Anexa 6 (Anexa 2a la Ordinul CNAS 944/2015)

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 12 AUGUST 2016

Co-plata maxima a Val. maxima suportata de Co-plata maxima a

asiguratului / UT sistemul de asigurari asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. beneficiaza de (pt. asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 90%
tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)

SE MODIFICA

76 B03AA07 COMBINATII (FERROSI SULFAS+ACIDUM ASCORBICUM) SORBIFER DURULES COMPR. FILM. 100mg+60mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. X 50 COMPR. FILM. P-6L 50 0,307800 0,000000 0,277020 0,030780

Pagina 1 din 1
 Anexa 7 (Anexa 2b la Ordinul CNAS 944/2015)

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 12 AUGUST 2016

Co-plata maxima a Val. maxima suportata Val. maxima suportata

asiguratului / UT (pt. de sistemul de asigurari Co-plata maxima a de sistemul de asigurari Co-plata maxima a
asiguratii care sociale de sanatate / UT asiguratului / UT (pt. sociale de sanatate / UT asiguratului / UT (pt.

Prescriptie
cant. beneficiaza de (pt. asiguratii care asiguratii care (pt. asiguratii care asiguratii care
UT/ Pret de compensare 100% beneficiaza de beneficiaza de beneficiaza de beneficiaza de
Tara det. amba referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
Nr. crt cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)

SE ADAUGA

1.096 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM)** LIPOCOMB 10 mg/10 mg CAPS. 10mg/10mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 (3X10) CAPS. P6L 30 4,033666 0,000000 2,016833 2,016833 3,630299 0,403367
1.097 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM)** LIPOCOMB 20 mg/10 mg CAPS. 20mg/10mg EGIS PHARMACEUTICALS PLC UNGARIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 (3X10) CAPS. P6L 30 4,111916 0,234750 2,055958 2,290708 3,700724 0,645942
1.098 FARA COMBINATII (METOPROLOLUM+IVABRADINUM)** IMPLICOR 25 mg/5 mg COMPR. FILM. 25mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 3,985133 0,094867 1,992566 2,087434 3,586619 0,493381
1.099 FARA COMBINATII (METOPROLOLUM+IVABRADINUM)** IMPLICOR 25 mg/7,5 mg COMPR. FILM. 25mg/7,5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 3,940000 0,000000 1,970000 1,970000 3,546000 0,394000
1.100 FARA COMBINATII (METOPROLOLUM+IVABRADINUM)** IMPLICOR 50 mg/5 mg COMPR. FILM. 50mg/5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 3,985133 0,154688 1,992566 2,147255 3,586619 0,553202
1.101 FARA COMBINATII (METOPROLOLUM+IVABRADINUM)** IMPLICOR 50 mg/7,5 mg COMPR. FILM. 50mg/7,5mg LES LABORATOIRES SERVIER FRANTA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. P6L 56 3,985133 0,015045 1,992566 2,007612 3,586619 0,413559
1.102 R03AL05 ACLIDINIUM BROMIDUM+FORMOTEROLUM FUMARAT** BRIMICA GENUAIR 340 micrograme/12 micrograme PULB. DE INHAL. 340 micrograme/12 micrograme ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR A 60 DE DOZE PRF 1 241,990000 0,000000 120,995000 120,995000 217,791000 24,199000
1.103 R03AL05 ACLIDINIUM BROMIDUM+FORMOTEROLUM FUMARAT** DUAKLIR GENUAIR 340 micrograme/12 micrograme PULB. DE INHAL. 340 micrograme/12 micrograme ASTRAZENECA AB SUEDIA CUTIE CU 1 INHALATOR A 60 DE DOZE PRF 1 241,990000 0,000000 120,995000 120,995000 217,791000 24,199000

SE MODIFICA

570 G03CX01 TIBOLONUM** LIVIAL (R) 2,5 mg COMPR. 2,5mg ORGANON NV OLANDA CUTIE X 1 BLIST. X 28 COMPR. P-RF 28 1,586071 0,000000 0,793035 0,793036 1,427463 0,158608
1.073 S01AE01 OFLOXACINUM FLOXAL (R) PICATURI OFT.-SOL. 0,3% DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE X 1 FLACON DIN PEJD X 5 ML PICATURI OFT., SOL. P6L 1 10,895000 3,325000 5,447500 8,772500 9,805500 4,414500
1.074 S01AE01 OFLOXACINUM FLOXAL (R) UNG. OFT. 0,3% DR. GERHARD MANN CHEM.PHARM.FABRIK GMBH GERMANIA CUTIE X 1 TUB DIN AL PREVAZUT CU APLICATOR X 3 G P6L 1 14,680000 0,000000 7,340000 7,340000 13,212000 1,468000
716 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL)** VIMOVO 500 mg/20 mg COMPR. ELIB. MODIF. 500 mg/20 mg ASTRA ZENECA AB SUEDIA CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 30 COMPR. ELIB. MODIF. PRF 30 1,611749 0,081251 0,805874 0,887126 1,450574 0,242426
717 M01AE52 COMBINATII (NAPROXEN + ESOMEPRAZOL)** VIMOVO 500 mg/20 mg COMPR. ELIB. MODIF. 500 mg/20 mg ASTRA ZENECA AB SUEDIA CUTIE CU 1 FLAC. PEID CU CAPAC PP PREVAZUT CU SIST. SECURIZAT PT. COPII SI DESICANT SILICAGEL X 60 COMPR. ELIB. MODIF. PRF 60 1,584666 0,000000 0,792333 0,792333 1,426199 0,158467

