Daftar Obar PRB Sesuai Ekatalog Januari 2015
Daftar Obar PRB Sesuai Ekatalog Januari 2015
Daftar Obar PRB Sesuai Ekatalog Januari 2015
N0
Diagno
Akarbose tablet/kaplet 50 mg
Glibenklamid tablet 5 mg
Gliklazid tab 30 mg
Gliklazid tab 80 mg
Glimepiride tablet 1 mg
Glimepiride tablet 2 mg
Glimepiride tablet 3 mg
Glimepiride tablet 4 mg
10
Glipizid tablet/kaplet/kapsul 5 mg
11
Glipizid tablet/kaplet/kapsul 10 mg
12
Glikuidon tab 30 mg
13
14
Human insulin short acting inj 100 UI/ml, penfill cartridge (Human Insulin
(Short Acting))
16
Human insulin short acting inj 100 UI/ml, penfill cartridge (Insulin human
Rapd)
17
Human insulin short acting inj 100 UI/ml, penfill cartridge (Insulin human
Rapd)
18
Human insulin short acting inj 100 UI/ml, vial (Human Insulin (Short
Acting))
19
Human insulin short acting inj 100 UI/ml, vial (Insulin human Rapd)
20
21
Human insulin intermediate acting inj 100 UI/ml, vial (Human Insulin
(Intermediate-Acting))
22
Human insulin intermediate acting inj 100 UI/ml, vial (Insulin human Basal)
23
24
25
26
27
Human insulin mix insulin inj 100 UI/ml, penfill cartridge (Human Insulin
(Premix: 30% Soluble + 70 % NPH Insulin))
28
Human insulin mix insulin inj 100 UI/ml, penfill cartridge (Insulin human
Comb)
29
Human insulin mix insulin inj 100 UI/ml, vial (Human Insulin (Premix: 30%
Soluble + 70 % NPH Insulin))
30
Human insulin mix insulin inj 100 UI/ml, vial (Insulin human Comb)
31
32
33
34
35
36
Analog insulin mix acting inj 100 UI/ml, Analog insulin mix acting inj 100
UI/ml (Premix 30% Insulin Aspart + 70% Protaminated Insulin Aspart
(Analogue))
37
Amlodipin tablet 5 mg
Amlodipin tablet 10 mg
Atenolol tablet/kapsul/kaplet 100 mg
Bisoprolol tablet 5 mg
Diltiazem HCl tablet 30 mg
Diltiazem Kapsul SR 100 mg
Diltiazem Kapsul SR 200 mg
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
Imidapril tab 5 mg
Imidapril tab 10 mg
Irbesartan tab 150 mg
Irbesartan tab 300 mg
Kandesartan tab 8 mg
Kandesartan tab 16 mg
Kaptopril tablet scored12,5 mg
Kaptopril tablet scored 25 mg
Kaptopril tablet 50 mg
Klonidin tablet 0,15 mg
Lisinopril tablet 5 mg
Lisinopril tablet 10 mg
Metildopa tablet salut 250 mg
Nifedipin tablet/kapsul 10 mg
77
78
79
80
81
82
83
84
85
86
87
88
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
Kodein tablet 10 mg
Kodein tablet 15 mg
Kodein tablet 20 mg
Antitusif
Espektoran
129
133
134
135
136
137
138
139
140
141
142
143
Metilprednisolon tablet 4 mg
Metilprednisolon tablet 8 mg
Analgesik Non Narkotik
