC04 CEFACLORUM CEFACLOR ARENA 500 mg CAPS. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 27,89 2,789000 1,355400 1,219860764 J01DC04 CEFACLORUM CEFACLOR TERAPIA 500 mg CAPS. 500mg TERAPIA SA ROMANIA CUTIE CU 1 BLIST. PVC/PVDC-AL X 15 CAPS. P-RF 15 32,67 2,178000 1,355400 1,219860765 J01DC04 CEFACLORUM CECLOR MR 500 mg COMPR. CU ELIB. PREL. 500mg ACTAVIS GROUP HF ISLANDA CUTIE CU 1 BLIST. PVC-ACLAR/AL X 10 COMPR. CU ELIB. PREL. PRF 10 26,19 2,619000 1,355400 1,219860766 J01DC04 CEFACLORUM CECLOR MR 750 mg COMPR. CU ELIB. PREL. 750mg ACTAVIS GROUP HF ISLANDA CUTIE CU 1 BLIST. PVC-ACLAR/AL X 10 COMPR. CU ELIB. PREL. PRF 10 35,79 3,579000 2,033100 1,829790767 J01DC04 CEFACLORUM CEFACLOR TERAPIA MR 375 COMPR. ELIB. PREL. 375mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC/PVDC/AL X 10 COMPR. ELIB. PREL. P-RF 10 32,82 3,282000 1,016550 0,914895768 J01DC04 CEFACLORUM CEFACLOR TERAPIA MR 750 COMPR. ELIB. PREL. 750mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. PREL. P-RF 10 55,59 5,559000 2,033100 1,829790769 J01DC04 CEFACLORUM CECLODYNE (R) MR 375 mg COMPR. FILM. ELIB. MODIF. 375mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 35,49 3,549000 1,016550 0,914895770 J01DC04 CEFACLORUM CECLODYNE (R) MR 500 mg COMPR. FILM. ELIB. MODIF. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PE-ACLAR/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 46,90 4,690000 1,355400 1,219860771 J01DC04 CEFACLORUM CECLODYNE (R) MR 750 mg COMPR. FILM. ELIB. MODIF. 750mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. MODIF. P-RF 10 66,58 6,658000 2,033100 1,829790772 J01DC04 CEFACLORUM CECLOR (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 16,73 16,730000 9,933750 8,940375773 J01DC04 CEFACLORUM CEFACLOR TERAPIA 125mg/5ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN.PT. 75 ML SUSP.ORALA P-RF 1 12,39 12,390000 9,933750 8,940375774 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250mg/5ml GRAN. PT. SUSP. ORALA 250 mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 75 ML SUSP. ORALA P-RF 1 22,30 22,300000 19,867500 17,880750775 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250mg/5ml GRAN. PT. SUSP. ORALA 250 mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 100 ML SUSP. ORALA P-RF 1 29,74 29,740000 26,490000 23,841000776 J01DC04 CEFACLORUM CECLOR (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 33,16 33,160000 19,867500 17,880750

Pagina 16 din 27

Page 107: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti777 J01DC04 CEFACLORUM CLORACEF (R) 125 PULB. PT. SUSP. ORALA 125mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP.+ LINGURITA DOZATOARE P-RF 1 11,90 11,900000 9,933750 8,940375778 J01DC04 CEFACLORUM CEFAKLOR 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 9,09 9,090000 7,947000 7,152300779 J01DC04 CEFACLORUM CLORACEF (R) 250 PULB. PT. SUSP. ORALA 250mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP. + LINGURITA DOZATOARE P-RF 1 21,40 21,400000 19,867500 17,880750780 J01DC04 CEFACLORUM CEFAKLOR 250 mg/5 ml PULB. PT. SUSP. ORALA 250mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 16,53 16,530000 15,894000 14,304600781 J01DD08 CEFIXIMUM EFICEF 100 mg CAPS. 100mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 21,56 2,156000 1,846462 1,661815782 J01DD08 CEFIXIMUM EFICEF (R) 200 mg CAPS. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 34,77 3,477000 3,477000 3,129300783 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU UN BLISTER PVC-PVDC/AL X 5 COMPRIMATE FILMATE PRF 5 55,99 11,198000 7,385850 6,647265784 J01DD08 CEFIXIMUM XIFIA 400mg COMPR. FILM. 400mg INN-FARM D.O.O. SLOVENIA CUTIE CU 2 BLISTERE PVC-PVDC/AL A CATE 5 COMPRIMATE FILMATE PRF 10 101,25 10,125000 7,385850 6,647265785 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM TAGREMIN COMPR. 400mg/80mg ZENTIVA S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,72 0,386000 0,328950 0,296055786 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM COMPR. 400mg/80mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,40 0,370000 0,328950 0,296055787 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM CO - TRIM ELL COMPR. 400mg/80mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,04 0,352000 0,328950 0,296055788 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM BITRIM 400mg/80mg COMPR. 400mg/80mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,72 0,386000 0,328950 0,296055789 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM EPITRIM SUSP. ORALA 200mg/40mg /5ml E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 FLACON DIN STICLA BRUNA CU MASURA DOZATOARE X 100 ML P-RF 1 4,76 4,760000 4,760000 4,284000790 J01EE01 SULFAMETHOXAZOLUM + TRIMETHOPRIMUM SUMETROLIM SUSP. ORALA 25mg/5mg/ml EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLACON DIN STICLA BRUNA X 100 ML SUSP. ORALA + MASURA DOZATOARE P-RF 1 10,48 10,480000 4,366125 3,929512791 J01FA01 ERYTHROMYCINUM ERITROMAGIS 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 7,09 0,354500 0,354500 0,319050792 J01FA01 ERYTHROMYCINUM ERITROMICINA 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 9,60 0,480000 0,419400 0,377460793 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 8,44 0,422000 0,419400 0,377460794 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 9,60 0,480000 0,419400 0,377460795 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200mg/5ml PULB. PT. SUSP. ORALA 200mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. X 30G + PULB. PT. 60 ML SUSP. ORALA + O LIGURITA DOZATOARE P-RF 1 11,46 11,460000 11,460000 10,314000796 J01FA09 CLARITHROMYCINUM CLAXIRIT 500 mg COMPR. CU ELIB. PREL. