Ordin 807_30.09.2016.pdf
Transcript of Ordin 807_30.09.2016.pdf
Anexa 6 (Anexa 2a la Ordinul CNAS 944/2015)
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP
tara det.
APP Ambalaj Pre
scri
pti
e
cant.
UT/
amba
laj
Pret de
referinta / UT
(RON)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
Val. maxima suportata de
sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)
SE ADAUGA
1.145 A03AD01 PAPAVERINI HYDROCHLORIDUM PAPAVERINE SOPHARMA 20 mg/ml SOL INJ. 20mg/ml CN UNIFARM S.A. ROMANIA CUTIE CU 10 FIOLE X 1 ML SOL. INJ. PRF 10 1,772000 0,000000 1,594800 0,177200
1.146 C07AA07 SOTALOLUM DAROB 80 mg COMPR. 80mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P6L 20 0,224650 0,292850 0,202185 0,315315
1.147 C07AB07 BISOPROLOLUM BISOGAMMA 5 mg COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 100 0,149800 0,000000 0,134820 0,014980
1.148 J01MA06 NORFLOXACINUM NORFLOXACINA ATB 400 mg COMPR. FILM. 400mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 20 0,809999 0,070001 0,728999 0,151001
1.149 M01AB16 ACECLOFENACUM ACOFAX 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 20 COMPR. FILM. P6L 20 0,137700 0,311300 0,123930 0,325070
1.150 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0,288562 0,362938 0,259705 0,391795
1.151 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 10 mg CAPS. 10mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,288562 0,407438 0,259705 0,436295
1.152 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,577125 0,223875 0,519412 0,281588
1.153 N06AB03 FLUOXETINUM* FLUOXETIN ARENA 20 mg CAPS. 20mg ARENA GROUP S.A. ROMANIA CUTIE CU 10 BLIST. PVC/AL X 10 CAPS. PRF 100 0,577125 0,143575 0,519412 0,201288
1.154 R05DA04 CODEINUM CODEINA SLAVIA 15mg COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,169500 0,004000 0,152550 0,020950
SE MODIFICA
173 C07AB02 METOPROLOLUM BETAPROL 100 mg COMPR. 100mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,217449 0,078884 0,195704 0,100629
174 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 0,217449 0,079051 0,195704 0,100796
175 C07AB02 METOPROLOLUM METOPROLOL LPH 100 mg COMPR. 100mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,217449 0,028551 0,195704 0,050296
176 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,217449 0,078884 0,195704 0,100629
177 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 100 mg COMPR. 100mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,217449 0,078884 0,195704 0,100629
178 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 0,217449 0,079051 0,195704 0,100796
179 C07AB02 METOPROLOLUM METOPROLOL ARENA 100 MG COMPR. 100mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,217449 0,024884 0,195704 0,046629
180 C07AB02 METOPROLOLUM METOPROLOL 100 mg COMPR. 100mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,217449 0,073051 0,195704 0,094796
181 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 0,217449 0,078884 0,195704 0,100629
182 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 100 mg COMPR. 100mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L 30 0,217449 0,078884 0,195704 0,100629
183 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 0,054362 0,044138 0,048925 0,049575
184 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 20 COMPR. P-6L 20 0,054362 0,044138 0,048925 0,049575
185 C07AB02 METOPROLOLUM METOPROLOL 25 mg COMPR. 25mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,054362 0,044304 0,048925 0,049741
186 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 0,054362 0,044304 0,048925 0,049741
187 C07AB02 METOPROLOLUM METOPROLOL LPH 25 mg COMPR. 25mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 20 COMPR. P-6L 60 0,054362 0,043971 0,048925 0,049408
188 C07AB02 METOPROLOLUM BETAPROL 50 mg COMPR. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,108724 0,073609 0,097851 0,084482
189 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 0,108724 0,073776 0,097851 0,084649
190 C07AB02 METOPROLOLUM METOPROLOL LPH 50 mg COMPR. 50mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,108724 0,055609 0,097851 0,066482
191 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg MAGISTRA C & C SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,108724 0,073609 0,097851 0,084482
192 C07AB02 METOPROLOLUM METOPROLOL TERAPIA 50 mg COMPR. 50mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-6L 30 0,108724 0,135276 0,097851 0,146149
193 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 0,108724 0,063776 0,097851 0,074649
194 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 0,108724 0,073609 0,097851 0,084482
195 C07AB02 METOPROLOLUM METOPROLOL 50 mg COMPR. 50mg SLAVIA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,108724 0,073776 0,097851 0,084649
196 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 0,108724 0,042942 0,097851 0,053815
197 C07AB02 METOPROLOLUM METOPROLOL ZENTIVA 50 mg COMPR. 50mg ZENTIVA S.A. ROMANIA CUTIE CU 3 BLIST. DIN PVC/AL X 10 COMPRIMATE P6L 30 0,108724 0,073609 0,097851 0,084482
198 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 190 mg COMPR. ELIB. MODIF. 190mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,413154 0,090846 0,371838 0,132162
199 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 47,5 mg COMPR. ELIB. MODIF. 47,5mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,103288 0,112378 0,092959 0,122707
200 C07AB02 METOPROLOLUM METOSUCCINAT SANDOZ 95 mg COMPR. ELIB. MODIF. 95mg HEXAL AG GERMANIA CUTIE CU 3 BLIST. PP/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,206577 0,151756 0,185919 0,172414
201 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 0,217449 0,079051 0,195704 0,100796
202 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 0,217449 0,078884 0,195704 0,100629
203 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 0,108724 0,072609 0,097851 0,083482
SUBLISTA A - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 90% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008 CU COMPLETARILE SI MODIFICARILE ULTERIOARE
VALABILA INCEPAND CU 01 OCTOMBRIE 2016
Pagina 1 din 3
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP
tara det.
