Lista Medicamentelor Valabila - 01.08.2019

ANEXA 6
(ANEXA 2a la Ordinul CNAS nr. 1611/2018)
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 MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILA INCEPAND CU 01 AUGUST 2019
Contributie maxima Val. maxima suportata de Contributie maxima

a asiguratului / UT sistemul de asigurari a asiguratului / UT
Prescriptie
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
Cod_CIM
cant. beneficiaza de (pt. asiguratii care beneficiaza de

Nr crt.
UT/ Pret de compensare 100% beneficiaza de compensare 90%

tara det. amba referinta / UT din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) referinta)
SE ADAUGA
1.093 W65820002 J01FA09 CLARITHROMYCINUM KLACID 250 mg COMPR. FILM. 250mg MYLAN ITALIA S.R.L. ITALIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 1,111499 0,939215 1,000349 1,050365
1.094 W65821002 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml MYLAN ITALIA S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML PRF 1 24,903000 2,767000 22,412700 5,257300
1.095 W65821001 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml MYLAN ITALIA S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML PRF 1 14,941800 5,828200 13,447620 7,322380
1.096 W64948001 N02CC01 SUMATRIPTANUM * IMIGRAN DR 100 mg COMPR. DISP. 100mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. PRF 2 10,577499 5,717501 9,519749 6,775251
1.097 W64946001 N02CC01 SUMATRIPTANUM * IMIGRAN DR 50 mg COMPR. DISP. 50mg GLAXOSMITHKLINE (IRELAND) LIMITED IRLANDA CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. PRF 2 5,288749 3,226251 4,759874 3,755126
SE MODIFICA
1.069 W42284004 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. PVC-AL-OPA/AL X 10 CAPS. GASTROREZ P-6L 30 0,532350 0,167650 0,479115 0,220885
415 W60908002 C10AA01 SIMVASTATINUM SIMVASTATINA ARENA 10 mg COMPR. FILM. 10 mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. DIN PVC - PVD /AL X 14 COMPR. FILM. P-6L 28 0,100099 0,240972 0,090089 0,250982
416 W12477002 C10AA01 SIMVASTATINUM ZEPLAN (R) 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILMP-6L 28 0,100099 0,114543 0,090089 0,124553
417 W42158001 C10AA01 SIMVASTATINUM SINTENAL 10 mg COMPR. FILM. 10mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,100099 0,228234 0,090089 0,238244
418 W08725001 C10AA01 SIMVASTATINUM VASILIP 10 mg COMPR. FILM. 10mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L 28 0,100099 0,200258 0,090089 0,210268
419 W42328001 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 10 mg COMPR. FILM. 10mg LABORMED PHARMA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 15 COMPR. FILM. P-6L 30 0,100099 0,240901 0,090089 0,250911
420 W56959001 C10AA01 SIMVASTATINUM SIMVACARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,100099 0,055615 0,090089 0,065625
422 W59878005 C10AA01 SIMVASTATINUM SIMVASTATIN TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,100099 0,055901 0,090089 0,065911
424 W12478002 C10AA01 SIMVASTATINUM ZEPLAN (R) 20 mg COMPR. FILM. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILMP-6L 28 0,200199 0,255872 0,180179 0,275892
425 W51357002 C10AA01 SIMVASTATINUM ZOCOR 20 mg COMPR. FILM. 20mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR.FILM. P-6L 28 0,200199 0,501586 0,180179 0,521606
427 W08479001 C10AA01 SIMVASTATINUM VASILIP 20 mg COMPR. FILM. 20mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. DIN PVC/PE/PVDC/AL X 7 COMPR. FILM. P-6L 28 0,200199 0,255515 0,180179 0,275535
428 W42327001 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 20 mg COMPR. FILM. 20mg LABORMED PHARMA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,200199 0,255801 0,180179 0,275821
429 W56960001 C10AA01 SIMVASTATINUM SIMVACARD 20 mg COMPR. FILM. 20mg ZENTIVA K.S. CEHIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 14 COMPR. FILM. P-6L 28 0,200199 0,058372 0,180179 0,078392
430 W58958005 C10AA01 SIMVASTATINUM SIMVASTATIN AUROBINDO 20 mg COMPR. FILM. 20mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/PE/PVDC/AL X 30 COMPR. FILM. P6L 30 0,200199 0,047801 0,180179 0,067821
432 W41703002 C10AA01 SIMVASTATINUM SIMVAHEXAL (R) 30 mg COMPR. FILM. 30mg HEXAL AG GERMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,300299 0,208034 0,270269 0,238064
434 W13137001 C10AA01 SIMVASTATINUM VASILIP (R) 40 mg COMPR. FILM. 40mg KRKA D.D. SLOVENIA CUTIE X 4 BLIST. PVC/PE/PVDC/AL X 7 COMPR. FILM P-6L 28 0,400399 0,378886 0,360359 0,418926
435 W41446002 C10AA01 SIMVASTATINUM ZEPLAN (R) 40 mg COMPR. FILM. 40mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 14 COMPR. FILM. P-6L 28 0,400399 0,178886 0,360359 0,218926
437 W52431001 C10AA01 SIMVASTATINUM SIMVASTATIN LPH 40 mg COMPR. FILM. 40mg LABORMED PHARMA S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,400399 0,727267 0,360359 0,767307
441 W06752001 C10AA02 LOVASTATINUM MEDOSTATIN COMPR. 20mg MEDOCHEMIE LTD. CIPRU CUTIE X 1 BLIST. X 10 COMPR. P-6L 10 0,133466 0,419534 0,120119 0,432881
442 W57367004 C10AA02 LOVASTATINUM LOVASTATINA ARENA 20 mg COMPR. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0,133466 0,808534 0,120119 0,821881
443 W43037001 C10AA03 PRAVASTATINUM PRAVATOR 20 mg COMPR. 20mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR.P-6L 28 0,200199 0,669443 0,180179 0,689463
1.036 W65064001 C10AA03 PRAVASTATINUM PRAVATOR 20 mg COMPR. 20mg TERAPIA S.A. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR.P-6L 28 0,200199 0,669443 0,180179 0,689463
444 W43843001 C10AA03 PRAVASTATINUM PRAVATOR 40 mg COMPR. 40mg RANBAXY U.K. LIMITED MAREA BRITANIE CUTIE X 4 BLISTERE DIN PA-AL-PVC/AL X 7 COMPRIMATE P-6L 28 0,400399 0,985315 0,360359 1,025355
1.037 W65065001 C10AA03 PRAVASTATINUM PRAVATOR 40 mg COMPR. 40mg TERAPIA S.A. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 COMPR.P-6L 28 0,400399 0,985315 0,360359 1,025355
472 W08307001 H02AB04 METHYLPREDNISOLONUM * LEMOD SOLU 125 mg 125mg
PULB+SOLV. PT. SOL. INJ./PERF. STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. LIOF. + 1 FIOLA SOLV. X 2 ML PRF 1 8,445625 0,834375 7,601062 1,678938
542 W44127002 J01DB01 CEFALEXINUM KEFLEX (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE P-RF 1 10,340000 1,110000 9,306000 2,144000
545 W64364001 J01DB01 CEFALEXINUM KEFLEX® 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TEVA B.V. OLANDA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + LINGURITA DOZATOARE PRF 1 10,340000 1,110000 9,306000 2,144000
589 W61210001 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,444599 0,079401 0,400139 0,123861
1.073 W65279001 J01FA09 CLARITHROMYCINUM KLACID SR 500 mg COMPR. ELIB. PREL. 500mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU 1 BLIST. PVC/PVDC/AL X 5 COMPR. ELIB. PREL. PRF 5 2,222998 0,563002 2,000698 0,785302
Pagina 1 din 2
Prescriptie
Cod_CIM (pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
Nr crt.

