ANEXA 1

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 CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008 CU COMPLETARILE SI MODIFICARILE ULTERIOARE VALABILA INCEPAND CU
6 MAI 2011

Val
suportata
de
Pret CNAS/UT
amanuntu (RON)Legea Val
l Pret nr. 95/2006 suportata
tara cant/a maximal/ amanuntul art 213 CNAS/UT
forma conce det. mbala ambalaj maximal/U alin.1 lit. a) (RON) pt.
Nr crt. cod ATC DCI Denumire Comerciala farm. ntratie Detinator APP APP Ambalaj Prescriptie j (RON) T (RON) si f) Adulti

SE MODIFICA

1 A02BA02 RANITIDINUM ULCORAN CAPS. 150mg EUROPHARM SA ROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 6.46 0.323000 0.210150 0.189135
4 A02BA02 RANITIDINUM RANITIDIN COMPR. 150mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 5.30 0.265000 0.210150 0.189135
3 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 4.51 0.225500 0.210150 0.189135
2 A02BA02 RANITIDINUM RANITIDIN ARENA 150mg COMPR. 150mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 6.58 0.329000 0.210150 0.189135
10 A02BA02 RANITIDINUM RANITIDINA ATB 150 MG COMPR. FILM. 150mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. X 10 COMPR. FILM. P-6L 20 6.84 0.342000 0.210150 0.189135
9 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 6.84 0.342000 0.210150 0.189135
8 A02BA02 RANITIDINUM RANITIDINA LAROPHARM 150 mg COMPR. FILM. 150mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 20 4.50 0.225000 0.210150 0.189135
7 A02BA02 RANITIDINUM RANITIDIN 150 mg COMPR. FILM. 150mg AC HELCOR SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 7.55 0.377500 0.210150 0.189135
6 A02BA02 RANITIDINUM RANITIDINA 150 mg COMPR. FILM. 150mg FILDAS TRADING SRL ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL-VMCH X 10 COMPR. FILM. P-6L 20 4.67 0.233500 0.210150 0.189135
5 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 6.93 0.346500 0.210150 0.189135
12 A02BA02 RANITIDINUM RANITIDINA LPH 300 mg COMPR. FILM. 300mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 17.09 0.569666 0.420300 0.378270
13 A02BA02 RANITIDINUM RANITIDINA ATB 300 mg COMPR. FILM. 300mg ANTIBIOTICE S.A. ROMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 10 6.39 0.639000 0.420300 0.378270
14 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 12.77 0.638500 0.420300 0.378270
11 A02BA02 RANITIDINUM RANITIDIN 300 mg COMPR. FILM. 300mg AC HELCOR SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 10 6.39 0.639000 0.420300 0.378270
19 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 9.34 0.333571 0.210150 0.189135
17 A02BA03 FAMOTIDINUM FAMODIN 20 COMPR. FILM. 20mg
AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 8.78 0.292666 0.210150 0.189135
22 A02BA03 FAMOTIDINUM QUAMATEL 40 mg COMPR. FILM. 40mg
GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 14 9.34 0.667142 0.420300 0.378270
24 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 18.01 0.900500 0.210150 0.189135
579 C09CA01 LOSARTANUM LORISTA 100 mg COMPR. FILM. 100mg
KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 28 COMPR. FILM. P-6L 28 32.37 1.156071 1.120081 1.008073
580 C09CA01 LOSARTANUM LOZAP 100 COMPR. FILM. ZENTIVA A.S.
100mg SLOVACIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 30 37.16 1.238666 1.120081 1.008073
582 C09CA01 LOSARTANUM TALOSAN 12,5 mg COMPR. FILM. 12,5mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 4.21 0.140333 0.140010 0.126009
581 C09CA01 LOSARTANUM TALOSAN 12,5 mg COMPR. FILM. 12,5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PA-AL- PVC/AL X 10 COMPR. FILM. P-6L 30 4.21 0.140333 0.140010 0.126009
589 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 17.67 0.631071 0.560040 0.504036
588 C09CA01 LOSARTANUM TALOSAN 50 mg COMPR. FILM. 50mg TERAPIA SA ROMANIA CUTIE X 3 FOLII AL/PE X 10 COMPR. FILM. P-6L 30 17.70 0.590000 0.560040 0.504036

