· has established a drug price reference index ... 72 anti -rabies serum (e quine) 200 iu/ml, 5...

Page

Overview

The high and extremely variable prices of medicines in the Philippines impact on access to effective, efficient and equitable health care. In 2009, a study conducted by Health Action International revealed that there was extreme variability in the procurement prices of essential medicines in the national and local public health facilities in the country. On average, originator brands and generic equivalents were procured almost 16 times and 3 times higher, respectively, compared to prices available on the international market. 1

DOH-Central Office Bids and Awards Committee (DOH-COBAC) and DOH hospitals were shown to have more efficient procurement prices compared to provincial and municipal health facilities, thus leading to variability in access to essential medicines across the Philippines.

Republic Act (RA) 9502 or the Universally Accessible Cheaper and Quality Medicines Act of 2008 gave the DOH instruments to monitor and regulate the prices of drugs and medicines to protect consumers and the public procuring entities from excessive mark-ups applied to prices of medicines resulting from information asymmetry and the lack of effective market competition. To address these issues, the DOH Pharmaceutical Division (formerly NCPAM) has established a Drug Price Reference Index (DPRI) for all essential medicines to guide all national and local government health facilities in the efficient sourcing of pharmaceutical products in the public sector.

What is the Drug Price Reference Index (DPRI)? The DPRI lists the ceiling prices of essential medicines for government bidding and procurement set by the DOH for all DOH Retained Hospitals and Regional Offices (ROs). Winning bid prices of essential medicines within the DPRI ceiling reflect efficient and effective procurement that facilitates consumer access to medicines and protection from excessive mark-ups of prices. The DPRI only reflects the acquisition costs including landed cost, packaging, drug content, quality assurance, manufacturing overheads and Food and Drug Administration (FDA) fees. The DPRI excludes other costs such as pharmacy services, preparation and storage fees and applicable taxes to medicines (i.e. VAT), and other reasonable pharmacy mark-ups, which are now being evaluated by the DOH.

The DPRI aims to improve the efficiency and good governance in the pricing and procurement of medicines in the public sector through establishing a transparent and publicly available reference price for affordable and quality medicines. It also aims to guide the Philippine Health Insurance Corporation (PHIC) in setting reimbursement caps for medicines both for inpatient and outpatient services.

1 Douglas B, Tisocki K (2009) Public Procurement Prices of Medicines in the Philippines. Health Action International

2 |

Page

All solid oral dosage forms referred to herein as “tablet” shall pertain to the following(DM No. 2015 – 0286):• Uncoated tablets;• Coated tablets (including film-coated and sugar-coated tablets);• Soluble tablets;• Dispersible tablets;• Effervescent tablets;• Tablets for use in mouth (Including orally disintegrating, sublingual and buccal tablets);• Modified-release tablets including delayed-release tablets (gastro-resistant/enteric-coated tablets) and sustained- release tablets (extended/prolonged-release tablets).

Who should use the DPRI? All government entities should be guided by the DPRI when procuring medicines. It shall be applied to all forms of procurement such as public bidding, direct contracting, shopping, negotiated procurement, emergency procurement and consignment to ensure that the government achieves the best value for money in sourcing essential medicines.

What are the sources of the Price Data? The DPRI is computed based on the prevailing public tender prices of the previous year (2014) reflected in the actual Purchase Orders (POs) submitted by the DOH Retained Hospitals, ROs, Central Office Bids and Awards Committee (COBAC) and Philippine International Trading Corporation (PITC) Pharma Inc. (PPI) to the DOH.

Only data coming from reputable suppliers are considered in the database which means that they should be licensed by the Philippine Food and Drug Administration (FDA) and have a certificate of Good Manufacturing Practice issued by the FDA.

How is the Drug Price Reference (DPR) determined? The DPR is set at the Median or the 50th percentile across the range of prevailing tender prices of essential medicines. For medicines with less than four (4) manufacturers, the DPR may be set at the lowest winning bid price from a reputable supplier. Projected inflationary costs have already been considered in the calculation of the DPR.

For innovator drugs approved for inclusion in the Philippine National Formulary, the price may be set by referencing with relevant international markets particularly those with similar income status (i.e. Thailand, India). It may also be informed by economic evaluations conducted in the Philippines used by the DOH to value their claimed clinical benefits and negotiate tender prices where an innovative pharmaceutical pro-duct has only one sole supplier.

How often shall the DPRI be updated? The DPRI shall be updated annually. All DOH hospitals and ROs are directed to submit a copy of their POs of the previous year to the DOH Pharmaceutical Division at or before the end of the first quarter of the succeeding year. The updated DPRI shall be based on the procurement price data of medicines from the previous year.

| 3

|

P a g e 4 | 19

Generic Name Dosage Strength / Form Lowest - Highest

Tender Price (Php) DPR (Php)

0 1 0.9% Sodium Chloride 1L Bottle 7.25 - 119.95 35.00 2 0.9% Sodium Chloride 50 mL Bottle 17.00 - 85.00 17.00 3 0.9% Sodium Chloride 500 mL Bottle 11.75 - 98.00 35.00

1 4 10% Dextrose in Water 1 L Bottle 16.25 - 68.50 35.00 5 10% Dextrose in Water 500 mL Bottle 19.80 - 80.00 35.00

5 6 5% Dextrose in 0.3% Sodium Chloride 1 L Bottle 23.00 - 125.00 35.00 7 5% Dextrose in 0.3% Sodium Chloride 500 mL Bottle 13.30 - 80.00 35.00 8 5% Dextrose in 0.9% Sodium Chloride 1 L Bottle 10.70 - 80.00 35.00 9 5% Dextrose in 0.9% Sodium Chloride 500 mL Bottle 11.75 - 115.51 35.00

10 5% Dextrose in Lactated Ringer's 1 L Bottle 10.70 - 80.00 35.00 11 5% Dextrose in Lactated Ringer's 500 mL Bottle 11.75 - 59.95 35.00 12 5% Dextrose in Water 1 L Bottle 15.50 - 69.50 35.00 13 5% Dextrose in Water 250 mL Bottle 40.00 - 96.10 35.00 14 5% Dextrose in Water 500 mL Bottle 11.50 - 100.00 35.00

A 15 Acarbose 100 mg Tablet 17.54 - 18.57 17.54 16 Acarbose 50 mg Tablet 5.92 - 11.01 5.92 17 Acetazolamide 250 mg Tablet 20.00 - 29.40 20.00 18 Acetylcysteine 100 mg Sachet 9.99 - 12.02 9.99 19 Acetylcysteine 100 mg/5 mL, 150 mL Suspension 226.80 - 252.00 226.80 20 Acetylcysteine 200 mg Sachet 5.00 - 21.88 5.00 21 Acetylcysteine 200 mg/mL, 25 mL Bottle 1,650.00 - 1,700.44 1,650.00 22 Acetylcysteine 600 mg Effervescent Tablet 18.00 - 49.12 18.00 23 Aciclovir 200 mg Tablet 2.35 - 50.03 5.25 24 Aciclovir 25 mg/mL, 10 mL Vial 730.00 - 976.05 730.00 25 Aciclovir 400 mg Tablet 7.29 - 88.49 15.00 26 Aciclovir 800 mg Tablet 22.50 - 295.00 53.65 27 Adenosine 3 mg/mL, 2 mL Vial 889.88 - 1,150.00 889.88 28 Albendazole 400 mg Chewable Tablet 0.83 - 4.50 0.83 29 Albumin, Human 20%, 50 mL Bottle 1,650.00 - 2,800.00 2,000.00 30 Albumin, Human 25%, 50 mL Bag 2,300.00 2,300.00 31 Albumin, Human 25%, 50 mL Bottle 2,000.00 - 3,100.00 2,000.00 32 Alcohol, Ethyl 70% Solution, 500 mL Bottle 48.90 - 53.00 48.90 33 Alendronate Sodium 70 mg Tablet 124.95 - 253.00 124.95 34 Alfuzosin 10 mg Tablet 24.76 - 47.75 24.76 35 All-in-One Admixtures 3-in-1 or Dual Energy Solution 3,000.00 - 3,360.00 3,000.00 36 Allopurinol 100 mg Tablet 0.43 - 7.14 0.70 37 Allopurinol 300 mg Tablet 0.92 - 20.30 1.18 38 Alprazolam 250 mcg Tablet 4.00 - 12.72 4.00 39 Alprazolam 500 mcg Tablet 5.00 - 16.00 5.00 40 Aluminum Hydroxide + Magnesium

Hydroxide 225 mg + 200 mg/5 mL, 120 mL Suspension

13.33 - 80.00 29.00

41 Aluminum Hydroxide + Magnesium Hydroxide

225 mg + 200 mg/5 mL, 60 mL Suspension

13.28 - 149.00 13.28

42 Amikacin (as Sulfate) 100 mg/mL, 2 mL Vial 13.82 - 339.00 13.82 43 Amikacin (as Sulfate) 125 mg/mL, 2 mL Vial 10.95 - 195.00 10.95 44 Amikacin (as Sulfate) 250 mg/mL, 2 mL Vial 10.88 - 194.00 10.88 45 Amikacin (as Sulfate) 50 mg/mL, 2 mL Vial 16.85 - 90.00 16.85 46 Amikacin (as Sulfate) 500 mg Powder Vial 17.65 - 28.48 17.65