Pagina 1 din 1
 Anexa 8
(Anexa 2c la Ordinul CNAS 944/2015)
SECIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREUL DE REFERIN CONFORM
DCI-urilor UTILIZATE N TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOLI
DIN H.G. NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE;
MEDICAMENTELE DIN ACEAST SUBLIST SE ELIBEREAZ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZ DE PRESCRIPIE MEDICAL CU REINERE N FARMACIE
VALABIL NCEPND CU 12 AUGUST 2016

Val. maxima suportata de Co-plata maxima a

sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA amba referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)

10. BOALA PARKINSON - G12

SE MODIFICA

76 N04BC09 ROTIGOTINUM** NEUPRO 2mg/24h PLASTURE TRANSDERMIC 2mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 7,975714 7,975714 0,000000
77 N04BC09 ROTIGOTINUM** NEUPRO 4mg/24h PLASTURE TRANSDERMIC 4mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 11,431428 11,431428 0,000000
78 N04BC09 ROTIGOTINUM** NEUPRO 6mg/24h PLASTURE TRANSDERMIC 6mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 14,614285 14,614285 0,000000
79 N04BC09 ROTIGOTINUM** NEUPRO 8mg/24h PLASTURE TRANSDERMIC 8mg/24h UCB MANUFACTURING IRELAND LTD. IRLANDA CUTIE X 28 PLASTURI TRANSDERMICI P-RF 28 17,376071 17,376071 0,000000

11. MIASTENIA GRAVIS - G13

SE ELIMINA

340 L01BA01 METHOTREXATUM METHOTREXATE 2,5 mg COMPR. FILM. 2,5mg CN UNIFARM S.A. ROMANIA CUTIE CU 10 BLIST. X 10 COMPR. FILM. PRF 100 0,327000 0,327000 0,000000
188 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 374,090000 374,090000 0,000000
1.839 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 82,990000 82,990000 0,000000
1.211 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 61,880000 61,880000 0,000000
1.987 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 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 46,730000 46,730000 0,000000
2.661 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 79,700000 79,700000 0,000000
1.482 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 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 118,008000 118,008000 9,082000
2.660 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.30ML SOLUTIA INJECTABILA PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 74,880000 74,880000 0,000000
1.481 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 98,340000 98,340000 0,000000
1.986 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 56,076000 56,076000 13,944000
2.341 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 110,680000 110,680000 0,000000

12. SCLEROZA MULTIPLA - G14

SE ELIMINA

10 L01BA01 METHOTREXATUM METHOTREXATE 2,5 mg COMPR. FILM. 2,5mg CN UNIFARM S.A. ROMANIA CUTIE CU 10 BLIST. X 10 COMPR. FILM. PRF 100 0,327000 0,327000 0,000000
11 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 374,090000 374,090000 0,000000
12 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 82,990000 82,990000 0,000000
13 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 61,880000 61,880000 0,000000
14 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 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 118,008000 118,008000 9,082000
15 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 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 46,730000 46,730000 0,000000
16 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 79,700000 79,700000 0,000000
17 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 98,340000 98,340000 0,000000
18 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 56,076000 56,076000 13,944000
19 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 110,680000 110,680000 0,000000
20 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.30ML SOLUTIA INJECTABILA PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 74,880000 74,880000 0,000000

Pagina 1 din 5
 Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA amba referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)

