ANEXA 6

(ANEXA 2a la Ordinul CNAS nr. 116/2022)

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, REPUBLICATA, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILA INCEPAND CU 01 IUNIE 2022

Contributie maxima Val. maxima suportata de Contributie maxima

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

Prescriptie
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Cod_CIM

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

Nr crt.

tara det. amba referinta / UT din pretul de compensare 90% din pretul din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) de referinta) referinta)

SE ADAUGA

1,014 W60679002 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 40 mg PULB. PT. SOL. PERF. 40mg ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 6 ML CU PULB. PT. SOL. PERF. PR/PRF 1 16.713000 1.857000 15.041700 3.528300
1,015 W68661001 A09AA02 PANCREATINUM ** PANKREAL 35000 CAPS. GASTROREZ. 420mg VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU 1 FLAC. DIN PEID INCHIS CU CAPAC DIN PP X 50 CAPS. GASTROREZ. P6L 50 2.646600 0.000000 2.381940 0.264660
1,016 W68245001 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. P6L 28 0.171000 0.122928 0.153900 0.140028
1,017 W68246001 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. P6L 28 0.342000 0.146214 0.307800 0.180414
1,018 W68244001 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. P6L 28 0.085500 0.139142 0.076950 0.147692

SE MODIFICA

26 W60679001 A02BC01 OMEPRAZOLUM OMEPRAZOL ZENTIVA 40 mg PULB. PT. SOL. PERF. 40mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 FLAC. DIN STICLA INCOLORA CU CAPACITATEA DE 10 ML CU PULB. PT. SOL. PERF. PR/PRF 1 16.713000 1.857000 15.041700 3.528300
96 W53697001 C01EA01 ALPROSTADILUM ** PRIDAX 20mcg CONC. PT. SOL. PERF. 20mcg GEBRO PHARMA GMBH AUSTRIA CUTIE CU 5 FIOLE PREVAZUTE CU PUNCT DE RUPERE X 1 ML CONC. PT. SOL. PERF. PR/PRF 5 52.041500 0.312500 46.837350 5.516650
97 W66688003 C01EA01 ALPROSTADILUM ** ALPROSTADIL ROMPHARM 20 micrograme PULB. PT. SOL. PERF. 20micrograme ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 15 FLAC. DE STICLA DE TIP I PR/PRF 15 51.104000 0.000000 45.993600 5.110400
98 W58530002 C01EA01 ALPROSTADILUM ** VASAPROSTAN 20 µg/ml PULB. PT. SOL. PERF. 20µg/ml UCB PHARMA GMBH GERMANIA CUTIE CU 15 FIOLE DIN STICLA INCOLORA CU PUNCT DE RUPERE, CU CAPACITATE DE 5 ML, CONTINÂND 48,2 MG PULB. PT. SOL. PERF. PRF 15 52.041500 10.029833 46.837350 15.233983
99 W67213002 C01EA01 ALPROSTADILUM ** VASAPROSTAN 20 µg/ml PULB. PT. SOL. PERF. 20µg/ml AMDIPHARM LIMITED IRLANDA CUTIE CU 15 FIOLE DIN STICLA INCOLORA,DE TIP I, CU PUNCT DE RUPERE, CU CAPACITATE DE 5 ML, CONTINÂND 48,2 MG PULB. PT. SOL. PERF. PRF 15 52.041500 10.029833 46.837350 15.233983
743 W42896001 M01AE03 KETOPROFENUM KETONAL DUO 150 mg CAPS. ELIB. PREL. 150mg SANDOZ S.R.L. ROMANIA CUTIE X 2 BLIST. AL/PVC-TE-PVDC X 10 CAPS. ELIB. PREL. P-6L 20 0.784349 0.076151 0.705914 0.154586
744 W03880001 M01AE03 KETOPROFENUM KETONAL RETARD 150 mg COMPR. ELIB. PREL. 150mg LEK PHARMACEUTICALS D.D. SLOVENIA CUTIE X 1 FLAC. X 20 COMPR. CU ELIB. PREL. P-6L 20 0.784349 0.150151 0.705914 0.228586
747 W43111001 M01AE03 KETOPROFENUM KETOPROXIN 50 mg COMPR. FILM. 50mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. PVC/ALX 10 COMPR. FILM. P-6L 20 0.261449 0.132051 0.235304 0.158196
756 W12691002 N02AX02 TRAMADOLUM TRAMADOL 50 mg CAPS. 50mg KRKA D.D. SLOVENIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.372206 0.024794 0.334985 0.062015
757 W52049001 N02AX02 TRAMADOLUM TRAMADOL ARENA 50 mg CAPS. 50mg ARENA GROUP S.A. ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 CAPS. P-RF 20 0.372206 0.143294 0.334985 0.180515
758 W60291001 N02AX02 TRAMADOLUM TRAMACALM 50 mg CAPS. 50mg A.C. HELCOR PHARMA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 0.372206 0.143794 0.334985 0.181015
759 W42440001 N02AX02 TRAMADOLUM TRAMAG 50 mg COMPR. 50mg MAGISTRA C & C ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.372206 0.143294 0.334985 0.180515
760 W42957001 N02AX02 TRAMADOLUM CLORHIDRAT DE TRAMADOL BIOEEL 50 mg COMPR. 50mg BIO EEL SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.372206 0.143294 0.334985 0.180515
761 W68093001 N02AX02 TRAMADOLUM CLORHIDRAT DE TRAMADOL BIOEEL 50 mg COMPR. 50mg BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 2 BLIST. PVC/AL X 10 COMPR. PRF 20 0.372206 0.143294 0.334985 0.180515
764 W61449001 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLIST. DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1.116625 0.011375 1.004962 0.123038
766 W61449011 N02AX02 TRAMADOLUM MABRON RETARD 150 mg COMPR. ELIB. PREL. 150mg MEDOCHEMIE LTD. CIPRU CUTIE CU 1 BLISTER DIN PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 10 1.116625 0.011375 1.004962 0.123038
767 W63389001 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 10 COMPR.FILM. CU ELIB. PREL. P-RF 10 1.116625 0.148375 1.004962 0.260038
768 W63389002 N02AX02 TRAMADOLUM TRAMAL RETARD 150 mg COMPR. ELIB. PREL. 150mg STADA ARZNEIMITTEL AG GERMANIA CUTIE CU 1 BLIST. PP/AL X 10 COMPR. ELIB. PREL. P-RF 10 1.116625 0.148375 1.004962 0.260038
771 W43360001 N02AX02 TRAMADOLUM TRAMADOL RETARD 150 mg COMPR. FILM. ELIB. PREL. 150mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR. FILM. ELIB. PREL. P-RF 30 1.116625 0.036375 1.004962 0.148038
772 W43361001 N02AX02 TRAMADOLUM TRAMADOL RETARD 200 mg COMPR. FILM. ELIB. PREL. 200mg KRKA D.D. NOVO MESTO SLOVENIA CUTIE X 3 BLIST. AL/PVC X 10 COMPR., FILM. ELIB. PREL. P-RF 30 1.488831 0.048169 1.339947 0.197053

SE ELIMINA

769 W58894002 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1.166000 0.000000 1.049400 0.116600

Pagina 1 din 1
 ANEXA 7
(ANEXA 2b la Ordinul CNAS nr. 116/2022)
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, REPUBLICATA, CU MODIFICARILE SI COMPLETARILE ULTERIOARE, VALABILA INCEPAND CU 01 IUNIE 2022

Contributie maxima a Val. maxima suportata Val. maxima suportata

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

Prescriptie
cant. beneficiaza de (pt. asiguratii care asiguratii care (pt. asiguratii care asiguratii care
Cod_CIM

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

Nr crt.

