DAFTAR

OBAT-OBAT E-KATALOG
JUNI 2016
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

AAFACT 1000 UI - Faktor VIII (Konsentrat) Serb Inj 1000 IU PT. Graha Farma 3,600,000
AAFACT 500 IU - Faktor VIII (Konsentrat) Serb Inj 500 IU/Vial+Pelarut 5 ml PT. Graha Farma 1,850,000
ACTATECAN - Irinotekan - inj 20 mg/mL PT ACTAVIS INDONESIA 795,000
ACTILYSE - Alteplase injeksi 50 mg/vial PT. Boehringer Ingelheim 4,125,000
ACTOPLATIN - Karboplatin inj 150 mg/15 mL PT ACTAVIS INDONESIA 175,000
ACTOPLATIN - Karboplatin inj 450 mg/45 mL PT ACTAVIS INDONESIA 407,500
ACTRAPID PENFILL - Human insulin short acting inj 100 UI/ml, penfill cartridge PT Ferron Par Pharmaceuticals 75,000
ACTRAPID VIAL - Human insulin short acting inj 100 UI/ml, vial PT Ferron Par Pharmaceuticals 143,500
ADALAT OROS 20 MG - Nifedipin tab 20 mg, slow release; oros PT Bayer Indonesia 2,999
ADALAT OROS 30 MG - Nifedipin tab 30 mg, oros PT Bayer Indonesia 3,500
ALBAPURE 20 VIAL 100 ML Albumin serum normal (human albumin) inj 20% P.T. Dexa Medica 850,000
ALBAPURE 20 VIAL 50 ML Albumin serum normal (human albumin) inj 20% vial 50 ml P.T. Dexa Medica 409,200
ALBUMAN 100 ML - Albumin Serum Normal (Human Albumin) Inj 20% 100 ml PT. Graha Farma 850,000
ALBUMAN 50 ML - Albumin Serum Normal (Human Albumin) Inj 20% 50 ml PT. Graha Farma 409,200
ALBUMINAR 25 - Albumin serum normal (human albumin) injeksi 25%, 100 ml PT Ferron Par Pharmaceuticals 1,500,000
ALKERAN - Melfalan Tablet 2 mg PT Glaxo Wellcome Indonesia 11,220
ALUVIA - Kombinasi: Lopinavir 200 mg; Ritonavir (LPV/r) 50 mg PT. Abbott Indonesia 6,600
AMINOFLUID - Larutan mengandung Asam Amino 1000 ml PT. Otsuka Indonesia 118,250
AMINOFLUID - Larutan mengandung Asam Amino 500 ml PT. Otsuka Indonesia 64,990
AMINOFUSIN HEPAR - Larutan mengandung Asam Amino (Asam Amino 5% dengan BCAA 45%, L-Ornithine L Aspartate 8.03 gr/L,
PT KALBE FARMA Tbk 88,500
Sorbitol 50 gr/L, Xylitol 50 gr/L)
AMINOFUSIN L600 - Larutan mengandung Asam Amino (Kombinasi AA 50 g/L, Sorbitol 50 g/L, Xylitol 50 g/L, Vit C 0.4 g/L, Inositol 0.5
PT KALBE FARMA Tbk 56,200
g/L, Niasinamida 0.06 g/L, Vit B6 0.04 g/L, Riboflavin Na Fosfat 2.5 mg/L, elektrolit)
AMINOFUSIN PAED - Larutan mengandung Asam Amino (Kombinasi Asam amino 50 g/L, Vitamin dan elektrolit) PT KALBE FARMA Tbk 52,000
AMINOLEBAN - Larutan mengandung Asam Amino 500 ml PT. Otsuka Indonesia 71,100

1
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

AMINOSTERIL INFANT 6% - Larutan mengandung Asam Amino (Asam Amino 6%, mengandung Taurine 0,24 gr/l, tidak mengandung
PT. Fresenius Kabi Combiphar 43,450
Elektrolit)
AMINOSTERIL N-HEPA - Larutan mengandung Asam Amino (Asam amino 8%) : Asam amino spesifik untuk gangguan hati dengan
PT. Fresenius Kabi Combiphar 71,500
konsentrasi tinggi BCAA 42%
AMIPAREN - Larutan mengandung Asam Amino (aminparen injeksi) PT. Otsuka Indonesia 86,275
ANZATAX 30MG/VIAL - Paklitaksel Inj 30mg/vial PT Tempo Scan Pacific, Tbk 200,000
APIDRA SOLOSTAR 100IU/ML 5PENS X3ML - Analog insulin rapid actinginj 100 UI/ml, vial/cartridge disposible/penfill cartridge (Insulin
PT Aventis Pharma 87,000
glulisine 100 IU/ml)
ARICEPT EVESS 10 MG Donepezil Tablet Effervesent 10 mg PT. Eisai Indonesia 12,485
ARIMIDEX 1 MG - Anastrozole 1 mg PT AstraZeneca Indonesia 34,900
ARIXTRA - Fondaparinuks inj 2,5 mg/0,5 ml PT Glaxo Wellcome Indonesia 241,667
AROMASIN - Eksemestan 25mg PT. Pfizer Indonesia 42,600
ARTESUNATE - Artesunate injeksi i.v./i.m. 60 mg/ml PT. PHARMA LABORATORIES 38,999
ASERING - Asetat Ringer (Asering Plabot) PT. Otsuka Indonesia 9,275
ATROVENT HFA - Ipratropium bromida anhidrous inhalasi 0.02 mg/dosis PT. Boehringer Ingelheim 83,500
ATROVENT SOLUTION FOR INHALATION 0.025% - Ipratropium bromida cairan inhalasi 0,025% PT. Boehringer Ingelheim 90,000
AVAMYS - Flutikason furoat intranasal spray PT Glaxo Wellcome Indonesia 103,000
AVASTIN - Bevasizumab injeksi 100mg/4ml PT. Boehringer Ingelheim 4,803,697
AVELOX INFUS - Moksifloksasin Infus 400mg/250ml PT Bayer Indonesia 240,000
AVELOX TABLET - Moksifloksasin Tablet PT Bayer Indonesia 30,500
AVODART - Dutasteride 0,5 mg PT SmithKline Beecham Pharmaceuticals 7,750
AZITHROMYCIN 250 MG KAPLET OGB Azitromisin tablet 250 mg PT. SOHO Industri Pharmasi 3,278
BANADOZ 100 - Sefpodoksim Proksetil 100 mg PT Sandoz Indonesia 4,250
BCG VACCINE (GS) - Vaksin BCG-GS PT. Bio Farma 59,950
BCG VACCINE (SII) - Vaksin BCG-SII PT. Bio Farma 59,950

2
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

BCG VACCINE SSI - Vaksin BCG inj i.k. 0,75 mg/mL + pelarut PT. Bio Farma 59,950
BEROTEC MDI - Fenoterol HBr aerosol 100 mcg/dosis PT. Boehringer Ingelheim 80,000
BEROTEC SOLUTION - Fenoterol HBr solution 0,1% PT. Boehringer Ingelheim 125,750
BETABLOK - Atenolol 100 mg PT KALBE FARMA Tbk 700
BIOPREXUM 5 MG - Perindoprilarginin tab 5 mg PT Darya Varia 2,640
BIVALENT ORAL POLIOMYELITIS Vaksin Polio b-OPV 10 dosis PT. Bio Farma 19,954
BLEOCIN - Bleomisin Serb Inj 15 mg/mL PT KALBE FARMA Tbk 345,000
BONDRONAT - Asam Ibandronat injeksi 6mg/6ml PT. Boehringer Ingelheim 2,209,000
BONESCAN KAEF - MDP (methylene diphosphonate) 1 mg methylene diphosphonic acid/mL PT. Kimia Farma (Persero) Tbk 510,000
BREXEL 20 MG - Dosetaksel inj 20 mg/0,5 mL PT KALBE FARMA Tbk 400,000
BREXEL 80 MG - Dosetaksel inj 80 mg/2 mL PT KALBE FARMA Tbk 1,325,000
BRICASMA RESPULES - Terbutaline sulphate 2.5 mg/ml PT AstraZeneca Indonesia 6,850
BRICASMA TURBUHALER 0,5 MG - Terbutalin sulfat 0.5 mg - 100 Dosis PT AstraZeneca Indonesia 56,012
BRILINTA 90 MG - Ticagrelor 90 mg PT AstraZeneca Indonesia 7,500
BUNASCAN - Bupivaciane 0.5 % PT Pratapa Nirmala 30,800
CA GLUCONAS 10 Kalsium Glukonat inj i.v 10% (100mg/ml) PT Ethica Industri Farmasi 9,955
CAMPTO - Irinotekan Inj 20mg/ml PT. Pfizer Indonesia 423,159
CARDACE 2.5MG 6X10 S TABLET - Cardace 2.5 mg PT Pharma Health Care 995
CARDURA 1MG - Doksazosin mesilat 1mg PT. Pfizer Indonesia 3,480
CARDURA 2MG - Doksazosin mesilat 2mg PT. Pfizer Indonesia 5,480
CASODEX 150 MG - Bicalutamide 150 mg PT AstraZeneca Indonesia 79,000
CASODEX 50 MG - Bicalutamide 50 mg PT AstraZeneca Indonesia 49,000
CATAPRES INJEKSI - Klonidin HCl injeksi 150 mcg/mL PT. Boehringer Ingelheim 32,600
CELLCEPT - Mikofenolat Mofetil 500mg PT. Boehringer Ingelheim 17,750

