KBPOM TENTANG HARGA JUAL OBAT GENERIK TAHUN 2001

BADAN PENGAWAS OBAT DAN MAKANAN REPUBLIK INDONESIA

KEPUTUSAN KEPALA BADAN PENGAWAS OBAT DAN MAKANAN REPUBLIK INDONESIA NOMOR: 05017/SK/KBPOM TENTANG HARGA JUAL OBAT GENERIK TAHUN 2001

KEPALA BADAN PENGAWAS OBAT DAN MAKANAN Menimbang

Mengingat

:

:

a.

Bahwa kesinambungan dalam penyediaan dan ketersediaan obat Generik dengan harga terjangkau yang selama ini dapat memenuhi kebutuhan masyarakat perlu terus dipertahankan;

b.

Bahwa kemampuan keuangan negara sangat terbatas sehingga tidak dapat menyediakan subsidi untuk pengadaan bahan baku obat;

c.

Bahwa berdasarkan butir a dan b diatas, maka harga obat generik perlu ditinjau dan ditetapkan kembali.

1.

Undang-undang Nomor 23 Tahun 1992 tentang Kesehatan;

2.

PP Nomor 25 Tahun 2000 tentang Kewenangan Pemerintah dan Kewenangan Provinsi Sebagai Daerah Otonom;

3.

Peraturan Menteri Kesehatan Nomor 085/Menkes/Per/I/ 1989 tentang Kewajiban Menulis Resep dan/atau Menggunakan Obat Generik di Fasilitas Pelayanan Kesehatan Pemerintah. MEMUTUSKAN

Menetapkan

:

KEPUTUSAN KEPALA BADAN PENGAWAS OBAT DAN MAKANAN TENTANG HARGA JUAL OBAT GENERIK TAHUN 2001.

Pertama

:

Harga Jual Obat Generik Tahun 2001 sebagaimana tercantum dalam lampiran I dan II Keputusan ini;

Kedua

:

Harga Jual Obat Generik Tahun 2001 sebagaimana dimaksud pada butir pertama adalah:


1. Harga Netto Apotik (HNA) Obat Generik adalah harga jual per satuan kemasan franko unit pelayanan Kesehatan Kabupaten/Kota dan Apotik, termasuk Pajak Pertambahan Nilai (PPN) sebasar 10%; 2. Harga Jual Apotik (HJA) Obat Generik adalah harga jual per satuan kemasan termasuk Pajak Pertambahan Nilai (PPN) sebesar 10%; Ketiga

:

Dengan diberlakukannya keputusan ini maka Keputusan Direktur Jenderal Pengawasan Obat dan Makanan No. HK.00.06.2.3981 tanggal 29 September 1999 tentang Harga Netto Apotik (HNA) Obat Generik dan No. HK.00.06.2.3982 tanggal 29 September 1999 tentang Harga Jual Apotik (HJA) Obat Generik dinyatakan tidak berlaku;

Keempat

:

Keputusan ini mulai berlaku sejak tanggal ditetapkan dan apabila terdapat kekurangan atau kekeliruan dalam Keputusan ini akan diadakan perubahan atau perbaikan seperlunya. Ditetapkan di : Jakarta Pada tanggal : 15 Mei 2001

Tembusan disampaikan kepada Yth. 1. Menteri Kesehatan dan Kesejahteraan Sosial RI 2. Sekretaris Jenderal Depkes & Kesos 3. Para Direktur Jenderal dilingkungan Depkes & Kesos 4. lnspektorat Badan Pengawas Obat dan Makanan 5. Kepala Dinas Kesehatan Propinsi seluruh Indonesia 6. Kepala Dinas Kesehatan Kab/Kota seluruh Indonesia 7. Kepala Balai Pemeriksaan Obat dan Makanan seluruh Indonesia 8. Gabungan Perusahaan Farmasi Indonesia Pusat 9. Direktur Rumah Sakit seluruh lndonesia.


HARGA NETTO APOTIK (HNA) OBAT GENERIK Lampiran I Nomor Tanggal NO.

: Keputusan Kepala Badan Pengawas Obat dan Makanan RI : 05017/SK/KBPOM. : 15 Mei 2001 NAMA OBAT

1

Albendazol tablet 400 mg

2 3 4 5 6 7

Alopurinol tablet 100 mg Ambroxol sirup 15mg/ml Ambroxol tablet 30 mg Amilorid tablet 5 mg Aminofilin injesi 24 mg/ml - 10 ml Aminofilina tablet 200 mg

8 9 10 11

Amitriptilin HCI tablet salut 25 mg Amoksisilin 250 mg + Asam Klavulanat 125 mg Amoksisilin 500 mg + Asam Klavulanat 125 mg Amoksisilin kapsul 250 mg

12 13 14 15 16 17 18 19 20

Amoksisilin kaplet 500 mg Amoksisilin sirup kering 12-5 mg/5ml Ampisilin kaplet 250 mg Ampisilin kaplet 500 mg Ampisilin serbuk injeksi (im/iv) 500 mg Ampisilin serbuk injeksi (im/iv) 1000 mg Ampisilin sirup kering 125 mg/5ml Antalgin (Metampiron) injeksi 250 mg/ml - 2 ml Antalgin (Metampiron) tablet 500 mg

21

Antasida DOEN suspensi, kombinasi : Magnesium Hidroksida 200 mg/ 5 ml + Alumunium Hidroksida 200 mg/ 5 ml

22

26 27 28

Antasida DOEN tablet, komb : Magnesium Hidroksida 200 mg+ Al Hidroksida 200 mg Antihemoroid DOEN kombinasi Antimigren DOEN kombinasi : Ergotamin Tartrat 1 mg + Kofein 50 mg Anti Parkinson DOEN kombinasi : Karbidopa 25 mg + Levodopa 250 mg Asam Askorbat ( Vit. C ) tablet 50 mg Asam Folat tablet 1 mg Asam Mefenamat kapsul 250 mg