APP Ambalaj Pre
scri
pti
e
cant.
UT/
amba
laj
Pret de
referinta / UT
(RON)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
Val. maxima suportata de
sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)
204 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 0,217449 0,238551 0,195704 0,260296
205 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 0,108724 0,271276 0,097851 0,282149
206 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 0,413154 0,090846 0,371838 0,132162
207 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 0,103288 0,112378 0,092959 0,122707
208 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 0,206577 0,151756 0,185919 0,172414
215 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 0,326174 0,029897 0,293556 0,062515
218 C07AB07 BISOPROLOLUM BISOPROLOL LPH 5mg COMPR. 5mg LABORMED PHARMA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. P-6L 30 0,163087 0,089579 0,146778 0,105888
220 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 0,326174 0,036826 0,293556 0,069444
221 C07AB07 BISOPROLOLUM CONCOR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 0,326174 0,556826 0,293556 0,589444
222 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 0,326174 0,175026 0,293556 0,207644
223 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 0,326174 0,034492 0,293556 0,067110
224 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 0,326174 0,020492 0,293556 0,053110
225 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 0,326174 0,033492 0,293556 0,066110
226 C07AB07 BISOPROLOLUM CONCOR COR 10 mg COMPR. FILM. 10mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,326174 0,759159 0,293556 0,791777
227 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 0,326174 0,021159 0,293556 0,053777
228 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 0,081543 0,161790 0,073388 0,169945
229 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 0,081543 0,292790 0,073388 0,300945
230 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 0,081543 0,127457 0,073388 0,135612
231 C07AB07 BISOPROLOLUM CONCOR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 30 0,163087 0,351913 0,146778 0,368222
233 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 0,163087 0,005813 0,146778 0,022122
234 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 0,163087 0,043246 0,146778 0,059555
235 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 0,163087 0,042246 0,146778 0,058555
236 C07AB07 BISOPROLOLUM CONCOR COR 5 mg COMPR. FILM. 5mg MERCK KGAA GERMANIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. FILM. P6L 30 0,163087 0,226246 0,146778 0,242555
237 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 0,163087 0,043246 0,146778 0,059555
697 J01MA01 OFLOXACINUM OFLOXIN 200 COMPR. FILM. 200mg ZENTIVA K.S. CEHIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 0,851200 1,103220 0,973780
698 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 0,245160 3,625840 0,220644 3,650356
699 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 0,245160 3,158840 0,220644 3,183356
700 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 0,612900 0,070100 0,551610 0,131390
701 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 0,612900 0,094100 0,551610 0,155390
702 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 0,612900 0,070100 0,551610 0,131390
703 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 0,612900 0,096100 0,551610 0,157390
704 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 0,612900 0,107100 0,551610 0,168390
705 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 0,612900 0,068100 0,551610 0,129390
706 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 0,612900 0,025100 0,551610 0,086390
707 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA AUROBINDO 250 mg COMPR. FILM. 250mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PVDC/AL X 10 COMPR. FILM. PRF 10 0,612900 0,087100 0,551610 0,148390
710 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 1,225800 0,096200 1,103220 0,218780
711 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 1,225800 0,145200 1,103220 0,267780
713 J01MA02 CIPROFLOXACINUM CIPRO QUIN (R) COMPR. FILM. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-RF 10 1,225800 0,145200 1,103220 0,267780
718 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 1,838700 2,032300 1,654830 2,216170
720 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 2,451600 10,102685 2,206440 10,347845
721 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 1,225800 8,327533 1,103220 8,450113
722 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 1,225800 1,665200 1,103220 1,787780
723 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 0,809999 0,006001 0,728999 0,087001
725 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 0,809999 0,070001 0,728999 0,151001
780 M01AB01 INDOMETACINUM INDOMETACIN LAROPHARM 25 mg CAPS. 25mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST., PVC/AL, X 10 CAPS. P-6L 20 0,068850 0,015150 0,061965 0,022035
781 M01AB01 INDOMETACINUM INDOMETACIN ARENA 25 MG CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,068850 0,005150 0,061965 0,012035
782 M01AB01 INDOMETACINUM INDOMETACIN ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 0,137700 0,045800 0,123930 0,059570
786 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL. P-6L 20 0,413099 2,061401 0,371789 2,102711
787 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 0,206549 0,374451 0,185894 0,395106
788 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 0,275400 0,079100 0,247860 0,106640
790 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 0,275400 0,269600 0,247860 0,297140
791 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 0,275400 0,079100 0,247860 0,106640
792 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 0,137700 0,042800 0,123930 0,056570
795 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 0,137700 0,105300 0,123930 0,119070
796 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 0,068850 0,128816 0,061965 0,135701
810 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 0,091799 0,258201 0,082619 0,267381
Pagina 2 din 3
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP
tara det.