3
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

CERTICAN 0,25 MG TAB - Everolimus tab 0,25mg PT Novartis Indonesia 11,813

CERTICAN 0,5 MG TAB - Everolimus tab 0,5mg PT Novartis Indonesia 23,250
CISPLATIN - Cisplatin serb inj 10 mg PT. DANKOS FARMA 25,250
CISPLATIN - Cisplatin serb inj 50 mg PT. DANKOS FARMA 110,000
CLINIMIX N9G15E - Larutan mengandung Asam Amino (Kombinasi Glukosa 75 gr dan elektrolit + Asam Amino 28 gr ) PT KALBE FARMA Tbk 225,000
CLINIMIX N9G20E - Larutan mengandung Asam Amino (Kombinasi Glukosa 100 gr dan elektrolit + Asam Amino 28 gr ) PT KALBE FARMA Tbk 230,000
CLINOLEIC 20% - Larutan mengandung Lipid (Infus Emulsi Lipid LCT (Omega 9, Omega 6), MCT - 20% 250 ml) PT KALBE FARMA Tbk 169,125
CLOZAPINE 100 - Klozapin 100 mg PT. Mersifarma Tirmaku Mercusana 5,000
CLOZAPINE 25 - Klozapin 25 mg PT. Mersifarma Tirmaku Mercusana 1,550
COFACT 250 IU - Faktor Koagulasi II (14-35 IU/ml), Faktor Koagulasi VII (7-20 IU/ml), Faktor Koagulasi IX (25 IU/ml), Faktor Koagulasi X
PT. Graha Farma 2,180,200
(14-35 IU/ml)
COFACT 500 IU/20 ML - Faktor Koagulasi II (14-35 IU/ml), Faktor Koagulasi VII (7-20 IU/ml), Faktor Koagulasi IX (25 IU/ml), Faktor
PT. Graha Farma 4,510,000
Koagulasi X (14-35 IU/ml)
COMAFUSIN HEPAR - Larutan mengandung Asam Amino (Asam Amino 5% dengan BCAA 50%, L-Ornithine L Aspartate 10 gr/L, Sorbito
PT. FINUSOLPRIMA FARMA INTERNASIONAL 81,750
50 gr/L, Xylitol 50 gr/L)
COMBIVENT UDV - Kombinasi : Ipratropium bromida 0,5 mg Salbutamol 2,5 mg cairan inhalasi PT. Boehringer Ingelheim 5,990
CONCOR 2.5 - Bisoprolol tablet 2,5 mg PT. Merck Tbk 746
CORDARONE - Amiodaron injeksi 150 mg/3 ml PT Aventis Pharma 12,480
CURACIL - Fluorourasil inj 500 mg/ 5 mL PT KALBE FARMA Tbk 36,050
CYCLOVID 1000 MG - Siklofosfamid serbuk injeksi i.v. 1000 mg PT. NOVELL PHARMACEUTICAL LABORATORIES 223,300
CYCLOVID 200 MG - Siklofosfamid serbuk injeksi i.v. 200 mg PT. NOVELL PHARMACEUTICAL LABORATORIES 71,500
CYCLOVID 500 MG - Siklofosfamid serbuk injeksi i.v. 500 mg PT. NOVELL PHARMACEUTICAL LABORATORIES 107,250
CYMEVENE - Gansiklovir serbuk injeksi 500mg (50mg/ml) PT. Boehringer Ingelheim 445,000
DACARBAZINE MEDAC 200 MG - Dakarbazin serb inj 200 mg/vial PT DIPA PHARMALAB INTERSAINS 275,000
DAUNOCIN - Daunorubisin serbuk injeksi 20 mg/vial PT. NOVELL PHARMACEUTICAL LABORATORIES 234,300

4
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

DBL CARBOPLATIN 150 MG - Karboplatin 150 mg / 15 ml PT Tempo Scan Pacific, Tbk 175,000
DBL CARBOPLATIN 450 MG - Karboplatin 450 mg / 45mL PT Tempo Scan Pacific, Tbk 407,500
DBL CYTARABINE INJECTION - Cytarabine 100mg/mL PT Tempo Scan Pacific, Tbk 585,000
DBL DACARBAZINE - Dacarbazine 200 mg/vial PT Tempo Scan Pacific, Tbk 275,000
DBL GEMCITABINE 1G - Gemcitabine HCI - Gemcitabine 1G/vial PT Tempo Scan Pacific, Tbk 800,000
DBL GEMCITABINE 200MG - Gemcitabine HCI - Gemcitabine 200mg PT Tempo Scan Pacific, Tbk 175,000
DBL GLICERYL TRINITRATE 50 MG/10 ML INJ. - Glyceryl Trinitrate 5mg/mL PT Tempo Scan Pacific, Tbk 130,000
DBL LEUCOVORIN - Kalsium Folinat (Leukovorin Ca) inj 50 mg/ml PT Tempo Scan Pacific, Tbk 82,000
DBL OXALIPLATIN 100MG - Oxaliplatin 100mg PT Tempo Scan Pacific, Tbk 800,000
DBL OXALIPLATIN 50MG - Oxaliplatin 50mg PT Tempo Scan Pacific, Tbk 400,000
DECULIN 15 MG - Pioglitazon tab 15 mg P.T. Dexa Medica USD 3,120.00
DECULIN 30 MG - Pioglitazon tab 30 mg P.T. Dexa Medica USD 4,525.00
DEPAKOTE ER 250 MG - Valproat tab SR 250 mg PT. Abbott Indonesia 2,990
DEPAKOTE ER 500 MG - Valproat tab SR 500 mg PT. Abbott Indonesia 6,000
DEPAKOTE TAB 250 MG - Valproat tablet salut 250 mg PT. Abbott Indonesia 1,750
DERMASOLON - Flucinolone Asetonide Salep 0.025 % PT Ikapharmindo Putramas 5,500
DESFERAL - Deferoksamin Mesilat Serbuk Injeksi 500mg PT Novartis Indonesia 117,500
DEXOCORT - Desoksimetason salep 0,25% PT. Kimia Farma (Persero) Tbk 9,818
DIAMICRON MR 60 - Gliklazid tab MR 60mg PT Darya Varia 5,665
DIPEPTIVEN - Larutan mengandung Asam Amino (Glutamine 20gr) PT. Fresenius Kabi Combiphar 229,900
DOCETAXEL - Dosetaksel inj 20 mg/0,5 mL PT ACTAVIS INDONESIA 400,000
DOCETAXEL - Dosetaksel inj 80 mg/2 mL PT ACTAVIS INDONESIA 1,325,000
DORNER - Beraprost Na PT. COMBINED IMPERIAL PHARMACEUTICALS 4,400
DULCOLAX SUPP INFANT - Bisakodil suppositoria 5 mg PT. Boehringer Ingelheim 4,990

