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 0152467 DOTAREM 1 FL 15 ML IV RR H 0 0 43,74 0,00 0 0152471 DOTAREM 1 FL 20 ML IV RR H 0 0 52,89 0,00 0 0305681 DOTAREM 1 FL 60 ML IV RR H 0 0 139,39 0,00 0 0210821 DOTAREM 1 SRG 15 ML IV RR H 0 0 43,77 0,00 0 0210834 DOTAREM 1 SRG 20 ML IV RR H 0 0 52,89 0,00 0 V08CA03 gadodiamide 0196301 OMNISCAN 1 FL 10 ML IV RR HC RM 0 0 31,32 0,00 0 0196329 OMNISCAN 1 FL 15 ML IV RR HC RM 0 0 35,10 0,00 0 0196346 OMNISCAN 1 FL 20 ML IV RR HC RM 0 0 69,41 0,00 0 0301357 OMNISCAN 287 MG/ML 1 FL P 20 ML IV RR HC RM 0 0 42,38 0,00 0 0269764 OMNISCAN 287 MG/ML 1 SRG 10 ML RR HC RM 0 0 31,32 0,00 0 0269778 OMNISCAN 287 MG/ML 1 SRG 15 ML RR HC RM 0 0 35,08 0,00 0 0269781 OMNISCAN 287 MG/ML 1 SRG 20 ML RR HC RM 0 0 42,36 0,00 0 V08CA04 gadoteridol 0347759 PROHANCE 279,3 MG/ML 1 FL 10 ML IV RR HC 0 0 31,58 0,00 0 0347762 PROHANCE 279,3 MG/ML 1 FL 15 ML IV RR HC 0 0 59,49 0,00 0 0347776 PROHANCE 279,3 MG/ML 1 FL 20 ML IV RR HC 0 0 54,47 0,00 0 0347745 PROHANCE 279,3 MG/ML 1 FL 5 ML IV RR HC 0 0 22,44 0,00 0 V08CA06 gadoversetamide 0469121 OPTIMARK 330,9 MG/ML 1 FL 10 ML IV RR HC 0 0 35,43 0,00 0 0469149 OPTIMARK 330,9 MG/ML 1 FL 15 ML IV RR HC 0 0 50,71 0,00 0 0469166 OPTIMARK 330,9 MG/ML 1 FL 20 ML IV RR HC 0 0 61,27 0,00 0 0469197 OPTIMARK 330,9 MG/ML 1 SRG 10 ML IV RR HC 0 0 35,43 0,00 0 0469216 OPTIMARK 330,9 MG/ML 1 SRG 15 ML IV RR HC 0 0 50,71 0,00 0 0469247 OPTIMARK 330,9 MG/ML 1 SRG 20 ML IV RR HC 0 0 61,27 0,00 0 0469264 OPTIMARK 330,9 MG/ML 1 SRG 30 ML IV RR HC 0 0 77,65 0,00 0 V08CA08 gadobenic acid 0254727 MULTIHANCE 0,5 M 1 FL V 10 ML IV RR HC 0 0 44,88 0,00 0 0254731 MULTIHANCE 0,5 M 1 FL V 15 ML IV RR HC 0 0 64,14 0,00 0 0254744 MULTIHANCE 0,5 M 1 FL V 20 ML IV RR HC 0 0 77,37 0,00 0 V08CA09 gadobutrol 0380929 GADOVIST PFS-1 1 SRG 10 ML IV RR H 0 0 64,71 0,00 0 0293658 GADOVIST PFS-1 1 SRG 15 ML IV RR H 0 0 92,50 0,00 0 0380932 GADOVIST PFS-1 1 SRG 20 ML IV RR H 0 0 111,64 0,00 0 0380915 GADOVIST PFS-1 1 SRG 7,5 ML IV RR H 0 0 50,95 0,00 0 V08CB03 iron oxide, nanoparticles 0203048 ENDOREM 1 AMP 8 ML IV RR H 0 0 129,97 0,00 0 V08DA Ultrasound contrast media 0253196 ECHOGEN 2% 1 KIT + 1 FL 5 ML IV RR HC 0 0 117,25 0,00 0 V08DA05 sulfur hexafluoride Page 222 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 0299391 SONOVUE 