590 W62391001 J01FA09 CLARITHROMYCINUM KLACID SR 500 mg COMPR. ELIB. PREL. 500mg BGP PRODUCTS LTD. MAREA BRITANIE CUTIE CU 1 BLIST. PVC/PVDC/AL X 5 COMPR. ELIB. PREL. PRF 5 2,222998 0,563002 2,000698 0,785302
591 W63492001 J01FA09 CLARITHROMYCINUM KLACID SR 500 mg COMPR. ELIB. PREL. 500mg MYLAN PRODUCTS LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. PVC/PVDC/AL X 5 COMPR. ELIB. PREL. PRF 5 2,222998 0,563002 2,000698 0,785302
592 W14043001 J01FA09 CLARITHROMYCINUM KLERIMED (R) 250 COMPR. FILM. 250mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 1,111499 0,107786 1,000349 0,218936
593 W44093001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 1,111499 0,034215 1,000349 0,145365
594 W08490001 J01FA09 CLARITHROMYCINUM FROMILID 250 COMPR. FILM. 250mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. P-RF 14 1,111499 0,189215 1,000349 0,300365
596 W62390002 J01FA09 CLARITHROMYCINUM KLACID 250 mg COMPR. FILM. 250mg BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 BLIST. PVC-PVDC/AL X 14 COMPR. FILM. PRF 14 1,111499 0,939215 1,000349 1,050365
602 W41838002 J01FA09 CLARITHROMYCINUM FROMILID (R) UNO COMPR. FILM. ELIB. PREL. 500mg KRKA D.D. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 7 COMPR. FILM. ELIB. PREL. P-RF 7 2,222998 0,341287 2,000698 0,563587
603 W62389002 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 100 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML PRF 1 24,903000 2,767000 22,412700 5,257300
605 W62389001 J01FA09 CLARITHROMYCINUM KLACID 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml BGP PRODUCTS S.R.L. ITALIA CUTIE CU 1 FLAC. PEID CU GRANULE PT. 60 ML SUSP. ORALA + 1 LINGURITA DOZATOARE X 2,5 ML/5 ML PRF 1 14,941800 5,828200 13,447620 7,322380
606 W44091001 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 42 G GRAN. PT. 60 ML SUSP . ORALA P-RF 1 29,883600 3,606400 26,895240 6,594760
754 W54214001 M01AE03 KETOPROFENUM KETOPROFEN TERAPIA 100MG/2ML 100mg/2ml
SOL. INJ./CONC. SOL. PERF. TERAPIA SA ROMANIA CUTIE X 5 FIOLE X 2 ML P-RF 5 2,102000 0,000000 1,891800 0,210200
789 W59300001 N02CC01 SUMATRIPTANUM * IMIGRAN DR 100 mg COMPR. DISP. 100mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. P-RF 2 10,577499 5,717501 9,519749 6,775251
790 W59299001 N02CC01 SUMATRIPTANUM * IMIGRAN DR 50 mg COMPR. DISP. 50mg GLAXO WELLCOME UK LIMITED MAREA BRITANIE CUTIE CU 1 BLIST. (OPA)-AL-PVC/AL X 2 COMPR. DISP. P-RF 2 5,288749 3,226251 4,759874 3,755126
793 W56160005 N02CC01 SUMATRIPTANUM * XIBIMER 50 mg COMPR. FILM. 50mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 COMPR. FILM. P-RF 6 5,288749 0,349584 4,759874 0,878459
814 W56688004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. DIIN POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,100463 0,056737 0,090416 0,066784
815 W64281004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 100 mg CAPS. 100 mg ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L
AUROBINDO PHARMA ROMANIA S.R.L. 50 0,100463 0,056737 0,090416 0,066784
816 W54332002 N03AX12 GABAPENTINUM GRIMODIN 100 mg CAPS. 100mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE CU BLIST. PVC-PVDC/AL X 60 CAPS. P-6L 60 0,100463 0,506703 0,090416 0,516750
817 W60025001 N03AX12 GABAPENTINUM GABAPENTIN ARENA 100 mg CAPS. 100mg ARENA GROUP S.A. ROMANIA CUTIE CU 6 BLIST. TRANSPARENTE PVC-PVDC/AL X 10 CAPS. P6L 60 0,100463 0,328370 0,090416 0,338417
818 W56689004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,301391 0,170009 0,271251 0,200149
819 W64282004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 300 mg CAPS. 300 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0,301391 0,170009 0,271251 0,200149
820 W41589005 N03AX12 GABAPENTINUM GABAGAMMA 300 mg CAPS. 300mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,301391 0,494909 0,271251 0,525049
821 W42824001 N03AX12 GABAPENTINUM GABARAN 300 mg CAPS. 300mg RANBAXY UK LTD. CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L
MAREA BRITANIE 50 0,301391 1,117009 0,271251 1,147149
1.052 W65059001 N03AX12 GABAPENTINUM GABARAN 300 mg CAPS. 300mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC-PVDC/AL X 10 CAPS. P6L 50 0,301391 1,117009 0,271251 1,147149
822 W43540001 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,301391 0,154609 0,271251 0,184749
825 W64360001 N03AX12 GABAPENTINUM GABALEPT 300 mg CAPS. 300mg TEVA B.V. OLANDA CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. P6L 100 0,301391 0,154609 0,271251 0,184749
826 W56690004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA LIMITED MAREA BRITANIE CUTIE CU BLIST. POLIAMIDA/AL/PVC-AL X 50 CAPS. P6L 50 0,401856 0,227344 0,361670 0,267530
827 W64283004 N03AX12 GABAPENTINUM GABAPENTIN AUROBINDO 400 mg CAPS. 400 mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 50 CAPS. P6L 50 0,401856 0,227344 0,361670 0,267530
828 W41590005 N03AX12 GABAPENTINUM GABAGAMMA 400 mg CAPS. 400mg WORWAG PHARMA GMBH & CO. KG GERMANIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,401856 0,854644 0,361670 0,894830
829 W42825001 N03AX12 GABAPENTINUM GABARAN 400 mg CAPS. 400mg RANBAXY UK LTD. CUTIE X 5 BLIST. PVC-PVDC/AL X 10 CAPS. P-6L
MAREA BRITANIE 50 0,401856 1,187544 0,361670 1,227730
1.053 W65060001 N03AX12 GABAPENTINUM GABARAN 400 mg CAPS. 400mg TERAPIA S.A. ROMANIA CUTIE CU 5 BLIST. PVC-PVDC/AL X 10 CAPS. P6L 50 0,401856 1,187544 0,361670 1,227730
830 W43541001 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 10 BLIST. AL/PVC X 10 CAPS. P-6L 100 0,401856 0,205744 0,361670 0,245930
833 W64361001 N03AX12 GABAPENTINUM GABALEPT 400 mg CAPS. 400mg TEVA B.V. OLANDA CUTIE CU 10 BLIST. PVC-PVDC TRANSPARENTA/AL X 10 CAPS. P6L 100 0,401856 0,205744 0,361670 0,245930
834 W42826001 N03AX12 GABAPENTINUM GABARAN 600 mg COMPR. FILM. 600mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P-6L 30 0,602785 1,692881 0,542506 1,753160
1.054 W65061001 N03AX12 GABAPENTINUM GABARAN 600 mg COMPR. FILM. 600mg TERAPIA S.A. ROMANIA CUTIE CU 3 BLIST. AL-PVC-PA/AL X 10 COMPR. FILM. P6L 30 0,602785 1,692881 0,542506 1,753160
SE ELIMINA
471 W04237001 H02AB04 METHYLPREDNISOLONUM * SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV P-RF 1 17,447499 4,122501 15,702749 5,867251
550 W41659001 J01DB05 CEFADROXILUM CEXYL 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. CU GRAN PENTRU 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 5,308749 7,851251 4,777874 8,382126
551 W41660001 J01DB05 CEFADROXILUM CEXYL 250 mg/5 ml GRAN. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA CUTIE X 1 FLAC. CU GRAN. PT. 60 ML SUSP. ORALA + O LINGURITA DOZATOARE P-RF 1 10,617499 1,402501 9,555749 2,464251
753 W03881002 M01AE03 KETOPROFENUM KETONAL 100 mg/ 2 ml SOL. INJ. 100mg/2ml LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 10 FIOLE X 2 ML SOL. INJ/CONC PT.SOL. PERF. P-RF 10 1,023000 0,000000 0,920700 0,102300
Pagina 2 din 2
ANEXA 7
(ANEXA 2b la Ordinul CNAS nr. 1611/2018)
SUBLISTA B - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 50% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) ALE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE PERSONALA
DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE, VALABILA INCEPAND CU 01 AUGUST 2019
Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie

maxima a de sistemul de maxima a de sistemul de maxima a
asiguratului / UT asigurari sociale de asiguratului / UT asigurari sociale de asiguratului / UT
(pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care sanatate / UT (pt. (pt. asiguratii care
Prescriptie
cant. beneficiaza de asiguratii care beneficiaza de asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Nr crt.
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) referinta) pretul de referinta) referinta) pretul de referinta) referinta)
SE ADAUGA
1.193 W65619003 B01AF02 APIXABANUM ** ELIQUIS 2,5 mg COMPR. FILM. 2,5mg BRISTOL-MYERS SQUIBB / PFIZER EEIG IRLANDA CUTIE CU BLIST. DIN PVC/PVDC/AL X 60 COMPR. FILM. PRF 60 5,619000 0,000000 2,809500 2,809500 5,057100 0,561900
1.194 W65679001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 5 mg COMPR. FILM. 5mg ACCORD HEALTHCARE S.L.U. SPANIA PRF
CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. 56 1,138874 1,566483 0,569437 2,135920 1,024986 1,680371
1.195 W65680001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 7,5 mg COMPR. FILM. 7,5mg ACCORD HEALTHCARE S.L.U. SPANIA P6L
CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. 56 1,708312 0,904723 0,854156 1,758879 1,537480 1,075555
1.196 W65814006 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 20 mg/5 mg COMPR. FILM. 20mg/5mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA P6L
CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITATI DOZATE OPA-AL-PVC/AL X 28 COMPR. FILM. 28 1,280000 1,055714 0,640000 1,695714 1,152000 1,183714
1.197 W65814001 C09DB02 OLMESARTANUM MEDOXOMILUM+AMLODIPINUM OLMESARTAN MEDOXOMIL/AMLODIPINA ACCORD 20 mg/5 mg COMPR. FILM. 20mg/5mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 1,280000 1,055714 0,640000 1,695714 1,152000 1,183714
1.202 W65497005 C10AA05 ATORVASTATINUM ATORVASTATIN TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,234333 0,000000 0,117166 0,117167 0,210899 0,023434
1.206 W65800016 C10AX09 EZETIMIBUM EZETIMIB ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. AL-PVC/ACLAR X 30 COMPR. PRF 30 3,032333 0,000000 1,516166 1,516167 2,729099 0,303234
1.207 W65800006 C10AX09 EZETIMIBUM EZETIMIB ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. AL/AL X 30 COMPR. PRF 30 3,032333 0,000000 1,516166 1,516167 2,729099 0,303234
1.208 W65720001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 300 UI/0,5 ml SOL INJ. 300UI/0,5ml THERAMEX IRELAND LIMITED IRLANDA PR/PRF
CUTIE X 1 CARTUS (STICLA TIP I) X 0.5 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE 1 398,571666 22,288334 199,285833 221,574167 358,714499 62,145501
1.209 W65721001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 450 UI/0,75 ml SOL INJ. 450UI/0,75ml THERAMEX IRELAND LIMITED IRLANDA PR/PRF
CUTIE X 1 CARTUS (STICLA TIP I) X 0.75 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE 1 595,870000 0,000000 297,935000 297,935000 536,283000 59,587000
1.210 W65722001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 900 UI/ 1,5ml SOL INJ. 900UI/1,5ml THERAMEX IRELAND LIMITED IRLANDA PR/PRF
CUTIE X 1 CARTUS (STICLA TIP I) X 1.5ML SOLUTIE INJECTABILA + 20 ACE PENTRU INJECTIE 1 1.091,710000 0,000000 545,855000 545,855000 982,539000 109,171000
1.211 W63613010 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 1,506961 0,929646 0,753480 1,683127 1,356264 1,080343
1.213 W63613003 N03AX16 PREGABALINUM ** # PREGABALINA TERAPIA 125 mg CAPS. 125mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 CAPS. PRF 56 1,506961 0,929646 0,753480 1,683127 1,356264 1,080343
1.215 W62312005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 150 mg CAPS. 150mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 0,513666 0,000000 0,256833 0,256833 0,462299 0,051367
1.216 W62280006 N03AX16 PREGABALINUM ** # PREGAMID 150 mg CAPS. 150mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,835666 0,000000 0,417833 0,417833 0,752099 0,083567
1.217 W62012003 N03AX16 PREGABALINUM ** # PREGLENIX 150 mg CAPS. 150mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,829107 0,000000 0,414553 0,414554 0,746196 0,082911
1.218 W62012001 N03AX16 PREGABALINUM ** # PREGLENIX 150 mg CAPS. 150mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 14 CAPS. PRF 14 0,857142 0,000000 0,428571 0,428571 0,771427 0,085715
1.219 W65702002 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 150 mg CAPS. 150mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,741250 0,000000 0,370625 0,370625 0,667125 0,074125
1.221 W65243001 N03AX16 PREGABALINUM ** # PREGABALIN SANDOZ 150 mg CAPS. 150mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,626071 0,000000 0,313035 0,313036 0,563463 0,062608
1.222 W63186011 N03AX16 PREGABALINUM ** # SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 0,742678 0,000000 0,371339 0,371339 0,668410 0,074268
1.224 W63186004 N03AX16 PREGABALINUM ** # SIRANALEN 150 mg CAPS. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,742678 0,000000 0,371339 0,371339 0,668410 0,074268
1.226 W62901001 N03AX16 PREGABALINUM ** # PREGABALIN SANDOZ GMBH 150 mg CAPS. 150mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,741250 0,000000 0,370625 0,370625 0,667125 0,074125
1.227 W62880005 N03AX16 PREGABALINUM ** # PREGABALINA DR. REDDY'S 150 mg CAPS. 150mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 56 CAPS. PRF 56 1,808356 0,858965 0,904178 1,763143 1,627520 1,039801
1.228 W62610002 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 150 mg CAPS. 150mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 56 CPAS. PRF 56 0,741250 0,000000 0,370625 0,370625 0,667125 0,074125
1.238 W62313005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 300 mg CAPS. 300mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 1,081000 0,000000 0,540500 0,540500 0,972900 0,108100
Pagina 1 din 3
Prescriptie
Cod_CIM
Nr crt.
1.248 W62311005 N03AX16 PREGABALINUM ** # PREGABALINA AUROBINDO 75 mg CAPS. 75mg AUROBINDO PHARMA (MALTA) LIMITEDMALTA CUTIE CU BLIST. PVC/AL X 60 CAPSULE PRF 60 0,385166 0,000000 0,192583 0,192583 0,346649 0,038517