Tara det. amba referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)

SE ADAUGA

1,219 W68118006 C10AX09 EZETIMIBUM EZETROL 10 mg COMPR. 10mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 2 BLIST. DIN POLICLOROTRIFLUOROETILENA/PVC/AL X 14 COMPR. PRF 28 1.234416 0.691655 0.617208 1.308863 1.110974 0.815097
1,220 W68673002 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** TWICOR 10 mg/10 mg COMPR. FILM. 10mg/10mg VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 2.319666 0.556334 1.159833 1.716167 2.087699 0.788301
1,221 W68672002 C10BA06 COMBINATII (ROSUVASTATINUM+EZETIMIBUM) ** TWICOR 20 mg/10 mg COMPR. FILM. 20mg/10mg VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. FILM. P6L 30 2.319666 0.729334 1.159833 1.889167 2.087699 0.961301
1,222 W68214001 G03CX01 TIBOLONUM ** LIVIAL 2,5 mg COMPR. 2,5mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 28 COMPR. PRF 28 1.750357 0.000000 0.875178 0.875179 1.575321 0.175036
1,223 W68114001 G03DC03 LYNESTRENOLUM * ORGAMETRIL 5 mg COMPR. 5mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE X 1 BLIST. AL/PVC-PVDC X 30 COMPR. P6L 30 0.348333 0.000000 0.174166 0.174167 0.313499 0.034834
1,224 W68250001 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 7 2.601332 0.667239 1.300666 1.967905 2.341198 0.927373
1,225 W68250003 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 2.601332 0.562953 1.300666 1.863619 2.341198 0.823087
1,226 W68247003 M01AH05 ETORICOXIBUM ARCOXIA 30 mg COMPR. FILM. 30mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 2 BLIST. DIN PA-AL-PVC/AL X 14 COMPRIMATE FILMATE PRF 28 0.650333 0.273238 0.325166 0.598405 0.585299 0.338272
1,227 W68248002 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 1.300666 0.546476 0.650333 1.196809 1.170599 0.676543
1,228 W68248003 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 1.300666 0.546476 0.650333 1.196809 1.170599 0.676543
1,229 W68249002 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 1.950999 0.569715 0.975499 1.545215 1.755899 0.764815
1,230 W68249003 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 1.950999 0.569715 0.975499 1.545215 1.755899 0.764815
1,231 W68213002 M05BA04 ACIDUM ALENDRONICUM * FOSAMAX 70 mg COMPR. 70mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 1 BLIST. AL/AL X 4 COMPR. P6L 4 5.170200 6.467300 2.585100 9.052400 4.653180 6.984320
1,232 W68213004 M05BA04 ACIDUM ALENDRONICUM * FOSAMAX 70 mg COMPR. 70mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L 2 5.170200 7.104800 2.585100 9.689900 4.653180 7.621820
1,233 W68647004 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. ORODISPERSABILE 24mg VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ORODISPERSABILE P6L 60 0.518216 0.434617 0.259108 0.693725 0.466394 0.486439
1,234 W68695003 R01AD58 COMBINATII (AZELASTINUM+FLUTICASONUM) ** DYMISTA 137 micrograme/50 micrograme/doza SPRAY NAZ.,SUSP. 137micrograme/50micrograme/doz VIATRIS HEALTHCARE LIMITED IRLANDA CUT IE CU 1 FLAC. DIN ST ICLA BRUNA, DE CAPACIT AT E 25 ML, A 23 G SPRAY NAZAL, SUSP. (CEL PUT IN 120 DOZE ELIBERAT E), PREVAZUT CU POMPA DE PULVERIZARE + APLICAT OR NAZAL DIN PP PRF 1 88.380000 0.000000 44.190000 44.190000 79.542000 8.838000
1,235 W68218002 R03DC03 MONTELUKASTUM * SINGULAIR 10 mg COMPR. FILM. 10mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P6L 28 0.873000 1.600571 0.436500 2.037071 0.785700 1.687871
1,236 W68298005 R03DC03 MONTELUKASTUM * SINGULAIR 4 mg COMPR. MAST. 4mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0.689517 1.784054 0.344758 2.128813 0.620565 1.853006
1,237 W68217002 R03DC03 MONTELUKASTUM * SINGULAIR 5 mg COMPR. MAST. 5mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P6L 28 0.861897 1.611674 0.430948 2.042623 0.775707 1.697864
1,238 W68297003 R03DC03 MONTELUKASTUM * SINGULAIR 4 mg GRANULE 4mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 28 PLICURI DIN PE/AL/POLIESTER CU GRANULE P6L 28 0.689517 1.871197 0.344758 2.215956 0.620565 1.940149