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/PVDC//AL X 7 COMPR. CU ELIB. PREL. PRF 7 32,05 4,578571 2,097000 1,887300797 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. ELIB. PREL. 500mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR. ELIB. PREL. PRF 6 29,37 4,895000 2,097000 1,887300798 J01FA09 CLARITHROMYCINUM KLACID (R) COMPR. FILM. 250mg ABBOTT SPA ITALIA CUTIE X 1 BLIST. X 14 COMPR. FILM. P-RF 14 28,57 2,040714 1,048500 0,943650799 J01FA09 CLARITHROMYCINUM KLERIMED (R) 250 COMPR. FILM. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 16,69 1,192142 1,048500 0,943650800 J01FA09 CLARITHROMYCINUM KLABAX 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 14,67 1,047857 1,047857 0,943071801 J01FA09 CLARITHROMYCINUM FROMILID 250 COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-RF 14 16,69 1,192142 1,048500 0,943650802 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 250 mg COMPR. FILM. 250mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR) PRF 14 11,34 0,810000 0,810000 0,729000803 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF 14 11,36 0,811428 0,811428 0,730285804 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 10,20 0,728571 0,728571 0,655713805 J01FA09 CLARITHROMYCINUM KLERIMED (R) 500 COMPR. FILM. 500mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 32,62 2,330000 2,097000 1,887300806 J01FA09 CLARITHROMYCINUM KLABAX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 32,08 2,291428 2,097000 1,887300807 J01FA09 CLARITHROMYCINUM FROMILID 500 COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-RF 14 32,62 2,330000 2,097000 1,887300808 J01FA09 CLARITHROMYCINUM ROCLARIN 500 mg COMPR. FILM. 500mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 43,35 2,167500 2,097000 1,887300809 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF 20 53,31 2,665500 2,097000 1,887300810 J01FA09 CLARITHROMYCINUM CLARITROMICINA TEVA 500 mg COMPR. FILM. 500mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 14 COMPR. FILM. (AMBALAJ TIP CALENDAR) PRF 14 24,62 1,758571 1,758571 1,582713811 J01FA09 CLARITHROMYCINUM LEKOKLAR 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM. PRF 14 32,62 2,330000 2,097000 1,887300812 J01FA09 CLARITHROMYCINUM CLARITROMICINA AUROBINDO 500 mg COMPR. FILM. 500mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLSIT. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 22,16 1,582857 1,582857 1,424571813 J01FA09 CLARITHROMYCINUM KLABAX MR 500 mg COMPR. FILM. ELIB. MODIF. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC/PVDC-AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 33,15 4,735714 2,097000 1,887300814 J01FA09 CLARITHROMYCINUM KLACID SR COMPR. FILM. ELIB. PREL. 500mg ABBOTT LABORATORIES LTD. MAREA BRITANIE CUTIE X 1 BLIST. PVC-PVDC/AL X 5 COMPR. FILM. ELIB. PREL. P-RF 5 36,43 7,286000 2,097000 1,887300815 J01FA09 CLARITHROMYCINUM FROMILID (R) UNO COMPR. FILM. ELIB. PREL. 500mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 28,09 4,012857 2,097000 1,887300816 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA ITALIA CUTIE X 1 FLACON PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML P-RF 1 39,14 39,140000 26,085000 23,476500817 J01FA09 CLARITHROMYCINUM KLACID (R) GRAN. PT. SUSP. ORALA 125mg/5ml ABBOTT SPA ITALIA CUTIE X 1 FLACON PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML P-RF 1 24,48 24,480000 15,651000 14,085900818 J01FA09 CLARITHROMYCINUM FROMILID (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. P-RF 1 23,30 23,300000 15,651000 14,085900819 J01FA09 CLARITHROMYCINUM LEKOKLAR 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ SRL ROMANIA CUTIE X 1 FLAC. PEID CU 41 G GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PP P-RF 1 26,21 26,210000 15,651000 14,085900820 J01FA09 CLARITHROMYCINUM KLABAX 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 18,94 18,940000 15,651000 14,085900821 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 51,09 51,090000 51,090000 45,981000822 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 31,68 31,680000 31,302000 28,171800823 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA PRF 1 28,78 28,780000 28,780000 25,902000824 J01FA09 CLARITHROMYCINUM KLACID I.V. LIOF. PT. SOL. PERF. 500mg ABBOTT LABORATORIES LTD. FRANTA CUTIE X 1 FLAC. LIOF. PT. SOL. PERF. S/P-RF 1 53,78 53,780000 25,576250 23,018625825 J01MA01 OFLOXACINUM ZANOCIN COMPR. FILM. 200mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 11,36 1,136000 1,136000 1,022400