8 MCG/ML PDR 1FL+1DISP MI+1SRG RR HC 0 0 65,00 0,00 0 V09CA Technetium (99mTc) compounds 0435199 PRIMOVIST 181,43 MG/ML 1 SRG 10 ML IV RR HC 0 0 157,29 0,00 0 V09GA01 technetium (99mTc) sestamibi 0511483 STAMICIS TROUSSE PREP RADIO 1 MG 5 FL MD RR HC 0 0 550,00 0,00 0 V09HA03 technetium (99mTc) antigranulocyte antibody 0557448 SCINTIMUN TROUSSE P RADIO 1MG 1 FL MTD+S RR HC 0 0 559,80 0,00 0 0557451 SCINTIMUN TROUSSE P RADIO 1MG 2 FL MTD+S RR HC 0 0 559,80 0,00 0 V09IX05 fluorodopa (18F) 0618381 DOPACIS 90 MBQ/ML 1 FL MTD RR HC 0 0 694,70 0,00 0 V10AA Yttrium (90Y) compounds 0346572 YTRACIS 1 FL 2 ML V RR HC 0 0 2.290,03 0,00 0 V10XX02 ibritumomab tiuxetan (90Y) 0362593 YY ZEVALIN 1,6 MG/ML 1 SET RR HC 0 0 8.419,31 0,00 0 0328512 AGNOLYT GTTS 50 ML P 0 0 5,82 10,37 0 0565663 AGNUCASTON 30 CPR P 0 0 3,91 7,49 0 0621728 ANGIPAX 40 CPR ORODISP P 0 0 4,17 7,83 0 0555703 ANGIPAX 60 CPR ORODISP P 0 0 3,99 7,55 0 0459921 ARKOGELULES AUBELINE 350 MG 150 CAPS P 0 0 13,65 23,93 0 0007757 ARNICAN CREME 35 G P 0 0 2,53 4,34 0 0247736 AUBELINE 350 MG 45 CAPS P 0 0 0,00 8,41 0 0303107 BALDRIPARAN N STARK BERUHIGUNG 100 DRG P 0 0 0,00 21,49 40 0305745 BALDRIPARAN N STARK BERUHIGUNG 40 DRG P 0 0 0,00 9,79 0 0447429 BEKUNIS SENNA 30 DRG P 0 0 0,00 4,10 0 0496194 BICIRKAN 30 CPR P 0 0 4,87 7,53 0 0013592 BIOCARDE 30 ML P 0 0 2,80 5,25 0 0559988 BOMBASTUS ABFUEHRTEE 20 SACH P 0 0 1,44 2,55 0 0559991 BOMBASTUS ARNIKABLUETEN TEE 50 G P 0 0 6,73 11,90 0 0560037 BOMBASTUS BAERENTRAUBENBLAETTER TEE 100G P 0 0 2,21 3,91 0 0560041 BOMBASTUS BAERENTRAUBENBLAETTER TEE 20SA P 0 0 1,44 2,55 0 0560006 BOMBASTUS BALDRIANWURZEL TEE 20 SACH P 0 0 2,02 3,57 0 0560023 BOMBASTUS BALDRIANWURZEL TEE 200 G P 0 0 2,98 5,26 0 0548323 BOMBASTUS BERUHIGUNGSTEE 20 SACH P 0 0 1,94 3,43 0 0555152 BOMBASTUS BERUHIGUNGSTEE 75 G P 0 0 2,76 4,89 0 0549902 BOMBASTUS BIRKENBLAETTER TEE 20 SACH P 0 0 1,58 2,80 0 0555247 BOMBASTUS BIRKENBLAETTER TEE 50 G P 0 0 1,28 2,26 0 0548337 BOMBASTUS BLASENNIEREN TEE 20 SACH P 0 0 1,94 3,43 0 0555166 BOMBASTUS BLASENNIEREN TEE 75 G P 0 0 1,82 3,22 0 0560054 BOMBASTUS BOHNENSCHALEN TEE 50 G P 0 0 1,72 3,05 0 Page 223 of 230
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Liste des médicaments commercialisés au Luxembourg - CNS

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