SE MODIFICA

184 W59480001 C09AA04 PERINDOPRILUM PERINDOPRIL TOSILAT TEVA 10 mg COMPR. FILM. 10mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L 30 0.852666 0.000000 0.426333 0.426333 0.767399 0.085267
186 W59479001 C09AA04 PERINDOPRILUM PERINDOPRIL TOSILAT TEVA 5 mg COMPR. FILM. 5mg TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU 1 FLAC. PP X 30 COMPR. FILM. P6L 30 0.427500 0.281166 0.213750 0.494916 0.384750 0.323916
476 W51918006 C10AX09 EZETIMIBUM EZETROL 10 mg COMPR. 10mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PCTFE/PVC/AL X 14 COMPR. P-RF 28 1.234416 0.691655 0.617208 1.308863 1.110974 0.815097
477 W60949001 C10AX09 EZETIMIBUM COLTOWAN 10 mg COMPR. 10mg GEDEON RICHTER ROMANIA SA ROMANIA CUTIE CU BLIST. PVC-PE-PVDC-PE-PVC/AL X 30 COMPR. PRF 30 1.234416 0.665917 0.617208 1.283125 1.110974 0.789359
478 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 1.234416 0.329250 0.617208 0.946458 1.110974 0.452692
761 W06864001 M01AE17 DEXKETOPROFENUM TADOR 25 mg COMPR. FILM. 25mg BERLIN CHEMIE AG (MENARINI GROUP) GERMANIA CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 10 0.522898 0.414102 0.261449 0.675551 0.470608 0.466392
762 W67023001 M01AE17 DEXKETOPROFENUM TADOR 25 mg COMPR. FILM. 25mg MENARINI INTERNATIONAL OPERATIONS LUXEMBOURG S.A. LUXEMBURG CUTIE X 1 BLIST. PVC/AL X 10 COMPR. FILM. P-6L 10 0.522898 0.414102 0.261449 0.675551 0.470608 0.466392
763 W67369002 M01AE17 DEXKETOPROFENUM DEKENOR 25 mg COMPR. FILM. 25mg KRKA D.D, NOVO MESTO SLOVENIA CUTIE CU BLISTERE DIN PVC-PVDC-FILM ALB PVC/HÂRTIE-FOLIE AL CU 20X1 COMPRIMATE FILMATE P6L 20 0.522898 0.259102 0.261449 0.520551 0.470608 0.311392
772 W08360006 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL X 10 CAPS. P-RF 30 0.650333 0.431333 0.325166 0.756500 0.585299 0.496367
777 W65173006 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg PFIZER EUROPE MA EEIG BELGIA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. PRF 30 0.650333 0.431333 0.325166 0.756500 0.585299 0.496367
778 W67264006 M01AH01 CELECOXIBUM CELEBREX 100 mg CAPS. 100mg UPJOHN EESV OLANDA CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. PRF 30 0.650333 0.431333 0.325166 0.756500 0.585299 0.496367
783 W60597003 M01AH01 CELECOXIBUM CELECOXIB ACTAVIS 200 mg CAPS. 200mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1.300666 0.000000 0.650333 0.650333 1.170599 0.130067
1,216 W68399003 M01AH01 CELECOXIBUM CELECOXIB TEVA 200 mg CAPS. 200mg TEVA B.V. OLANDA CUTIE CU BLIST. PVC/AL X 30 CAPS. PRF 30 1.300666 0.000000 0.650333 0.650333 1.170599 0.130067
779 W08361006 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 3 BLIST. PVC/AL X 10 CAPS. P-RF 30 1.300666 0.043000 0.650333 0.693333 1.170599 0.173067
780 W08361004 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG MAREA BRITANIE CUTIE X 1 BLIST. PVC/AL X 10 CAPS. P-RF 10 1.300666 0.089334 0.650333 0.739667 1.170599 0.219401
781 W60459003 M01AH01 CELECOXIBUM ALGOXIB 200 mg CAPS. 200mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. PVC-PVDC/AL X 30 CAPS. PRF 30 1.300666 0.000000 0.650333 0.650333 1.170599 0.130067
782 W60520003 M01AH01 CELECOXIBUM ACLEXA 200 mg CAPS. 200mg CUTIE CU BLIST. PVC/AL X 30 CAPS.
KRKA, D.D., NOVO MESTO SLOVENIA PRF 30 1.299666 0.000000 0.649833 0.649833 1.169699 0.129967
784 W61089003 M01AH01 CELECOXIBUM CELECOXIB TERAPIA 200 mg CAPS. 200mg TERAPIA SA ROMANIA CUTIE CU BLIST. PVC/ACLAR-AL X 30 CAPS. PRF 30 1.300666 0.000000 0.650333 0.650333 1.170599 0.130067
785 W65174004 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG BELGIA
CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 1.300666 0.089334 0.650333 0.739667 1.170599 0.219401
786 W65174006 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg PFIZER EUROPE MA EEIG BELGIA
CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. PRF 30 1.300666 0.043000 0.650333 0.693333 1.170599 0.173067
787 W67265004 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg UPJOHN EESV OLANDA
CUTIE CU 1 BLIST. PVC/AL X 10 CAPS. PRF 10 1.300666 0.089334 0.650333 0.739667 1.170599 0.219401
788 W67265006 M01AH01 CELECOXIBUM CELEBREX 200 mg CAPS. 200mg UPJOHN EESV OLANDA
CUTIE CU 3 BLIST. PVC/AL X 10 CAPS. PRF 30 1.300666 0.043000 0.650333 0.693333 1.170599 0.173067
789 W51225001 M01AH05 ETORICOXIBUM ARCOXIA 120 mg COMPR. FILM. 120mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 7 2.601332 0.667239 1.300666 1.967905 2.341198 0.927373
791 W62615001 M01AH05 ETORICOXIBUM IMESOL 120 mg COMPR. FILM. 120mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 7 COMPR. FILM. PRF 7 2.601332 0.634382 1.300666 1.935048 2.341198 0.894516
792 W62615002 M01AH05 ETORICOXIBUM IMESOL 120 mg COMPR. FILM. 120mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORAT UNIDOZA AL/AL X 7X1 COMPR. FILM. PRF 7 2.601332 0.634382 1.300666 1.935048 2.341198 0.894516
796 W63049001 M01AH05 ETORICOXIBUM COXIENT 120 mg COMPR. FILM. 120mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 2.601332 0.667239 1.300666 1.967905 2.341198 0.927373
801 W62612001 M01AH05 ETORICOXIBUM IMESOL 30 mg COMPR. FILM. 30mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 28 COMPR. FILM. PRF 28 0.650333 1.035738 0.325166 1.360905 0.585299 1.100772
802 W62612002 M01AH05 ETORICOXIBUM IMESOL 30 mg COMPR. FILM. 30mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORAT UNIDOZA AL/AL X 28X1 COMPR. FILM. PRF 28 0.650333 1.035738 0.325166 1.360905 0.585299 1.100772
803 W53204005 M01AH05 ETORICOXIBUM ARCOXIA 30 mg COMPR. FILM. 30mg MERCK SHARP & DOHME ROMANIA S.R.L. ROMANIA CUTIE CU 2 BLIST. DIN PA-AL-PVC/AL X 14 COMPRIMATE FILMATE PRF 28 0.650333 0.273238 0.325166 0.598405 0.585299 0.338272
804 W63046003 M01AH05 ETORICOXIBUM COXIENT 30 mg COMPR. FILM. 30mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 0.650333 1.480381 0.325166 1.805548 0.585299 1.545415
805 W63217003 M01AH05 ETORICOXIBUM ROTICOX 30 mg COMPR. FILM. 30mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 0.650333 0.939309 0.325166 1.264476 0.585299 1.004343
806 W63676002 M01AH05 ETORICOXIBUM ETORICOXIB AUROBINDO 30 mg COMPR. FILM. 30mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 0.650333 0.575381 0.325166 0.900548 0.585299 0.640415
807 W63794005 M01AH05 ETORICOXIBUM GEROCOXAN 30 mg COMPR. FILM. 30mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 0.650333 0.912167 0.325166 1.237334 0.585299 0.977201
808 W51227002 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 1.300666 0.546476 0.650333 1.196809 1.170599 0.676543
809 W51227003 M01AH05 ETORICOXIBUM ARCOXIA 60 mg COMPR. FILM. 60mg MERCK SHARP & DOHME ROMANIA CUTIE X 1 BLIST. PA-AL-PVC/AL X 14 COMPR. FILM. P-RF 14 1.300666 0.546476 0.650333 1.196809 1.170599 0.676543
810 W62613001 M01AH05 ETORICOXIBUM IMESOL 60 mg COMPR. FILM. 60mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. PRF 14 1.300666 1.045762 0.650333 1.696095 1.170599 1.175829
811 W62613002 M01AH05 ETORICOXIBUM IMESOL 60 mg COMPR. FILM. 60mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORAT UNIDOZA AL/AL X 14X1 COMPR. FILM. PRF 14 1.300666 1.045762 0.650333 1.696095 1.170599 1.175829
812 W62796001 M01AH05 ETORICOXIBUM DOLOXIB 60 mg COMPR. FILM. 60mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 1.300666 0.546476 0.650333 1.196809 1.170599 0.676543

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

Prescriptie
cant. beneficiaza de (pt. asiguratii care asiguratii care (pt. asiguratii care asiguratii care
Cod_CIM

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

Nr crt.