Page

P a g e 5 | 19



47 Amino Acid Solutions for Hepatic Failure

8%, 500 mL Bottle 394.00 - 798.00 394.00

48 Amino Acid Solutions for Infants 6%, 100 mL Bottle 362.00 - 480.00 362.00 49 Amino Acid Solutions for Renal

Conditions 7%, 500 mL Bottle 420.00 - 490.00 420.00

50 Amino Acids, Crystalline Standard 5%, 500 mL Bottle 366.00 - 468.16 366.00 51 Amino Acids, Crystalline Standard 7%, 500 mL Bottle 453.60 - 489.00 453.60 52 Amino Acids, Crystalline Standard 8%, 500 mL Bottle 348.50 - 465.00 348.50 53 Amino Acids, Crystalline Standard 9.12%, 20 mL Ampule 120.00 - 280.00 120.00 54 Aminophylline 25 mg/mL, 10 mL Ampule 14.00 - 84.00 14.00 55 Amiodarone 200 mg Tablet 4.95 - 20.00 16.50 56 Amiodarone 50 mg/mL, 3 mL Ampule 135.00 - 488.00 135.00 57 Amlodipine 10 mg Tablet 0.29 - 4.70 0.72 58 Amlodipine 5 mg Tablet 0.28 - 4.00 0.61 59 Amoxicillin 100 mg/mL, 10 mL Drops 11.35 - 48.60 13.78 60 Amoxicillin 100 mg/mL, 15 mL Drops 11.43 - 68.00 14.00 61 Amoxicillin 125 mg/5 mL, 60 mL Suspension 12.35 - 97.50 14.25 62 Amoxicillin 250 mg Capsule 0.76 - 3.80 0.76 63 Amoxicillin 250 mg/5 mL, 60 mL Suspension 12.75 - 97.50 15.78 64 Amoxicillin 500 mg Capsule 1.05 - 6.80 1.26 65 Amphotericin B (Non-Lipid Complex) 50 mg Vial 2,748.00 2,748.00 66 Ampicillin + Sulbactam 1.5 g Vial 87.54 - 1,239.77 300.00 67 Ampicillin + Sulbactam 250 mg + 125 mg Vial 78.39 - 246.00 78.39 68 Ampicillin + Sulbactam 500 mg + 250 mg Vial 20.00 - 250.00 72.19 69 Ampicillin 1 g Vial 6.92 - 60.00 9.14 70 Ampicillin 250 mg Vial 3.97 - 49.88 6.70 71 Ampicillin 500 mg Vial 3.59 - 63.22 5.45 72 Anti-rabies Serum (Equine) 200 IU/mL, 5 mL Vial 920.00 - 1,350.00 920.00 73 Anti-tetanus Serum (ATS) (Equine) 1500 IU/mL, 1 mL Ampule 18.00 - 28.00 18.00 74 Ascorbic Acid (Vitamin C) 100 mg/5 mL, 120 mL Syrup 14.68 - 99.50 19.13 75 Ascorbic Acid (Vitamin C) 100 mg/5 mL, 60 mL Syrup 9.10 - 30.00 11.85 76 Ascorbic Acid (Vitamin C) 100 mg/mL, 15 mL Drops 9.10 - 58.93 12.60 77 Ascorbic Acid (Vitamin C) 100 mg/mL, 60 mL Drops 10.44 - 12.00 10.44 78 Ascorbic Acid (Vitamin C) 500 mg Tablet 0.45 - 3.95 0.68 79 Aspirin 80 mg Tablet 0.65 - 2.88 0.91 80 Atenolol 100 mg Tablet 2.80 - 11.00 2.80 81 Atenolol 50 mg Tablet 1.26 - 2.79 1.26 82 Atracurium 10 mg/mL, 2.5 mL Ampule 43.68 - 384.00 115.75 83 Atropine 1 mg/mL, 1 mL Ampule 2.20 - 25.00 2.20 84 Atropine 1%, 5 mL Eye Drops Bottle 168.50 - 260.49 168.50 85 Azithromycin 200 mg/5 mL, 15 mL Suspension 160.00 - 365.52 160.00 86 Azithromycin 200 mg/5 mL, 30 mL Suspension 189.75 - 241.50 189.75 87 Azithromycin 500 mg Tablet 10.00 - 110.77 47.50 88 Azithromycin 500 mg Vial 238.90 - 750.00 707.16

B 89 Baclofen 10 mg Tablet 16.00 - 49.50 16.00 90 Balanced Multiple Maintenance

Solution with 5% Dextrose for Adult 1 L Bottle 11.75 - 125.00 35.00

91 Balanced Multiple Maintenance Solution with 5% Dextrose for Pedia

500 mL Bottle 15.00 - 80.00 35.00

92 Balanced Multiple Replacement Solution with 5% Dextrose

1 L Bottle 25.00 - 120.00 35.00

| 5

Page

P a g e 6 | 19



93 Balanced Multiple Replacement Solution with 5% Dextrose

500 mL Bottle 35.05 - 46.00 35.00

94 Beractant 25 mg/mL, 4 mL Vial 10,073.92 - 11,070.25 10,073.92 95 Betahistine 24 mg Tablet 32.00 - 45.87 32.00 96 Betahistine 8 mg Tablet 7.20 - 35.00 15.00 97 Betamethasone 0.1%, 5 g Tube Cream 36.71 - 160.00 36.71 98 Biperiden Hydrochloride 2 mg Tablet 2.69 - 9.88 2.69 99 Biphasic Isophane Human Insulin

70/30 (Recombinant DNA) 70% Isophane Suspension + 30% Soluble Insulin in 100 IU/mL, 10 mL Vial

164.29 - 280.00 211.50

100 Biphasic Isophane Human Insulin 70/30 (Recombinant DNA)

70% Isophane Suspension + 30% Soluble Insulin in 100 IU/mL, 3 mL Disposable Syringe

341.90 - 420.00 341.90

101 Bisacodyl 10 mg Suppository 14.12 - 29.62 14.12 102 Bisacodyl 5 mg Suppository 22.85 - 39.00 22.85 103 Bisacodyl 5 mg Tablet 0.35 - 14.96 1.05 104 Bleomycin (as Sulfate) 15 mg Vial 1,770.00 1,770.00 105 Bromazepam 1.5 mg Tablet 8.01 8.01 106 Budesonide + Formoterol 160 mcg + 4.5 mcg, 60 Doses Dry

Powder Inhaler 709.42 - 854.35 709.42

107 Budesonide 250 mcg/mL, 2 mL Respiratory Solution

9.00 - 50.67 9.00

108 Bumetanide 1 mg Tablet 21.08 - 22.19 21.08 109 Bumetanide 500 mcg/mL, 4 mL Ampule 388.74 - 409.20 388.74 110 Bupivacaine 0.5% (Isobaric), 5 mL Ampule 55.20 - 422.00 176.30 111 Bupivacaine 0.5%, 10 mL Ampule 57.55 - 402.10 132.33 112 Bupivacaine 0.5%, 10 mL Vial 98.00 - 271.20 98.00 113 Bupivacaine 0.5%, 4 mL with 8% Dextrose Ampule 55.20 - 790.00 168.50 114 Butamirate Citrate 50 mg MR Tablet 10.75 - 23.90 10.75 115 Butorphanol (as Tartrate) 2 mg/mL, 1 mL Vial 368.00 - 423.50 368.00

C 116 Calcium Carbonate + Cholecalciferol

(Vit. D3) 1.25 g (Equiv. to 500 mg Elem. Calcium) + 250 IU Tablet

3.45 - 4.20 3.45

117 Calcium Carbonate + Cholecalciferol (Vit. D3)

600 mg Elemental Calcium + 400 IU Tablet

4.00 - 4.45 4.00

118 Calcium Carbonate 500 mg Tablet 0.79 - 10.00 1.40 119 Calcium Carbonate 600 mg Tablet 3.99 - 5.00 3.99 120 Calcium Folinate (Leucovorin

Calcium) 10 mg/mL, 5 mL Vial 139.75 - 450.00 139.75

121 Calcium Gluconate 10%, 10 mL Ampule 6.93 - 49.45 11.60 122 Calcium Gluconate 10%, 10 mL Vial 11.79 - 18.36 11.79 123 Calcium Gluconate 10%, 20 mL Bottle 18.00 - 23.00 18.00 124 Candesartan Cilexetil 16 mg Tablet 21.00 - 27.68 21.00 125 Candesartan Cilexetil 8 mg Tablet 11.00 - 14.45 11.00 126 Capecitabine 500 mg Tablet 86.25 - 89.00 86.25 127 Captopril 25 mg Tablet 0.47 - 6.05 0.68 128 Captopril 50 mg Tablet 2.80 - 4.56 2.80 129 Carbachol 0.01%, 1.5 mL Intraocular Solution

Vial 500.00 - 504.16 500.00

130 Carbamazepine 200 mg Tablet 0.88 - 20.83 1.39 131 Carboplatin 10 mg/mL, 15 mL Vial 540.00 - 1,205.00 540.00 132 Carboplatin 10 mg/mL, 45 mL Vial 2,094.50 - 3,800.00 2,094.50 133 Carboplatin 150 mg Powder Vial 561.26 - 873.60 561.26 134 Carboplatin 450 mg Powder Vial 1,100.00 - 1,372.68 1,100.00