1.249 W62278006 N03AX16 PREGABALINUM ** # PREGAMID 75 mg CAPS. 75mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 0,904178 0,012488 0,452089 0,464577 0,813760 0,102906
1.250 W62011003 N03AX16 PREGABALINUM ** # PREGLENIX 75 mg CAPS. 75mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 56 CAPS.
PRF 56 0,736250 0,000000 0,368125 0,368125 0,662625 0,073625
1.251 W62011001 N03AX16 PREGABALINUM ** # PREGLENIX 75 mg CAPS. 75mg GLENMARK PHARMACEUTICALS S.R.O. REPUBLICA CEHA CUTIE CU BLIST. PVC/AL X 14 CAPS.
PRF 14 0,760714 0,000000 0,380357 0,380357 0,684642 0,076072
1.252 W65701002 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 75 mg CAPS. 75mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 56 CAPS.
PRF 56 0,649464 0,000000 0,324732 0,324732 0,584517 0,064947
1.253 W65701001 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 75 mg CAPS. 75mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 14 CAPS.
PRF 14 0,671428 0,000000 0,335714 0,335714 0,604285 0,067143
1.254 W65242001 N03AX16 PREGABALINUM ** # PREGABALIN SANDOZ 75 mg CAPS. 75mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,568750 0,000000 0,284375 0,284375 0,511875 0,056875
1.257 W63185004 N03AX16 PREGABALINUM ** # SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 56 CAPS.
PRF 56 0,649464 0,000000 0,324732 0,324732 0,584517 0,064947
1.258 W63185001 N03AX16 PREGABALINUM ** # SIRANALEN 75 mg CAPS. 75mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 14 CAPS.
PRF 14 0,671428 0,000000 0,335714 0,335714 0,604285 0,067143
1.259 W62900001 N03AX16 PREGABALINUM ** # PREGABALIN SANDOZ GMBH 75 mg CAPS. 75mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,646964 0,000000 0,323482 0,323482 0,582267 0,064697
1.261 W62609002 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 75 mg CAPS. 75mg ACCORD HEALTHCARE LIMITED CUTIE CU BLIST. PVC/AL X 56 CPAS.
MAREA BRITANIE PRF 56 0,649464 0,000000 0,324732 0,324732 0,584517 0,064947
1.262 W62609001 N03AX16 PREGABALINUM ** # PREGABALIN ACCORD 75 mg CAPS. 75mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PVC/AL X 14 CPAS.
PRF 14 0,671428 0,000000 0,335714 0,335714 0,604285 0,067143
1.265 W64181001 N03AX16 PREGABALINUM ** # SIRANALEN 20 mg/ml SOL. ORALA 20mg/ml MEDOCHEMIE LTD. CIPRU PRF
CUTIE CU 1 FLAC. PEID CONTINAND 473 ML SOL. ORALA, O SERINGA PT. ADMINISTRARE ORALA, UN ADAPTOR DIN PLASTIC ALB CARE SE ATASEAZA LA FLAC. PRIN IMPINGERE 1 114,047043 29,732957 57,023521 86,756479 102,642338 41,137662
SE MODIFICA
82 W63737001 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFASIGMA S.P.A. ITALIA CUTIE CU 2 BLIST. PVDC-PVC/AL-PVDC A CATE 25 CAPS. MOI P6L 50 1,837350 0,314850 0,918675 1,233525 1,653615 0,498585
112 W63258002 C01EB17 IVABRADINUM ** IVABRADINE ZENTIVA 5 mg COMPR. FILM. 5 mg ZENIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,138874 0,246840 0,569437 0,816277 1,024986 0,360728
113 W42777003 C01EB17 IVABRADINUM ** CORLENTOR 5mg COMPR. FILM. 5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 1,138874 0,748447 0,569437 1,317884 1,024986 0,862335
114 W62962004 C01EB17 IVABRADINUM ** BIXEBRA 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,138874 0,247911 0,569437 0,817348 1,024986 0,361799
115 W62962014 C01EB17 IVABRADINUM ** BIXEBRA 5 mg COMPR. FILM. 5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PERFORAT PT ELIBERAREA UNEI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. FILM. P6L 56 1,138874 0,247911 0,569437 0,817348 1,024986 0,361799
116 W63479001 C01EB17 IVABRADINUM ** RAENOM 5 mg COMPR. FILM. 5mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,138874 0,247911 0,569437 0,817348 1,024986 0,361799
117 W63443003 C01EB17 IVABRADINUM ** FELOCORD 5 mg COMPR. FILM. 5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,138874 1,566483 0,569437 2,135920 1,024986 1,680371
118 W63904002 C01EB17 IVABRADINUM ** IVABRADINA AUROBINDO 5 mg COMPR. FILM. 5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,138874 0,378447 0,569437 0,947884 1,024986 0,492335
119 W63775001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 5 mg COMPR. FILM. 5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. PRF 56 1,138874 1,566483 0,569437 2,135920 1,024986 1,680371
120 W42779003 C01EB17 IVABRADINUM ** CORLENTOR 7,5mg COMPR. FILM. 7,5mg LES LAB. SERVIER FRANTA CUTIE X 56 COMPR. FILM. (BLIST. AL/PVC TIP CALENDAR) P-6L 56 1,708312 0,179009 0,854156 1,033165 1,537480 0,349841
121 W62963004 C01EB17 IVABRADINUM ** BIXEBRA 7,5 mg COMPR. FILM. 7,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,708312 0,039545 0,854156 0,893701 1,537480 0,210377
122 W62963014 C01EB17 IVABRADINUM ** BIXEBRA 7,5 mg COMPR. FILM. 7,5mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PERFORAT PT ELIBERAREA UNEI DOZATE DIN OPA-AL-PVC/AL X 56X1 COMPR. FILM. P6L 56 1,708312 0,039545 0,854156 0,893701 1,537480 0,210377
124 W63480001 C01EB17 IVABRADINUM ** RAENOM 7,5 mg COMPR. FILM. 7,5mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,708312 0,222223 0,854156 1,076379 1,537480 0,393055
125 W63444003 C01EB17 IVABRADINUM ** FELOCORD 7,5 mg COMPR. FILM. 7,5mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. TIP CALENDAR OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,708312 0,904723 0,854156 1,758879 1,537480 1,075555
126 W63905001 C01EB17 IVABRADINUM ** IVABRADINA AUROBINDO 7,5 mg COMPR. FILM. 7,5mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 56 COMPR. FILM. P6L 56 1,708312 0,061866 0,854156 0,916022 1,537480 0,232698
127 W63776001 C01EB17 IVABRADINUM ** IVABRADINA ACCORD 7,5 mg COMPR. FILM. 7,5mg ACCORD HEALTHCARE LIMITED MAREA BRITANIE CUTIE CU BLIST. PERFORATE PT. ELIBERAREA UNEI UNITAZI DOZATE AL/AL X 56X1 COMPR. FILM. P6L 56 1,708312 0,904723 0,854156 1,758879 1,537480 1,075555
364 W51412001 C10AA04 FLUVASTATINUM LESCOL XL 80 mg COMPR. ELIB. PREL. 80mg NOVARTIS PHARMA GMBH GERMANIA CUTIE CU BLIST. AL/AL X 28 (4X7) COMPR. ELIB. PREL. P-6L 28 0,800799 0,215629 0,400399 0,616029 0,720719 0,295709
