OMEDIT Pays de la Loire Suivi des UCD T2A DCI ABATACEPT 9300181 ORENCIA 250MG PERF FL+SRG 2. TARIF DCI 01/02/2013 9368664 HUMIRA 40 MG INJ FL 0,8 ML + NEC 1. INSCRIPTION 11/02/2012 2. TARIF 9251092 9307562 9395000 06/12/2013 AGALSIDASE ALFA 9269034 REPLAGAL 1MG/ML FL 1ML 9238861 1 626,24 1 600,96 01/04/2013 3 201,92 ALEMTUZUMAB 9236388 MABCAMPATH 10MG/ML INJ AMP 3. RADIATION 9273981 20/06/2013 MABCAMPATH 30MG/ML INJ FV 3. RADIATION 20/06/2013 ALPHA-1-ANTITRYPSINE HUMAINE 9275715 ALFALASTIN 33,33 MG INJ FV + FV 3. RADIATION 01/03/2012 ALPHA-ALGLUCOCIDASE 9293216 MYOZYME 50 MG PERF FL 1. INSCRIPTION 2. TARIF 05/04/2012 16/11/2013 525,00 01/11/2012 318,60 01/10/2013 1 023,46 01/10/2013 278,13 01/06/2013 298,63 01/06/2013 1 043,85 AZACITIDINE 9274762 VIDAZA 25MG/ML INJ FL 2. TARIF BEVACIZUMAB 9261110 AVASTIN 25MG/ML PERF FL 16ML 2. TARIF 9261104 AVASTIN 25MG/ML PERF FL 4ML 2. TARIF BORTEZOMIB 9318910 VELCADE 1MG INJ FL 2. TARIF 9260010 VELCADE 3,5MG INJ FL 1 2. TARIF DCI 01/04/2013 01/12/2013 FABRAZYME 35MG PERF FL20ML 2. TARIF DCI 464,64 457,42 AGALSIDASE BETA 9235058 DCI 01/04/2013 01/12/2013 REPLAGAL 1MG/ML PERF FL3,5ML 2. TARIF 2. TARIF DCI 443,62 417,01 06/12/2013 2. TARIF 2. TARIF DCI 01/02/2013 01/08/2013 ZALTRAP 25 MG/ML PERF FL 8 ML 1. INSCRIPTION DCI 443,62 417,01 ZALTRAP 25 MG/ML PERF FL 4 ML 1. INSCRIPTION DCI 01/02/2013 01/08/2013 AFLIBERCEPT 9394992 DCI 462,11 HUMIRA 40MG INJ STY0,8ML +T. 2. TARIF 2. TARIF DCI 03/03/2012 HUMIRA 40MG INJ SRG0,8ML +T. 2. TARIF 2. TARIF DCI 366,16 ADALIMUMAB BRENTUXIMAB VEDOTIN 9391344 1. INSCRIPTION Page 1 sur 13 ADCETRIS 50 MG PERF FL 05/07/2013 OMEDIT pays de la Loire 22/01/2014 DCI CABAZITAXEL 9365950 JEVTANA 60 MG PERF FL + FL 1. INSCRIPTION 2. TARIF DCI 31/07/2013 14/09/2013 CARMUSTINE 9010750 BICNU INJ FL + AMP 3. RADIATION DCI 01/03/2012 CETUXIMAB 9301111 ERBITUX 5MG/ML PERF FL 100ML 2. TARIF 9301128 177,19 01/01/2013 1 356,75 COAGULATION HUMAINS 9394940 FACTANE 200 UI/ML FV + FV 10 ML 1. INSCRIPTION 9394957 25/12/2013 FACTANE 200 UI/ML FV + FV 5 ML 1. INSCRIPTION 25/12/2013 COMPLEXE PROTHROMBIQUE HUMAIN 9394905 CONFIDEX 1 000 UI INJ FL + FL 1. INSCRIPTION DCI 01/08/2013 EVOLTRA 1MG/ML PERF FL 20 ML 2. TARIF DCI 885,94 CLOFARABINE 9294954 DCI 01/08/2013 ERBITUX 5MG/ML PERF FL 20ML 2. TARIF DCI 4 100,00 25/12/2013 CONESTAT ALPHA 9362696 RUCONEST 2100U INJ FL 1. INSCRIPTION 07/09/2011 2. TARIF 2. TARIF 30/11/2011 01/06/2013 840,00 756,00 15/10/2013 121,40 15/10/2013 121,40 15/10/2013 121,40 15/10/2013 12,14 15/10/2013 12,14 15/10/2013 12,14 15/10/2013 157,82 15/10/2013 157,82 15/10/2013 157,82 15/10/2013 182,10 15/10/2013 182,10 15/10/2013 182,10 15/10/2013 18,21 15/10/2013 18,21 15/10/2013 18,21 15/10/2013 18,21 DCI DARBEPOETINE ALFA 9334961 ARANESP 100MCG INJ SEC 0,5ML 2. TARIF 9233243 ARANESP 100MCG INJ SRG0,5ML 2. TARIF 9274609 ARANESP 100MCG INJ STYLO0,5ML 2. TARIF 9334955 ARANESP 10MCG INJ SEC 0,4ML 2. TARIF 9233237 ARANESP 10MCG INJ SRG0,4ML 2. TARIF 9274590 