APP Ambalaj Pre
scri
pti
e
cant.
UT/
amba
laj
Pret de
referinta / UT
(RON)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
Val. maxima suportata de
sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 90%
din pretul de
referinta)
811 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 0,091799 0,434201 0,082619 0,443381
816 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 0,137700 0,597800 0,123930 0,611570
817 M01AB16 ACECLOFENACUM ACE-TAB 100 mg COMPR. FILM. 100mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. P6L 20 0,137700 0,340800 0,123930 0,354570
818 M01AB16 ACECLOFENACUM AFLAMIL 100 mg PULB. PT.SUSP. ORALA 100mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 20 PLICURI UNIDOZA DIN MATERIAL COMPLEX DIN HARTIE DE TIP OPALINA LAMINATA PE UN STRAT DE ALUMINIU (20 ΜM) SI FILM DIN PEJD P6L 20 0,137700 1,200300 0,123930 1,214070
1.116 R05DA04 CODEINUM FOSFAT DE CODEINA 15 mg COMPR. 15mg SINTOFARM SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. P-RF 30 0,169500 0,030833 0,152550 0,047783
1.117 R05DA04 CODEINUM CODEINA FOSFORICA COMPR. 15mg BIO EEL SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 25 COMPR. P-RF 25 0,169500 0,035700 0,152550 0,052650
1.119 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0,169500 0,004000 0,152550 0,020950
1.121 R05DA04 CODEINUM CODEINA FOSFAT MCC 15 mg COMPR. 15mg MAGISTRA C & C SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,169500 0,020000 0,152550 0,036950
SE ELIMINA
171 C07AA07 SOTALOLUM DAROB 80 mg COMPR. 80mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 2 BLIST. PP/AL X 10 COMPR. P6L 20 0,224650 0,292850 0,202185 0,315315
266 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 0,123333 0,000000 0,110999 0,012334
276 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 0,264299 0,029201 0,237869 0,055631
284 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 0,125333 0,000000 0,112799 0,012534
294 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 0,132149 0,237851 0,118934 0,251066
Pagina 3 din 3
Anexa 7 (Anexa 2b la Ordinul CNAS 944/2015)
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP
Tara det.
APP Ambalaj Pre
scri
pti
e
cant.
UT/
amba
laj
Pret de
referinta / UT
(RON)
Co-plata maxima a
asiguratului / UT (pt.
asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
Val. maxima suportata
de sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 50% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT (pt.
asiguratii care
beneficiaza de
compensare 50% din
pretul de referinta)
Val. maxima suportata
de sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT (pt.
asiguratii care
beneficiaza de
compensare 90% din
pretul de referinta)
SE ADAUGA
1.116 A02BX05 BISMUTHI SUBCITRAS ULCAMED 120 mg COMPR. FILM. 120mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. FILM. P6L 60 0,315200 0,683633 0,157600 0,841233 0,283680 0,715153
1.117 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 10 COMPR. FILM. PRF 10 1,541000 0,000000 0,770500 0,770500 1,386900 0,154100
1.118 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 250 mg COMPR. FILM. 250mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 5 COMPR. FILM. PRF 5 1,562000 0,000000 0,781000 0,781000 1,405800 0,156200
1.119 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 5 COMPR. FILM. PRF 5 4,422000 0,000000 2,211000 2,211000 3,979800 0,442200
1.120 J01MA12 LEVOFLOXACINUM LEVOFLOXACINA ARENA 500 mg COMPR. FILM. 500mg ARENA GROUP S.A. ROMANIA CUTIE CU 1 BLIST. PVC/PE/PVDC/AL X 10 COMPR. FILM. PRF 10 4,175000 0,000000 2,087500 2,087500 3,757500 0,417500
SE MODIFICA
69 B01AB04 DALTEPARINUM**# FRAGMIN 2500 UI/0,2 ml SOL. INJ. 2500ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 10 BLIST. INDIVIDUALE CONTINAND FIECARE 1 SERINGA PREUMPLUTA FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP X 0,2 ML SOLUTIE INJECTABILA S/P-RF 10 4,970291 1,228709 2,485145 3,713855 4,473261 1,725739
70 B01AB04 DALTEPARINUM**# FRAGMIN 5000 UI/0,2 ml SOL. INJ. 5000ui/0,2ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 10 BLISTERE INDIVIDUALE CONTINÂND FIECARE O SERINGA PREUMPLUTA, FARA SISTEM DE BLOCARE A ACULUI NEEDLE-TRAP A 0,2 ML SOLUTIE INJECTABILA S/P-RF 10 9,940583 1,510417 4,970291 6,480709 8,946524 2,504476
72 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 4,970291 1,456709 2,485145 3,941855 4,473261 1,953739
73 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 9,940583 1,719417 4,970291 6,689709 8,946524 2,713476
74 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 14,910874 0,077126 7,455437 7,532563 13,419786 1,568214
77 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 4,970291 1,474709 2,485145 3,959855 4,473261 1,971739
79 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 6,627053 1,869947 3,313526 5,183474 5,964347 2,532653
81 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 9,940583 3,244417 4,970291 8,214709 8,946524 4,238476
