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Healthcare Market Access: Morocco

© phamax AG, 2015 - All Rights Reserved

1 EXECUTIVE SUMMARY ..................................................................................................................................5

2 COUNTRY LANDSCAPE...................................................................................................................................7

2.1 Geography .............................................................................................................................. 7

2.2 Economic environment........................................................................................................... 8

2.3 Demographics....................................................................................................................... 10

2.4 Political structure and environment...................................................................................... 13

3 HEALTHCARE INFRASTRUCTURE............................................................................................................ 14

3.1.1 Healthcare system......................................................................................................... 16

4 MARKET ACCESS............................................................................................................................................ 20

4.1 Health insurance system....................................................................................................... 20

4.1.1 AMO: Mandatory health insurance (Assurance Maladie Obligatoire) ........................ 21

4.1.2 RAMED: Medical assistance scheme (Régime d’Assistance Médicale) ...................... 24

4.1.3 INAYA: Health insurance for the self-employed......................................................... 25

4.2 Drug prescribing and dispensing practices ........................................................................... 27

4.3 Comparison of regional regulatory agencies and environment ............................................ 28

4.3.1 Southern African Development Community (SADC):................................................. 30

4.3.2 Economic Community of West African States (ECOWAS): ....................................... 30

4.3.3 East African Community (EAC): ................................................................................. 30

4.4 Drug approval and reimbursement process in Morocco....................................................... 31

5 CONCLUSION ................................................................................................................................................... 33

6 APPENDIX.......................................................................................................................................................... 34

6.1 Glossary................................................................................................................................ 34

6.2 Coverage rates for long-term and costly conditions ............................................................. 36

6.3 Essential drug list of Morocco.............................................................................................. 40

6.4 Reimbursement of anti-cancer drugs (in MAD)................................................................... 68

6.5 Bibliography......................................................................................................................... 83

6.6 Methodology......................................................................................................................... 84

6.6.1 Secondary research ....................................................................................................... 84

6.6.2 Data validation.............................................................................................................. 84

6.7 Disclaimer............................................................................................................................. 84

6.8 Contact us ............................................................................................................................. 85

TABLE OF CONTENTS

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Table 1: GDP Real growth rate of Morocco.................................................................................................8 Table 2: GDP composition (2012 estimates) by sector of origin .................................................................8 Table 3: Demographic breakdown of Morocco based on 2014 estimates..................................................11 Table 4: Major urban cities and their population based on 2011 estimates................................................11 Table 5: Educational parameters ................................................................................................................12 Table 6: Access to safe drinking water and sanitation ...............................................................................14 Table 7: Healthcare indicators of Morocco ................................................................................................16 Table 8: Breakdown of healthcare delivery in public and private sectors..................................................17 Table 9: Breakdown of income and major expenditure of CNSS and CNOPS for 2012 ..........................24 Table 10: Breakdown of income and major expenditure of RAMED for 2012 .........................................25 Table 11: Coverage rates for long-term and costly conditions...................................................................36 Table 12: Coverage rate of lasting and costly disorders.............................................................................39 Table 13: Essential drug list of Morocco....................................................................................................40 Table 14: Reimbursements of anti-cancer drugs ........................................................................................68

LIST OF TABLES

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Figure 1: Changing trends of demographics of Morocco...........................................................................10 Figure 2: Breakdown share of hospital beds (A) in public and private hospitals......................................18 Figure 3: Health care professionals (B) in public and private hospitals....................................................18 Figure 4: Financing of total health expenditure in Morocco ......................................................................19 Figure 5: Intended coverage of population by insurance scheme...............................................................20 Figure 6: Share of AMO coverage by insurance provider..........................................................................21 Figure 7: CNSS pay-outs for short-term, long-term, and family care (A)..................................................23 Figure 8: CNSS beneficiaries receiving short-term, long-term, and family care (B) ................................23 Figure 9: Drug approval and reimbursement process in Morocco .............................................................32

LIST OF FIGURES

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1 Executive Summary

The Kingdom of Morocco is a country in the Maghreb region of North Africa. Morocco obtained independence from French rule on 2nd March, 1956. The country has a constitutional monarchy and an elected parliament. The majority of the country’s population belongs to the economically productive age group of 25–54 years, with the median age of the population being 28.1 years. Nearly 57% of population resides in urban locations. Morocco has capitalized on its proximity to Europe and on its relatively cheap labor force to forge an open market oriented economy. As per 2013 estimates, the national GDP (PPP) stands at USD 180 billion, with an estimated per capita income (PPP) of USD 5,500 and an estimated GDP real growth rate of 5.1%. The majority of GDP comes from services sector and mining. However, agriculture employs a huge work force (40%) while contributing 15% to national GDP. However, the income/wealth distribution has a huge gap with Gini coefficient of 0.41.

In terms of its healthcare infrastructure, however, circumstances are not ideal: As per the reports from US government, Morocco has insufficient trained physicians (0.62 per 1,000 people) and hospital beds (1.1 per 1,000 people) for its population. The prevalence of HIV/AIDS in Morocco is comparatively low 0.1% (2012 estimates), indicating the ability of Moroccan MoH in implementing healthcare programs. Over the recent years the data shows that Morocco has achieved significant success in improving maternal and child health. However, for poorer sections of the society access to care is still a problem.

The Ministry of Health (MoH), Government of Morocco and the National Health Insurance Agency (ANAM) are the prime regulatory bodies responsible for overall healthcare access and regulations in Morocco. The MoH is responsible for development and implementation of government policy on public health; the Department of Pharmacy of MoH licenses marketing of new drugs in the country based on safety and efficacy data; and ANAM is the main regulatory body governing health insurance schemes in Morocco. Currently, there are two major health insurance schemes in Morocco: AMO (Assurance Maladie Obligatoire) for the salaried public and private sector employees and for self-employed people, and RAMED (Régime d’Assistance Médicale) for the poorer sections of society. Both schemes together cover the healthcare needs of more than 50% of the Moroccan population. Being premium based, AMO insurance provides better health coverage than that of the government funded RAMED insurance scheme. The analysis of the spending under both AMO and RAMED indicates that chronic diseases, though accounting for fewer cases still command the majority of expenses.

Public healthcare systems account for the majority of healthcare services (nearly 75% of healthcare in Morocco based on HCPs employed) provided in the country; while the private and non-governmental organization (NGOs) based healthcare systems account for the remaining (~25%). Although public hospitals represent a higher share in terms of number of beds, they receive hardly 10% of insurance spending. This indicates that majority of the patients prefer to attend private

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medical hospitals. As per the World Health Organization (WHO), total healthcare expenditure in Morocco amounts to approximately MAD 19 billion (approximately 5% of GDP), of which 51.6% is financed by households independently and 44.4% by collective financing (taxes, insurance, and local authorities).

Approval from Dept. of pharmacy, MoH is necessary before marketing any drug in Morocco. If the drug is already approved by one of the Western regulatory agencies (US FDA or EU EMEA), then the approval process for Morocco would be greatly accelerated. For reimbursement decisions, ANAM assesses new drugs based on their safety and efficacy parameters and also based on their cost implications.

The physicians generally prescribe the drugs that are reimbursed. However, they do have the liberty to prescribe non-reimbursed drugs, in which case the patient will have to pay for themselves.

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2 Country landscape

2.1 Geography

Morocco, also known as the Kingdom of Morocco, is a country in the Maghreb region of North Africa. The country borders the North Atlantic to the northwest, Algeria to the east, and Mauritania to the south. The political capital of Morocco is Rabat; however, Casablanca is the largest city in the nation. Other major cities are Marrakesh, Tangier, Tetouan, Salé, Fes, Agadir, Meknes, Oujda, Kenitra, and Nador. Morocco is divided into 16 regions, which, in turn, are subdivided into 62 prefectures and provinces. [1].

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Source: book, C.T.W.F. Morocco. [cited 2014 24th July]


2.2 Economic environment

Morocco has a liberal economy. Its proximity to Europe and relatively low labor costs compared to that of Europe has helped the country to build a diverse, open-market-oriented regime. As per 2013 estimates, the national GDP (adjusted for purchasing power parity, PPP) stands at USD 180 billion, with an estimated per capita income (PPP) of USD 5,500 and an estimated GDP growth rate (real growth rate) of 5.1% (Table 1) [1].

Table 1: GDP Real growth rate of Morocco

Year Real growth rate

2013 5.1%

2012 2.7%

2011 5%

The majority of the Moroccan gross domestic product (GDP) comes from the services sector (Table 2), followed by industries such as mining and processing (especially phosphates), food processing, leather goods, textiles, construction, energy and tourism. However, Morocco still depends heavily on agriculture: it accounts for ~14% of GDP and employs 40%–45% of population. Due to over dependence on agriculture, economic growth has been erratic and relatively slow (Table 2), depending on the variations in rainfall [1].