Pagina 17 din 27

Page 108: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti826 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 20,02 2,002000 1,189800 1,070820827 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 37,31 3,731000 0,237960 0,214164828 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 100 mg COMPR. FILM. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 65,61 3,280500 0,237960 0,214164829 J01MA02 CIPROFLOXACINUM CIPROCIN 250 mg COMPR. FILM. 250mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 6,83 0,683000 0,594900 0,535410830 J01MA02 CIPROFLOXACINUM CIPRINOL 250 mg COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 6,83 0,683000 0,594900 0,535410831 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 250 mg COMPR. FILM. 250mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 6,83 0,683000 0,594900 0,535410832 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 6,83 0,683000 0,594900 0,535410833 J01MA02 CIPROFLOXACINUM CUMINOL 250 mg COMPR. FILM. 250mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 12,30 0,615000 0,594900 0,535410834 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 250mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 6,93 0,693000 0,594900 0,535410835 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 6,56 0,656000 0,594900 0,535410836 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 12,30 0,615000 0,594900 0,535410837 J01MA02 CIPROFLOXACINUM CIPRINOL 500 mg COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 13,22 1,322000 1,189800 1,070820838 J01MA02 CIPROFLOXACINUM CIPROCIN 500 mg COMPR. FILM. 500mg E.I.P.I.CO. MED S.R.L. ROMANIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 13,22 1,322000 1,189800 1,070820839 J01MA02 CIPROFLOXACINUM CIPROLEN (R) 500 mg COMPR. FILM. 500mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 13,22 1,322000 1,189800 1,070820840 J01MA02 CIPROFLOXACINUM CUMINOL 500 mg COMPR. FILM. 500mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 13,22 1,322000 1,189800 1,070820841 J01MA02 CIPROFLOXACINUM CIFRAN COMPR. FILM. 500mg RANBAXY UK LIMITED MAREA BRITANIE CUTIE X 1 BLIST. PVC/PVDC-AL X 10 COMPR. FILM. P-RF 10 8,78 0,878000 0,878000 0,790200842 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 13,22 1,322000 1,189800 1,070820843 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 9,23 0,923000 0,923000 0,830700844 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 16,43 0,821500 0,821500 0,739350845 J01MA02 CIPROFLOXACINUM CIPRINOL 750 mg COMPR. FILM. 750mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 BLIST. AL/PVC-PVDC X 10 COMPR. FILM. P-RF 10 38,50 3,850000 1,784700 1,606230846 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA ARENA 750 mg COMPR. FILM. 750mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 37,31 3,731000 1,784700 1,606230847 J01MA02 CIPROFLOXACINUM CIPROBAY XR 1000 mg COMPR. FILM. ELIB. PREL. 1000 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 84,70 12,100000 2,379600 2,141640848 J01MA02 CIPROFLOXACINUM CIPROBAY XR 500 mg COMPR. FILM. ELIB. PREL. 500 mg BAYER PHARMA AG GERMANIA CUTIE X 1 BLIST. DIN PP/AL X 3 COMPR. FILM. ELIB. PREL. P-RF 3 27,63 9,210000 1,189800 1,070820849 J01MA03 PEFLOXACINUM PEFLOXACIN LAROPHARM COMPR. FILM. 400mg LAROPHARM S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 27,86 2,786000 1,189800 1,070820850 J01MA06 NORFLOXACINUM NORFLOXACINA LPH 400 mg COMPR. FILM. 400mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 20 15,73 0,786500 0,786500 0,707850851 J01MA06 NORFLOXACINUM NOLICIN 400 mg COMPR. FILM. 400mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 17,60 0,880000 0,856625 0,770962852 J01MA06 NORFLOXACINUM NOR QUIN 400 mg COMPR. FILM. 400mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-RF/S 20 17,60 0,880000 0,856625 0,770962853 J01MA06 NORFLOXACINUM NORFLOXACIN HELCOR 400 mg COMPR. FILM. 400mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 17,60 0,880000 0,856625 0,770962854 J01MB02 ACIDUM NALIDIXICUM NALIXID 500 mg CAPS. 500mg ZENTIVA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-RF 30 29,29 0,976333 0,976333 0,878699855 J01XD01 METRONIDAZOLUM METRONIDAZOL ARENA 250 mg (J01XD01) COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 7,72 0,257333 0,257333 0,231599856 J01XD01 METRONIDAZOLUM METRONIDAZOL ARENA 250 mg (J01XD01) COMPR. 250mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 7,72 0,257333 0,257333 0,231599857 J01XD01 METRONIDAZOLUM FLAGYL ( vezi J01XD01) COMPR. FILM. 250mg LABORATOIRE AVENTIS FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 7,09 0,354500 0,297187 0,267468858 J01XD01 METRONIDAZOLUM FLAGYL ( vezi J01XD01) COMPR. FILM. 250mg LABORATOIRE AVENTIS FRANTA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 20 7,09 0,354500 0,297187 0,267468859 J01XD01 METRONIDAZOLUM METRONIDAZOL A 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 100,25 8,354166 8,354166 7,518749860 J01XD01 METRONIDAZOLUM METRONIDAZOL A 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML S/P-RF 1 9,11 9,110000 8,632083 7,768874861 J01XD01 METRONIDAZOLUM METRONIDAZOL B 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 12 FLACOANE X 200 ML S/P-RF 12 98,29 8,190833 8,190833 7,371749862 J01XD01 METRONIDAZOLUM METRONIDAZOL B 5 g/l SOL. PERF. 5g/l INFOMED FLUIDS SRL ROMANIA CUTIE X 1 FLACON X 200 ML S/P-RF 1 8,91 8,910000 8,632083 7,768874863 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN STICLA INCOLORA X 100 ML SOL. PERF. S/P-RF 10 48,92 4,892000 4,316041 3,884436864 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 10 FLAC. DIN PEJD X 100 ML SOL. PERF. S/P-RF 10 48,37 4,837000 4,316041 3,884436865 J01XD01 METRONIDAZOLUM METRONIDAZOL BRAUN 5mg/ml SOL. PERF. 5mg/ml B. BRAUN MELSUNGEN AG GERMANIA CUTIE X 20 FLAC. DIN PEJD X 100 ML SOL. PERF. S/P-RF 20 278,47 13,923500 4,316041 3,884436866 J02AC01 FLUCONAZOLUM FLUCOVIM 100 CAPS. 100mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 4 CAPS. P-RF 4 25,61 6,402500 3,978321 3,580488867 J02AC01 FLUCONAZOLUM FUNGOLON 100 mg CAPS. 100mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 2 BLIST. PVC/AL X 8 CAPS. P-RF 16 82,66 5,166250 3,978321 3,580488868 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 CAPS. P-RF 2 9,43 4,715000 3,978321 3,580488869 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 100 mg CAPS. 100mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 31,51 4,501428 3,978321 3,580488870 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 100 mg CAPS. 100mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 28,51 4,072857 3,978321 3,580488871 J02AC01 FLUCONAZOLUM FLUCOVIM 150 CAPS. 150mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 FLAC. X 1 CAPS. P-RF 1 9,94 9,940000 5,967481 5,370732872 J02AC01 FLUCONAZOLUM DIFLUCAN 150 mg CAPS. 150mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 25,08 25,080000 5,967481 5,370732873 J02AC01 FLUCONAZOLUM FLUCORIC 150 mg CAPS. 150mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 1 CAPS. P-RF 1 18,86 18,860000 5,967481 5,370732874 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 150 CAPS. 150mg SANDOZ SRL GERMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 14,58 14,580000 5,967481 5,370732