83 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 13,254107 2,763893 6,627053 9,390947 11,928696 4,089304
84 B01AB10 TINZAPARINUM**# INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN FLACOANE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (20000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT IN AURIU SI CAPSA DE SIGURANTA DIN PP DE CULOARE PORTOCALIE PR/PRF 10 28,401662 24,409338 14,200831 38,610169 25,561495 27,249505
85 B01AB10 TINZAPARINUM**# INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN FLACOANE 20000 UI anti-Xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 FLAC. DIN STICLA INCOLORA X 2 ML (40000 UI ANTI-XA) SOL. INJ., CU DOP DE CAUCIUC DE CULOARE CENUSIE DESCHIS, ARMATURA DE ETANSARE DIN AL LACUIT CU LAC DE CULOARE VERDE SI CAPSA DE SIGURANTA DIN PP DE CULOARE VERDE INCHIS PR/PRF 10 56,803330 56,081670 28,401665 84,483335 51,122997 61,762003
86 B01AB10 TINZAPARINUM**# INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN SERINGI PREUMPLUTE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA 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 4,970291 7,357709 2,485145 9,842855 4,473261 7,854739
87 B01AB10 TINZAPARINUM**# INNOHEP 10000 UI ANTI-XA/ml SOL. INJ. IN SERINGI PREUMPLUTE 10000UI anti-XA/ml LEO PHARMA A/S DANEMARCA CUTIE CU 10 SERINGI PREUMPLUTE X 0.45 ML (4500 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU PR/PRF 10 6,390373 9,463627 3,195186 12,658814 5,751335 10,102665
88 B01AB10 TINZAPARINUM**# INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 2 SERINGI PREUMPLUTE X 0,50 ML (10000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ROSU PR/PRF 2 7,100414 29,889586 3,550207 33,439793 6,390372 30,599628
89 B01AB10 TINZAPARINUM**# INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 2 SERINGI PREUMPLUTE X 0,70 ML (14000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC GALBEN PR/PRF 2 19,881166 30,538834 9,940583 40,479417 17,893049 32,526951
90 B01AB10 TINZAPARINUM**# INNOHEP 20000 UI ANTI-Xa/ml SOL. INJ. IN SERINGI PREUMPLUTE 20000UI anti-Xa/ml LEO PHARMA A/S DANEMARCA CUTIE CU 2 SERINGI PREUMPLUTE X 0,90 ML (18000 UI ANTI-XA) SOL. INJ., CU DISPOZITIV DE SIGURANTA PT. AC, INTRODUSE INTR-UN SUPORT DIN PLASTIC CU CAPAC ALBASTRU PR/PRF 2 25,561499 34,213501 12,780749 46,994251 23,005349 36,769651
91 B01AB11 SULODEXIDUM** VESSEL DUE F CAPS. MOI 250ULS ALFA WASSERMANN SPA ITALIA CUTIE X 2 BLIST. PVDC-PVC/AL-PVDC X 25 CAPS. MOI P-RF 50 1,854700 0,209700 0,927350 1,137050 1,669230 0,395170
92 B01AB11 SULODEXIDUM** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFA WASSERMANN SPA ITALIA CUTIE X 3 BLIST. PVDC-PVC/AL-PVDC A CATE 20 CAPS. MOI P-RF 60 1,854700 0,209800 0,927350 1,137150 1,669230 0,395270
93 B01AB11 SULODEXIDUM** COREFLUX 250 ULS CAPS. MOI 250ULS SANIENCE S.R.L. ROMANIA CUTIE CU 5 BLIST. PVC/AL X 10 CAPS. MOI PRF 50 1,645000 0,000000 0,822500 0,822500 1,480500 0,164500
94 B01AB11 SULODEXIDUM** COREFLUX 600 ULS/2 ml SOL INJ. 600ULS/2ml SANIENCE S.R.L. ROMANIA CUTIE CU 10 FIOLE DIN STICLA BRUNA CU INEL DE RUPERE X 2 ML SOL. INJ. PRF 10 6,486000 0,000000 3,243000 3,243000 5,837400 0,648600
95 B01AB11 SULODEXIDUM** VESSEL DUE F SOL. INJ. 600ULS/2ml ALFA WASSERMANN SPA ITALIA CUTIE X 10 FIOLE DIN STICLA GALBENA X 2 ML P-RF 10 6,841749 1,067251 3,420874 4,488126 6,157574 1,751426
678 J01MA12 LEVOFLOXACINUM TAVANIC 250 mg COMPR. FILM. 250mg TERAPIA S.A. ROMANIA CUTIE X1 BLIST. PVC/AL. X 7 COMPR. FILM. P-RF 7 2,451600 1,399828 1,225800 2,625628 2,206440 1,644988
680 J01MA12 LEVOFLOXACINUM LEVALOX 250 mg COMPR. FILM. 250mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 7 COMPR. FILM. PRF 7 2,451600 0,052685 1,225800 1,278485 2,206440 0,297845
683 J01MA12 LEVOFLOXACINUM TAVANIC 500 mg COMPR. FILM. 500mg TERAPIA S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 7COMPR. FILM. P-RF 7 4,903200 1,688228 2,451600 4,139828 4,412880 2,178548
686 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 4,903200 6,180800 2,451600 8,632400 4,412880 6,671120
687 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 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120
688 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 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120
689 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 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120
690 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 FILMATE PRF 5 4,903200 2,302800 2,451600 4,754400 4,412880 2,793120
1.013 R03DC03 MONTELUKASTUM* MONTELUKAST AUROBINDO 4 mg COMPR. MAST. 4mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,527428 0,191143 0,263714 0,454857 0,474685 0,243886
1.027 R03DC03 MONTELUKASTUM* MONTELUKAST AUROBINDO 5 mg COMPR. MAST. 5mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0,659285 0,114286 0,329642 0,443929 0,593356 0,180215