Table 2: GDP composition (2012 estimates) by sector of origin

Sector Contribution Labor share Agriculture 15.1% 44.6%

Industry 31.7% 19.8%

Services 53.2% 35.5%

Inequality, poverty and vulnerability remain important challenges. Morocco’s Gini coefficient (measure of inequality of income distribution among citizens: coefficient of zero means maximum equality while coefficient of 1 or 100% means maximum inequality) of 0.41 reflects high level of inequality in incomes and access to services. With 13.3% of the population still living just above the poverty

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line, it also means that a fifth of Morocco’s population (6.3 million people) still lives either in poverty or just above the poverty line. This highlights disproportionate income distribution with low ability to spend for goods and services. Being a country which is largely dependent on the performance of the agricultural sector, the rural populations make up two-thirds of the poor, largely employed in agricultural and informal (including fisheries and forestry) activities. In addition, overall unemployment remains high at around 9%, with urban youth unemployment reaching 35.4%, and labor participation rates among the lowest among emerging economies, with less than half of the population economically active [2]. The United Nations Development Programme (UNDP)’s human development report (HDR) places the human development index (HDI) of Morocco at 0.591, positioning the country at 130 out of 187 countries and territories [3].

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Source: Sante, R.d.M.M.d.l., strategie sectorielle de sante maroc 2012-2016. 2012

2.3 Demographics

The 2014 estimated population of Morocco is about 32.98 million, with a growth rate of 1.02% [1, 2] A majority of this population belongs to the economically productive age group of 25–54 years (Table 3) [1]. The median age of the population is 28.1 years [1]. The birth rate of population is 18.47 births/1,000 population, while the death rate is 4.79 deaths/1,000 population [1]. As per 2011 estimates, 57% of the population lived in urban localities in the country’s major cities with annual rate of urbanization at 1.62%. The major urban cities with their population are mentioned in the Table 4 [1].

As for the age structure, the population under 14 years represented 44.4% in 1960 which changed to 31% in 2004 and will decline to 20.9% in 2030. The population of 15-59 years increased from 51.6% in 1960 to 60% in 2004 and will reach 63.8% in 2030. The population of 60 and over, which was only 4% in 1960 reached to 8% in 2004 and will be representing 15.3% in 2030 [4]. In 2030, there will be a reversal of the age pyramid with a decline in the proportion of young people (under 15 years, who would decrease from 44.4% to 29.8%) and an increase in the proportion of older people from 7% to 15% in 2030 [4].

Figure 1: Changing trends of demographics of Morocco

The changing trends of demographics in Morocco indicates that the proportion of population which would be economically productive would continue to increase for next 15 years, which in turn would probably translate into better economic prospects for society and increased business opportunities. Furthermore, the increasing percentage of population over the age of 60 years, heralds the diseases and conditions which mainly afflict late age. It also highlights the need for setting up infrastructure to cater for the healthcare needs of elderly.

Morocco's official languages are Arabic and Berber. The country's distinctive group of Moroccan Arabic dialects is referred to as Darija. Approximately 89.8%

010203040506070

1960 2004 2030

< 14 years 15-59 years >60 years

With the median age group of 28.1 years a majority (42%) of Moroccan population belong to the economically productive age group of 25-54 years. This exemplifies the economic potential of Morocco in terms of business opportunities in various sectors.

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of the whole population can communicate to some degree in Moroccan Arabic. While, Arabic is the official language of Morocco, French is generally used in Government, diplomacy, and in business [1].

Table 3: Demographic breakdown of Morocco based on 2014 estimates

Age group (years)

Percentage of population (%) Male Female

0–14 26.7% 4,479,676 4,342,605

15–24 17.7% 2,899,041 2,931,856

25–54 42.0% 6,693,877 7,146,696

55–64 7.3% 1,200,733 1,203,447

65 and above 6.3% 940,291 1,148,984

Table 4: Major urban cities and their population based on 2011 estimates

City name Estimated population

Casablanca 3.046 million

Rabat 1.843 million

Fes 1.088 million

Marrakech 939,000

Tangier 810,000

Agadir 805,000

Education in Morocco is free and compulsory through primary school. As per 2011 estimates the literacy rate among 15 years and above who can read and write was 67.1% (male: 76.1%; female: 57.6%). The average school attendance is 11 years (male: 12 years; female: 11 years). The unemployment rate among youth of ages 15 to 24 years is 18.6% (male: 18.4%; female: 19.2%) (Table 5) [1].

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Table 5: Educational parameters

Parameter Rate Male Female

Literacy rate (15 years and above) 67.1% 76.1% 57.6%

School attendance (years) 11 years 12 years 11 years

Unemployment rate (15 to 24 years) 18.6% 18.4% 19.2%

Morocco has several universities, institutes for higher learning, and polytechnics. The leading institutions in Morocco include Mohammed V University in Rabat (the country’s largest university, with branches in Casablanca and Fès), the Hassan II Agriculture and Veterinary Institute in Rabat (conducts social science research and agricultural research), and Al-Akhawayn University in Ifrane (the first English-language university in North Africa, inaugurated in 1995) [1]. The al-Qarawiyin University, founded in the city of Fez in 859 AD as a madrasa, is considered by some sources, including UNESCO, to be the oldest active university of the world. As per 2009 data Morocco spends 5.4% of its GDP on education which points towards the availability of relatively skilled resources which can fuel the country’s economy.

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2.4 Political structure and environment

Morocco obtained independence from French rule on 2nd March 1956. Morocco has a constitutional monarchy and an elected parliament. The King of Morocco holds executive and legislative powers, over the military, foreign affairs, and religious matters. However, executive power is mainly exercised by the elected government, while legislative power is vested in both the government and the two chambers of parliament, the Assembly of Representatives and the Assembly of Councilors [5]. Morocco has an independent judiciary: the Supreme Court or Court of Cassation which consists of 5-judge panels organized into civil, family matters, commercial, administrative, social, and criminal sections. The Supreme Court judges are appointed by the monarch based on the recommendations of the Supreme Council of the Judiciary. The subordinate courts include courts of appeal; regional and sadad courts (for religious, civil and administrative, and penal adjudication) (2).

Morocco has been given the status of non-NATO ally by the US government. Morocco is included in the European Union's European Neighborhood Policy which aims at bringing the European Union (EU) and its neighbors closer.

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3 Healthcare infrastructure

As per the reports from US government, Morocco has insufficient trained physicians (0.62 per 1,000 people) and hospital beds (1.1 per 1,000 people) for its population [1]. Access to safe drinking water and improved sanitation facilities are still poor especially in rural areas (Table 6).

Table 6: Access to safe drinking water and sanitation

Parameter Urban Rural Total

Drinking water (Improved) 98.5% 63.6% 83.6%

Drinking water (Unimproved) 1.5% 36.4% 16.4%

Sanitation (Improved) 84.5% 63.1% 75.4%

Sanitation (Unimproved) 15.5% 36.9% 24.6%

Improved drinking water: piped water into dwelling, yard, or plot; public tap or standpipe; tubewell or borehole; protected dug well; protected spring; or rainwater collection.

Improved sanitation: use of any of the following facilities: flush or pour-flush to a piped sewer system, septic tank or pit latrine; ventilated improved pit (VIP) latrine; pit latrine with slab; or a composting toilet.

Unimproved drinking water: unprotected dug well; unprotected spring; cart with small tank or drum; tanker truck; surface water, which includes rivers, dams, lakes, ponds, streams, canals or irrigation channels; or bottled water.

Unimproved sanitation: use of any of the following facilities: flush or pour-flush not piped to a sewer system, septic tank or pit latrine; pit latrine without a slab or open pit; bucket; hanging toilet or hanging latrine; shared facilities of any type; no facilities; or bush or field.

The prevalence of HIV/AIDS in Morocco is comparatively low 0.1% (2012 estimates) [1], indicating the successful of implementation of AIDS prevention programs. The contraceptive usage rate is nearly 67%. Over recent years the coverage of prenatal care has improved significantly; the proportion of women who had at least one pre-natal consultation has increased from 67.8% in 2004 (85% in urban areas and 48% in rural areas) to 80% in 2010 (94% urban and 68% rural), and the proportion of births attended by skilled personnel has increased from 63% in 2004 to 77.1% in 2011 [4]. These data points showcase the success

The healthcare situation in Morocco is poor; with over 0.62 physicians per 1,000 population, Morocco has far less number of physicians than the WHO prescribed standard of 2.3.

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achieved in improving maternal and child healthcare both in terms of improvement of infrastructure and health access.

However, for poorer sections of the society, access to care is still a problem. In Morocco, most of the urban population lives less than 5 km from a healthcare facility, whereas in rural areas, only 30% of the population are less than 5 km from a healthcare facility, 59% live between 5 and 10 km, and 11% live more than 8 km (MoH 2010) [6].