Tara det. amba referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
813 W62796004 M01AH05 ETORICOXIBUM DOLOXIB 60 mg COMPR. FILM. 60mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 1.300666 0.419334 0.650333 1.069667 1.170599 0.549401
814 W63047002 M01AH05 ETORICOXIBUM COXIENT 60 mg COMPR. FILM. 60mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1.300666 0.417191 0.650333 1.067524 1.170599 0.547258
815 W63218002 M01AH05 ETORICOXIBUM ROTICOX 60 mg COMPR. FILM. 60mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1.300666 0.546476 0.650333 1.196809 1.170599 0.676543
816 W63218004 M01AH05 ETORICOXIBUM ROTICOX 60 mg COMPR. FILM. 60mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 1.300666 0.486476 0.650333 1.136809 1.170599 0.616543
817 W63426004 M01AH05 ETORICOXIBUM KOSTAROX 60 mg COMPR. FILM. 60mg SANDOZ S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. P6L 14 1.300666 0.546476 0.650333 1.196809 1.170599 0.676543
818 W63677002 M01AH05 ETORICOXIBUM ETORICOXIB AUROBINDO 60 mg COMPR. FILM. 60mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1.300666 0.428619 0.650333 1.078952 1.170599 0.558686
819 W63795005 M01AH05 ETORICOXIBUM GEROCOXAN 60 mg COMPR. FILM. 60mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1.300666 0.435762 0.650333 1.086095 1.170599 0.565829
821 W51226002 M01AH05 ETORICOXIBUM ARCOXIA 90 mg COMPR. FILM. 90mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. PA-AL-PVC/AL X 7 COMPR. FILM. P-RF 14 1.950999 0.569715 0.975499 1.545215 1.755899 0.764815
822 W62614001 M01AH05 ETORICOXIBUM IMESOL 90 mg COMPR. FILM. 90mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. AL/AL X 14 COMPR. FILM. PRF 14 1.950999 0.545429 0.975499 1.520929 1.755899 0.740529
823 W62614002 M01AH05 ETORICOXIBUM IMESOL 90 mg COMPR. FILM. 90mg TERAPIA S.A. ROMANIA CUTIE CU BLIST. PERFORAT UNIDOZA AL/AL X 14X1 COMPR. FILM. PRF 14 1.950999 0.545429 0.975499 1.520929 1.755899 0.740529
824 W62797001 M01AH05 ETORICOXIBUM DOLOXIB 90 mg COMPR. FILM. 90mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 7 COMPR. FILM. PRF 7 1.950999 0.233286 0.975499 1.208786 1.755899 0.428386
825 W62797004 M01AH05 ETORICOXIBUM DOLOXIB 90 mg COMPR. FILM. 90mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 1.950999 0.162572 0.975499 1.138072 1.755899 0.357672
826 W63048002 M01AH05 ETORICOXIBUM COXIENT 90 mg COMPR. FILM. 90mg ALVOGEN MALTA OPERATIONS (ROW) LTD. MALTA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1.950999 0.543286 0.975499 1.518786 1.755899 0.738386
827 W63219003 M01AH05 ETORICOXIBUM ROTICOX 90 mg COMPR. FILM. 90mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 14 COMPR. FILM. PRF 14 1.950999 0.139001 0.975499 1.114501 1.755899 0.334101
828 W63219005 M01AH05 ETORICOXIBUM ROTICOX 90 mg COMPR. FILM. 90mg KRKA, D.D., NOVO MESTO SLOVENIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. FILM. PRF 28 1.950999 0.071501 0.975499 1.047001 1.755899 0.266601
835 W60296004 M05BA04 ACIDUM ALENDRONICUM * FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 2 COMPR. P6L 2 5.170200 7.104800 2.585100 9.689900 4.653180 7.621820
836 W60296002 M05BA04 ACIDUM ALENDRONICUM * FOSAMAX 70 mg COMPR. 70mg MERCK SHARP & DOHME ROMANIA CUTIE CU 1 BLIST. AL/AL X 4 COMPR. P6L 4 5.170200 6.467300 2.585100 9.052400 4.653180 6.984320
839 W56763001 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 12 COMPR. FILM. P-6L 12 5.170200 3.800633 2.585100 6.385733 4.653180 4.317653
840 W56763002 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 2 COMPR. FILM. P-6L 2 5.170200 4.589800 2.585100 7.174900 4.653180 5.106820
841 W56763003 M05BA04 ACIDUM ALENDRONICUM * ADRONIK 70 mg COMPR. FILM. 70mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. PVC-PVDC/AL X 4 COMPR. FILM. P-6L 4 5.170200 4.277300 2.585100 6.862400 4.653180 4.794320
843 W61163003 M05BA07 ACIDUM RISEDRONICUM * ACTONEL SAPTAMANAL 35 mg COMPR. FILM. 35mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR. FILM. P-6L 4 5.170200 7.142300 2.585100 9.727400 4.653180 7.659320
845 W66497003 M05BA07 ACIDUM RISEDRONICUM * ACTONEL SAPTAMANAL 35 mg COMPR. FILM. 35mg THERAMEX IRELAND LIMITED IRLANDA CUTIE CU 1 BLIST. PVC/AL X 4 COMPR. FILM. P-6L 4 5.170200 7.142300 2.585100 9.727400 4.653180 7.659320
846 W61164001 M05BA07 ACIDUM RISEDRONICUM * ACTONEL 75 mg COMPR. FILM. 75mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L 2 11.079000 13.556000 5.539500 19.095500 9.971100 14.663900
847 W66214001 M05BA07 ACIDUM RISEDRONICUM * ACTONEL 75 mg COMPR. FILM. 75mg THERAMEX IRELAND LIMITED IRLANDA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L 2 11.079000 13.556000 5.539500 19.095500 9.971100 14.663900
848 W66432001 M05BA07 ACIDUM RISEDRONICUM * RISEDRONAT AUROBINDO 75 mg COMPR. FILM. 75mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU 1 BLIST. PVC/AL X 2 COMPR. FILM. P6L 2 11.079000 3.536000 5.539500 9.075500 9.971100 4.643900
849 W66935003 M05BA07 ACIDUM RISEDRONICUM * ACTONEL 35 mg COMPR. GASTROREZ. 35mg THERAMEX IRELAND LIMITED IRLANDA CUTIE CU BLIST. PVC/AL X 4 COMPR. P6L 4 5.170200 16.159800 2.585100 18.744900 4.653180 16.676820
850 W63914002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL AUROBINDO 70 mg/2800 UI COMPR. 70mg/2800UI AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 5.170200 1.377300 2.585100 3.962400 4.653180 1.894320
851 W63922002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ZENTIVA 70 mg/2800 UI COMPR. 70mg/2800UI ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 5.170200 7.207300 2.585100 9.792400 4.653180 7.724320
852 W64728002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UI MERCK SHARP & DOHME OLANDA CUTIE X 4 COMPR. (1 BLISTER DIN AL/AL X 4 COMPR.) P6L 4 5.170200 3.884800 2.585100 6.469900 4.653180 4.401820
853 W67694002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/2800UI COMPR. 70mg/2800UI N.V. ORGANON OLANDA CUTIE X 4 COMPR. (1 BLISTER DIN AL/AL X 4 COMPR.) P6L 4 5.170200 3.884800 2.585100 6.469900 4.653180 4.401820
854 W62143003 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UI TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR., AMBALAJ TIP CALENDAR P6L 4 5.170200 0.404800 2.585100 2.989900 4.653180 0.921820
855 W62143001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UI TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4 COMPR. P6L 4 5.170200 0.404800 2.585100 2.989900 4.653180 0.921820
856 W62143002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * DA-BONE 70 mg/5600 UI COMPR. 70mg/5600UI TEVA PHARMACEUTICALS S.R.L. ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 4X1 COMPR. P6L 4 5.170200 0.404800 2.585100 2.989900 4.653180 0.921820
857 W63915002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL AUROBINDO 70 mg/5600 UI COMPR. 70mg/5600UI AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 5.170200 1.762300 2.585100 4.347400 4.653180 2.279320
858 W63923002 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ZENTIVA 70 mg/5600 UI COMPR. 70mg/5600UI ZENTIVA, K.S. REPUBLICA CEHA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 5.170200 7.504800 2.585100 10.089900 4.653180 8.021820
859 W64729001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI MERCK SHARP & DOHME OLANDA CUTIE X 2 COMPR. (1 BLISTER DIN AL/AL X 2 COMPR.) P6L 2 5.170200 4.189800 2.585100 6.774900 4.653180 4.706820
860 W65841001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * ACID ALENDRONIC/COLECALCIFEROL ACCORD 70 mg/5600 UI COMPR. 70mg/5600UI ACCORD HEALTHCARE POLSKA SP. Z O.O. POLONIA CUTIE CU BLIST. PA-AL-PVC/AL X 4 COMPR. P6L 4 5.170200 7.504800 2.585100 10.089900 4.653180 8.021820
861 W67697001 M05BB03 COMBINATII (ACIDUM ALENDRONICUM+COLECALCIFEROLUM) * FOSAVANCE 70mg/5600UI COMPR. 70mg/5600UI N.V. ORGANON OLANDA CUTIE X 2 COMPR. (1 BLISTER DIN AL/AL X 2 COMPR.) P6L 2 5.170200 4.189800 2.585100 6.774900 4.653180 4.706820
1,029 W57876003 N07CA01 BETAHISTINUM VERTIMED 16 mg COMPR. 16mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 30 COMPR. P6L 30 0.345477 0.054189 0.172738 0.226928 0.310929 0.088737
1,030 W56369001 N07CA01 BETAHISTINUM BETAHISTINA LPH 16 mg COMPR. 16mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 30 0.345477 0.297189 0.172738 0.469928 0.310929 0.331737
1,031 W66442004 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 16 mg COMPR. 16mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 60 COMPR. P6L 60 0.345477 0.048023 0.172738 0.220762 0.310929 0.082571
1,033 W57312003 N07CA01 BETAHISTINUM BETAHISTINA LPH 24 mg COMPR. 24 mg LABORMED PHARMA SA ROMANIA CUTIE CU 6 BLIST. DIN PVC-PVDC/AL X 10 COMPR. P-6L 60 0.518216 0.007284 0.259108 0.266392 0.466394 0.059106
1,035 W55890001 N07CA01 BETAHISTINUM BETAHISTINA MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 2 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 20 0.518216 0.007284 0.259108 0.266392 0.466394 0.059106
1,036 W55890002 N07CA01 BETAHISTINUM BETAHISTINA MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 5 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 50 0.518216 0.007184 0.259108 0.266292 0.466394 0.059006
1,039 W55890003 N07CA01 BETAHISTINUM BETAHISTINA MCC 24 mg COMPR. 24mg MAGISTRA C&C SRL ROMANIA CUTIE CU 6 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 60 0.518216 0.007284 0.259108 0.266392 0.466394 0.059106
1,040 W61967003 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. 24mg BGP PRODUCTS B.V. OLANDA CUTIE CU 3 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 60 0.518216 0.314284 0.259108 0.573392 0.466394 0.366106
1,041 W61967001 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. 24mg BGP PRODUCTS B.V. OLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 0.518216 0.340784 0.259108 0.599892 0.466394 0.392606
1,044 W64556001 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. 24mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 1 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 20 0.518216 0.340784 0.259108 0.599892 0.466394 0.392606
1,045 W64556003 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. 24mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 3 BLIST. PVC-PVDC/AL X 20 COMPR. P6L 60 0.518216 0.314284 0.259108 0.573392 0.466394 0.366106
1,047 W55889001 N07CA01 BETAHISTINUM BETAHISTINA MCC 8 mg COMPR. 8mg MAGISTRA C&C SRL ROMANIA CUTIE CU 3 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 30 0.172738 0.023928 0.086369 0.110297 0.155464 0.041202
1,048 W55889002 N07CA01 BETAHISTINUM BETAHISTINA MCC 8 mg COMPR. 8mg MAGISTRA C&C SRL ROMANIA CUTIE CU 10 BLIST. PVC-PVDC-TE TRANSPARENT/AL X 10 COMPR. P-6L 100 0.172738 0.024062 0.086369 0.110431 0.155464 0.041336
1,049 W57875009 N07CA01 BETAHISTINUM VERTIMED 8 mg COMPR. 8mg MEDOCHEMIE LTD. CIPRU CUTIE CU BLIST. PVC/PE/PVDC-AL X 100 COMPR. P6L 100 0.172738 0.024062 0.086369 0.110431 0.155464 0.041336
1,050 W56368004 N07CA01 BETAHISTINUM BETAHISTINA LPH 8 mg COMPR. 8mg LABORMED PHARMA S.A. ROMANIA CUTIE CU 9 BLIST. PVC-PVDC/AL X 10 COMPR. P-6L 90 0.172738 0.023928 0.086369 0.110297 0.155464 0.041202
1,051 W62009002 N07CA01 BETAHISTINUM BETASERC 8 mg COMPR. 8mg BGP PRODUCTS B.V. OLANDA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR. P-6L 100 0.172738 0.080562 0.086369 0.166931 0.155464 0.097836
1,052 W64555002 N07CA01 BETAHISTINUM BETASERC 8 mg COMPR. 8mg MYLAN HEALTHCARE B.V. OLANDA CUTIE CU 4 BLIST. PVC-PVDC/AL X 25 COMPR. P6L 100 0.172738 0.080562 0.086369 0.166931 0.155464 0.097836
1,053 W66441006 N07CA01 BETAHISTINUM BETAHISTINA DICLORHIDRAT AUROBINDO 8 mg COMPR. 8mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PA-AL-PVC/AL X 100 COMPR. P6L 100 0.172738 0.024062 0.086369 0.110431 0.155464 0.041336
1,054 W62326004 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. ORODISPERSABILE 24mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ORODISPERSABILE P6L 60 0.518216 0.434617 0.259108 0.693725 0.466394 0.486439
1,055 W66245004 N07CA01 BETAHISTINUM BETASERC 24 mg COMPR. ORODISPERSABILE 24mg MYLAN IRE HEALTHCARE LIMITED IRLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 60 COMPR. ORODISPERSABILE P6L 60 0.518216 0.434617 0.259108 0.693725 0.466394 0.486439
1,130 W56567005 R03DC03 MONTELUKASTUM * MONTELUKAST ACTAVIS 4 mg COMPR. MAST. 4mg ACTAVIS GROUP PTC EHF. ISLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. MAST. P6L 30 0.689517 0.130149 0.344758 0.474908 0.620565 0.199101
1,132 W58990005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 4 mg COMPR. MAST. 4mg AUROBINDO PHARMA (MALTA) LIMITED MALTA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0.689517 0.080840 0.344758 0.425599 0.620565 0.149792
1,133 W58747005 R03DC03 MONTELUKASTUM * SINGULAIR 4 mg COMPR. MAST. 4mg MERCK SHARP & DOHME ROMANIA CUTIE CU BLIST. OPA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0.689517 1.784054 0.344758 2.128813 0.620565 1.853006
1,134 W66475005 R03DC03 MONTELUKASTUM * MONTELUKAST AUROBINDO 4 mg COMPR. MAST. 4mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PA-AL-PVC/AL X 28 COMPR. MAST. P6L 28 0.689517 0.080840 0.344758 0.425599 0.620565 0.149792
1,135 W67728005 R03DC03 MONTELUKASTUM * MONTELUKAST TEVA 4 mg COMPR. MAST. 4mg TEVA B.V. OLANDA CUTIE CU BLIST. OPA-AL-PVC/AL X 30 COMPR. MAST. P6L 30 0.689517 0.130149 0.344758 0.474908 0.620565 0.199101
1,136 W51361004 R03DC03 MONTELUKASTUM * SINGULAIR 5 mg COMPR. MAST. 5mg MERCK SHARP & DOHME ROMANIA CUTIE X 2 BLIST. OPA-AL-PVC/AL X 14 COMPR. MAST. P6L 28 0.861897 1.611674 0.430948 2.042623 0.775707 1.697864
1,140 W58090003 R03DC03 MONTELUKASTUM * SINGULAIR 4 mg GRANULE 4mg MERCK SHARP & DOHME ROMANIA CUTIE CU 28 PLICURI DIN PE/AL/POLIESTER CU GRANULE P6L 28 0.689517 1.871197 0.344758 2.215956 0.620565 1.940149

