Formularelor specifice pentru verificarea respectarii criteriilor de eligibilitate aferente protocoalelor terapeutice pentru medicamentele notate cu (**)1, (**)1 Ω si (**)1β in lista cuprinzand denumirile comune internationale corespunzatoare medicamentelor de care beneficiaza asiguratii, cu sau fara contributie personala, pe baza de prescriptie medicala, in sistemul de asigurari sociale de sanatate, precum si denumirile comune Internationale corespunzatoare medicamentelor care se acorda in cadrul programelor nationale de sanatate, aprobata prin HG nr.720/2008, cu modificarile si completarile ulterioare si a metodologiei de transmitere a acestora in platforma informatica din asigurarile de sanatate.

Fișiere atașate

1) formular specific A001E - ORLISTATUM.docx 2) formular specific A008E - IMIGLUCERASUM.docx 3) formular specific B02BX04 - ROMIPLOSTINUM.docx 4) formular specific H005E - ACROMEGALIE.docx 5) formular specific H006C - TUMORI NEURO.docx 6) formular specific L004C.1 - BEVACIZUMABUM-mamar.docx 7) formular specific L004C.2 - BEVACIZUMABUM-colorectal.docx 8) formular specific L004C.3 - BEVACIZUMABUM-renal.docx 9) formular specific L004C.4 - BEVACIZUMABUM-pulmonar.docx 10) formular specific L008C.1 - IMATINIBUM-hematologie.docx 11) formular specific L008C.2 - IMATINIBUM-DFB.docx 12) formular specific L008C.3 - IMATINIBUM-GIST.docx 13) formular specific L012C - BORTEZOMIBUM.docx 14) formular specific L014C - RITUXIMABUM.docx 15) formular specific L01BB06 - CLOFARABINUM.docx 16) formular specific L01BB07 - NELARABINUM.docx 17) formular specific L01BC07 - AZACITIDINUM.docx 18) formular specific L01BC08 - DECITABINUM.docx 19) formular specific L01CX01.1 - TRABECTEDINUM-ovar.docx 20) formular specific L01CX01.2 - TRABECTEDINUM-sarcom.docx 21) formular specific L01XC08 - PANITUMUMABUM.docx 22) formular specific L01XC10 - OFATUMUMAB.docx 23) formular specific L01XC12 - BRENTUXIMAB VEDOTIN.docx 24) formular specific L01XE06 - DASATINIBUM.docx 25) formular specific L01XE07 - LAPATINIBUM.docx 26) formular specific L01XE08 - NILOTINIBUM.docx 27) formular specific L01XE10 - EVEROLIMUS (VOTUBIA).docx 28) formular specific L01XE10A - EVEROLIMUS (AFINITOR).docx 29) formular specific L01XE11.1 - PAZOPANIBUM-renal.docx 30) formular specific L01XE11.2 - PAZOPANIBUM-sarcom.docx 31) formular specific L01XE13 - AFATINIBUM.docx 32) formular specific L01XE14 - BOSUTINIBUM.docx 33) formular specific L01XE16 - CRIZOTINIBUM.docx 34) formular specific L01XE17 - AXITINIBUM.docx 35) formular specific L01XE18 - RUXOLITINIBUM.docx 36) formular specific L01XE23 - DABRAFENIBUM.docx 37) formular specific L01XE27 - IBRUTINIBUM.docx 38) formular specific L01XX44 - AFLIBERCEPTUM.docx 39) formular specific L01XX46 - OLAPARIBUM.docx 40) formular specific L026C.1 - TRASTUZUMABUM-adjuv.docx 41) formular specific L026C.2 - TRASTUZUMABUM-neoadjv.docx 42) formular specific L02BX03.1 - ABIRATERONUM-postch.docx 43) formular specific L02BX03.2 - ABIRATERONUM-prech.docx 44) formular specific L031C.1 - ERLOTINIBUM-pancreas.docx 45) formular specific L031C.2 - ERLOTINIBUM-pulmon.docx 46) formular specific L033C - TRASTUZUMABUM-metastatic.docx 47) formular specific L037C.1 - CETUXIMABUM-cap,gat.docx 48) formular specific L037C.2 - CETUXIMABUM-colorectal.docx 49) formular specific L038C.1 - SORAFENIBUM-HCC.docx 50) formular specific L038C.2 - SORAFENIBUM-renal.docx 51) formular specific L038C.3 - SORAFENIBUM-tiroidian.docx 52) formular specific L039M - AIJ.docx 53) formular specific L040M - AP.docx 54) formular specific L041M - SPONDILITA.docx 55) formular specific L042C.1 - SUNITINIBUM-renal.docx 56) formular specific L042C.2 - SUNITINIBUM-GIST.docx 57) formular specific L043M - POLIARTRITA.docx 58) formular specific L044L - PSORIAZIS.docx 59) formular specific L047C.1 - PEMETREXEDUM-mezotel.docx 60) formular specific L047C.2 - PEMETREXEDUM-pulmonar.docx 61) formular specific L04AX02 - TALIDOMIDUM.docx 62) formular specific B02BX05 - ELTROMBOPAG.docx 63) formular specific L01XC15- OBINUTUZUMAB.docx 64) formular specific L01XE24 - PONATINIBUM.docx