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 01 NOIEMBRIE 2016

Val. maxima suportata

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

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

SE ADAUGA

1.155 A02BC01 OMEPRAZOLUM OMEPRAZOL FARMEX 20 mg CAPS. GASTROREZ. 20mg FARMEX COMPANY SRLROMANIA CUTIE X 3 BLIST. AL/AL X 10 CAPS. GASTROREZ.
P6L 30 0,535492 0,159508 0,481942 0,213058
1.156 A02BC01 OMEPRAZOLUM OMEPRAZOL FARMEX 20 mg CAPS. GASTROREZ. 20mg FARMEX COMPANY SRLROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,535492 0,159508 0,481942 0,213058
1.157 J01CA04 AMOXICILLINUM AMOXICILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRLROMANIA CUTIE X 2 BLIST. X 10 CAPS. P-RF 20 0,440500 0,000000 0,396450 0,044050
1.158 J01CA04 AMOXICILLINUM AMOXICILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRLROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,483636 0,108364 0,435272 0,156728
1.159 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY SRLROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,558500 0,000000 0,502650 0,055850
1.160 J01CF04 OXACILLINUM OXACILINA FORTE 500 mg CAPS. 500mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 0,621580 0,128420 0,559422 0,190578
1.161 J05AB01 ACICLOVIRUM ACICLOVIR FARMEX 200 mg CAPS. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. P-RF 20 0,803362 0,267638 0,723025 0,347975

SE MODIFICA

1 A02BC01 OMEPRAZOLUM ULTOP CAPS. GASTROREZ. 20mg KRKA D.D. SLOVENIA CUTIE X 1 FLAC. PE X 14 CAPS. GASTROREZ. P-6L 14 0,535492 0,140222 0,481942 0,193772
2 A02BC01 OMEPRAZOLUM OMEPRAZOL 20 mg CAPS. GASTROREZ. 20mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PVC-AL-PA/AL X 7 CAPS. GASTROREZ. P-6L 14 0,535492 0,150222 0,481942 0,203772
3 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SAROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 20 0,535492 0,128508 0,481942 0,182058
4 A02BC01 OMEPRAZOLUM OMERAN 20 CAPS. GASTROREZ. 20mg EUROPHARM SA ROMANIA CUTIE X 4 BLIST. AL/AL X 7 CAPS. GASTROREZ.P-6L 28 0,535492 0,258079 0,481942 0,311629
5 A02BC01 OMEPRAZOLUM OMEPRAZOL 20 mg CAPS. GASTROREZ. 20mg SLAVIA PHARM SRL ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,535492 0,247174 0,481942 0,300724
6 A02BC01 OMEPRAZOLUM OMEPRAZOL TERAPIA 20 mg CAPS. GASTROREZ. 20mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,535492 0,243508 0,481942 0,297058
7 A02BC01 OMEPRAZOLUM OMEPRAZOL ARENA 20 mg CAPS. GASTROREZ. 20mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. GASTROREZ. P-6L 30 0,535492 0,226174 0,481942 0,279724
8 A02BC01 OMEPRAZOLUM OMEPRAZOL ROMPHARM 20 mgCAPS. GASTROREZ. 20mg ROMPHARM COMPANY SRL ROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ. P-6L 30 0,535492 0,203174 0,481942 0,256724
10 A02BC01 OMEPRAZOLUM OMEZ 20mg CAPS. GASTROREZ. 20mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 3 FOLII AL/PE-PE/AL X 10 CAPS. GASTROREZ. P-6L 30 0,535492 0,205174 0,481942 0,258724
12 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 4 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 28 0,535492 0,258079 0,481942 0,311629
13 A02BC01 OMEPRAZOLUM OMZATOL 20 mg CAPS. GASTROREZ. 20mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 CAPS. GASTROREZ. P-6L 14 0,535492 0,258079 0,481942 0,311629
14 A02BC01 OMEPRAZOLUM OMEPRAZOL ATB 20 mg CAPS. GASTROREZ. 20mg ANTIBIOTICE S.A. ROMANIA CUTIE X 2 FOLII AL/PE X 10 CAPS. GASTR. P-6L 20 0,535492 0,312008 0,481942 0,365558
18 A02BC01 OMEPRAZOLUM OMEPRAZOL LPH 20 mg CAPS. GASTROREZ. 20mg LABORMED PHARMA SAROMANIA CUTIE X 3 BLIST. PVC/AL X 10 CAPS. GASTROREZ P-6L 30 0,535492 0,129174 0,481942 0,182724
19 A02BC01 OMEPRAZOLUM OMERAN 20 mg CAPS. GASTROREZ. 20mg GLAXOSMITHKLINE (GSK) SRL ROMANIA CUTIE CU 4 BLIST. AL/AL X 7 CAPS. GASTROREZ. P6L 28 0,535492 0,258079 0,481942 0,311629
20 A02BC01 OMEPRAZOLUM ORTANOL 40 mg CAPS. GASTROREZ. 40mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 BLIST. AL/AL X 7 CAPS. GASTROREZ.P-6L 7 1,070984 0,120444 0,963885 0,227543
22 A02BC01 OMEPRAZOLUM OMEDAR 20 mg COMPR. GASTROREZ. 20mg DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. DE STICLA BRUNA X 28 COMPR. FILM. GASTROREZ. P-6L 28 0,535357 0,000000 0,481821 0,053536
25 A02BC03 LANSOPRAZOLUM LEVANT 15 mg CAPS. GASTROREZ. 15mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 0,267746 0,218682 0,240971 0,245457
26 A02BC03 LANSOPRAZOLUM LANZUL CAPS. GASTROREZ. 30mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PE-PVDC/AL X 7 CAPS. GASTROREZ. P-6L 14 0,535492 0,437365 0,481942 0,490915
27 A02BC03 LANSOPRAZOLUM LEVANT 30 mg CAPS. GASTROREZ. 30mg RANBAXY UK LTD. MAREA BRITANIE CUTIE X 2 BLIST. PVC-AL-PO/AL-PE X 7 CAPS. GASTROREZ. P-6L 14 0,535492 0,306650 0,481942 0,360200
28 A02BC03 LANSOPRAZOLUM LANZAP 30mg CAPS. GASTROREZ. 30mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 CAPS. GASTROREZ. P-6L 20 0,535492 0,328008 0,481942 0,381558
152 C04AD03 PENTOXIFYLLINUM PENTOXI RETARD 400 mg COMPR. ELIB. PREL. 400mg TERAPIA SA ROMANIA CUTIE X 4 BLIST. X 10 COMPR. CU ELIB. PREL. P-6L 40 0,426199 0,155551 0,383579 0,198171
154 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,426199 0,104801 0,383579 0,147421
155 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 400 mg COMPR. ELIB. PREL. 400mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 0,426199 0,000001 0,383579 0,042621
156 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 5 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 50 0,639299 0,062701 0,575369 0,126631
157 C04AD03 PENTOXIFYLLINUM PENTOXIFILINA SR ZENTIVA 600 mg COMPR. ELIB. PREL. 600mg ZENTIVA AS SLOVACIA CUTIE X 10 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 100 0,639299 0,039001 0,575369 0,102931
158 C04AD03 PENTOXIFYLLINUM VASONIT RETARD 600 mg COMPR. ELIB. PREL. 600mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X 5 BLIST. PVC/AL X 10 COMPR. ELIB. PREL.
P-6L 50 0,639299 0,036501 0,575369 0,100431
161 C04AD03 PENTOXIFYLLINUM ANGIOPENT 600 mg COMPR. FILM. ELIB. PREL. 600mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST., AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,639299 0,183701 0,575369 0,247631
498 C10AB05 FENOFIBRATUM LIPOFIB 160 mg CAPS. 160mg TERAPIA SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,789000 0,000000 0,710100 0,078900
500 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. ELIB. MODIF. 160mg LAB. FOURNIER SA FRANTA CUTIE X 3 BLIST. PVC- PE-PVDC/AL X 10 COMPR. CU ELIB. MOD. P-6L 30 0,986400 0,110600 0,887760 0,209240
501 C10AB05 FENOFIBRATUM LIPANTHYL SUPRA 160 mg COMPR. ELIB. MODIF. 160mg MYLAN MEDICAL SAS FRANTA CUTIE X 3 BLIST. PVC- PE-PVDC/AL X 10 COMPR. ELIB. MODIF. P-6L 30 0,986400 0,110600 0,887760 0,209240
502 C10AB05 FENOFIBRATUM LIPANTIL NANO 145 mg COMPR. FILM. 145mg LABORATOIRES FOURNIER S.A.S. FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,986400 0,109600 0,887760 0,208240
503 C10AB05 FENOFIBRATUM LIPANTIL NANO 145 mg COMPR. FILM. 145mg MYLAN MEDICAL SAS FRANTA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 30 0,986400 0,109600 0,887760 0,208240
546 J01CA04 AMOXICILLINUM AMOXICILINA ANTIBIOTICE 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,483636 0,123364 0,435272 0,171728