365 W12893001 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. AL/AL X 30 COMPR. FILM. P-6L 30 0,300299 0,597034 0,150149 0,747184 0,270269 0,627064
366 W54696007 C10AA05 ATORVASTATINUM ATORIS 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR.FILM. P-6L 30 0,300299 0,065367 0,150149 0,215517 0,270269 0,095397
367 W55516003 C10AA05 ATORVASTATINUM ASCORD 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 0,300299 0,444034 0,150149 0,594184 0,270269 0,474064
369 W59408001 C10AA05 ATORVASTATINUM STAVRA 10 mg COMPR. FILM. 10mg ALKALOID-INT D.O.O. SLOVENIA CUTIE CU BLIST. PVC-TE-PVDC/AL X 30 COMPR. FILM. P6L 30 0,300299 0,094034 0,150149 0,244184 0,270269 0,124064
370 W57297016 C10AA05 ATORVASTATINUM ATORVASTATINA MYLAN 10 mg COMPR. FILM. 10mg GENERICS (UK) LTD MAREA BRITANIE CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,300299 0,051367 0,150149 0,201517 0,270269 0,081397
374 W64877001 C10AA05 ATORVASTATINUM SORTIS 10 mg COMPR. FILM. 10mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,300299 0,597034 0,150149 0,747184 0,270269 0,627064
377 W55517003 C10AA05 ATORVASTATINUM ASCORD 20 mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P-6L 30 0,600599 0,366067 0,300299 0,666367 0,540539 0,426127
384 W64878001 C10AA05 ATORVASTATINUM SORTIS 20 mg COMPR. FILM. 20mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,600599 0,572067 0,300299 0,872367 0,540539 0,632127
1.102 W64879006 C10AA05 ATORVASTATINUM SORTIS 40 mg COMPR. FILM. 40mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P6L 14 1,201199 0,127372 0,600599 0,727972 1,081079 0,247492
408 W13864001 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM.
P-6L 28 0,600599 2,725829 0,300299 3,026129 0,540539 2,785889
1.182 W62399024 C10AA07 ROSUVASTATINUM ROSUVASTATINA TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30X1 COMPR. FILM. P6L 30 0,600599 0,012734 0,300299 0,313034 0,540539 0,072794
410 W57059005 C10AA07 ROSUVASTATINUM ROSWERA 10 mg COMPR. FILM. 10mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,600599 0,045067 0,300299 0,345367 0,540539 0,105127
411 W55990002 C10AA07 ROSUVASTATINUM ROSTAT 10 mg COMPR. FILM. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,600599 0,190734 0,300299 0,491034 0,540539 0,250794
412 W59899004 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,600599 0,707258 0,300299 1,007558 0,540539 0,767318
413 W59899017 C10AA07 ROSUVASTATINUM ROSUVASTATINA TERAPIA 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 28 COMPR. FILM. P6L 28 0,600599 0,707258 0,300299 1,007558 0,540539 0,767318
416 W61054001 C10AA07 ROSUVASTATINUM ROSUVASTATINA ATB 10 mg COMPR. FILM. 10mg ANTIBIOTICE S.A. ROMANIA CUTIE CU 3 BLIST. OPA-AL-PVC/AL X 10 COMPR. FILM. P6L 30 0,600599 0,292067 0,300299 0,592367 0,540539 0,352127
1.138 W65079001 C10AA07 ROSUVASTATINUM CRESTOR 10 mg COMPR. FILM. 10mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. FILM. P6L 28 0,600599 2,725829 0,300299 3,026129 0,540539 2,785889
409 W55327002 C10AA07 ROSUVASTATINUM ROSUCARD 10 mg COMPR. FILM. 10mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,600599 0,056734 0,300299 0,357034 0,540539 0,116794
420 W64682002 C10AA07 ROSUVASTATINUM ROSI 10 mg COMPR. FILM. 10mg SWYSSI AG GERMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0,600599 1,597067 0,300299 1,897367 0,540539 1,657127
422 W13865001 C10AA07 ROSUVASTATINUM CRESTOR 20 mg COMPR. FILM. 20mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. X 14 COMPR. FILM.
P-6L 28 1,201199 3,663801 0,600599 4,264401 1,081079 3,783921
Pagina 2 din 3
Prescriptie
Cod_CIM
Nr crt.
443 W43678001 C10AA07 ROSUVASTATINUM CRESTOR 5 mg COMPR. FILM. 5mg ASTRAZENECA UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. AL/AL X 14 COMPR. FILM. P-6L 28 0,300299 2,335772 0,150149 2,485922 0,270269 2,365802
444 W57058005 C10AA07 ROSUVASTATINUM ROSWERA 5 mg COMPR. FILM. 5mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 0,300299 0,029034 0,150149 0,179184 0,270269 0,059064
445 W55989002 C10AA07 ROSUVASTATINUM ROSTAT 5 mg COMPR. FILM. 5mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P-6L 30 0,300299 0,484034 0,150149 0,634184 0,270269 0,514064
449 W60391003 C10AA07 ROSUVASTATINUM ROVASTAMED 5mg COMPR. FILM. 5mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. DIN OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,300299 0,780415 0,150149 0,930565 0,270269 0,810445
558 W60481002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL - f 75 UI (5,5 µg) PULB. + SOLV. PT. SOL. INJ. 75UI MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV. P-RF/R 1 99,642916 28,677084 49,821458 78,498542 89,678624 38,641376
1.143 W65133002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL - f 75 UI (5,5 µg) PULB. + SOLV. PT. SOL. INJ. 75UI MERCK EUROPE B.V.OLANDA CUTIE X 1 FLAC. DIN STICLA INCOLORA CU PULB. PT. SOL. INJ. + 1 SERINGA PREUMPLUTA X 1 ML SOLV. PR/PRF 1 99,642916 28,677084 49,821458 78,498542 89,678624 38,641376
559 W63029001 G03GA05 FOLLITROPINUM ALFA **1 # OVALEAP 300 UI/0,5 ml SOL INJ. 300UI/0,5ml TEVA B.V. OLANDA CUTIE X 1 CARTUS (STICLA TIP I) X 0.5 ML SOLUTIE INJECTABILA + 10 ACE PENTRU INJECTIE PR/PRF 1 398,571666 22,288334 199,285833 221,574167 358,714499 62,145501
1.111 W63834001 G03GA05 FOLLITROPINUM ALFA **1 # BEMFOLA 150 UI/0,25 ml SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 150UI/0,25ml GEDEON RICHTER PLC UNGARIA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 1 AC PT. INJECTARE PR/PRF 1 199,285833 17,384167 99,642916 117,027084 179,357249 37,312751
562 W60480002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 300 UI/0,5 ml ( 22 µg/0,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 300UI/0,5ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 8 ACE PT. ADM. P-RF/R 1 398,571666 38,638334 199,285833 237,924167 358,714499 78,495501