SE ELIMINA

188 W62353001 C09AA10 TRANDOLAPRILUM GOPTEN 0,5 mg CAPS. 0,5mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 10 CAPS. P-6L 20 0.085500 0.149500 0.042750 0.192250 0.076950 0.158050
190 W62355001 C09AA10 TRANDOLAPRILUM GOPTEN 2 mg CAPS. 2mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0.342000 0.073000 0.171000 0.244000 0.307800 0.107200
192 W62357001 C09AA10 TRANDOLAPRILUM GOPTEN 4 mg CAPS. 4mg MYLAN HEALTHCARE GMBH GERMANIA CUTIE X 2 BLIST. X 14 CAPS. P-6L 28 0.684000 0.095285 0.342000 0.437285 0.615600 0.163685

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

Prescriptie
cant. beneficiaza de (pt. asiguratii care asiguratii care (pt. asiguratii care asiguratii care
Cod_CIM

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

Nr crt.

Tara det. amba referinta / UT din pretul de compensare 50% din compensare 50% din compensare 90% din compensare 90% din
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) pretul de referinta) pretul de referinta) pretul de referinta) pretul de referinta)
959 W60802001 N04BC05 PRAMIPEXOLUM * CALMOLAN 0,26 mg COMPR. ELIB. PREL. 0,26mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 10 COMPR. ELIB. PREL. PRF 10 0.315565 0.387435 0.157782 0.545218 0.284008 0.418992
967 W60805002 N04BC05 PRAMIPEXOLUM * CALMOLAN 2,1 mg COMPR. ELIB. PREL. 2,1mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF 30 2.548801 1.558532 1.274400 2.832933 2.293920 1.813413

Pagina 3 din 3
 ANEXA 8
(ANEXA 2c la Ordinul CNAS nr. 116/2022)
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, REPUBLICATA, 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 IUNIE 2022

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)

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

SE ADAUGA

238 W68245001 C09AA02 ENALAPRILUM RENITEC 10 mg COMPR. 10mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. P6L 28 0.263400 0.263400 0.030528
239 W68246001 C09AA02 ENALAPRILUM RENITEC 20 mg COMPR. 20mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. P6L 28 0.437400 0.437400 0.050814
240 W68244001 C09AA02 ENALAPRILUM RENITEC 5 mg COMPR. 5mg ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 2 BLIST. AL/AL X 14 COMPR. P6L 28 0.121800 0.121800 0.102842

