1附表一:部分抗肿瘤药品最高零售价格表金额单位:元序号定价目录序号药品通用名称剂型规格单位最高零售价格备注1358阿霉素注射剂10mg瓶39.0*△注射剂10mg(冻干粉)瓶41.0注射剂10mg*5瓶盒184注射剂10mg:1ml支38.02359白消安片剂2mg*60片瓶15.6*3360氮芥注射剂5mg:5ml*5支盒26.3*△注射剂25mg:5ml*5支盒90.2注射剂5mg*5瓶盒31.0注射剂5mg:1ml支5.6注射剂5mg:1ml*5支盒26.34361环磷酰胺注射剂200mg瓶6.0*△片剂50mg*100片瓶30.0*△5362卡铂注射剂100mg:10ml支97.5*△注射剂150mg:15ml支133注射剂50mg:10ml支57.4注射剂100mg瓶40.1*注射剂100mg(冻干粉)瓶42.1注射剂100mg*5瓶盒1896363塞替派注射剂10mg:1ml*5支盒28.1*△2注射剂10mg:1ml支6.0注射剂10mg:5ml支6.07364顺铂注射剂10mg(冻干粉)瓶19.1*注射剂20mg(冻干粉)瓶32.5注射剂10mg:2ml瓶16.9*注射剂10mg:2ml*10支盒155注射剂20mg:100ml瓶37.2注射剂20mg:20ml*10瓶盒265注射剂20mg:20ml瓶28.8注射剂20mg:20ml*5瓶盒136注射剂30mg:6ml支39.2注射剂50mg:50ml瓶74.8注射剂10mg瓶6.5*注射剂20mg瓶11.1注射剂20mg*5瓶盒52.18365丝裂霉素注射剂10mg瓶60.0*△注射剂10mg*10瓶盒552注射剂2mg*10瓶盒161注射剂2mg(冻干粉)瓶18.1注射剂2mg(溶媒结晶粉)瓶18.1注射剂2mg*5瓶盒82.5注射剂20mg瓶10239366司莫司汀胶囊50mg*5粒瓶84.6*10367阿柔比星注射剂20mg瓶111*11368奥沙利铂注射剂100mg瓶935*注射剂100mg(冻干粉)瓶937注射剂40mg:20ml瓶463注射剂50mg瓶550注射剂50mg(冻干粉)瓶55112370吡柔比星注射剂10mg支170*13371表柔比星注射剂10mg瓶137*△注射剂10mg*10瓶盒1259注射剂10mg(冻干粉)瓶13914372氮甲片剂50mg*100片瓶36.4*15373福莫司汀注射剂208mg瓶1735*16374卡莫司汀注射剂125mg:2ml瓶159*注射剂125mg瓶16017375六甲蜜胺片剂50mg*20片瓶188*肠溶片100mg*12片盒215胶囊100mg*24粒盒381片剂100mg*12片瓶196片剂50mg*100片瓶887片剂50mg*40片盒36718376洛莫司汀胶囊40mg*4粒瓶33.5*4胶囊40mg*6粒瓶49.519377尼莫司汀注射剂25mg瓶387*△20378柔红霉素注射剂20mg瓶41.7*注射剂20mg*10瓶盒383注射剂20mg*5瓶盒19621379硝卡芥注射剂40mg瓶86.1*△注射剂20mg瓶50.6注射剂20mg(冻干粉)瓶51.822380异环磷酰胺注射剂1g瓶179*注射剂1g*10瓶盒1648注射剂1g(冻干粉)瓶181注射剂500mg瓶10523381阿糖胞苷注射剂50mg:5ml支9.6*△注射剂1g:10ml支95.1注射剂100mg瓶18.0注射剂50mg(冻干粉)瓶12.6注射剂50mg*10瓶盒97.4注射剂50mg瓶10.6注射剂50mg*5瓶盒50.0注射剂50mg*5瓶(冻干粉)盒59.4注射剂50mg:5ml*5支盒45.3注射剂500