14. DEMENTE(DEGENERATIVE, VASCULARE, MIXTE) - G 16

SE MODIFICA

1 N06DA02 DONEPEZILUM** YASNAL 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU, BLIST., DIN OPA-AL-PVC/AL CU 28 COMPR. FILM. P-RF 28 1,251428 1,251428 0,000000
2 N06DA02 DONEPEZILUM** DAVIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 1,256570 1,256570 0,896763
3 N06DA02 DONEPEZILUM** DAVIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 1,256570 1,256570 0,896763
4 N06DA02 DONEPEZILUM** TUADIN 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 1,237666 1,237666 0,000000
6 N06DA02 DONEPEZILUM** DONECEPT 10 MG COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 1,047142 1,047142 0,000000
7 N06DA02 DONEPEZILUM** COGNEZIL 10 mg COMPR. FILM. 10mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X BLISTERE PVC/AL X 28 COMPRIMATE FILMATE P-RF 28 1,256570 1,256570 0,477001
8 N06DA02 DONEPEZILUM** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 1,256570 1,256570 0,862001
9 N06DA02 DONEPEZILUM** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-RF 50 1,256570 1,256570 0,755230
10 N06DA02 DONEPEZILUM** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. P-RF 56 1,256570 1,256570 0,755037
11 N06DA02 DONEPEZILUM** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 1,256570 1,256570 0,755096
12 N06DA02 DONEPEZILUM** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 98 COMPR. FILM. P-RF 98 1,256570 1,256570 0,650981
13 N06DA02 DONEPEZILUM** DOSPELIN 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P-RF 100 1,256570 1,256570 0,651030
14 N06DA02 DONEPEZILUM** DONEPEZIL TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 1,256570 1,256570 0,564096
15 N06DA02 DONEPEZILUM** XALINAT 10 mg COMPR. FILM. 10mg GALENICA S.A. GRECIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 1,256570 1,256570 1,059858
16 N06DA02 DONEPEZILUM** YASNAL 5 mg COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL CU 28 COMPR. FILM. P-RF 28 0,985000 0,985000 0,000000
17 N06DA02 DONEPEZILUM** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-RF 30 1,158856 1,158856 0,383810
18 N06DA02 DONEPEZILUM** DAVIA 5 mg COMPR. FILM. 5mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 COMPR. FILM. P-RF 30 1,158856 1,158856 0,383810
19 N06DA02 DONEPEZILUM** TUADIN 5 mg COMPR. FILM. 5mg ANTIBIOTICE S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. P-RF 30 1,158856 1,158856 0,347144
20 N06DA02 DONEPEZILUM** DONECEPT 5 MG COMPR. FILM. 5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE X BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 0,965714 0,965714 0,000000
21 N06DA02 DONEPEZILUM** COGNEZIL 5 mg COMPR. FILM. 5mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE X BLISTERE PVC/AL X 28 COMPRIMATE FILMATE P-RF 28 1,158856 1,158856 0,127215
22 N06DA02 DONEPEZILUM** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. P-RF 28 1,158856 1,158856 0,371144
23 N06DA02 DONEPEZILUM** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 50 COMPR. FILM. P-RF 50 1,158856 1,158856 0,293744
24 N06DA02 DONEPEZILUM** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. P-RF 56 1,158856 1,158856 0,294179
25 N06DA02 DONEPEZILUM** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 60 COMPR. FILM. P-RF 60 1,158856 1,158856 0,293810
26 N06DA02 DONEPEZILUM** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 98 COMPR. FILM. P-RF 98 1,158856 1,158856 0,218797
27 N06DA02 DONEPEZILUM** DOSPELIN 5 mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 100 COMPR. FILM. P-RF 100 1,158856 1,158856 0,218944
28 N06DA02 DONEPEZILUM** DONEPEZIL TORRENT 5 mg COMPR. FILM. 5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC/AL X 30 COMPR. FILM. PRF 30 1,158856 1,158856 0,100477
29 N06DA02 DONEPEZILUM** XALINAT 5 mg COMPR. FILM. 5mg GALENICA S.A. GRECIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-RF 28 1,158856 1,158856 0,553286
30 N06DA02 DONEPEZILUM** YASNAL 10 mg COMPR. ORODISPERSABILE 10 mg KRKA D.D. SLOVENIA CUTIE CU BLIST. OPA/AL/PVC SI FOLIE PET-AL TIP "PEEL-OPEN" A CATE 28 COMPR. ORODISP. PRF 28 1,251428 1,251428 0,000000
31 N06DA02 DONEPEZILUM** ARICEPT EVESS COMPR. ORODISPERSABILE 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC-PVDC-PE-PVDC-PVC X 14 COMPR. ORODISPERSABILE P-RF 28 1,256570 1,256570 4,127001
32 N06DA02 DONEPEZILUM** DONEPEZIL TEVA 10 mg COMPR. ORODISPERSABILE 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP. P-RF 28 1,187142 1,187142 0,000000
33 N06DA02 DONEPEZILUM** DONEPEZIL STADA HEMOFARM 10 mg COMPR. ORODISPERSABILE 10mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ORODISPERSABILE PRF 28 1,256570 1,256570 0,854858
34 N06DA02 DONEPEZILUM** DONEPEZIL STADA HEMOFARM 10 mg COMPR. ORODISPERSABILE 10mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE PRF 28 1,256570 1,256570 2,433430
35 N06DA02 DONEPEZILUM** DARIZOL 10 mg COMPR. ORODISPERSABILE 10mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PCTFE(ACLAR)/AL /FOLIE DE AL DETASABILA X 14 COMPR. ORODISPERSABILE PRF 28 1,256428 1,256428 0,000000
36 N06DA02 DONEPEZILUM** ARICEPT EVESS COMPR. ORODISPERSABILE 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. ORODISPERSABILE PRF 28 1,256570 1,256570 4,127001
37 N06DA02 DONEPEZILUM** YASNAL 5 mg COMPR. ORODISPERSABILE 5 mg KRKA D.D. SLOVENIA CUTIE CU BLIST. OPA/AL/PVC SI FOLIE PET-AL "PEEL-OPEN" A CATE 28 COMPR. ORODISP. PRF 28 1,158856 1,158856 0,023286
38 N06DA02 DONEPEZILUM** ARICEPT EVESS COMPR. ORODISPERSABILE 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 2 BLIST. AL/PVC-PVDC-PE-PVDC-PVC X 14 COMPR. ORODISPERSABILE P-RF 28 1,158856 1,158856 2,940786
39 N06DA02 DONEPEZILUM** DONEPEZIL TEVA 5 mg COMPR. ORODISPERSABILE 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 28 COMPR. ORODISP. P-RF 28 1,158856 1,158856 0,028286
40 N06DA02 DONEPEZILUM** DONEPEZIL STADA HEMOFARM 5 mg COMPR. ORODISPERSABILE 5mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. PVC-PCTFE/AL X 28 COMPR. ORODISPERSABILE PRF 28 1,055357 1,055357 0,000000
41 N06DA02 DONEPEZILUM** DONEPEZIL STADA HEMOFARM 5 mg COMPR. ORODISPERSABILE 5mg STADA HEMOFARM SRL ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. ORODISPERSABILE PRF 28 1,158856 1,158856 1,506144
42 N06DA02 DONEPEZILUM** DARIZOL 5 mg COMPR. ORODISPERSABILE 5mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC-PCTFE(ACLAR)/AL /FOLIE DE AL DETASABILA X 14 COMPR. ORODISPERSABILE PRF 28 1,158856 1,158856 0,498286
43 N06DA02 DONEPEZILUM** ARICEPT EVESS COMPR. ORODISPERSABILE 5mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. ORODISPERSABILE PRF 28 1,158856 1,158856 2,940786
44 N06DA03 RIVASTIGMINUM** RIVASTIGMINA TORRENT 1,5 mg CAPS. 1,5mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. P-RF/R 56 1,178570 1,178570 0,114108
45 N06DA03 RIVASTIGMINUM** RIDAXIN 1,5 mg CAPS. 1,5mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 1,178570 1,178570 0,005715
46 N06DA03 RIVASTIGMINUM** NIMVASTID 1.5mg CAPS. 1.5mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PVDC/AL X 28 CAPSULE P-RF/R 28 0,982142 0,982142 0,000000
47 N06DA03 RIVASTIGMINUM** NIMVASTID 3mg CAPS. 3mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST. PVC/PVDC/AL X 28 CAPSULE P-RF/R 28 1,174285 1,174285 0,000000