ARANESP 10MCG INJ STYLO0,4ML 2. TARIF 9334978 ARANESP 130MCG INJ SEC 0,65ML 2. TARIF 9304434 ARANESP 130MCG INJ SRG 0,65ML 2. TARIF 9304440 ARANESP 130MCG INJ STY 0,65ML 2. TARIF 9334990 ARANESP 150MCG INJ SEC 0,3ML 2. TARIF 9233289 ARANESP 150MCG INJ SRG0,3ML 2. TARIF 9274621 ARANESP 150MCG INJ STYLO0,3ML 2. TARIF 9233266 ARANESP 15MCG INJ FL 1ML 2. TARIF 9334984 ARANESP 15MCG INJ SEC 0,375ML 2. TARIF 9233272 ARANESP 15MCG INJ SRG0,375ML 2. TARIF 9274615 2. TARIF Page 2 sur 13 ARANESP 15MCG INJ STYL0,375ML OMEDIT pays de la Loire 22/01/2014 9335009 ARANESP 20MCG INJ SEC 0,5ML 2. TARIF 9233295 2. TARIF 9274638 48,56 15/10/2013 48,56 15/10/2013 607,00 15/10/2013 607,00 15/10/2013 607,00 15/10/2013 60,70 15/10/2013 60,70 15/10/2013 60,70 15/10/2013 72,84 15/10/2013 72,84 15/10/2013 72,84 15/10/2013 72,84 15/10/2013 97,13 15/10/2013 97,13 15/10/2013 97,13 ARANESP 80MCG INJ STYLO0,4ML 2. TARIF DCI 15/10/2013 ARANESP 80MCG INJ SRG0,4ML 2. TARIF 9274710 48,56 ARANESP 80MCG INJ SEC 0,4ML 2. TARIF 9233390 15/10/2013 ARANESP 60MCG INJ STYLO0,3ML 2. TARIF 9335073 48,56 ARANESP 60MCG INJ SRG0,3ML 2. TARIF 9274704 15/10/2013 ARANESP 60MCG INJ SEC 0,3ML 2. TARIF 9233384 36,42 ARANESP 60MCG INJ FL 1ML 2. TARIF 9335067 15/10/2013 ARANESP 50MCG INJ STYLO0,5ML 2. TARIF 9233378 36,42 ARANESP 50MCG INJ SRG0,5ML 2. TARIF 9274673 15/10/2013 ARANESP 50MCG INJ SEC 0,5ML 2. TARIF 9233361 36,42 ARANESP 500MCG INJ STYLO1ML 2. TARIF 9335044 15/10/2013 ARANESP 500MCG INJ SRG1ML 2. TARIF 9274696 364,20 ARANESP 500MCG INJ SEC 1ML 2. TARIF 9250922 15/10/2013 ARANESP 40MCG INJ STYLO0,4ML 2. TARIF 9335050 364,20 ARANESP 40MCG INJ SRG0,4ML 2. TARIF 9274667 15/10/2013 ARANESP 40MCG INJ SEC 0,4ML 2. TARIF 9233355 364,20 ARANESP 40MCG INJ FL 1 ML 2. TARIF 9335038 15/10/2013 ARANESP 30MCG INJ STYLO0,3ML 2. TARIF 9233349 30,35 ARANESP 30MCG INJ SRG0,3ML 2. TARIF 9274644 15/10/2013 ARANESP 30MCG INJ SEC 0,3ML 2. TARIF 9233326 24,27 ARANESP 300MCG INJ STYLO0,6ML 2. TARIF 9335015 15/10/2013 ARANESP 300MCG INJ SRG0,6ML 2. TARIF 9274650 24,27 ARANESP 300MCG INJ SEC 0,6ML 2. TARIF 9233332 15/10/2013 ARANESP 25MCG INJ FL 1ML 2. TARIF 9335021 24,27 ARANESP 20MCG INJ STYLO0,5ML 2. TARIF 9233303 15/10/2013 ARANESP 20MCG INJ SRG0,5ML DEXRAZOXANE 9365625 CYRDANAX 20 MG/ML INJ FL 500 MG 1. INSCRIPTION 05/07/2013 2. TARIF 10/08/2013 DCI 104,00 DOCETAXEL 9361484 3. RADIATION Page 3 sur 13 DOCEFREZ 20 MG INJ FL + FL 01/03/2012 OMEDIT pays de la Loire 22/01/2014 9361490 DOCEFREZ 80 MG INJ FL + FL 3. RADIATION 9366636 01/03/2012 DOCETAXEL ACT 20 MG/ML FL 1 ML 3. RADIATION 9366642 01/03/2012 DOCETAXEL ACT 20 MG/ML FL 14 ML 3. RADIATION 9366659 01/03/2012 DOCETAXEL ACT 20 MG/ML FL 7 ML 3. RADIATION 9367535 01/03/2012 DOCETAXEL EBEWE 10 MG/ML FL 16ML 2. TARIF 9367535 28/09/2011 3. RADIATION 9352887 01/03/2012 DOCETAXEL EBW 10 MG/ML FL 2 ML 3. RADIATION 9352893 01/03/2012 DOCETAXEL EBW 10 MG/ML FL 8 ML 3. RADIATION 9371637 01/03/2012 DOCETAXEL EG 20 MG/ML FL 1 ML 3. RADIATION 