As per 1992 study on the morbidity burden, Morocco faces a triple health challenge: infectious diseases (including maternal and child health) 33.4%; non-communicable diseases 55.8% and trauma 10.8% [4]. The country also faces problems of malnutrition (3.1% children below 5 years as per 2011 estimates) and adult obesity (16.4% as per 2008 estimates) [1]. According to National Population and Family Health survey in 2011, the proportion of children who suffer from, underweight, acute malnutrition and chronic malnutrition are respectively is 3.1%, 2.3% and 14.9% [4]. Tuberculosis, leishmaniasis, community bacterial meningitis and zoonosis still remain major public health problems [4]. According to WHO, as per 2011 data, the burden of disease attributable to environmental degradation in Morocco is 18% of the total disease burden, which is equivalent to 30 DALYs (Adjusted Life Years by disability) lost to 1000 population per year, and 32,000 premature deaths per year [4]. All these above factors indicate the current health burden of Morocco, the possible focus of healthcare reforms and opportunities for private enterprises. Some of the healthcare indicators of Morocco are mentioned in Table 7.

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Table 7: Healthcare indicators of Morocco

Parameter Data

Mean age of mothers at 1st birth 25.4

Total fertility rate 2.15 children born/woman

Life expectancy at birth 76.51

Maternal mortality rate 100 deaths/100,000 live births

Infant mortality rate 24.52 deaths/1,000 live births

Contraceptive prevalence rate 67.4%

Healthcare expenditure (2011 est) 6% of GDP

Physician density (2009 est) 0.62 physicians per 1,000 population

Hospital bed density (2009 est) 1.1 beds per 1,000 population

Inhabitant per public sector doctor 2,900

Inhabitant per private sector doctor 3,693

Inhabitant per hospital bed (public sector) 1,150

The main causes of mortality reported in 2007

• Illnesses of the circulatory system: 22.14%

• Tumours: 11.04% • Certain illnesses linked to the

perinatal period: 8.84% • Endocrine, nutritional and

metabolic illnesses: 6.3%.

Vaccination coverage (in %) of children of 12 to 23 months

• BCG: 98.4% • MMR: 90.4% • Completely vaccinated children:

89.1%

3.1.1 Healthcare system

The Ministry of Health (MoH) is responsible for the development and implementation of government policy on population health. The MoH works in conjunction with relevant departments to promote health at a national level. This is very significant because the public healthcare system (health care resources of the Ministry of Health, the Royal Armed Forces, Local Communities and other Ministerial Departments) accounts for the majority healthcare services provided in the country (Table 8) [6, 7].

In order to improve the healthcare in Morocco the government has come up with a sector wise strategy for the period of 2012 to 2016 [4]. Under this program the

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Source: WHO. THE MOROCCO COUNTRY CASE STUDY: Positive Practice Environments. 18th April, 2014]

main areas of actions are restructuring of medical emergencies, improvement of communicable and non-communicable disease management including mental health and cancers, consolidation of rural health, fight against maternal and infant mortality, increasing access of RAMED insurance (medical assistance scheme for poor people), improving human resource management and upgrade of hospitals. The development of a national drug policy and review of drug prices are also among the priorities [4] of MoH.

Healthcare in Morocco is generally provided via three strategies: fixed, mobile, and roaming. In the fixed strategy, the patient approaches a basic healthcare provider. The mobile and roaming strategies are implemented to cover the rural regions. In the mobile healthcare strategy a medical team periodically visits areas located far from health centers. In the roaming strategy, a nurse or a health worker visits far flung areas to distribute certain medicines like oral rehydration sachets, contraceptive pills, eye cream, etc. and to promote healthcare procedures for pregnant women, diabetics, and other chronic diseases.

The public healthcare delivery system in Morocco can also be categorized into different levels depending on the level of expert services provided by the hospital [6]. There are 2,626 basic health centers, 138 hospitals, 97 general hospitals, 37 specialized hospitals, and 4 university medical colleges (at Rabat, Casablanca, Fez, and Marrakech). The public health service infrastructure comprises 27,350 beds and 38,000 healthcare professionals (HCPs) [6]. The private medical establishments approximately include 220 clinics, 30 dialysis centers, and about 100 radiologist’s offices, which together account for 6,156 beds and 10,800 HCPs [6]. The private non-profit healthcare delivery structure accounts for only a minor share of healthcare delivery in Morocco (1,874 beds) (Table 8) [6].

Table 8: Breakdown of healthcare delivery in public and private sectors

Sector Hospital beds, n (%)

Healthcare professionals

employed, n (%)

Public 27,350 (77%) 38,000 (78%)

Private 6,156 (18%) 10,800 (22%)

Public autonomous and NGOs 1,874 (5%) NA

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Figure 2: Breakdown share of hospital beds (A) in public and private

hospitals

Figure 3: Health care professionals (B) in public and private

hospitals

The Basic Healthcare Centers provide health and hygiene services to the population in both rural and urban areas. The different activities or services that are provided in these centers include: birth assistance, dental consultations and dental care, emergency care, general medical consultations, hospitalization, laboratory examinations, mental health, radiological examinations, school hygiene, specialized medical consultations, testing and water treatment [6].

As per the World Health Organization (WHO), based on data of year 2000, the total healthcare expenditure in Morocco amounts to approximately MAD 19 billion (i.e., ~5% of GDP), of which 51.6% is financed by households (out of pocket) independently and 44.4% by collective financing (taxes, insurance, and local authorities) (Figure 4) [7]. At the end of 2008, the total healthcare expenditure in

Public sector, 27,350 (77%)

Private sector, 6,156 (18%)

Public autonomous and NGOs, 1,874 (5%)

Public sector, 38,000 (78%)

Private sector, 10,800 (22%)

Morocco has an elaborate network of primary healthcare centers to tertiary hospitals. Public hospitals account for majority of healthcare in Morocco.

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Source: WHO. Country Cooperation Strategy for WHO and Morocco 2008–2013. 16th April, 2014]

Morocco was USD 4.3 billion for the year, which was 5.6% of the GDP [6]. The analysis of spending shows that the national healthcare system spends more than 33.6% of its monetary resources on buying medicine and medical goods indicating the enormous potential for the pharmaceutical industry. Ambulatory care, including health promotion check-ups and external consultations, represents 35.2% of spending [6].

Figure 4: Financing of total health expenditure in Morocco

MoH has a national sanitary information system (SNIS) for gathering information and managing maternal and childhood health programs [8]. It is a computer program-based, system which allows data entry and validity, synthesizing graphs for different activities as well as a control panel for decision making. The data transmission from basic health structure to central level is made electronically, which are accessible for consultation to all structures of the Health Ministry. However, there seems to be a lack of integration of different health information and management systems [8].

52% 44%

4% Total health expenditure USD 2.31 billion

Households Taxes, insurance, local government Other

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4 Market access 4.1 Health insurance system

The MoH offers the entire population access to clinics, health centers, dispensaries, diagnostic centers, and public hospitals [9]. All Moroccans are eligible to receive care at MoH facilities. Through their local government, the poor can obtain a certificat d’indigence, which permits them to receive free care at public health facilities [9]. Those who are not eligible to receive certificat d’indigence can also receive subsidized healthcare at MoH facilities. However, concerns exist over the quality of care at these facilities, and hence people tend to prefer private healthcare providers.

The government of Morocco has initiated two major healthcare insurance packages: AMO and RAMED. The Assurance Maladie Obligatoire (AMO) is a payroll-based mandatory health insurance plan for public and formal private-sector employees. The Régime d’Assistance Médicale (RAMED) is a publicly financed fund to cover healthcare services for the poor. Both reforms are aimed at improving the access to healthcare [9]. In 2007, INAYA was introduced as a scheme that would fill the gaps left by AMO and RAMED; it provided coverage to the self-employed population. Each of these schemes are intended to cover nearly one-third of the Moroccan population (Figure 5) [7]. However, of recently INAYA is being merged with AMO. The regulatory body overseeing the operations of health insurance schemes in Morocco is Agence Nationale de l’Assurance Maladie (ANAM; English: National Health Insurance Agency) [7].

Figure 5: Intended coverage of population by insurance scheme

AMO 34%

RAMED 30%

INAYA 31%

Others 5%

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4.1.1 AMO: Mandatory health insurance (Assurance Maladie Obligatoire)

AMO is a basic medical coverage (insurance) scheme under law No 65-00; it is the basis of social health protection in Morocco. The scheme came into effect on January 4, 2005 [7]. The beneficiaries under AMO include:

• Officials and civil servants of the state, local authorities, public health

facilities, and corporations registered under public law

• Persons subject to the social security scheme in the private sector

• Pensioners in both the private and public sectors

Currently, there are more than 6,000,000 members and over 8,600,000 beneficiaries (4,600,000 in the private sector and 4,000,000 in the public sector), excluding former resistance fighters, students, etc. AMO is managed by the Caisse nationale de Sécurité Sociale (CNSS; English: National Social Security Fund) for nearly 2,800,000 private sector employees, and, by private insurance companies for the remainder 1,800,000 private sector employees. Caisse nationale des Organismes de Protection Sociale (CNOPS; English: National Fund for Social Welfare Bodies) provides AMO health insurance to nearly 3,200,000 public sector employees, while the Royal Armed Forces cover the 800,000 military personnel (Figure 6) [7].