Pagina 2 din 5
 Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA amba referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
48 N06DA03 RIVASTIGMINUM** RIVASTIGMINE SANDOZ 3mg CAPS. 3mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST.PVC/AL X 56 CAPS. P-RF/R 56 1,409142 1,409142 0,983358
49 N06DA03 RIVASTIGMINUM** RIVASTIGMINA TORRENT 3 mg CAPS. 3mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. P-RF/R 56 1,409142 1,409142 0,554429
50 N06DA03 RIVASTIGMINUM** RIDAXIN 3 mg CAPS. 3mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 1,409107 1,409107 0,000000
51 N06DA03 RIVASTIGMINUM** RIDAXIN 4,5 mg CAPS. 4,5mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 2,080285 2,080285 0,156857
52 N06DA03 RIVASTIGMINUM** RIDAXIN 6 mg CAPS. 6mg NEOLA PHARMA S.R.L. ROMANIA CUTIE CU 4 BLIST. PVC/AL X 14 CAPS. P-RF/R 56 2,724428 2,724428 0,128250
53 N06DA03 RIVASTIGMINUM** NIMVASTID 1.5 mg COMPR. ORODISPERSABILE 1.5mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R 28 0,982142 0,982142 0,000000
54 N06DA03 RIVASTIGMINUM** NIMVASTID 3mg COMPR. ORODISPERSABILE 3mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R 28 1,174285 1,174285 0,000000
55 N06DA03 RIVASTIGMINUM** NIMVASTID 4.5 mg COMPR. ORODISPERSABILE 4.5mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R 28 1,733571 1,733571 0,000000
56 N06DA03 RIVASTIGMINUM** NIMVASTID 6mg COMPR. ORODISPERSABILE 6mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE X BLIST.UNIDOZA OPA/AL/PVC/PET/AL X (28 X 1) COMPR. ORODISPESABILE P-RF/R 28 2,270357 2,270357 0,000000
57 N06DA03 RIVASTIGMINUM** EXELON 13,3mg/24h PLASTURE TRANSDERMIC 13,3/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 11,130666 11,130666 0,000000
58 N06DA03 RIVASTIGMINUM** EXELON 4,6mg/24h PLASTURE TRANSDERMIC 4,6mg/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 3,568800 3,568800 4,503200
59 N06DA03 RIVASTIGMINUM** EVERTAS 4,6 mg/24 h PLASTURE TRANSDERMIC 4,6mg/24h ZENTIVA, K.S. REPUBLICA CEHA CUTIE X 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HARTIE/TEREFTALAT DE POLIETILENA/ALUMINIU/PILIACRILONITRIL PREVAZUTE CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 1 PLASTURE TRANSDERMIC PRF 30 2,974000 2,974000 0,000000
60 N06DA03 RIVASTIGMINUM** EXELON 9,5mg/24h PLASTURE TRANSDERMIC 9,5mg/24h NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 6,295999 6,295999 1,776001
61 N06DA03 RIVASTIGMINUM** EVERTAS 9,5 mg/24 h PLASTURE TRANSDERMIC 9,5mg/24h ZENTIVA, K.S. REPUBLICA CEHA CUTIE X 30 PLICURI DIN MATERIAL MULTILAMINAT DIN HARTIE/TEREFTALAT DE POLIETILENA/ALUMINIU/PILIACRILONITRIL PREVAZUTE CU SISTEM DE INCHIDERE SECURIZAT PENTRU COPII X 1 PLASTURE TRANSDERMIC PRF 30 5,246666 5,246666 0,000000
62 N06DA03 RIVASTIGMINUM** RIVASTIGMINA DR. REDDY'S 4,6 mg/24 ore PLASTURI TRANSDERMICI 4,6mg/24ore DR. REDDY'S LABORATORIES ROMANIA CUT IE CU 30 PLICURI DIN MAT ERIAL MULT ILAMINAT DIN HRT IE/POLIET ILENT EREFT ALAT /AL/POLIACRILONIT RIL CU CU SIST EM DE NCHIDERE SECURIZAT PENT RU COPII, A CT E 1 PLAST URE T RANSDERMIC PROT EJ. DE O FOLIE DIN FILM DIN T EREFT ALAT DE POLIET ILENA SILICONAT A PRF 30 3,568800 3,568800 1,677866
63 N06DA03 RIVASTIGMINUM** RIVASTIGMINA DR. REDDY'S 9,5 mg/24 ore PLASTURI TRANSDERMICI 9,5mg/24ore DR. REDDY'S LABORATORIES ROMANIA CUT IE CU 30 PLICURI DIN MAT ERIAL MULT ILAMINAT DIN HRT IE/POLIET ILENT EREFT ALAT /AL/POLIACRILONIT RIL CU CU SIST EM DE NCHIDERE SECURIZAT PENT RU COPII, A CT E 1 PLAST URE T RANSDERMIC PROT EJ. DE O FOLIE DIN FILM DIN T EREFT ALAT DE POLIET ILENA SILICONAT A PRF 30 5,246666 5,246666 0,000000
64 N06DA03 RIVASTIGMINUM** RIVASTIGMINA TEVA 2 mg/ml SOL. ORALA 2mg/ml TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA X 125 ML SOL. ORALA + 1 SERINGA DOZATOARE P-RF/R 1 301,224000 301,224000 132,156000
65 N06DA03 RIVASTIGMINUM** RIVASTIGMINA SANDOZ 2mg/ml SOL. ORALA 2mg/ml SANDOZ GMBH AUSTRIA CUTIE CU FLAC. DIN STICLA BRUNA A 120 ML SOL.ORALA + SERINGA DOZATOARE PR 1 251,020000 251,020000 0,000000
66 N06DA04 GALANTAMINUM** GALSYA 16 mg CAPS. ELIB. PREL. 16mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,815666 1,815666 0,000000
67 N06DA04 GALANTAMINUM** GALANTAMINA ZENTIVA 16 mg CAPS. ELIB. PREL. 16mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. PRF 28 1,513571 1,513571 0,000000
68 N06DA04 GALANTAMINUM** GALSYA 24 mg CAPS. ELIB. PREL. 24mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,815666 1,815666 0,000000
69 N06DA04 GALANTAMINUM** GALANTAMINA ZENTIVA 24 mg CAPS. ELIB. PREL. 24mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. PRF 28 1,513571 1,513571 0,000000