29 30 31 31

Asam Mefenamat tablet salut selaput 500 mg Asetosal tablet 100 mg Asetosal tablet 500 mg Asetosal tablet 500 mg

23 24 25

KEMASAN ktk 5 x 6 tablet

HNA + PPN (Rupiah) 12.221

strip 10 x 10 tablet btl 60 ml strip 10x10 tablet strip 10 x 10 tablet ktk 30 amp @ 10ml btl 100 tablet btl 1000 tablet strip 10 x 10 tablet ktk 30 kaplet ktk 30 kaplet strip 10 x 10 kapsul ktk 120 kapsul strip 10 x 10 kaplet btl 60 ml strip 10 x 10 kaplet strip 10 x 10 kaplet dus 1 vial dus 1 vial btl 60 ml ktk 30 amp/2ml strip 10 x 10 tablet btl 1000 tablet btl 60 ml

12.833 3.600 13.200 10.320 23.750 6.500 43.440 10.920 70.320 100.000 27.300 32.670 48.420 3.315 23.400 44.750 3.800 4.750 3.120 10.000 9.000 62.790 3.250

strip 10 x 10 tablet btl 1000 tablet dus 10 supp 100 tablet

7.865 42.952 10.500 12.840

ktk 100 tablet

85.200

btl 1000 tablet btl 100 tablet strip 10 x 10 kapsul strip 12 x 10 kapsul strip 10 x 10 kaplet ktk 100 tablet ktk 100 tablet ktk 100 tablet

16.804 3.500 13.728 16.434 26.350 6.306 10.560 10.560

BADAN PENGAWAS OBAT DAN MAKANAN REPUBLIK INDONESIA NO.

NAMA OBAT

32 33

Asiklovir cream 5 % Asiklovir tablet 200 mg

34

Asiklovir tablet 400 mg

35 36 37 38 39 40 41

Atropin Sulfat injeksi 0,25 mg/ml - 1 ml Atropin Suffat tablet 0,5 mg Atropin Sulfat tetes mata 0,5% Betametason krim 0,1 % Bezafibrate tablet 200 mg Deksametason Injeksi 5 mg/ml - 1 ml Deksametason tablet 0,5 mg

42 43

Dekstrometorfan sirup 10 mg/5 ml Dekstrometorfan tablet 15 mg

44 45 46

Diazepam injeksi 5 mg/ml - 2 ml Diazepam tablet 2 mg Diazepam tablet 5 mg

47 48 49 50 51 52 53 54 55

Difenhidramin HCI lnjeksi 10 mg/ml - 1 ml Digoksin tablet 0,25 mg Dikloksasilin kapsul 125 mg Diltiazem tablet salut 30 mg Dimenhidrinat tablet 50 mg Doksisiklin kapsul 100 mg Efedrin HCI tablet 25 mg Epinefrin HCI/Bitartrat inj 0,1 %-1 ml Eritromisin kapsul 250 mg

56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71

Eritromisin kapsul 500 mg Eritromisin sirup 200 mg/5 ml Etambutol tablet 250 mg Etambutol tablet 500 mg Eter Anestetik Famotidine tablet 20 mg Famotidine tablet 40 mg Fenilbutazon tablet salut 200 mg Fenobarbital injeksi 50 mg/ml - 2 ml Fenobarbital tablet 30 mg Fenobarbital tablet 100 mg Fenoksimetil Penisilin tablet 250 mg Fenoksimetil Penisilin tablet 500 mg Fero Sulfat tablet salut 300 mg Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml Fitomenadion (Vit.K1) tablet salut gula 10 mg

KEMASAN tube 5 gr ktk 50 tablet ktk 30 tablet ktk 100 tablet ktk 50 tablet ktk 30 tablet ktk 100 tablet ktk 100 amp @ 1 ml btl 500 tablet 24 btl @ 5 ml 25 tube @ 5 g strip 5 x 10 tablet ktk 100 amp @ 1 ml strip 10 x 10 tablet btl 1000 tablet btl 60 ml strip 10 x 10 tablet btl 1000 tablet ktk 100 amp @ 2 ml btl 1000 tablet btl 100 tablet btl 500 tablet ktk 30 amp @ 1 ml strip 10 x 10 tablet strip 10 x 10 kapsul strip 10 x 10 tablet btl 100 tablet strip 10 x 10 kapsul btl 1000 tablet ktk 30 amp @ 1 ml strip 10 x 10 kapsul ktk 120 kapsul strip 10 x 10 kapsul btl 60 ml strip 20 x 10 tablet strip 10 x 10 tablet btl 140 ml strip 5x10 tablet strip 5x10 tablet btl 1000 tablet Ktk 30 amp @ 2 ml btl 1000 tablet btl 250 tablet strip 10 x 10 tablet strip 10 x 10 tablet btl 1000 tablet Ktk 30 amp @ 1 ml btl 100 tablet

HNA + PPN (Rupiah) 3.525 49.000 29.700 89.400 78.000 48.000 136.080 32.000 13.890 72.593 62.500 23.700 117.650 8.125 30.875 3.120 9.375 66.250 75.600 12.720 3.480 11.200 14.300 9.750 40.680 26.000 9.700 31.500 39.719 9.877 50.400 59.000 97.000 7.550 38.500 36.500 9.360 9.500 14.500 80.400 11.880 14.665 11.220 24.375 42.400 18.600 31.000 68.063


