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 T<strong>au</strong>x délivrance prescription 0330881 HYCAMTIN 1 MG/ML PDR 5 FL 3 ML PERF RR HC 0 0 157,62 0,00 0 0233162 HYCAMTIN 4 MG PDR 1 FL 5 ML PERF RR HC 0 0 260,09 0,00 0 L01XX19 irinotecan 0227621 CAMPTO 100 MG 1 FL 5 ML PERF RR HC 0 0 70,22 0,00 0 0482087 CAMPTO 300 MG 1 FL 15 ML PERF RR HC 0 0 238,82 0,00 0 0227618 CAMPTO 40 MG 1 FL 2 ML PERF RR HC 0 0 28,08 0,00 0 0491718 IRINOSIN 100 MG PERF 5 FL 5 ML IV RR HC 0 0 70,22 0,00 0 0491704 IRINOSIN 40 MG PERF 5 FL 2 ML IV RR HC 0 0 28,08 0,00 0 0500056 IRINOSIN 500 MG PERF 1 FL A DIL 25 ML RR HC 0 0 398,04 0,00 0 0559926 IRINOTECAN ACTAVIS 100 MG 1 FL 5 ML DIL RR HC 0 0 514,77 0,00 0 0559912 IRINOTECAN ACTAVIS 40 MG 1 FL 2 ML DIL RR HC 0 0 36,32 0,00 0 0559943 IRINOTECAN ACTAVIS 500 MG 1 FL 25 ML DIL RR HC 0 0 90,81 0,00 0 0543294 IRINOTECAN EG 100 MG 1 FL 5 ML DIL IV RR HC 0 0 57,84 0,00 0 0543331 IRINOTECAN EG 300 MG 1 FL 15 ML DIL IV RR HC 0 0 169,28 0,00 0 0543281 IRINOTECAN EG 40 MG 1 FL 2 ML DIL IV RR HC 0 0 24,40 0,00 0 0516509 IRINOTECAN HOSPIRA 100 MG 1 FL 5 ML IV RR HC 0 0 68,85 0,00 0 0516493 IRINOTECAN HOSPIRA 40 MG 1 FL 2 ML IV RR HC 0 0 27,53 0,00 0 0516512 IRINOTECAN HOSPIRA 500 MG 1 FL 25ML IV RR HC 0 0 390,28 0,00 0 0607228 IRINOTECAN KABI 100 MG 5 ML 1 FL RR HC 0 0 185,74 0,00 0 0607214 IRINOTECAN KABI 40 MG 2 ML FL IV RR HC 0 0 74,29 0,00 0 0607245 IRINOTECAN KABI 500 MG 25 ML 1 FL IV RR HC 0 0 928,68 0,00 0 L01XX25 bexarotene 0299634 TARGRETIN 75 MG 100 CAPS RR DC 0 0 1.090,79 0,00 0 L01XX27 arsenic trioxide 0315237 TRISENOX 1 MG/ML 10 AMP A D PERF RR HC X 0 0 3.730,11 0,00 0 L01XX32 bortezomib 0569113 VELCADE 1 MG PDR 1 FL IV RR HC 0 0 327,00 0,00 0 0368566 VELCADE 3,5 MG PDR 1 FL IV RR HC 0 0 1.097,28 0,00 0 L01XX35 anagrelide 0389441 L01XX41 XAGRID 0,5 MG 100 CAPS RR C X 1 5 456,98 493,12 100 0623981 HALAVEN 0,88 MG 1 FL V 2 ML IV RR HC 0 0 400,00 0,00 0 L02AA02 polyestradiol phosphate 0041728 ESTRADURINE 80 MG PDR 1 FL + S 2 ML IM RR 0 0 3,85 8,79 100 L02AB01 megestrol 0141186 MEGACE 160 MG 30 CPR RR 0 0 31,83 41,46 100 L02AB02 medroxyprogesterone 0029866 DEPO PROVERA 500 MG 1 AMP 3,3 ML IM RR 0 0 6,61 12,41 100 0095133 PROVERA 100 MG 50 CPR RR 0 0 13,98 21,60 100 Page 134 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public