9371637 01/03/2012 DOCETAXEL EG 20 MG/ML FL 1ML 2. TARIF 9371643 01/03/2012 DOCETAXEL HPI 10 MG/ML FL 8 ML 01/03/2012 DOCETAXEL ITA 20 MG/0,5 ML FL + FL 3. RADIATION 9353711 01/03/2012 DOCETAXEL ITA 80 MG/2 ML FL + FL 3. RADIATION 9348383 01/03/2012 DOCETAXEL TVC 20 MG/0,5 ML FL + FL 3. RADIATION 9348408 01/03/2012 DOCETAXEL TVC 80 MG/2 ML FL + FL 3. RADIATION 9353964 01/03/2012 TAXOTERE 160 MG/8 ML PERF FL 3. RADIATION 9178082 01/03/2012 TAXOTERE 20 mg INJ FL + FL 3. RADIATION 9342877 01/03/2012 TAXOTERE 20 MG/1 ML PERF FL 3. RADIATION 9178099 01/03/2012 TAXOTERE 80 mg INJ FL + FL 3. RADIATION 9342883 01/03/2012 TAXOTERE 80 MG/4 ML PERF FL 3. RADIATION DCI 01/03/2012 DROTRECOGINE ALFA (ACTIVE) 9242348 XIGRIS 20 mg INJ FL 3. RADIATION 9241604 01/03/2012 XIGRIS 5 mg INJ FL 3. RADIATION DCI 271,60 DOCETAXEL HPI 10 MG/ML FL 2 ML 3. RADIATION 9353705 28/09/2011 01/03/2012 01/03/2012 3. RADIATION 9351830 69,84 DOCETAXEL HPI 10 MG/ML FL 16 ML 3. RADIATION 9351824 28/09/2011 DOCETAXEL EG 20 MG/ML FL 4 ML 2. TARIF 3. RADIATION 9351818 526,72 DOCETAXEL EBW 10 MG/ML FL 16 ML 01/03/2012 EPOETINE ALFA 9311210 BINOCRIT 10000UI INJ SRG 1ML 2. TARIF 2. TARIF 9311204 2. TARIF 2. TARIF Page 4 sur 13 01/04/2012 15/10/2013 68,55 61,70 01/04/2012 15/10/2013 6,86 6,17 BINOCRIT 1000UI INJ SRG 0,5ML OMEDIT pays de la Loire 22/01/2014 9363431 BINOCRIT 20 000 UI INJ SRG 0,5 ML + AIG 2. TARIF 2. TARIF 2. TARIF 9343612 01/04/2012 15/10/2013 137,10 123,39 01/04/2012 15/10/2013 13,71 12,34 BINOCRIT 2000UI INJ SRG 1ML 2. TARIF 2. TARIF 9363454 147,42 137,10 123,39 BINOCRIT 20000UI INJ SRG 0,5ML 2. TARIF 2. TARIF 9311227 04/02/2012 01/04/2012 15/10/2013 BINOCRIT 30 000 UI INJ SRG 0,75 ML + AIG 2. TARIF 2. TARIF 2. TARIF 04/02/2012 01/04/2012 15/10/2013 221,13 205,65 185,09 01/04/2012 15/10/2013 205,65 185,09 2. TARIF 01/04/2012 20,56 2. TARIF 15/10/2013 18,51 9343629 BINOCRIT 30000UI INJ SG 0,75ML 2. TARIF 2. TARIF 9311233 9363477 BINOCRIT 3000UI INJ SRG 0,3ML BINOCRIT 40 000 UI INJ SRG 1 ML + AIG 2. TARIF 2. TARIF 04/02/2012 01/04/2012 294,84 274,20 2. TARIF 15/10/2013 246,78 01/04/2012 15/10/2013 274,20 246,78 01/04/2012 15/10/2013 27,42 24,67 01/04/2012 15/10/2013 34,28 30,85 01/04/2012 15/10/2013 41,13 37,02 2. TARIF 01/04/2012 54,84 2. TARIF 15/10/2013 49,36 15/10/2013 61,70 15/10/2013 18,51 15/10/2013 24,67 15/10/2013 30,85 15/10/2013 37,02 9343635 BINOCRIT 40000UI INJ SRG 1ML 2. TARIF 2. TARIF 9311256 BINOCRIT 4000UI INJ SRG 0,4ML 2. TARIF 2. TARIF 9311262 BINOCRIT 5000UI INJ SRG 0,5ML 2. TARIF 2. TARIF 9311279 BINOCRIT 6000UI INJ SRG 0,6ML 2. TARIF 2. TARIF 9311285 9147934 BINOCRIT 8000UI INJ SRG 0,8ML EPREX 10000UI INJ FL1ML 2. TARIF 9272645 EPREX 10000UI/ML INJ SRG 0,3ML 2. TARIF 9272651 EPREX 10000UI/ML INJ SRG 0,4ML 2. TARIF 9226303 EPREX 10000UI/ML INJ SRG0,5ML 2. TARIF 9226326 EPREX 10000UI/ML INJ SRG0,6ML 2. TARIF 9226332 EPREX 10000UI/ML INJ SRG0,7ML 3. RADIATION 9226349 20/06/2013 EPREX 10000UI/ML INJ SRG0,8ML 2. TARIF 