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["大病保险特殊用药名单及首批特约药店"]
["序号","医保编码","医保中文名称","英文名称","医保文件剂型","商品名","剂型","规格","单位","转换比","包装材质","生产企业","协议价格","赠药情况","按量控制","额度控制（年或总量）","首批特约药店"]
[1,"Db0020151001","甲磺酸伊马替尼片","Imatinib Mesylate Tablets","片  剂","格列卫","片  剂","0.1g","盒",60,"铝箔","Novartis Pharma Schweiz AG",10800,"连续购买3个月后，赠送9个月","6盒／年","64800元／年","华润衢州医药有限公司（天福堂药店）"]
[2,"Db0020151002","注射用培美曲塞二钠","Pemetrexed Disodium For Injecton","注射剂","力比泰","注射剂","500mg","瓶",1,"玻瓶","Lilly France","11151元","连续购买4个周期后，赠药至进展","常规一个周期500ｍｇ+300ｍｇ，四个周期总共4支*500+12支*100／年，最大剂量4*500+4*500支／年","89208元／总量","华润衢州医药有限公司（天福堂药店）"]
[null,null,"注射用培美曲塞二钠","Pemetrexed Disodium For Injecton","注射剂","力比泰","注射剂","100mg","瓶",1,"玻瓶","Eli Lilly & Company","3252.58元","连续购买4个周期后，赠药至进展",null,null,"华润衢州医药有限公司（天福堂药店）"]
[3,"Db0020151003","吉非替尼","GefitinibTabLets","片  剂","易瑞沙","片  剂","0.25g","盒",10,"PVC/铝箔泡罩包装","AstraZeneca UK Limited","4597元","连续购买4个月后,赠药至进展","12盒／年","55164元／总量","华润衢州医药有限公司（天福堂药店） 、滋福堂龙游新华路分店"]
[4,"Db0020151004","盐酸多柔比星脂质体注射液","Doxorubicin Hydrochloride LIposome Injection","注射剂","里葆多","脂质体注射液","20mg/10ml","瓶",1,"西林瓶","上海复旦张江生物医药股份有限公司","4000元/瓶","无",null,null,"华润衢州医药有限公司（天福堂药店）"]
[5,"Db0020151005","西妥昔单抗注射液","Cetuximab Solution for Infusion","注射剂","爱必妥","注射剂","100mg／20ml/瓶","瓶",1,"玻瓶","德国默克公司（Merck KGaA）","3805元/瓶","连续购买3个月后起赠药","疗程12周，每周4支，首次+2支，总共50支，最大剂量76支","289180元／总量","华润衢州医药有限公司（天福堂药店）、延寿堂大药房"]
[6,"Db0020151006","注射用地西他滨","Decitabine for Injection","注射剂","晴唯可","注射剂","10mg","支",1,"安瓿瓶","正大天晴药业集团股份有限公司","1206元","无赠药",null,null,"华润衢州医药有限公司（天福堂药店）"]
[null,"Db0020151006","注射用地西他滨","Decitabine for Injection","注射剂","晴唯可","注射剂","25mg","支",1,"安瓿瓶","正大天晴药业集团股份有限公司","2434元","无赠药",null,null,"华润衢州医药有限公司（天福堂药店）"]
[null,"Db0020151006","注射用地西他滨","Decitabine for Injection","注射剂","晴唯可","注射剂","50mg","支",1,"安瓿瓶","正大天晴药业集团股份有限公司","4138元","无赠药",null,null,"华润衢州医药有限公司（天福堂药店）"]
[7,"Db0020151007","抗人T细胞兔免疫球蛋白","Anti-human T Lymphocyte Rabbit Immunoglobublin","注射剂","ATG- Fresenius S","注射剂","100mg(5ml)/瓶)","瓶",1,"玻璃瓶","Fresenius Biotech GmbH","3700元","无赠药",null,null,"暂无定点"]
[8,"Db0020151008","注射用曲妥珠单抗","Trastuzumab Injection","注射剂","赫赛汀","注射剂","440mg（20ml）／瓶","瓶",1,"玻璃瓶","Genentech Inc.",19450,"乳腺癌：连续购买6瓶赠8瓶；胃癌：连续购买5瓶赠7瓶","乳腺癌7瓶／胃癌7瓶","136150元／年","延寿堂大药房"]
[9,"Db0020151009","注射用重组人凝血因子VIIa","Recombinant Human Coagulaiion Factor Vlla for Injection","粉针剂","诺其","粉针剂","1mg(50KIU)／支","支",1,"玻璃瓶","丹麦诺和诺德公司（Novo Nordisk A/S）","6350元","连续或累计购买4支赠1支","血友病人平均年出血量4次，每次使用4－5支，总量20支／年","不控","市区长生堂药店"]
[10,"Db0020151010","利妥昔单抗注射液","Rituximab Injection","注射剂","美罗华","注射液","100mg/10ml","瓶",1,"玻璃瓶装","Roche Diagnostics GmbH",3416,"无赠药",null,null,"延寿堂大药房"]
[null,"Db0020151010","利妥昔单抗注射液","Rituximab Injection","注射剂","美罗华","注射液","500mg/50ml","瓶",1,"玻璃瓶装","Roche Diagnostics GmbH",16041,"无赠药",null,null,"延寿堂大药房"]
[11,"Db0020151011","注射用英夫利西单抗","Infliximab for Injection","注射剂","类克","注射剂","100mg／支","支",1,"玻璃瓶装","Cilag AG",5180,"连续购买4个疗程后，赠2个疗程","2－3瓶／疗程，一年9个疗程，每人最多使用二个循环","124320元／总量","华润衢州医药有限公司（天福堂药店）"]
[12,"Db0020151012","碳酸镧咀嚼片","Lanthanum Carbonate ChewableTablets   ","片剂","福斯利诺","片剂","500mg","瓶",20,"高密度聚乙烯瓶","Hamol Limited(Shire Pharmaceutical Contracts Limited)",317,"无赠药",null,null,"暂无定点"]
[13,"Db0020151013","尼妥珠单抗注射液","Nimotuzumab Injection","注射剂","泰欣生","注射剂","50mg/瓶（10mL）","瓶",1,"玻璃瓶","百泰生物药业有限公司",2378,"无赠药",null,null,"华润衢州医药有限公司（天福堂药店）"]
[14,"Db0020151014","注射用醋酸兰瑞肽","Lanreotide acetate for injection","注射剂","索马杜林","注射剂","40mg","支",1,"每盒装有冻干粉1瓶，2ml溶剂1支，并附带1个专用无菌注射用具包","IPSEN PHARMA BIOTECH",2930,"无赠药",null,null,"衢州佑安医药零售有限公司"]
[15,"Db0020151015","特立帕肽注射液","Teriparatide Injection","注射剂","复泰奥","注射液","20μg : 80μl，2.4ml/支","支",1,"预装注射笔","Lilly France","5810元","连续购买6支赠7支","6支／年，治疗期最长为2年","34860元／年，69720元／总量","华润衢州医药有限公司（天福堂药店）"]

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