Pagina 1 din 3
 Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
547 J01CA04 AMOXICILLINUM AMOXICILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 5 CAPS. P-RF 10 0,483636 0,106364 0,435272 0,154728
548 J01CA04 AMOXICILLINUM AMOXICILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,483636 0,009364 0,435272 0,057728
550 J01CA04 AMOXICILLINUM OSPAMOX 500 mg COMPR. FILM. 500mg SANDOZ GMBH AUSTRIA CUTIE X 2 BLIST. PVC-PVDC/AL X 6 COMPR.FILM.
P-RF 12 0,483636 0,008030 0,435272 0,056394
552 J01CA04 AMOXICILLINUM DUOMOX 1000 mg 1000mg
COMPR. PT. DISPERSIE ORALA ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 0,967273 0,008227 0,870545 0,104955
554 J01CA04 AMOXICILLINUM DUOMOX 500 mg 500mg
COMPR. PT. DISPERSIE ORALA ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 0,483636 0,115864 0,435272 0,164228
555 J01CA04 AMOXICILLINUM DUOMOX 750 mg 750mg
COMPR. PT. DISPERSIE ORALA ASTELLAS PHARMA EUROPE BV OLANDA CUTIE X 4 BLIST. AL/PVC X 5 COMPR. P-RF 20 0,725455 0,035545 0,652909 0,108091
565 J01CF04 OXACILLINUM OXACILINA ARENA 250 mg CAPS. 250mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,310790 0,057710 0,279711 0,088789
566 J01CF04 OXACILLINUM OXACILINA 250 mg CAPS. 250mg ANTIBIOTICE SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,310790 0,080710 0,279711 0,111789
567 J01CF04 OXACILLINUM OXACILINA SANDOZ 250 mg CAPS. 250mg SANDOZ SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,310790 0,089210 0,279711 0,120289
568 J01CF04 OXACILLINUM OXACILINA 500 mg CAPS. 500mg ANTIBIOTICE SA ROMANIA CUTIE X 1 BLIST. X 10 CAPS. P-RF 10 0,621580 0,156420 0,559422 0,218578
569 J01CF04 OXACILLINUM OXACILINA ARENA 500 mg CAPS. 500mg ARENA GROUP SA ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,621580 0,021420 0,559422 0,083578
570 J01CF04 OXACILLINUM OXACILINA SANDOZ 500 mg CAPS. 500mg SANDOZ SRL ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 0,621580 0,108420 0,559422 0,170578
627 J01DC02 CEFUROXIMUM ZINNAT (R) 125 mg COMPR. FILM. 125mg GLAXOWELLCOME UK LTD. MAREA BRITANIE CUTIE X 1 BLIST. X 10 COMPR. FILM. P-RF 10 1,131000 0,000000 1,017900 0,113100
632 J01DC02 CEFUROXIMUM ZINNAT GRAN. PT. SUSP. ORALA 125mg/5ml GLAXO WELLCOME UK LTD. MAREA BRITANIE CUTIE CU 1 FLAC. DIN STICLA BRUNA CONTINAND GRANULE PT. 50 ML SUSP. ORALA + 1 MASURA DOZATOARE P-RF 1 11,995000 8,145000 10,795500 9,344500
646 J01DC04 CEFACLORUM CECLOR (R) 125 mg/5 ml GRAN. PT. SUSP. ORALA 125mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 8,996250 4,933750 8,096625 5,833375
647 J01DC04 CEFACLORUM CEFACLOR TERAPIA 125mg/5ml GRAN. PT. SUSP. ORALA 125mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN.PT. 75 ML SUSP.ORALA P-RF 1 8,996250 0,063750 8,096625 0,963375
648 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250mg/5ml GRAN. PT. SUSP. ORALA 250 mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 75 ML SUSP. ORALA P-RF 1 17,950000 0,000000 16,155000 1,795000
650 J01DC04 CEFACLORUM CECLOR (R) 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml ACTAVIS GROUP HF ISLANDA CUTIE X 1 FLAC. PEID DE CULOARE ALBA, CU GRANULE PT. 75 ML SUSP. ORALA + 1 LINGURITA DOZATOARE P-RF 1 17,992500 9,617500 16,193250 11,416750
651 J01DC04 CEFACLORUM CLORACEF (R) 125 PULB. PT. SUSP. ORALA 125mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP.+ LINGURITA DOZATOARE P-RF 1 8,996250 0,063750 8,096625 0,963375
652 J01DC04 CEFACLORUM CEFAKLOR 125 mg/5 ml PULB. PT. SUSP. ORALA 125mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 7,197000 1,863000 6,477300 2,582700
653 J01DC04 CEFACLORUM CLORACEF (R) 250 PULB. PT. SUSP. ORALA 250mg/5ml DAR AL DAWA PHARMA S.R.L. ROMANIA CUTIE X 1 FLAC. CU PULB. PT. 75ML SUSP. + LINGURITA DOZATOARE P-RF 1 17,940000 0,000000 16,146000 1,794000
654 J01DC04 CEFACLORUM CEFAKLOR 250 mg/5 ml PULB. PT. SUSP. ORALA 250mg/5ml STADA HEMOFARM S.R.L. ROMANIA CUTIE X 1 FLAC. PULB. PT. 60 ML SUSP. ORALA + O MASURA DOZATOARE P-RF 1 14,394000 2,136000 12,954600 3,575400
667 J01FA01 ERYTHROMYCINUM ERITROMICINA SANDOZ 200 mg COMPRIMATE COMPR. 200mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,379800 0,042200 0,341820 0,080180
668 J01FA01 ERYTHROMYCINUM ERITROMICINA ATB 200 mg COMPR. 200mg ANTIBIOTICE SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,379800 0,117700 0,341820 0,155680
669 J01FA09 CLARITHROMYCINUM CLAXIRIT 500 mg COMPR. CU ELIB. PREL. 500mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/PVDC//AL X 7 COMPR. CU ELIB. PREL. PRF 7 1,899000 0,535285 1,709100 0,725185
670 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 1,899000 1,849000 1,709100 2,038900
672 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 0,949500 0,222642 0,854550 0,317592
673 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 0,949500 0,137642 0,854550 0,232592