70 N06DA04 GALANTAMINUM** GALSYA 8 mg CAPS. ELIB. PREL. 8mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 1,815666 1,815666 0,000000
71 N06DA04 GALANTAMINUM** GALANTAMINA ZENTIVA 8 mg CAPS. ELIB. PREL. 8mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. TRANSPARENTE PVC-PE-PVDC/AL X 28 CAPS. ELIB. PREL. PRF 28 1,513571 1,513571 0,000000
72 N06DA04 GALANTAMINUM** REMINYL (R) 4 mg/ml SOL. ORALA 4mg/ml JANSSEN-PHARMACEUTICA NV BELGIA CUTIE X 1 FLACON X 100 ML + 1 PIPETA DOZATOARE P-RF 1 124,860000 124,860000 0,000000
73 N06DX01 MEMANTINUM** MEMANTINA RATIOPHARM 10 mg COMPR. FILM. 10 mg RATIOPHARM GMBH GERMANIA CUTIE CU BLISTERE DIN FOLIE PVC/PVDC-AL X 56 COMPRIMATE FILMATE PR 56 0,650714 0,650714 0,000000
74 N06DX01 MEMANTINUM** EBIXA 10 mg COMPR. FILM. 10mg H. LUNDBECK A/S DANEMARCA CUTIE X 56 COMPR. FILM. (BLIST. AL/PP) P-RF/R 56 0,650785 0,650785 1,572250
75 N06DX01 MEMANTINUM** MEMANTINA TORRENT 10 mg COMPR. FILM. 10mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. PR 56 0,650785 0,650785 0,009572
76 N06DX01 MEMANTINUM** NEMDATINE 10mg COMPR. FILM. 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 0,647857 0,647857 0,000000
77 N06DX01 MEMANTINUM** MEMANTINA DR. REDDY'S 10 mg COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 0,570892 0,570892 0,000000
78 N06DX01 MEMANTINUM** MIRVEDOL 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0,650535 0,650535 0,000000
79 N06DX01 MEMANTINUM** MEMANTINA AUROBINDO 10 mg COMPR. FILM. 10mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0,542321 0,542321 0,000000
80 N06DX01 MEMANTINUM** MEMANTINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 56 COMPR. FILM. PR 56 0,650785 0,650785 0,034393
81 N06DX01 MEMANTINUM** MEMANTINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PR 56 0,650785 0,650785 0,034393
82 N06DX01 MEMANTINUM** MEMANTINA ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 0,650785 0,650785 0,005286
83 N06DX01 MEMANTINUM** MARIXINO 10mg COMPR. FILM. 10mg CONSILIENT HEALTH LTD. IRLANDA CUTIE X BLISTER PVC/PVDC/AL X 56 COMPRIMATE FILMATE PR 56 0,619821 0,619821 0,000000
84 N06DX01 MEMANTINUM** COGNOMEM 10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 0,650785 0,650785 0,034393
85 N06DX01 MEMANTINUM** MEMANTINA LANNACHER HEILMITTEL 10 mg COMPR. FILM. 10mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 70 COMPR. FILM. PR 70 0,628428 0,628428 0,000000
86 N06DX01 MEMANTINUM** MANTOMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM. PRF 56 0,650785 0,650785 0,032965
87 N06DX01 MEMANTINUM** MANTOMED 10 mg COMPR. FILM. 10mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PRF 56 0,650785 0,650785 0,032965
88 N06DX01 MEMANTINUM** MEMANTINE ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC-AL X 14 COMPR. FILM. PR 14 0,648571 0,648571 0,000000
89 N06DX01 MEMANTINUM** MEMANTINE ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC-AL X 28 COMPR. FILM. PR 28 0,647857 0,647857 0,000000
90 N06DX01 MEMANTINUM** MEMANTINA RATIOPHARM 20 mg COMPR. FILM. 20 mg RATIOPHARM GMBH GERMANIA CUTIE X BLISTERE DIN FOLIE PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 1,644428 1,644428 0,100572
91 N06DX01 MEMANTINUM** MEMANTINA TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 COMPR. FILM. PR 56 1,644428 1,644428 0,373786
92 N06DX01 MEMANTINUM** NEMDATINE 20mg COMPR. FILM. 20mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLISTERE DIN PVC/PVDC-AL X 28 COMPRIMATE FILMATE PR 28 1,552500 1,552500 0,000000
93 N06DX01 MEMANTINUM** MEMANTINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 28 COMPR. FILM. PR 28 1,644428 1,644428 0,449500
94 N06DX01 MEMANTINUM** MEMANTINA TERAPIA 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 28 COMPR. FILM. PR 28 1,644428 1,644428 0,449500
95 N06DX01 MEMANTINUM** MEMANTINA ATB 20 mg COMPR. FILM. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PR 28 1,491071 1,491071 0,000000
96 N06DX01 MEMANTINUM** COGNOMEM 20 mg COMPR. FILM. 20mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 COMPR. FILM. PR 56 1,644285 1,644285 0,000000
97 N06DX01 MEMANTINUM** MANTOMED 20 mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. TRANSPARENT PVC-PE-PVDC/AL X 56 COMPR. FILM. PRF 56 1,644428 1,644428 0,419857
98 N06DX01 MEMANTINUM** MANTOMED 20 mg COMPR. FILM. 20mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PA-AL-PVC/AL X 56 COMPR. FILM. PRF 56 1,644428 1,644428 0,419857
99 N06DX01 MEMANTINUM** MEMANTINE ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC-AL X 14 COMPR. FILM. PRF 14 1,540714 1,540714 0,000000