NAMA OBAT

72

Furosemid tablet 40 mg

73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97

Furosemid injeksi 10 mg/ml Garam Oralit untuk 200 ml air, kombinasi Gemfibrozil kapsul 300 mg Gemfibrozil tablet 600 mg Gentamisin injeksi 80 mg/2 ml Gentamisin Sulfat salep 1 % Gentamisin Sulfat tetes mata 0,3 % Glibenklamid tablet 5 mg Gliseril Guayakolat tablet 100 mg Glukosa larutan infus 5 % steril Glukosa larutan infus 10 % steril Griseofulvin tablet 125 mg, Micronized Haloperidol tablet 0,5 mg Haloperidol tablet 1,5 mg Haloperidol tablet 5 mg Hidroklorotiazid (HCT) tablet 25 mg Hidrokortison krim 2,5 % Ibuprofen tablet 200 mg lbuprofen tablet 400 mg Indometasin kapsul 25 mg Isoniazid tablet 100 mg Isoniazid tablet 300 mg Isosorbiddinitrat tablet sublingual 5 mg Kalsium Laktat (Kalk) tablet 500 mg Kaptopril tablet 12,5 mg

98

Kaptopril tablet 25 mg

99 100 101 102 103 104

Kaptopril tablet 50 mg Karbamazepin tablet 200 mg Ketotifen syrup 1 mg / ml Ketotifen tablet 1 mg Klonidin tablet 0,15 mg Kloramfenikol kapsul 250 mg

105 106 107 108 109 110 111 112 113

Kloramfenikol salep mata 1 % Kloramfenikol suspensi 125 mg/ 5 ml Kloramfenikol tetes mata 0,5 % Kloramfenikol tetes telinga 3 % Klorfeniramina Maleat (CTM) tablet 4 mg Klorokuin tab 150 mg Klorpromazin HCI injeksi 5 mg/ml - 2 ml Klorpromazin HCI injeksi 25 mg/ml - 1 ml Klorpromazin HCI tablet salut 25 mg

KEMASAN strip 10 x 10 tablet strip 20 x 10 tablet btl 250 tablet ktk 25 ampul/2 ml dos 25 sachet strip 10x10 kapsul strip 10x10 tablet dus 1 vial / ampul ktk 10 tube @ 5 g btl 5 ml strip 10 x 10 tablet btl 1000 tablet btl 500 ml btl 500 ml strip 10 x 10 tablet strip 10 x 10 tablet strip 10 x 10 tablet strip 10 x 10 tablet btl 1000 tablet 1 tube @ 5 g btl 100 tablet strip 10 x 10 tablet strip 10 x 10 kapsul btl 1000 tablet btl 1000 tablet strip 10 x 10 tablet btl 1000 tablet strip 6 x 10 tablet strip 10 x 10 tablet strip 6 x 10 tablet strip 10 x 10 tablet Strip 10 x 10 tablet strip 10 x 10 tablet btl 60 ml strip 10 x 10 tablet strip 10 x 10 tablet ktk 120 kapsul btl 1000 kapsul botol 250 kapsul tube 5 g btl 60 ml btl 5 ml 24 botol @ 5 ml btl 1000 tablet btl 1000 tablet Ktk 30 amp @ 2 ml Ktk 30 amp @ 1 ml btl 1000 tablet

HNA + PPN (Rupiah) 8.820 16.920 16.380 38.000 8.600 50.580 90.000 4.800 18.750 3.380 15.900 28.795 4.560 4.800 17.500 7.201 10.625 16.350 16.500 2.640 9.000 19.500 11.040 28.320 72.000 10.500 35.899 12.000 19.200 19.500 31.500 52.500 39.585 5.450 21.500 20.500 25.700 189.800 53.550 1.563 5.300 4.125 56.200 15.276 84.000 9.450 9.450 25.920


NAMA OBAT

114

Klorpromazin HCI tablet salut 100 mg

115 116 117

Klorpropamid tablet 100 mg Kodein Fosfat tablet 10 mg Kombinasi Natrium Klorida dan Glukosa larutan infus steril 0,45% / 2,5% Kombinasi Natrium Klorida dan Glukosa larutan infus steril 0,9% / 5% Kombinasi Natrium Klorida dan Glukosa larutan infus steril 0,9% / 10% Kombinasi Pirimetamin 25 mg + Sulfadoksin 500 mg tablet

118 119 120

121 122 123

124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149

Kotrimoksazol Suspensi, kombinasi Suffa metosakzol 100 mg + Trimetroprim 20mg/ 5 ml Kotrimoksazol Suspensi, kombinasi : Sulfa metosakzol 200 mg + Trimetroprim 40 mg/ 5 ml Kotrimaksazol tablet kombinasi : Sulfametosakzol 400 mg + Trimetroprin 80 mg Kotrimoksazol tablet pediatrik, kombinasi : Sulfametosakzol 100 mg + Trimetroprim 20 mg Kuinin Dihidroklorida injeksi 25 % - 2 ml Kuinin (Kina) tablet 200 mg Lidokain injeksi 1% Lidokain comp.injeksi, kombinasi : Lidokain HCI 2 % + Epinefrin 1;80.000 – 2 ml Lidokain injeksi 2% Mebendazol tablet 100 mg Metilergometrin Maleat tablet 0,125 mg Metronidazol tablet 250 mg Metronidazof tablet 500 mg Mikonazol krim 2 % Natrium Bikarbonat tablet 500 mg Natrium Diklofenak tablet 25 mg Natrium Diklofenak tablet 50 mg Natrium Klorida lart lnfus 0.9 % steril Natrium Tlosulfat injeksi 25 % - 10 ml Nifedipin tablet 10 mg Nistatin tablet salut gula 500.000 IU/g Nistatin tablet vaginal 100.000 IU/g Ofloxacin tablet 200 mg Ofloxacin tablet 400 mg Oksitetrasiklin HCI salep mata 1 % Oksitetrasiklin HCI salep 3 % Oksitetrasiklin HCI injeksi i.m.50 mg/ml Omeprazol 20 mg Papaverin injeksi 40 mg/ml

KEMASAN btl 1000 tablet botol 250 tablet btl 500 tablet btl 250 tablet Btl 500 ml