Figure 6: Share of AMO coverage by insurance provider

2,800,000 , 33%

1,800,000 , 21%

3,200,000 , 37%

800,000 , 9%

CNSS Private sector insurers CNOPS Royal Armed Forces

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For insured persons and their dependents, AMO guarantees coverage for the risks and costs of healthcare associated with disease or accidents, maternity, and physical or functional rehabilitation. More specifically, AMO covers all the following for both the public and private sectors [7]:

• Childbirth

• Medical/surgical hospitalization, including day care services

• Management and follow-up care of long-term conditions and long and

expensive conditions

• Monitoring of pregnancy, delivery, and postpartum care

• Well-child care up to the age of 12

• Medical devices and implants required for different medical and surgical

procedures

• Refundable prosthetic devices and braces

• Refundable medicines required for the above care

For the public sector employees, the package also includes outpatient care and examination (medical consultations, laboratory tests, medical imaging/functional explorations, medicines, etc.). The funding for the insurance premiums is equally shared between employer and employee up to a fixed ceiling. Care is billed on the basis of national reference fees and tariffs set by ANAM.

Furthermore, CNSS owns a chain of polyclinics: with 1000 hospital beds, 42 operating rooms, 11 maternity centers, 13 ICUs, 9 dialysis centers, 13 medical laboratories, 137 medical imaging scanners, 1 neonatal resuscitation department, 2 cardiology intensive care units, and 10 rehabilitation units. CNSS hospitals are open to all patients and those insured by the various private companies. As per 2012 data, almost 29% of CNSS beneficiaries were under long-term care (Figure 7 & 8), and this long-term care accounted for 61% of the total benefits paid out by CNSS (Figure 7 & 8) [10].

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Source: CNSS, M. Key figures. 30th April, 2014]


Figure 7: CNSS pay-outs for short-term, long-term, and family care (A)

Figure 8: CNSS beneficiaries receiving short-term, long-term, and family

care (B)

Financially, the income of the two insurance organizations (CNSS, CNOPS) for employees stands at (for the year 2012) 8.11 billion MAD, but they spend about 5.30 billion MAD on benefits. Majority of the expenditure happens for the long-term conditions (ALD) and lengthy and costly diseases (ALC), which alone constitute more than 50% of overall spending. The breakdown of revenue and expenditure per organization is given in Table 9 [11]. The major expenses under AMO are accounted by medications (33%), hospitalizations (16%) and dialysis (12%) [11].

These cost factors indicate that chronic diseases while accounting for fewer cases still command higher expenses. With the majority of the population shifting to middle and old age in coming decades, the burden of chronic diseases is expected

61%

4%

35% Long term care

Short term care

Family care

29%

7% 64%

Long term care

Short term care

Family care

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Source: ANAM, Roadmap 2014-18. 2014

to increase in Morocco: healthcare funding should follow. Providing appropriate healthcare solutions to long term conditions of cardiovascular, diabetes, cancers and autoimmune conditions would become a focus for MoH in coming near future and also would provide opportunities for private enterprises.

Table 9: Breakdown of income and major expenditure of CNSS and

CNOPS for 2012

Parameter CNSS CNOPS Total

Income (billion MAD) 3.767 4.340 8.107

Planned expenditure (billion MAD) 1.795 3.506 5.301

Spending for ALD/ALC 58.7% 45.9% 49.9%

Drug expenditure 33.3% 33.4% 33.3%

4.1.2 RAMED: Medical assistance scheme (Régime d’Assistance Médicale)

RAMED is a basic medical coverage scheme intended for deprived sections of the society; it was introduced in 2002 under law No 65-00. Under this scheme, individuals with a certificat d’indigence (English: certificate of indigence) can access free care at public healthcare and hospital facilities.

Under RAMED, households with an income of less than MAD 300 (US$34) per capita per month will be eligible for free health insurance. Households with monthly per capita income of MAD 300–600 (US$34–$68) will purchase insurance based on a slab scale. To protect the poor from financial burden, there are no caps on coverage [9]; however, they can only access care at public healthcare hospitals. The following categories of people are eligible for RAMED [7]:

• Persons not covered by a basic AMO scheme and without sufficient resources

to meet the costs of medical care for themselves and/or their spouse(s)

• Dependents, that is, non-wage earning children aged up to 21, who are not

otherwise covered by the basic AMO scheme (age limit may be extended up to

26 in the event of prolonged illness with adequate justification)

25



Source: ANAM, Roadmap 2014-18. 2014

• Children with physical disabilities, irrespective of age, who are totally and

permanently unable to fulfil a remunerated activity as a result of a physical or

mental incapacity

• Residents of charitable institutions, orphanages, hospices, rehabilitation

facilities, and any non-profit public or private care facility accommodating

abandoned children or adults with no family

• Prisoners

• Persons who have no permanent place to reside

The estimated population eligible under RAMED is at 8.5 million, including 4 million in absolute poverty. The scheme is managed and regulated by ANAM. Financially, the income of the RAMED insurance scheme stands at (for the year 2012) 1.9 billion MAD, while spending about 1.06 billion MAD on benefits. The major contributors for RAMED funding are local authorities (177 million MAD), vulnerable population/beneficiaries (136 million MAD) and government (1,611 million MAD). Just like under AMO the majority of the expenditure under RAMED happens for the long-term conditions (ALD) and lengthy and costly diseases (ALC), which alone constitute more than 50% of overall spending. This again highlights the economic burden imposed by chronic medical conditions which need early diagnosis and management in order to prevent cost overruns in late stages: an opportunity for relevant players in the healthcare industry. The breakdown of revenue and expenditure per organization is given in Table 10 [11].

Table 10: Breakdown of income and major expenditure of RAMED

for 2012

Parameter RAMED

Income (billion MAD) 1.924

Planned expenditure (billion MAD) 1.065

Spending for ALD/ALC 31%

4.1.3 INAYA: Health insurance for the self-employed

INAYA was introduced in 2007 to fill in the gaps left by the existing AMO and RAMED schemes. Now this scheme is being merged with AMO. INAYA scheme was aimed at providing health coverage to the self-employed (craftsmen and retailers with or without business premises and their assistants) and freelance professionals. The estimated population eligible under the scheme is around 10

26



million [7]. Considering the fact that self-employed people constitute nearly one-third of the Moroccan population, this process constitutes a major expansion of the healthcare insurance system in Morocco [12]. Funding for this scheme is expected to come from the premiums to be paid by the beneficiaries.

The population covered by health insurance reached 10.8 million beneficiaries by 2012, or 33.7% of Morocco's population, as against 25% in 2006. The insurance management bodies spent 8.2 Billion MAD (excluding administrative costs), or 762 MAD/ year per beneficiary, as against 602 MAD/ year per beneficiary in 2006 [4]. However, the public hospitals, despite representing more than 80% of national bed capacity, only receive 9.8% of insurance spending in the context of direct payments and 6.6% of the total health insurance spending [4]. Furthermore, the rural areas are facing a human resource crunch as the majority of healthcare professionals (22% of public physicians and 50% of private physicians) are concentrated in Greater Casablanca and Rabat areas [4].

Morocco has an elaborate system of health insurance schemes. These schemes though successful yet need to cover nearly 50% of population. Majority of insurance expenditure is incurred on long term care.

27



4.2 Drug prescribing and dispensing practices

The physicians generally prescribe the drugs that are reimbursed. However, they do have the liberty to prescribe non-reimbursed drugs, in which case the patient will have to pay for themselves. There are also situations wherein the physician has to prescribe drugs that are not yet licensed in Morocco and that will have to be imported, however, with special approval from the MoH. In such cases, the physician must be able to justify his decision with evidence of efficacy and benefit for the patient. At public hospitals, an in-house pharmaco-vigilance committee assesses the need for new drugs and recommends them to the MoH for purchase. The drug, if approved, would then be purchased by the MoH for the hospital [12]. However, in the private sector, the patients are left to find and purchase the drug themselves from a private pharmacy. As per law, the health insurance providers and NGOs are not supposed to provide drugs themselves [12].