5
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

DUROGESIC 12,5 MU MATRIX - Fentanil patch 12,5 mcg/jam PT. Kimia Farma (Persero) Tbk 97,725
DUROGESIC 25 MU MATRIX - Fentanil patch 25 mcg/jam PT. Kimia Farma (Persero) Tbk 188,000
DUROGESIC 50 MU MATRIX - Fentanil patch 50 mcg/jam PT. Kimia Farma (Persero) Tbk 350,000
EAS PFRIMER - Larutan mengandung Asam Amino (Asam Amino Esensial 7%+Xylitol 10 g/L+ Histidine) PT. FINUSOLPRIMA FARMA INTERNASIONAL 53,000
ELOXATIN - Oksaliplatin serbuk injeksi 100 mg / vial PT Aventis Pharma 800,000
ELOXATIN - Oksaliplatin serbuk injeksi 50 mg / vial PT Aventis Pharma 400,000
EPEEDO Epirubisin - serb inj 50 mg/25mL PT. Kimia Farma (Persero) Tbk 475,000
EPISINDAN - Epirubisin serb inj 10 mg/5 mL PT ACTAVIS INDONESIA 99,000
EPISINDAN - Epirubisin serb inj 50 mg/25mL PT ACTAVIS INDONESIA 475,000
EPOTREX 2000 IU - EPOTREX 2000 IU - Eritropoetin-alfa inj 2000 PT. NOVELL PHARMACEUTICAL LABORATORIES 99,000
EPREX 2000 - Eritropoetin-alfa inj 2000 Ul/ml PT. SOHO Industri Pharmasi 99,000
ERBITUX - Setuksimab infus 5 mg/ml PT. Merck Tbk 3,650,000
ESMERON - Rokuronium injeksi i.v. 50 mg/5ml PT Merck Sharp Dohme Pharma Tbk 46,539
EUTHYROX 100 - Levotiroksin tablet/kapsul/kapsul 100 mcg PT. Merck Tbk 850
EUTHYROX 50 - Levotiroksin tablet/kaplet/kapsul 50 mcg PT. Merck Tbk 719
EXJADE 250 MG TAB - Deferasiroks tablet disp/eff 250mg PT Novartis Indonesia 76,000
EXJADE 500 MG TAB - Deferasiroks tablet disp/eff 500mg PT Novartis Indonesia 150,000
FARGOXIN INJ - Digoksin injeksi 0,25 mg/ml PT Pratapa Nirmala 22,000
FARMABES INJEKSI 25 MG - Diltiazem Injeksi 25 mg/5mL PT Pratapa Nirmala 55,000
FARNORMIN - Atenolol 50 mg PT Pratapa Nirmala 352
FARPRESIN - Vasopresin injeksi i.m/s.k 20 UI/ml PT Pratapa Nirmala 77,000
FARSORBID INJ - Isosorbid Dinitrat injeksi i.v 10 mg/10 ml PT Pratapa Nirmala 33,000
FATRAL - Sertraline 50 mg PT Pratapa Nirmala 3,300
FEMAPLEX - Letrozol tablet 2,5 mg PT DIPA PHARMALAB INTERSAINS 9,000

6
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

FEMARA - Letrozol tablet/kaplet/kapsul 2,5 mg PT Novartis Indonesia 9,000

FERRIPROX ORAL SOLUTION - Deperipron 250 ml PT Sydna Farma 1,680,000
FERRIPROX ORAL SOLUTION - Deperipron 500 mL PT Sydna Farma 3,350,000
FERRIPROX TABLET - Deperipron PT Sydna Farma 33,000
FLAGYL - Metronidazol supositoria 500 mg PT Aventis Pharma 3,220
FLEET PHOSPHOSODA - Natrium Fosfat lar oral PT. COMBINED IMPERIAL PHARMACEUTICALS 38,500
FLIXOTIDE NBULES - Flutikason Propionat nebules 0,5 mg PT Glaxo Wellcome Indonesia 14,500
FLUDARA IV LYO - Fludarabin inj 50 mg PT Aventis Pharma 1,500,000
FLUDARA ORAL - Fludarabin tab 10 mg PT Aventis Pharma 330,000
FONKOGEM - Gemsitabine inj 1000mg/vial PT FONKO INTERNATIONAL PHARMACEUTICALS 800,000
FONKOGEM - Gemsitabine inj 200mg/vial PT FONKO INTERNATIONAL PHARMACEUTICALS 175,000
FONKOPAC - Paklitaksel inj 100mg/vial PT FONKO INTERNATIONAL PHARMACEUTICALS 500,000
FONKOPAC - Paklitaksel inj 300mg/vial PT FONKO INTERNATIONAL PHARMACEUTICALS 1,500,000
FONKOPAC - Paklitaksel inj 30mg/vial PT FONKO INTERNATIONAL PHARMACEUTICALS 200,000
FRESOFOL 1% MCT/LCT - Propofol injeksi i.v., bolus 1% PT. Fresenius Kabi Combiphar 15,642
GADOVIST 5 MG - Gadobutrol macrocyclic 5 mg PT Bayer Indonesia 292,000
GADOVIST 7,5 MG - Gadobutrol macrocyclic 7,5 mg PT Bayer Indonesia 440,000
GAMARAAS - IMUNOGLOBULIN INTRAVENA INJ 250mg/50ml PT. COMBINED IMPERIAL PHARMACEUTICALS 2,275,900
GAVISTAL DROPS - Metoklopramid drop botol 10 mL PT. MEPROFARM 5,280
GEMCIKAL - Gemsitabin inj 1000 mg/vial PT KALBE FARMA Tbk 800,000
GEMCIKAL - Gemsitabin inj 200 mg/vial PT KALBE FARMA Tbk 175,000
GEMEDAC 1000 MG - Gemsitabin inj 1000 mg/vial PT DIPA PHARMALAB INTERSAINS 800,000
GEMEDAC 200 MG - Gemsitabin inj 200 mg/vial PT DIPA PHARMALAB INTERSAINS 175,000
GEMTAVIS - Gemsitabin inj 1000 mg/vial PT ACTAVIS INDONESIA 800,000

7
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

GEMTAVIS - Gemsitabin inj 200 mg/vial PT ACTAVIS INDONESIA 175,000

GENERIK INN - ACT (Artesunate tablet 50 mg + Amodiaquine anhydrida tablet 200 mg) PT. Kimia Farma (Persero) Tbk 1,375
GENERIK INN - Akarbose tablet/kaplet 100 mg P.T. Dexa Medica 908
GENERIK INN - Akarbose tablet/kaplet 50 mg P.T. Dexa Medica 657
GENERIK INN - Alopurinol tablet 100 mg PT PERTIWI AGUNG 86
GENERIK INN - Alopurinol tablet 300 mg PT.Bernofarm 200
GENERIK INN - Alprazolam tablet/kapsul/kaplet 0,25 mg P.T. Dexa Medica 380
GENERIK INN - Alprazolam tablet/kapsul/kaplet 1 mg PT. Kimia Farma (Persero) Tbk 233
GENERIK INN - Amikasin injeksi 250 mg/ml P.T. Dexa Medica 29,700
GENERIK INN - Amlodipin tablet 10 mg PT PERTIWI AGUNG 330
GENERIK INN - Amlodipin tablet 5 mg PT PERTIWI AGUNG 187
GENERIK INN - Amoksisilin kapsul/kaplet/tablet scored 500 mg PT.Bernofarm 272
GENERIK INN - Ampisilin serbuk injeksi i.v. 1000 mg/vial PT.Bernofarm 5,100
GENERIK INN - Antihemoroid, kombinasi: bismut subgalat 150 mg heksaklorofen 2,5 mg lidokain 10 mg seng oksida 120 mg PT. Kimia Farma (Persero) Tbk 3,045
GENERIK INN - Antimalaria DOEN kombinasi : Pirimetamin 25 mg Sulfadoksin 500 mg PT. Kimia Farma (Persero) Tbk 520
GENERIK INN - Asam Askorbat (Vitamin C) tablet/kapsul/kaplet 250 mg PT. Kimia Farma (Persero) Tbk 159
GENERIK INN - Asam traneksamat injeksi 50 mg/ml PT.Bernofarm 2,950
GENERIK INN - Asiklovir tablet/kapsul/kaplet 400 mg PT. Kimia Farma (Persero) Tbk 345
GENERIK INN - Azitromisin tablet 500 mg PT. Kimia Farma (Persero) Tbk 4,500
GENERIK INN - Betametason krim 0,1% (sebagai Valerat) PT. Kimia Farma (Persero) Tbk 1,520
GENERIK INN - Captopril 25mg PT. ERRITA PHARMA 80
GENERIK INN - CARBOPLATIN 150 mg/15 mL PT. DANKOS FARMA 175,000
GENERIK INN - Carboplatin Inj 450 mg/45 mL PT. DANKOS FARMA 407,500
GENERIK INN - Clopidogrel 75 mg PT. Hexpharm Jaya Laboratories 3,400

8
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

GENERIK INN - Desoksimetason krim 0,25% P.T. Dexa Medica 10,000

GENERIK INN - Diazepam tablet/kapsul/kaplet 2 mg PT. Kimia Farma (Persero) Tbk 45
GENERIK INN - Dimenhidrinat tablet/kapsul/kaplet 50 mg PT. Kimia Farma (Persero) Tbk 104
GENERIK INN - Doksisiklin 100 mg PT Yarindo Farmatama 270
GENERIK INN - Domperidon tetes 5 mg/mL PT.Bernofarm 15,600
GENERIK INN - Doxorubicin HCl 10 mg/vial PT. DANKOS FARMA 49,500
GENERIK INN - Doxorubicin HCl 50 mg/vial PT. DANKOS FARMA 253,000
GENERIK INN - Efavirens tablet salut 600 mg PT. Kimia Farma (Persero) Tbk 6,375
GENERIK INN - Epirubicin HCL 50 mg/25 mL PT. DANKOS FARMA 475,000
GENERIK INN - Epirubicin HCL 10 mg/5 mL PT. DANKOS FARMA 99,000
GENERIK INN - Eritromisin sirup kering 200 mg/ 5 ml PT. Phyto Kemo Agung Farma 7,700
GENERIK INN - Etambutol tablet 250 mg (HCl) PT. Kimia Farma (Persero) Tbk 314
GENERIK INN - Eugenol cairan PT. Kimia Farma (Persero) Tbk 18,100
GENERIK INN - Fenitoin Kapsul/Kaplet 100 mg PT Ikapharmindo Putramas 154
GENERIK INN - Fentanil injeksi i.m/i.v 0,05 mg/ml, ampul 2 ml PT. Kimia Farma (Persero) Tbk 40,000
GENERIK INN - Flukonazol tablet/kapsul 150 mg PT. Kimia Farma (Persero) Tbk 18,000
GENERIK INN - Glimepiride tablet 1 mg PT. Kimia Farma (Persero) Tbk 265
GENERIK INN - Glimepiride tablet 2 mg PT. Kimia Farma (Persero) Tbk 436
GENERIK INN - Glimepiride tablet 3 mg PT. Kimia Farma (Persero) Tbk 404
GENERIK INN - Glimepiride tablet 4 mg PT. Kimia Farma (Persero) Tbk 430
GENERIK INN - Glukosa larutan infus 10% PT Widatra Bhakti 7,500
GENERIK INN - Glukosa larutan infus 5 % steril PT Widatra Bhakti 6,900
GENERIK INN - Hidrokortison krim 2,5 % PT. Kimia Farma (Persero) Tbk 2,798
GENERIK INN - Ibuprofen 200 mg PT Yarindo Farmatama 110