9226355 15/10/2013 3. RADIATION 9167440 20/06/2013 EPREX 10000UI/ML INJ SRG1ML 2. TARIF 9147940 15/10/2013 9272668 Page 5 sur 13 61,70 EPREX 2000UI INJ FL1ML 3. RADIATION 3. RADIATION 49,36 EPREX 10000UI/ML INJ SRG0,9ML 20/06/2013 EPREX 2000UI/ML INJ FL 0,5ML 20/06/2013 OMEDIT pays de la Loire 22/01/2014 9273403 EPREX 2000UI/ML INJ SRG 0,5ML 2. TARIF 9311687 2. TARIF 9207719 6,17 15/10/2013 185,09 15/10/2013 246,78 EPREX 40000UI INJ FL1ML 2. TARIF 9284476 15/10/2013 EPREX 40000U/ML INJ SRG0 75ML EPREX 40000UI INJ SOL INJ SER 0,5ML 2. TARIF 15/10/2013 123,39 15/10/2013 246,78 15/10/2013 24,67 15/10/2013 12,34 15/10/2013 6,07 15/10/2013 60,70 15/10/2013 60,70 15/10/2013 607,00 15/10/2013 12,14 15/10/2013 121,40 15/10/2013 121,40 15/10/2013 18,21 15/10/2013 182,10 15/10/2013 24,28 15/10/2013 3,04 15/10/2013 3,04 15/10/2013 30,35 15/10/2013 303,50 15/10/2013 36,42 15/10/2013 364,24 01/04/2012 15/10/2013 6,86 6,17 2. TARIF 01/04/2012 68,55 2. TARIF 15/10/2013 61,70 01/04/2012 15/10/2013 68,55 61,70 01/04/2012 15/10/2013 6,86 6,17 9284482 EPREX 40000UI INJ SOL INJ SER 1ML 2. TARIF 9147957 EPREX 4000UI INJ FL1ML 2. TARIF 9272674 EPREX 4000UI/ML INJ SRG 0,5ML 2. TARIF DCI EPOETINE BETA 9201094 NEORECORMON 1000 INJ SRG 2. TARIF 9193928 NEORECORMON 10000 INJ CART. 2. TARIF 9201102 NEORECORMON 10000 INJ SRG 2. TARIF 9193940 NEORECORMON 100000 INJ FL+AMP 2. TARIF 9201119 NEORECORMON 2000 INJ SRG 2. TARIF 9199173 NEORECORMON 20000 INJ CART. 2. TARIF 9201125 NEORECORMON 20000 INJ SRG 2. TARIF 9201131 NEORECORMON 3000 INJ SRG 2. TARIF 9255718 NEORECORMON 30000 INJ SRG 1 2. TARIF 9227900 NEORECORMON 4000 INJ SRG 2. TARIF 9193992 NEORECORMON 500 INJ FL+AMP 2. TARIF 9201148 NEORECORMON 500 INJ SRG 2. TARIF 9201154 NEORECORMON 5000 INJ SRG 2. TARIF 9194023 NEORECORMON 50000 INJ FL+AMP 2. TARIF 9227917 NEORECORMON 6000 INJ SRG 2. TARIF 9227923 NEORECORMON 60000 INJ CART. 2. TARIF DCI EPOETINE THETA 9342908 EPORATIO 1000 UI/0,5ML SRG 2. TARIF 2. TARIF 9342920 9342937 EPORATIO 10000UI/1ML SRG EPORATIO 10000UI/1ML SRG +D 2. TARIF 2. TARIF 9342914 2. TARIF 2. TARIF Page 6 sur 13 EPORATIO 1000UI/0,5ML SRG + D OMEDIT pays de la Loire 22/01/2014 9342943 EPORATIO 2000 UI/0,5ML SRG 2. TARIF 2. TARIF 01/04/2012 15/10/2013 13,71 12,34 01/04/2012 15/10/2013 137,10 123,39 2. TARIF 01/04/2012 137,10 2. TARIF 15/10/2013 123,39 2. TARIF 01/04/2012 13,71 2. TARIF 15/10/2013 12,34 01/04/2012 15/10/2013 20,56 18,51 01/04/2012 15/10/2013 205,65 185,09 01/04/2012 15/10/2013 205,65 185,09 2. TARIF 01/04/2012 20,56 2. TARIF 15/10/2013 18,51 01/04/2012 15/10/2013 27,42 24,67 01/04/2012 15/10/2013 27,42 24,67 01/04/2012 15/10/2013 34,28 30,85 01/04/2012 15/10/2013 34,28 30,85 01/04/2012 15/10/2013 68,55 61,70 2. TARIF 01/04/2012 6,86 2. TARIF 15/10/2013 6,17 01/04/2012 15/10/2013 137,10 123,39 01/04/2012 15/10/2013 13,71 12,34 01/04/2012 15/10/2013 205,65 185,09 01/04/2012 15/10/2013 20,56 18,51 2. TARIF 01/04/2012 274,20 2. TARIF 15/10/2013 246,78 01/04/2012 