mg瓶61.8524382氟尿嘧啶注射剂250mg:10ml*5支盒10.5*注射剂250mg:10ml*15支盒30.3注射剂500mg:250ml瓶13.0片剂50mg*100片瓶8.5*乳膏剂100mg:4g(软塑管)支1.4*植入剂100mg(管装)瓶770*△植入剂100mg(散装)瓶494*△25383甲氨蝶呤注射剂100mg瓶32.0*△注射剂1g瓶187注射剂100mg*10瓶盒294注射剂100mg(冻干粉)瓶34.0注射剂100mg*5瓶盒151注射剂100mg*5瓶(冻干粉)盒160注射剂100mg:10ml*10支盒285注射剂5mg*10瓶盒29.7注射剂5mg*10瓶(冻干粉)盒31.5注射剂5mg瓶3.2注射剂5mg(冻干粉)瓶3.4注射剂5mg*5瓶(冻干粉)盒16.2注射剂500mg:20ml支106注射剂500mg:5ml支106片剂2.5mg*100片瓶21.2*626384羟基脲片剂500mg*100片瓶120*胶囊250mg*24粒盒17.827386吉西他滨注射剂200mg瓶360○注射剂200mg(冻干粉)瓶362○注射剂1g瓶1324*注射剂1g(冻干粉)瓶132628388硫鸟嘌呤片剂25mg*40片盒95.7*29389巯嘌呤片剂50mg*100片瓶57.2*30390脱氧氟尿苷胶囊200mg*30粒瓶213*31391放线菌素D注射剂200ug瓶23.0*△注射剂200ug*10瓶盒211注射剂200ug(冻干粉)瓶25.032392平阳霉素注射剂8mg瓶62.8*33395拓扑替康注射剂2mg瓶199*注射剂2mg(冻干粉)瓶201注射剂4mg瓶33934396长春新碱注射剂1mg*5瓶盒43.0*注射剂1mg*10瓶盒83.9注射剂1mg瓶9.1注射剂1mg*5瓶(冻干粉)盒52.435397高三尖杉酯碱注射剂1mg:1ml支5.6*△注射剂1mg:1ml*10支盒51.5736398羟喜树碱注射剂5mg:5ml支84.5*注射剂10mg瓶145注射剂10mg:10ml支144注射剂10mg:10ml*2支盒280注射剂10mg:5ml支144注射剂2mg*10瓶盒390注射剂2mg瓶42.4注射剂2mg(冻干粉)瓶43.4注射剂2mg:2ml支41.9注射剂2mg:2ml*5支盒198注射剂5mg*10瓶盒786注射剂5mg瓶85.5注射剂5mg(冻干粉)瓶87.5注射剂5mg:2ml支84.5注射剂5mg:2ml*5支盒398注射剂5mg:2ml*6支盒475注射剂8mg瓶12337399依托泊苷注射剂100mg:5ml瓶23.0*注射剂100mg瓶24.0注射剂100mg:5ml*5支盒108注射剂40mg:2ml支11.4软胶囊50mg*10粒盒308*8软胶囊25mg*20粒盒353胶囊50mg*10粒盒277*胶囊25mg*40粒盒620片剂50mg*10片盒27738400长春地辛注射剂4mg瓶220*△注射剂1mg瓶76.1注射剂1mg(冻干粉)瓶76.739402长春瑞宾注射剂10mg:1ml瓶270*注射剂10mg瓶271注射剂10mg(冻干粉)瓶273注射剂10mg:1ml*10支盒247940403多西他赛注射剂20mg:1ml瓶712*注射剂20mg瓶713注射剂20mg:1ml*2支盒1388注射剂40mg:2ml支121041404三尖杉酯碱注射剂1mg:1ml*10支盒69.8*注射剂1mg:1ml支7.642405替尼泊苷注射剂50mg:5ml瓶146*注射剂50mg:5ml*5支盒68743406紫杉醇注射剂30mg:5ml瓶555*