28



4.3 Comparison of regional regulatory agencies and environment

Medicine Regulatory Agencies (MRA) in Africa face significant challenges in meeting their mandate. Their pharmaceutical regulatory capacity is below that of Europe, Latin America, and Asia. A 2004 WHO study reported that 90% of African MRAs lacked sufficient capacity to guarantee the quality, efficacy, and safety of medicines in their country [13]. A study conducted by WHO in 2006 concluded that among African countries, only South Africa had a fully functional MRA. The MRAs of Nigeria, Zimbabwe, Senegal, Tunisia, Morocco, and Algeria were functional but needed strengthening in regulation of clinical trials. The MRAs of Ghana, Egypt, Uganda, and Ethiopia had “potential“ although they were not yet fully functional [13].

African MRAs traditionally have focused on assessment of generic products. For the review of innovative products they have relied mainly on Western MRAs [14]. However, off recently more and more products are being developed specifically for the African market. This has put African MRAs under pressure to develop their skills and capabilities in regulatory services. In general, a drug that is already approved by one of the western MRAs (such as the European Union (EU)’s EMEA or the US FDA) will find it comparatively easier to receive approval in Morocco as well. Given the absence of well-established MRAs in the African countries, pharmaceutical product development companies/organizations use various alternative routes for registration of generic/innovative drugs [14].

i. Western regulatory approval

• Routine regulatory approval

The majority of new products are first registered with well-established

Western regulatory authorities (US FDA, EU EMEA, UK Medicines etc)

even for the products that are likely to have little or no use in the West

but are crucial for developing countries. Under this approach, companies

wait for FDA or EMEA approval following which they submit the

dossier to African MRAs for approval.

• Orphan drug legislation

Orphan drug legislation in the US, EU, Japan, and Australia provides

incentives for manufacturers to develop drugs for diseases that have too

few patients to constitute a profitable market. Under this channel

approvals may be given even without large-scale clinical trials.

• Expedited approvals

o Accelerated approval (US FDA)/ Conditional approval (EU EMEA)

o Priority review (US FDA)/ Fast Track (EU EMEA)

29



o Fast Track (US FDA)

ii. Neglected disease specific pathways

• EMEA Article 58

This mechanism was established by the European Commission in 2004 to

facilitate developing-country registration of medicines of major public

health interest, and not for a formal registration.

• WHO prequalification

This initiative was started in 2001 as a means to assure the quality of drugs

procured through the UN system. Many African MRAs rely heavily on the

WHO drug pre-qualification system as a proxy dossier assessment and, in

some cases, the MRA quickly approve products that have received WHO

prequalification. The program was earlier stipulated for drugs for

HIV/AIDS, malaria, and tuberculosis; however, it has now invited

companies to submit products for reproductive health, influenza, and zinc

supplements.

• US FDA “tentative approval” and PEPFAR

As part of the US President’s Emergency Plan for AIDS Relief program

(PEPFAR), the US FDA would evaluate the safety, efficacy and quality

of HIV drugs purchased with PEPFAR funds for use outside the US.

iii. Alternative regulatory pathways

• Parallel Western and developing country approval

Under this the companies submit full dossiers to the Western regulator and

developing country MRAs, both of who conduct their regulatory reviews

simultaneously but independently.

• Twinned Western and developing country approval

Twinned review refers to a process whereby a developing country regulator

would assess a pharmaceutical dossier in consultation with, a well-

resourced western regulatory agency.

• First approval by a developing country regulator

Under this approach, the company submits the dossier first to a developing

country regulator, usually their home regulator.

• WHO vaccine prequalification

The WHO Vaccine Prequalification program was set up in 1987 as a service

to UNICEF and other UN vaccine procurement agencies. It aims to

30



determine that products bought by these agencies and used in national

immunization services are safe, effective, and meet operational and

quality standards. The African governments rely heavily on WHO

vaccine pre-qualification.

The complex African regulatory environment had led to difficulties in optimal use of resources by the MRAs. Therefore, a great deal of effort is being committed to African regulatory harmonization. To this end, various communities are being formed, including the following [13]:

4.3.1 Southern African Development Community (SADC):

SADC was formally established by treaty in Namibia on August 17th, 1992. It consists of 15 member states (Angola, Botswana, Democratic Republic of the Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia, and Zimbabwe), and aims to share resources and expertise among various MRAs, provide training, develop guidelines, harmonize clinical trials etc. [13].

4.3.2 Economic Community of West African States (ECOWAS):

ECOWAS is a West African Drugs Regulatory Authority Network (WADRAN) of Anglophone and francophone West African states for fighting counterfeit medications, evaluating dossiers, and conducting Good Manufacturing Practices investigations and surveillance after registration of drugs [13].

4.3.3 East African Community (EAC):

EAC is working toward harmonization of drug registration procedures as an objective to achieve good pharmaceutical standards without posing an obstacle to the free movement of pharmaceutical products [13].

31



4.4 Drug approval and reimbursement process in Morocco

Any drug, either produced locally or imported, even at the sample level, must obtain authorization from the Department of Pharmacy, MoH, prior to sale or distribution (even for free) [15]. Moreover, this authorization is necessary before any drug can be considered for reimbursement. The MoH states that authorization can only be issued if the drug meets certain prerequisites for appropriate testing to highlight efficacy, ensure its safety under normal conditions of use, demonstrate its therapeutic value, and establish bioequivalence when it comes to a generic drug. Thus, the manufacturer can show the clinical trial data of the drug to showcase its safety and efficacy parameters [15]. However, if the drug has already been proven to be efficacious and has been approved by one of the Western regulatory agencies (US FDA or EU EMEA), then the approval process for Morocco will be greatly accelerated. The intellectual property protection laws in Morocco are comparatively better; a generic drug can only be sold when the patent of the reference drug expires [15].

ANAM is the regulatory agency responsible for insurance reimbursement in Morocco. For a new drug to be approved for reimbursement, it must pass through two stages of evaluation. First, ANAM’s Transparency Committee assesses new drugs based on their efficacy and superiority to existing strategies of treatment. The Transparency committee assesses new drugs based solely on efficacy and safety parameters and not based on cost parameters. The committee accepts the clinical trial data from other countries and it is not necessary in every case to conduct a study in the host country for drug reimbursement. If the application passes this stage, it is sent to the Economic Committee to assess the cost implications. The recommendations of both committees are taken into account before ANAM submits reimbursement recommendations to the MoH for approval. Currently, of the approximately 5,000 drug formulations approved for distribution in Morocco, reimbursement is available for 3,000 drug formulations [12].

While the Economic Committee falls directly under the purview of ANAM, the Transparency Committee is an independent body associated with ANAM. The members of the Transparency Committee include a president and vice-president, who are appointed by the MoH; representatives from the National Organization of Humanity and Ethics and from the Ethics Organization of Physicians and Pharmacists; the Department of Pharmacy and Drugs; and four independent expert physicians nominated by ANAM [12]. The expert physicians are permanent members, but can recommend other external experts, if a certain drug is outside their scope of expertise.

Drug prices in Morocco are controlled and the policy guidelines tend towards lower prices for certain important therapeutic classes. Generally, drugs that could have a major impact on key public health issues can be expected to suffer significant cost pressures. If the price of the drug is beyond the scope of the planned budget, then the committee might ask the manufacturer to reduce the price [12]. However, the MoH is currently proposing a new system to [15]:

ANAM is the key regulatory body tasked with approval of new drugs and with approval of reimbursement for drugs.

32




• Establish an updated regulatory framework for products with local manufacturing and imported products

• Improve access to medicines while containing costs • Provide solutions to national pharmaceutical environment

Figure 9: Drug approval and reimbursement process in Morocco

Apply for approval from Dept. of pharmacy, MoH

Any drugs, either produced locally or imported must obtain authorization before marketing. Post-approval drug can be marketed in the country.

• Authorization is necessary before any drug can be considered for reimbursement

• Clinical trial data from other countries will be considered for approval

Reimbursement application to ANAM

ANAM is the regulatory agency responsible for insurance reimbursement in Morocco. Assessment of new drugs for reimbursement is made by two committees: the Transparency committee and the Economic committee.

Transparency committee of ANAM

• Assesses new drugs on their safety, efficacy and superiority to existing strategies of treatment

• Prior clinical trial data would be helpful at this stage

Economic committee of ANAM

Based on recommendations from Transparency committee of ANAM the application is forwarded to Economic committee.

MoH approval

The recommendations of both Transparency and Economic committees sent to MoH for approval.

The approval of new drug for reimbursement is based on safety, efficacy, superiority and cost. Even costly drugs are reimbursed.