6 |

Page

P a g e 7 | 19



135 Carvedilol 25 mg Tablet 1.80 - 28.50 4.75 136 Carvedilol 6.25 mg Tablet 0.83 - 4.40 1.57 137 Cefadroxil 500 mg Capsule 20.50 - 27.00 20.50 138 Cefalexin 100 mg/mL, 10 mL Drops 15.40 - 29.75 15.40 139 Cefalexin 125 mg/5 mL, 60 mL Bottle 15.31 - 105.68 15.31 140 Cefalexin 250 mg Capsule 1.40 - 7.80 1.69 141 Cefalexin 250 mg/5 mL, 60 mL Bottle 14.95 - 174.96 22.67 142 Cefalexin 500 mg Capsule 1.76 - 17.50 2.11 143 Cefazolin 1 g Vial 11.48 - 242.50 20.92 144 Cefazolin 500 mg Vial 17.19 - 120.00 17.19 145 Cefepime 1 g Vial 56.30 - 950.00 130.00 146 Cefepime 500 mg Vial 161.39 - 510.00 161.39 147 Cefixime 100 mg Capsule 15.50 - 68.00 15.50 148 Cefixime 100 mg/5 mL, 30 mL Suspension 170.00 - 397.86 170.00 149 Cefixime 100 mg/5 mL, 60 mL Suspension 178.00 - 656.52 235.00 150 Cefixime 20 mg/mL, 10 mL Suspension 107.00 - 190.00 107.00 151 Cefixime 200 mg Capsule 3.65 - 89.83 18.22 152 Cefixime 400 mg Capsule 168.00 168.00 153 Cefotaxime 1 g + 4 mL Diluent Vial 16.42 - 450.00 39.26 154 Cefotaxime 500 mg + 2 mL Diluent Vial 36.92 - 94.38 36.92 155 Cefoxitin 1 g Vial 226.00 - 470.00 226.00 156 Ceftazidime 1 g Vial 29.89 - 430.00 46.99 157 Ceftazidime 500 mg Vial 43.50 - 290.00 43.50 158 Ceftriaxone 1 g + 10 mL Diluent Vial 10.29 - 329.00 19.12 159 Ceftriaxone 500 mg + 5 mL Diluent Vial 29.68 - 89.92 29.68 160 Cefuroxime 1.5 g Vial 74.89 - 182.00 74.89 161 Cefuroxime 125 mg/5 mL, 50 mL Suspension 149.00 - 221.60 170.00 162 Cefuroxime 125 mg/5 mL, 70 mL Suspension 160.00 - 310.10 160.00 163 Cefuroxime 250 mg Tablet 10.42 - 25.95 10.42 164 Cefuroxime 250 mg Vial 28.82 - 98.50 28.82 165 Cefuroxime 250 mg/5 mL, 60 mL Suspension 98.00 - 398.40 245.12 166 Cefuroxime 500 mg Tablet 2.56 - 24.00 13.00 167 Cefuroxime 750 mg Vial 13.20 - 200.00 20.62 168 Celecoxib 100 mg Capsule 4.00 - 12.50 4.00 169 Celecoxib 200 mg Capsule 1.79 - 28.59 8.00 170 Celecoxib 400 mg Capsule 15.00 - 34.98 19.88 171 Cetirizine 1 mg/mL, 30 mL Bottle 29.00 - 100.00 75.50 172 Cetirizine 1 mg/mL, 60 mL Bottle 52.00 - 118.00 89.45 173 Cetirizine 10 mg Tablet 0.30 - 13.80 0.78 174 Cetirizine 10 mg/mL, 10 mL Drops 58.00 - 150.00 123.76 175 Chloramphenicol 0.5%, 5 mL Ear Drops Bottle 90.00 - 165.71 90.00 176 Chloramphenicol 1 g Vial 13.75 - 140.00 13.75 177 Chloramphenicol 125 mg/5 mL, 60 mL Suspension 17.49 - 199.64 21.82 178 Chloramphenicol 500 mg Capsule 1.98 - 34.66 2.10 179 Chlorphenamine (Chlorpheniramine) 10 mg/mL, 1 mL Ampule 8.00 - 22.48 8.00 180 Chlorphenamine (Chlorpheniramine) 4 mg Tablet 0.21 - 3.50 0.31 181 Chlorpromazine 100 mg Tablet 0.57 - 5.90 0.57 182 Chlorpromazine 200 mg Tablet 1.00 - 11.38 1.00 183 Cilostazol 100 mg Tablet 6.25 - 56.45 6.25 184 Cilostazol 50 mg Tablet 3.25 - 15.01 7.00 185 Cinnarizine 25 mg Tablet 0.68 - 5.00 1.05 186 Cinnarizine 75 mg Capsule 80.00 - 143.00 80.00

| 7

Page

P a g e 8 | 19



187 Ciprofloxacin 2 mg/mL, 100 mL Vial 15.45 - 785.07 33.29 188 Ciprofloxacin 250 mg Tablet 1.14 - 24.00 1.14 189 Ciprofloxacin 500 mg Tablet 0.82 - 11.00 1.39 190 Cisplatin 1 mg/mL, 10 mL Vial 168.25 - 364.00 168.25 191 Cisplatin 1 mg/mL, 50 mL Vial 276.89 - 567.50 449.00 192 Cisplatin 10 mg Powder Vial 123.25 - 130.66 123.25 193 Cisplatin 50 mg Powder Vial 276.89 - 474.50 276.89 194 Clarithromycin 125 mg/5 mL, 50 mL Suspension 115.00 - 346.75 172.25 195 Clarithromycin 125 mg/5 mL, 70 mL Suspension 150.00 - 346.50 150.00 196 Clarithromycin 250 mg Tablet 11.20 11.20 197 Clarithromycin 250 mg/5 mL, 70 mL Suspension 465.00 - 925.00 465.00 198 Clarithromycin 500 mg Tablet 7.70 - 28.50 11.04 199 Clindamycin 150 mg Capsule 1.62 - 22.07 1.83 200 Clindamycin 150 mg/mL, 2 mL Ampule 119.99 - 1,159.00 119.99 201 Clindamycin 150 mg/mL, 4 mL Ampule 57.43 - 411.37 124.50 202 Clindamycin 300 mg Capsule 1.99 - 39.31 2.49 203 Clindamycin 75 mg/5 mL, 60 mL Suspension 105.09 - 364.45 105.09 204 Clobetasol 0.05%, 5g Cream Tube 85.40 - 92.30 85.40 205 Clobetasol 0.05%, 5g Ointment Tube 90.00 - 150.00 90.00 206 Clonazepam 2 mg Tablet 3.00 - 10.02 3.00 207 Clonidine 150 mcg Tablet 3.45 - 34.82 19.00 208 Clonidine 150 mcg/mL, 1 mL Ampule 87.92 - 149.25 87.92 209 Clonidine 75 mcg Tablet 11.00 - 34.80 15.25 210 Clopidogrel 75 mg Tablet 0.27 - 11.16 3.84 211 Cloxacillin (as Sodium) 125 mg/5 mL, 60 mL Bottle 13.48 - 67.00 17.22 212 Cloxacillin (as Sodium) 250 mg Capsule 2.20 - 5.68 2.20 213 Cloxacillin (as Sodium) 250 mg/5 mL, 60 mL Bottle 28.93 - 47.52 28.93 214 Cloxacillin (as Sodium) 500 mg Capsule 1.34 - 9.26 2.56 215 Clozapine 100 mg Tablet 2.38 - 36.00 18.20 216 Co-Amoxiclav (Amoxicillin +

Potassium Clavulanate) 1 g Tablet 13.79 - 24.29 13.79

217 Co-Amoxiclav (Amoxicillin + Potassium Clavulanate)


70.00 - 106.10 70.00


200 mg + 28.5 mg/5 mL, 70 mL Suspension

85.00 - 184.64 85.00


250 mg + 125 mg Tablet 8.18 - 28.30 15.94


250 mg + 62.5 mg/5 mL, 60 mL Suspension

90.00 - 279.56 140.00



120.00 - 450.00 120.00


500 mg + 125 mg Tablet 6.30 - 35.00 9.00

223 Colchicine 500 mcg Tablet 1.87 - 4.95 3.43 224 Combined Amino Acids Sorbitol 500 mL Bottle 540.00 - 750.00 540.00 225 Cotrimoxazole (Sulfamethoxazole +

Trimethoprim) 200 mg + 40 mg/5 mL, 60 mL Suspension

9.89 - 65.00 12.33

226 Cotrimoxazole (Sulfamethoxazole + Trimethoprim)

400 mg + 80 mg, 5 mL Ampule 14.00 - 20.00 14.00


400 mg + 80 mg Capsule 0.52 - 0.59 0.52


400 mg + 80 mg Tablet 0.52 - 2.50 0.77


400 mg + 80mg/5 mL, 60 mL Suspension

12.33 - 186.27 18.00

8 |

Page

P a g e 9 | 19




800 mg + 160 mg Tablet 0.92 - 31.86 1.10

231 Cyclophosphamide 1 g Powder Vial 254.00 - 500.00 254.00 232 Cyclophosphamide 200 mg Powder Vial 133.33 - 150.00 133.33 233 Cyclophosphamide 500 mg Powder Vial 165.00 - 250.00 165.00 234 Cytarabine 100 mg Powder Vial 102.60 - 185.00 102.60 235 Cytarabine 100 mg/mL, 1 mL Vial 103.50 103.50 236 Cytarabine 100 mg/mL, 5 mL Vial 427.75 - 501.67 427.75