Pagina 3 din 5
 Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA amba referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
100 N06DX01 MEMANTINUM** MEMANTINE ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC-AL X 28 COMPR. FILM. PRF 28 1,491071 1,491071 0,000000
101 N06DX01 MEMANTINUM** MEMANTINA TEVA 10 mg COMPR. ORODISPERSABILE 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. ORODISPERSABILE PR 56 0,650785 0,650785 0,034393
102 N06DX01 MEMANTINUM** MEMANTINA TEVA 20 mg COMPR. ORODISPERSABILE 20mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PT. ELIBERAREA UNEI UNITATI DOZATE DIN OPA-AL-PVC/AL X 28X1 COMPR. ORODISPERSABILE PR 28 1,370357 1,370357 0,000000
103 N06DX01 MEMANTINUM** EBIXA 5mg/doza PICATURI ORALE - SOL. 5mg/doza H LUNDBECK A/S DANEMARCA CUTIE X 1 FLACON DIN STICLA BRUNA CU POMPA DOZATOARE X 50 ML SOLUTIE P-RF/R 1 115,980000 115,980000 25,020000
104 N06DX01 MEMANTINUM** MEMANTINA TEVA 10 mg/ml SOL. ORALA 10 mg/ml ROMANIA
TEVA PHARMACEUTICALS S.R.L. CUTIE CU 1 FLAC. DIN STICLA + SERINGA DOZATOARE A 50 ML SOL. ORALA PR 1 96,650000 96,650000 0,000000
105 N06DX01 MEMANTINUM** MEMANTINA TORRENT 10 mg/ml SOL. ORALA 10mg/ml TORRENT PHARMA SRL ROMANIA CUTIE CU 1 FLAC. A 100 ML SOL. SOL. ORALA SI O POMPA DOZATOARE PR 1 183,300000 183,300000 0,000000