9
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

GENERIK INN - Isoniazid tablet/kapsul/kaplet 100 mg PT. Phyto Kemo Agung Farma 65
GENERIK INN - Isoniazid tablet/kapsul/kaplet 300 mg PT. Phyto Kemo Agung Farma 158
GENERIK INN - Ketoconazole krim 2% PT. Hexpharm Jaya Laboratories 2,850
GENERIK INN - Ketokonazol krim 2% PT. Kimia Farma (Persero) Tbk 2,569
GENERIK INN - Klonidin tablet 0,15 mg PT. Kimia Farma (Persero) Tbk 184
GENERIK INN - Kodein tablet 10 mg PT. Kimia Farma (Persero) Tbk 500
GENERIK INN - Kodein tablet 15 mg PT. Kimia Farma (Persero) Tbk 850
GENERIK INN - Kodein tablet 20 mg PT. Kimia Farma (Persero) Tbk 1,100
GENERIK INN - Kombinasi Injeksi Depot (G) : Medroksi progesteron asetat 25 mg Estradiol sipionat 5 mg PT TRIYASA NAGAMAS FARMA 5,700
GENERIK INN - Kombinasi tablet salut : Besi (II) sulfat 7H2O 200 mg Asam folat 0,25 mg PT. Kimia Farma (Persero) Tbk 50
GENERIK INN - Kontrasepsi pil oral, kombinasi :* Levonorgestrel 150 mcg Etinilestradiol 30 mcg PT. Kimia Farma (Persero) Tbk 2,089
GENERIK INN - Kuinin injeksi i.v. 25% (sebagai 2 HCl) PT. Kimia Farma (Persero) Tbk 6,200
GENERIK INN - Laktulosa sir 3,335 g/5 mL PT Ikapharmindo Putramas 14,500
GENERIK INN - Lamivudine tablet 150 mg PT. Kimia Farma (Persero) Tbk 1,500
GENERIK INN - Levofloksasin inf 5 mg/ml PT.INFION 40,000
GENERIK INN - Lidokain injeksi 2% (HCL) PT.Bernofarm 839
GENERIK INN - Manitol lar infus 20% PT. FINUSOLPRIMA FARMA INTERNASIONAL 44,000
GENERIK INN - Meropenem inj 1 g PT.Bernofarm 54,000
GENERIK INN - Meropenem serb inj 500 mg/vial PT.Bernofarm 44,960
GENERIK INN - Metadon sir 50mg/5ml PT. Kimia Farma (Persero) Tbk 275,000
GENERIK INN - Metformin HCl kaplet 850 mg PT.Bernofarm 198
GENERIK INN - Metformin HCl tablet 500 mg PT.Bernofarm 113
GENERIK INN - Methotrexate 50 mg PT. DANKOS FARMA 38,500
GENERIK INN - Metilprednisolon inj 500 mg/8 mL PT.Bernofarm 89,990

10
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

GENERIK INN - Metilprednisolon tablet 4 mg PT. Natura Laboratoria Prima 205

GENERIK INN - Metoklopramide tablet 5 mg PT. Kimia Farma (Persero) Tbk 108
GENERIK INN - Metronidazol infus 500 mg/100 ml PT. Natura Laboratoria Prima 9,950
GENERIK INN - Metronidazol tablet 250 mg PT. Phyto Kemo Agung Farma 110
GENERIK INN - Metronidazole sirup 125mg/ 5ml PT. MEPROFARM 3,800
GENERIK INN - Metronidazole Tablet 500 mg PT. Phyto Kemo Agung Farma 160
GENERIK INN - Mikonazol krim/salep 2 % (Nitrat) PT. Kimia Farma (Persero) Tbk 3,000
GENERIK INN - Morfin HCL inj 10 mg/ml PT. Kimia Farma (Persero) Tbk 8,400
GENERIK INN - Morfin tablet 10 mg PT. Kimia Farma (Persero) Tbk 1,400
GENERIK INN - Nacl 0,9% PT Widatra Bhakti 6,410
GENERIK INN - Nevirapin tablet 200 mg PT. Kimia Farma (Persero) Tbk 2,800
GENERIK INN - Omeprazol injeksi 40 mg/ 10 ml PT. Natura Laboratoria Prima 36,000
GENERIK INN - Ondansteron 8 mg PT Yarindo Farmatama 1,189
GENERIK INN - Paclitaxel 100 mg/ vial PT. DANKOS FARMA 500,000
GENERIK INN - Paclitaxel 30 mg/ vial PT. DANKOS FARMA 200,000
GENERIK INN - Parasetamol tablet 500 mg PT.Imfarmind Farmasi Industri 89
GENERIK INN - Petidin injeksi i.m/s.k/i.v lambat 50 mg/ml (HCl) PT. Kimia Farma (Persero) Tbk 14,500
GENERIK INN - Piridoksin (Vitamin B6) tablet/kapsul/kaplet 10 mg (HCl) PT. Kimia Farma (Persero) Tbk 118
GENERIK INN - Povidon Iodida larutan 10% 60 ml PT. Kimia Farma (Persero) Tbk 5,998
GENERIK INN - Ramipril tablet 2,5 mg P.T. Dexa Medica 285
GENERIK INN - Ranitidin injeksi 25 mg/ml PT. Natura Laboratoria Prima 1,140
GENERIK INN - Ringer Laktat PT Widatra Bhakti 7,150
GENERIK INN - Salbutamol 2 mg (sebagai Sulfat) PT Yarindo Farmatama 59
GENERIK INN - Sefiksim kapsul/kaplet 100 mg PT.Bernofarm 859

11
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

GENERIK INN - Setirizin kapsul 10 mg PT PERTIWI AGUNG 181

GENERIK INN - Simvastatin scored tablet 10 mg PT. Natura Laboratoria Prima 169
GENERIK INN - Simvastatin tablet 20 mg PT. Natura Laboratoria Prima 391
GENERIK INN - Tenofovir tab 300 mg PT. Kimia Farma (Persero) Tbk 8,100
GENERIK INN - Tramadol injeksi 50 mg/ml PT. Natura Laboratoria Prima 2,395
GENERIK INN - Vaksin BCG Kering (BF) PT. Bio Farma 59,950
GENERIK INN - Vaksin Campak inj s.k + pelarut PT. Bio Farma 28,204
GENERIK INN - Vaksin Hepatitis B Rekombinan PT. Bio Farma 20,900
GENERIK INN - Vaksin Jerap Difteri Tetanus (DT) cairan inj i.m 40/15 lf per mL PT. Bio Farma 17,798
GENERIK INN - Vaksin Jerap difteri tetanus (Td) cairan inj i.m 4/15 if per mL PT. Bio Farma 16,500
GENERIK INN - Vaksin jerap tetanus (tetanus adsorbed toxoid / TT) inj (i.m.) PT. Bio Farma 14,498
GENERIK INN - Vaksin Meningitis Meningococcal polysacharide Group A.C.Y.W135 Menivax ACYW - (untuk Kebutuhan Haji dan Umroh)) PT. Bio Farma 214,500
GENERIK INN - Vaksin polio t-OPV drops 10 dosis PT. Bio Farma 19,954
GENERIK INN - Vaksin polio t-OPV drops 20 dosis PT. Bio Farma 34,815
GENERIK INN - Valsartan tab 160 mg P.T. Dexa Medica 2,700
GENERIK INN - Valsartan tab 80 mg P.T. Dexa Medica 1,800
GENERIK INN - Verapamil tablet 80 mg (HCl) PT. Kimia Farma (Persero) Tbk 234
GENERIK INN - Vitamin B Kompleks tablet PT. Kimia Farma (Persero) Tbk 115
GENERIK INN - Warfarin Tablet 1 mg PT. Eisai Indonesia 979
GENERIK INN - Zidofudin 100 mg PT. Kimia Farma (Persero) Tbk 1,700
GENERIK INN - Zidovudin 300 mg + Lamivudine 150 mg PT. Kimia Farma (Persero) Tbk 3,700
GENERIK INN - Zinc tablet dispersible20 mg PT. Kimia Farma (Persero) Tbk 473
GLICAB - Gliklazid tab 80 mg PT Tempo Scan Pacific, Tbk 235
GLIVEC - Imatinib Mesilat tab 100mg (Risk Sharing Berdasarkan SK Menkes 2015) PT Novartis Indonesia 211,000