D 237 Dactinomycin (Actinomycin D) 500 mcg Powder Vial 350.00 - 360.00 350.00 238 Dexamethasone 4 mg Tablet 15.50 - 21.28 15.50 239 Dexamethasone 4 mg/mL, 2 mL Ampule 13.00 - 108.00 27.69 240 Dexamethasone 4 mg/mL, 2 mL Vial 18.20 - 49.85 18.20 241 Dexamethasone 5 mg/mL, 1 mL Ampule 26.82 - 72.08 26.82 242 Dextran, High Molecular Weight, 6%,

Dextran 70 in 0.9% NaCl 500 mL Bottle 450.00 - 504.00 450.00

243 Dextran, High Molecular Weight, 6%, Dextran 70 in 5% Dextrose

500 mL Bottle 400.00 - 502.74 400.00

244 Dextromethorphan 10 mg Tablet 0.85 - 3.00 0.85 245 Diazepam 10 mg Tablet 13.49 - 14.03 13.49 246 Diazepam 5 mg Tablet 5.89 - 15.00 5.89 247 Diazepam 5 mg/mL, 2 mL Ampule 28.12 - 101.95 59.35 248 Diclofenac 25 mg/mL, 3 mL Ampule 4.10 - 185.00 14.50 249 Diclofenac 50 mg Tablet 0.29 - 20.45 0.51 250 Dicycloverine (Dicyclomine) 10 mg Tablet 0.23 - 4.90 0.23 251 Dicycloverine (Dicyclomine) 10 mg/5 mL, 60 mL Syrup 8.95 - 60.00 8.95 252 Digoxin 250 mcg Tablet 3.46 - 13.45 3.46 253 Digoxin 250 mcg/mL, 2 mL Ampule 89.49 - 164.85 89.49 254 Digoxin 50 mcg/mL, 60 mL Elixir 677.73 - 694.05 677.73 255 Diltiazem 30 mg Tablet 2.84 - 21.92 9.88 256 Diltiazem 60 mg Tablet 2.95 - 30.83 15.00 257 Dimeglumine Gadopentetate 469 mg/mL, 10 mL Vial 1,800.00 - 2,500.00 1,800.00 258 Diphenhydramine (as Hydrochloride) 12.5 mg/5 mL, 60 mL Syrup 10.00 - 60.00 15.54 259 Diphenhydramine (as Hydrochloride) 50 mg Capsule 0.51 - 28.00 0.85 260 Diphenhydramine (as Hydrochloride) 50 mg/mL, 1 mL Ampule 34.50 - 199.89 47.94 261 Dobutamine 1 mg/mL, 250 mL D5W Pre-mixed 189.00 - 750.50 189.00 262 Dobutamine 12.5 mg/mL, 20 mL Vial 96.95 - 420.00 130.00 263 Dobutamine 4 mg/mL, 250 mL D5W Pre-mixed 480.00 - 1,200.00 480.00 264 Dobutamine 50 mg/mL, 5 mL Ampule 105.50 - 400.00 169.75 265 Docetaxel 20 mg/0.5 mL, 0.5 mL Vial 1,077.00 - 3,500.00 1,077.00 266 Docetaxel 40 mg/mL, 2 mL Vial 4,112.00 - 12,000.00 4,112.00 267 Domperidone 1 mg/mL, 60 mL Suspension 99.45 - 304.50 289.56 268 Domperidone 10 mg Tablet 1.23 - 21.05 2.80 269 Dopamine 1.6 mg/mL, 250 mL D5W Pre-mixed 224.50 - 550.00 224.50 270 Dopamine 40 mg/mL, 5 mL Ampule 21.59 - 144.00 45.75 271 Dopamine 800 mcg/mL, 250 mL D5W Pre-mixed 199.00 - 420.00 199.00 272 Doxorubicin 10 mg Powder Vial 128.30 - 359.00 128.30 273 Doxorubicin 2 mg/mL, 25 mL Vial 612.22 - 1,000.00 612.22 274 Doxorubicin 50 mg Powder Vial 540.25 - 1,150.00 540.25 275 Doxycycline (as Hyclate) 100 mg Capsule 0.72 - 104.15 0.93 276 Dydrogesterone 10 mg Tablet 42.00 - 56.39 42.00

| 9

Page

P a g e 10 | 19



E 277 Enalapril 10 mg Tablet 0.57 - 7.50 5.45 278 Enalapril 20 mg Tablet 5.96 - 12.54 9.41 279 Enalapril 5 mg Tablet 2.33 - 5.72 3.85 280 Enoxaparin 100 mg/mL, 0.2 mL Pre-filled Syringe 394.40 - 507.56 394.40 281 Enoxaparin 100 mg/mL, 0.4 mL Pre-filled Syringe 229.00 - 500.00 229.00 282 Enoxaparin 100 mg/mL, 0.6 mL Pre-filled Syringe 378.48 - 543.00 378.48 283 Enteral Nutrition - Fiber-Containing 400 g Can 514.24 - 732.74 514.24 284 Ephedrine 50 mg/mL, 1 mL Ampule 48.50 - 244.00 48.50 285 Epinephrine 1 mg/mL, 1 mL Ampule 32.95 - 98.60 41.89 286 Epoetin Alfa (recombinant human

erythropoietin) 10,000 IU/mL, Pre-filled Syringe 1,600.00 - 1,700.00 1,600.00

287 Epoetin Alfa (recombinant human erythropoietin)

2,000 IU/0.5 mL, Pre-filled Syringe 299.00 - 597.60 299.00




4,000 IU/mL, 1 mL Vial 427.00 - 1,153.80 427.00

290 Epoetin Beta (recombinant erythropoietin)


291 Epoetin Beta (recombinant erythropoietin)

5,000 IU/0.3 mL, Pre-filled Syringe 950.10 - 1,076.78 950.10

292 Ertapenem (as Sodium) 1 g Vial 2,345.75 - 3,000.00 2,345.75 293 Erythromycin 0.5%, 3.5g Eye Ointment Tube 88.82 - 189.00 124.25 294 Erythromycin 0.5%, 5g Eye Ointment Tube 95.00 - 404.50 95.00 295 Erythromycin 200 mg/5 mL, 60 mL Suspension 33.00 - 65.00 33.00 296 Erythromycin 500 mg Tablet 2.88 - 5.00 2.88 297 Escitalopram (as Oxalate) 10 mg Tablet 5.19 - 16.00 8.80 298 Ethambutol Hydrochloride 400 mg Tablet 2.89 - 4.32 2.89 299 Ethinylestradiol + Levonorgestrel 30 mcg + 150 mcg Cycle 18.00 - 28.50 18.00 300 Etoposide 100 mg Vial 330.00 - 445.00 330.00 301 Etoposide 20 mg/mL, 5 mL Vial 241.00 - 560.00 241.00

F 302 Famotidine 10 mg/mL, 2 mL Ampule 60.00 - 199.80 60.00 303 Felodipine 10 mg MR Tablet 8.00 - 22.77 14.30 304 Felodipine 2.5 mg MR Tablet 11.28 - 16.96 11.28 305 Felodipine 5 mg MR Tablet 3.50 - 18.00 7.40 306 Fenofibrate 160 mg Tablet 23.75 - 32.00 23.75 307 Fenofibrate 200 mg Capsule 8.50 - 24.00 17.00 308 Fentanyl 50 mcg/mL, 10 mL Ampule 90.00 - 660.00 90.00 309 Fentanyl 50 mcg/mL, 2 mL Ampule 68.00 - 280.00 80.75 310 Ferrous Salt (Equiv. to 15 mg Elem. Iron/0.6 mL),

15 mL Drops 15.05 - 28.00 15.05

311 Ferrous Salt (Equiv. to 30 mg Elem. Iron/5 mL), 60 mL Syrup

11.55 - 73.50 11.55

312 Ferrous Salt Equiv. to 60 mg Elem. Iron Tablet 0.44 - 3.00 0.44 313 Ferrous Sulfate + Folic Acid 60 mg Elem. Iron + 400 mcg Capsule 0.48 - 3.99 0.48 314 Ferrous Sulfate + Folic Acid 60 mg Elem. Iron + 400 mcg Tablet 0.36 - 3.90 0.58 315 Filgrastim 150 mcg/0.6 mL, Vial 1,068.00 - 1,400.00 1,068.00 316 Filgrastim 300 mcg/1.2 mL, Vial 950.00 - 3,000.00 950.00 317 Finasteride 5 mg Tablet 10.50 - 26.00 10.50 318 Fluconazole 150 mg Capsule 39.56 - 519.83 85.00 319 Fluconazole 2 mg/mL, 100 mL Vial 41.00 - 2,476.21 41.00 320 Fluconazole 200 mg Capsule 184.41 - 660.78 184.41

10 |

Page

P a g e 11 | 19



321 Fluconazole 50 mg Capsule 39.55 - 187.27 39.55 322 Fluorouracil 50 mg/mL, 10 mL Vial 59.75 - 99.00 80.00 323 Fluoxetine 20 mg Capsule 6.99 - 32.25 6.99 324 Fluoxetine 20 mg Dispersible Tablet 9.80 - 29.95 9.80 325 Fluphenazine (as Decanoate) 25 mg/mL, 10 mL Vial 375.00 - 822.00 375.00 326 Fluticasone + Salmeterol 125 mcg + 25 mcg, 120 Doses Metered