15/10/2013 27,42 24,67 9342972 EPORATIO 20000UI/1ML SRG 2. TARIF 2. TARIF 9342989 9342966 9342995 EPORATIO 20000UI/1ML SRG + D EPORATIO 2000UI/0,5ML SRG + D EPORATIO 3000 UI/0,5ML SRG 2. TARIF 2. TARIF 9343026 EPORATIO 30000UI/1ML SRG 2. TARIF 2. TARIF 9343032 EPORATIO 30000UI/1ML SRG + D 2. TARIF 2. TARIF 9343003 9343049 EPORATIO 3000UI/0,5ML SRG + D EPORATIO 4000UI/0,5ML SRG 2. TARIF 2. TARIF 9343055 EPORATIO 4000UI/0,5ML SRG +D 2. TARIF 2. TARIF 9343061 EPORATIO 5000UI/0,5ML SRG 2. TARIF 2. TARIF 9343078 EPORATIO 5000UI/0,5ML SRG + D 2. TARIF 2. TARIF DCI EPOETINE ZETA 9315610 RETACRIT 10000U/1ML INJ SRG 2. TARIF 2. TARIF 9315604 9315633 RETACRIT 1000U/0,3ML INJ SRG RETACRIT 20000U/0,5ML INJ SRG 2. TARIF 2. TARIF 9315627 RETACRIT 2000U/0,6ML INJ SRG 2. TARIF 2. TARIF 9315662 RETACRIT 30000U/0,75ML INJ SRG 2. TARIF 2. TARIF 9315656 RETACRIT 3000U/0,9ML INJ SRG 2. TARIF 2. TARIF 9315685 9315679 2. TARIF 2. TARIF Page 7 sur 13 RETACRIT 40000U/1ML INJ SRG RETACRIT 4000U/0,4ML INJ SRG OMEDIT pays de la Loire 22/01/2014 9315691 RETACRIT 5000U/0,5ML INJ SRG 2. TARIF 2. TARIF 01/04/2012 15/10/2013 34,28 30,85 01/04/2012 15/10/2013 41,13 37,02 2. TARIF 01/04/2012 54,84 2. TARIF 15/10/2013 49,36 20/06/2013 10/08/2013 608,00 9315716 RETACRIT 6000U/0,6ML INJ SRG 2. TARIF 2. TARIF 9315722 DCI RETACRIT 8000U/0,8ML INJ SRG EPTACOG ALFA ACTIVE 9389732 NOVOSEVEN 1 MG INJ FL + SRG 1. INSCRIPTION 2. TARIF 9389749 NOVOSEVEN 2 MG INJ FL + SRG 1. INSCRIPTION 20/06/2013 2. TARIF 9389755 1. INSCRIPTION 2. TARIF 9389761 3 040,00 20/06/2013 10/08/2013 4 864,00 11/07/2012 03/08/2012 4 864,00 23/03/2012 04/07/2012 320,00 26/09/2013 19/09/2013 01/03/2014 43,80 42,27 24/04/2013 01/03/2014 109,50 105,67 ERIBULINE 9368954 HALAVEN 0,44 MG/ML INJ FL 2 ML 1. INSCRIPTION 2. TARIF DCI 20/06/2013 10/08/2013 NOVOSEVEN 8MG INJ FL + FL 1. INSCRIPTION 2. TARIF DCI 1 216,00 NOVOSEVEN 8 MG INJ FL + SRG 1. INSCRIPTION 2. TARIF 9384077 10/08/2013 NOVOSEVEN 5 MG INJ FL + SRG ETANERCEPT 9391048 ENBREL 10 MG PEDIA FL + SRG + N 1. INSCRIPTION 2. TARIF 2. TARIF 9242615 ENBREL 25MG INJ FL+SRG +NEC 2. TARIF 2. TARIF 9295853 ENBREL 25MG INJ FL+SRG 0,5ML +NEC 2. TARIF 2. TARIF 9295876 24/04/2013 01/03/2014 109,50 105,67 ENBREL 25MG/ML PEDIA FL+SRG +NEC 2. TARIF 24/04/2013 109,50 2. TARIF 01/03/2014 105,67 24/04/2013 01/03/2014 219,00 211,34 24/04/2013 01/03/2014 219,00 211,34 24/04/2013 01/03/2014 219,00 211,34 9270787 ENBREL 50MG INJ FL+SRG+NEC 2. TARIF 2. TARIF 9295882 ENBREL 50MG INJ SRG 1ML +NEC 2. TARIF 2. TARIF 9341725 ENBREL 50MG INJ STY 2. TARIF 2. TARIF DCI FACTEUR VIII DE COAGULATION HUMAIN 9169321 MONOCLATE 1 000 UI INJ FL + FL + NEC 3. RADIATION 9169344 01/03/2012 MONOCLATE 500 UI INJ FL + FL + NEC 3. RADIATION DCI 01/03/2012 FIBRINOGÈNE HUMAIN 9360527 2. TARIF Page 8 sur 13 RIASTAP 1 g 28/09/2011 463,00 OMEDIT pays de la Loire 22/01/2014 DCI FULVESTRANT 9261073 FASLODEX 250 MG/5 ML INJ SRG + A 3. RADIATION DCI 01/03/2012 GALSULFASE 9287196 NAGLAZYME 