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
Daftar Harga Obat Rujuk Balik Sesuai Ekatalog Januari 2015 dan SK Menkes Nomor KF/03.01/Menkes/312
Harga KM
Diagnosa/ Nama Obat/ Kekuatan
REGIONAL I
Akarbose
tab 50 mg
Akarbose
tab 100 mg
Glibenklamid
tab 2,5 mg
Glibenklamid
tab 5 mg
Gliklazid
Diamicron 30 MR
tab MR 30 mg
Gliklazid
Diamicron 60 SR
tab SR 60 mg
Gliklazid
Glicab
tab 80 mg
Glimepirid
tab 1 mg
Glimepirid
tab 2 mg
Glimepirid
tab 3 mg
5,400
Glimepirid
tab 4 mg
Glipizid
Glucotrol
tab 5 mg
3,000
Glipizid
Glucotrol
tab 10 mg
3,207
Glikuidon
tab 30 mg
Metformin
tab 500 mg
Metformin
tab 850 mg
Human insulin* :
Human insulin* :
198
Human insulin* :
nti Hipertensi
Amlodipin
Amlodipin
Atenolol
Atenolol
Bisoprolol
Diltiazem
Diltiazem
Diltiazem
tab 5 mg
tab 10 mg
tab 50 mg
tab 100 mg
tab 5 mg
tab 30 mg
kaps SR 100 mg
kaps SR 200 mg
Analog insulin* :
Analog insulin* :
Analog insulin* :
522
1,410
Doksazosin
Doksazosin
Hidroklorotiazid
Imidapril
Imidapril
Irbesartan
Irbesartan
Kandesartan
Kandesartan
Kaptopril
Kaptopril
Kaptopril
Klonidin
Lisinopril
Lisinopril
Lisinopril
Metildopa
Nifedipin
Nifedipin
Nifedipin
Perindoprilarginin
Propranolol
Ramipril
Ramipril
Ramipril
Telmisartan
Telmisartan
Valsartan
Valsartan
Verapamil
Verapamil
BAT UNTUK PENYAKIT JANTUNG
nti Angina
Atenolol
Diltiazem HCl
Gliseril trinitrat
Gliseril trinitrat
Gliseril trinitrat
Isosorbid dinitrat
Isosorbid dinitrat
nti Aritmia
Amiodaron
Digoksin
Propranolol
Propranolol
Verapamil
nti Agregasi Platelet
Asam asetilsalisilat (asetosal)
Asam asetilsalisilat (asetosal)
Klopidogrel
bat untuk Gagal Jantung
tab 1 mg
tab 2 mg
tab 25 mg
tab 5 mg
tab 10 mg
tab 150 mg
tab 300 mg
tab 8 mg
tab 16 mg
tab 12,5 mg
tab 25 mg
tab 50 mg
tab 0,15 mg
tab 5 mg
tab 10 mg
tab 20 mg
tab sal 250 mg
kaps 10 mg
tab SR 20 mg
tab SR 30 mg
tab 5 mg
tab 10 mg
tab 2,5 mg
tab 5 mg
tab 10 mg
tab 40 mg
tab 80 mg
tab 80 mg
tab 160 mg
tab 80 mg
tab 240 mg
tab 50 mg
tab 30 mg
tab sublingual 0,5 mg
kap SR 2,5 mg
kap SR 5 mg
tab 5 mg
tab 10 mg
48
800
1,013
190
tab 200 mg
tab 0,25 mg
tab 10 mg
tab 40 mg
tab 80 mg
tab 80 mg
tab 100 mg
tab 75 mg
148
Bisoprolol
Bisoprolol
Digoksin
Furosemid
Kaptopril
Kaptopril
Kaptopril
Karvediol
Spironolakton
Ramipril
Ramipril
BAT UNTUK PENYAKIT ASMA
nti Asma
Aminofilin
Aminofilin
Budesonid
Budesonid
tab 2,5 mg
tab 5 mg
tab 0,25 mg
tab 40 mg
tab scored 12,5 mg
tab scored 25 mg
tab 50 mg
kaps 6,25 mg
tab 25 mg
tab 5 mg
tab 10 mg
tab 150 mg
tab scored 200 mg
serbuk ih100 mcg/dosis
ih 200 mcg/dosis , 100 dosis