Dose Inhaler 125.65 - 459.00 267.30

327 Fluticasone + Salmeterol 250 mcg + 25 mcg, 120 Doses Metered Dose Inhaler

250.00 - 639.00 466.50

328 Fluticasone + Salmeterol 250 mcg + 50 mcg, 60 Doses Dry Powder Inhaler

399.00 - 894.60 399.00

329 Fluticasone + Salmeterol 500 mcg + 50 mcg, 60 Doses Dry Powder Inhaler

1,186.50 - 1,198.54 1,186.50

330 Fluticasone + Salmeterol 50 mcg + 25 mcg, 120 Doses Metered Dose Inhaler

107.20 - 289.00 107.20

331 Fluticasone 0.0.5% / Dose, 120 Doses Nasal Aqueous Solution

392.46 - 500.00 392.46

332 Folic Acid 5 mg Capsule 2.80 - 6.45 2.80 333 Folic Acid 5 mg Tablet 1.49 - 6.10 2.28 334 Fondaparinux 2.5 mg/0.5 mL, Solution 1,176.00 - 1,352.27 1,176.00 335 Furosemide 10 mg/mL, 2 mL Ampule 1.93 - 44.00 2.99 336 Furosemide 20 mg Tablet 0.54 - 3.00 0.84 337 Furosemide 40 mg Tablet 0.44 - 12.69 0.70 338 Fusidate Sodium/Fusidic Acid 2%, 5 g Cream Tube 35.00 - 308.32 35.00 339 Fusidate Sodium/Fusidic Acid 2%, 1.5 g Medicated Surgical Dressing

Ointment Sachet 94.41 - 99.66 94.41

G 340 Gabapentin 100 mg Capsule 7.50 - 31.40 12.16 341 Gabapentin 300 mg Capsule 8.73 - 32.67 13.00 342 Gemcitabine 1 g Vial 5,100.00 - 10,100.00 5,100.00 343 Gemcitabine 200 mg Vial 1,450.00 - 2,050.00 1,450.00 344 Gentamicin 0.3%, 5 mL Eye Drops Bottle 119.00 - 130.00 119.00 345 Gentamicin 40 mg/mL, 2 mL Ampule 1.63 - 44.00 4.90 346 Glibenclamide 5 mg Tablet 0.27 - 3.50 0.27 347 Gliclazide 30 mg MR Tablet 1.80 - 14.00 2.95 348 Gliclazide 60 mg MR Tablet 10.00 - 14.00 10.00 349 Gliclazide 80 mg Tablet 2.00 - 8.00 3.80 350 Glipizide 5 mg Tablet 4.60 - 12.58 4.60 351 Glucose (Dextrose) 50%, 50 mL Vial 11.33 - 50.00 11.33 352 Glyceryl Trinitrate (Nitroglycerine) 5 mg Patch 50.00 - 108.00 50.00

H 353 Haloperidol 20 mg Tablet 15.50 - 34.00 15.50 354 Haloperidol 5 mg Tablet 2.08 - 16.74 4.31 355 Haloperidol 5 mg/mL, 1 mL Ampule 104.44 - 399.89 104.44 356 Haloperidol 50 mg/mL, 1 mL Ampule 149.50 - 215.00 149.50 357 Heparin (as Sodium) 1000 IU/mL, 5 mL Vial 34.45 - 108.00 54.98 358 Heparin (as Sodium) 5000 IU/mL, 5 mL Vial 155.55 - 242.00 155.55 359 Hydralazine 20 mg/mL, 1 mL Ampule 120.00 - 258.50 120.00 360 Hydralazine 25 mg Tablet 19.39 - 20.89 19.39 361 Hydrochlorothiazide 25 mg Tablet 3.10 - 3.18 3.10 362 Hydrocortisone 1%, 5 g Cream Tube 60.00 - 108.00 60.00 363 Hydrocortisone 100 mg Powder Vial 18.43 - 240.50 24.80 364 Hydrocortisone 250 mg Powder Vial 23.40 - 397.00 23.40 365 Hydrocortisone 500 mg Powder Vial 78.79 - 109.85 78.79

| 11

Page

P a g e 12 | 19



366 Hydrogen Peroxide 3%, 120 mL Bottle 14.30 - 71.56 14.30 367 Hydroxyethyl Starch 6%, 500 mL Bottle 419.00 - 1,650.00 419.00 368 Hydroxyurea 500 mg Capsule 19.50 - 22.50 19.50 369 Hydroxyzine 10 mg Tablet 8.46 - 31.15 8.46 370 Hydroxyzine 2 mg/mL, 60 mL Syrup 150.00 - 199.99 150.00 371 Hydroxyzine 25 mg Tablet 14.95 - 31.15 14.95 372 Hyoscine (as N-butyl bromide) 10 mg Tablet 1.56 - 17.87 1.73 373 Hyoscine (as N-butyl bromide) 20 mg/mL, 1 mL Ampule 9.00 - 101.20 11.13

I 374 Ibuprofen 100 mg/5 mL, 60 mL Bottle 22.68 - 61.86 28.31 375 Ibuprofen 200 mg Tablet 0.55 - 3.40 0.55 376 Ibuprofen 200 mg/5 mL, 60 mL Bottle 55.00 - 115.00 55.00 377 Ibuprofen 400 mg Tablet 0.68 - 20.00 0.89 378 Ifosfamide 2 g Vial 2,067.00 - 2,800.00 2,067.00 379 Intraocular Irrigating Solution

(Balanced Salt Solution) 500 mL Bottle 230.00 - 490.00 230.00

380 Iohexol 300 mg Iodine/mL, 50 mL Vial 1,026.80 - 1,437.52 1,026.80 381 Iopamidol 612 mg/mL equiv to 300 mg Iodine,

100 mL Vial 1,345.00 - 2,350.00 1,345.00

382 Iopamidol 612 mg/mL equiv to 300 mg Iodine, 50 mL Vial

558.87 - 1,400.00 558.87

383 Iopamidol 755 mg/mL equiv. to 370 mg Iodine 100 mL Vial

1,650.00 - 2,700.00 1,650.00

384 Iopamidol 755 mg/mL equiv to 370 mg Iodine, 50 mL Vial

950.00 - 1,400.00 950.00

385 Ioversol 636 mg/mL equiv. to 300 mg/mL Iodine, 50 mL Vial

1,200.00 - 1,280.00 1,200.00

386 Ipratropium + Salbutamol 500 mcg + 2.5 mg, 2.5 mL Respiratory Solution

9.29 - 40.46 10.49

387 Irbesartan + Hydrochlorothiazide 150 mg + 12.5 mg Tablet 16.00 - 22.71 16.00 388 Irbesartan + Hydrochlorothiazide 300 mg + 12.5 mg Tablet 21.00 - 56.00 21.00 389 Irbesartan 150 mg Tablet 10.50 - 21.00 10.50 390 Irbesartan 300 mg Tablet 6.00 - 34.00 22.50 391 Isoflurane 100 mL Inhalation Bottle 549.00 - 6,200.00 549.00 392 Isoniazid + Rifampicin + Ethambutol 75 mg + 150 mg + 275 mg Tablet 5.10 - 6.25 5.10 393 Isoniazid + Rifampicin +

Pyrazinamide + Ethambutol 75 mg + 150 mg + 400 mg + 275 mg Tablet

3.98 - 8.00 5.63

394 Isoniazid 200 mg/5 mL, 120 mL Syrup 30.45 - 60.00 43.75 395 Isophane Insulin Human 100 IU/mL, 10 mL Vial 164.29 - 280.00 217.95 396 Isosorbide Dinitrate 1 mg/mL, 10 mL Ampule 400.00 - 779.00 400.00 397 Isosorbide Dinitrate 10 mg Tablet 1.63 - 19.20 9.82 398 Isosorbide Dinitrate 5 mg Tablet 3.00 - 46.75 8.08 399 Isosorbide-5-Mononitrate 20 mg Tablet 10.50 - 38.00 10.50 400 Isosorbide-5-Mononitrate 60 mg MR Tablet 3.40 - 70.30 6.50 401 Isoxsuprine Hydrochloride 10 mg Tablet 1.95 - 16.45 8.95 402 Isoxsuprine Hydrochloride 5 mg/mL, 2 mL Ampule 93.87 - 217.50 93.87 403 Itraconazole 100 mg Capsule 25.00 - 30.00 25.00

K 404 Ketamine 50 mg/mL, 10 mL Vial 610.00 - 12,825.00 610.00 405 Ketorolac 30 mg/mL, 1 mL Ampule 4.98 - 120.00 19.66

L 406 Lactated Ringer's Solution 1 L Bottle 10.00 - 80.00 35.00 407 Lactated Ringer's Solution 500 mL Bottle 19.80 - 59.95 35.00 408 Lactulose 3.3 g/5 mL, 120 mL Syrup 56.25 - 465.00 56.25