1.086 B01AB05 ENOXAPARINUM**# CLEXANE 2000 UI anti-Xa/0,2ml SOL. INJ. 2000UI anti-Xa/0,2ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,2 ML SOL INJ. PR/PRF 10 4,970291 1,456709 2,485145 3,941855 4,473261 1,953739
1.087 B01AB05 ENOXAPARINUM**# CLEXANE 4000 UI anti-Xa/0,4ml SOL. INJ. 4000UI anti-Xa/0,4ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 0,5 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,4 ML SOL INJ. PR/PRF 10 9,940583 1,719417 4,970291 6,689709 8,946524 2,713476
1.088 B01AB05 ENOXAPARINUM**# CLEXANE 6000 UI anti-Xa/0,6ml SOL. INJ. 6000UIanti-Xa/0,6ml SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 10 SERINGI PREUMPLUTE (DIN STICLA INCOLORA DE TIP I, CU O CAPACITATE DE 1 ML, PREVAZUTA CU AC CU UN CAP RIGID DIN PLASTIC FARA FILET SI PISTON X 0,6 ML SOL INJ. PR/PRF 10 14,910874 0,077126 7,455437 7,532563 13,419786 1,568214
SE ELIMINA
76 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 4,995999 1,449001 2,497999 3,947001 4,496399 1,948601
78 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 6,661331 1,835669 3,330665 5,166335 5,995197 2,501803
80 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 9,991999 3,193001 4,995999 8,189001 8,992799 4,192201
82 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 13,322663 2,695337 6,661331 9,356669 11,990396 4,027604
861 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM CIPLA 10 mg COMPR. FILM. 10mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. PRF 28 0,848928 0,000000 0,424464 0,424464 0,764035 0,084893
1.046 R06AE09 LEVOCETIRIZINUM LEVOCETIRIZINA CIPLA 5 mg COMPR. FILM. 5mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,561333 0,000000 0,280666 0,280667 0,505199 0,056134
SUBLISTA B - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) ALE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE PERSONALA
DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE, VALABILA INCEPAND CU 01 OCTOMBRIE 2016
Pagina 1 din 1
Anexa 8
(Anexa 2c la Ordinul CNAS 944/2015)
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP
TARA
DET. APP AMBALAJ Pre
scri
pti
e
cant.
UT/
amba
laj
Pret de
referinta / UT
(RON)
Val. maxima suportata de
sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
SE ADAUGA
256 C07AB07 BISOPROLOLUM BISOGAMMA 5 mg COMPR. FILM. 5mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE CU 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 100 0,146799 0,146799 0,003001
SE ADAUGA
40 J05AF05 LAMIVUDINUM**** LAMIVUDINE TEVA 100 mg COMPR. FILM. 100 mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 2,836666 2,836666 0,000000
41 J05AF07 TENOFOVIRUM DISOPROXIL**** VIROFOB 245 mg COMPR. FILM. 245mg ALVOGEN IPCO S.AR.L. LUXEMBURG CUTIE CU 1 FLAC. PEID CU CAPAC DIN PP X 30 COMPR. FILM. PR 30 27,475333 27,475333 0,000000
SE MODIFICA
5 J05AB04 RIBAVIRINUM**** RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 1,966369 1,966369 0,000000
11 J05AF07 TENOFOVIRUM DISOPROXIL**** 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 32,970399 32,970399 8,027267
12 J05AF07 TENOFOVIRUM DISOPROXIL**** TENOFOVIR DISOPROXIL TEVA 245 mg COMPR. FILM. 245mg TEVA 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 27,475333 27,475333 0,000000
13 J05AF07 TENOFOVIRUM DISOPROXIL**** TENOFOVIR DISOPROXIL TEVA 245 mg COMPR. FILM. 245mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEÎD CU PERETII ÎNGROSATI CU CAPAC PREVAZUT CU SISTEM SECURIZAT PENTRU COPII DIN PP SI RECIPIENT CU DESICANT, A 30 COMPR. FILM. PR 30 27,475333 27,475333 0,000000
7. CIROZA HEPATICA - G7
SE ADAUGA
63 J05AF05 LAMIVUDINUM**** LAMIVUDINE TEVA 100 mg COMPR. FILM. 100 mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/PVDC/AL X 30 COMPR. FILM. P-RF/R 30 2,836666 2,836666 0,000000
SE MODIFICA
29 J05AB04 RIBAVIRINUM**** REBETOL 200 mg CAPS. 200mg MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 140 CAPS. ( BLIST. PVC/PE/PVDC ) P-RF/R 140 2,359642 2,359642 5,522429
30 J05AB04 RIBAVIRINUM**** COPEGUS 200mg COMPR. FILM. 200mg ROCHE ROMANIA SRL ROMANIA CUTIE X 1 FLAC. PEID X 168 COMPR. FILM. P-RF/R 168 2,359642 2,359642 5,438215
31 J05AB04 RIBAVIRINUM**** RIBAVIRINA AUROBINDO 200 mg COMPR. FILM. 200mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 168 COMPR. FILM. PRF 168 1,966369 1,966369 0,000000
32 J05AB04 RIBAVIRINUM**** MODERIBA 200 mg COMPR. FILM. 200mg ABBVIE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. PEID X 168 COMPR. PRF 168 2,359642 2,359642 2,847203
SE ADAUGA
190 A04AA05 PALONOSETRONUM** PALONOSETRON ACCORD 250 micrograme SOL INJ. 250micrograme ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 FLAC. CARE CONTINE 5 ML SOLUTIE PALONOSETRON PRF 1 214,310000 214,310000 0,000000
1.INSUFICIENTA CARDIACA CRONICA(CLASA III SAU IV NYHA) - G 1
SECŢIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREŢUL DE REFERINŢĂ CONFORM
DCI-urilor UTILIZATE ÎN TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOLI
DIN H.G. NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE;
MEDICAMENTELE DIN ACEASTĂ SUBLISTĂ SE ELIBEREAZĂ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZĂ DE PRESCRIPŢIE MEDICALĂ CU REŢINERE ÎN FARMACIE
VALABILĂ ÎNCEPÂND CU 01 OCTOMBRIE 2016
4. HEPATITELE CRONICE DE ETIOLOGIE VIRALA B, C şi D - G4
8. Leucemii, limfoame, aplazie medulara, gamapatii monoclonale maligne, mieloproliferari cronice si tumori maligne, sindroame mielodisplazice - G10
Pagina 1 din 5
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP
TARA
DET. APP AMBALAJ Pre
scri
pti
e
cant.
UT/
amba
laj
Pret de
referinta / UT
(RON)
Val. maxima suportata de
sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
191 J02AC03 VORICONAZOLUM** VORICONAZOL FRESENIUS KABI 200 mg PULB. PT. SOL. PERF. 200mg FRESENIUS KABI ROMANIA SRL ROMANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA TIP I, CU CAPACITATEA DE 25 ML, CU PULBERE PT. SOL. PERF. PRF 1 354,010000 354,010000 0,000000
192 R05DA04 CODEINUM CODEINA SLAVIA 15mg COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,173500 0,173500 0,000000
SE MODIFICA
16 A04AA05 PALONOSETRONUM** ALOXI SOL. INJ. 250 mcg/5ml HELSINN BIREX PHARMACEUTICALS LTD. IRLANDA CUTIE X 1 FLAC. DIN STICLA X 5 ML SOL. INJ. P-RF 1 257,172000 257,172000 72,548000
176 R05DA04 CODEINUM CODEINA FOSFAT COMPR. 15mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-RF 20 0,173500 0,173500 0,000000
SE MODIFICA
136 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM TORRENT 750 mg COMPR. FILM. 750 mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. DIN PVC-PVDC/AL X 30 COMPR. FILM. PRF 30 2,362000 2,362000 0,000000
137 N03AX14 LEVETIRACETAMUM** MYAKELL 750 mg COMPR. FILM. 750mg ROMASTRU TRADING SRL ROMANIA CUTIE CU 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. PRF 30 2,834400 2,834400 0,423600
142 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM DESITIN 750 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 750mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 60 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 60 2,834400 2,834400 0,042766
SE ELIMINA
110 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM CIPLA 1000 mg COMPR. FILM. 1000mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 1,878799 1,878799 0,049867
122 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM CIPLA 250 mg COMPR. FILM. 250mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 0,477666 0,477666 0,000000
135 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM CIPLA 500 mg COMPR. FILM. 500mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 0,644666 0,644666 0,000000
138 N03AX14 LEVETIRACETAMUM** LEVETIRACETAM CIPLA 750 mg COMPR. FILM. 750mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. FILM. PRF 30 1,425000 1,425000 0,000000
10. BOALA PARKINSON - G12
SE ADAUGA
107 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,782500 1,782500 0,000000
108 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 125 mg/31,25 mg/200 mg COMPR. FILM. 125mg/31,25mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,782500 1,782500 0,000000
109 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,822800 1,822800 0,000000
110 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 175 mg/43,75 mg/200 mg COMPR. FILM. 175mg/43,75mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,730800 1,730800 0,000000
111 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 200 mg/50 mg/200 mg COMPR. FILM. 200mg/50mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,730800 1,730800 0,000000
112 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 50 mg/12,5 mg/200 mg COMPR. FILM. 50mg/12,5mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,646200 1,646200 0,000000
113 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM)*** SASTRAVI 75 mg/18,75 mg/200 mg COMPR. FILM. 75mg/18,75mg/200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM. P6L 100 1,846300 1,846300 0,000000
114 N04BD02 RASAGILINUM*** HIPERAVIA 1 mg COMPR. 1mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. PRF 30 6,445999 6,445999 2,148334
115 N04BD02 RASAGILINUM*** SAGILIA 1 mg COMPR. 1mg MEDOCHEMIE LTD CIPRU CUTIE CU BLIST. PVC-PE-PVDC/AL X 30 COMPR. PRF 30 6,445999 6,445999 3,153667
116 N04BD02 RASAGILINUM*** AZILECT 1mg COMPR. 1mg TEVA BV OLANDA CUTIE X 30 COMPR.(BLIST. AL/AL) P-RF 30 6,445999 6,445999 1,411334
SE MODIFICA
82 N04BD02 RASAGILINUM*** AZILECT 1mg COMPR. 1mg TEVA PHARMA GMBH GERMANIA CUTIE X 30 COMPR.(BLIST. AL/AL) P-RF 30 6,445999 6,445999 1,411334
SE ELIMINA
9. EPILEPSIE - G11
13. BOLI PSIHICE (SCHIZOFRENIE, TULBURĂRI SCHIZOTIPALE ŞI DELIRANTE, TULBURĂRI AFECTIVE MAJORE, TULBURĂRI PSIHOTICE ACUTE ŞI BOLI PSIHICE COPII, AUTISM, TULBURĂRI CU
DEFICIT DE ATENŢIE/HIPERREACTIVITATE) - G15
Pagina 2 din 5
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP
TARA
DET. APP AMBALAJ Pre
scri
pti
e
cant.