• Assessment of cost implications of reimbursements

• If the price of the drug is beyond the scope of the planned budget, then the committee might ask the manufacturer to reduce the price

• Price negotiations

33



5 Conclusion

Morocco, officially known as the Kingdom of Morocco, is a constitutional monarchy with an elected parliament in the Maghreb region of North Africa. The majority of its population belongs to the economically productive age group of 25–54, which also makes the country economically robust. In Morocco, public healthcare systems account for the majority of healthcare services provided. However, organized-sector workers such as private and public sector employees prefer private clinics over public hospitals, as they are reimbursed under the AMO scheme. It is in private hospitals that the majority of insurance reimbursement happens. The poor (those holding a certificate of indigence) are provided free medical care at public hospitals under RAMED, which is financed directly by the government. However, the healthcare services under RAMED are limited as compared with those under AMO, and, moreover, RAMED does not provide reimbursement, only free treatment. Nearly 50% of Moroccans are covered by some form of medical insurance (~30% by AMO and ~20% by RAMED). Despite that, nearly half of the healthcare expenditure in Morocco is still out-of-pocket, as the health insurance framework is not yet completely established. With the majority of the population shifting to middle and old age in coming decades, the burden of chronic diseases is expected to increase in Morocco, so healthcare funding should do the same. Providing appropriate healthcare solutions to long term conditions of cardiovascular, diabetes, cancers and autoimmune conditions would become a focus for MoH in coming near future and also would provide opportunities for private enterprises.

Regardless of the inaccuracies in health insurance, approval for reimbursement (especially for costly and specialized therapeutics) still represents a major advantage toward achieving patient access. Furthermore, as Morocco does not have a well-established MRA, approval by a Western agency (e.g., US FDA or EU EMEA) is a very good first step toward securing approval for marketing in Morocco. An added advantage is that the Moroccan MRA, that is the Department of Pharmacy of the MoH, will approve drugs on the basis of clinical trials conducted outside the country. Physicians generally prescribe the drugs that are reimbursed. However, they do have the liberty to prescribe non-reimbursed drugs and in such cases the patient will have to pay out of their pocket for the medications.

Our analyses of the current healthcare activities in Morocco and the general trends in emerging markets shows policy makers and patient bodies are demanding greater influence in the drug selection process. As a result, a collaborative approach needs to be promoted to outline and manage public policies. It is important for each stakeholder to include scientific and rational data to support their issues and concerns. This is of particular importance in countries like Morocco, where the MoH and ANAM evaluate drugs on both efficacy and economic impact.

34



6 Appendix

6.1 Glossary

ALD (French) : long-term conditions

ALC (French) : lengthy and costly diseases

AMO : Moroccan mandatory health insurance scheme(Assurance Maladie Obligatoire)

ANAM : Moroccan National Health Insurance Agency(Agence Nationale de l’Assurance Maladie)

ASR : age-standardized rate

BCG : Bacillus Calmette-Guerin vaccine for tuberculosis

CNOPS : Moroccan National Fund for Social Welfare Bodies(Caisse nationale des Organismes de Protection Sociale)

CNSS : Moroccan National Social Security Fund (Caisse nationale de Sécurité Sociale)

EAC : East African Community

ECOWAS : Economic Community of West African States

ESMO : European Society for Medical Oncology

EMA : European Medicines Agency

EU : European Union

FSRC : focus scientific research center

GDP : gross domestic product

HCP : healthcare professional

HDI : human development index

HDR : human development reports

INAYA : Moroccan health insurance scheme for self-employed

MAD : Moroccan dirham

MMR : Measles Mumps and Rubella vaccine

MoH : Moroccan Ministry of Health

MRA : Medicine Regulatory Agencies

NATO : North Atlantic Treaty Organization

NGO : non-governmental organization

PEPFAR : US President’s Emergency Plan for AIDS Relief

35



PET : positron emission tomography

PPP : purchasing power parity

RAMED : Moroccan publicly financed fund for healthcare services to the poor (Régime d’Assistance Médicale)

SADC : Southern African Development Community

UNDP : United Nations Development Programme

UNESCO : United Nations Educational, Scientific and Cultural Organization

US : the United States of America

USD : United States dollar

FDA : Food and Drug Administration (US)

WHO : World Health Organization

36



6.2 Coverage rates for long-term and costly conditions

Table 11: Coverage rates for long-term and costly conditions

Long lasting diseases DiseasesNew reimbursement

rate

Malignancies Malignancies 95%

Malignancy of the lymph tissue or

haematopoietic tissue

Malignancy of the lymph tissue or

haematopoietic tissue95%

Liver cirrhosis Liver cirrhosis 97%

Active chronic liver disease

(Hepatitis B and C)

Active chronic liver disease

(Hepatitis B and C)97%

Terminal stage of renal disease Terminal stage of renal disease 98%

Severe Aplastic Severe Aplastic 99%

Hereditary bleeding disorders Hereditary bleeding disorders 97%

Severe myelodysplasia Severe myelodysplasia 94%

Multiple Sclerosis Multiple Sclerosis 96%

Stroke or ischemic or haemorrhagic

medullary

Stroke or ischemic or haemorrhagic

medullary90%

Chronic respiratory insufficiencySevere chronic respiratory

insufficiency90%

Coronary disease

Stable angina 85%

Revascularized coronary

(Angioplasty or bypass)85%

Unstable angina or syndrome 85%

Acute Myocardial Infraction (MI) 85%

Chronic hemolytic anemia severe

Thalassemia major 96%

Homozygous sickle cell 96%

Chronic autoimmune hemolytic

anemia 96%

Severe asthma

Moderate to severe chronic asthma 90%

Severe asthma episodes 90%

Acute Severe Asthma 90%

37




rate

Rheumatoid polyarthritis Rheumatoid arthritis severe

progressive93%

Severe kidney disease

Glomerulonephritis 96%

Pyelonephritis 96%

Renal interstitial 96%

Renal vascular 96%

Hereditary kidney disease or

congenital96%

Nephrotic syndrome Nephrotic syndrome 96%

Acute renal failure Acute renal failure 95%

Heart failureLeft ventricular failure 83%

Right ventricular failure 83%

Ulcerative colitis Ulcerative colitis 81%

Crohn`s disease Crohn`s disease 81%

Systemic lupus erythematosus Systemic lupus erythematosus 97%

Severe epilepsySevere epilepsy 97%

Status epilepticus 97%

Progressive systemic sclerosis Progressive systemic sclerosis 91%

Vasculitis Vasculitis 93%

Mental disorders and /or personality

due to an injury, a brain dysfunction

or physical injury

Mental disorders and /or personality

due to an injury, a brain dysfunction

or physical injury

83%

High blood pressure (hypertension)

severe

HTA with high CV risk 77%

Hypertension with LVH 77%

HTA with IC 77%

HTA with myocardial ischemia 77%

HTA with IR 77%

Hypertension with hypertensive

retinopathy77%

HTA with ATCD stroke 77%

38




rate

HTA with ATCD transient ischemia 77%

With arterial hypertension Member

lower77%

Severe forms of the neurological

and neuromuscular disease

MM hereditary myopathy 85%

MM Inflammatory Myopathy 85%

MM Myasthenia 85%

MM SD Lambert-Eaton 85%

The MNP-polyneuritis 85%

MNP-Multiple mononeuropathy 85%

MNP-polyradiculoneuritis 85%

MNP-Hereditary neuropathy 85%

The spastic paraparesis MMCA-

family85%

MMCA-Charcot’s disease (ALS) 85%

The hereditary ataxias MMCA 85%

State mental deficit

Mental retardation 83%

Acquired dementia :Alzheimer’s

disease83%

Secondary dementias 83%

Glaucoma Glaucoma 83%

Acquired Immunodeficiency

Syndrome (AIDS)

Acquired Immunodeficiency

Syndrome (AIDS)85%

Source: ANAM website; http://www.assurancemaladie.ma/anam.php?id_espace=6&id_srub=18#38

http://www.assurancemaladie.ma/anam.php?id_espace=6&id_srub=18#38

39



Table 12: Coverage rate of lasting and costly disorders

Procedure Break down Coverage rate

Organ transplantation

Kidney 100%

Liver 100%

Heart 100%

Cornea 100%

Bone Marrow 100%

Cardiac surgery

Rheumatic valvular 100%

Congenital heart 100%

Coronary disease 100%

Laying Pace Maker 100%

Chronic arterial disease 100%

Source: ANAM website; http://www.assurancemaladie.ma/anam.php?id_espace=6&id_srub=18#38