Pagina 18 din 27

Page 109: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti875 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 150 mg CAPS. 150mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 6,59 6,590000 5,967481 5,370732876 J02AC01 FLUCONAZOLUM FLUCONAZOL 150 mg CAPS. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 9,68 9,680000 5,967481 5,370732877 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 150 mg CAPS. 150mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 8,20 8,200000 5,967481 5,370732878 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 150 mg CAPS. 150mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 1 CAPS. P-RF 1 6,59 6,590000 5,967481 5,370732879 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 150 MG CAPS. 150mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 9,03 9,030000 5,967481 5,370732880 J02AC01 FLUCONAZOLUM MYCOSYST 150 mg CAPS. 150mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 4 BLIST. AL/PVC X 1 CAPS. P-RF 4 63,10 15,775000 5,967481 5,370732881 J02AC01 FLUCONAZOLUM FLUCONAZOL ACTAVIS 150 mg CAPS. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 CAPS. PRF 1 10,06 10,060000 5,967481 5,370732882 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 150 mg CAPS. 150mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 9,94 9,940000 5,967481 5,370732883 J02AC01 FLUCONAZOLUM FLUCONAZOL ROMPHARM 150 mg CAPS. 150mg ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 1 CAPS. PRF 1 12,94 12,940000 5,967481 5,370732884 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU 1 BLIST. PVC TRANSPARENT/PVDC-AL X 1 CAPS. PRF 1 6,01 6,010000 5,967481 5,370732885 J02AC01 FLUCONAZOLUM FLUCONAZOL ZENTIVA 150 mg CAPS. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE X 1 BLIST. AL/PVC X 1 CAPS. P-RF 1 12,03 12,030000 5,967481 5,370732886 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 200 mg CAPS. 200mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 39,37 5,624285 5,624285 5,061856887 J02AC01 FLUCONAZOLUM FLUCOVIM 50 CAPS. 50mg VIM SPECTRUM SRL ROMANIA CUTIE X 1 BLIST. X 7 CAPS. P-RF 7 22,56 3,222857 1,989160 1,790244888 J02AC01 FLUCONAZOLUM DIFLUCAN 50 mg CAPS. 50mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 56,54 8,077142 1,989160 1,790244889 J02AC01 FLUCONAZOLUM FLUCORIC 50 mg CAPS. 50mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. FOLIE PVC-PVDC/AL X 7 CAPS. P-RF 7 29,61 4,230000 1,989160 1,790244890 J02AC01 FLUCONAZOLUM FLUCONAZOL SANDOZ (R) 50 CAPS. 50mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 41,93 5,990000 1,989160 1,790244891 J02AC01 FLUCONAZOLUM FLUCONAZOLE TEVA 50 mg CAPS. 50mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 16,69 2,384285 1,989160 1,790244892 J02AC01 FLUCONAZOLUM FLUCONAZOL 50 mg CAPS. 50mg SLAVIA PHARM SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 19,58 2,797142 1,989160 1,790244893 J02AC01 FLUCONAZOLUM FLUCONAZOL MEDOCHEMIE 50 mg CAPS. 50mg MEDOCHEMIE ROMANIA SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 16,15 2,307142 1,989160 1,790244894 J02AC01 FLUCONAZOLUM FLUCONAZOL BIOGALENICA 50 mg CAPS. 50mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 CAPS. P-RF 7 15,76 2,251428 1,989160 1,790244895 J02AC01 FLUCONAZOLUM FLUCONAZOL ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 7 CAPS. P-RF 7 19,12 2,731428 1,989160 1,790244896 J02AC01 FLUCONAZOLUM FLUCONAZOL LPH 50 mg CAPS. 50mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 7 CAPS. PRF 7 22,56 3,222857 1,989160 1,790244897 J02AC01 FLUCONAZOLUM FLUCONAZOL AUROBINDO 50 mg CAPS. 50mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC TRANSPARENT/PVDC-AL X 7 CAPS. PRF 7 14,02 2,002857 1,989160 1,790244898 J02AC01 FLUCONAZOLUM DIFLUCAN 10 mg/ml PULB. PT. SUSP. ORALA 10mg/ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 1 FLAC. PEID, DE CAPACITATE 60 ML + 1 LINGURITA DOZATOARE A 5 ML, CU PULB. PT. 35 ML SUSP.O PRF 1 31,71 31,710000 13,924124 12,531711899 J02AC01 FLUCONAZOLUM DIFLAZON 2mg/ml SOL. PERF. 2mg/ml KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 1 FLACON DIN STICLA INCOLORA X 100 ML S/PR-F 1 45,82 45,820000 35,193375 31,674037900 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 20,23 1,011500 0,775350 0,697815901 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 21,42 1,071000 0,775350 0,697815902 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 21,42 1,071000 0,775350 0,697815903 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 19,48 1,948000 1,550700 1,395630904 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 17,15 0,857500 0,775350 0,697815905 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL./PVC X 10 COMPR. P-RF 20 17,23 0,861500 0,775350 0,697815906 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg COMPR. 200mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 4 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 20 13,81 0,690500 0,690500 0,621450907 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 17,23 0,861500 0,775350 0,697815908 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 17,23 0,861500 0,775350 0,697815909 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR. P-RF 10 27,18 2,718000 1,550700 1,395630910 J05AB01 ACICLOVIRUM VIROLEX PULB. PT. SOL. INJ./PERF. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 5 FLAC. X 250 MG PULB. PT. SOL. INJ./PERF. S/P-RF 5 282,97 56,594000 56,594000 50,934600911 M01AB01 INDOMETACINUM INDOMETACIN LAROPHARM 25 mg CAPS. 25mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST., PVC/AL, X 10 CAPS. P-6L 20 1,62 0,081000 0,079425 0,071482912 M01AB01 INDOMETACINUM INDOMETACIN ARENA 25 MG CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 2,14 0,071333 0,071333 0,064199913 M01AB01 INDOMETACINUM INDOMETACIN ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 3,53 0,176500 0,158850 0,142965914 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE AL-PE X 3 SUPOZ. P-6L 6 4,13 0,688333 0,380999 0,342899915 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 6,87 0,687000 0,380999 0,342899916 M01AB01 INDOMETACINUM INDOMETACIN 50 mg SUPOZ. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 6,59 0,659000 0,380999 0,342899917 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. ELIB. PREL. P-6L 20 47,70 2,385000 0,476550 0,428895918 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 20,49 0,683000 0,238275 0,214447919 M01AB05 DICLOFENACUM TRATUL 50 mg CAPS. MOI GASTROREZ. 50mg GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 CAPS. MOI GASTROREZ. P-6L 30 6,39 0,213000 0,158850 0,142965920 M01AB05 DICLOFENACUM DICLOTARD® 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL P-6L 20 8,54 0,427000 0,317700 0,285930921 M01AB05 DICLOFENACUM DICLAC (R) 75 ID COMPR. ELIB. MODIF. 75mg HEXAL AG GERMANIA CUTIE X 1 BLIST. AL/PP X 10 COMPR. ELIB. MODIF. P-6L 10 3,93 0,393000 0,238275 0,214447922 M01AB05 DICLOFENACUM VOLTAREN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL. P-6L 10 6,56 0,656000 0,317700 0,285930923 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 8,55 0,427500 0,317700 0,285930