Pagina 1 din 2
 Val
suportata
de
Pret CNAS/UT
amanuntu (RON)Legea Val
l Pret nr. 95/2006 suportata
tara cant/a maximal/ amanuntul art 213 CNAS/UT
forma conce det. mbala ambalaj maximal/U alin.1 lit. a) (RON) pt.
Nr crt. DCI
cod ATC Denumire Comerciala farm. ntratie Detinator APP APP Ambalaj Prescriptie j (RON) T (RON) si f) Adulti
587 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 17.70 0.590000 0.560040 0.504036
586 C09CA01 LOSARTANUM LORISTA COMPR. FILM. 50mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. DIN PVC-PVDC/AL X 14 COMPR. FILM. P-6L 28 17.78 0.635000 0.560040 0.504036
585 C09CA01 LOSARTANUM COZAAR COMPR. FILM. 50mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPACE AL/PVC-PE-PVDC X 14 COMPR. FILM. P-6L 28 63.80 2.278571 0.560040 0.504036
590 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 19.40 0.646666 0.560040 0.504036
700 D01AC02 MICONAZOLUM MICONAZOL NITRAT 2% CREMA 2% SLAVIA PHARM SRL ROMANIA CUTIE X 1 TUB X 20 G P-RF 1 6.75 6.750000 6.152250 5.537025
701 D01AC02 MICONAZOLUM MICONAL ECOBI CREMA 20mg/g FARMACEUTICI ECOBI S.A.S ITALIA CUTIE X 1 TUB DIN AL X 30 G CREMA P-RF 1 9.40 9.400000 9.228375 8.305537
702 D01AC10 BIFONAZOLUM BIAZOL 10 mg/g CREMA 10mg/g GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 1 TUB X 15 G CREMA P-RF 1 9.35 9.350000 4.614187 4.152768

Pagina 2 din 2
 ANEXA 2
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 CONTRIBUTIE PERSONALA DIN HG NR. 720/2008
CU MODIFICARILE SI COMPLETARILE ULTERIOARE VALABILA INCEPAND CU 6 MAI 2011

Pret Val suportata

amanuntu de CNAS/UT Val
l Pret (RON)Legea suportata
tara cant/a maximal/a amanuntul nr. 95/2006 CNAS/UT
forma concent det. mbala mbalaj maximal/UT art 213 alin.1 (RON) pt.
Nr. crt cod ATC DCI Denumire Comerciala farm. ratie Detinator APP APP Ambalaj Prescriptie j (RON) (RON) lit. a) si f) Adulti

SE ADAUGA

921 C09CA04 IRBESARTANUM IRBESARTAN TERAPIA 150 mg COMPR. FILM. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 53.93 1.926071 1.120081 0.56004
922 C09CA04 IRBESARTANUM IRBESARTAN TERAPIA 300 mg COMPR. FILM. 300mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 70.44 2.515714 2.240163 1.120081