1MG/ML PERF FL5ML 2. TARIF 2. TARIF DCI 9377137 01/03/2012 IDARUBICINE 9371726 IDARUBICINE MYL 1 MG/ML FL 10 ML 1. INSCRIPTION 2. TARIF 2. TARIF 9371778 9371732 123,34 59,17 28/09/2011 01/01/2012 242,40 109,06 28/09/2011 01/01/2012 123,34 59,17 01/03/2013 ZAVEDOS 25 mg GELU 3. RADIATION 9208647 22/10/2011 23/11/2011 01/01/2012 ZAVEDOS 10 mg GELU 3. RADIATION 9208630 460,56 207,21 IDARUBICINE TEVA 1 MG/ML FL 5 ML 2. TARIF 2. TARIF 9208624 22/10/2011 23/11/2011 01/01/2012 IDARUBICINE TEVA 1 MG/ML FL 10 ML 2. TARIF 2. TARIF 9365097 242,40 109,06 IDARUBICINE MYL 1 MG/ML FL 5 ML 1. INSCRIPTION 2. TARIF 2. TARIF 9365080 22/10/2011 23/11/2011 01/01/2012 IDARUBICINE MYL 1 MG/ML FL 20 ML 1. INSCRIPTION 2. TARIF 2. TARIF 01/03/2013 ZAVEDOS 5 mg GELU 3. RADIATION 01/03/2013 ILOPROST 9297467 VENTAVIS 10MCG/ML NEB A.1ML 2. TARIF 9256965 01/01/2012 17,43 01/01/2012 17,43 VENTAVIS 10MCG/ML NEB A.2ML 2. TARIF IMMUNOGLOBULINE ANTILYMPHOCYTE 9055511 LYMPHOGLOBULINE INJ FL 5 ml 3. RADIATION 07/09/2011 IMMUNOGLOBULINE ANTITHYMOCYTE 9295511 THYMOGLOBULINE 5 MG/ML FL 3. RADIATION DCI 828,00 HEXVIX 85 MG VESIC FV + FP 3. RADIATION DCI 25/08/2012 29/09/2012 HEXYL AMINOLÉVULINATE 9297332 DCI 828,00 SIMPONI 50 MG INJ STY 0,5 ML 1. INSCRIPTION 2. TARIF DCI 25/08/2012 29/09/2012 SIMPONI 50 MG INJ SRG 0,5 ML 1. INSCRIPTION 2. TARIF DCI 1 372,75 1 300,41 GOLIMUMAB 9377120 DCI 01/03/2013 01/03/2014 07/09/2011 IMMUNOGLOBULINE HUMAINE NORMALE 9199078 GAMMAGARD 50MG/ML FL+FL100ML 2. TARIF 9199055 2. TARIF 9368983 1. INSCRIPTION 2. TARIF Page 9 sur 13 01/09/2012 275,00 01/09/2012 550,00 26/10/2011 23/11/2011 90,00 GAMMAGARD 50MG/ML FL+FL200ML HIZENTRA 200 MG/ML INJ FV 10 ml OMEDIT pays de la Loire 22/01/2014 9369008 HIZENTRA 200 MG/ML INJ FV 20 ml 1. INSCRIPTION 2. TARIF 9369014 10/08/2013 25/12/2013 INHIBITEUR DE C1 ESTERASE HUMAINE 9268081 BERINERT 500U INJ FL + FL 2. TARIF 01/03/2013 CINRYZE 500 UI INJ FL + FL 1. INSCRIPTION 2. TARIF 27/10/2012 09/02/2013 INSUPLANT 400 UI INJ FL 10 ML 3. RADIATION 01/03/2012 IPILIMUMAB 9374050 YERVOY 5 mg/ml Perf FL 10 ml 1. INSCRIPTION 2. TARIF 9374067 25/04/2012 08/03/2013 14 000,00 REVLIMID 10 MG GELU 3. RADIATION 9298136 01/03/2013 REVLIMID 15 MG GELU 3. RADIATION 9298142 01/03/2013 REVLIMID 25 MG GELU 3. RADIATION 9298159 01/03/2013 REVLIMID 5 MG GELU 3. RADIATION 01/03/2013 MÉTHOXY POLYÉTHYLÈNE GLYCOL-ÉPOÉTINE BÊTA 9313870 MIRCERA 100MCG INJ SRG 0,3ML 2. TARIF 9324632 9313887 15/10/2013 345,01 15/10/2013 431,27 15/10/2013 51,75 15/10/2013 621,02 15/10/2013 86,25 15/10/2013 129,38 MIRCERA 50MCG INJ SRG 0,3ML 2. TARIF 9313924 258,76 MIRCERA 360 MCG INJ SRG 0,6ML 2. TARIF 9313918 15/10/2013 MIRCERA 30 MCG INJ SRG 0,3ML. 2. TARIF 9324655 207,01 MIRCERA 250MCG INJ SRG 0,3ML 2. TARIF 9324649 15/10/2013 MIRCERA 200MCG INJ SRG 0,3ML 2. TARIF 9313901 172,51 MIRCERA 150MCG INJ SRG 0,3ML 2. TARIF 9313893 15/10/2013 MIRCERA 120 MCG INJ SRG 0,3ML 2. TARIF MIRCERA 75MCG INJ SRG 0,3ML 2. TARIF DCI 3 500,00 LÉNALIDOMIDE 