Liste des médicaments commercialisés au Luxembourg - CNS

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Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public Taux délivrance prescription 0312526 NEIS VAC C 1 SRG 0,5 ML IM R 0 0 25,61 36,28 0 J07AH04 meningococcus, tetravalent purified polysaccharides antigen 0193036 MENCEVAX ACWY PDR 1 FL UD SC R 0 0 21,50 32,06 0 J07AH08 meningococcus, tetravalent purified polysaccharides antigen conjugated 0617479 MENVEO 5 FL PDR + 5 FL SOL 0,5 ML R 0 0 40,00 51,11 0 0652031 NIMENRIX PSV 1 FL + 1 SRG PRER + 2 AIG R 0 0 40,00 51,11 0 J07AJ51 pertussis, inactivated, whole cell, combinations with toxoids 0210848 INFANRIX DTPA 1 SRG 0,5 ML IM R 0 0 0,00 16,86 0 J07AJ52 pertussis, purified antigen, combinations with toxoids 0293563 BOOSTRIX 1 SRG UD 0,5 ML IM R 0 0 11,72 18,78 0 J07AL01 pneumococcus, purified polysaccharides antigen 0508314 PNEUMO 23 25 MCG 1 SRG 0,5 ML IMSC R 0 0 17,17 27,60 0 0303348 PNEUMOVAX 23 1 FL 0,5 ML IMSC R 0 0 17,17 27,60 0 J07AL02 pneumococcus, purified polysaccharides antigen conjugated 0380821 PREVENAR 1 FL + SRG + 2 AIG R 0 0 54,79 66,34 0 0300086 PREVENAR 1 FL 0,5 ML IM R 0 0 54,79 66,34 0 0539243 PREVENAR 13 1 SRG + AIG SEP R 0 0 60,71 72,44 0 J07AM51 tetanus toxoid, combinations with diphtheria toxoid 0195979 TEDIVAX PRO ADULTO 1 SRG 0,5 ML IM R 0 0 3,01 7,92 0 J07AP01 typhoid, oral, live attenuated 0611041 VIVOTIF 3 CAPS R 0 0 11,51 19,76 0 J07AP03 typhoid, purified polysaccharide antigen 0266048 TYPHERIX 1 SRG UD 0,5 ML IM R 0 0 0,00 23,38 0 0188036 TYPHIM VI 0,025 MG 1 SRG 0,5 ML IMSC R 0 0 14,93 25,28 0 0472614 TYPHIM VI 0,025MG 1SRG SS AIG 0,5ML+1AIG R 0 0 14,93 25,28 0 J07AX Other bacterial vaccines 0015986 BRONCHOVAXOM AD 10 CAPS R 0 0 9,63 16,55 0 0016000 BRONCHOVAXOM AD 30 CAPS R 0 0 23,11 33,72 0 0016014 BRONCHOVAXOM ENF 10 CAPS R 0 0 6,49 11,15 0 0016028 BRONCHOVAXOM ENF 30 CAPS R 0 0 15,58 25,96 0 0187865 LUIVAC 3 MG 28 CPR R 0 0 0,00 22,73 0 0187879 LUIVAC 3 MG 56 CPR R 0 0 0,00 42,24 0 0143731 UROVAXOM 6 MG 30 CAPS R 0 0 29,01 39,79 0 0143745 UROVAXOM 6 MG 90 CAPS R 0 0 69,63 81,62 0 J07BA01 encephalitis, tick borne, inactivated, whole virus 0395791 FSME IMMUN 2,4 MCG 1 SRG 0,5 ML IM R 0 0 22,93 33,52 0 0395742 FSME IMMUN JR 1,2 MCG 1 SRG 0,25 ML IM R 0 0 18,34 28,80 0 J07BA02 encephalitis, Japanese, inactivated, whole virus Page 122 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public Taux délivrance prescription 0521638 IXIARO SUSP 1 SRG 0,5 ML IMSC RR 0 0 68,95 80,92 0 J07BB02 influenza, inactivated, split virus or surface antigen 0152727 ALPHA RIX 1 SRG 0,5 ML IMSC R 6 3 5,13 8,79 100 0421176 INFLEXAL-V 1 SRG IMSC R 6 3 5,13 8,79 100 0421193 INFLEXAL-V 10 SRG IMSC R 0 0 6,13 0,00 0 0057146 INFLUVAC S 1 SRG 0,5 ML UD IMSC R 6 3 5,13 8,79 100 0513197 INTANZA 0,15 MCG 1 SRG 0,1 ML R 0 0 6,13 11,64 0 0246966 MUTAGRIP S 1 SRG 0,5 ML IMSC R 0 0 0,00 8,79 0 0125361 VAXIGRIP 1 SRG 0,5 ML IMSC R 6 3 5,12 8,79 100 J07BC01 hepatitis B, purified antigen 0039599 ENGERIX B 20 MCG 1 FL 1 D 0,5 ML + SRG R 0 0 17,72 25,92 0 0205459 ENGERIX B JR 10 MCG 1 SRG UD 0,5 ML IM R 0 0 9,85 16,45 0 0436327 HBVAXPRO 40 MCG 1 FL 1 ML IM R 0 0 48,54 59,69 0 0362058 HBVAXPRO 5 MCG 1 SRG + AIG 0,5 ML IM R 0 0 7,59 13,46 0 0362075 HBVAXPRO 5 MCG 1 SRG SS AIG 0,5 ML IM R 0 0 8,58 14,73 0 J07BC02 hepatitis A, inactivated, whole virus 0287048 EPAXAL 1 D 0,5 ML IM R 0 0 27,72 38,46 0 0206067 HAVRIX 1440 U 1 SRG 1 ML IM R 0 0 33,45 44,36 0 0230224 HAVRIX JR 720 U 1 SRG 0,5 ML IM R 0 0 18,72 29,18 0 J07BC20 combinations 0228162 TWINRIX AD 1 SRG UD IM R 0 0 41,89 53,05 0 0232215 TWINRIX ENF 1 SRG UD IM R 0 0 29,11 39,89 0 J07BD52 measles, combinations with mumps and rubella, live attenuated 0251935 PRIORIX PDR 1 D 0,5 ML SC R 0 0 13,74 21,30 0 J07BF03 poliomyelitis, trivalent, inactivated, whole virus 0056202 IMOVAX POLIO 1 SRG 0,5 ML IMSC R 0 0 5,46 9,38 0 J07BG01 rabies, inactivated, whole virus 0388796 RABIPUR PDR 1 FL + 1 SRG + S IM R 0 0 34,15 45,09 0 J07BH01 rota virus, live attenuated 0488449 ROTARIX SP BUV 1 APPLIC ADM OR 1,5 ML R 0 0 56,98 69,16 0 0430449 ROTARIX SP BUV 1 FL + 1 SRG + 1 ADAPT R 0 0 61,80 74,29 0 0488497 ROTARIX SP BUV 1 TUBE SOUPLE 1,5 ML R 0 0 56,98 68,98 0 0436876 ROTATEQ GTTS 2 ML R 0 0 41,20 51,61 0 J07BK01 varicella, live attenuated 0376246 PROVARIVAX 1350 U 1 FL 0,5MG + SRG + AIG R 0 0 39,93 51,03 0 0125022 VARILRIX PDR 1D + S R 0 0 36,96 47,10 0 J07BK02 zoster, live attenuated 0436019 ZOSTAVAX PDR 1 FL + 1 SRG + 2 AIG 0,65ML R 0 0 120,00 137,16 0 Page 123 of 230
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Liste des médicaments commercialisés au Luxembourg - CNS

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