http://www.assurancemaladie.ma/anam.php?id_espace=6&id_srub=18#38

40



6.3 Essential drug list of Morocco

Table 13: Essential drug list of Morocco

Class Therapeutic CODEName Common

InternationalPackaging

Metabolism --Hematology --

Diabetes --Nutrition200100103 Acarbose 100Mg Tablet

Box Of 90

Tablets

Cardiology - Medicines 1120010103 Acenocoumarol 4Mg TabletsBox Of 100

Tablets

Analgesics --Antipyretics --

Anti- InflammatoryDMP93

Acetyl Salicylate Lysine

100Mg BagBox Of 20 Packs

Cardiology - Medicines DMP18Acetyl Salicylate Lysine

160Mg BagBox 30 Packs



Acetyl Salicylate Lysine 1G

Injection

Box Of 6 Bottles

+ Solvent



Acetyl Salicylate Lysine

250Mg BagBox Of 20 Packs

Cardiology - Medicines DMP188Acetyl Salicylate Lysine

300Mg BagBox 30 Packs

Infectious disease DMP19 Aciclovir 200Mg TabletBox Of 25

Tablets

Infectious disease DMP20 Aciclovir 250Mg Injection Box 1 Bottle

Ophthalmology DMP190Aciclovir 3% Ophthalmic

OintmentTube 4.5 Billion

Dermatology DMP195 Aciclovir 5% Cream Tube 10 G

Analgesics -- Antipyretics --

Anti- Inflammatory1000010103

Acid 500Mg Tablets

Acetylsalicylic

Box Of 1000

Tablets

Rheumatology 1010070103Alendronique Acid 70Mg

TabletsBox Of 4 Tablets

Dermatology 2010000201 Fusidic Acid 2% Ointment Or Tube 15 G

41





Cream

Infectious disease 4000250103 Fusidic Acid 250Mg TabletBox Of 10

Tablets

Anesthesia - Resuscitation 100010201 Adrenaline Injection 0.25Mg Box 100 Bulbs

Anesthesia - Resuscitation DMP1 Adrenaline Injection 0,50Mg Box 100 Bulbs

Anesthesia - Resuscitation 100020201 Adrenaline Injection 1Mg Box 100 Bulbs

Infectious disease 440210106Albendazole 4% Oral

SuspensionBottle 10Ml

Infectious disease 440200103 Albendazole 400Mg Tablet Box 1 Tablet

Rheumatology 1020010103 Allopurinol 100Mg TabletBox Of 100

Tablets

Rheumatology 1020030103 Allopurinol 300Mg TabletBox Of 28

Tablets

Pneumology 120300506 Ambroxol 0.3% Syrup Bottle 150Ml

Products Contrast DMP21

Amidotrizoate De Sodium And

De Meglumine

30% Injection

Bottle 250Ml +

Infusion

Products Contrast DMP106

Amidotrizoate De Sodium And

De Meglumine

76% Injection

Bottle 50Ml +

Infusion

Infectious disease DMP23 Amikacin 250Mg InjectionBox + 1 Vial

Solvent

Infectious disease DMP3 Amikacin 500Mg InjectionBox + 1 Vial

Solvent

Cardiology - Medicines 720040501 Amiodarone 150Mg Injection Box Of 6 Bulbs

Cardiology - Medicines DMP24 Amiodarone 200Mg TabletBox Of 40

Tablets

Psychiatry - Neurology 1220020103 25Mg Tablets Amitriptyline Box Of 60

42





Tablets

Psychiatry - Neurology DMP84 Amitriptyline 4% Sol Oral Bottle 20Ml

Cardiology - Medicines 780051003 10Mg Tablets AmlodipineBox Of 28

Tablets

Cardiology - Medicines 780050103 Amlodipine 5Mg TabletBox Of 28

Tablets

Infectious disease 4100125105

Amoxicillin 125Mg + Acid

Clavulanic Powder To

Suspension Oral

Bottle 60Ml

Infectious disease 410010105Amoxicillin 125Mg Powder

To Suspension Oral

Box Of 10

Bottles 60Ml

Infectious disease DMP140Amoxicillin 1G + Acid

Clavulanic Injection

Box Of 10

Bottles

Infectious disease 410010001Amoxicillin + 1G Clavulanic

Acid BagBox 14 Packs

Infectious disease 410010003 Amoxicillin 1G TabletsBox Of 24

Tablets

Infectious disease Amoxicillin 1G Injection Box 1 Bulb


Amoxicillin 250Mg + Acid

Clavulanic Powder To

Suspension Oral

Box 1 Bottle

60Ml

Infectious disease 410030105Amoxicillin 250Mg Powder

To Suspension Oral

Box Of 10

Bottles 60Ml

Infectious disease DMP25Amoxicillin 500Mg + Acid

Clavulanic Tablets

Box Of 24

Tablets

Infectious disease 4100500501Amoxicillin 500Mg + Acid

Clavulanic InjectionBox 1 Bottle

Infectious disease 410040103 Amoxicillin 500Mg Tablet Or Box De 24

43





Capsule Tablets Or

Capsules

Infectious disease DMP107Amphotericin B 10% Oral


Infectious disease 450050501Amphotericin B Injection

50MgBottle 15Ml

Infectious disease 410050505 Ampicillin 1G InjectionBox Of 50

Bottles + Solvent

Infectious disease 410060505 Ampicillin 250Mg InjectionBox Of 50

Bottles + Solvent

Infectious disease 410070505 Ampicillin 500Mg InjectionBox Of 50

Bottles + Solvent

Pneumology 820010106

Antitussive Central Syrup

Adult To Base De

Codeine, Codethylene,

Pholcodine Or

Box Of 25

Bottles 125Ml

Cardiology - Medicines DMP101 Atenolol 100Mg TabletBox Of 28

Tablets

Anesthesia - Resuscitation 100060201 Atracurium Injection 50Mg Box Of 10 Bulbs

Anesthesia - Resuscitation 100060501 Atracurium Injection 25Mg Box Of 10 Bulbs

Anesthesia - Resuscitation 640010601 Atropine 0.25Mg Injection Box 100 Bulbs

Anesthesia - Resuscitation 640050601 Atropine 0,50Mg Injection Box 100 Bulbs

Anesthesia - Resuscitation 640070601 Atropine 1Mg Injection Box 100 Bulbs

Pneumology DMP26Aerosol Beclomethasone

50ΜgBottle 200 Doses

Infectious disease 410100505Benzathine Benzylpenicillin

0,6MIU Injection

Box Of 50

Bottles + Solvent

Infectious disease 410080505 Benzathine Benzylpenicillin Box Of 50

44





1,2MIU Injection Bottles + Solvent

Dermatology 440011207Benzoate De Benzyl 10% +

Sulfiram 2% Solution Skin

Box Of 25

Bottles 150Ml

Infectious disease 410290505Benzylpenicillin 1MIU

Injection

Box Of 50

Bottles + Solvent

Infectious disease 410280505Benzylpenicillin 5MIU

Injection

Box Of 6 Bottles

+ Solvent

Infectious disease 410270305Benzylpenicillin Procaine

1MIU Injection

Box Of 50

Bottles + Solvent


Anti- InflammatoryDMP27 Betamethasone 4Mg Injection Box 3 Bulbs



Betamethasone 8Mg Injection

With Syringe And Needle

Sterile

Box 1 Bulb

Dermatology 2300011215 Biogaze Dressing CompressesBox Of 20

Compresses

Cardiology - Medicines 820010103 10Mg Tablets BisoprololBox Of 28

Tablets


Diabetes --Nutrition200025103 Bromocriptine 2.5 Mg Tablets

Box Of 30

Tablets

Anesthesia - Resuscitation 640010501N-Butyl Bromide 10Mg

Tablets Of Hyoscine

Box Of 40

Tablets

Anesthesia - Resuscitation 640010105Bromide N-Butyl Hyoscine

10Mg Suppositories

Box Of 6

Suppositories

Anesthesia - Resuscitation 640020501N-Butyl Bromide For Injection

20Mg HyoscineBox Of 50 Bulbs

Anesthesia - Resuscitation 210011107 Bupivacaine 0.25% Injection Bottle 20Ml

Anesthesia - Resuscitation 210051107 Bupivacaine 0.50% Injection Bottle 20Ml

45





Anesthesia - Resuscitation 260011105Buprenorphine 0.3Mg

InjectionDe10 Bulbs Box


Diabetes --Nutrition20005103 Cabergoline 0.5 Mg Tablets Box 8 Tablets


Diabetes --Nutrition2100010103

Calcium Tablets Effervescent

1G

Box Of 30

Tablets



Calcium 500Mg + Vitamin D3

400 IU Tablets

Box Of 30

Tablets


Diabetes --Nutrition2100010501 Calcium Injection 87Mg Box 5 Bulbs

Cardiology - Medicines 820020103 25Mg Tablets CaptoprilBox Of 30

Tablets

Cardiology - Medicines DMP120 50Mg Tablets CaptoprilBox Of 30

Tablets

Psychiatry - Neurology 1240010103 Carbamazepine 200Mg TabletBox Of 50

Tablets

Psychiatry - Neurology 1240120103 Carbamazepine 400Mg TabletBox Of 30