674 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 0,949500 0,286214 0,854550 0,381164
677 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 0,949500 0,997642 0,854550 1,092592
678 J01FA09 CLARITHROMYCINUM KLERIMED (R) 500 COMPR. FILM. 500mg MEDOCHEMIE LTD. CIPRU CUTIE X 2 BLIST. AL/PVC-PVDC X 7 COMPR. FILM. P-RF 14 1,899000 0,012428 1,709100 0,202328
679 J01FA09 CLARITHROMYCINUM KLABAX 500 mg COMPR. FILM. 500mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 14 COMPR. FILM. P-RF 14 1,899000 0,140285 1,709100 0,330185
680 J01FA09 CLARITHROMYCINUM FROMILID 500 COMPR. FILM. 500mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 2 BLIST. PVC-PVDC/AL X 7 COMPR. FILM.
P-RF 14 1,899000 0,022428 1,709100 0,212328
682 J01FA09 CLARITHROMYCINUM CLAR 500 COMPR. FILM. 500mg GLENMARK PHARMACEUTICALS S.R.O. CUTIE X 5 BLIST. AL/PVC X 4 COMPR. FILM. P-RF
REPUBLICA CEHA 20 1,899000 0,457000 1,709100 0,646900
683 J01FA09 CLARITHROMYCINUM LEKOKLAR 500 mg COMPR. FILM. 500mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. PVC/PVDC-AL X 14 COMPR. FILM.
PRF 14 1,899000 0,012428 1,709100 0,202328
685 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 1,899000 0,535285 1,709100 0,725185
687 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 24,147750 2,122250 21,732975 4,537025
690 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 14,488650 5,231350 13,039785 6,680215
692 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 28,977300 3,892700 26,079570 6,790430
693 J01FA09 CLARITHROMYCINUM LEKOKLAR 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml SANDOZ S.R.L. ROMANIA PRF
CUTIE CU 1 FLAC. PEID + SERINGA DE MASURAT DIN PE/PP CU MARCAJE LA 2,5, 3,75 ML SI 5,0 ML SI 1 LINGURITA DOZATOARE DIN PE/PP CU MARCAJE LA 1,25 ML, 2,5 ML SI 5,0 ML CU 41,0 GRANULE PT 60 ML SUSP. ORALA 1 28,977300 0,882700 26,079570 3,780430
770 J05AB01 ACICLOVIRUM ACICLOVIR 200 mg CAPS. 200mg SLAVIA PHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,803362 0,245138 0,723025 0,325475
771 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 200 mg CAPS. 200mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0,803362 0,307638 0,723025 0,387975
772 J05AB01 ACICLOVIRUM ACICLOVIR ARENA 400 mg CAPS. 400mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 CAPS. P-RF 10 1,606725 0,413275 1,446052 0,573948
773 J05AB01 ACICLOVIRUM ACICLOVIR TERAPIA 200 mg COMPR. 200mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0,803362 0,086638 0,723025 0,166975
776 J05AB01 ACICLOVIRUM ACICLOVIR LAROPHARM 200 mg COMPR. 200mg LAROPHARM S.R.L. ROMANIA CUTIE X 2 BLIST. X 10 COMPR. P-RF 20 0,803362 0,090138 0,723025 0,170475
777 J05AB01 ACICLOVIRUM ACICLOVIR-RICHTER 200 mg COMPR. 200mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. AL/PVC X 10 COMPR. PRF 20 0,803362 0,090138 0,723025 0,170475
778 J05AB01 ACICLOVIRUM ACICLOVIR 400 mg COMPR. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 5 COMPR.P-RF 10 1,606725 1,151275 1,446052 1,311948
780 M01AB01 INDOMETACINUM INDOMETACIN LAROPHARM 25 mg CAPS. 25mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST., PVC/AL, X 10 CAPS. P-6L 20 0,066599 0,017401 0,059939 0,024061
781 M01AB01 INDOMETACINUM INDOMETACIN ARENA 25 MG CAPS. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,066599 0,007401 0,059939 0,014061
782 M01AB01 INDOMETACINUM INDOMETACIN ARENA 50 MG CAPS. 50mg ARENA GROUP SA ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-6L 20 0,133199 0,050301 0,119879 0,063621
786 M01AB05 DICLOFENACUM DICLOREUM 150 mg CAPS. ELIB. PREL. 150mg ALFA WASSERMANN SPA ITALIA CUTIE CU 2 BLIST. PVC/AL X 10 CAPS. ELIB. PREL.
P-6L 20 0,399599 2,074901 0,359639 2,114861
787 M01AB05 DICLOFENACUM DICLOFENAC DUO PHARMASWISS 75 mg CAPS. ELIB. PREL. 75mg PHARMASWISS CESKA REPUBLIKA S.R.O. CEHIA CUTIE X 3 BLIST. PVC/PVDC/AL X 10 CAPS. ELIB. PREL. P-6L 30 0,199799 0,381201 0,179819 0,401181
788 M01AB05 DICLOFENACUM DICLOTARD® 100 mg COMPR. CU ELIB. PREL. 100mg TERAPIA SA ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. ELIB. PREL P-6L 20 0,266399 0,088101 0,239759 0,114741
790 M01AB05 DICLOFENACUM VOLTAREN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg NOVARTIS PHARMA GMBH GERMANIACUTIE X 1 BLIST. PVC-PE-PVDC/AL. X 10 COMPR. FILM. ELIB. PREL.
P-6L 10 0,266399 0,278601 0,239759 0,305241
791 M01AB05 DICLOFENACUM REFEN (R) RETARD COMPR. FILM. ELIB. PREL. 100mg STADA HEMOFARM S.R.L. ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. FILM. ELIB. PREL. P-6L 20 0,266399 0,088101 0,239759 0,114741
792 M01AB05 DICLOFENACUM VOLTAREN (R) 50 COMPR. FILM. GASTROREZ. 50mg NOVARTIS PHARMA GMBH GERMANIACUTIE X 2 BLIST. PVC-PE-PVDC/AL X 10 COMPR. FILM. GASTROREZ. P-6L 20 0,133199 0,047301 0,119879 0,060621