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

SE ELIMINA

7 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 374,090000 374,090000 0,000000
8 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 82,990000 82,990000 0,000000

Tratamentul se iniiaz de ctre medicul din specialitatea reumatologie, nefrologie, medicin intern, pediatrie, reabilitare medical i dermatovenerologie.

21. GLAUCOM - G 26

SE MODIFICA

12 S01ED51 COMBINATII ( BRINZOLAMIDUM + TIMOLOLUM)** AZARGA PIC. OFT. SUSP. 10mg/ml+5mg/ml ALCON LABORATORIES (UK) LTD. MAREA BRITANIE CUTIE X 1 FLAC. X 5 ML SUSP. OFT. P-RF 1 58,030000 58,030000 0,000000

22. PEMFIGUS - G 27

SE ELIMINA

23 L01BA01 METHOTREXATUM METHOTREXATE 2,5 mg COMPR. FILM. 2,5mg CN UNIFARM S.A. ROMANIA CUTIE CU 10 BLIST. X 10 COMPR. FILM. PRF 100 0,327000 0,327000 0,000000
24 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 5000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 FLACON X 50 ML S 1 374,090000 374,090000 0,000000
25 L01BA01 METHOTREXATUM METHOTREXAT "EBEWE" 1000 mg CONC. PT. SOL. INJ./PERF. 100mg/ml EBEWE PHARMA GES.M.B.H. NFG KG AUSTRIA CUTIE X 1 TUB DIN MATERIAL PLASTIC X 1 FIOLA X 10 ML S 1 82,990000 82,990000 0,000000
26 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 61,880000 61,880000 0,000000
27 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 2,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 118,008000 118,008000 9,082000
28 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 1,0 ML SOL INJ. + AC DE UNICA FOLOSINTA PT. INJE PR 1 46,730000 46,730000 0,000000
29 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 79,700000 79,700000 0,000000
30 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,40ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 98,340000 98,340000 0,000000
31 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,20ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 56,076000 56,076000 13,944000
32 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0,50ML SOL. INJ. PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 110,680000 110,680000 0,000000
33 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRPARATE GERMANIA CUTIE X 1 SERINGA PREUMPLUTA X 0.30ML SOLUTIA INJECTABILA PREVAZUTA CU AC SI TAMPOANE CU ALCOOL P-RF 1 74,880000 74,880000 0,000000

28. SPONDILITA ANKILOZANTA - G 31d

SE ADAUGA

13 L04AB05 CERTOLIZUMAB PEGOL**** CIMZIA SOL. INJ. IN SERINGA PREUMPLUTA 200 mg UCB PHARMA SA BELGIA CUTIE X 2 SERINGI PREUMPLUTE DIN STICLA CU PISTON A 1 ML + 2 TAMPOANE CU ALCOOL P-RF/R 2 1.859,470000 1.859,470000 0,000000