12 |

Page

P a g e 13 | 19



409 Lactulose 3.35 g/5 mL, 120 mL Syrup 52.29 - 294.00 52.29 410 Lagundi 300 mg Tablet 1.49 - 4.00 1.49 411 Lagundi 300 mg/5 mL, 60 mL Syrup 55.00 - 66.67 55.00 412 Lagundi 600 mg Tablet 3.15 - 3.60 3.15 413 Lamotrigine 50 mg Tablet 27.34 27.34 414 Lansoprazole 30 mg MR Tablet 24.00 - 72.80 24.00 415 L - Asparaginase 10,000 IU Vial 2,054.00 2,054.00 416 Levofloxacin 5 mg/mL, 100 mL Vial 139.95 - 380.00 199.50 417 Levofloxacin 500 mg Tablet 2.25 - 35.75 11.76 418 Levofloxacin 750 mg Tablet 17.65 - 60.00 30.00 419 Levothyroxine 100 mcg Tablet 6.27 - 15.44 6.27 420 Levothyroxine 25 mcg Tablet 2.85 - 8.00 2.85 421 Levothyroxine 50 mcg Tablet 4.80 - 5.40 4.80 422 Lidocaine 10%, 50 mL Spray 1,879.23 - 2,100.31 1,879.23 423 Lidocaine 2%. 1.8 mL w/ Epinephrine Carpule 11.75 - 17.90 11.75 424 Lidocaine 2%, 5 mL Ampule 3.00 - 26.00 5.44 425 Lidocaine 2%, 5 mL Vial 4.82 - 35.00 4.82 426 Lidocaine 2%, 50 mL Vial 8.00 - 59.00 24.00 427 Lithium Carbonate 450 mg MR Tablet 2.25 - 5.08 2.25 428 Loperamide 2 mg Capsule 0.30 - 6.49 0.30 429 Loratadine 10 mg Tablet 0.89 - 21.85 2.20 430 Loratadine 5 mg/5 mL, 30 mL Syrup 111.66 - 175.50 111.66 431 Losartan + Hydrochlorothiazide 100 mg + 25 mg Tablet 3.00 - 20.82 3.00 432 Losartan + Hydrochlorothiazide 50 mg + 12.5 mg Tablet 1.28 - 7.75 2.22 433 Losartan 100 mg Tablet 1.39 - 23.71 3.33 434 Losartan 50 mg tablet 0.59 - 3.95 1.31

M 435 Magnesium Sulfate 250 mg/mL, 10 mL Ampule 5.22 - 26.50 5.22 436 Magnesium Sulfate 250 mg/mL, 2 mL Ampule 8.92 - 27.00 8.92 437 Magnesium Sulfate 250 mg/mL, 20 mL Vial 8.00 - 65.00 8.00 438 Mannitol 20% 500 mL Bottle 44.23 - 197.00 72.90 439 Mebendazole 100 mg/5 mL, 30 mL Suspension 10.00 - 48.00 10.00 440 Mebendazole 100 mg/5 mL, 60 mL Suspension 10.00 - 21.84 10.00 441 Mecobalamin 500 mcg Tablet 12.95 - 17.72 12.95 442 Mecobalamin 500 mcg/mL, 1 mL Ampule 179.00 - 289.56 179.00 443 Medroxyprogesterone 10 mg Tablet 29.79 - 69.89 29.79 444 Medroxyprogesterone 150 mg/mL, 1 mL Vial 46.00 - 57.00 46.00 445 Medroxyprogesterone 50 mg/mL, 3 mL Vial + Syringe 37.49 - 52.88 37.49 446 Mefenamic Acid 250 mg Capsule 0.35 - 2.25 0.50 447 Mefenamic Acid 250 mg Tablet 0.35 - 0.69 0.35 448 Mefenamic Acid 50 mg/5 mL, 60 mL Suspension 9.98 - 15.45 9.98 449 Mefenamic Acid 500 mg Capsule 0.42 - 4.98 0.74 450 Mefenamic Acid 500 mg Tablet 0.39 - 2.37 0.48 451 Mercaptopurine 50 mg Tablet 17.50 - 18.89 17.50 452 Meropenem 1 g Vial 285.00 - 1,356.46 315.56 453 Meropenem 500 mg Vial 162.12 - 380.00 200.00 454 Mesna 100 mg/mL, 4 mL Ampule 130.00 - 135.00 135.00 455 Metformin Hydrochloride 500 mg Tablet 0.39 - 5.30 0.78 456 Methotrexate 100 mg/mL, 10 mL Vial 4,295.46 - 4,545.45 4,295.46 457 Methotrexate 2.5 mg Tablet 7.25 - 11.50 7.25 458 Methotrexate 25 mg/mL, 2 mL Vial 112.00 - 190.00 112.00 459 Methotrexate 25 mg/mL, 20 mL Vial 2,147.72 - 2,272.72 2,147.72

| 13

Page

P a g e 14 | 19



460 Methotrexate 50 mg/mL, 1 mL Vial 155.25 - 156.00 155.25 461 Methyldopa 250 mg Tablet 2.62 - 20.87 11.15 462 Methylergometrine 125 mcg Tablet 1.50 - 25.90 2.70 463 Methylergometrine 200 mcg/mL, 1 mL Ampule 9.88 - 102.95 12.40 464 Methylprednisolone 1 g/16 mL + Diluent Vial 2,263.94 - 3,419.11 2,263.94 465 Methylprednisolone 125 mg/mL, 2 mL + Diluent Vial 702.98 - 1,212.04 702.98 466 Methylprednisolone 16 mg Tablet 15.69 - 34.85 19.00 467 Methylprednisolone 4 mg Tablet 1.00 - 10.42 7.00 468 Methylprednisolone 40 mg/mL, 1 mL Vial 216.52 - 644.55 216.52 469 Methylprednisolone 500 mg/7.7 mL + Diluent Vial 1,049.00 - 1,560.00 1,049.00 470 Metoclopramide 10 mg Tablet 0.90 - 7.96 1.30 471 Metoclopramide 5 mg/5 mL, 60 mL Syrup 20.00 - 50.40 20.00 472 Metoclopramide 5 mg/mL, 2 mL Ampule 1.98 - 35.87 2.66 473 Metoprolol (as Tartrate) 100 mg Tablet 1.14 - 5.45 1.67 474 Metoprolol (as Tartrate) 50 mg Tablet 0.45 - 3.51 0.73 475 Metronidazole 125 mg/5 mL, 60 mL Suspension 10.50 - 59.00 13.74 476 Metronidazole 5 mg/mL, 100 mL Vial 10.12 - 70.00 15.56 477 Metronidazole 500 mg Tablet 0.52 - 20.86 0.72 478 Midazolam 1 mg/mL, 5 mL Ampule 90.00 - 169.45 90.00 479 Midazolam 1 mg/mL, 5 mL Vial 89.49 - 94.00 89.49 480 Midazolam 15 mg Tablet 22.27 - 24.74 22.27 481 Midazolam 5 mg/mL, 3 mL Ampule 129.40 - 248.50 129.40 482 Midazolam 5 mg/mL, 1 mL Ampule 69.92 - 154.34 69.92 483 Modified Fluid Gelatin (Formerly

Polymerisate of Degraded Succinylated Gelatin)

4% Solution, 500 mL Bottle 500.00 - 750.00 500.00

484 Monobasic Sodium Phosphate, Dibasic Sodium Phosphate

19 g/7 g Solution per 133 mL Bottle 180.00 - 216.00 180.00

485 Monobasic Sodium Phosphate, Dibasic Sodium Phosphate

48 g/18 g per 100 mL Solution, 45 mL Bottle

180.00 - 223.00 180.00

486 Montelukast 10 mg Tablet 8.00 - 36.10 11.58 487 Montelukast 4 mg Chewable Tablet 4.78 - 43.32 8.75 488 Montelukast 4 mg Sachet 11.60 - 75.00 11.60 489 Montelukast 5 mg Chewable Tablet 5.22 - 14.00 8.75 490 Morphine (As Sulfate) 10 mg Tablet 16.66 - 24.95 16.66 491 Morphine (As Sulfate) 10 mg/mL, 1 mL Ampule 30.00 - 102.80 53.30 492 Morphine (As Sulfate) 30 mg Tablet 36.26 - 59.75 36.26 493 Multivitamins Adult Capsule 0.78 - 6.00 1.48 494 Multivitamins Adult Tablet 0.50 - 8.00 2.45 495 Multivitamins Per 1 mL, 15 mL Drops 12.90 - 60.92 12.90 496 Multivitamins Per 5 mL, 120 mL Syrup 24.00 - 158.40 65.50 497 Multivitamins Per 5 mL, 60 mL Syrup 9.50 - 74.00 15.10 498 Mupirocin 2% 15 g Ointment Tube 179.20 - 250.85 179.20 499 Mupirocin 2%, 5g Ointment Tube 59.95 - 270.00 69.68 500 Mycophenolate Mofetil 500 mg Tablet 60.00 - 84.00 60.00

N 501 Nalbuphine 10 mg/mL, 1 mL Ampule 24.29 - 275.20 77.95 502 Naloxone 400 mcg/mL, 1 mL Ampule 95.00 - 535.80 345.00 503 Naproxen Sodium 550 mg Tablet 1.85 - 19.76 5.38 504 Neostigmine 500 mcg/mL, 1 mL Ampule 90.55 - 180.50 90.55 505 Nicardipine 1 mg/mL, 10 mL Ampule 508.50 - 1,822.93 508.50 506 Nicardipine 1 mg/mL, 2 mL Ampule 82.00 - 160.00 82.00 507 Nifedipine 10 mg Capsule 2.00 - 9.90 2.00