12
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

GRANOCYTE 34 1VL HSA FREE - Lenograstim inj 263 mcg/mL PT Aventis Pharma 760,000
HAEMOCTIN - Faktor VIII (konsentrat) serb inj 1000 UI PT. Kimia Farma (Persero) Tbk 3,600,000
HAEMOCTIN - Faktor VIII (konsentrat) serb inj 230 -340 UI PT. Kimia Farma (Persero) Tbk 925,000
HAEMOCTIN - Faktor VIII (konsentrat) serb inj 250 UI/vial + pelarut 5 mL PT. Kimia Farma (Persero) Tbk 925,000
HAEMOCTIN - Faktor VIII (konsentrat) serb inj 480 - 600 IU PT. Kimia Farma (Persero) Tbk 1,850,000
HAEMOCTIN - Faktor VIII (konsentrat) serb inj 500 UI/vial + pelarut 5 mL PT. Kimia Farma (Persero) Tbk 1,850,000
HALDOL DECANOAS - Haloperidol inj 50 mg/ml PT. SOHO Industri Pharmasi 97,500
HALOTHANE - Halotan Inhalasi P.T. Dexa Medica 700,000
HARNAL D - TAMSULOSIN HCI 0,2 mg PT. COMBINED IMPERIAL PHARMACEUTICALS 7,100
HEMAPO 10.000 IU - Eritropoetin-alfa inj 10000 UI/mL PT KALBE FARMA Tbk 325,000
HEMAPO 3000 - Eritropoetin-alfa inj 3000 UI/mL PT KALBE FARMA Tbk 139,950
HEPSERA - Adefovir Dipivoksil tablet/kaplet 10 mg PT SmithKline Beecham Pharmaceuticals 29,800
HERBESSER CD 100 - Diltiazem Kapsul SR 100 mg PT. Tanabe Indonesia 4,290
HERBESSER CD 100 - Diltiazem Kapsul SR 100mg -100 PT. Tanabe Indonesia 4,290
HERBESSER CD 200 - Diltiazem Kapsul SR 200 mg PT. Tanabe Indonesia 4,650
HERBESSER CD 200 - Diltiazem Kapsul SR 200mg -100 PT. Tanabe Indonesia 4,650
HERBESSER POWDER INJECTION 50MG - Diltiazem infus injeksi 50 mg PT. Tanabe Indonesia 148,500
HERCEPTIN - Trastuzumab serbuk injeksi 440 mg/vial PT. Boehringer Ingelheim 19,608,034
HOLOXAN INJEKSI 1000 - Ifosfamid serbuk injeksi 1000 mg/vial PT MUGI LABORATORIES 1,413,500
HUMALOG - Analog insulin rapid actinginj 100 UI/ml, vial/cartridge disposible/penfill cartridge (Insulin lispro (rDNA origin)) PT Bayer Indonesia 87,000
HUMALOG KWIKPEN - Analog Insulin Rapid Acting Inj 100 UI/ml PT Bayer Indonesia 87,000
HUMALOG MIX 25 - Analog insulin mix insulininj 100 UI/ml, vial/cartridge disposible/penfill cartridge (25% insulin lispro, 75% insulin
PT Bayer Indonesia 105,000
lispro protamine suspension, (rDNA))
HUMALOG MIX 25 KWIKPEN - Analog Insulin Mix Insulin Inj 100 UI/ml PT Bayer Indonesia 110,000
HUMAN ALBUMIN 20% BIOTEST Albumin serum normal (human albumin) inj 20% PT. Kimia Farma (Persero) Tbk 850,000
13
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

HUMAN ALBUMIN 20% BIOTEST Albumin serum normal (human albumin) inj 20% @50 ml PT. Kimia Farma (Persero) Tbk 409,200
HUMULIN 30/70 KWIKPEN - Human Insulin Mix Insulin Inj 100 UI/ml PT Bayer Indonesia 79,800
HUMULIN N KWIKPEN - Human Insulin Intermediate Acting Inj 100 UI/ml PT Bayer Indonesia 79,800
HUMULIN R KWIKPEN - Human Insulin Short Acting Inj 100 UI/ml PT Bayer Indonesia 79,800
HUMULIN R VIAL - Human insulin short acting inj 100 UI/ml, vial (Insulin human Rapd) PT Bayer Indonesia 143,500
HYPERHEP B - Hepatitis B imunoglobulin (human) PT DIPA PHARMALAB INTERSAINS 1,300,000
ILAIDIN DROPS - Oksimetazolin Tetes Hidung 0.025% PT. Merck Tbk 27,550
ILIADIN SPRAY - Oksimetazolin Tetes Hidung 0.050% PT. Merck Tbk 29,000
INSULATARD PENFILL - Human insulin N acting inj 100 UI/ml,penfill cartridge PT Ferron Par Pharmaceuticals 75,000
INSULATARD VIAL - Human insulin N acting inj 100 UI/ml, vial PT Ferron Par Pharmaceuticals 143,500
INTRALIPID - Larutan mengandung Lipid (Infus Emulsi Lipid 20%) PT. Fresenius Kabi Combiphar 71,995
INVICLOT - Heparin injeksi i.v./s.k. 5000 UI/ml PT Pratapa Nirmala 42,900
IRESSA 250 MG - Gefitinib 250 mg PT AstraZeneca Indonesia 295,000
ISONAT 10 - Isosorbid dinitrat tablet/kaplet/kapsul 10 mg PT. Kimia Farma (Persero) Tbk 189
ISOPTIN 240 MG - Verapamil tab 240 mg PT. Abbott Indonesia 6,680
JURNISTA Hidromorfon HCL tablet oros 16 mg PT. Kimia Farma (Persero) Tbk 50,000
JURNISTA Hidromorfon HCL tablet oros 8 mg PT. Kimia Farma (Persero) Tbk 37,500
KA EN 1B - Larutan mengandung Elektrolit PT. Otsuka Indonesia 9,273
KA EN 3A - Larutan Karbohidrat+elektrolit(NaCl 2,34 Na Laktat 2,24, KCL 0,76, Deskstrosa 27 gram) PT. Otsuka Indonesia 10,050
KA EN 3B - Larutan Karbohidrat+elektrolit(NaCl 1,75 , KCL 1,5, Na Laktat 2,24,Deskstrosa 27 gram) PT. Otsuka Indonesia 10,050
KA ENMG 3 - Larutan mengandung Karbohidrat+Elektrolit PT. Otsuka Indonesia 9,600
KABIVEN 1440 ML - Larutan mengandung Asam Amino (Kombinasi Asam Amino: 34gr, Glukosa: 97gr, Lipid: 51gr dan Elektrolit (Kalori =
PT. Fresenius Kabi Combiphar 308,000
1000 kkal, Akses peripheral))
KABIVEN 1920 ML - Larutan mengandung Asam Amino (Kombinasi Asam Amino: 45gr, Glukosa: 130gr, Lipid: 68gr dan Elektrolit (Kalori =
PT. Fresenius Kabi Combiphar 358,600
1400 kkal, Akses peripheral))