UT/
amba
laj
Pret de
referinta / UT
(RON)
Val. maxima suportata de
sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
232 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM CIPLA 10 mg COMPR. FILM. 10mg CIPLA EUROPE NV BELGIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. PRF 28 0,848928 0,848928 0,000000
SE ADAUGA
55 L01BA01 METHOTREXATUM NAMAXIR 10 mg SOL INJ. IN SERINGA PREUMPLUTA 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,40 ML SOL. INJ. PR 4 39,762500 39,762500 0,000000
56 L01BA01 METHOTREXATUM NAMAXIR 15 mg SOL INJ. IN SERINGA PREUMPLUTA 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,38 ML SOL. INJ. PR 4 39,762500 39,762500 0,000000
57 L01BA01 METHOTREXATUM NAMAXIR 25 mg SOL INJ. IN SERINGA PREUMPLUTA 25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,63 ML SOL. INJ. PR 4 66,270000 66,270000 0,000000
58 L01BA01 METHOTREXATUM NAMAXIR 7,5 mg SOL INJ. IN SERINGA PREUMPLUTA 7,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,30 ML SOL. INJ. PR 4 29,767500 29,767500 0,000000
SE MODIFICA
9 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. 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 35,721000 35,721000 26,159000
12 L01BA01 METHOTREXATUM METOTREXAT EBEWE 10 mg/ml SOL. 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 47,715000 47,715000 31,985000
14 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 47,715000 47,715000 22,305000
15 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 79,524000 79,524000 31,156000
16 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.30ML SOLUTIA INJECTABILA PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 47,715000 47,715000 27,165000
SE ADAUGA
43 H05AA02 TERIPARATIDUM** FORSTEO 20µg/80µl SOL. INJ. 20µg/80µl ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 2,4 ML (28 DOZE X 20 ΜCG/80ΜCL) P-RF 1 1.417,480000 1.417,480000 0,000000
SE ADAUGA
32 S01EC03 DORZOLAMIDUM DORZOLAMIDA ARENA 20 mg/ml PIC. OFT., SOL. 20mg/ml ARENA GROUP S.A. ROMANIA CUTIE CU 1 FLAC. ALB, OPAC DIN PE DE DENSITATE MEDIE, CU CAPACITATEA DE 10 ML, PREVAZUT CU PICURATOR SIGILAT SI UN CAPAC ASAMBLATE DIN 2 PIESE, CU 5 ML PIC. OFT., SOL. P6L 1 14,530000 14,530000 0,000000
33 S01EC03 DORZOLAMIDUM TRUSOPT 20 mg/ml PIC. OFT., SOL. 20mg/ml SANTEN OY FINLANDA CUTIE CU 1 FLAC. DE TIP OCUMETER PLUS ALCATUIT DINTR-UN FLAC. TRANSLUCID DIN PEÎD,CU CAPACITATEA DE 8 ML,CU PICURATOR DIN PEÎD,ÎNCHIS CU UN CAPAC ALCATUIT DIN 2 COMPONENTE SI PREVAZUT CU BANDA DE SIGURANTA, CA PARTE A ETICHETEI PROD.X5 ML SOL.OFT. P6L 1 17,436000 17,436000 4,904000
34 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) COSOPT 20 mg/l + 5 mg/ml PIC. OFT.-SOL. 20mg/ml+5mg/ml SANTEN OY FINLANDA CUTIE CU 1 FLACON DE TIP OCUMETER PLUS X 5 ML PIC. OFT., SOL. P6L 1 31,716000 31,716000 4,204000
SE MODIFICA
2 S01EC03 DORZOLAMIDUM TRUSOPT SOL. OFT. 20mg/ml MERCK SHARP & DOHME ROMANIA CUTIE CU 1 FLAC. DE TIP OCUMETER PLUS ALCATUIT DINTR-UN FLAC. TRANSLUCID DIN PE×D,CU CAPACITATEA DE 8 ML,CU PICURATOR DIN PE×D,ŒNCHIS CU UN CAPAC ALCATUIT DIN 2 COMPONENTE SI PREVAZUT CU BANDA DE SIGURANTA, CA PARTE A ETICHETEI PROD.X5 ML SOL.OFT. P-6L 1 17,436000 17,436000 4,904000
15 S01ED51 COMBINATII (DORZOLAMIDUM+TIMOLOLUM) COSOPT PIC. OFT.-SOL. 20mg/ml+5mg/ml MERCK SHARP & DOHME ROMANIA CUTIE X 1 FLACON DE TIP OCUMETER PLUS X 5ML PIC. OFT., SOL. P-6L 1 31,716000 31,716000 4,204000
18. BOLI ENDOCRINE (GUŞĂ ENDEMICĂ, INSUFICIENŢĂ SUPRARENALĂ CRONICĂ, DIABETUL INSIPID, MIXEDEMUL ADULTULUI, TUMORI HIPOFIZARE CU EXPANSIUNE SUPRASELARĂ, TUMORI NEUROENDOCRINE ŞI
16. POLIARTRITA REUMATOIDA , ARTROPATIA PSORIAZICA SI ARTRITA JUVENILA - G 18
21. GLAUCOM - G 26
Pagina 3 din 5
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP
TARA
DET. APP AMBALAJ Pre
scri
pti
e
cant.