Pagina 2 din 3
 Val. maxima suportata
Co-plata maxima de sistemul de Co-plata maxima
a asiguratului / UT asigurari sociale de a asiguratului / UT
(pt. asiguratii sanatate / UT (pt. (pt. asiguratii

Prescriptie
cant. care beneficiaza asiguratii care care beneficiaza
UT/ Pret de de compensare beneficiaza de de compensare
tara det. amb referinta / 100% din pretul compensare 90% din 90% din pretul de
Nr crt. cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj alaj UT (RON) de referinta) pretul de referinta) referinta)
795 M01AB05 DICLOFENACUM VOLTAREN RAPID (R) DRAJ. 50mg NOVARTIS PHARMA GMBH GERMANIA CUTIE X 1 BLIST. PVC-PE-PVDC/AL X 10 DRAJ. P-6L 10 0,133199 0,109801 0,119879 0,123121
796 M01AB05 DICLOFENACUM DICLOFENAC ARENA 25 mg DRAJ. GASTROREZ. 25mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 DRAJ. GASTROREZ. P-6L 30 0,066599 0,131067 0,059939 0,137727
810 M01AB15 KETOROLACUM TROMETHAMIN KETOROL COMPR. FILM. 10mg DR. REDDY'S LABORATORIES ROMANIA CUTIE X 2 BLIST. PVC-PVDC/AL X 10 COMPR. FILM. P-6L 20 0,088799 0,261201 0,079919 0,270081
811 M01AB15 KETOROLACUM TROMETHAMIN KETANOV 10 mg COMPR. FILM. 10mg TERAPIA SA ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL A CATE 10 COMPR. FILM. P-6L 20 0,088799 0,437201 0,079919 0,446081
816 M01AB16 ACECLOFENACUM AFLAMIL 100mg COMPR. FILM. 100mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 10 COMPR. P-6L 20 0,133199 0,602301 0,119879 0,615621
817 M01AB16 ACECLOFENACUM ACE-TAB 100 mg COMPR. FILM. 100mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 20 COMPR. FILM. P6L 20 0,133199 0,345301 0,119879 0,358621
818 M01AB16 ACECLOFENACUM AFLAMIL 100 mg PULB. PT.SUSP. ORALA 100mg GEDEON RICHTER ROMANIA S.A. ROMANIA CUTIE CU 20 PLICURI UNIDOZA DIN MATERIAL COMPLEX DIN HARTIE DE TIP OPALINA LAMINATA PE UN STRAT DE ALUMINIU (20 ΜM) SI FILM DIN PEJD P6L 20 0,133199 1,204801 0,119879 1,218121
1.053 N06AX16 VENLAFAXINUM** EFECTIN EP 150 mg CAPS. ELIB. PREL. 150 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,838321 1,174536 0,754488 1,258369
1.054 N06AX16 VENLAFAXINUM** ELIFY EP 150 mg CAPS. ELIB. PREL. 150 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST PVC/AL X 30 CAPS.CU ELIB. PREL. PRF 30 0,838321 0,160012 0,754488 0,243845
1.055 N06AX16 VENLAFAXINUM** IVRYX 150mg CAPS. ELIB. PREL. 150 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,838321 0,022393 0,754488 0,106226
1.056 N06AX16 VENLAFAXINUM** VELAXIN 150 mg CAPS. ELIB. PREL. 150mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,838321 0,470250 0,754488 0,554083
1.058 N06AX16 VENLAFAXINUM** VENLAFAXINA ACTAVIS 150 mg CAPS. ELIB. PREL. 150mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 0,838321 0,018107 0,754488 0,101940
1.059 N06AX16 VENLAFAXINUM** VENLAFAXINA ARENA EP 150 mgCAPS. ELIB. PREL. 150mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,838321 0,470345 0,754488 0,554178
1.060 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF 30 0,838321 0,470345 0,754488 0,554178
1.061 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 150 mg CAPS. ELIB. PREL. 150mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,838321 0,470345 0,754488 0,554178
1.063 N06AX16 VENLAFAXINUM** FOBILESS 37,5 mg CAPS. ELIB. PREL. 37,5mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL.
P-RF 30 0,209580 0,386753 0,188622 0,407711
1.064 N06AX16 VENLAFAXINUM** VENLAFAXINA ARENA EP 37,5 mgCAPS. ELIB. PREL. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,209580 0,622086 0,188622 0,643044
1.065 N06AX16 VENLAFAXINUM** EFECTIN EP 75 mg CAPS. ELIB. PREL. 75 mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE CU BLIST. DIN PVC/AL X 28 CAPS. ELIB. PREL. PRF 28 0,419160 0,899054 0,377244 0,940970
1.066 N06AX16 VENLAFAXINUM** ELIFY EP 75 mg CAPS. ELIB. PREL. 75 mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. PRF 30 0,419160 0,330173 0,377244 0,372089
1.069 N06AX16 VENLAFAXINUM** VELAXIN 75 mg CAPS. ELIB. PREL. 75mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 2 BLIST. PVC-PVDC/AL X 14 CAPS. CU ELIB. PREL P-RF 28 0,419160 0,465840 0,377244 0,507756
1.071 N06AX16 VENLAFAXINUM** FOBILESS 75 mg CAPS. ELIB. PREL. 75mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE X BLIST. PVC/AL X 30 CAPS. CU ELIB. PREL. P-RF 30 0,419160 0,243506 0,377244 0,285422
1.072 N06AX16 VENLAFAXINUM** VENLAFAXINA ACTAVIS 75 mgCAPS. ELIB. PREL. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 28 CAPS. CU ELIB. PREL. P-RF 28 0,419160 0,237268 0,377244 0,279184
1.073 N06AX16 VENLAFAXINUM** VENLAFAXINA ARENA EP 75 mg CAPS. ELIB. PREL. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE-PVDC/AL X 10 CAPS. CU ELIB. PREL. P-RF 30 0,419160 0,460173 0,377244 0,502089
1.074 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 75 mgCAPS. ELIB. PREL. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-ACLAR/AL X 30 CAPS. ELIB. PREL. PRF 30 0,419160 0,466173 0,377244 0,508089
1.075 N06AX16 VENLAFAXINUM** VENLAFAXINA TERAPIA 75 mgCAPS. ELIB. PREL. 75mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. ELIB. PREL. PRF 30 0,419160 0,466173 0,377244 0,508089
1.077 N06AX16 VENLAFAXINUM** VENLAFAXINA ARENA 37,5 mg COMPR. 37,5mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,209580 0,622086 0,188622 0,643044
1.078 N06AX16 VENLAFAXINUM** VENLAFAXINA ARENA 50 mg COMPR. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,279440 0,567893 0,251496 0,595837
1.079 N06AX16 VENLAFAXINUM** VENLAFAXINA ARENA 75 mg COMPR. 75mg ARENA GROUP S.A. ROMANIA CUTIE X 3 BLIST. PVC-PE- PVDC/AL X 10 COMPR. P-RF 30 0,419160 0,460173 0,377244 0,502089