HNA + PPN (Rupiah) 90.720 22.680 27.600 41.250 4.980

Btl 500 ml

4.980

Btl 500 ml

4.980

Btl 100 tablet

39.125

Strip 10 x 10 tablet

42.000 2.500

Btl 60 ml

3.465

Btl 100 tablet

17.375

Strip 10 x 10 tablet Strip 10 x 10 tablet

17.900 7.000

Ktk 100 amp @ 2 ml

120.000

Btl 1000 tablet Ktk 100 amp @ 2 ml Ktk 100 amp @ 2 ml

200.000 26.880 43.438

Ktk 100 amp @ 2 ml Strip 10 x 10 tablet Strip 10 x 10 tablet Strip 10 x 10 tablet Strip 10 x 10 tablet Tube 10 g Btl 1000 tablet Ktk 50 tablet Ktk 50 tablet Btl 500 ml Ktk 10 ampul @ 10 ml Strip 10 x 10 tablet Strip 10 x 10 tablet Strip 10 x 10 dragee Strip 5x10 tablet Strip 5x10 tablet Ktk 25 tube Ktk 25 tube @ 5g 10 vial Btl 7 kapsul Ktk 100 amp @ 1 ml

33.600 1.800 13.200 11.000 16.400 3.400 9.576 12.000 17.000 4.620 11.040 30.000 48.875 30.624 70.400 137.500 30.840 24.281 41.580 16.800 36.000


NAMA OBAT

150 151 152

Papaverin tablet 40 mg Parasetamol sirup 120 mg/5 ml Parasemol tablet 500 mg

153 154 155 156

Perphenazin tablet 4 mg Petidin HCI injeksi 50 mg/ml - 2 ml Pilokarpin HCI/Nitrat tetes mata 2% Pirantel tablet 125 mg

157 158 159

Pirazinamid tablet 500 mg Piridoksin (Vitamin B6) tablet 10 mg Piroksikam tablet 10 mg

160

Piroksikam kapsul 20 mg

161

Povidin Iodida 10 %

162 163 164 165 166 167 168 169 170 171

Prazikuantel tablet 600 mg Prazosin tablet 1 mg Prednison tablet 5 mg Primakuin tablet 15 mg Prometazin tablet 12,5 mg Prometazin tablet 25 mg Propiltiourasil tablet 100 mg Propranolol tablet 10 mg Propranolot tablet 40 mg Ranitidin tablet 150 mg

172 173 174 175

Reserpin tablet 0,10 mg Reserpin tablet 0,25 mg Retinol (Vitamin A) kapsul 50.000 IU Rifampisin kapsul 300 mg

176 177 178 179 180 181 182 183 184 185 186 187

Rifampisin kaplet 450 mg Rifampisin tablet 600 mg Ringer laktat larutan infus steril Salbutamol tablet 2 mg Salbutamol tablet 4 mg Sefadroksil kapsul 250 mg Sefadroksil kapsul 500 mg Sefadroksil sirup kering 125 mg/5ml Sefadroksil sirup kering 250 mg/5ml Sefaleksin kapsul 250 mg Sefaleksin kapsul 500 mg Sefaleksin sirup kering 125 mg/5ml

KEMASAN Btl 1000 tablet Btl 60 ml Strip 10 x 10 tablet Btl 1000 tablet Btl 100 tablet Ktk 10 amp @ 2 ml 24 btl @ 5 ml Strip 25 x 4 tablet Kotak 60 tablet Strip 10 x 10 tablet Btl 1000 tablet Strip 10 x 10 tablet Strip 12 x 10 kapsul Strip 12 x 10 kapsul Strip 10 x 10 tablet Strip 12 x 10 kapsul Btl 30 ml Btl 60 ml Btl 300 ml Btl 1000 ml Strip 10 x 10 tablet Strip 10 x 10 tablet Btl 1000 tablet Btl 1000 tablet Btl 30 tablet Btl 30 tablet Btl 100 tablet Strip 10 x 10 tablet Strip 10 x 10 tablet Ktk 3 x 10 tablet Ktk 10 x 10 tablet Btl 500 tablet Btl 500 tablet Btl 1000 tablet Strip 10 x 10 kapsul Ktk 120 kapsul Strip 10 x 10 kaplet Strip 10 x 10 tablet Btl 500 ml Strip 10 x 10 tablet Strip 10 x 10 tablet Ktk 50 kapsul Ktk 50 kapsul Btl 60 ml Btl 60 ml Ktk 50 kapsul Ktk 50 kapsul Btl 60 ml

HNA + PPN (Rupiah) 51.625 2.375 7.579 41.844 3.840 19.063 125.123 19.680 14.575 42.600 17.028 12.200 13.000 13.000 17.300 19.750 1.875 3.000 9.720 33.600 156.776 24.720 94.510 69.960 966 1.380 32.544 6.600 14.400 18.360 58.752 7.920 10.440 138.000 71.200 72.000 97.890 122.400 5.520 10.600 12.000 71.500 114.000 9.720 17.880 41.500 78.500 6.600

BADAN PENGAWAS OBAT DAN MAKANAN REPUBLIK INDONESIA NO. 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220

NAMA OBAT Sefaleksin sirup kering 250 mg/5ml Sefotaksim serbuk injeksi 500 mg/vial Sefotaksim serbuk injeksi 1000 mg/vial Sefotaksim serbuk injeksi 2000 mg/vial Seftazidim serbuk injeksi 1000 mg/vial Seftriakson serbuk injeksi 250 mg/vial Seftriakson serbuk injeksi 500 mg/vial Seftriakson serbuk injeksi 1000 mg/vial Sefuroksim serbuk injeksi 250 mg/vial Sefuroksim serbuk injeksi 750 mg/vial Sefuroksim serbuk injeksi 1000 mg/vial Sefuroksim tablet salut selaput 250 mg Sianokobalamin (Vit.B12) injeksi 500 mg/ml Simetidin tablet 200 mg Siprofloksasin tablet 250 mg Siprofloksasin tablet 500 mg Siprofloksasin tetes mata 0,3 % Spiramisin tablet 250 mg Spiramisin tablet 500 mg Streptomisin Suffat Injeksi 1500 mg/ml Sulfadimidin tablet 500 mg Tetrasiklin HCI kapsul 250 mg Tetrasiklin HCI kapsul 500 mg Tiamfenikol kapsul 250 mg Tiamfenikol kapsul 500 mg Tiamin HCI (Vit.B1) injeksi 100 mg/mi - 1 ml Tiamin HCI/Mononitrat (Vit.B1) tablet 50 mg Tramadol tablet 50 mg Tramadol kapsul 50 mg Triheksifenidil tablet 2 mg Trisulfa tablet 500 mg Verapamil tablet 80 mg Vitamin B Kompleks tablet