Pagina 4 din 5
 Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA amba referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)

NOTA:
- Pentru medicamentele corespunztoare acestei seciuni iniierea tratamentului se face de ctre medicul de specialitate, altul dect medicul de familie, excepie fcnd medicamentele din G1 - Insuficien
cardiac cronic (clasa III sau IV Nyha) poziiile 2 - 7 i 9, pentru care iniierea tratamentului poate fi efectuat i de ctre medicul de familie.
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii.
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (***) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii i cu aprobarea
comisiilor de la nivelul caselor judeene de asigurri de sntate.
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (****) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii i cu aprobarea
comisiilor de la nivelul Casei Naionale de Asigurri de Sntate.
- Medicamentul corespunztor DCI-ului notat cu (3) se livreaz mpreun cu solventul.
- Medicamentele corespunztoare DCI-urilor notate cu (4) se import cu avizul Ageniei Naionale a Medicamentului i a Dispozitivelor Medicale.
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (5) se utilizeaz numai pentru cazurile fr rspuns terapeutic la prednisonum.
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu () se efectueaz n baza contractelor cost-volum-rezultat ncheiate.
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu () se efectueaz n baza contractelor cost-volum ncheiate.

Pagina 5 din 5
 Anexa 10 (Anexa 2e la Ordinul CNAS 944/2015)

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 12 AUGUST 2016

Co-plata maxima a Val. maxima suportata de Co-plata maxima a

asiguratului / UT sistemul de asigurari asiguratului / UT
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care

Prescriptie
cant. beneficiaza de (pt. asiguratii care beneficiaza de
UT/ Pret de compensare 100% beneficiaza de compensare 20%
tara det. amba referinta / UT din pretul de compensare 20% din din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)

SE MODIFICA

88 M05BA06 ACIDUM IBANDRONICUM* ACID IBANDRONIC TEVA 150 mg COMPR. FILM. 150 mg TEVA PHARMA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 1 COMPRIMAT FILMAT P6L 1 28,089642 7,310358 5,617928 29,782072
89 M05BA06 ACIDUM IBANDRONICUM* OSSICA 150 mg COMPR. FILM. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P-6L 1 28,089642 7,590358 5,617928 30,062072
90 M05BA06 ACIDUM IBANDRONICUM* QUODIXOR 150 mg COMPR. FILM. 150mg ALVOGEN IPCO S.AR.L LUXEMBURG CUTIE CU BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P-6L 1 28,089642 7,580358 5,617928 30,052072
91 M05BA06 ACIDUM IBANDRONICUM* OSAGRAND 150 mg COMPR. FILM. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 COMPR. FILM. P6L 1 28,089642 6,940358 5,617928 29,412072
92 M05BA06 ACIDUM IBANDRONICUM* ACID IBANDRONIC SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P6L 1 28,089642 7,590358 5,617928 30,062072
93 M05BA06 ACIDUM IBANDRONICUM* ACID IBANDRONIC AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P6L 1 28,089642 6,950358 5,617928 29,422072
94 M05BA06 ACIDUM IBANDRONICUM* OSSICA 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA A 3 ML SOL. INJ. + 1 AC PT. INJECTIE P6L 1 104,030000 0,000000 20,806000 83,224000
95 M05BA06 ACIDUM IBANDRONICUM* ACID IBANDRONIC ACCORD 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA SI 1 AC PT. INJECTARE PR/PRF 1 100,840000 0,000000 20,168000 80,672000
96 M05BA06 ACIDUM IBANDRONICUM* OSAGRAND 3 mg/3 ml SOL. INJ. 3mg/3ml ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FIOLA DIN STICLA INCOLORA X 3 ML SOL. INJ. P6L 1 104,615000 0,195000 20,923000 83,887000
97 M05BA06 ACIDUM IBANDRONICUM* BONVIVA 3mg/3ml SOL. INJ. IN SERINGA PREUMPLUTA 3mg/3ml ROCHE REGISTRATION LTD. MAREA BRITANIE CUTIE X 1 SERINGA PREUMPLUTA DIN STICLA X 3 ML SOL. INJ. + 1 AC P-6L 1 104,615000 48,285000 20,923000 131,977000

NOT:
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (*) se iniiaz de ctre medicul de specialitate n limita competenei i poate fi prescris n continuare de medicul de familie pe baza scrisorii
medicale emise de medicul de specialitate.
- Tratamentul cu medicamentele corespunztoare DCI-urilor notate cu (**) se efectueaz pe baza protocoalelor terapeutice elaborate de comisiile de specialitate ale Ministerului Sntii.

Pagina 1 din 1