1.144 W65135002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 300 UI/0,5 ml ( 22 µg/0,5 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 300UI/0,5ml MERCK EUROPE B.V.OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,5 ML SOL. INJ. + 8 ACE PT. ADM. PR/PRF 1 398,571666 38,638334 199,285833 237,924167 358,714499 78,495501
563 W60485002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 450 UI/0,75 ml (33 µg/0,75 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 450UI/0,75ml MERCK SERONO EUROPE LIMITED MAREA BRITANIE CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA P-RF/R 1 597,857500 33,252500 298,928750 332,181250 538,071750 93,038250
1.145 W65134002 G03GA05 FOLLITROPINUM ALFA **1 # GONAL-f 450 UI/0,75 ml (33 µg/0,75 ml) SOL. INJ. IN STILOU INJECTOR PREUMPLUT 450UI/0,75ml MERCK EUROPE B.V.OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 0,75 ML SOL. INJ. + 12 ACE PT. ADM. SUBCUTANATA PR/PRF 1 597,857500 33,252500 298,928750 332,181250 538,071750 93,038250
565 W61937001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS + 6 ACE PR/PRF 1 398,412238 23,217762 199,206119 222,423881 358,571014 63,058986
566 W64697001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 300UI/0,36 ml SOL. INJ. 300UI/0,36ml MERCK SHARP & DOHME OLANDA CUTIE CU 1 CARTUS + 6 ACE PR/PRF 1 398,412238 23,217762 199,206119 222,423881 358,571014 63,058986
567 W43251001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml N. V. ORGANON OLANDA CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.195,236714 143,973286 597,618357 741,591643 1.075,713042 263,496958
568 W61938001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml MERCK SHARP & DOHME MAREA BRITANIE CUTIE X 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.195,236714 143,973286 597,618357 741,591643 1.075,713042 263,496958
569 W64696001 G03GA06 FOLLITROPINUM BETA **1 # PUREGON 900UI/1,08 ml SOL. INJ. 900UI/1,08ml MERCK SHARP & DOHME OLANDA CUTIE CU 1 CARTUS SOL. INJ. + 9 ACE PR/PRF 1 1.195,236714 143,973286 597,618357 741,591643 1.075,713042 263,496958
639 W13604002 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 3 Mil. UI COMPR. FILM. 3M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 5 COMPR. FILM. P-RF 10 1,481997 1,242003 0,740998 1,983002 1,333797 1,390203
640 W13604003 J01FA02 SPIRAMYCINUM ROVAMYCINE 3 Mil. UI COMPR. FILM. 3MilU.I. LABORATOIRES AVENTIS FRANTA CUTIE CU 1 BLIST. AL/PVC X 10 COMPR. FILM. PRF 10 1,481997 1,242003 0,740998 1,983002 1,333797 1,390203
641 W63534001 J01FA02 SPIRAMYCINUM ROVAMYCINE 3 Mil. UI COMPR. FILM. 3MilU.I. SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/PVC X 5 COMPR. FILM. PRF 10 1,481997 1,242003 0,740998 1,983002 1,333797 1,390203
642 W63534002 J01FA02 SPIRAMYCINUM ROVAMYCINE 3 Mil. UI COMPR. FILM. 3MilU.I. SANOFI ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. AL/PVC X 10 COMPR. FILM. PRF 10 1,481997 1,242003 0,740998 1,983002 1,333797 1,390203
644 W00517001 J01FA10 AZITHROMYCINUM SUMAMED 250 mg CAPS. 250mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF 6 3,704996 1,068337 1,852498 2,920835 3,334496 1,438837
645 W64359001 J01FA10 AZITHROMYCINUM SUMAMED 250 mg CAPS. 250mg TEVA B.V. OLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF 6 3,704996 1,068337 1,852498 2,920835 3,334496 1,438837
646 W00518001 J01FA10 AZITHROMYCINUM SUMAMED 125 mg COMPR. FILM. 125mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 6 COMPR. FILM. P-RF 6 1,852496 2,500837 0,926248 3,427085 1,667246 2,686087
647 W64356001 J01FA10 AZITHROMYCINUM SUMAMED 125 mg COMPR. FILM. 125mg TEVA B.V. OLANDA CUTIE CU 1 BLIST. PVC/AL X 6 COMPR. FILM. PRF 6 1,852496 2,500837 0,926248 3,427085 1,667246 2,686087
650 W00519001 J01FA10 AZITHROMYCINUM SUMAMED 500 mg COMPR. FILM. 500mg PLIVA LJUBLJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. AL/PVC X 3 COMPR. FILM. P-RF 3 7,409993 1,630007 3,704996 5,335004 6,668993 2,371007
658 W64357001 J01FA10 AZITHROMYCINUM SUMAMED 500 mg COMPR. FILM. 500mg TEVA B.V. OLANDA CUTIE CU 1 BLIST. PVC/AL X 3 COMPR. FILM. PRF 3 7,409993 1,630007 3,704996 5,335004 6,668993 2,371007
660 W42901001 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 100 mg/5 ml PULB. PT. SUSP. ORALA 100mg/5ml SANDOZ SRL ROMANIA CUTIE CU 1 FLAC. PEID + 1 SERINGA DOZATOARE DIN PE/PP (10 ML) GRADATA IN DIVIZIUNI DE 0,25 ML CONTINAND PULB. PT 20 ML (400 MG) SUSP. ORALA P-RF 1 13,281596 7,068404 6,640798 13,709202 11,953436 8,396564
711 W43063001 M01AE17 DEXKETOPROFENUM TADOR INJECT SOL. INJ./CONC. PT. SOL. PERF. 50mg/2ml LUXEMBOURG
MENARINI INTERNATIONAL OPERATIONS S.A. CUTIE X 5 FIOLE X 2 ML SOL. INJ./CONC. PT.SOL.PERF. P-RF 5 3,908000 0,000000 1,954000 1,954000 3,517200 0,390800
839 W41743001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 14 CAPS., (BLIST. PVC/AL)P-RF 14 0,904178 0,187250 0,452089 0,639339 0,813760 0,277668
840 W41743002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER LIMITED MAREA BRITANIE CUTIE X 56 CAPS., (BLIST. PVC/AL)P-RF 56 0,904178 0,150822 0,452089 0,602911 0,813760 0,241240
841 W64906002 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 56 CAPS. (BLIST. PVC/AL) PRF 56 0,904178 0,150822 0,452089 0,602911 0,813760 0,241240
842 W64906001 N03AX16 PREGABALINUM ** # LYRICA 75 mg CAPS. 75mg PFIZER EUROPE MA EEIG BELGIA CUTIE X 14 CAPS. (BLIST. PVC/AL) PRF 14 0,904178 0,187250 0,452089 0,639339 0,813760 0,277668
SE ELIMINA
83 W63737002 B01AB11 SULODEXIDUM ** VESSEL DUE F 250 ULS CAPS. MOI 250ULS ALFASIGMA S.P.A. ITALIA CUTIE CU 3 BLIST. PVDC-PVC/AL-PVDC A CATE 20 CAPS. MOI P6L 60 1,905200 0,172800 0,952600 1,125400 1,714680 0,363320
Pagina 3 din 3
ANEXA 8
(ANEXA 2c la Ordinul CNAS nr. 1611/2018)
SECŢIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREŢUL DE REFERINŢĂ CONFORM
DCI-urilor UTILIZATE ÎN TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOLI
DIN H.G. NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE;
MEDICAMENTELE DIN ACEASTĂ SUBLISTĂ SE ELIBEREAZĂ PRIN FARMACII CU CIRCUIT DESCHIS PE BAZĂ DE PRESCRIPŢIE MEDICALĂ CU REŢINERE ÎN FARMACIE
VALABILĂ ÎNCEPÂND CU 01 AUGUST 2019
Val. maxima suportata Contributie maxima