KEMASAN Btl 100 ml Btl 60 ml Dus 1 vial Dus 1 vial Dus 1 vial Dus 1 vial Dus 1 vial @ 10 ml Dus 1 vial @ 10 ml Dus 1 vial @ 10 ml Dus 1 vial @ 10 ml Dus 1 vial @ 10 ml Dus 1 vial @ 10 ml Strip 10 x 1 tablet Ktk 100 amp @ 1 ml Strip 10 x 10 tablet Strip 5 x 10 tablet Strip 5 x 10 tablet Btl 10 ml Ktk 50 tablet Ktk 50 tablet Ktk 30 vial @ 15 ml Botol 1000 tablet Btl 1000 kapsul Strip 10 x 10 kapsul Ktk 100 kapsul Ktk 100 kapsul Ktk 30 amp @ 1 ml 1000 tablet Ktk 50 tablet Ktk 50 kapsul Strip 10 x 10 tablet Btl 1000 tablet Strip 10 x 10 tablet Btl 1000 tablet

HNA + PPN (Rupiah) 9.840 11.400 14.960 23.100 37.950 38.880 7.470 14.500 26.600 3.720 9.000 12.000 31.080 46.485 18.900 52.600 90.950 4.400 52.800 103.000 54.840 97.520 110.240 21.875 42.000 72.000 12.250 27.720 38.000 40.000 5.700 99.264 41.950 18.000


HARGA JUAL APOTIK (HJA) OBAT GENERIK Lampiran II Nomor Tanggal NO.

: Keputusan Kepala Badan Pengawas Obat dan Makanan RI : 05017/SK/KBPOM : 15 Mei 2001 NAMA OBAT

1 2 3 4 5 6 7

Albendazol tablet 400 mg Alopurinol tablet 100 mg Ambroxol sirup 15mg/ml Ambroxol tablet 30 mg Amilorid tablet 5 mg Aminofilin injeksi 24 mg/ml - 10 ml Aminofilina tablet 200 mg

8 9 10 11

Amitriptilin HCI tablet salut 25 mg Amoksisilin 250 mg + Asam Klavulanat 125 mg Amoksisilin 500 mg + Asam Klavulanat 125 mg Amokslsilin kapsul 250 mg

12 13 14 15 16 17 18 19 20

Amoksisilin kaplet 500 mg Amoksisilin sirup kering 12-5 mg/5ml Ampisilin kaplet 250 mg Ampisilin kaplet 500 mg Ampisifin serbuk lnjeksi (im/iv) 500 mg Ampisilin serbuk lnjeksi (im/iv) 1000 mg Ampisilin sirup kering 125 mg/5ml Antalgin (Metampiron) lnjeksi 250 mg/ml - 2 ml Antalgin (Metampiron) tablet 500 mg

21

Antasida DOEN suspensi, kombinasi : Magnesium Hidroksida 200 mg/5 ml Alumunium Hidroksida 200 mg/5 ml

22

Antasida DOEN tablet komb : Magnesium Hidroksida 200 mg+Al Hidroksida 200 mg

23 24

26 27 28

Antihemoroid DOEN kombinasi Andmigren DOEN kombinasi : Ergotamin Tartrat 1 mg + Kofein 50 mg Anti Parkinson DOEN kombinasi : Karbidopa 25 mg + Levodopa 250 mg Asam Askorbat ( Vit. C ) tablet 50 mg Asam Folat tablet 1 mg Asam Mefenamat kapsul 250 mg

29 30

Asam Mefenamat tablet salut selaput 500 mg Asetosal tablet 100 mg

25

ktk 5 X 6 tablet strip 10 x 10 tablet btl 60 ml strip 10x10 tablet strip 10 x 10 tablet ktk 30 amp @ 10ml btl 100 tablet btl 1000 tablet strip 10 x 10 tablet ktk 30 kaplet ktk 30 kaplet strip 10 x 10 kapsul ktk 120 kapsul strip 10 x 10 kaplet btl 60 ml strip 10 x 10 kaplet strip 10 x 10 kaplet dus 1 vial dus 1 vial btl 60 ml ktk 30 amp/2ml strip 10 x 10 tablet btl 1000 tablet btl 60 ml

HNA + PPN (Rupiah) 15.888 16.682 4.680 17.160 13.416 26.125 8.450 56.472 14.196 91.416 130.000 35.490 42.471 62.946 4.310 30.420 58.175 4.180 5.225 4.056 11.000 11.700 81.627 4.225

strip 10 x 10 tablet

10.225

btl 1000 tablet dus 10 supp 100 tablet

55.838 13.650 16.692

ktk 100 tablet

110.760

KEMASAN

btl 1000 tablet btl 100 tablet strip 10 x 10 kapsul strip 12 x 10 kapsul strip 10 x 10 kaplet ktk 100 tablet

21.845 4.550 17.846 21.354 34.255 8.198


NAMA OBAT

31 32 33

Asetosal tablet 500 mg Asiklovir cream 5 % Asiklovir tablet 200 mg

34

Asiklovir tablet 400 mg

35 36 37 38 39 40 41

Atropin Sulfat injeksi 0,25 mg/ml - 1 ml Atropin Suffat tablet 0,5 mg Atropin Sulfat tetes mata 0,5% Betametason krim 0,1 % Bezafibrate tablet 200 mg Deksametason Injeksi 5 mg/ml - 1 ml Deksametason tablet 0,5 mg