14
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

KALIPAR - Kalium aspartat tab 300 mg PT Tempo Scan Pacific, Tbk 694
KIDMIN - Larutan mengandung Asam Amino 200 ml PT. Otsuka Indonesia 49,220
KOATE 250 UI - Faktor VIII (konsentrat) serb inj 250 IU/vial + pelarut 5 ml PT DIPA PHARMALAB INTERSAINS 925,000
KOATE DVI 1000 IU - Faktor VIII (konsentrat) serb inj 1000 IU + Pelarut 10 ml PT DIPA PHARMALAB INTERSAINS 3,600,000
KOATE DVI 230 - 340 IU - Faktor VIII (konsentrat) serb inj 230-340 IU + Pelarut 5 ml PT DIPA PHARMALAB INTERSAINS 925,000
KOATE DVI 480 - 600 IU - Faktor VIII (konsentrat) serb inj 480 - 600 IU+ Pelarut 5 ml PT DIPA PHARMALAB INTERSAINS 1,850,000
KOATE DVI 500 IU - Faktor VIII (konsentrat) serb inj 500 IU + Pelarut 5 ml PT DIPA PHARMALAB INTERSAINS 1,850,000
KSR - Kalium Klorida tablet SR 600 mg PT. Merck Tbk 1,700
LANTUS SOLOSTAR 100IU/ML 5PENS X3ML - Analog insulin long acting inj 100 UI/ml, vial/cartridge disposible/penfill cartridge (Insulin
PT Aventis Pharma 85,000
glargine 100 IU/ml)
LETRAZ - Letrozol tablet 2.5 mg PT KALBE FARMA Tbk 9,000
LEUCOGEN - Filgastrim Inj. 300 mg PT KALBE FARMA Tbk 375,000
LEUNASE - Asparaginase serbuk injeksi 10.000 UI/vial PT Widatra Bhakti 1,175,000
LEVEMIR FLEXPEN - Analog insulin long acting inj 100 UI/ml, (flexpen @ 3ml) PT Ferron Par Pharmaceuticals 85,000
LEVOPAR TABLET - Antiparkinson DOEN tablet kombinasi : Benserazid 25 mg Levodopa 100 mg PT. MEPROFARM 1,500
LEZRA - Letrozole 2,5 mg PT ACTAVIS INDONESIA 9,000
LOVENOX 2000 ANTI-XA - Enoksaparin sodium inj 20 mg/0,2 mL PT Aventis Pharma 48,000
LOVENOX 4000 ANTI-XA - Enoksaparin sodium inj 40 mg/0,4 mL PT Aventis Pharma 85,000
LOVENOX 6000 ANTI-XA - Enoksaparin sodium inj 60 mg/0,6 mL PT Aventis Pharma 117,500
MABTHERA 100MG/10ML - Rituksimab injeksi 100mg/10ml PT. Boehringer Ingelheim 3,164,805
MABTHERA 500MG/50ML - Rituksimab injeksi 500mg/50ml PT. Boehringer Ingelheim 15,824,026
MARTOS - Larutan mengandung Karbohidrat PT. Otsuka Indonesia 31,100
MELAVITA Asam retinoat krim 0,1% PT. Galenium Pharmasia Laboratories 9,750
MEPTIN INHALATION SOLUTION 0.3 ML - Prokaterol cairan ih 30 mcg PT. Otsuka Indonesia 6,200
MEPTIN INHALATION SOLUTION 0.5 ML - Prokaterol cairan ih 50 mcg PT. Otsuka Indonesia 6,200
15
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

MEPTIN SWINGHALER - Prokaterol serbuk inhaler 10 mcg PT. Otsuka Indonesia 86,250
MESTINON - Piridostigmin PT MUGI LABORATORIES 7,447
METHOTREXATE EBEWE - Metotreksat serbuk injeksi i.v/i.m./i.t. 5 mg PT Sandoz Indonesia 21,120
MEYLON - Natrium Bikarbonat Injeksi i.v 8,4% PT. Otsuka Indonesia 6,200
MICARDIS 40MG - Telmisartan tab 40mg PT. Boehringer Ingelheim 3,900
MICARDIS 80MG - Telmisartan tab 80 mg PT. Boehringer Ingelheim 6,500
MIXTARD PENFILL - Human insulin mix insulin inj 100 UI/ml, penfill cartridge (Premix: 30% Soluble + 70 % NPH Insulin) PT Ferron Par Pharmaceuticals 75,000
MIXTARD VIAL - Human insulin mix insulin inj 100 UI/ml, vial (Premix: 30% Soluble + 70 % NPH Insulin) PT Ferron Par Pharmaceuticals 143,500
MST CONTINUS 10 MG - Morfin HCL tablet SR 10 mg PT. Mahakam Beta Farma 15,620
MST CONTINUS 15 MG - Morfin HCL tablet SR 15 mg PT. Mahakam Beta Farma 22,990
MST CONTINUS 30 MG - Morfin HCL tablet SR 30 mg PT. Mahakam Beta Farma 41,470
MYCAMINE - micafungin PT. COMBINED IMPERIAL PHARMACEUTICALS 320,000
N-ACE CAIRAN INHALASI - N-asetil sistein inj. nebules 100 mg PT Pratapa Nirmala 13,200
NAPRODOX Doksorubisin - serb inj 10 mg/vial (i.v.) PT. Kimia Farma (Persero) Tbk 49,500
NAPRODOX INJ. 50 MG - Doksorubisin serbuk injeksi i.v. 50 mg/vial PT. Kimia Farma (Persero) Tbk 253,000
NAPROTAX Paklitaksel - inj 30 mg/vial PT. Kimia Farma (Persero) Tbk 200,000
NASACORT AQ - Triamsinolon asetonid nasal spray 55 mcg/puff PT Aventis Pharma 106,750
NAVELBINE INJEKSI 10 - Vinorelbin inj. 10 mg/ml PT MUGI LABORATORIES 1,229,998
NEOSTIGMIN HAMELN INJ - Neostigmine-hameln 0,5 mg/ml PT Pharma Health Care 9,500
NEPHROSTERIL - Larutan mengandung Asam Amino (Asam Amino 7%, Komposisi: Asam Amino esensial: Asam Amino non esensial = 60 :
PT. Fresenius Kabi Combiphar 45,870
40)
NIFLEC polietilen glikol PT. Meiji Indonesia 123,200
NITRAL - Gliseril trinitrat tab sublingual 0,5 mg PT ACTAVIS INDONESIA 1,500
NITROKAF FORTE - Gliseril trinitrat kaps SR 5 mg PT. Kimia Farma (Persero) Tbk 2,310
NITROKAF RETARD - Gliseril trinitrat kaps SR 2,5 mg PT. Kimia Farma (Persero) Tbk 1,500
16
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

NOKOBA - Nalokson injeksi 0,4 mg/ml PT Pratapa Nirmala 61,600

NONAFACT 1000 IU - Faktor IX Kompleks Serb Inj 1000 IU/Vial+Pelarut 10 ml PT. Graha Farma 8,888,000
NONAFACT 500 IU - Faktor IX Kompleks Serb Inj 500 IU/Vial+Pelarut 5 ml PT. Graha Farma 4,620,000
NOVOMIX FLEXPEN - Analog insulin mix acting inj 100 UI/ml (Premix 30% Insulin Aspart + 70% Protaminated Insulin Aspart) PT Ferron Par Pharmaceuticals 110,000
NOVORAPID FLEXPEN - Analog insulin rapid acting inj 100 UI/ml, vial/cartridge disposible/penfill cartridge (Insulin Aspart) PT Ferron Par Pharmaceuticals 87,000
NOVORAPID VIAL - Analog insulin rapid acting inj 10ml, vial (Insulin Aspart) PT Ferron Par Pharmaceuticals 214,995
NOVOSEVEN - Faktor VIIa (rekombinan) serb inj 1 mg/vial + pelarut untuk injeksi PT Ferron Par Pharmaceuticals 9,749,993
OBAT ANTI MALARIA DIHYDROARTEMISININ 40MG PIPERAQUINE PHOSPATE 320MG - Obat Anti Malaria PT. Mersifarma Tirmaku Mercusana 3,498
OBUCORT SWINGHALER - Budesonid inhaler 200 mcg/puff, 200 dosis PT. Otsuka Indonesia 106,000
OCTALBIN 25% - Albumin serum normal (human albumin) inj 25% 100 ml PT KALBE FARMA Tbk 1,500,000
OCTALBIN 25% - Albumin serum normal (human albumin)inj 25% 50 ml PT KALBE FARMA Tbk 750,000
OCTALBIN 5 % - Albumin serum Normal (human albumin) 5%, 250 mL PT KALBE FARMA Tbk 900,000
OCTIDE - Octreotide 0.1 mg/mL PT Pratapa Nirmala 80,000
ONBREZ BREEZHALER 150MCG Indacaterol Serb ih 150mcg PT Novartis Indonesia 11,750
ONBREZ BREEZHALER 300MCG Indakaterol serbuk ih 300mcg PT Novartis Indonesia 11,750
OTSU - KCL 7,46% - Klarium Clorida7,46% 25 ml PT. Otsuka Indonesia 3,099
OTSU SWI 25 ML - Air untuk Injeksi 25 ml PT. Otsuka Indonesia 2,750
OTSU-MGSO4 20 - Magnesium sulfat injeksi 20% PT. Otsuka Indonesia 3,200
OTSU-MGSO4 40 - Magnesium sulfat injeksi 40% PT. Otsuka Indonesia 3,650
OXALIPLATIN MEDAC 100 MG - Oksaliplatin serb inj 100 mg/vial PT DIPA PHARMALAB INTERSAINS 800,000
OXALIPLATIN MEDAC 50 MG - Oksaliplatin serb inj 50 mg/vial PT DIPA PHARMALAB INTERSAINS 400,000
OXYTOCIN INJLQ 10 IU Oksitosin inj 10 UI/ml PT Ethica Industri Farmasi 1,900
PACLIMEDAC 100 MG - Paklitaksel inj 100 mg/vial PT DIPA PHARMALAB INTERSAINS 500,000
PACLIMEDAC 30 MG - Paklitaksel inj 30 mg/vial PT DIPA PHARMALAB INTERSAINS 200,000