UT/
amba
laj
Pret de
referinta / UT
(RON)
Val. maxima suportata de
sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
SE ADAUGA
25 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
26 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
SE MODIFICA
9 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000
10 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. 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 4 940,998000 940,998000 34,782000
SE ADAUGA
13 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
14 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
SE MODIFICA
4 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000
5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. 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 4 940,998000 940,998000 34,782000
SE ADAUGA
14 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
15 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
SE MODIFICA
4 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000
5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. 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 4 940,998000 940,998000 34,782000
SE ADAUGA
14 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
15 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
26. POLIARTITRITA REUMATOIDA - G31b
27. ARTROPATIA PSORIAZICA - G31c
28. SPONDILITA ANKILOZANTA - G 31d
29. ARTRITA JUVENILA - G 31e
Pagina 4 din 5
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP
TARA
DET. APP AMBALAJ Pre
scri
pti
e
cant.
UT/
amba
laj
Pret de
referinta / UT
(RON)
Val. maxima suportata de
sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
SE MODIFICA
5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000
6 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. 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 4 940,998000 940,998000 34,782000
SE ADAUGA
11 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
12 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
SE MODIFICA
4 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 940,998000 940,998000 34,782000
5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. 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 4 940,998000 940,998000 34,782000
30. PSORIAZIS CRONIC SEVER - G 31f
Pagina 5 din 5
Anexa 9 (Anexa 2d la Ordinul CNAS 944/2015)
Nr. crt
cod
ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP
Tara det.
APP Ambalaj Pre
sc
rip
tie
cant.
UT/
ambal
aj
Pret de
referinta / UT
(RON)
Val. maxima suportata de
sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 100% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
SE ADAUGA
210 A11DA03 BENFOTIAMINUM NEUROSSEN 300 mg COMPR. FILM. 300mg AAA-PHARMA GMBH GERMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P6L 30 2,566333 2,566333 0,000000
211 A11DBN1 COMBINATII NEUROSSEN INJEKT SOL. INJ. FARA CONCENTRATIE AAA-PHARMA GMBH GERMANIA CUTIE X 10 FIOLE DIN STICLA BRUNA PREVAZUTE CU PUNCT DE RUPERE X 2 ML SOL. INJ. PRF 10 3,713000 3,713000 0,000000
SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% DIN PREȚUL DE REFERINȚĂ - CONFORM DCI-URILOR, ALTELE DECÂT CELE DIN
SUBLISTELE A, B, SUBLISTA C SECŢIUNEA C1 ŞI SUBLISTA D, CORESPUNZĂTOARE MEDICAMENTELOR, DE CARE BENEFICIAZĂ COPIII PÂNĂ LA 18 ANI, TINERII DE LA 18
LA 26 DE ANI DACĂ SUNT ELEVI, UCENICI SAU STUDENŢI, DACĂ NU REALIZEAZĂ VENITURI, PRECUM ŞI GRAVIDE ŞI LEHUZE, ÎN TRATAMENTUL AMBULATORIU,
DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILĂ ÎNCEPÂND CU 01 OCTOMBRIE 2016
Pagina 1 din 1
Anexa 10 (Anexa 2e la Ordinul CNAS 944/2015)
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP
tara det.
APP Ambalaj Pre
scri
pti
e
cant.
UT/
amba
laj
Pret de
referinta / UT
(RON)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 100%
din pretul de
referinta)
Val. maxima suportata de
sistemul de asigurari
sociale de sanatate / UT
(pt. asiguratii care
beneficiaza de
compensare 20% din
pretul de referinta)
Co-plata maxima a
asiguratului / UT
(pt. asiguratii care
beneficiaza de
compensare 20%
din pretul de
referinta)
SE MODIFICA
19 A02BX02 SUCRALFATUM VENTER COMPR. 1g KRKA D.D. SLOVENIA CUTIE X 5 BLIST. X 10 COMPR. P-6L 50 0,315200 0,010200 0,063040 0,262360
SUBLISTA D - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 20% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008 CU COMPLETARILE SI MODIFICARILE ULTERIOARE
VALABILA INCEPAND CU 01 OCTOMBRIE 2016
Pagina 1 din 1