SE ELIMINA

153 C04AD03 PENTOXIFYLLINUM PENTOXI RETARD 400 mg COMPR. ELIB. PREL. 400mg TERAPIA SA ROMANIA CUTIE CU 2 BLIST. X 10 COMPR. ELIB. PREL. P-6L 20 0,432283 0,460717 0,389054 0,503946
642 J01DC04 CEFACLORUM CEFACLOR TERAPIA MR 750 COMPR. ELIB. PREL. 750mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. X 10 COMPR. ELIB. PREL. P-RF 10 1,474200 1,020800 1,326780 1,168220
649 J01DC04 CEFACLORUM CEFACLOR TERAPIA 250mg/5ml GRAN. PT. SUSP. ORALA 250 mg/5 ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. DIN PEID CU GRAN. PT. 100 ML SUSP. ORALA P-RF 1 17,950000 0,000000 16,155000 1,795000
691 J01FA09 CLARITHROMYCINUM KLABAX 250 mg/5 ml GRAN. PT. SUSP. ORALA 250mg/5ml TERAPIA SA ROMANIA CUTIE X 1 FLAC. PEID X 70 G GRAN. PT. 100 ML SUSP . ORALA P-RF 1 47,603250 5,406750 42,842925 10,167075
1.149 M01AB16 ACECLOFENACUM ACOFAX 100 mg COMPR. FILM. 100mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 20 COMPR. FILM. P6L 20 0,137700 0,311300 0,123930 0,325070
1.067 N06AX16 VENLAFAXINUM** IVRYX 75mg CAPS. ELIB. PREL. 75 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,391428 0,000000 0,352285 0,039143