42 43

Dekstrometorfan sirup 10 mg/5 ml Dekstrometorfan tablet 15 mg

44 45 46

Diazepam injeksi 5 mg/ml - 2 ml Diazepam tablet 2 mg Diazepam tablet 5 mg

47 48 49 50 51 52 53 54 55

Difenhidramin HCI lnjeksi 10 mg/mi - 1 ml Digoksin tablet 0,25 mg Dikloksasilin kapsul 125 mg Diltiazem tablet salut 30 mg Dimenhidrinat tablet 50 mg Doksisiklin kapsul 100 mg Efedrin HCI tablet 25 mg Epinefrin HCI/Bitartrat inj 0,1 %-1 ml Eritromisin kapsul 250 mg

56 57 58 59 60 61 62 63 64 65 66 67 68 69 70

Eritromisin kapsul 500 mg Eritromisin sirup 200 mg/5 ml Etambutol tablet 250 mg Etambutol tablet 500 mg Eter Anestetik Famotidine tablet 20 mg Famotidine tablet 40 mg Fenilbutazon tablet salut 200 mg Fenobarbital injeksi 50 mg/ml - 2 ml Fenobarbital tablet 30 mg Fenobarbital tablet 100 mg Fenoksimetil Penisilin tablet 250 mg Fenoksimetil Penisilin tablet 500 mg Fero Sulfat tablet salut 300 mg Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml

KEMASAN ktk 100 tablet tube 5 g ktk 50 tablet ktk 30 tablet ktk 100 tablet ktk 50 tablet ktk 30 tablet ktk 100 tablet ktk 100 amp @ 1 ml btl 500 tablet 24 btl @ 5 ml 25 tube @ 5 g strip 5 x 10 tablet ktk 100 amp @ 1 ml strip 10 x 10 tablet btl 1000 tablet btl 60 ml strip 10 x 10 tablet btl 1000 tablet ktk 100 amp @ 2 ml btl 1000 tablet btl 100 tablet btl 500 tablet ktk 30 amp @ 1 ml strip 10 x 10 tablet strip 10 x 10 kapsul strip 10 x 10 tablet btl 100 tablet strip 10 x 10 kapsul btl 1000 tablet ktk 30 amp @ 1 ml strip 10 x 10 kapsul ktk 120 kapsul strip 10 x 10 kapsul btl 60 ml strip 20 x 10 tablet strip 10 x 10 tablet btl 140 ml strip 5x 10 tablet strip 5x10 tablet btl 1000 tablet ktk 30 amp @ 2 ml btl 1000 tablet btl 250 tablet strip 10 x 10 tablet strip 10 x 10 tablet btl 1000 tablet ktk 30 amp @ 1 ml

HNA + PPN (Rupiah) 13.728 4.583 63.700 38.610 116.220 101.400 62.400 176.904 35.200 18.057 94.371 81.250 30.810 129.415 10.563 40.138 4.056 12.188 86.125 83.160 16.536 4.525 14.560 15.730 12.675 52.884 33.800 12.610 40.950 51.634 10.865 65.520 76.700 9.815 50.050 47.450 12.168 12.350 18.850 104.520 13.068 19.065 14.586 31.688 55.120 24.180 34.100


NAMA OBAT

71

Fitomenadion (Vit.K1) tablet salut gula 10mg

72

Furosemid tablet 40 mg

73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97

Furosemid injeksi 10 mg/ml Garam Oralit untuk 200 ml air, kombinasi Gemfibrozil kapsul 300 mg Gemfibrozil tablet 600 mg Gentamisin injeksi 80 mg/2 ml Gentamisin Sulfat salep 1 % Gentamisin Sulfat tetes mata 0,3 % Glibenklamid tablet 5 mg Gilseril Guayakolat tablet 100 mg Glukosa larutan infus 5 % steril Glukosa larutan lnfus 10 % steril Griseofulvin tablet 125 mg, Micronized Haloperidol tablet 0,5 mg Haloperidol tablet 1,5 mg Haloperidol tablet 5 mg Hidroklorodazid (HCT) tablet 25 mg Hidrokortison krim 2,5 % Ibuprofen tablet 200 mg lbuprofen tablet 400 mg Indometasin kapsul 25 mg Isoniazid tablet 100 mg Isoniazid tablet 300 mg Isosorbiddinitrat tablet sublingual 5 mg Kalsium Laktat (Kalk) tablet 500 mg Kaptopril tablet 12,5 mg

98

Kaptopril tablet 25 mg

99 100 101 102 103 104

Kaptopril tablet 50 mg Karbamazepin tablet 200 mg Ketotifen syrup 1 mg 1 ml Ketotifen tablet 1 mg Klonidin tablet 0,15 mg Kloramfenikol kapsul 250 mg

105 106 107 108 109 110

Kloramfenikol salep mata 1 % Kloramfenikol suspensi 125 mg/5 ml Kloramfenikol tetes mata 0,5 % Kloramfenikol tetes telinga 3 % Klorfeniramina Maleat (CTM) tablet 4 mg Klorokuin tab 150 mg