Pagina 19 din 27

Page 110: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti924 M01AB05 DICLOFENACUM VOLTAREN (R) 50 COMPR. FILM. GASTROREZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L 20 6,56 0,328000 0,158850 0,142965925 M01AB05 DICLOFENACUM DICLOFENAC 50 mg COMPR. FILM. GASTROREZ. 50mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 4,25 0,212500 0,158850 0,142965926 M01AB05 DICLOFENACUM DICLOFENAC HELCOR 50 mg COMPR. FILM. GASTROREZ. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. GASTROREZ. P-6L 20 2,27 0,113500 0,113500 0,102150927 M01AB05 DICLOFENACUM VOLTAREN RAPID (R) DRAJ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L 10 2,34 0,234000 0,158850 0,142965928 M01AB05 DICLOFENACUM DICLOFENAC ARENA 25 mg DRAJ. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L 30 5,72 0,190666 0,079425 0,071482929 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 DRAJ GASTROREZ. P-6L 20 2,65 0,132500 0,132500 0,119250930 M01AB05 DICLOFENACUM DICLOFENAC ARENA 50 mg DRAJ. GASTROREZ. 50mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 30 DRAJ GASTROREZ. P-6L 30 3,98 0,132666 0,132666 0,119399931 M01AB05 DICLOFENACUM VOLTAREN (R) SOL. INJ. 25mg/ml NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 FIOLE CU PUNCT DE RUPERE X 3 ML P-RF 5 9,40 1,880000 1,210837 1,089753932 M01AB05 DICLOFENACUM TRATUL (R) SOL. INJ. 30mg/ml GEROT PHARMAZEUTIKA GES.M.B.H. AUSTRIA CUTIE X 1 BLIST PVC X 5 FIOLE DIN STICLA BRUNA X 3 ML SOL. INJ. P-RF 5 14,24 2,848000 1,453005 1,307704933 M01AB05 DICLOFENACUM DICLOFENAC 75 mg SOL. INJ. 75mg/3ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 3 MLP-RF 5 6,10 1,220000 1,210837 1,089753934 M01AB05 DICLOFENACUM REFEN 75 mg SOL. INJ./PERF. 25mg/ml STADA HEMOFARM S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA X 3 ML SOL. INJ./PERF. P-RF 5 4,05 0,810000 0,810000 0,729000935 M01AB05 DICLOFENACUM CLAFEN 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDANTE X 3 SUPOZ. P-6L 6 3,94 0,656666 0,656666 0,590999936 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 100mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 FOLIE PVC/PE-JD X 5 SUPOZ. P-6L 5 5,47 1,094000 0,761999 0,685799937 M01AB05 DICLOFENACUM DICLOFENAC 100 mg SUPOZ. 100mg SINTOFARM SA ROMANIA CUTIE X 2 FOLII PVC/PE X 5 SUPOZ. P-6L 10 6,95 0,695000 0,695000 0,625500938 M01AB05 DICLOFENACUM DICLOFENAC SODIC 100 mg SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII TERMOSUDATE PVC/PE X 5 SUPOZ. P-6L 10 6,38 0,638000 0,638000 0,574200939 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 12,5 mg SUPOZ. 12,5 mg SINTOFARM S.A. ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 3 SUPOZITOARE P6L 6 3,64 0,606666 0,095249 0,085724940 M01AB05 DICLOFENACUM DICLOFENAC SINTOFARM 12,5 mg SUPOZ. 12,5 mg SINTOFARM S.A. ROMANIA CUTIE X 2 FOLII TERMOSUDATE DIN PVC-PE X 5 SUPOZITOARE P6L 10 6,01 0,601000 0,095249 0,085724941 M01AB05 DICLOFENACUM VOLTAREN (R) SUPOZ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 FOLII PVC/PEJD X 5 SUPOZ. P-6L 10 9,45 0,945000 0,380999 0,342899942 M01AB15 KETOROLACUM TROMETHAMIN KETOROL COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 6,75 0,337500 0,105899 0,095309943 M01AB15 KETOROLACUM TROMETHAMIN KETANOV 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. FILM. P-6L 20 10,14 0,507000 0,105899 0,095309944 M01AB15 KETOROLACUM TROMETHAMIN KETANOV SOL. INJ. 30mg/ml TERAPIA SA ROMANIA CUTIE X 10 FIOLE X 1 ML P-RF 10 24,75 2,475000 1,614450 1,453005945 M01AB15 KETOROLACUM TROMETHAMIN KETOROL SOL. INJ. 30mg/ml DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. X 10 FIOLE DIN STICLA BRUNA X 1 ML SOL. INJ. P-RF 10 19,61 1,961000 1,614450 1,453005946 M01AB16 ACECLOFENACUM AFLAMIL 100mg COMPR. FILM. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR. P-6L 20 22,71 1,135500 0,158850 0,142965947 M01AC02 TENOXICAMUM TENOXICAM LPH 20 mg CAPS. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 11,45 0,572500 0,451350 0,406215948 M01AC02 TENOXICAMUM TENOXICAM ARENA 20 mg COMPR. 20mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 14,11 0,705500 0,451350 0,406215949 M01AC02 TENOXICAMUM NEO - ENDUSIX (R) COMPR. FILM. 20mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 1 BLIST. X 10 COMPR. FILM. P-6L 10 6,35 0,635000 0,451350 0,406215950 M01AC02 TENOXICAMUM NEO - ENDUSIX (R) LIOF. + SOLV. PT. SOL. INJ. 20mg ANFARM HELLAS S.A. PHARMACEUTICALS GRECIA CUTIE X 1 FLAC. PULB. + 1 FIOLA SOLV. P-RF 1 5,44 5,440000 1,768500 1,591650951 M01AC06 MELOXICAMUM MOVALIS (R) 15 mg COMPR. 15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 15,44 0,772000 0,451350 0,406215952 M01AC06 MELOXICAMUM MOVALIS (R) 15 mg COMPR. 15mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 10 7,70 0,770000 0,451350 0,406215953 M01AC06 MELOXICAMUM MELOXICAM LPH 15 mg COMPR. 15mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 10,03 0,501500 0,451350 0,406215954 M01AC06 MELOXICAMUM MELOXICAM SANDOZ 15 mg COMPR. 15mg HEXAL AG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 9,98 0,499000 0,451350 0,406215955 M01AC06 MELOXICAMUM RECOXA 15 COMPR. 15mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 6,92 0,346000 0,346000 0,311400956 M01AC06 MELOXICAMUM MELOXICAM MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 10,03 0,501500 0,451350 0,406215957 M01AC06 MELOXICAMUM VALZER 15 mg COMPR. 15mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 10,03 0,501500 0,451350 0,406215958 M01AC06 MELOXICAMUM NOFLAMEN 15 mg COMPR. 15mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X BLIST. OPA-AL-PVC/AL X 10 COMPR. P-6L 10 5,01 0,501000 0,451350 0,406215959 M01AC06 MELOXICAMUM NOFLAMEN 15 mg COMPR. 15mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X BLIST. OPA-AL-PVC/AL X 20 COMPR. P-6L 20 10,03 0,501500 0,451350 0,406215960 M01AC06 MELOXICAMUM MELOXICAM VIM SPECTRUM 15 mg COMPR. 15mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 10,03 0,501500 0,451350 0,406215961 M01AC06 MELOXICAMUM ASPIFLEX 15 mg COMPR. 15mg BMF PHARM S.R.L. ROMANIA CUTIE X 2, BLIST. PVC/AL X 10 COMPR. P-6L 20 10,03 0,501500 0,451350 0,406215962 M01AC06 MELOXICAMUM Meloxicam Zentiva 15 mg comprimate COMPR. 15mg ZENTIVA AS CEHIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 6,92 0,346000 0,346000 0,311400963 M01AC06 MELOXICAMUM MOVALIS (R) 7,5 mg COMPR. 7,5mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 10 7,41 0,741000 0,225675 0,203107964 M01AC06 MELOXICAMUM MOVALIS (R) 7,5 mg COMPR. 7,5mg BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 14,84 0,742000 0,225675 0,203107965 M01AC06 MELOXICAMUM MELOXICAM LPH 7,5 mg COMPR. 7,5mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-6L 20 9,65 0,482500 0,225675 0,203107966 M01AC06 MELOXICAMUM MELOXICAM SANDOZ 7,5 mg COMPR. 7,5mg HEXAL AG GERMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 9,65 0,482500 0,225675 0,203107967 M01AC06 MELOXICAMUM MELOXICAM MCC 7,5 mg COMPR. 7,5mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIAT. AL/PVC X 10 COMPR. P-6L 20 9,65 0,482500 0,225675 0,203107968 M01AC06 MELOXICAMUM VALZER 7,5mg COMPR. 7,5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 20 9,65 0,482500 0,225675 0,203107969 M01AC06 MELOXICAMUM MELOXICAM VIM SPECTRUM 7,5 mg COMPR. 7,5mg VIM SPECTRUM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 9,65 0,482500 0,225675 0,203107970 M01AC06 MELOXICAMUM ASPIFLEX 7,5 mg COMPR. 7,5mg BMF PHARM S.R.L. ROMANIA CUTIE X 2, BLIST. PVC/AL X 10 COMPR. P-6L 20 9,65 0,482500 0,225675 0,203107971 M01AC06 MELOXICAMUM MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ. 15mg/1,5ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 3 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ. PRF 3 5,89 1,963333 1,768500 1,591650972 M01AC06 MELOXICAMUM MELOXICAM ROMPHARM 15 mg/1,5 ml SOL INJ. 15mg/1,5ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA INCOLORA, PREVAZUTE CU INEL DE RUPERE, CU CAPACITATEA DE 2 ML CARE CONTIN 1,5 ML SOL. INJ. PRF 5 9,82 1,964000 1,768500 1,591650