9298113 DCI 25/04/2012 08/03/2013 YERVOY 5 mg/ml Perf FL 40 ml 1. INSCRIPTION 2. TARIF DCI 600,00 INSULINE HUMAINE 400 UI/ML 9227573 DCI 504,00 INHIBITEUR DE LA C1 ESTÉRASE HUMAINE 9382351 DCI 450,00 PRIVIGEN 100 MG/ML PERF FV 400 ML 1. INSCRIPTION DCI 45,00 05/07/2013 2. TARIF DCI 26/10/2011 23/11/2011 HIZENTRA 200MG/ML INJ FV 50ML 1. INSCRIPTION 9395112 180,00 HIZENTRA 200 MG/ML INJ FV 5 ml 1. INSCRIPTION 2. TARIF 9392326 26/10/2011 23/11/2011 MIGLUSTAT 9246725 ZAVESCA 100 mg, gélule 3. RADIATION 9246725 01/03/2013 ZAVESCA 100MG GELU 2. TARIF 01/03/2013 82,65 2. TARIF 01/03/2014 78,29 Page 10 sur 13 OMEDIT pays de la Loire 22/01/2014 DCI MOROCTOCOG ALFA 9390209 REFACTO AF 250 UI INJ SRG + MAT 1. INSCRIPTION 2. TARIF DCI 9383497 ADVATE 1 000 UI INJ FL + FL2ML + N 25/08/2012 2. TARIF 9383505 9383511 9371815 9353036 180,00 25/08/2012 29/09/2012 360,00 14/03/2012 ARZERRA 100 MG PERF FL 5 ML 14/03/2012 PANITUMUMAB 9307160 VECTIBIX 20MG/ML PERF FL 10ML 2. TARIF 9307177 9307183 01/07/2013 774,00 01/07/2013 1 548,00 01/07/2013 387,00 01/09/2013 01/07/2014 225,27 215,68 01/09/2013 01/07/2014 1 071,60 1 026,00 06/12/2013 14/12/2013 2 861,20 VECTIBIX 20MG/ML PERF FL 20ML 2. TARIF VECTIBIX 20MG/ML PERF FL 5ML 2. TARIF PEMETREXED 9311670 ALIMTA 100MG PERF FL 2. TARIF 2. TARIF 9261771 ALIMTA 500MG PERF FL 1 2. TARIF 2. TARIF PERTUZUMAB 9395106 PERJETA 420 MG PERF FL 14 ML 1. INSCRIPTION 2. TARIF PIRARUBICINE 9143534 THEPRUBICINE 10 mg INJ FL + A 3. RADIATION 9143540 01/03/2012 THEPRUBICINE 20 mg INJ FL + A 3. RADIATION 9143557 01/03/2012 THEPRUBICINE 50 mg INJ FL + FL 3. RADIATION 01/03/2012 RASBURICASE 9239116 FASTURTEC 1,5 mg/ml FL + A.1 ml 3. RADIATION 9239381 01/03/2012 FASTURTEC 1,5 mg/ml FL + A.5 ml 3. RADIATION DCI 25/08/2012 29/09/2012 ARZERRA 1 000 MG PERF FL 50 ML 1. INSCRIPTION DCI 1 080,00 OFATUMUMAB 1. INSCRIPTION DCI 25/08/2012 29/09/2012 ADVATE 500 UI INJ FL + FL2ML + N 1. INSCRIPTION 2. TARIF DCI 720,00 ADVATE 250 UI INJ FL + FL2ML + N 1. INSCRIPTION 2. TARIF 9383528 29/09/2012 ADVATE 1 500 UI INJ FL + FL2ML + N 1. INSCRIPTION 2. TARIF DCI 2 160,00 OCTOCOG ALPHA 1. INSCRIPTION DCI 20/06/2013 10/08/2013 BENEFIX 3 000 UI INJ FL + SRG 1. INSCRIPTION 2. TARIF DCI 180,00 NONACOG ALFA 9390184 DCI 20/06/2013 10/08/2013 01/03/2012 TEMSIROLIMUS 9304776 2. TARIF 2. TARIF Page 11 sur 13 TORISEL 25MG/ML PERF FL+FL 01/09/2013 01/06/2014 836,00 792,00 OMEDIT pays de la Loire 22/01/2014 DCI THYROTROPINE ALFA 9206921 THYROGEN 0,9MG INJ FL 2. TARIF DCI 371,45 01/04/2013 333,04 01/04/2013 666,08 01/04/2013 133,22 TOCILIZUMAB 9331879 ROACTEMRA 20MG/ML INJ FL 10ML 2. TARIF 9331885 ROACTEMRA 20MG/ML INJ FL 20ML 2. TARIF 9331891 ROACTEMRA 20MG/ML INJ FL 4ML 2. TARIF DCI 01/01/2013 TOPOTÉCAN 9311581 HYCAMTIN 0,25 MG GELU 3. RADIATION 9311598 01/03/2013 HYCAMTIN 1 MG GELU 3. RADIATION 9187023 01/03/2013 HYCAMTIN 4 mg PERF FL 5 ml 3. RADIATION 9378496 01/03/2013 POTACTASOL 1 MG INJ FL 1 1. INSCRIPTION 25/01/2012 2. TARIF 