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 0461879 UTROGESTAN 200 MG 45 CAPS RR 0 0 12,91 20,27 80 0262441 UTROGESTAN VAGINAL 100 MG 90 CAPS RR 0 0 13,17 20,48 80 G03DB01 dydrogesterone 0171624 DUPHASTON 10 MG 42 CPR RR 0 0 9,56 15,97 80 G03DB04 nomegestrol 0309999 LUTENYL 5 MG 30 CPR RR 0 0 8,58 14,76 80 0525279 LUTENYL 5 MG 90 CPR RR 0 0 20,22 28,55 80 0497921 NOGEST 5 MG 30 CPR RR 0 0 8,41 14,66 80 0497949 NOGEST 5 MG 60 CPR RR 0 0 13,99 21,61 80 0497966 NOGEST 5 MG 90 CPR RR 0 0 19,82 28,23 80 G03DC02 norethisterone 0093674 PRIMOLUT NOR FORTE 10 MG 30 CPR RR 0 0 2,93 7,83 80 G03DC03 lynestrenol 0083289 ORGAMETRIL 5 MG 30 CPR RR 0 0 2,00 6,71 80 G03FA01 norethisterone and estrogen 0252543 ACTIVELLE 3*28 CPR RR 0 0 36,10 47,10 80 0200533 KLIOGEST 3*28 CPR RR 0 0 30,21 41,03 80 G03FA14 dydrogesterone and estrogen 0293062 FEMOSTON CONTI 3*28 CPR RR 0 0 30,36 41,18 80 0569967 FEMOSTON LOW 0,5/2,5 MG 84 CPR RR 0 0 30,36 40,54 80 G03FA15 dienogest and estrogen 0308473 CLIMODIEN 2/2 3*28 CPR RR 0 0 29,06 39,84 80 G03FA17 drospirenone and estrogen 0354798 ANGELIQ 1/2 MG 28 CPR RR 0 0 17,85 28,30 0 0354803 ANGELIQ 1/2 MG 3*28 CPR RR 0 0 41,36 52,51 0 G03FB Progestogens and estrogens, sequential preparations 0370287 NAEMIS 1,5/3,75 MG 3*24 CPR RR 0 0 36,83 48,54 0 G03FB01 norgestrel and estrogen 0026864 CYCLOCUR 3*21 DRG RR 0 0 4,33 9,57 80 G03FB05 norethisterone and estrogen 0310911 NOVOFEM 3*28 CPR RR 0 0 22,04 32,61 0 0255805 TRISEQUENS 2 MG 3*28 CPR RR 0 0 9,09 15,50 80 G03FB06 medroxyprogesterone and estrogen 0250258 DIVIPLUS 3*28 CPR RR 0 0 7,21 13,17 80 0173811 DIVIVA 3*21 CPR RR 0 0 5,74 11,33 80 G03FB08 dydrogesterone and estrogen 0305471 FEMOSTON 1/10 3*28 CPR RR 0 0 20,29 30,80 80 Page 94 of 230
Numéro national Dénomination abrégée mode de conditions de OD RMP PCC Prix ex-usine Prix public Taux délivrance prescription 0229921 FEMOSTON 2/10 3*28 CPR RR 0 0 20,29 30,80 80 G03GA01 chorionic gonadotrophin 0093206 PREGNYL 1500 U 3 AMP + S 1 ML IM RR C 0 0 4,57 9,88 80 0511761 PREGNYL 5000 U 1 AMP + S 1 ML IM RR C 0 0 3,93 8,96 80 0093237 PREGNYL 5000 U 3 AMP + S 1 ML IM RR C 0 0 8,74 14,95 80 G03GA02 human menopausal gonadotrophin 0330913 MENOPUR FERRING 75 U PDR 10 FL + S IMSC RR C 0 0 174,02 189,15 80 G03GA04 urofollitropin 0434001 FOSTIMON 150 U/ML PDR 1 FL + S IMSC RR C 0 0 32,94 44,41 80 0434028 FOSTIMON 150 U/ML PDR 10 FL + S IMSC RR C 0 0 329,44 360,90 80 0433969 FOSTIMON 75 U/ML PDR 1 FL + S IMSC RR C 0 0 16,47 22,75 80 0433986 FOSTIMON 75 U/ML PDR 10 FL + S IMSC RR C 0 0 164,72 184,97 80 G03GA05 follitropin alfa 0365239 GONAL F 300 U 1 STYLO 0,5 ML + 8 AIG RR C 0 0 101,41 116,37 80 0365242 GONAL F 450 U 1 STYLO 0,75 ML + 7 AIG RR C 0 0 151,10 169,05 80 0215231 GONAL F 75 U PDR 1 AMP+S 1 ML SC RR C 0 0 25,98 35,02 80 0365256 GONAL F 900 U 1 STYLO 1,5 ML + 20 AIG RR C 0 0 298,95 325,74 80 G03GA06 follitropin beta 0279435 PUREGON 300 U 1 CRT 0,36 ML SC RR C 0 0 91,37 105,73 80 0279449 PUREGON 600 U 1 CRT 0,72 ML SC RR C 0 0 173,59 192,88 80 0389082 PUREGON 900 U 1 CRT 1,08 ML + AIG RR C 0 0 260,32 284,80 80 G03GA08 choriogonadotropin alfa 0297061 OVITRELLE 250 MCG SOL 1 FL + S SC RR C 0 0 56,56 68,16 80 G03GA09 corifollitropin alfa 0555815 ELONVA 100 MG 1 SRG 0,5 ML + 1 AIG SC RR C 0 0 544,54 570,79 80 0558767 ELONVA 150 MG 1 SRG 0,5 ML + 1 AIG SC RR C 0 0 544,54 570,79 80 G03GA30 combinations 0462733 PERGOVERIS 150 U PDR 10 FL + S 1 ML SC RR C 0 0 724,40 756,04 80 G03GB02 clomifene 0023070 CLOMID 50 MG 10 CPR RR C 0 0 3,85 8,97 80 0088495 PERGOTIME 50 MG 10 CPR RR C 0 0 4,15 7,13 0 0088481 PERGOTIME 50 MG 5 CPR RR C 0 0 4,10 9,17 80 G03HA01 cyproterone 0006049 ANDROCUR 10 MG 45 CPR RR 0 0 0,00 19,51 80 0006035 ANDROCUR 50 MG 50 CPR RR 0 0 20,02 28,45 80 0442548 CYPROPLEX 50 MG 50 CPR RR 0 0 20,57 31,09 0 G03HB01 cyproterone and estrogen 0186093 CLIMEN 3*21 DRG RR 0 0 19,03 29,51 80 Page 95 of 230
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Liste des médicaments commercialisés au Luxembourg - CNS

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