ih 200 mcg/dosis , 200 dosis
inh 80/4,5 mcg
inh 160/4,5 mcg
tab 0,5 mg
aerosol ih 100 mcg/puff
Cairan inh 0,1%
inh 20mcg/puff
tab 4 mg
tab 16 mg
tab 2 mg
tab 4 mg
lar ih 0,5 %
sir 2 mg/5 mL
serb
inh100
200mcg
mcg/kaps +
aerosol
rotahaler. Ket : 1 paket berisi
100 caps @ 200 mcg +
tab
100 mg
rotahaler
tab 150 mg
tab SR 300 mg
tab 2,5 mg
1,360
80
100,000
10,560
340
1,170
inh 50 mcg/puff
tab 10 mg
tab 15 mg
tab 20 mg
kaps 200 mg
750
inh 20 mcg/puff
kaps 18 mcg + handihaller
kaps 18 mcg, refill
kaps 50 mg
kaps 100 mg
tab 30 mg
tab 100 mg
tab 200 mg
sir 100 mg/5 mL
tab sal 250 mg
tab sal 500 mg
tab SR 250 mg
tab SR 500 mg
sir 250 mg/5 mL
13,000
98
210
1,680
tab 200 mg
tab 400 mg
tab 150 mg
tab 250 mg
tab 4 mg
tab 8 mg
tab 5 mg
kaps 250 mg
kaps 500 mg
tab 200 mg
tab 400 mg
sir 100 mg/5 mL
sir 200 mg/5 mL
tab 25 mg
tab 50 mg
tab 500 mg
kaps lunak 0,25 mcg
kaps lunak 0,5 mcg
tab 0,5 mg
tab 1,5 mg
tab 5 mg
tab 100 mg
tab 1 mg
tab 2 mg
tab 3 mg
tab 5 mg
tab 80 mg
115
126
560
2,500
tab 100 mg
tab 75 mg
tab 10 mg
tab 25 mg
60
60
tab 50 mcg
58
tab 50 mg
tab 80 mg
tab 100 mg
tab sal 10 mg
tab sal 20 mg
/Menkes/312/2014
REGIONAL III
REGIONAL IV
Harga
Pabrik
56 PT. Indofarma
5,670
5,940
6,480
3,150
3,300
3,600
3,367
3,528
3,848
207
217
237
574
1,550
626
1,691
700
645
134
3,667
4,015
PT Kalbe Farma
PT. Pratapa Nirmala
PT. Indofarma
PT. Tanabe Indonesia
PT. Tanabe Indonesia
840
1,064
200
53
880
114
209
58
960
1,216
228
2,120
3,908
1,425
2,470
3,100
4,900
62
84
140
184
350
600
800
100
2,999
3,500
2,420
995
580
1,013
3,900
6,500
3,900
6,500
234
6,200
134
1,500
1,493
2,171
88
189
PT. Indofarma
PT. Actavis Indonesia
PT. Kimia Farma
PT. Kimia Farma
PT. Indofarma
163
178
1,428
1,496
1,632
84
88
96
105,000
110,000
120,000
746
645
97
85
62
84
140
1,360
315
580
1,013
80 PT. Erela
90 PT. Marin Liza Farmasi
93,000
106,000
110,500
117,600
68
72,900
117,500
80,000
205
635
59
11,088
11,616
12,672
63,750 PT. Glaxo Wellcome Indonesia
5,867 PT. Glaxo Wellcome Indonesia
357
1,229
374
1,287
408
1,404
825
900
13,650
14,300
15,600
103
221
108
231
118
252
1,764
1,848
2,016
127
138
132
139
151
112
110
150
3,499
4,499
133
200
588
2,625
616
2,750
672
3,000
PT. Bernofarm
PT. Yarindo Farmatama
PT. Novapharin
PT. Indofarma
PT. Indofarma
PT. Phapros, Tbk
PT. Novell Pharmaeutical Laboratories
59
69
96
144
1,200
1,008
2,000
405
PT. Indofarma
PT. Indofarma
PT. Indofarma
PT. Mersifarma Tirmaku Mercusana
PT. Dexa Medica
PT. Mersifarma Tirmaku Mercusana
PT. Dexa Medica
PT. Darya Varia
66
66
72
72
61
64
70
57 PT. Afifarma