Pagina 3 din 3
 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 01 NOIEMBRIE 2016

Val. maxima suportata Val. maxima suportata

Co-plata maxima a de sistemul de Co-plata maxima a de sistemul de Co-plata 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
UT/ Pret de compensare 100% beneficiaza de compensare 50% beneficiaza de compensare 90%
Tara det. amb referinta / din pretul de compensare 50% din din pretul de compensare 90% din din pretul de
Nr. crt 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

1.121 C10AB02 BEZAFIBRATUM BEZAFIBRAT FARMEX 200 mg COMPR. 200mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,370000 0,000000 0,185000 0,185000 0,333000 0,037000
1.122 J02AC02 ITRACONAZOLUM* ITRACONAZOL FARMEX 100 mg CAPS. 100mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. PVCA/AL X 5 CAPS. PRF 15 2,144666 0,000000 1,072333 1,072333 1,930199 0,214467

SE MODIFICA

30 A02BC05 ESOMEPRAZOLUM NEXIUM 20 mg COMPR. GASTROREZ. 20mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/PVC-AL-POLIAMIDA X 7 COMPR. GASTROREZISTENTE P-6L 14 0,713988 0,803869 0,356994 1,160863 0,642589 0,875268
35 A02BC05 ESOMEPRAZOLUM PRAGASTROL 20 mg COMPR. GASTROREZ. 20mg ALVOGEN IPCO S.A.R.L LUXEMBOURG CUTIE CU BLIST. AL-PVC/AL X 30 (3X10) COMPR. GASTROREZ. P6L 30 0,713988 0,006012 0,356994 0,363006 0,642589 0,077411
36 A02BC05 ESOMEPRAZOLUM NEXIUM 40 mg COMPR. GASTROREZ. 40mg ASTRAZENECA AB SUEDIA CUTIE CU 2 BLIST. AL/PVC-AL-POLIAMIDA X 7 COMPR. GASTROREZISTENTE P-6L 14 1,427978 0,702736 0,713989 1,416725 1,285180 0,845534
41 A02BC05 ESOMEPRAZOLUM ESOMEPRAZOL TERAPIA 20mg COMPR. GASTROREZISTENTE 20mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PE-DESICANT-PEID/AL X 14 COMPR. GASTROREZISTENTE P-6L 14 0,713988 0,223869 0,356994 0,580863 0,642589 0,295268
645 J01FA02 SPIRAMYCINUM ROVAMYCINE (R) 1,5 Mil. UI COMPR. FILM. 1,5 M ui LAB. AVENTIS FRANTA CUTIE X 2 BLIST. AL/PVC X 8 COMPR. FILM. P-RF 16 0,632997 0,005753 0,316498 0,322252 0,569697 0,069053
646 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 1,265998 1,347002 0,632999 1,980001 1,139398 1,473602
647 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 1,265998 1,347002 0,632999 1,980001 1,139398 1,473602
648 J01FA10 AZITHROMYCINUM AZATRIL 250 mg CAPS. 250mg BALKANPHARMA RAZGRAD AD BULGARIA CUTIE X 1 BLIST. AL/PVC X 6 CAPS.P-RF 6 3,164998 0,126668 1,582499 1,709167 2,848498 0,443168
649 J01FA10 AZITHROMYCINUM SUMAMED 250 mg CAPS. 250mg PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 BLIST. PVC-PVDC/AL X 6 CAPS. P-RF 6 3,164998 1,901668 1,582499 3,484167 2,848498 2,218168
650 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 1,582497 2,564169 0,791248 3,355418 1,424247 2,722419
651 J01FA10 AZITHROMYCINUM AZITROMICINA SANDOZ 250 mg COMPRIMATE FILMATE COMPR. FILM. 250mg SANDOZ S.R.L. ROMANIA CUTIE X 1 BLIST. X 6 COMPR. FILM.P-RF 6 3,164998 0,126668 1,582499 1,709167 2,848498 0,443168
654 J01FA10 AZITHROMYCINUM AZIBIOT 250 mg COMPR. FILM. 250mg KRKA ,D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. PVC-PVDC/AL X 6 COMPR.FILM. PRF 6 3,164998 0,126668 1,582499 1,709167 2,848498 0,443168
655 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 6,329997 2,253336 3,164998 5,418335 5,696997 2,886336
663 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 3 COMPR. FILM. P-RF 3 7,596000 7,830666 3,798000 11,628666 6,836400 8,590266
664 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 600 mg COMPR. FILM. 600mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 3 COMPR. FILM. P-RF 3 7,596000 7,830666 3,798000 11,628666 6,836400 8,590266
666 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 12,878796 6,461204 6,439398 12,900602 11,590916 7,749084
668 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT.15 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 19,318200 2,941800 9,659100 12,600900 17,386380 4,873620
669 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 30 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 38,636400 1,043600 19,318200 20,361800 34,772760 4,907240
670 J01FA10 AZITHROMYCINUM SUMAMED FORTE PULB. PT. SUSP. ORALA 200mg/5ml PLIVA LJUBLIJANA D.O.O. SLOVENIA CUTIE X 1 FLAC. DIN PEID CU PULB. PT. 37,5 ML SUSP. ORALA + SERINGA SI LINGURITA DOZATOARE P-RF 1 48,295500 12,064500 24,147750 36,212250 43,465950 16,894050