14 |

Page

P a g e 15 | 19



508 Nifedipine 30 mg MR Tablet 25.18 - 39.60 25.18 509 Nifedipine 5 mg Capsule 1.08 - 16.90 1.08 510 Norepinephrine 1 mg/mL, 2 mL Ampule 138.88 - 530.00 138.88 511 Norepinephrine 1 mg/mL, 4 mL Ampule 252.48 - 960.00 252.48 512 Norfloxacin 400 mg Tablet 2.17 - 3.10 2.17 513 Nystatin 100,000 Units/mL, 30 mL Suspension 136.00 - 390.00 136.00

O 514 Octreotide 100 mcg/mL, 1 mL Ampule 500.00 - 600.00 500.00 515 Ofloxacin 0.3%, 5 mL Ear Drops Bottle 145.00 - 198.50 145.00 516 Ofloxacin 0.3%, 5 mL Eye Drops Bottle 118.44 - 237.50 118.44 517 Ofloxacin 2 mg/mL, 100 mL Vial 153.48 - 1,100.00 153.48 518 Ofloxacin 200 mg Tablet 2.28 - 37.85 4.00 519 Ofloxacin 400 mg Tablet 3.29 - 43.76 4.37 520 Olanzapine 10 mg Tablet 6.12 - 72.00 30.00 521 Omeprazole 20 mg Capsule 0.74 - 9.50 1.40 522 Omeprazole 40 mg Powder Vial + 10 mL Solvent

Ampule 19.95 - 165.00 58.46

523 Omeprazole 40 mg Capsule 5.80 - 28.50 10.35 524 Ondansetron (as Hydrochloride) 2 mg/mL, 2 mL Ampule 285.00 - 420.56 285.00 525 Ondansetron (as Hydrochloride) 2 mg/mL, 4 mL Ampule 154.50 - 756.60 261.17 526 Oral Rehydration Salts (ORS 75-

replacement) 20.5 g Sachet 10.29 - 14.50 10.29

527 Oral Rehydration Salts (ORS 75-replacement)

4.1 g Sachet 8.00 -11.06 8.00


5.125 g Sachet 4.60 - 7.00 4.60


2.17 g Sachet 3.38 - 5.00 3.38

530 Oseltamivir 75 mg Capsule 33.00 - 98.56 33.00 531 Oxacillin 500 mg Vial 18.89 - 140.00 18.89 532 Oxaliplatin 2 mg/mL, 50 mL Vial 4,500.00 - 12,000.00 4,500.00 533 Oxycodone 10 mg Tablet 83.00 - 91.29 83.00 534 Oxycodone 10 mg/mL, 1 mL Ampule 1,075.00 1,075.00 535 Oxytocin 10 IU/mL, 1 mL Ampule 3.94 - 192.13 7.99

P 536 Paclitaxel 6 mg/mL, 5 mL Vial 985.00 - 1,430.00 985.00 537 Paracetamol 100 mg/mL, 15 mL Drops 9.84 - 45.35 11.80 538 Paracetamol 120 mg/5 mL (125 mg/5 mL), 60 mL

Bottle 9.91 - 79.75 12.95

539 Paracetamol 125 mg Suppository 14.12 - 24.88 14.12 540 Paracetamol 150 mg/mL, 2 mL Ampule 4.90 - 52.00 16.89 541 Paracetamol 250 mg Suppository 20.00 - 68.88 20.00 542 Paracetamol 250 mg/5 mL, 60 mL Bottle 8.87 - 80.00 12.38 543 Paracetamol 500 mg Tablet 0.17 - 3.11 0.23 544 Penicillin G Benzathine

(Benzathine Benzylpenicillin) 1,200,000 Units Vial 41.98 - 167.53 41.98

545 Penicillin G Crystalline 1,000,000 Units Vial 3.79 - 17.00 3.79 546 Penicillin G Crystalline 5,000,000 Units Vial 12.83 - 45.00 12.83 547 Pethidine 50 mg/mL, 2 mL Ampule 100.00 - 207.00 100.00 548 Phenobarbital 120 mg/mL (130 mg/mL), 1 mL

Ampule 377.00 - 833.00 377.00

549 Phenobarbital 15 mg Tablet 1.95 - 1.98 1.95 550 Phenobarbital 30 mg Tablet 2.20 - 2.54 2.20 551 Phenobarbital 60 mg Tablet 3.02 - 3.98 3.02

|15

Page

P a g e 16 | 19



552 Phenoxymethyl Penicillin (Penicillin V)

250 mg Capsule 9.08 - 10.00 9.08

553 Phenoxymethyl Penicillin (Penicillin V)

500 mg Capsule 13.87 - 14.00 13.87

554 Phenylephrine 2.5%, 5 mL Eye Drops Bottle 318.60 - 340.56 318.60 555 Phenytoin 100 mg Capsule 7.08 - 42.00 7.08 556 Phenytoin 50 mg/mL, 2 mL Ampule 130.00 - 600.00 245.00 557 Phytomenadione 10 mg/mL, 1 mL Ampule 6.38 - 92.65 17.62 558 Piperacillin + Tazobactam 2 g + 250 mg Vial 53.72 - 330.00 93.00 559 Piperacillin + Tazobactam 4 g + 500 mg Vial 72.48 - 685.00 120.00 560 Potassium Chloride 2 mEq/mL, 20 mL Vial 9.48 - 32.00 9.48 561 Potassium Chloride 750 mg Durules (Equiv. to Approx. 10

mEq) Tablet 15.27 - 28.00 15.27

562 Potassium Citrate 10 mEq Tablet 9.00 - 13.20 9.00 563 Povidone Iodine 10%, 1 Gallon Bottle 409.00 - 650.00 409.00 564 Povidone Iodine 10%, 120 mL Bottle 35.20 - 54.00 35.20 565 Povidone Iodine 10%, 60 mL Bottle 25.00 - 60.00 25.00 566 Povidone Iodine 7.5% Surgical Skin Cleanser, 1 Gallon

Bottle 409.00 - 650.00 409.00

567 Praziquantel 600 mg Tablet 11.88 11.88 568 Prednisolone 1%, 5 mL Eyes Drops Bottle 110.00 - 228.57 156.00 569 Prednisolone 20 mg Tablet 4.50 - 13.40 4.50 570 Prednisolone 20 mg/5 mL, 60 mL Syrup 120.00 - 180.00 120.00 571 Prednisolone 5 mg Tablet 0.55 - 0.95 0.55 572 Prednisone 10 mg Tablet 1.52 - 15.00 1.52 573 Prednisone 10 mg/5 mL, 60 mL Suspension 60.00 - 168.00 60.00 574 Prednisone 20 mg Tablet 2.80 - 11.10 4.80 575 Prednisone 5 mg Tablet 0.53 - 2.80 0.53 576 Propofol 10 mg/mL, 20 mL Ampule 84.45 - 1,032.00 119.25 577 Propofol 10 mg/mL, 20 mL Vial 81.33 - 122.00 81.33 578 Propofol 10 mg/mL, 50 mL Vial 600.00 - 820.00 600.00 579 Propranolol 10 mg Tablet 0.50 - 11.53 0.50 580 Propranolol 40 mg Tablet 0.65 - 18.33 0.65 581 Propylthiouracil 50 mg Tablet 8.20 - 18.80 8.20 582 Pyrazinamide 250 mg/5 mL, 120 mL Suspension 44.70 - 65.00 44.70 583 Pyrazinamide 250 mg/5 mL, 60 mL Suspension 35.00 - 65.00 35.00

Q 584 Quetiapine (as Fumarate) 200 mg Tablet 23.47 - 33.00 23.47

R 585 Rabies Chick Embryo Cell (Purified

Inactivated) 2.5 IU/mL, 1 Dose + 1 mL Diluent Vial

730.00 - 1,750.00 730.00

586 Rabies Immunoglobulin (Human) 150 IU/mL, 2 mL Ampule 3,000.00 - 4,889.00 3,000.00 587 Rabies Immunoglobulin (Human) 150 IU/mL, 2 mL Vial 3,160.00 - 4,950.00 3,160.00 588 Ranitidine 150 mg Tablet 0.55 - 7.50 0.76 589 Ranitidine 25 mg/mL, 2 mL Ampule 0.59 - 35.00 2.98 590 Ranitidine 300 mg Tablet 0.55 - 69.74 2.23 591 Regular, Insulin (Recombinant DNA,

Human) 100 IU/mL, 10 mL Vial 164.29 - 385.00 218.00

592 Retinol (Vitamin A) 100,000 IU Soft Gel Capsule 1.10 1.10 593 Retinol (Vitamin A) 200,000 IU Soft Gel Capsule 1.29 1.29 594 Rifampicin 200 mg/5 mL, 120 mL Suspension 103.45 - 190.00 114.88 595 Rifampicin 200 mg/5 mL, 60 mL Suspension 94.00 - 120.00 94.00 596 Risperidone 2 mg Tablet 1.99 - 82.00 17.64