SE MODIFICA

287 C09CA03 VALSARTANUM DIOVAN 160 mg COMPR. FILM. 160mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-6L 28 115.23 4.1153570 2.2401630 1.1200810
289 C09CA03 VALSARTANUM DIOVAN 40 mg COMPR. FILM. 40mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-6L 28 71.06 2.5378570 0.5600400 0.2800200
291 C09CA03 VALSARTANUM CORETON 80 mg COMPR. FILM. 80mg ZENTIVA K.S. REPUBLICA SLOVACA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 33.59 1.1996420 1.1200810 0.5600400
290 C09CA03 VALSARTANUM DIOVAN 80 mg COMPR. FILM. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 2 BLIST. AL/PVC-PE-PVDC X 14 COMPR. FILM. P-6L 28 90.80 3.2428570 1.1200810 0.5600400
294 C09CA04 IRBESARTANUM IRBESARTAN SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 33.10 1.1821420 1.1200810 0.5600400
295 C09CA04 IRBESARTANUM IRPRESTAN 150 mg COMPR. FILM. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 33.10 1.1033330 1.1033330 0.5516660
296 C09CA04 IRBESARTANUM IFIRMASTA 150 mg COMPR. FILM. 150mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PE/PVDC/AL X 28 COMPR. FILM. P-6L 28 36.92 1.3185710 1.1200810 0.5600400
292 C09CA04 IRBESARTANUM APROVEL 150mg COMPR. FILM. 150mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 65.97 2.3560710 1.1200810 0.5600400
297 C09CA04 IRBESARTANUM IRBESARTAN TEVA 150 mg COMPR. FILM. 150mg TEVA PHARMA B.V. OLANDA CUTIE X BLIST. PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 33.10 1.1821420 1.1200810 0.5600400
293 C09CA04 IRBESARTANUM IRBESARTAN WINTHROP 150mg COMPR. FILM. 150mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X 28 COMPR. FILM. (BLIST. PVC/PVDC/AL) P-6L 28 44.36 1.5842850 1.1200810 0.5600400
299 C09CA04 IRBESARTANUM APROVEL 300mg COMPR. FILM. 300mg SANOFI PHARMA - BRISTOL MYERS SQUIBB FRANTA CUTIE X BLIST PVC/PVDC/AL X 28 COMPR. FILM. P-6L 28 87.05 3.1089280 2.2401630 1.1200810
301 C09CA04 IRBESARTANUM IRBESARTAN SANDOZ 300 mg COMPR. FILM. 300mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P-6L 28 64.09 2.2889280 2.2401630 1.1200810
304 C09CA06 CANDESARTANUM CILEXETIL ATACAND COMPR. 16mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 65.96 2.3557140 2.2401630 1.1200810
306 C09CA06 CANDESARTANUM CILEXETIL ATACAND COMPR. 8mg ASTRAZENECA AB SUEDIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 COMPR. P-6L 28 55.44 1.9800000 1.1200810 0.5600400
309 C09CA07 TELMISARTANUM TOLURA 40 mg COMPR. 40mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST.OPA-AL-PVC/AL X 28 COMPR. P-6L 28 38.99 1.3925000 1.1200810 0.5600400
308 C09CA07 TELMISARTANUM PRITOR 40 mg COMPR. 40mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 28COMPR.( BLIST. PERFORATE UNIDOZA PA/AL/PVC ) P-6L 28 63.35 2.2625000 1.1200810 0.5600400
310 C09CA07 TELMISARTANUM TEZEO 40 mg COMPR. 40mg ZENTIVA, K.S. REPUBLICA SLOVACA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. P-6L 30 41.77 1.3923330 1.1200810 0.5600400
307 C09CA07 TELMISARTANUM MICARDIS 40 mg COMPR. 40mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 28 COMPR. ( BLIST. PA/AL/PVC) P-6L 28 59.99 2.1425000 1.1200810 0.5600400
311 C09CA07 TELMISARTANUM MICARDIS 80 mg COMPR. 80mg BOEHRINGER INGELHEIM PHARMA GMBH & CO. KG GERMANIA CUTIE X 28COMPR. ( BLIST. PA/AL/PVC) P-6L 28 76.51 2.7325000 2.2401630 1.1200810
312 C09CA07 TELMISARTANUM PRITOR 80 mg COMPR. 80mg BAYER SCHERING PHARMA AG GERMANIA CUTIE X 28COMPR.( BLIST. PERFORATE UNIDOZA PA/AL/PVC ) P-6L 28 76.51 2.7325000 2.2401630 1.1200810
540 G04CB01 FINASTERIDUM* FINANORM 5 mg COMPR. FILM. 5mg ICN POLFA RZESZOW S.A. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P-6L 30 34.85 1.1616660 1.1609160 0.5804580
542 G04CB01 FINASTERIDUM* TAREDOX 5 mg COMPR. FILM. 5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM. P-6L 28 33.61 1.2003570 1.1609160 0.5804580
538 G04CB01 FINASTERIDUM* FINASTERIDA BIOGALENICA 5 mg COMPR. FILM. 5mg LABORATOARELE PROF.DR.MORAIT S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 33.61 1.2003570 1.1609160 0.5804580
537 G04CB01 FINASTERIDUM* TAREDOX 5 mg COMPR. FILM. 5mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM. P-6L 28 33.61 1.2003570 1.1609160 0.5804580
536 G04CB01 FINASTERIDUM* PROSCAR 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC/PE/PVD-AL X 14 COMPR.FILM. P-6L 28 63.60 2.2714280 1.1609160 0.5804580
535 G04CB01 FINASTERIDUM* PROSCAR 5 mg COMPR. FILM. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PVC/PE/PVD-AL X 14 COMPR.FILM. P-6L 14 32.88 2.3485710 1.1609160 0.5804580
543 G04CB02 DUTASTERIDUM* AVODART 0,5 mg CAPS. MOI 0,5mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE X 3 BLIST.PVC-PVDC/AL X 10 CAPS. MOI P-6L 30 94.50 3.1500000 3.1500000 1.5750000

LIOF.+
SOLV. PT. CUTIE X 1 KIT X 1 FLAC. CU LIOFILIZAT
SUSP. INJ. (MICROSFERE) + 1 FIOLA X 2 ML SOLV. + 1
622 L02AE02 LEUPRORELINUM***# LUCRIN DEPOT 3,75mg ELIB. PREL. 3,75mg ABBOTT LABORATORIES LTD. SPANIA SERINGA SI TAMPON IMB S/P-RF 1 425.50 425.5000000 382.9500000 191.4750000