T<strong>au</strong>x délivrance prescription 0095147 PROVERA 250 MG 40 CPR RR 0 0 25,14 34,10 100 0144403 PROVERA 400 MG 25 CPR RR 0 0 22,83 31,55 100 0450925 PROVERA 500 MG 30 CPR RR 0 0 33,52 43,31 100 0144899 PROVERA 500 MG/5 ML SIR 100 ML RR 0 0 30,29 39,76 100 L02AE01 buserelin 0158197 SUPREFACT NASAL 0,1 MG/D 1 FL 100 D RR 0 0 31,51 41,10 100 0111870 SUPREFACT NASAL 0,1 MG/D 4 FL 100 D RR 0 0 126,74 143,22 100 L02AE02 leuprorelin 0393099 DEPO ELIGARD 22,5 MG PDR 1 SRG + S SC RR C 0 0 184,85 204,81 100 0470461 DEPO ELIGARD 45 MG PDR 1 SRG + S SC RR C 0 0 369,73 400,77 100 0393118 DEPO ELIGARD 7,5 MG PDR 1 SRG + S SC RR C 0 0 86,41 100,47 100 0554835 LUCRIN DEPOT 11,25 MG 1 SRG PREREMPLIE RR C 0 0 178,07 197,62 100 0400159 LUCRIN DEPOT 3,75 MG 1 SRG PREREMPLIE RR C 0 0 88,84 103,05 100 L02AE03 goserelin 0141818 ZOLADEX DEPOT 3,6 MG 1 SRG SC RR 0 0 115,00 130,78 100 0216841 ZOLADEX LA 10,8 MG 1 SRG SC RR 0 0 296,05 322,68 100 L02AE04 triptorelin 0299956 DECAPEPTYL SR 11,25 MG 1 SRG + S 2 ML RR 0 0 253,64 277,72 100 0591517 DECAPEPTYL SR 22,5 MG 1 FL + S RR 0 0 466,02 502,81 100 0299942 DECAPEPTYL SR 3,75 MG 1 SRG + S 2 ML RR 0 0 111,78 127,37 100 L02BA01 tamoxifen 0217768 NOLVADEX 10 MG 98 CPR RR 0 0 11,75 18,82 100 0217771 NOLVADEX D 20 MG 56 CPR RR 0 0 15,13 23,03 100 0206697 NOLVADEX D 20 MG 90 CPR UD RR 0 0 24,32 0,00 0 0172604 TAMIZAM 20 MG 60 CPR RR 0 0 17,22 25,37 100 0209508 TAMIZAM 20 MG 90 CPR RR 0 0 24,02 32,86 100 L02BA02 toremifene 0257214 FARESTON 60 MG 100 CPR RR 0 0 72,32 85,36 100 L02BA03 fulvestrant 0568939 FASLODEX 250 MG 2 SRG PRER 5 ML + 2 AIG RR 0 0 485,00 522,93 100 L02BB01 flutamide 0325006 FLUTAMIDE EG 250 MG 100 CPR RR 0 0 41,02 51,58 100 0459285 FLUTAMIDE EG 250 MG 200 CPR RR 0 0 82,04 95,84 0 0242354 FLUTAPLEX 250 MG 100 CPR RR 0 0 39,61 50,02 100 0242368 FLUTAPLEX 250 MG 200 CPR RR 0 0 73,80 87,11 100 L02BB03 bicalutamide 0461333 BICALUTAMID RATIO 50 MG 30 CPR RR 0 0 44,79 58,10 100 0461364 BICALUTAMID RATIO 50 MG 90 CPR RR 0 0 129,78 151,11 100 0519965 BICALUTAMIDE EG 50 MG 100 CPR RR 0 0 203,06 224,12 100 Page 135 of 230
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Liste des médicaments commercialisés au Luxembourg - CNS

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