17
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

PACLIMEDAC 300 MG - Paklitaksel inj 300 mg/vial PT DIPA PHARMALAB INTERSAINS 1,500,000
PAN-AMIN G - Larutan mengandung Asam Amino (pan amin-g) PT. Otsuka Indonesia 45,950
PATANOL - Olopatadin tts mata 0,1% PT Tempo Scan Pacific, Tbk 72,500
PEGASYS - Pegylated interferon alfa-2a injeksi 135mcg/0,5ml PT. Boehringer Ingelheim 1,077,815
PEGASYS - Pegylated interferon alfa-2a injeksi 180mcg/0,5ml PT. Boehringer Ingelheim 1,248,000
PENTABIO - Vaksin DTP-HB-Hib PT. Bio Farma 76,285
PLASBUMIN 25% 100 ML - Albumin serum normal (human albumin) injeksi 25%, 100 ml PT DIPA PHARMALAB INTERSAINS 1,500,000
PLASBUMIN 25% 20 ML - Albumin serum normal (human albumin) injeksi 25%, 20 ml PT DIPA PHARMALAB INTERSAINS 373,000
PLASBUMIN 25% 50 ML - Albumin serum normal (human albumin) injeksi 25%, 50 ml PT DIPA PHARMALAB INTERSAINS 750,000
PLASBUMIN 5% 250 ML - Albumin serum normal (human albumin) injeksi 5% 250 ml PT DIPA PHARMALAB INTERSAINS 900,000
PLASBUMIN 5% 50 ML - Albumin serum normal (human albumin) injeksi 5% 50 ml PT DIPA PHARMALAB INTERSAINS 283,000
PLASMANATE - Fraksi protein plasma lar inf 5% PT DIPA PHARMALAB INTERSAINS 920,000
PLAXAT - Oksaliplatin serb inj 100 mg/vial PT ACTAVIS INDONESIA 800,000
PLAXAT - Oksaliplatin serb inj 50 mg/vial PT ACTAVIS INDONESIA 400,000
PRADAXA - Dabigatran eteksilat kapsul 110 mg PT. Boehringer Ingelheim 14,250
PRADAXA - Dabigatran eteksilat kapsul 75 mg PT. Boehringer Ingelheim 14,250
PRIMOLUT N - Noretisteron tablet 5 mg PT Bayer Indonesia 2,618
PRIMOVIST - Gadoksetat disodium 0,25 mmol gadoxetate disodium/mL PT Bayer Indonesia 2,720,000
PROGRAF - TACROLIMUS 0,5 MG PT. COMBINED IMPERIAL PHARMACEUTICALS 12,850
PROGRAF - TACROLIMUS 1 MG PT. COMBINED IMPERIAL PHARMACEUTICALS 25,800
PROSOGAN INJ. - Lansoprazol Inj 30 mg/ml PT.Takeda Indonesia 88,500
PROTOFEN SUPP - Ketoprofen supositoria 100 mg PT. Kimia Farma (Persero) Tbk 2,722
PULAREX - Atapulgit tablet 600 mg PT Pabrik Pharmasi Zenith 190
PULMICORT RESPULES - Budesonide 0.25 mg/ml PT AstraZeneca Indonesia 9,725

18
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

PULMICORT TURBUHALER - Budesonide Turbuhaler 200 mcg 100 Dosis PT AstraZeneca Indonesia 101,000
RABIPUR - Vaksin rabies, untuk manusia serbuk injeksi s.k./i.k. + booster PT Novartis Indonesia 78,500
RECORMON - Eritropoetin-beta injeksi 2000 UI/0,3ml PT. Boehringer Ingelheim 128,500
REQUIP PD 24 HOUR 2 MG - Ropinirol Tablet lepas lambat 2 mg PT Glaxo Wellcome Indonesia 5,750
REQUIP PD 24 HOUR 4 MG - Ropinirol Tablet lepas lambat 4 mg PT Glaxo Wellcome Indonesia 6,850
REQUIP PD 24 HOUR 8 MG - Ropinirol Tablet lepas lambat 8 mg PT Glaxo Wellcome Indonesia 8,000
RETHAPYL - Teofilin tab SR 300 mg PT. Kimia Farma (Persero) Tbk 1,050
REXTA - Oksaliplatin serb inj 50 mg/vial PT KALBE FARMA Tbk 400,000
RITALIN - Metilfenidat tablet 10 mg PT Novartis Indonesia 1,950
RITALIN LA - Metilfenidat kapsul LA 20 mg PT Novartis Indonesia 7,450
SANDIMMUN NEORAL 100MG KAP - Siklosporin kaps 100 mg PT Novartis Indonesia 42,500
SANDIMMUN NEORAL 25MG KAP - Siklosporin kapsul lunak 25 mg PT Novartis Indonesia 11,800
SANDOSTATIN LAR - Oktreotid 10 mg PT Novartis Indonesia 2,975,000
SCABIMITE CREAM 10 - Permetrin krim 5% PT. Galenium Pharmasia Laboratories 12,155
SEBIVO 600 MG TAB - Telbivudin tab 600 mg PT Novartis Indonesia 28,300
SERETIDE DISKUS 100 MCG - Kombinasi: Salmeterol 50 mcg; Flutikason propionat 100 mcg PT Glaxo Wellcome Indonesia 100,833
SERETIDE DISKUS 250 MCG - Kombinasi: Salmeterol 50 mcg; Flutikason propionat 250 mcg PT Glaxo Wellcome Indonesia 113,333
SERETIDE DISKUS 500 MCG Salmeterol 50 mcg + Flutikason Propionate 500 mcg PT Glaxo Wellcome Indonesia 123,948
SEROQUEL XR 200 MG - Quetiapine 200 mg PT AstraZeneca Indonesia 19,000
SEROQUEL XR 300 MG - Quetiapine 300 mg PT AstraZeneca Indonesia 20,500
SEROQUEL XR 400 MG - Quetiapine 400 mg PT AstraZeneca Indonesia 24,900
SIFROL ER 0,375MG - Pramipeksol tab ER 0,375 mg PT. Boehringer Ingelheim 8,000
SIFROL ER 0,750MG - Pramipeksol tab ER 0,750 mg PT. Boehringer Ingelheim 12,700
SIKZONOATE INJEKSI - Flufenazin injeksi i.m. 25 mg/ml PT. Mersifarma Tirmaku Mercusana 57,500

19
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

SIMARC 2 - Warfarin tablet 2 mg PT Pratapa Nirmala 950

SINDAXEL 100 MG/16,67 ML - Paklitaksel inj 100 mg/vial PT ACTAVIS INDONESIA 500,000
SINDAXEL 30 MG/5 ML - Paklitaksel injeksi 30 mg/vial PT ACTAVIS INDONESIA 200,000
SINDROXOCIN - Doksorubisin serbuk injeksi i.v. 10 mg/vial PT ACTAVIS INDONESIA 49,500
SINDROXOCIN - Doksorubisin serbuk injeksi i.v. 50 mg/vial PT ACTAVIS INDONESIA 253,000
SMOFLIPID 20% Larutan mengandung Lipid ( Kombinasi seimbang dari 4 jenis lipid : Fish Oil 15%, Soy bean oil 30%, MCT/LCT 30%, Olive
PT. Fresenius Kabi Combiphar 71,500
Oil 25% )
SOJOURN - Sevofluran ih PT Pratapa Nirmala 1,320,000
SOLUVIT N Larutan mengandung Lipid ( Vitamin larut air : B komplek dan Vitamin C ) kombinasi dengan vitamin larut lemak untuk bayi,
PT. Fresenius Kabi Combiphar 61,490
anak dan dewasa
SPIRIVA 10S + HANDIHALER - Tiotropium serbuk inhalasi 18 mcg + handihaller PT. Boehringer Ingelheim 162,000
SPIRIVA POWDER FOR INHALATION 18MCG 30S - Tiotropium 18 mcg serbuk inhalasi refill PT. Boehringer Ingelheim 14,750
STALEVO - Kombinasi: Levodopa 100 mg; Karbidopa 25 mg; Entekapon 200 mg PT Novartis Indonesia 8,800
STESOLID - Diazepam larutan rektal 10 mg/2,5 mL PT ACTAVIS INDONESIA 16,748
STESOLID - Diazepam larutan rektal 5 mg/2,5 mL PT ACTAVIS INDONESIA 11,525
SUFENTANYL INJEKSI IV.EPIDURAL 5 MCG / ML - Sufentanil injeksi iv, epidural 5 mcg/ml PT. Kimia Farma (Persero) Tbk 160,000
SURVANTA - Beractant injeksi / suspensi 25 mg/mL PT. Abbott Indonesia 3,450,000
SYMBICORT 80/4.5 MCG - Budesonide Formoterol 80/4.5 mcg 60 Dosis PT AstraZeneca Indonesia 121,000
SYMBICORT TURBUHALER 160/4.5 MCG - Budesonide - Formoterol 160/4.5 mcg 120 dosis PT AstraZeneca Indonesia 134,500
SYMBICORT TURBUHALER 160/4.5 MCG - Budesonide - Formoterol 160/4.5 mcg 60 Dosis PT AstraZeneca Indonesia 121,000
TACEEDO Dosetaksel - inj 20 mg/0,5 mL PT. Kimia Farma (Persero) Tbk 400,000
TACEEDO Dosetaksel - inj 80 mg/2 mL PT. Kimia Farma (Persero) Tbk 1,325,000
TANAPRESS 10MG - Imidapril tab 10 mg PT. Tanabe Indonesia 4,554
TANAPRESS 10MG - Imidapril tab 10mg -100 PT. Tanabe Indonesia 4,554
TANAPRESS 5MG - Imidapril tab 5 mg PT. Tanabe Indonesia 2,442

