DAFTAR PENGADAAN OBAT BERDASARKAN E-CATALOGUE OBAT

Formulir 2

E-CATALOGUE OBAT
VOLUME KEBUTUHAN
No NAMA OBAT, BENTUK SEDIAAN, KEKUATAN KEMASAN SATUAN JUMLAH HARGA (RUPIAH)
(SATUAN)
HARGA SATUAN
PENYEDIA DISTRIBUTOR
(Rupiah)

1 2 3 4 5 6 7 8 9

(Seretide Inhaler 50 mcg) PT. Glaxo Wellcome PT. Anugerah

1 Dus, Botol 120 Dosis Botol 55,000 0
Komb. Salmeterol 25mcg dan Fluticasone Prop. 50 mcg Indonesia Pharmindo Lestari
(Seretide Diskus 100 mcg) PT. Glaxo Wellcome PT. Anugerah
2 Dus, Foil Strip @ 60 Dosis Diskus 103,817 0
Komb. Salmeterol 50mcg dan Fluticasone Prop. 100 mcg Indonesia Pharmindo Lestari
(Seretide Diskus 250 mcg) PT. Glaxo Wellcome PT. Anugerah
3 Dus, Foil Strip @ 60 Dosis Diskus 116,687 0
Komb. Salmeterol 50mcg dan Fluticasone Prop. 250 mcg Indonesia Pharmindo Lestari
(Seretide Diskus 500 mcg) PT. Glaxo Wellcome PT. Anugerah
4 Dus, Foil Strip @ 60 Dosis Diskus 127,617 0
Komb. Salmeterol 50mcg dan Fluticasone Prop. 500 mcg Indonesia Pharmindo Lestari
(Flixotide Nebules) Dus, 2 Flow Wrap @ 5 PT. Glaxo Wellcome PT. Anugerah
5 Botol 14,929 0
Fluticasone Propionate Nebule 0,5mg nebule @1 Dosis (2ml) Indonesia Pharmindo Lestari
(Zinnat 250 mg) Dus, 1 Blister @ 10 Tablet PT. Glaxo Wellcome PT. Anugerah
6 Tablet 4,500 0
Sefuroksim Tablet/Kapsul/Kaplet 250 mg Salut Selaput Indonesia Pharmindo Lestari
(Zinnat 500 mg) Dus, 1 Blister @ 10 Tablet PT. Glaxo Wellcome PT. Anugerah
7 Tablet 4,500 0
Sefuroksim Tablet/Kapsul/Kaplet 500 mg Salut Selaput Indonesia Pharmindo Lestari
(Requip PD 24 hour 2 mg) Dus, 7 Blister @ 4 tablet PT. Glaxo Wellcome PT. Anugerah
8 Tablet 5,920 0
Ropinirol Tablet Salut 2 mg Lepas Lambat Indonesia Pharmindo Lestari
(Requip PD 24 hour 4 mg) Dus, 7 Blister @ 4 tablet PT. Glaxo Wellcome PT. Anugerah
9 Tablet 7,053 0
Ropinirol Tablet Salut 4 mg Lepas Lambat Indonesia Pharmindo Lestari
(Requip PD 24 hour 8 mg) Dus, 7 Blister @ 4 tablet PT. Glaxo Wellcome PT. Anugerah
10 Tablet 8,237 0
Ropinirol Tablet Salut 8 mg Lepas Lambat Indonesia Pharmindo Lestari
(Avodart) Dus, Botol Plastik @ 30 PT. SmithKline Beecham PT. Anugerah
11 Kapsul 4,700 0
Dutasterid Kapsul Lunak 0,5mg Kapsul Pharmaceuticals Pharmindo Lestari
(Avamys) Dus, Botol 120 Dosis PT. Glaxo Wellcome PT. Anugerah
12 Botol 107,120 0
Fluticasone Furoate Intranasal Spray Spray Indonesia Pharmindo Lestari
(Hepsera) PT. SmithKline Beecham PT. Anugerah
13 Dus, 3 Blister @ 10 tablet tablet 30,700 0
Adefovir Dipivoksil tablet/kaplet 10 mg Pharmaceuticals Pharmindo Lestari
(Alkeran) PT. Glaxo Wellcome PT. Anugerah
14 Dus @ 25 tablet (botol) Tablet 11,552 0
Melfalan tablet 2 mg Indonesia Pharmindo Lestari
Lamictal 25 mg PT. Glaxo Wellcome PT. Anugerah
15 Dus, 3 Blister @ 10 tablet Tablet 2,837 0
(Lamotrigine) Indonesia Pharmindo Lestari
Lamictal 50 mg PT. Glaxo Wellcome PT. Anugerah
16 Dus, 3 Blister @ 10 tablet Tablet 2,650 0
(Lamotrigine) Indonesia Pharmindo Lestari
Keppra 250 mg Dus, 3 Blister @ 10 Tablet PT. Glaxo Wellcome PT. Anugerah
17 Tablet 4,000 0
(levetiracetam) Salut Selaput Indonesia Pharmindo Lestari
Keppra 500 mg Dus, 2 Blister @ 10 Tablet PT. Glaxo Wellcome PT. Anugerah
18 Tablet 4,700 0
(levetiracetam) Salut Selaput Indonesia Pharmindo Lestari
Imuran PT. Glaxo Wellcome PT. Anugerah
19 Dus, 4 Blister @ 25 tablet Tablet 7,490 0
(Azathioprine) Indonesia Pharmindo Lestari
(Ventolin Inhaler) PT. Glaxo Wellcome PT. Anugerah
20 Dus, Botol 200 Dosis Botol 60,000 0
Sabutamol inhalasi/aerosol 100mcg/dosis Indonesia Pharmindo Lestari
(Ventolin Nebules) Dus, 4x5 Botol Plastik @ PT. Glaxo Wellcome PT. Anugerah
21 Botol 4,000 0
Salbutamol cairan inhalasi 0,1% 2.5ml Indonesia Pharmindo Lestari
(Ventolin Rotacaps) PT. Glaxo Wellcome PT. Anugerah
22 Dus, 8 Blister @ 16 Kapsul Kapsul 450 0
Salbutamol serbuk inhalasi 200mcg/kapsul Indonesia Pharmindo Lestari
(Ventolin Rotahaler) PT. Glaxo Wellcome PT. Anugerah
23 Dus, 1 Rotahaler Rotahaler 6,550 0
Salbutamol serbuk inhalasi 200mcg/kapsul+rotahaler Indonesia Pharmindo Lestari

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