△注射剂100mg:16.7ml瓶1395注射剂150mg:25ml瓶19029注射剂20mg瓶408注射剂30mg瓶556注射剂30mg:5ml*10支盒510144407门冬酰胺酶(L-门冬酰胺酶)注射剂1万单位瓶187*45408氨鲁米特片剂250mg*100片瓶150*片剂125mg*60片瓶53.946409他莫昔芬片剂10mg*60片瓶46.0*片剂10mg*100片瓶75.247410阿那曲唑片剂1mg*14片盒228*△48413来曲唑片剂2.5mg*10片盒191*片剂2.5mg*1片盒20.849414托瑞米芬片剂40mg*14片瓶84.0*片剂60mg*30片盒23950415依西美坦片剂25mg*10片瓶204*片剂25mg*14片盒281片剂25mg*30片盒587片剂7.5mg*10片盒81.051417替加氟注射剂200mg:5ml支35.9*注射剂200mg:2ml支35.9注射剂200mg:5ml*5支盒169注射剂500mg:10ml支72.410注射剂500mg:100ml瓶82.5片剂50mg*100片瓶24.7*52418安吖啶注射剂75mg:1.5ml瓶182*53419达卡巴嗪注射剂100mg瓶156*注射剂100mg*10瓶盒1437注射剂200mg瓶26654421氟他胺片剂250mg*20片瓶146*胶囊125mg*20粒盒85.7片剂250mg*12片瓶89.0片剂250mg*50片瓶35255422甲异靛片剂25mg*50片瓶214*56423卡莫氟片剂50mg*24片盒76.3*57424美司钠注射剂400mg:4ml瓶17.1*注射剂400mg:4ml*5支盒80.658425米托蒽醌注射剂5mg*2瓶盒124*注射剂2mg:2ml支30.6注射剂5mg瓶63.7注射剂5mg(冻干粉)瓶65.7注射剂5mg*2瓶(冻干粉)盒128注射剂5mg:10ml支62.7注射剂5mg:5ml支62.7注射剂5mg:5ml*2支盒1221159426维A酸片剂10mg*20片盒33.5*胶囊20mg*20粒盒57.060427维胺酯胶囊25mg*24粒盒29.0*胶囊25mg*20粒盒24.361428亚砷酸注射剂5mg:5ml支85.5*△注射剂10mg:10ml支14562429亚叶酸钙注射剂100mg:10ml瓶81.2*△注射剂100mg:10ml*10支盒746注射剂100mg:10ml*2支盒158注射剂100mg:10ml*5支盒383注射剂100mg:100ml瓶86.2注射剂15mg:2ml支19.0注射剂25mg:10ml瓶28.1注射剂30mg:10ml支32.3注射剂30mg:3ml支32.3注射剂300mg:30ml瓶188注射剂100mg瓶43.5*注射剂100mg(冻干粉)瓶45.5注射剂100mg*3瓶(冻干粉)盒131注射剂200mg瓶74.0注射剂25mg瓶15.1注射剂25mg(冻干粉)瓶15.712注射剂3mg瓶3.0注射剂3mg(冻干粉)瓶3.1注射剂3mg*5瓶盒14.0注射剂3mg*5瓶(冻干粉)盒14.6注射剂30mg瓶17.3注射剂300mg瓶101注射剂5mg瓶4.4注射剂50mg瓶25.6注射剂50mg(冻干粉)瓶26.8片剂15mg*30片瓶125*片剂15mg*100片瓶397片剂15mg*21片盒88.3片剂15mg*50片瓶204片剂25mg*30片瓶184注:1、表中备注栏内有“*”的为代表品。2、表中备注栏内有“△”的品种,其价格为临时价格。3、表中备注栏内有“○”的规格,暂不按照差比价规则执行,其价格为临时价格。