16 |

Page

P a g e 17 | 19



597 Risperidone 4 mg Tablet 5.42 - 20.00 5.42 598 Rocuronium 10 mg/mL, 2.5 mL Vial 321.00 - 480.00 321.00 599 Rocuronium 10 mg/mL, 5 mL Ampule 214.00 - 410.00 214.00 600 Rocuronium 10 mg/mL, 5 mL Vial 230.00 - 410.00 230.00 601 Ropivacaine 10 mg/mL, 10 mL Ampule 372.42 - 413.80 372.42 602 Rosuvastatin (as Calcium) 10 mg Tablet 7.00 - 31.50 8.88 603 Rosuvastatin (as Calcium) 20 mg Tablet 9.00 - 38.31 12.00

S 604 Salbutamol 1 mg/mL, 2.5 mL Respiratory

Solution 2.22 - 15.00 4.89

605 Salbutamol 100 mcg/Dose, 200 Doses Metered Dose Inhaler

69.92 - 347.40 69.92

606 Salbutamol 2 mg Tablet 0.18 - 3.00 0.27 607 Salbutamol 2 mg/5 mL, 60 mL Syrup 8.89 - 45.00 10.99 608 Salbutamol 2 mg/mL, 2.5 mL Respiratory

Solution 4.45 - 20.00 4.45

609 Sambong 250 mg Tablet 1.80 - 1.98 1.80 610 Sambong 500 mg Tablet 4.50 - 9.75 4.50 611 Sertraline 50 mg Tablet 4.69 - 53.34 8.29 612 Sevoflurane 250 mL Bottle 4,497.00 - 19,222.50 4,497.00 613 Silver Sulfadiazine 1%, 15 g Cream Tube 93.89 - 120.00 93.89 614 Silver Sulfadiazine 1%, 20 g Cream Tube 47.50 - 456.80 47.50 615 Silver Sulfadiazine 1%, 25 g Cream Tube 81.50 - 376.00 89.89 616 Silver Sulfadiazine 1%, 5 g Cream Tube 93.29 - 145.00 93.29 617 Silver Sulfadiazine 1%, 50 g Cream Tube 120.00 - 124.49 120.00 618 Silver Sulfadiazine 1%, 500 g Cream Jar 799.00 - 3,044.56 799.00 619 Simvastatin 10 mg Tablet 1.13 - 7.60 1.85 620 Simvastatin 20 mg Tablet 0.42 - 11.66 1.54 621 Simvastatin 40 mg Tablet 3.20 - 12.00 5.00 622 Sodium Bicarbonate 1 mEq/mL, 50 mL Ampule 47.55 - 103.99 47.55 623 Sodium Bicarbonate 1 mEq/mL, 50 mL Vial 48.92 - 100.86 48.92 624 Sodium Chloride 2.5 mEq/mL, 20 mL Vial 18.00 - 60.00 18.00 625 Spironolactone 100 mg Tablet 23.36 - 30.62 23.36 626 Spironolactone 25 mg Tablet 6.90 - 41.00 6.90 627 Spironolactone 50 mg Tablet 12.14 - 18.76 12.14 628 Standard Senna Concentrate 187 mg Tablet 5.90 - 7.56 5.90 629 Standard Senna Concentrate 374 mg Tablet 9. 95 - 10.53 9.95 630 Sterile Water For injection 1 L Bottle 48.50 - 60.00 48.50 631 Sterile Water For injection 50 mL Bottle 13.00 - 32.00 13.00 632 Streptokinase 1,500,000 IU Vial 3,200.00 - 6,600.00 3,200.00 633 Streptomycin 1 g Vial 7.09 - 40.00 7.09 634 Sucralfate 1 g Tablet 30.26 - 34.10 30.26 635 Suxamethonium (Succinylcholine) 20 mg/mL, 10 mL Vial 169.00 - 374.95 169.00

T 636 Tacrolimus 1 mg Capsule 84.40 - 202.69 84.40 637 Tamoxifen 20 mg Tablet 4.90 - 15.40 4.90 638 Tamsulosin 200 mcg Capsule 20.00 - 54.00 42.85 639 Telmisartan + Hydrochlorothiazide 40 mg + 12.5 mg Tablet 17.39 - 22.92 17.39 640 Telmisartan + Hydrochlorothiazide 80 mg + 12.5 mg Tablet 30.60 - 38.81 30.60 641 Telmisartan 40 mg Tablet 12.00 - 22.92 20.02 642 Telmisartan 80 mg Tablet 30.00 - 39.63 30.00 643 Terbutaline 500 mcg/mL, 1 mL Ampule 13.00 - 79.50 13.00

|17

Page

P a g e 18 | 19



644 Tetanus Immunoglobulin (Human) 250 IU/mL, 1 mL Ampule 639.00 - 750.00 639.00 645 Tetanus Immunoglobulin (Human) 250 IU/mL, 1 mL Pre-filled Syringe 545.00 - 1,084.00 545.00 646 Tetanus Immunoglobulin (Human) 250 Units/mL, 2 mL Vial 800.00 - 1,185.00 800.00 647 Tetanus Toxoid 0.5 mL Ampule 20.12 - 99.89 27.15 648 Tetracycline 500 mg Capsule 1.90 1.90 649 Thiamazole (Methimazole) 5 mg Tablet 3.75 - 5.62 3.75 650 Thiopental Sodium 1 g + 50 mL Vial 1,098.00 - 1,299.00 1,098.00 651 Timolol 0.5%, 5 mL Eye Drops Bottle 165.00 - 195.00 165.00 652 Tinzaparin Sodium 10,000 Anti-XA IU/mL, 2 mL Vial 1,289.74 - 1,357.62 1,289.74 653 Tiotropium 18 mcg/dose Dry Powder Inhaler 72.56 - 263.00 72.56 654 Tobramycin + Dexamethasone 0.3% + 0.1%, 5 mL Eye Drops Bottle 98.50 - 350.00 154.00 655 Tobramycin + Dexamethasone 0.3% + 0.1%, 3.5 g Eye Ointment

Tube 387.45 - 426.19 387.45

656 Tobramycin 0.3%, 5 mL Eye Drops Bottle 98.50 - 271.43 98.50 657 Topiramate 50 mg Tablet 10.00 - 13.00 10.00 658 Tramadol 100 mg MR Tablet 70.56 - 86.00 70.56 659 Tramadol 50 mg Capsule 1.00 - 10.00 2.24 660 Tramadol 50 mg/mL, 1 mL Ampule 3.78 - 70.00 5.25 661 Tramadol 50 mg/mL, 2 mL Ampule 3.50 - 178.11 6.40 662 Tranexamic Acid 100 mg/mL, 5 mL Ampule 5.94 - 114.00 14.79 663 Tranexamic Acid 500 mg Capsule 4.39 - 15.85 6.45 664 Trimetazidine 20 mg Tablet 2.00 - 21.20 5.82 665 Trimetazidine 35 mg Tablet 4.50 - 26.92 9.57 666 Tropicamide 0.5%, 5 mL Eye Drops Bottle 310.50 - 341.55 310.50

U 667 Ursodeoxycholic Acid 250 mg Capsule 37.60 - 54.98 37.60

V 668 Valproate Disodium/Valproic Acid 250 mg Tablet 22.83 - 27.45 22.83 669 Valproic Acid 250 mg/5 mL, 120 mL Syrup 285.50 - 493.14 285.50 670 Valproic Acid 500 mg/5 mL, 5 mL Vial 1,701.23 - 1,913.89 1,701.23 671 Valsartan + Hydrochlorothiazide 80 mg + 12.5 mg Tablet 41.31 - 52.56 41.31 672 Valsartan 160 mg Tablet 60.50 60.50 673 Valsartan 80 mg Tablet 41.31 41.31 674 Vancomycin 500 mg Vial 149.40 - 585.00 212.78 675 Vecuronium 4 mg/mL + 1 mL Solvent Ampule 339.00 - 349.50 339.00 676 Verapamil 2.5 mg/mL, 2 mL Ampule 126.52 - 156.59 126.52 677 Verapamil 240 mg MR Tablet 26.12 - 45.92 26.12 678 Verapamil 40 mg Tablet 18.38 - 23.88 18.38 679 Vero Cell (Purified) 2.5 IU/0.5 mL + Diluent Vial 650.00 - 1,380.00 650.00 680 Vinblastine 10 mg Vial 705.00 - 770.00 705.00 681 Vincristine (As Sulfate) 1 mg/mL, 1 mL Vial 155.00 - 168.45 155.00 682 Vincristine (As Sulfate) 1 mg/mL, 2 mL Vial 223.50 - 380.50 223.50 683 Vitamin B1 B6 B12 100 mg + 100 mg + 1 mg, 3 mL

Ampule 29.80 - 129.00 60.00

684 Vitamin B1 B6 B12 100 mg + 5 mg + 50 mcg Tablet 0.44 - 4.00 0.81 W

685 Warfarin 1 mg Tablet 9.00 - 17.84 9.00 686 Warfarin 2.5 mg Tablet 7.50 - 12.79 7.50 687 Warfarin 5 mg Tablet 10.00 - 22.00 10.00

18 |

P a g e 19 | 19



Z 688 Zinc 27.5 mg/mL (Equiv. to 10 mg Elem.

Zinc), 15 mL Drops 24.00 - 78.50 24.00

689 Zinc 55 mg/mL (Equiv. to 20 mg Elem. Zinc), 60 mL Syrup

18.57 - 64.00 40.48

690 Zolpidem 10 mg Tablet 39.93 - 59.77 39.93

· has established a drug price reference index ... 72 anti -rabies serum (e quine) 200 iu/ml, 5...

Documents