111

Klorpromazin HCI injeksi 5 mg/ml - 2 ml

KEMASAN btl 100 tablet

HNA + PPN (Rupiah) 88.481

strip 10 x 10 tablet

11.466

strip 20 x 10 tablet btl 250 tablet ktk 25 ampul/2 ml dos 25 sachet strip 10x10 kapsul strip 10x10 tablet dus 1 vial / ampul ktk 10 tube @ 5 g btl 5 ml strip 10 x 10 tablet btl 1000 tablet btl 500 ml btl 500 ml strip 10 x 10 tablet strip 10 x 10 tablet strip 10 x 10 tablet strip 10 x 10 tablet btl 1000 tablet 1 tube @ 5 g btl 100 tablet strip 10 x 10 tablet strip 10 x 10 kapsul btl 1000 tablet btl 1000 tablet strip 10 x 10 tablet btl 1000 tablet strip 6 x 10 tablet strip 10 x 10 tablet strip 6 x 10 tablet strip 10 x 10 tablet strip 10 x 10 tablet strip 10 x 10 tablet btl 60 ml strip 10 x 10 tablet strip 10 x 10 tablet ktk 120 kapsul btl 1000 kapsul botol 250 kapsul tube 5 g btl 60 ml btl 5 ml 24 botol @ 5 ml btl 1000 tablet btl 1000 tablet

21.996 21.294 41.800 11.180 65.754 117.000 5.280 24.375 4.394 20.670 37.464 5.928 6.240 22.750 9.362 13.813 21.255 21.450 3.432 11.700 25.350 14.352 36.816 93.600 13.650 46.680 24.960 25.350 40.950 68.250 51.461 7.085 27.950 26.650 33.410 246.740 69.615 2.031 6.890 5.363 73.060 19.859 109.200

ktk 30 amp @ 2 ml

10.395


NAMA OBAT

112 113 114

Klorpromazin HCI injeksi 25 mg/ml - 1 ml Klorpromazin HCI tablet salut 25 mg Klorpromazin HCI tablet salut 100 mg

115 116 117

Klorpropamid tablet 100 mg Kodein Fosfat tablet 10 mg Kombinasi Natrium Klorida dan Glukosa larutan infus steril 0,45% / 2,5% Kombinasi Natrium Klorida dan Glukosa larutan infus steril 0,9% / 5% Kombinasi Natrium Klorida dan Glukosa larutan infus steril 0,9% / 10% Kombinasi Pirimetamin 25 mg + Sulfadoksin 500 mg tablet

118 119 120

121 122

Kotrimoksazol Suspensi, kombinasi : Suffa metosakzol 100 mg + Trimetroprim 20mg/ 5 ml Kotrimoksazol Suspensi, kombinasi : Suffa metosakzol 200 mg + Trimetroprim 40 mg/ 5 ml

123

Kotrimaksazol tablet kombinasi :Sulfametosakzol 400 mg + Trimetroprin 80 mg

124

Kotrimoksazol tablet pediatrik, kombinasi : Sulfametosakzol 100 mg + Trimetroprim 20 mg Kuinin Dihidroklorida injeksi 25 % - 2 ml Kuinin (Kina) tablet 200 mg Lidokain injeksi 1% Lidokain comp.injeksi, kombinasi : Lidokain HCI 2 % + Epinefrin 1;80.000 – 2 ml Lidokain injeksi 2% Mebendazol tablet 100 mg Metilergometrin Maleat tablet 0,125 mg Metronidazol tablet 250 mg Metronidazol tablet 500 mg Mikonazol krim 2 % Natrium Bikarbonat tablet 500 mg Natrium Diklofenak tablet 25 mg Natrium Diklofenak tablet 50 mg Natrium Klorida lart lnfus 0.9 % steril Natrium Tiosulfat injeksi 25 % - 10 ml Nifedipin tablet 10 mg Nistatin tablet salut gula 500.000 IU/g Nistatin tablet vaginal 100.000 IU/g Ofloxacin tablet 200 mg Ofloxacin tablet 400 mg Oksitetrasiklin HCI salep mata 1 % Oksitetrasikfin HCI salep 3 % Oksitetrasiklin HCI injeksi i.m.50 mg/ml

125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147

KEMASAN ktk 30 amp @ 1 ml btl 1000 tablet btl 1000 tablet botol 250 tablet btl 500 tablet btl 250 tablet btl 500 ml

HNA + PPN (Rupiah) 10.395 33.696 117.936 29.484 35.880 53.625 6.474

btl 500 ml

6.474

btl 500 ml

6.474

btl 100 tablet

50.863

strip 10 x 10 tablet btl 60 ml

54.600 3.250 4.505

btl 100 tablet

22.588

strip 10 x 10 tablet strip 10 x 10 tablet

23.270 9.100

ktk 100 amp @ 2 ml btl 1000 tablet ktk 100 amp @ 2 ml ktk 100 amp @ 2 ml

132.000 260.000 29.568 47.781

ktk 100 amp @ 2 ml strip 10 x 10 tablet strip 10 x 10 tablet strip 10 x 10 tablet strip 10 x 10 tablet tube 10 g btl 1000 tablet ktk 50 tablet ktk 50 tablet btl 500 ml ktk 10 ampul @ 10 ml strip 10 x 10 tablet strip 10 x 10 tablet strip 10 x 10 dragee strip 5x10 tablet strip 5x10 tablet ktk 25 tube ktk 25 tube @ 5 g 10 vial

36.960 23.400 17.160 14.300 21.320 4.420 12.449 15.600 22.100 6.006 12.144 39.000 63.538 39.811 91.520 178.750 40.092 31.565 45.738


NAMA OBAT

148 149 150 151 152

Omeprazol 20 mg Papaverin lnjeksi 40 mg/ml Papaverin tablet 40 mg Parasetamol sirup 120 mg/5 ml Parasemol tablet 500 mg

153 154 155 156

Perphenazin tablet 4 mg Petidin HCI injeksi 50 mg/ml - 2 ml Pilokarpin HCI/Nitrat tetes mata 2% Pirantel tablet 125 mg

157 158 159

Pirazinamid tablet 500 mg Piridoksin (Vitamin B6) tablet 10 mg Piroksikam tablet 10 mg