3. RADIATION 11/02/2012 01/03/2013 9378504 POTACTASOL 4 MG INJ FL 1 1. INSCRIPTION 25/01/2012 2. TARIF 3. RADIATION 11/02/2012 01/03/2013 9368925 01/03/2013 TOPOTECAN EBW 1MG/ML INJ 1 ML 3. RADIATION 9368931 01/03/2013 TOPOTECAN EBW 1MG/ML INJ 4 ML 3. RADIATION 9355029 01/03/2013 TOPOTECAN HPI 4 MG INJ FL 4 ML 3. RADIATION 9368836 01/03/2013 TOPOTECAN KABI 1 MG/ML FL 4 ML 2. TARIF 2. TARIF 9368836 28/09/2011 01/01/2012 01/03/2013 TOPOTECAN MDC 1 MG/ML INJ 1ML 3. RADIATION 9379946 01/03/2013 TOPOTECAN MDC 1 MG/ML INJ 4 ML 3. RADIATION 9379917 01/03/2013 TOPOTECAN MDC 1MG/ML INJ 1ML 1. INSCRIPTION 2. TARIF 9379946 01/03/2013 TOPOTECAN MYL 1 MG/ML INJ 4 ML 01/03/2013 TOPOTECAN TEVA 4 MG/4 ML FL 4 ML 2. TARIF 2. TARIF 9372482 28/09/2011 01/01/2012 3. RADIATION Page 12 sur 13 300,00 240,00 TOPOTECAN TVC 4 MG INJ FL 4 ML 3. RADIATION 9386001 240,00 TOPOTECAN MYL 1 MG/ML INJ 2 ML 3. RADIATION 9372482 11/07/2012 03/08/2012 01/03/2013 3. RADIATION 9365513 60,00 TOPOTECAN MYL 1 MG/ML INJ 1 ML 3. RADIATION 9365507 11/07/2012 03/08/2012 TOPOTECAN MDC 1MG/ML INJ 4ML 1. INSCRIPTION 2. TARIF 9365499 300,00 240,00 TOPOTECAN KBI 1 MG/ML INJ FL SP 3. RADIATION 9379917 240,00 TOPOTECAN EBW 1 MG/ML INJ 3 ML 3. RADIATION 9368919 60,00 01/03/2013 TOPOTECANE ACC 1 MG/ML INJ 4 ML 01/03/2013 OMEDIT pays de la Loire 22/01/2014 9381222 TOPOTECANE AHL 4 MG INJ FL 5ML 3. RADIATION 9381222 01/03/2013 TOPOTECANE AHL 4MG INJ FL 5ML 1. INSCRIPTION 11/07/2012 2. TARIF 03/08/2012 9386001 TOPOTECANE, ACC 1 mg/ml inj 4 ml 1. INSCRIPTION DCI 27/12/2012 TRASTUZUMAB 9220097 HERCEPTIN 150MG INJ FL 2. TARIF DCI 240,00 01/06/2013 536,87 02/03/2013 01/03/2014 2 847,01 2 747,36 02/03/2013 01/03/2014 2 847,01 2 747,36 USTEKINUMAB 9328096 STELARA 45MG INJ FL 0,5ML 2. TARIF 2. TARIF 9351787 STELARA 45MG INJ SRG 0,5ML 2. TARIF 2. TARIF 9351793 STELARA 90 MG INJ SRG 1 ML 1. INSCRIPTION 06/04/2012 2. TARIF 2. TARIF 2. TARIF 05/05/2012 02/03/2013 01/03/2014 2 950,27 2 847,01 2 747,36 01/03/2012 01/01/2014 1 409,54 1 339,07 DCI VÉRAGLUCERASE ALPHA 9355035 VPRIV 400U PERF FL 2. TARIF 2. TARIF DCI VINFLUNINE 9344853 JAVLOR 25 MG / ML INJ FL 2 (BOUCHON BUTYLE ELASTOMERE GRIS) 3. RADIATION 9348087 01/03/2012 JAVLOR 25 MG / ML INJ FL 4 (BOUCHON BUTYLE ELASTOMERE GRIS) 3. RADIATION 9344847 01/03/2012 JAVLOR 25 MG/ML INJ FL 10 (BOUCHON BUTYLE ELASTOMERE GRIS) 3. RADIATION 9348093 01/03/2012 JAVLOR 25 MG/ML INJ FL 10 ML (BOUCHON CHLOROBUTYLE ELASTOMERE NOIR) 3. RADIATION 9348101 01/03/2012 JAVLOR 25 MG/ML INJ FL 2 ML (BOUCHON CHLOROBUTYLE ELASTOMERE NOIR) 3. RADIATION 9348118 01/03/2012 JAVLOR 25 MG/ML INJ FL 4 ML (BOUCHON CHLOROBUTYLE ELASTOMERE NOIR) 3. RADIATION DCI 01/03/2012 ZICONOTIDE 9306870 PRIALT 100 MCG/ML PERF FL 1 ML 3. RADIATION 9317477 01/03/2012 PRIALT 100 MCG/ML PERF FL 2 ML 3. RADIATION 9306887 3. RADIATION Page 13 sur 13 01/03/2012 PRIALT 100 MCG/ML PERF FL 5 ML 01/03/2012 OMEDIT pays de la Loire 22/01/2014
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