de sistemul de asigurari a asiguratului / UT
sociale de sanatate / UT (pt. asiguratii care
Prescriptie
cant. (pt. asiguratii care beneficiaza de
Cod_CIM
UT/ Pret de beneficiaza de compensare 100%

Nr crt.
TARA amba referinta / UT compensare 100% din din pretul de

cod ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ laj (RON) pretul de referinta) referinta)
4. HEPATITELE CRONICE DE ETIOLOGIE VIRALA B, C şi D - G4
SE ADAUGA
84 W65812001 J05AF07 TENOFOVIRUM DISOPROXIL **1 TENOFOVIR DISOPROXIL ACCORD 245 mg COMPR. FILM. 245mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. UNIDOZA OPA-AL-PVC/AL X 30X1 COMPR. FILM. PR 30 14,880799 14,880799 7,592201
85 W65671001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 0,5 mg COMPR. FILM. 0,5mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 30 X 1 COMPR. FILM. PR 30 9,668799 9,668799 8,277534
86 W65672001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 1 mg COMPR. FILM. 1mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 30 X 1 COMPR. FILM. PR 30 28,233333 28,233333 0,000000
87 W65658001 L03AA02 FILGRASTIMUM (G-CSF) ** ACCOFIL 30 MU/0,5 ml SOL. INJ. SAU PERF. IN SERINGA PREUMPLUTA 30MU/0,5 ml ACCORD HEALTHCARE S.L.U. SPANIA AMBALAJ CU 1 SERINGA PREUMPLUTA (STICLA) CU 0,5 ML SOL. INJ. PR 1 83,590000 83,590000 0,000000
5. HEPATITA AUTOIMUNA - G5
SE ELIMINA
3 W04237001 H02AB04 METHYLPREDNISOLONUM SOLU - MEDROL ACT-O-VIAL LIOF. SI SOLV.PT.SOL.INJ 250mg/4ml PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 FLAC. BICOMPARTIMENTAT (COMPARTIMENT INFERIOR) LIOF. PT. SOL. INJ. + (COMPARTIMENT SUPERIOR) 4ML SOLV P-RF 1 21,570000 21,570000 0,000000
7. CIROZA HEPATICA - G7
SE ADAUGA
102 W65671001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 0,5 mg COMPR. FILM. 0,5mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 30 X 1 COMPR. FILM. PR 30 9,668799 9,668799 8,277534
103 W65672001 J05AF10 ENTECAVIRUM **1 ENTECAVIR ACCORD 1 mg COMPR. FILM. 1mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 30 X 1 COMPR. FILM. PR 30 28,233333 28,233333 0,000000
8. Leucemii, limfoame, aplazie medulara, gamapatii monoclonale maligne, mieloproliferari cronice si tumori maligne, sindroame mielodisplazice - G10
SE ADAUGA
238 W65704001 A04AA05 PALONOSETRONUM ** PALONOSETRON ACCORD 250 micrograme SOL INJ. 250micrograme ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 1 FLAC. CARE CONTINE 5 ML SOLUTIE PALONOSETRON PRF 1 121,560000 121,560000 0,000000
239 W65715001 J02AC03 VORICONAZOLUM ** VORICONAZOLE ACCORD 200 mg COMPR. FILM. 200mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. PRF 28 11,965714 11,965714 0,000000
240 W65688001 J02AX04 CASPOFUNGINUM ** CASPOFUNGIN ACCORD 50 mg PULB. PT. CONC. PT. SOL. PERF. 50mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 10 ML CARE CONTINE 50 MG PULB. PT. CONC. PT. SOL. PERF. PR 1 969,350000 969,350000 0,000000
241 W65689001 J02AX04 CASPOFUNGINUM ** CASPOFUNGIN ACCORD 70 mg PULB. PT. CONC. PT. SOL. PERF. 70mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 1 FLAC. DIN STICLA TRANSPARENTA CU CAPACITATEA DE 10 ML CARE CONTINE 70 MG PULB. PT. CONC. PT. SOL. PERF. PR 1 1.243,530000 1.243,530000 0,000000
242 W65794001 L01XX35ANAGRELIDUM ** ANAGRELIDA ACCORD 0,5 mg CAPS. 0,5mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 9,346800 9,346800 0,460100
243 W65795001 L01XX35ANAGRELIDUM ** ANAGRELIDA ACCORD 1 mg CAPS. 1mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU 1 FLAC. PEID X 100 CAPS. PR 100 18,208300 18,208300 0,000000
9. EPILEPSIE - G11
SE ADAUGA
Pagina 1 din 5
Prescriptie
Cod_CIM

Nr crt.

173 W65702002 N03AX16 PREGABALINUM ** PREGABALIN ACCORD 150 mg CAPS. 150mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 56 CAPS. PRF 56 0,616399 0,616399 0,124851
175 W65243001 N03AX16 PREGABALINUM ** PREGABALIN SANDOZ 150 mg CAPS. 150mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,616399 0,616399 0,009672
179 W65242001 N03AX16 PREGABALINUM ** PREGABALIN SANDOZ 75 mg CAPS. 75mg SANDOZ GMBH AUSTRIA CUTIE CU BLIST. PVC/PVDC/AL X 56 CAPS. PRF 56 0,462199 0,462199 0,106551
12. SCLEROZA MULTIPLA - G14
SE ELIMINA
13. BOLI PSIHICE (SCHIZOFRENIE, TULBURĂRI SCHIZOTIPALE ŞI DELIRANTE, TULBURĂRI AFECTIVE MAJORE, TULBURĂRI PSIHOTICE ACUTE ŞI BOLI PSIHICE COPII, AUTISM, TULBURĂRI CU DEFICIT DE
ATENŢIE/HIPERREACTIVITATE) - G15
SE ADAUGA
318 W65804004 N05AH04 QUETIAPINUM ** QUETIAPINA ACCORD 200 mg COMPR. CU ELIB. PREL. 200mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PVDC/AL X 60 COMPR. CU ELIB. PREL. PRF 60 0,753999 0,753999 0,159834
321 W65661001 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ACCORD 10 mg COMPR. 10mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST DIN AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE CU 28X1 COMPR. PRF 28 2,040399 2,040399 0,588172
322 W65662002 N05AX12 ARIPIPRAZOLUM ** ARIPIPRAZOLE ACCORD 15 mg COMPR. 15mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST DIN AL/AL PERFORATE PENTRU ELIBERAREA UNEI UNITATI DOZATE CU 28X1 COMPR. PRF 28 1,710357 1,710357 0,000000
323 W65091001 N05AX12 ARIPIPRAZOLUM ** ABILIFY MAINTENA 400mg PULB. + SOLV. PT. SUSP. INJ. CU ELIB. PREL. 400mg OTSUKA PHARMACEUTICAL NETHERLANDS B.V. OLANDA CUTIE CU 1 FL. CU PULB.,1 FL. DE 2 ML CU SOLV., 1SERINGA LUER-LOCK DE 3 ML CU AC HYPODERMIC SECURIZAT DE CALIBRU 21,DE 38 MM PREATASAT,1SERINGA JETABILA DE 3 ML CU VÂRF LUER-LOCK,1ADAPTOR PT. FLAC. SI 3 ACE HIPODERMICE SECURIZATE PRF 1 1.021,710000 1.021,710000 0,000000
14. DEMENŢE (DEGENERATIVE, VASCULARE, MIXTE) - G 16
SE ADAUGA
86 W65675002 N06DX01 MEMANTINUM ** MEMANTINE ACCORD 10 mg COMPR. FILM. 10mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/PE/PVDC-AL X 28 COMPR. FILM. PR 28 0,496428 0,496428 0,000000
87 W65676002 N06DX01 MEMANTINUM ** MEMANTINE ACCORD 20 mg COMPR. FILM. 20mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/PE/PVDC-AL X 28 COMPR. FILM. PR 28 1,570357 1,570357 0,000000
22. PEMFIGUS - G 27
SE ELIMINA
23. BOALA GAUCHER - G 29
SE ADAUGA
5 W65802002 A16AX06 MIGLUSTATUM **1 MIGLUSTAT ACCORD 100 mg CAPS. 100mg ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PVC-PE-PCTFE/AL X 84X1 PR 84 220,073928 220,073928 0,000000
IMUNOSUPRESOARE SELECTIVE - G31

25. BOALA CRONICA INFLAMATORIE INTESTINALA - G31a
SE MODIFICA
Pagina 2 din 5
Prescriptie
Cod_CIM

Nr crt.