Pagina 1 din 2
 Pret Val suportata
amanuntu de CNAS/UT Val
l Pret (RON)Legea suportata
tara cant/a maximal/a amanuntul nr. 95/2006 CNAS/UT
forma concent det. mbala mbalaj maximal/UT art 213 alin.1 (RON) pt.
Nr. crt cod ATC DCI Denumire Comerciala farm. ratie Detinator APP APP Ambalaj Prescriptie j (RON) (RON) lit. a) si f) Adulti
LIOF. +
SOLV. PT. CUTIE X 7 FLAC. CU LIOF. PT. SOL. INJ. + 7
624 L02AE04 TRIPTORELINUM***# DIPHERELINE 0,1 mg SOL. INJ. 0,1mg IPSEN PHARMA FRANTA FIOLE X 1 ML SOLV. S/P-RF 7 133.04 19.0057140 10.2119910 5.1059950
PULB. +
SOLV. PT.
SUSP. INJ. CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT.
CU ELIB. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA
625 L02AE04 TRIPTORELINUM***# DIPHERELINE PR 11,25 mg PREL. 11,25mg IPSEN PHARMA FRANTA X 2 ML SOLV. + 1 B S/P-RF 1 1,171.73 1,171.7300000 1,148.8500140 574.4250060
PULB. +
SOLV. PT.
SUSP. INJ. CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT.
CU ELIB. SUSP. INJ. + 1 FIOLA DIN STICLA INCOLORA
626 L02AE04 TRIPTORELINUM***# DIPHERELINE 3,75 mg PREL. 3,75mg IPSEN PHARMA FRANTA X 2 ML SOLV. + 1 B S/P-RF 1 436.24 436.2400000 436.2400000 218.1200000
GONAPEPTYL ZILNIC 0,1 0,1mg/ CUTIE X 28 SERINGI PREUMPLUTE DIN
628 L02AE04 TRIPTORELINUM***# mg/ml SOL. INJ. ml FERRING ARZEIMITTEL GES.MBH AUSTRIA STICLA INCOLORA X 1 ML SOL. INJ S/P-RF 28 818.33 29.2260710 10.2119910 5.1059950
GONAPEPTYL ZILNIC 0,1 0,1mg/ CUTIE X 7 SERINGI PREUMPLUTE DIN STICLA
627 L02AE04 TRIPTORELINUM***# mg/ml SOL. INJ. ml FERRING ARZEIMITTEL GES.MBH AUSTRIA INCOLORA X 1 ML SOL. INJ S/P-RF 7 230.24 32.8914280 10.2119910 5.1059950

Pagina 2 din 2
 ANEXA 3

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 PENTRU CARE DECONTAREA SE FACE PE BAZA PROTOCOALELOR TERAPEUTICE CU MONITORIZAREA PRESCRIERII ŞI CONSUMULUI PRIN
COMISIILE PARITARE; MEDICAMENTELE DIN ACEASTĂ SUBLISTĂ SE ELIBEREAZĂ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZĂ DE PRESCRIPŢIE MEDICALĂ CU REŢINERE ÎN FARMACIE ( P-RF)
DIN HG NR. 720/2008 CU MODIFICARILE SI COMPLETARILE ULTERIOARE
VALABILĂ ÎNCEPÂND CU 6 MAI 2011

VAL.SUPOR
TATAT VAL.SUP
PRET CNAS/ ORTATA
AMANUN PRET UT(RON)- T CNAS/
TUL AMANUNT LEGEA NR. UT
CONCE TARA MAXIMA UL 95/2006 ART (RON)
NTRATI DET. CANTI L MAXIMAL/ 213 alin.(1) PT.
NR.CRT COD ATC DCI Denumire Comerciala FORMA FARMACEUTICA E DETINATOR APP APP AMBALAJ Prescriptie TATE (RON) UT (RON) lit. a) si f) ADULTI

16. POLIARTRITA REUMATOIDA , ARTROPATIA PSORIAZICA SI ARTRITA JUVENILA - G 18

SE ADAUGA

71 L04AA13 LEFLUNOMIDUM** LEFLUNOMIDE WINTHROP 10mg COMPR. FILM. 10mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. P-RF/R 30 179.89 5.996333 5.996333 5.996333
72 L04AA13 LEFLUNOMIDUM** LEFLUNOMIDE WINTHROP 20mg COMPR. FILM. 20mg SANOFI- AVENTIS DEUTSCHLAND GMBH GERMANIA CUTIE X 1 FLAC. PEID X 30 COMPR. FILM. P-RF/R 30 187.99 6.266333 6.266333 6.266333