160

Piroksikam kapsul 20 mg

161

Povidin lodida 10 %

162 163 164 165 166 167 168 169 170 171

Prazikuantel tablet 600 mg Prazosin tablet 1 mg Prednison tablet 5 mg Primakuin tablet 15 mg Prometazin tablet 12,5 mg Prometazin tablet 25 mg Propiltiourasil tablet 100 mg Propranolol tablet 10 mg Propranolot tablet 40 mg Ranitidin tablet 150 mg

172 173 174 175

Reserpin tablet 0,10 mg Reserpin tablet 0,25 mg Retinol (Vitamin A) kapsul 50.000 IU Rifampisin kapsul 300 mg

176 177 178 179 180 181 182 183 184 185 186

Rifampisin kaplet 450 mg Rifampisin tablet 600 mg Ringer laktat larutan infus steril Salbutamot tablet 2 mg Salbutamol tablet 4 mg Sefadroksil kapsul 250 mg Sefadroksil kapsul 500 mg Sefadroksil sirup kering 125 mg/5ml Sefadroksil sirup kering 250 mg/5ml Sefaleksin kapsul 250 mg Sefaleksin kapsul 500 mg

KEMASAN btl 7 kapsul ktk 100 amp @ 1 ml btl 1000 tablet btl 60 ml strip 10 x 10 tablet btl 1000 tablet btl 100 tablet ktk 10 amp @ 2 ml 24 btl @ 5 ml strip 25 x 4 tablet kotak 60 tablet strip 10 x 10 tablet btl 1000 tablet strip 10 x 10 tablet strip 12 x 10 kapsul strip 10 x 10 tablet strip 12 x 10 kapsul btl 30 ml btl 60 ml btl 300 ml btl 1000 ml strip 10 x 10 tablet strip 10 x 10 tablet strip 10 x 10 tablet btl 1000 tablet btl 30 tablet btl 30 tablet btl 100 tablet strip 10 x 10 tablet strip 10 x 10 tablet ktk 3 x 10 tablet ktk 10 x 10 tablet btl 500 tablet btl 500 tablet btl 1000 tablet strip 10 x 10 kapsul ktk 120 kapsul strip 10 x 10 kaplet strip 10 x 10 tablet btl 500 ml strip 10 x 10 tablet strip 10 x 10 tablet ktk 50 kapsul ktk 50 kapsul btl 60 ml btl 60 ml ktk 50 kapsul ktk 50 kapsul

HNA + PPN (Rupiah) 21.840 39.600 67.113 3.088 9.853 54.397 4.992 20.969 162.660 25.584 18.948 55.380 22.136 15.860 16.900 22.490 25.675 2.438 3.900 12.636 43.680 203.809 32.136 122.863 90.948 1.256 1.794 42.307 8.580 18.720 23.868 76.378 10.296 13.572 179.400 92.560 93.600 127.257 159.120 7.176 13.780 15.600 92.950 148.200 12.636 23.244 53.950 102.050


NAMA OBAT

187

Sefaleksin sirup kering 125 mg/5ml

188 189 190 191 192

Sefaleksin sirup kering 250 mg/5ml Sefotaksim serbuk injeksi 500 mg/vial Sefotaksim serbuk injeksi 1000 mg/vial Sefotaksim serbuk injeksi 2000 mg/vial Seftazidim serbuk injeksi 1000 mg/vial

193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220

Seftriakson serbuk injeksi 250 mg/vial Seftriakson serbuk injeksi 500 mg/vial Seftriakson serbuk injeksi 1000 mg/vial Sefuroksim serbuk injeksi 250 mg/vial Sefuroksim serbuk injeksi 750 mg/vial Sefuroksim serbuk injeksi 1000 mg/vial Sefuroksim tablet salut selaput 250 mg Sianokobalamin (Vit.B12) injeksi 500 mg/ml Simetidin tablet 200 mg Siprofloksasin tablet 250 mg Siprofloksasin tablet 500 mg Siprofloksasin tetes mata 0,3 % Spiramisin tablet 250 mg Spiramisin tablet 500 mg Streptomisin Suffat Injeksi 1500 mg/ml Sulfadimidin tablet 500 mg Tetrasiklin HCI kapsul 250 mg Tet-asiklin HCI kapsul 500 mg Tiamfenikol kapsul 250 mg Tiamfenikol kapsul 500 mg Tiamin HCI (Vit.B1) injeksi 100 mg/mi - 1 ml Tiamin HCI/Mononitrat (Vit.B1) tablet 50 mg Tramadol tablet 50 mg Tramadol kapsul 50 mg Triheksifenidil tablet 2 mg Trisulfa tablet 500 mg Verapamil tablet 80 mg Vitamin B Kompleks tablet

KEMASAN btl 60 ml btl 100 ml btl 60 ml dus 1 vial dus 1 vial dus 1 vial dus 1 vial dus 1 vial @ 10 ml dus 1 vial @ 10 ml dus 1 vial @ 10 ml dus 1 vial @ 10 ml dus 1 vial @ 10 ml dus 1 vial @ 10 ml strip 10 x 1 tablet ktk 100 amp @ 1 ml strip 10 x 10 tablet strip 5 x 10 tablet strip 5 x 10 tablet btl 10 ml ktk 50 tablet ktk 50 tablet ktk 30 vial @ 15 ml botol 1000 tablet btl 1000 kapsul strip 10 x 10 kapsul ktk 100 kapsul ktk 100 kapsul ktk 30 amp @ 1 ml 1000 tablet ktk 50 tablet ktk 50 kapsul strip 10 x 10 tablet btl 1000 tablet strip 10 x 10 tablet btl 1000 tablet

HNA + PPN (Rupiah) 12.792 14.820 16.456 25.410 41.745 42.768 8.217 15.950 29.260 4.092 9.900 13.200 34.188 51.123 24.570 68.380 118.235 5.720 68.640 133.900 60.324 126.776 143.312 28.438 54.600 93.600 13.475 36.036 49.400 52.000 7.410 129.043 54.535 23.400

KBPOM TENTANG HARGA JUAL OBAT GENERIK TAHUN 2001

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