SE MODIFICA

228 W62448001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 24 mg/26 mg COMPR. FILM. 24mg/26mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 28 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 28 11.340714 11.340714 0.000000
229 W64479001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 24 mg/26 mg COMPR. FILM. 24mg/26mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 28 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 28 11.340714 11.340714 0.000000
230 W62449001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 49 mg/51 mg COMPR. FILM. 49mg/51mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 56 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 56 10.470178 10.470178 0.000000
231 W64480001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 49 mg/51 mg COMPR. FILM. 49mg/51mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 56 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 56 10.470178 10.470178 0.000000
232 W62450001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 97 mg/103 mg COMPR. FILM. 97mg/103mg NOVARTIS EUROPHARM LTD. MAREA BRITANIE CUTIE CU 56 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 56 10.469642 10.469642 0.000000
233 W64481001 C09DX04 COMBINATII (SACUBITRILUM+VALSARTANUM) ** Ω ENTRESTO 97 mg/103 mg COMPR. FILM. 97mg/103mg NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 56 COMPR. FILM. (BLIST. PVC/PVDC/AL X 14 COMPR. FILM.) PRF 56 10.469642 10.469642 0.000000

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

SE MODIFICA

130 W61708002 L01XX35 ANAGRELIDUM ** THROMBOREDUCTIN 0,5 mg CAPS. 0,5mg AOP ORPHAN PHARMACEUTICALS AG AUSTRIA CUTIE CU 1 FLAC. DIN PE X 100 CAPS. PRF 100 5.431080 5.431080 0.000020

SE ELIMINA

54 W41532001 B03XA02 DARBEPOETINUM ALFA ** ARANESP 300mcg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R 1 1,867.670000 1,867.670000 0.000000
131 W64277002 L01XX35 ANAGRELIDUM ** ANAGRELIDA ZENTIVA 0,5 mg CAPS. 0,5mg ZENTIVA, K.S. CUTIE CU 1 FLAC. PEID X 100 CAPS.
REPUBLICA CEHA PR 100 5.431080 5.431080 2.358620
191 W58894002 N02AX02 TRAMADOLUM TRADOLAN RETARD 200 mg COMPR. ELIB. PREL. 200mg LANNACHER HEILMITTEL GES.M.B.H. AUSTRIA CUTIE CU 3 BLIST. PVC/AL X 10 COMPR. CU ELIB. PREL. PRF 30 1.166000 1.166000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea oncologie, hematologie, oncologie şi hematologie pediatrică sau pediatrie cu supraspecializarea în hematooncologie pediatrică/oncologie pediatrică sau competenţă în oncopediatrie sau atestat de studii complementare în oncologie şi hematologie pediatrică.

9. EPILEPSIE - G11

SE MODIFICA

30 W08325001 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 50 MINI-PLICURI DIN HARTIE/AL/PE CU MINI-COMPR. CU ELIB. PRELUNG. P-6L 50 1.834200 1.834200 0.000000
77 W57148004 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 750 mg GRANULE ACOPERITE, IN PLIC UNIDOZA 750mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 60 PLICURI UNIDOZA DIN HARTIE/AL/PE CONTINAND GRANULE ACOPERITE PRF 60 2.240833 2.240833 0.000000
78 W57146002 N03AX14 LEVETIRACETAMUM ** LEVETIRACETAM DESITIN 250 mg GRANULE DRAJEFIATE IN PLIC 250mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 30 PLICURI DIN HARTIE/AL/PE CONTINAND GRANULE DRAJEFIATE PRF 30 0.745333 0.745333 0.000000
153 W63827001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 100mg COMPR. FILM. 100mg U.C.B. PHARMA S.A. BELGIA CUTIE CU BLISTERE DIN PVC / PCTFE - AL X 56 COMPRIMATE FILMATE PRF 56 7.805357 7.805357 0.000000
154 W63823001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 10mg COMPR. FILM. 10mg U.C.B. PHARMA S.A. BELGIA CUTIE CU BLISTERE DIN PVC / PCTFE - AL X 14COMPRIMATE FILMATE PRF 14 8.047857 8.047857 0.000000
155 W63824001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 25mg COMPR. FILM. 25mg U.C.B. PHARMA S.A. BELGIA CUTIE CU BLISTERE DIN PVC / PCTFE - AL X 56 COMPRIMATE FILMATE PRF 56 7.661071 7.661071 0.000000
156 W63825001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 50mg COMPR. FILM. 50mg U.C.B. PHARMA S.A. BELGIA CUTIE CU BLISTERE DIN PVC / PCTFE - AL X 56 COMPRIMATE FILMATE PRF 56 7.459821 7.459821 0.000000
157 W63826001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 75mg COMPR. FILM. 75mg U.C.B. PHARMA S.A. BELGIA CUTIE CU BLISTERE DIN PVC / PCTFE - AL X 56 COMPRIMATE FILMATE PRF 56 8.320000 8.320000 0.000000
158 W63829001 N03AX23 BRIVARACETAMUM ** Ω BRIVIACT 10mg/ml SOL. ORALA 10mg/ml U.C.B. PHARMA S.A. BELGIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, 300 ML, PREVAZUT CU SISTEM DE INCHIDERE SECURIZAT PT. COPII (PE) + 1 SERINGA PT. ADMINISTRARE ORALA (PP, PE), GRADATA, A 5 ML SI 10 ML + 1 ADAPTOR PT. SERINGA (PE) PRF 1 442.570000 442.570000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea neurologie şi neurologie pediatrică.

Pagina 1 din 3
 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)

10. BOALA PARKINSON ŞI ALTE AFECŢIUNI NEUROLOGICE - G12

SE ELIMINA

5 W61590003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 100 mg/25 mg/200 mg COMPR. FILM. 100mg/25mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM.
REPUBLICA CEHA PRF 100 1.341840 1.341840 0.162160
9 W61591003 N04BA03 COMBINATII (LEVODOPUM+CARBIDOPUM+ENTACAPONUM) ** TADOGLEN 150 mg/37,5 mg/200 mg COMPR. FILM. 150mg/37,5mg/200 mg GLENMARK PHARMACEUTICALS S.R.O. CUTIE CU 1 FLAC. PEID X 100 COMPR. FILM.
REPUBLICA CEHA PRF 100 1.430000 1.430000 0.000000
41 W60802001 N04BC05 PRAMIPEXOLUM ** CALMOLAN 0,26 mg COMPR. ELIB. PREL. 0,26mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 10 COMPR. ELIB. PREL. PRF 10 0.703000 0.703000 0.000000
49 W60805002 N04BC05 PRAMIPEXOLUM ** CALMOLAN 2,1 mg COMPR. ELIB. PREL. 2,1mg G.L. PHARMA GMBH AUSTRIA CUTIE CU BLIST. AL/OPA-AL-PVC X 30 COMPR. ELIB. PREL. PRF 30 4.107333 4.107333 0.000000

Tratamentul se initiaza de catre medicul in specialitatea neurologie

11. MIASTENIA GRAVIS - G13

SE ADAUGA

8 W68713001 N07AA02 PYRIDOSTIGMINI BROMIDUM MESTINON 60 mg DRAJ. 60mg VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE X 1 FLAC. DIN STICLA BRUNA, PREVAZUTE CU UN CAPAC DIN PEID X 20 DRAJ. PRF 20 0.706500 0.706500 0.000000

Tratamentul se initiaza de catre medicul in specialitatea neurologie

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

8 W08325001 N03AG01 ACIDUM VALPROICUM + SARURI ORFIRIL LONG 1000 mg MINICOMPR. ELIB. PREL. 1000mg DESITIN ARZNEIMITTEL GMBH GERMANIA CUTIE CU 50 MINI-PLICURI DIN HARTIE/AL/PE CU MINI-COMPR. CU ELIB. PRELUNG. P-6L 50 1.834200 1.834200 0.000000

Tratamentul se iniţiază de către medicul în specialitatea psihiatrie şi psihiatrie pediatrică/neuropsihiatrie infantilă.