Pagina 20 din 27

Page 111: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti973 M01AC06 MELOXICAMUM MELOX 15 mg/1,5 ml SOL. INJ. 10mg/ml MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC A 5 FIOLE TRANSPARENTE DIN STICLA CU CAPACITATEA DE 2 ML, CONTINAND 1,5 ML PRF 5 9,83 1,966000 1,768500 1,591650974 M01AC06 MELOXICAMUM MOVALIS 15mg/1,5ml SOL. INJ. 15mg/1,5ml BOEHRINGER INGELHEIM INTERNATIONAL GMBH GERMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1,5 ML SIL. INJ. P-RF 5 15,12 3,024000 1,768500 1,591650975 M01AC06 MELOXICAMUM MELOXICAM 15 mg SUPOZ. 15mg MAGISTRA C & C ROMANIA CUTII X 2 FOLII TERMOSUDATE PVC/PE X 3 SUPOZ. P-6L 6 9,46 1,576666 0,664200 0,597780976 M01AE03 KETOPROFENUM KETOPROFEN SR TERAPIA 100 MG CAPS. ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL. P-6L 10 11,93 1,193000 0,532049 0,478844977 M01AE03 KETOPROFENUM KETONAL (R) DUO 150 mg CAPS. ELIB. PREL. 150mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC-TE-PVDC X 10 CAPS. ELIB. PREL. P-6L 20 16,49 0,824500 0,798075 0,718267978 M01AE03 KETOPROFENUM KETONAL UNO CAPS. ELIB. PREL. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC-TE-PVDC X 10 CAPS. ELIB. PREL. P-6L 20 26,32 1,316000 1,064100 0,957690979 M01AE03 KETOPROFENUM KETOPROFEN SR TERAPIA 200 MG CAPS. ELIB. PREL. 200mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. CU ELIB. PREL. P-6L 10 15,13 1,513000 1,064100 0,957690980 M01AE03 KETOPROFENUM KETONAL RETARD COMPR. ELIB. PREL. 150mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. X 20 COMPR. CU ELIB. PREL. P-6L 20 15,02 0,751000 0,751000 0,675900981 M01AE03 KETOPROFENUM RUBIFEN 100 mg COMPR. FILM. 100 mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 9,03 0,451500 0,451500 0,406350982 M01AE03 KETOPROFENUM PROFENID (R) 100 mg COMPR. FILM. 100mg LAB. AVENTIS FRANTA CUTIE X 2 BLIST X 15 COMPR. FILM. P-6L 30 13,20 0,440000 0,440000 0,396000983 M01AE03 KETOPROFENUM KETONAL FORTE 100 mg COMPR. FILM. 100mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. X, 20 COMPR. FILM. P-6L 20 11,62 0,581000 0,532049 0,478844984 M01AE03 KETOPROFENUM KETOPROXIN 100 mg COMPR. FILM. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L 20 7,89 0,394500 0,394500 0,355050985 M01AE03 KETOPROFENUM KETOPROXIN 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L 20 7,15 0,357500 0,266024 0,239421986 M01AE03 KETOPROFENUM PROFENID (R) LP 200 mg COMPR. FILM. ELIB. PREL. 200mg LAB. AVENTIS FRANTA CUTIE X 1 BLIST X 14 COMPR. FILM. ELIB. PREL. P-6L 14 13,36 0,954285 0,954285 0,858856987 M01AE03 KETOPROFENUM KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ. 100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 5 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ PRF 5 5,70 1,140000 1,138000 1,024200988 M01AE03 KETOPROFENUM KETOPROFEN ROMPHARM 100 mg/2ml SOL. INJ. 100 mg/2ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA PREVAZUTE CU INEL DE RUPERE A CATE 2ML SOL. INJ PRF 10 11,36 1,136000 1,136000 1,022400989 M01AE03 KETOPROFENUM KETONAL 100 mg/ 2 ml SOL. INJ. 100mg/2ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 10 FIOLE X 2 ML SOL. INJ/CONC PT.SOL. PERF. P-RF 10 11,36 1,136000 1,136000 1,022400990 M01AE03 KETOPROFENUM KETOPROFEN TERAPIA 100MG/2ML SOL. INJ./CONC. SOL. PERF. 100mg/2ml TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML P-RF 5 9,63 1,926000 1,138000 1,024200991 M01AE03 KETOPROFENUM RUBIFEN (R) 100 mg SUPOZ. 100mg ANTIBIOTICE SA ROMANIA CUTIE X 2 FOLII TERMOSUDATE METALIZATE AL-PE X 3 SUPOZ. P-6L 6 4,10 0,683333 0,660583 0,594524992 M01AE03 KETOPROFENUM KETOMAG SUPOZ. 100mg MAGISTRA C & C ROMANIA CUTIE X 2 FOLII LAMINATE PVC/PE X 5 SUPOZ. P-6L 10 6,53 0,653000 0,653000 0,587700993 M04AA01 ALLOPURINOLUM* MILURIT 100 mg COMPR. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. P-6L 50 8,23 0,164600 0,148399 0,133559994 M04AA01 ALLOPURINOLUM* MILURIT 300 mg COMPR. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 30 COMPR. P-6L 30 12,87 0,429000 0,429000 0,386100995 M04AC01 COLCHICINUM COLCHICINA COMPR. 1mg BIOFARM SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 20 COMPR. P-RF 40 5,76 0,144000 0,144000 0,129600996 N02AX02 TRAMADOLUM TRAMADOL CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,82 0,291000 0,283348 0,255013997 N02AX02 TRAMADOLUM MABRON 50 mg CAPS. 50mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 3,85 0,385000 0,283348 0,255013998 N02AX02 TRAMADOLUM K-ALMA (R) CAPS. 50mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 7,67 0,383500 0,283348 0,255013999 N02AX02 TRAMADOLUM TRAMADOL ARENA CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 9,00 0,450000 0,283348 0,2550131.000 N02AX02 TRAMADOLUM TRAMACALM CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 3,85 0,385000 0,283348 0,2550131.001 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg CAPS. 50mg ZENTIVA A.S. SLOVACIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 5,61 0,280500 0,280500 0,2524501.002 N02AX02 TRAMADOLUM TRAMAG 50 COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,67 0,383500 0,283348 0,2550131.003 N02AX02 TRAMADOLUM TRAMADOL EEL COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 7,67 0,383500 0,283348 0,2550131.004 N02AX02 TRAMADOLUM TRAMADOLOR (R) 100 ID COMPR. ELIB. MODIF. 100mg HEXAL AG GERMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. MODIF. P-RF 10 6,30 0,630000 0,566699 0,5100291.005 N02AX02 TRAMADOLUM TRALGIT SR 100 COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 18,89 0,629666 0,566699 0,5100291.006 N02AX02 TRAMADOLUM TRAMADOL RETARD 100 mg COMPR. ELIB. PREL. 100mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU 3 BLIST. AL/PVC X 10 COMPR. ELIB. PREL. PRF 30 18,91 0,630333 0,566699 0,5100291.007 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 100 mg COMPR. ELIB. PREL. 100mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 18,89 0,629666 0,566699 0,5100291.008 N02AX02 TRAMADOLUM TRALGIT SR 150 COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 27,55 0,918333 0,850049 0,7650441.009 N02AX02 TRAMADOLUM TRADOLAN RETARD 150 mg COMPR. ELIB. PREL. 150mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 33,41 1,113666 0,850049 0,7650441.010 N02AX02 TRAMADOLUM TRAMADOL SR ZENTIVA 150 mg COMPR. ELIB. PREL. 150mg ZENTIVA AS SLOVACIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. ELIB. PREL. P-RF 30 27,55 0,918333 0,850049 0,7650441.011 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 34,30 1,143333 1,133398 1,0200581.012 N02AX02 TRAMADOLUM TRADOLAN 50 mg COMPR. FILM. 50mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-RF 30 10,65 0,355000 0,283348 0,2550131.013 N02AX02 TRAMADOLUM TRAMAL RETARD 100 mg COMPR. FILM. ELIB. PREL. 100mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. AL/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-RF 10 9,69 0,969000 0,566699 0,5100291.014 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 22,03 2,203000 0,850049 0,7650441.015 N02AX02 TRAMADOLUM TRAMADOL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-RF 30 41,57 1,385666 0,850049 0,7650441.016 N02AX02 TRAMADOLUM TRAMAL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg GRUNENTHAL GMBH GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. ELIB. PREL. P-RF 10 28,18 2,818000 1,133398 1,0200581.017 N02AX02 TRAMADOLUM TRAMADOL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL. P-RF 30 53,20 1,773333 1,133398 1,0200581.018 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA SLOVACA CUTIE CU 1 BLIST. OPA-AL-PVC/AL X 10 COMPR. ORODISPERSABILE PRF 10 3,84 0,384000 0,283348 0,2550131.019 N02AX02 TRAMADOLUM TRAMADOL ZENTIVA 50 mg COMPR. ORODISPERSABILE 50mg ZENTIVA, A.S. REPUBLICA SLOVACA CUTIE CU 1 BLIST. PVC-PVDC/AL X 10 COMPR. ORODISPERSABILE PRF 10 3,84 0,384000 0,283348 0,2550131.020 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 5 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 5 9,83 1,966000 1,629810 1,4668291.021 N02AX02 TRAMADOLUM MABRON SOL. INJ. 100mg MEDOCHEMIE LTD. CIPRU CUTIE X 100 FIOLE DIN STICLA BRUNA X 2 ML SOL. INJ. S/P-RF 100 134,56 1,345600 1,345600 1,211040