SE ELIMINA

251 C09CA03 VALSARTANUM AVASSAN 80 mg COMPR. FILM. 80mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,694285 0,108572 0,347142 0,455715 0,624856 0,178001
652 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 6 COMPR. FILM. P-RF 6 3,213211 0,078455 1,606605 1,685061 2,891889 0,399777
653 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 6 COMPR. FILM. P-RF 6 3,213211 0,078455 1,606605 1,685061 2,891889 0,399777
866 N06AB10 ESCITALOPRAMUM** SERODEPS 20mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 1,359642 0,000000 0,679821 0,679821 1,223677 0,135965

Pagina 1 din 1
 Anexa 8
(Anexa 2c la Ordinul CNAS 944/2015)
SECŢIUNEA C1 - LISTA MEDICAMENTELOR CU PROCENT DE COMPENSARE 100% DIN PREŢUL DE REFERINŢĂ CONFORM
DCI-urilor UTILIZATE ÎN TRATAMENTUL AMBULATORIU AL UNOR GRUPE DE BOL
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 NOIEMBRIE 2016

Val. maxima suportata de Co-plata maxima a

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

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

1.INSUFICIENTA CARDIACA CRONICA(CLASA III SAU IV NYHA) - G 1

SE ELIMINA

218 C09CA03 VALSARTANUM** AVASSAN 80 mg COMPR. FILM. 80mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. P6L 28 0,351306 0,351306 0,451551

8. Leucemii, limfoame, aplazie medulara, gamapatii monoclonale maligne, mieloproliferari cronice si tumori maligne, sindroame mielodisplazice - G10

SE ADAUGA

193 J02AC02 ITRACONAZOLUM ITRACONAZOL FARMEX 100 mg CAPS. 100mg FARMEX COMPANY S.R.L. ROMANIA CUTIE CU 3 BLIST. PVCA/AL X 5 CAPS. PRF 15 2,144666 2,144666 0,000000
194 J02AC03 VORICONAZOLUM** VORICONAZOL DR. REDDY'S 200 mg COMPR. FILM. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 86,687142 86,687142 0,000000

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 MODIFICA

238 N06AB10 ESCITALOPRAMUM** ESCITALOPRAM TORRENT 20 mg COMPR. FILM. 20mg TORRENT PHARMA SRL ROMANIA CUTIE CU BLIST. PVC-PEJD-PVDC/AL X 28 COMPR. FILM. PRF 28 1,642800 1,642800 0,625771

SE ELIMINA

237 N06AB10 ESCITALOPRAMUM** SERODEPS 20mg COMPR. FILM. 20mg TERAPIA SA ROMANIA CUTIE CU BLIST. AL/POLIAMIDA/PVC X 28 COMPR. FILM. P-RF 28 1,359642 1,359642 0,000000
274 N06AX16 VENLAFAXINUM** IVRYX 75mg CAPS. ELIB. PREL. 75 mg NEOLA PHARMA S.R.L. ROMANIA CUTIE X 2 BLIST. PCV-ACLAR/AL X 14 CAPS. CU ELIB. PREL. P-RF 28 0,391200 0,391200 0,000228

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

SE MODIFICA

9 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
12 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
14 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml GERMANIA
MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE 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
15 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml GERMANIA
MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATE 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
16 L01BA01 METHOTREXATUM METOJECT 50mg/ml SOL. INJ. IN SERINGA PREUMPLUTA 50mg/ml MEDAC GESELLSCAFT FUR KLINISCHE SPEZIALPRÄPARATEGERMANIA 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

SE ELIMINA

55 L01BA01 METHOTREXATUM NAMAXIR 10 mg SOL INJ. IN SERINGA PREUMPLUTA 10mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,40 ML SOL. INJ. PR 4 39,762500 39,762500 0,000000
56 L01BA01 METHOTREXATUM NAMAXIR 15 mg SOL INJ. IN SERINGA PREUMPLUTA 15mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,38 ML SOL. INJ. PR 4 39,762500 39,762500 0,000000
57 L01BA01 METHOTREXATUM NAMAXIR 25 mg SOL INJ. IN SERINGA PREUMPLUTA 25mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,63 ML SOL. INJ. PR 4 66,270000 66,270000 0,000000
58 L01BA01 METHOTREXATUM NAMAXIR 7,5 mg SOL INJ. IN SERINGA PREUMPLUTA 7,5mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 4 SERINGI PREUMPLUTE DIN STICLA INCOLORA, PREVAZUTE CU AC PT. INJECTIE SI TAMPON CU ALCOOL A 0,30 ML SOL. INJ. PR 4 29,767500 29,767500 0,000000

Pagina 1 din 4
 Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
19 L04AA13 LEFLUNOMIDUM** LEFLON 10 mg COMPR. FILM. 10mg NEOLA PHARMA SRL ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 30 COMPR. PR 30 1,899666 1,899666 0,000000

24. BOLI VENERICE (SIFILIS, GONOREE, INFECTIA CU CHLAMIDIA) - G 3

SE ELIMINA

30 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PVC-ACLAR/AL X 6 COMPR. FILM. P-RF 6 3,291666 3,291666 0,000000
31 J01FA10 AZITHROMYCINUM AZITROMICINA TERAPIA 250 mg COMPR. FILM. 250mg TERAPIA SA ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 6 COMPR. FILM. P-RF 6 3,291666 3,291666 0,000000

IMUNOSUPRESOARE SELECTIVE - G31

Pagina 2 din 4
 Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

Prescriptie
cant. (pt. asiguratii care beneficiaza de
UT/ Pret de beneficiaza de compensare 100%
TARA ambal referinta / UT compensare 100% din din pretul de
NR.CRT COD ATC DCI Denumire Comerciala forma farm. concentratie DETINATOR APP DET. APP AMBALAJ aj (RON) pretul de referinta) referinta)
26. POLIARTITRITA REUMATOIDA - G31b

SE MODIFICA

9 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
10 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000

SE ELIMINA

25 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
26 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000

27. ARTROPATIA PSORIAZICA - G31c

SE MODIFICA

4 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000

SE ELIMINA

13 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
14 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000

28. SPONDILITA ANKILOZANTA - G 31d

SE MODIFICA

4 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000

SE ELIMINA

14 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
15 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000