20
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

TANAPRESS 5MG - Imidapril tab 5mg -100 PT. Tanabe Indonesia 2,442
TAPROS 1.88MG - Leuprorelin Asetat 1.88 mg PT.Takeda Indonesia 750,000
TAPROS 3.75 MG - Leuprorelin Asetat 3.75 MG PT.Takeda Indonesia 500,000
TAPROS 3M - Leuprorelin Asetat 11.25 mg PT.Takeda Indonesia 2,916,000
TARCEVA 100 MG - Erlotinib 100mg PT. Boehringer Ingelheim 590,000
TARCEVA 150 MG - Erlotinib 150mg PT. Boehringer Ingelheim 590,000
TARIVID OTIC SOLUTION - Tarivid Otic Solution 5 ml PT KALBE FARMA Tbk 48,500
TASIGNA - Nilotinib kapsul 150mg (Risk Sharing berdasrkan SK Menkes 2015) PT Novartis Indonesia 211,000
TASIGNA - Nilotinib kapsul 200mg (Risk Sharing Berdasarkan SK Menkes 2015) PT Novartis Indonesia 380,875
TERRELL - Isofluran inhalasi botol 100 ml PT Pratapa Nirmala 270,000
TETAGAM - Human tetanus imunoglobulinn injeksi i.m. 250 UI P.T. Dexa Medica 170,000
THYROZOL 10 - Tiamazol tab 10 mg PT. Merck Tbk 1,195
THYROZOL 5 - Tiamazol tab 5 mg PT. Merck Tbk 610
TOPAMAX Topiramat tablet 100 mg PT. SOHO Industri Pharmasi 9,475
TOPAMAX Topiramat tablet 25 mg PT. SOHO Industri Pharmasi 3,950
TOPAMAX Topiramat tablet 50 mg PT. SOHO Industri Pharmasi 5,980
TOTILAC - Larutan mengandung Elektrolit (Sodium Lactate sol (50%) 113 gr/L, Potassium Chloride 0.3 gr/L, Calcium Chloride 0.2 gr/L,
PT KALBE FARMA Tbk 90,000
elektrolit)
TRAVATAN - Travoprost tetes mata 0,004% PT Tempo Scan Pacific, Tbk 80,000
TRIOFUSIN 1600 - Larutan mengandung Karbohidrat 40% (Fructose 200 g, Glucose 110 g, Xylitol 100 g/ L) PT KALBE FARMA Tbk 95,250
TRIOFUSIN 500 - Larutan mengandung Karbohidrat 12% (Fructose 60 g, Glucose 33 g, Xylitol 30 g/ L) PT KALBE FARMA Tbk 47,000
TRIOFUSIN E1000 - Larutan mengandung Karbohidrat 24% (Fructose 120 g, Glucose 66 g, Xylitol 60 g/ L + elektrolit) PT KALBE FARMA Tbk 57,750
TUTOFUSIN OPS - Larutan mengandung Karbohidrat + Elektrolit (Acetate, Na, K, Cl, Ca, Mg, Sorbitol 50 gr/L) PT KALBE FARMA Tbk 39,325
TYKERB - Lapatinib tab 250 mg PT SmithKline Beecham Pharmaceuticals 72,600
ULTRAVIST 300/100 MG - Iopromide 300-370 mg Iodium/mL (300 mg / 100 ml) PT Bayer Indonesia 280,000
21
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

ULTRAVIST 300/50 MG - Iopromide 300-370 mg Iodium/mL (300 mg / 50 ml) PT Bayer Indonesia 141,530
ULTRAVIST 370/100 MG - Iopromide 300-370 mg Iodium/mL (370 mg / 100 ml) PT Bayer Indonesia 340,000
ULTRAVIST 370/50 MG - Iopromide 300-370 mg Iodium/mL (370 mg / 50 ml) PT Bayer Indonesia 170,500
UROMITEXAN INJEKSI. - Mesna inj 100 mg/mL PT MUGI LABORATORIES 80,443
V - BLOC - Karvedilol Tab 6,25 mg PT KALBE FARMA Tbk 1,360
VAGIZOL - Metronidazol ovula 500 mg PT. Kimia Farma (Persero) Tbk 4,100
VALCYTE - Valgansiklovir tablet 450mg PT. Boehringer Ingelheim 170,000
VENTOLIN ROTACAPS - Salbutamol serb inh 200 mcg/kaps PT Glaxo Wellcome Indonesia 450
VENTOLIN ROTAHALER - Ventolin Rotahaler PT Glaxo Wellcome Indonesia 6,550
VERMOX 500 - Mebendazole Tablet 500 mg PT. TAISHO PHARMACEUTICAL INDONESIA Tbk 8,800
VIGAMOX - Moksifloksasin tetes mata 0,5% PT Tempo Scan Pacific, Tbk 81,000
VINCRISTINE KALBE - Vinkristin ser inj 1 mg (iv)) PT KALBE FARMA Tbk 48,500
VINCRISTINE KALBE - Vinkristin serb inj 2 mg (iv) PT KALBE FARMA Tbk 84,250
VINORELSIN - Vinorelbin inj. 10 mg/ml, vial PT ACTAVIS INDONESIA 685,750
VITALIPID N-ADULT Larutan mengandung Lipid ( Vitamin larut lemak : A, D, E, K ) untuk dewasa PT. Fresenius Kabi Combiphar 29,975
VITALIPID N-INFANT Larutan mengandung Lipid ( Vitamin larut lemak : A, D, E, K ) untuk bayi & anak PT. Fresenius Kabi Combiphar 23,749
VOLUVEN - Koloid HES BM 130.000 lar inf 6% PT. Fresenius Kabi Combiphar 33,000
WIDA 2A - Larutan mengandung Karbohidrat + Elektrolit (2A) PT Widatra Bhakti 8,100
WIDA D5-1/2NS - Larutan Mengandung Karbohidrat+Elektrolit (D5-1/2NS) PT Widatra Bhakti 9,400
WIDA D5-1/4NS - Larutan Mengandung Karbohidrat+Elektrolit (D5-1/4NS) PT Widatra Bhakti 9,350
WIDA D5-NS - Larutan Mengandung Karbohidrat+Elektrolit (D5NS) PT Widatra Bhakti 8,025
WIDA HSD - Larutan Mengandung Karbohidrat+Elektrolit (HSD) PT Widatra Bhakti 10,825
WIDA RD - Larutan Mengandung Karbohidrat+Elektrolit (RD) PT Widatra Bhakti 8,550
WIDA RL - Ringer Laktat 1000 ml PT Widatra Bhakti 11,025

22
 HARGA SATUAN
NAMA OBAT NAMA PENYEDIA
TERKECIL (Rp)

XALATAN 0,005% - Latanoprost 0,005% PT. Pfizer Indonesia 121,500

XARELTO 10 MG - Rivaroksaban tab 10 mg PT Bayer Indonesia 24,675
XARELTO 15 MG - Rivaroksaban tab 15 mg PT Bayer Indonesia 23,500
XARELTO 20 MG - Rivaroksaban tab 20 mg PT Bayer Indonesia 23,500
XELODA - Kapesitabin tablet 500mg PT. Boehringer Ingelheim 31,000
XYLOCAINE JELLY 2% - Lidocaine HCL 20 mg/ g PT AstraZeneca Indonesia 40,000
ZIRCUM KID SIRUP - Zinc sir 20 mg/5 Ml PT. MEPROFARM 7,400
ZOLADEX 10,8 MG - Goserelin acetate 10.8 mg PT AstraZeneca Indonesia 2,467,000
ZOLADEX 3,6 MG - Goserelin Asetate inj 3.6 mg PT AstraZeneca Indonesia 882,000
ZOMETA - Asam zoledronat 4mg/100ml PT Novartis Indonesia 1,500,000
ZYPREXA IM - Olanzapin inj 10 mg/vial PT Bayer Indonesia 130,000

23