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

SE MODIFICA

38 W59938005 N06DA03 RIVASTIGMINUM ** EXELON 13,3mg/24h PLASTURE TRANSDERMIC 13,3/24h NOVARTIS EUROPHARM LTD. CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC
MAREA BRITANIE PR 30 6.251000 6.251000 0.000000
39 W64475005 N06DA03 RIVASTIGMINUM ** EXELON 13,3 mg/24h PLASTURE TRANSDERMIC 13,3mg/24h NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 PLICURI X 1 PLASTURE TRANSDERMIC PR 30 6.251000 6.251000 0.000000
40 W64475008 N06DA03 RIVASTIGMINUM ** EXELON 13,3 mg/24h PLASTURE TRANSDERMIC 13,3mg/24h NOVARTIS EUROPHARM LTD. IRLANDA CUTIE X 30 PLICURI DIN HÂRTIE/PET/PE/AL/PA X 1 PLASTURE TRANSDERMIC PR 30 6.251000 6.251000 0.000000

Tratamentul se initiaza de catre medicul in specialitatea psihiatrie, neurologie sau geriatrie

18. BOLI ENDOCRINE ŞI METABOLICE - G 22

SE ADAUGA

84 W68665001 H05AA02 TERIPARATIDUM ** TERIPARATID LABORMED 20 micrograme/80 microlitri SOL INJ. IN STILOU INJECTOR PREUMPLUT 20micrograme/80microlitri LABORMED PHARMA S.A. ROMANIA CUTIE CU 1 CARTUS PREVAZUT CU UN PISTON (CAUCIUC HALOBUTILIC) ASAMBLAT INTR-UN STILOU INJECTOR PREUMPLUT CARE CONTINE 2,4 ML SOL. INJ. PRF 1 882.612000 882.612000 0.008000
85 W68665002 H05AA02 TERIPARATIDUM ** TERIPARATID LABORMED 20 micrograme/80 microlitri SOL INJ. IN STILOU INJECTOR PREUMPLUT 20micrograme/80microlitri LABORMED PHARMA S.A. ROMANIA CUTIE CU 3 CARTUSE PREVAZUTE CU UN PISTON (CAUCIUC HALOBUTILIC) ASAMBLATE INTR-UN STILOU INJECTOR PREUMPLUT CARE CONTINE 2,4 ML SOL. INJ. PRF 3 882.612000 882.612000 0.001333

SE MODIFICA

65 W55488001 H05AA02 TERIPARATIDUM ** FORSTEO 20µg/80µl SOL. INJ. 20micrograme/80microlitri ELI LILLY NEDERLAND BV OLANDA CUTIE X 1 STILOU INJECTOR (PEN) PREUMPLUT X 2,4 ML (28 DOZE X 20 ΜCG/80ΜCL) P-RF 1 882.610000 882.610000 0.000000

Pagina 2 din 3
 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)
20. BOALA CRONICA DE RINICHI - faza predializa - G 25

SE ELIMINA

33 W41532001 B03XA02 DARBEPOETINUM ALFA ** ARANESP 300mcg/0,6ml SOL. INJ. IN SERINGA PREUMPLUTA 300mcg/0,6ml AMGEN EUROPE BV OLANDA CUTIE X 1 SERINGA PREUMPLUTA A 1 ML X 0,6 ML P-RF/R 1 1,867.670000 1,867.670000 0.000000

Tratamentul se initiaza de catre medicul in specialitatea nefrologie.

21. BOLI DEGENERATIVE ALE OCHIULUI (GLAUCOM ŞI BOLI MACULARE) - G 26

SE ADAUGA

52 W68605001 S01ED51 COMBINATII (BIMATOPROSTUM + TIMOLOLUM) VIZIMACO 0,3 mg/ml+5 mg/ml PIC. OFT., SOL. 0,3mg/ml+5mg/ml BAUSCH + LOMB IRELAND LIMITED IRLANDA CUTIE CU 1 FLAC. DIN PEJD, CU CAPACITATEA DE 5 ML, PREVAZUT CU PICURATOR DIN PEID SI SILICON X 3 ML PIC. OFT., SOL. PRF 1 51.440000 51.440000 0.000000

SE MODIFICA

47 W62677001 S01EE05 TAFLUPROSTUM ** Ω SAFLUTAN 15 micrograme/ml PIC. OFT., SOL., FIOLA UNIDOZA 15micrograme/ml SANTEN OY FINLANDA CUTIE CU 3 PUNGI A CATE 10 FIOLE UNIDOZA DIN PEJD X 0,3 ML PIC. OFT., SOL. (30 FIOLE) PRF 30 2.143666 2.143666 0.000000
48 W59598001 S01LA05 AFLIBERCEPTUM ** Ω EYLEA 40mg/ml SOL INJ. 40mg/ml BAYER PHARMA AG GERMANIA PR
CUTIE X 1 FLACON DIN STICLA CU SOLUTIE INJECTABILA (4MG AFIBERCEPT /100 MICROLITRI SOL.) 1 3,075.090000 3,075.090000 0.000000
49 W63881001 S01LA05 AFLIBERCEPTUM ** Ω EYLEA 40mg/ml SOL INJ. 40mg/ml BAYER AG GERMANIA CUTIE X 1 FLACON DIN STICLA CU SOLUTIE INJECTABILA+1 AC CU FILTRU PR 1 3,075.090000 3,075.090000 0.000000
50 W66674001 S01LA06 BROLUCIZUMABUM ** Ω BEOVU 120 mg/ml SOL INJ. IN SERINGA PREUMPLUTA 120mg/ml NOVARTIS EUROPHARM LTD. IRLANDA CUTIE CU 1 SERINGA PREUMPLUTA (0,165 ML SOLUTIE STERILA) PR 1 3,075.090000 3,075.090000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea oftalmologie.

24. BOLI VENERICE (SIFILIS, GONOREE, INFECTIA CU CHLAMIDIA) - G 30

SE ADAUGA

78 W68020002 J01MA02 CIPROFLOXACINUM CIPROFLOXACINA VIOSER 2 mg/ml SOL. PERF. 2mg/ml VIOSER S.A. PARENTERAL SOLUTIONS INDUSTRY GRECIA CUTIE CU 10 FLAC. TRANSPARENTE DIN PEJD X 200 ML SOL. PERF. PR 10 17.683000 17.683000 0.000000

Tratamentul se iniţiază de către medicul în specialitatea dermatologie şi obstetrică-ginecologie (pentru gonoree şi infecţia cu Chlamidia).

Pagina 3 din 3
 ANEXA 9
(ANEXA 2d la Ordinul CNAS nr. 116/2022)

SECŢIUNEA C3 - LISTA DE MEDICAMENTE CU PROCENT DE COMPENSARE 100% DIN PREȚUL 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, REPUBLICATA, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILĂ ÎNCEPÂND CU 01 IUNIE 2022

Val. maxima suportata de Contributie maxima

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 det. amba referinta / UT compensare 100% din din pretul de

cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) pretul de referinta) referinta)