Pagina 3 din 4
 Val. maxima suportata de Co-plata maxima a
sistemul de asigurari asiguratului / UT (pt.
sociale de sanatate / UT asiguratii care

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

29. ARTRITA JUVENILA - G 31e

SE MODIFICA

5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
6 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000

SE ELIMINA

14 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
15 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000

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

SE MODIFICA

4 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. (INSERINGA PREUMPLUTA) 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 SERINGI PREUMPLUTE X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000
5 L04AB01 ETANERCEPTUM**** ENBREL 50mg SOL. INJ. IN STILOU INJECTOR PREUMPLUT 50mg PFIZER LIMITED MAREA BRITANIE CUTIE X 4 STILOURI INJECTOARE PREUMPLUTE (PEN) X 4 TAMPOANE CU ALCOOL P-RF/R 4 975,780000 975,780000 0,000000

SE ELIMINA

11 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL INJ. IN SERINGA PREUMPLUTA 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 SERINGI PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000
12 L04AB01 ETANERCEPTUM**** BENEPALI 50 mg SOL. INJ. IN STILOU INJECTOR (PEN) PREUMPLUT 50mg SAMSUNG BIOEPIS UK LIMITED MAREA BRITANIE CUTIE CU 4 STILOURI INJECTOARE (PEN) PREUMPLUTE A CATE 50 MG PR 4 784,165000 784,165000 0,000000

Pagina 4 din 4
 Anexa 9 (Anexa 2d la Ordinul CNAS 944/2015)

SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% DIN PREȚUL DE REFERINȚ Ă - 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 NOIEMBRIE 201

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%
cod Tara det. amba referinta / UT compensare 100% din din pretul de
Nr. crt ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)

SE ADAUGA

212 J02AC03 VORICONAZOLUM** VORICONAZOL DR. REDDY'S 200 mg COMPR. FILM. 200mg DR. REDDY'S LABORATORIES ROMANIA CUTIE CU BLIST. PVC/AL X 28 COMPR. FILM. PRF 28 86,687142 86,687142 0,000000

Pagina 1 din 1
 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 01 NOIEMBRIE 2016

Val. maxima suportata

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

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

SE ADAUGA

120 N06BX03 PIRACETAMUM PIRACETAM FARMEX 400 mg COMPR. 400mg FARMEX COMPANY SRLROMANIA CUTIE X 4 BLIST. AL/PVC X 10 COMPR. P-6L 40 0,099824 0,011176 0,019964 0,091036

SE MODIFICA

101 N06BX03 PIRACETAMUM PIRACETAM ARENA 400 mg CAPS. 400mg ARENA GROUP SA ROMANIA CUTIE X 3 BLIST. AL/PVC X 10 CAPS. P-6L 30 0,099824 0,265842 0,019964 0,345702
102 N06BX03 PIRACETAMUM PIRACETAM SLAVIA 400 mg COMPR. 400mg SLAVIA PHARM SRL ROMANIA CUTIE X 4 BLIST. DIN PVC/AL X 10 COMPR. P-6L 40 0,099824 0,019176 0,019964 0,099036
103 N06BX03 PIRACETAMUM PIRACETAM MCC 400mg COMPR. 400mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,099824 0,061176 0,019964 0,141036
104 N06BX03 PIRACETAMUM PIRACETAM SINTOFARM 400 mg COMPR. 400mg SINTOFARM SA ROMANIA CUTIE X 2 BLIST. PVC/AL X 10 COMPR. P-6L 20 0,099824 0,072676 0,019964 0,152536
105 N06BX03 PIRACETAMUM PIRACETAM SINTOFARM 400 mg COMPR. 400mg SINTOFARM SA ROMANIA CUTIE X 4 BLIST. PVC/AL X 10 COMPR. P-6L 40 0,099824 0,061676 0,019964 0,141536
106 N06BX03 PIRACETAMUM PIRACETAM LAROPHARM 400 mgCOMPR. 400mg LAROPHARM SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0,099824 0,212176 0,019964 0,292036
108 N06BX03 PIRACETAMUM NOOTROPIL 1200 mg COMPR. FILM. 1200mg U.C.B. PHARMA S.A. BELGIA CUTIE CU 10 BLIST. PVC/AL X 10 COMPR. FILM. P6L 100 0,299475 0,106725 0,059895 0,346305
109 N06BX03 PIRACETAMUM LUCETAM COMPR. FILM. 400mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 60 COMPR.FILM. P-6L 60 0,099824 0,021842 0,019964 0,101702
110 N06BX03 PIRACETAMUM PIRACETAM HELCOR 400mg COMPR. FILM. 400mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. FILM. P-6L 20 0,099824 0,022676 0,019964 0,102536
111 N06BX03 PIRACETAMUM PIRACETAM-RICHTER 400 mg COMPR. FILM. 400mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. FILM.P6L 20 0,099824 0,082176 0,019964 0,162036
112 N06BX03 PIRACETAMUM LUCETAM COMPR. FILM. 800mg EGIS PHARMACEUTICALS P.L.C. UNGARIA CUTIE X 1 FLAC. DIN STICLA BRUNA X 30 COMPR.FILM. P-6L 30 0,199650 0,021683 0,039930 0,181403
113 N06BX03 PIRACETAMUM NOOTROPIL 800 mg COMPR. FILM. 800mg U.C.B. PHARMA S.A. BELGIA CUTIE CU 6 BLIST. PVC/AL X 15 COMPR. FILM.P6L 90 0,199650 0,140905 0,039930 0,300625
114 N06BX03 PIRACETAMUM PIRACETAM HELCOR 800mg COMPR. FILM. 800mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR.FILM. P-6L 20 0,199650 0,021350 0,039930 0,181070
115 N06BX03 PIRACETAMUM PIRACETAM-RICHTER 800 mg COMPR. FILM. 800mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. FILM.P6L 20 0,199650 0,021350 0,039930 0,181070

Pagina 1 din 1