1 W57617003 L04AB02 INFLIXIMABUM **1 REMICADE 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg JANSSEN BIOLOGICS B.V. OLANDA CUTIE X 3 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 3 1.289,508000 1.289,508000 455,192000
4 W60071001 L04AB02 INFLIXIMABUM **1 REMSIMA 100mg PULB. PT. CONC. PT. SOL. PERF. 100mg CELLTRION HEALTHCARE HUNGARY KFT. UNGARIA CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.289,508000 1.289,508000 221,212000
18 W65000001 L04AB02 INFLIXIMABUM **1 ZESSLY 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg SANDOZ GMBH AUSTRIA CUTIE CU 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.289,508000 1.289,508000 211,142000
SE ELIMINA
2 W60070001 L04AB02 INFLIXIMABUM **1 INFLECTRA 100 mg PULB. PT. CONC. PT. SOL. PERF. 100mg HOSPIRA UK LIMITED MAREA BRITANIE CUTIE X 1 FLAC. DIN STICLA CU PULB. PT. CONC. PT. SOL. PERF. PR 1 1.074,590000 1.074,590000 0,000000
Pagina 3 din 5
Prescriptie
Cod_CIM

Nr crt.

26. POLIARTITRITA REUMATOIDA - G31b
SE MODIFICA
SE ELIMINA
27. ARTROPATIA PSORIAZICA - G31c
SE MODIFICA
SE ELIMINA
28. SPONDILITA ANKILOZANTA - G 31d
SE MODIFICA
SE ELIMINA
30. PSORIAZIS CRONIC SEVER (PLĂCI) - G 31f
SE MODIFICA
Pagina 4 din 5
Prescriptie
Cod_CIM

Nr crt.

SE ELIMINA
Pagina 5 din 5
ANEXA 9
(ANEXA 2d la Ordinul CNAS nr. 1611/2018)
SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% DIN PRE ȚUL DE REFERINȚĂ - CONFORM DCI-URILOR, ALTELE DECÂT CELE DIN SUBLISTELE A, B,
SUBLISTA C SECŢIUNEA C1 ŞI SUBLISTA D, CORESPUNZĂTOARE MEDICAMENTELOR, DE CARE BENEFICIAZĂ COPIII PÂNĂ LA 18 ANI, TINERII DE LA 18 LA 26 DE ANI DACĂ SUNT
ELEVI, UCENICI SAU STUDENŢI, DACĂ NU REALIZEAZĂ VENITURI, PRECUM ŞI GRAVIDE ŞI LEHUZE, ÎN TRATAMENTUL AMBULATORIU,
DIN HG NR. 720/2008, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILĂ ÎNCEPÂND CU 01 AUGUST 2019
Val. maxima suportata de Contributie maxima

sistemul de asigurari a asiguratului / UT
Prescriptie
Cod_CIM

Nr crt.
Tara det. ambal referinta / UT compensare 100% din din pretul de

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj aj (RON) pretul de referinta) referinta)
SE ADAUGA
245 W65715001 J02AC03 VORICONAZOLUM ** VORICONAZOLE ACCORD 200 mg COMPR. FILM. 200mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. PRF 28 11,965714 11,965714 0,000000
SE ELIMINA
146 W60142001 M01AE01 IBUPROFENUM IBUPROFEN CIPLA 400 COMPR. FILM. 400mg CIPLA (UK) LIMITED MAREA BRITANIE CUTIE CU 2 BLIST. PVCAL X 10 COMPR. FILM. P6L 20 0,205000 0,205000 0,000000
Pagina 1 din 1
ANEXA 10
(ANEXA 2e la Ordinul CNAS nr. 1611/2018)
SUBLISTA D - LISTA MEDICAMENTELOR CU NIVEL DE COMPENSARE 20% DIN PRETUL DE REFERINTA CONFORM
DENUMIRILOR COMUNE INTERNATIONALE (DCI) CORESPUNZATOARE MEDICAMENTELOR DE CARE BENEFICIAZA ASIGURATII, IN TRATAMENTUL AMBULATORIU CU SI FARA CONTRIBUTIE
PERSONALA DIN HG NR. 720/2008, CU COMPLETARILE SI MODIFICARILE ULTERIOARE,
VALABILA INCEPAND CU 01 AUGUST 2019

Prescriptie
(pt. asiguratii care sociale de sanatate / UT (pt. asiguratii care
Cod_CIM

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SE ADAUGA
112 W65656001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC ACCORD 3 mg SOL INJ. IN SERINGA PREUMPLUTA 3mg ACCORD HEALTHCARE S.L.U. SPANIA CUTIE CU 1 SERINGA PREUMPLUTA DIN STICLA INCOLORA SI 1 AC PT. INJECTARE PR/P6L 1 73,800000 32,410000 14,760000 91,450000
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Lista Medicamentelor Valabila - 01.08.2019

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ANEXA 6

(ANEXA 2a la Ordinul CNAS nr. 1611/2018)

Contributie maxima Val. maxima suportata de Contributie maxima

cant. beneficiaza de (pt. asiguratii care beneficiaza de

UT/ Pret de compensare 100% beneficiaza de compensare 90%

UT/ Pret de compensare 100% beneficiaza de compensare 90%

Contributie Val. maxima suportata Contributie Val. maxima suportata Contributie

Val. maxima suportata Contributie maxima

UT/ Pret de beneficiaza de compensare 100%

TARA amba referinta / UT compensare 100% din din pretul de

4. HEPATITELE CRONICE DE ETIOLOGIE VIRALA B, C şi D - G4

UT/ Pret de beneficiaza de compensare 100%

TARA amba referinta / UT compensare 100% din din pretul de

12. SCLEROZA MULTIPLA - G14

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

23. BOALA GAUCHER - G 29

IMUNOSUPRESOARE SELECTIVE - G31

UT/ Pret de beneficiaza de compensare 100%

TARA amba referinta / UT compensare 100% din din pretul de

UT/ Pret de beneficiaza de compensare 100%

TARA amba referinta / UT compensare 100% din din pretul de

27. ARTROPATIA PSORIAZICA - G31c

28. SPONDILITA ANKILOZANTA - G 31d

30. PSORIAZIS CRONIC SEVER (PLĂCI) - G 31f

UT/ Pret de beneficiaza de compensare 100%

TARA amba referinta / UT compensare 100% din din pretul de

Val. maxima suportata de Contributie maxima

UT/ Pret de beneficiaza de compensare 100%

Tara det. ambal referinta / UT compensare 100% din din pretul de

Contributie maxima Val. maxima suportata de Contributie maxima

cant. beneficiaza de (pt. asiguratii care beneficiaza de

UT/ Pret de compensare 100% beneficiaza de compensare 20%

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