Pagina 21 din 27

Page 112: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.022 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 1 ML S/P-RF 5 4,93 0,986000 0,814902 0,7334111.023 N02AX02 TRAMADOLUM TRAMADOL SOL. INJ. 50mg/ml KRKA D.D. SLOVENIA CUTIE X 5 FIOLE X 2 ML S/P-RF 5 13,10 2,620000 1,629810 1,4668291.024 N02AX02 TRAMADOLUM TRAMADOL SUPOZ. 100mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. X, 5 SUPOZ. P-RF 5 5,58 1,116000 1,116000 1,0044001.025 N02CC01 SUMATRIPTANUM* IMIGRAN DR 100 mg COMPR. DISP. 100mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. P-RF 2 44,81 22,405000 10,719166 9,6472491.026 N02CC01 SUMATRIPTANUM* IMIGRAN DR 50 mg COMPR. DISP. 50mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. P-RF 2 25,36 12,680000 5,359583 4,8236241.027 N02CC01 SUMATRIPTANUM* XIBIMER 100 mg COMPR. FILM. 100mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 6 58,12 9,686666 9,686666 8,7179991.028 N02CC01 SUMATRIPTANUM* SUMACTA 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF 6 58,12 9,686666 9,686666 8,7179991.029 N02CC01 SUMATRIPTANUM* XIBIMER 50 mg COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 6 41,45 6,908333 5,359583 4,8236241.030 N02CC01 SUMATRIPTANUM* SUMACTA 50 mg COMPR. FILM. 50mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 2 BLIST. PVC/AL X 3 COMPR. FILM. PRF 6 41,47 6,911666 5,359583 4,8236241.031 N03AF01 CARBAMAZEPINUM TEGRETOL (R) 200 COMPR. 200mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. PVC-PE-PVDC/AL X 10 COMPR. P-6L 50 17,38 0,347600 0,234866 0,2113791.032 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA LPH 200 mg COMPR. 200mg LABORMED PHARMA SA ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,2035801.033 N03AF01 CARBAMAZEPINUM CARBAVIM COMPR. 200mg VIM SPECTRUM SRL ROMANIA CUTIE X 5 BLIST. AL/PVC X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,2035801.034 N03AF01 CARBAMAZEPINUM CARBEPSIL 200mg COMPR. 200mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,2035801.035 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN COMPR. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,96 0,248000 0,234866 0,2113791.036 N03AF01 CARBAMAZEPINUM CARBAMAZEPIN EEL COMPR. 200mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,50 0,225000 0,225000 0,2025001.037 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 200 mg COMPR. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 4,96 0,248000 0,234866 0,2113791.038 N03AF01 CARBAMAZEPINUM FINLEPSIN COMPR. 200mg S.C. TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. P-6L 50 11,31 0,226200 0,226200 0,2035801.039 N03AF01 CARBAMAZEPINUM CARBEPSIL 400mg COMPR. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 26,26 0,525200 0,469733 0,4227591.040 N03AF01 CARBAMAZEPINUM CARBAMAZEPINA ARENA 400 mg COMPR. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 10,51 0,525500 0,469733 0,4227591.041 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 150 mg COMPR. CU ELIB. PRELUNGITA 150mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIB. PRELUNGITA P6L 50 15,16 0,303200 0,176149 0,1585341.042 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 300 mg COMPR. CU ELIBERARE PRELUNGITA 300mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L 50 20,62 0,412400 0,352299 0,3170691.043 N03AF01 CARBAMAZEPINUM TIMONIL RETARD 600 mg COMPR. CU ELIBERARE PRELUNGITA 600mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. CU ELIBERARE PRELUNGITA P6L 50 36,53 0,730600 0,704599 0,6341391.044 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 300 mg COMPR. ELIB. PREL. 300mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL P-6L 50 20,68 0,413600 0,352299 0,3170691.045 N03AF01 CARBAMAZEPINUM NEUROTOP (R) RETARD 600 mg COMPR. ELIB. PREL. 600mg GEROT PHARMAZEUTIKA GMBH AUSTRIA CUTIE X 5 BLIST. AL/PVDC-PVC X 10 COMPR. ELIB. PREL. P-6L 50 36,59 0,731800 0,704599 0,6341391.046 N03AF01 CARBAMAZEPINUM TEGRETOL CR 200 COMPR. FILM. ELIB. PREL. 200mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 5 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L 50 19,17 0,383400 0,234866 0,2113791.047 N03AF01 CARBAMAZEPINUM FINLEPSIN 200 RETARD COMPR. FILM. ELIB. PREL. 200mg S.C. TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 BLIST. AL-HARTIE/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 12,43 0,248600 0,234866 0,2113791.048 N03AF01 CARBAMAZEPINUM TEGRETOL CR 400 COMPR. FILM. ELIB. PREL. 400mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 3 BLIST. AL-PVC/PVDC X 10 COMPR. FILM. CU ELIB. PREL. P-6L 30 25,35 0,845000 0,469733 0,4227591.049 N03AF01 CARBAMAZEPINUM FINLEPSIN 400 RETARD COMPR. FILM. ELIB. PREL. 400mg S.C. TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE X 5 BLIST. AL-HARTIE CERATA/PVC-PVDC X 10 COMPR. FILM. ELIB. PREL. P-6L 50 25,27 0,505400 0,469733 0,4227591.050 N03AF01 CARBAMAZEPINUM TIMONIL SIROP SUSP. ORALA 100mg/5ml DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE X 1 FLACON X 250 ML SUSP.ORALA + MASURA DOZATOARE P-6L 1 22,51 22,510000 22,510000 20,2590001.051 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. DIIN POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 7,20 0,144000 0,144000 0,1296001.052 N03AX12 GABAPENTINUM GABAGAMMA 100 mg CAPS. 100mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 60,61 0,606100 0,288282 0,2594531.053 N03AX12 GABAPENTINUM GRIMODIN 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 33,34 0,555666 0,288282 0,2594531.054 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L 50 22,54 0,450800 0,288282 0,2594531.055 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L 100 43,63 0,436300 0,288282 0,2594531.056 N03AX12 GABAPENTINUM GABAPENTIN ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 23,56 0,392666 0,288282 0,2594531.057 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 21,80 0,436000 0,436000 0,3924001.058 N03AX12 GABAPENTINUM GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 133,56 1,335600 0,864853 0,7783671.059 N03AX12 GABAPENTINUM GABARAN 300 mg CAPS. 300mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 65,96 1,319200 0,864853 0,7783671.060 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 133,09 1,330900 0,864853 0,7783671.061 N03AX12 GABAPENTINUM GRIMODIN 300 mg CAPS. 300mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 63,62 1,060333 0,864853 0,7783671.062 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L 50 47,92 0,958400 0,864853 0,7783671.063 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 300 mg CAPS. 300mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L 100 91,03 0,910300 0,864853 0,7783671.064 N03AX12 GABAPENTINUM GABAPENTIN ARENA 300 mg CAPS. 300mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 51,89 0,864833 0,864833 0,7783491.065 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 28,81 0,576200 0,576200 0,5185801.066 N03AX12 GABAPENTINUM GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 175,18 1,751800 1,153140 1,0378261.067 N03AX12 GABAPENTINUM GABARAN 400 mg CAPS. 400mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L 50 72,72 1,454400 1,153140 1,0378261.068 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 169,16 1,691600 1,153140 1,0378261.069 N03AX12 GABAPENTINUM GRIMODIN 400 mg CAPS. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 85,96 1,432666 1,153140 1,0378261.070 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 400 mg CAPS. 400mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 50 CAPS. P6L 50 64,12 1,282400 1,153140 1,037826