SE ADAUGA

259 W68210001 D07XC01 COMBINATII (BETAMETHASONUM +ACIDUM SALICYILICUM) DIPROSALIC 0,64 mg+20 mg/g SOL. CUT. 0,64mg+20mg/g ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN PEJD, DE CULOARE ALBA, PREVAZUT CU PICURATOR DIN PEJD X 30 ML SOL. CUT. PRF 1 14.750000 14.750000 0.000000
260 W68209001 D07XC01 COMBINATII (BETAMETHASONUM +ACIDUM SALICYILICUM) DIPROSALIC 0,64 mg+30 mg/g UNGUENT 0,64 mg+30 mg/g ORGANON BIOSCIENCES S.R.L. ROMANIA CUTIE CU 1 TUB DIN AL X 15 G UNGUENT PRF 1 6.210000 6.210000 0.000000
261 W68696003 D11AH02 PIMECROLIMUS ELIDEL 10 mg/g CREMA 10mg/g VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU 1 TUB AL X 30 G CREMA PRF 1 128.170000 128.170000 0.000000
262 W68650001 M01AE01 IBUPROFENUM BRUFEN RETARD 800 mg COMPR. ELIB. PREL. 800mg VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU BLIST. PVC/PVDC-AL X 30 COMPR. CU ELIB. PREL. P6L 30 0.849666 0.849666 0.000000
263 W68648002 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU BLIST. AL/PVC X 30 COMPR. FILM. P6L 30 0.256800 0.256800 0.373533
264 W68648005 M01AE01 IBUPROFENUM BRUFEN 400 mg COMPR. FILM. 400mg VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU BLIST. PVC-PVDC/AL X 30 COMPR. FILM. P6L 30 0.256800 0.256800 0.373533
265 W68649001 M01AE01 IBUPROFENUM BRUFEN 20 mg/ml SUSP. ORALA 20mg/ml VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU 1 FLAC. DIN PET DE CULOARE BRUNA CU CAPAC DIN AL SI SIGILIU DIN PEJD + SERINGA DOZATOARE DIN PP DE 5 ML, A 100 ML SUSP. ORALA P6L 1 14.760000 14.760000 0.000000
266 W68662001 N02AJ08 COMBINATII (IBUPROFENUM+CODEINUM) BRUFEN PLUS 400 mg/30 mg COMPR. FILM. 400mg/30mg VIATRIS HEALTHCARE LIMITED IRLANDA CUTIE CU BLIST. AL/PVDC-PVC/PVDC X 30 COMPR. FILM. PRF 30 1.030666 1.030666 0.000000
267 W68587004 N02BB02 METAMIZOLUM NATRIUM ALVOTOR 500 mg/ml PIC. ORALE, SOL. 500mg/ml BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, PREVAZUT CU PICURATOR DIN PEJD A 100 ML PIC. ORALE, SOL. PRF 1 31.340000 31.340000 0.000000
268 W68587002 N02BB02 METAMIZOLUM NATRIUM ALVOTOR 500 mg/ml PIC. ORALE, SOL. 500mg/ml BIOEEL MANUFACTURING S.R.L. ROMANIA CUTIE CU 1 FLAC. DIN STICLA BRUNA, PREVAZUT CU PICURATOR DIN PEJD A 20 ML PIC. ORALE, SOL. PRF 1 8.470000 8.470000 0.000000
269 W66119001 S01AA24 KANAMYCINUM KANAMICINA ATB 10 mg/g UNG. OFT. 10mg/g ANTIBIOTICE SA ROMANIA CUTIE X 1 TUB AL X 6 G PRF 1 15.960000 15.960000 0.000000

Pagina 1 din 1
 ANEXA 10
(ANEXA 2e la Ordinul CNAS nr. 116/2022)

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, REPUBLICATA, CU MODIFICARILE SI COMPLETARILE ULTERIOARE,
VALABILA INCEPAND CU 01 IUNIE 2022

Contributie maxima Val. maxima suportata de Contributie maxima

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

Prescriptie
cant. beneficiaza de (pt. asiguratii care beneficiaza de
Cod_CIM

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

Nr crt.

tara det. amba referinta / UT din pretul de compensare 20% din pretul din pretul de
cod ATC DCI Denumire Comerciala forma farm. concentratie Detinator APP APP Ambalaj laj (RON) referinta) de referinta) referinta)

SE MODIFICA

110 W66456002 M01AE02 NAPROXENUM NAPROXEN AUROBINDO 250 mg COMPR. 250mg ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 10 COMPR. P6L
AUROBINDO PHARMA ROMANIA S.R.L. 10 0.392174 0.408826 0.078434 0.722566
111 W04449002 M01AE02 NAPROXENUM REUXEN 250 mg COMPR. 250mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.392174 0.436826 0.078434 0.750566
113 W04450002 M01AE02 NAPROXENUM REUXEN 500 mg COMPR. 500mg AC HELCOR PHARMA SRL ROMANIA CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-6L 20 0.784349 0.535151 0.156869 1.162631
72 W08513001 M01AX17 NIMESULIDUM LEMESIL 100 mg COMPR. 100mg ANFARM HELLAS S.A. GRECIA CUTIE CU 2 BLIST. PVC-PVDC/AL X 10 COMPR. P-RF 20 0.392174 0.043826 0.078434 0.357566
73 W08886001 M01AX17 NIMESULIDUM NIMESULID MCC 100 mg COMPR. 100mg MAGISTRA C & C ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0.392174 0.043826 0.078434 0.357566
74 W42589001 M01AX17 NIMESULIDUM NIMESULID SLAVIA COMPR. 100mg SLAVIA PHARM SRL ROMANIA CUTIE CU 1 BLIST. PVC/AL X 10 COMPR. P-RF 10 0.392174 0.043826 0.078434 0.357566
75 W43252002 M01AX17 NIMESULIDUM APONIL 100 mg COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 2 BLIST. AL/PVC X 10 COMPR. P-RF 20 0.392174 0.043826 0.078434 0.357566
76 W43252001 M01AX17 NIMESULIDUM APONIL 100 mg COMPR. 100mg MEDOCHEMIE LTD CIPRU CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0.392174 0.043826 0.078434 0.357566
77 W51945001 M01AX17 NIMESULIDUM NIMESULIDA ARENA 100 mg COMPR. 100mg ARENA GROUP S.A. ROMANIA CUTIE X 1 BLIST. AL/PVC X 10 COMPR. P-RF 10 0.392174 0.629826 0.078434 0.943566
78 W63141001 M01AX17 NIMESULIDUM AULIN 100 mg COMPR. 100mg ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE CU BLIST. AL/PVC X 10 COMPR. PRF 10 0.392174 0.279826 0.078434 0.593566
79 W63142009 M01AX17 NIMESULIDUM AULIN 100 mg GRAN. PT. SUSP. ORALA 100mg/plic ANGELINI PHARMA ÖSTERREICH GMBH AUSTRIA CUTIE CU 15 PLICURI DIN AL/HÂRTIE/PE SAU AL/HÂRTIE/PE/FOLIE SURLYN A CÂTE 2 G GRANULE PENTRU SUSPENSIE ORALA PRF 15 0.392174 0.284492 0.078434 0.598232
80 W61456002 M01AX17 NIMESULIDUM NIMELID 100 mg/plic GRANULE PT. SUSP. ORALA 100mg/plic ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 10 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA PRF 10 0.392174 0.043826 0.078434 0.357566
81 W61456003 M01AX17 NIMESULIDUM NIMELID 100 mg/plic GRANULE PT. SUSP. ORALA 100mg/plic ROMPHARM COMPANY S.R.L. ROMANIA CUTIE CU 30 PLICURI DIN FOLIE MULTISTRAT (HARTIE/AL/PE) X 2 G GRANULE PT. SUSP. ORALA PRF 30 0.392174 0.043492 0.078434 0.357232
84 W55441001 M05BA06 ACIDUM IBANDRONICUM * OSSICA 150 mg COMPR. FILM. 150mg GEDEON RICHTER PLC. UNGARIA CUTIE CU 1 BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P-6L 1 22.158000 12.172000 4.431600 29.898400
85 W57485004 M05BA06 ACIDUM IBANDRONICUM * OSAGRAND 150 mg COMPR. FILM. 150mg ZENTIVA K.S. REPUBLICA CEHA CUTIE CU 1 BLIST. PVC-PVDC/AL X 1 COMPR. FILM. P6L 1 22.158000 2.462000 4.431600 20.188400
86 W58574001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC SANDOZ 150 mg COMPR. FILM. 150mg SANDOZ S.R.L. ROMANIA CUTIE CU 1 BLIST. PA-AL-PVC/AL X 1 COMPR. FILM. P6L 1 22.158000 17.212000 4.431600 34.938400
87 W63021001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC TEVA 150 mg COMPR. FILM. 150mg TEVA B.V. OLANDA CUTIE CU BLIST. DIN PVC/ACLAR/PVC-AL X 1 COMPRIMAT FILMAT P6L 1 22.158000 0.382000 4.431600 18.108400
88 W66455001 M05BA06 ACIDUM IBANDRONICUM * ACID IBANDRONIC AUROBINDO 150 mg COMPR. FILM. 150mg AUROBINDO PHARMA ROMANIA S.R.L. ROMANIA CUTIE CU BLIST. PVC-PE-PVDC/AL X 1 COMPR. FILM. P6L 1 22.158000 16.062000 4.431600 33.788400

Pagina 1 din 1