20. BOALA CRONICA DE RINICHI - faza predializa - G 25

SE ADAUGA

67 C09CA04 IRBESARTANUM** IRBESARTAN TERAPIA 150 mg COMPR. FILM. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 53.93 1.926071 1.323999 1.323999
68 C09CA04 IRBESARTANUM** IRBESARTAN TERAPIA 300 mg COMPR. FILM. 300mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. P-6L 28 70.44 2.515714 1.922799 1.922799

Pagina 1 din 1
 ANEXA 4

SECŢIUNEA C2 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% din pret de decontare - conform denumirilor comune internaţionale
corespunzătoare medicamentelor de care beneficiaza asiguratii inclusi in programele nationale de sănătate cu scop curativ in tratamentul ambulatoriu si
spitalicesc
DIN HG NR. 720/2008 CU MODIFICARILE SI COMPLETARILE ULTERIOARE SI ORDINUL MS NR. 426/2009
VALABILĂ ÎNCEPÂND CU 6 MAI 2011

Pret cu
Grupa Pret cu Pret cu amanuntul
Nr. Forma Concentr ridicata amanuntul maximal /
terapeut Denumire generica Denumire comerciala Firma Tara Ambalaj Prescriptie Cantitate
maximal / maximal / U.T. = Pret
crt farmaceutica atie / U.T.
ica ambalaj ambalaj de decontare
/ U.T.

P3: PROGRAMUL NATIONAL DE ONCOLOGIE

SE MODIFICA

CUTIE X 1 FLAC. DIN STICLA INCOLORA X 50ML

PULB. PT. SOL. PHARMACEUTICAL WORKS CONTINAND 1 G GEMCITABINA PULB.PT. SOL.
68 L01BC05 GEMCITABINUM** GEMCITABINE POLPHARMA 1 g PERF. 1g POLPHARMA SA POLONIA PERF. S 1 183.59 224.13 224.130000
CUTIE X 1 FLAC. DIN STICLA INCOLORA X 10ML
PULB. PT. SOL. PHARMACEUTICAL WORKS CONTINAND 200MG GEMCITABINA PULB.PT.
73 L01BC05 GEMCITABINUM** GEMCITABINE POLPHARMA 200 mg PERF. 200mg POLPHARMA SA POLONIA SOL. PERF. S 1 41.05 53.70 53.700000
CONC. PT. SOL. MAREA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 2
153 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml PERF. 10mg/ml HOSPIRA UK LTD BRITANIE ML CONC. PT. SOL. PERF. S/P-RF 1 262.36 320.29 320.290000
CONC. PT. SOL. MAREA CUTIE CU 1 FLAC. DIN STICLA INCOLORA X 8
152 L01CD02 DOCETAXELUM** DOCETAXEL HOSPIRA 10 mg/ml PERF. 10mg/ml HOSPIRA UK LTD BRITANIE ML CONC. PT. SOL. PERF. S/P-RF 1 920.56 1,041.56 1,041.560000

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 ANEXA 5

SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% - CONFORM DCI-URILOR DIN CANAMED, ALTELE DECÂT CELE DIN SUBLISTELE A, B, C1, C2,
INDICATE PENTRU COPII PÂNĂ LA 18 ANI, TINERI DE LA 18 LA 26 DE ANI DACA SUNT ELEVI, STUDENŢI SAU UCENICI DACĂ NU REALIZEAZĂ VENITURI, PRECUM ŞI GRAVIDE ŞI
LĂUZE
DIN HG NR. 720/2008 CU MODIFICARILE SI COMPLETARILE ULTERIOARE
VALABILĂ ÎNCEPÂND CU 6 MAI 2011

VAL.SUPOR
TATAT
CNAS/
PRET PRET UT(RON)- VAL.SUPO
AMANUN AMANUNT LEGEA NR. RTATAT
forma TUL UL 95/2006 ART CNAS/ UT
Denumire farmaceutic concentr tara det. MAXIMAL MAXIMAL/ 213 alin.(1) (RON) PT.
Nr. crt cod ATC DCI Comerciala a atie Detinator APP APP Ambalaj Prescriptie cant (RON) UT (RON) lit. a) si f) ADULTI

SE MODIFICA

105 D01AC08 KETOCONAZOLUM KETOCONAZOL CREMA 2% TIS FARMACEUTIC SA ROMANIA CUTIE X 1 TUB PEJD X 15 G P-RF 1 5.32 5.32 5.320000 5.320000
104 D01AC08 KETOCONAZOLUM NIZORAL CREMA 2% JANSSEN PHARMACEUTICA N.V. BELGIA CUTIE X 1 TUB X 15 G P-RF 1 9.01 9.01 6.384000 6.384000

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