Pagina 22 din 27

Page 113: Lista medicamentelor valabila din 01.04.2015.pdf

Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APPtara det.

APP Ambalaj Prescriptie

cant/ambala

j

Pret amanunt

ul maximal/ambalaj (RON)

Pret amanuntul maximal/UT

(RON)

Val suportata de CNAS/UT (RON)Legea

nr. 95/2006 art 213 alin.1 lit. a)

si f)

Val suportata CNAS/UT (RON) pt.

Adulti1.071 N03AX12 GABAPENTINUM GABAPENTINA PFIZER 400 mg CAPS. 400mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. PVC/PVDC/AL X 100 CAPS. P6L 100 121,79 1,217900 1,153140 1,0378261.072 N03AX12 GABAPENTINUM GABAPENTIN ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 64,86 1,081000 1,081000 0,9729001.073 N03AX12 GABAPENTINUM GABARAN 600 mg COMPR. FILM. 600mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 65,21 2,173666 1,729711 1,5567391.074 N03AX12 GABAPENTINUM GRIMODIN 600 mg COMPR. FILM. 600mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 123,68 2,061333 1,729711 1,5567391.075 N03AX12 GABAPENTINUM GABARAN 800 mg COMPR. FILM. 800mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 104,24 3,474666 2,306281 2,0756521.076 N03AX12 GABAPENTINUM GRIMODIN 800 mg COMPR. FILM. 800mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. FILM. P-6L 60 197,38 3,289666 2,306281 2,0756521.077 N05AD01 HALOPERIDOLUM HALOPERIDOL LAROPHARM 0,5 mg COMPR. 0,5mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 3,24 0,162000 0,089699 0,0807291.078 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 1 mg COMPR. 1mg ARENA GROUP S.A. ROMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. PRF 30 7,72 0,257333 0,179399 0,1614591.079 N05AD01 HALOPERIDOLUM HALOPERIDOL ARENA 2 mg COMPR. 2mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLISTERE PVC/AL X 10 COMPRIMATE PRF 30 10,80 0,360000 0,358799 0,3229191.080 N05AD01 HALOPERIDOLUM HALDOL COMPR. 5mg JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 17,94 0,717600 0,717600 0,6458401.081 N05AD01 HALOPERIDOLUM HALOPERIDOL ROMPHARM 2 mg/ml PIC. ORALE, SOL. 2 mg/ml ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 1 FLACON PEJD CU PICURATOR PEJD X 10 ML PIC. OFT., SOL. PRF 1 5,39 5,390000 3,587998 3,2291981.082 N05AD01 HALOPERIDOLUM HALOPERIDOL 2 mg/ml PIC. ORALE-SOL. 2mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 FLACON PICURATOR X 10ML PICATURI ORALE-SOLUTIE P-RF 1 6,66 6,660000 3,587998 3,2291981.083 N05AD01 HALOPERIDOLUM HALOPERIDOL DECANOAT SOL. INJ. 50mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE X 1 ML P-RF 5 44,52 8,904000 8,904000 8,0136001.084 N05AD01 HALOPERIDOLUM HALOPERIDOL RICHTER 5 mg/ml SOL. INJ. 5mg/ml GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 5 FIOLE DIN STICLA INCOLORA X 1 ML SOL