Tablets


Diabetes --Nutrition960010103 Carbimazole 5Mg Tablet

Box Of 50

Tablets

Pneumology DMP6 Carbocysteine 5% Syrup Bottle 125Ml

Cardiology - Medicines 84000103 Carvedilol 6.25Mg TabletsBox Of 30

Tablets

Infectious disease DMP31 Cefalotin 1G InjectionBox + 1 Vial

Solvent

Infectious disease 401100105Cefixime 100Mg Powder To

Suspension Oral

Box 1 Bottle

40Ml

Infectious disease 401040105 Cefixime 40Mg Powder To Box 1 Bottle

46





Suspension Oral 40Ml

Infectious disease 40110005 Ceftazidime 1G Injection Box 1 Bottle

Infectious disease DMP32 Ceftriaxone 1G InjectionBox + 1 Vial

Solvent

Infectious disease DMP33 Ceftriaxone 250Mg InjectionBox + 1 Vial

Solvent

Infectious disease DMP34 Ceftriaxone 500Mg InjectionBox Of 20

Bottles + Solvent

Allergology 300010201 10Mg Tablets CetirizineBox Of 15

Tablets

Allergology 300010101Cetirizine 1Mg / Ml Oral


Gastroenterology 600100001Coal Assets Or Plant Tablets

Or Capsules

Box De 30

Tablets Or

Capsules

Psychiatry - Neurology 1210020103 Chlorpromazine 100Mg TabletBox Of 50

Tablets

Psychiatry - Neurology 1210160103 25Mg Tablets ChlorpromazineBox Of 50

Tablets

Psychiatry - Neurology 1210011001Chlorpromazine Injection

25MgBox 5 Bulbs

Ophthalmology 1310031619Chlortetracycline 1%

Ophthalmic Ointment

Box Of 50 Tubes

5 G

Dermatology 1810011219Chlortetracycline 3%

Ointment Skin25 Tubes 15 G

Cardiology - Medicines DMP39Potassium Chloride Injection

10%Box 100 Bulbs

Cardiology - Medicines DMP141 Potassium Chloride Capsule Box Of 40

47





600Mg Capsules

Infectious disease DMP1420 200Mg Ciprofloxacin Injection Bottle 100Ml

Infectious disease DMP142 Ciprofloxacin Tablets 500MgBox Of 10

Tablets

Anesthesia - Resuscitation 100080103Cisatracurium 10Mg / 5Ml

InjectionBox 5 Bulbs

Psychiatry - Neurology 1220070103 25Mg Tablets ClomipramineBox Of 30

Tablets

Psychiatry - Neurology 1220061001 Clomipramine Injection 25Mg Box Of 10 Bulbs

Psychiatry - Neurology DMP40 Clonazepam 2Mg TabletBox Of 40

Tablets

Cardiology - Medicines 730040501Clonidine 0.15Mg / Ml

InjectionBox Of 30 Bulbs

Cardiology - Medicines 730040105 Clonidine 0.15Mg TabletsBox Of 20

Tablets

Cardiology - Medicines 7300750103 Clopidogrel Tablets 75MgBox Of 28

Tablets

Rheumatology 1020020103 Colchicine Tablets 1MgBox Of 40

Tablets

Dermatology 1890061202 Collargol 5% OintmentBox 25 Tubes

5G

Ophthalmology 1340041609Cyclopentolate 0.5% Eye

Drops

Box Of 10

Bottles 0.5Ml

Oncology --Hormone Therapy -

-Immunology101004201

Cyclophosphamide 200Mg

Injection

Box Of 10

Bottles


-Immunology101004501

Cyclophosphamide 500Mg

InjectionBox 1 Bottle

Analgesics --Antipyretics -- DMP41 Dexamethasone Tablets 0.5Mg Box Of 40

48





Anti- Inflammatory Tablets


Anti- InflammatoryDMP143 Dexamethasone Injection 5Mg Box 3 Bulbs

Allergology 300020103Dexchlorpheniramine 2Mg

Tablet

Box Of 30

Tablets

Psychiatry - Neurology 1230020501 Diazepam Injection 10Mg Box Of 50 Bulbs

Psychiatry - Neurology 1230040103 Diazepam 5Mg TabletBox Of 40

Tablets



Diclofenac 25Mg

Suppositories

Box 10

Suppositories



Diclofenac 100Mg

Suppositories

Box 10

Suppositories



Diclofenac 12.5Mg

Suppositories

Box 10

Suppositories


Anti- InflammatoryDMP9 50Mg Tablets Diclofenac

Box Of 100

Tablets


Anti- Inflammatory1000141475 Diclofenac Injection 75Mg Box 2 Bulbs

Cardiology - Medicines 740030103 Digoxin 0.25 Mg TabletsBox Of 30

Tablets

Cardiology - Medicines DMP48 Digoxin 5% Oral Solution Bottle 60Ml

Cardiology - Medicines 730030105 25Mg Tablets DihydralazineBox Of 40

Tablets

Cardiology - Medicines 750010901Diltiazem 90Mg Tablets Or

Capsules

Box De 30

Tablets Or

Capsules

Cardiology - Medicines 710020803Dinitrate Isosorbide 20Mg

Capsules

Box Of 60

Capsules

49






Tablets

Box Of 60

Tablets


Tablet

Box Of 30

Tablets

Gastroenterology 6013000301 Diosmectite 3G Bag Box 60 Packs

Cardiology - Medicines 750030103 Diosmin 300Mg TabletBox Of 30

Tablets

Anesthesia - Resuscitation 100130201 Dobutamine 250Mg Injection Box 1 Bottle

Gastroenterology DMP49Domperidone 0.1% Oral


Gastroenterology DMP50 10Mg Tablets DomperidoneBox Of 20

Tablets

Anesthesia - Resuscitation 100100201 Dopamine 200Mg Injection Box Of 20 Bulbs

Anesthesia - Resuscitation 100030201 Dopamine Injection 50Mg Box Of 50 Bulbs


-Immunology1010030205 Doxorubicin Injection 50Mg Box 1 Bottle

Infectious disease 410700103 Doxycycline 200Mg TabletBox Of 10

Tablets

Solvents 2300040201Water For Injection

Preparation

Box 100 Bulbs

5Ml

Dermatology DMP510Econazole 1% Ointment Or

CreamTube 30 G

Gynecology - Obstetrics DMP51Econazole 150Mg Ova

GynaecologicalBox 3 Ova

Cardiology - Medicines 750050201 20Mg Tablets EnalaprilBox Of 28

Tablets

Cardiology - Medicines 750050005 Enalapril 5Mg TabletBox Of 28

Tablets

50





Dermatology 1840061207Eosine Disodium 2% Solution

Skin

Carton Of 15

Bottles Of 1

Litre

Anesthesia - Resuscitation 100150202 Ephedrine 3% Injection Box Of 10 Bulbs



Epoetin Alfa 2000Ui / Ml

Injection

Box Of 10

Bottles




Injection

Box Of 6 Needle

0.5Ml




Injection

Box Of 6 Needle

0.5Ml




Injection

Box Of 6 Needle

0.4Ml


Diabetes --Nutrition300010506 Epoetin Beta 1000Ui Injection Box Of 6 Needle









Epoetin Beta 10000Ui

InjectionBox Of 6 Needle

Infectious disease 410170116Erythromycin 125Mg Pellet

To Suspension OralBox 12 Packs

Infectious disease 410180103 Erythromycin Tablets 500MgBox Of 100

Tablets

Cardiology - Medicines DMP540 Etamsylate 250Mg TabletBox Of 20

Tablets

51





Cardiology - Medicines DMP54 Etamsylate 250Mg Injection Box Of 6 Bulbs

Cardiology - Medicines DMP55 Etamsylate 500Mg TabletBox Of 20

Tablets

Anesthesia - Resuscitation 100180301 Etomidate 2Mg / Ml Injection Box 5 Bulbs

Cardiology - Medicines 7500200103 Fenofibrate 200Mg CapsulesBox Of 30

Capsules

Anesthesia - Resuscitation DMP85Fentanyl 100 Micrograms / 2

Ml InjectableBox 5 Bulbs

Anesthesia - Resuscitation DMP86Fentanyl 500Μg / 10 Ml

InjectableBox Of 10 Bulbs


Diabetes --Nutrition140010106 Iron Pediatric Syrup Bottle 150Ml


Diabetes --Nutrition140030501 Filgrastim 300Μg Injection Box 1 Syringe


Diabetes --Nutrition1400480501 Filgrastim 480Μg Injection Box 1 Syringe

Infectious disease 410670105Flucloxacillin 125Mg Oral

Suspension

Box Of 10

Bottles 60Ml

Infectious disease 410510501 Flucloxacillin 1G InjectionBox Of 10

Bottles + Solvent

Infectious disease 410660501 Flucloxacillin 250Mg InjectionBox Of 10

Bottles + Solvent

Infectious disease 410680105Flucloxacillin 250Mg Oral

Suspension

Box Of 10

Bottles 60Ml

Infectious disease 410680103 Flucloxacillin 500Mg CapsuleBox Of 12

Capsules

Infectious disease 410500501 Flucloxacillin 500Mg InjectionBox Of 10

Bottles + Solvent

52





Infectious disease 411150103 Fluconazole 150Mg CapsulesBox Of 4

Capsules

Infectious disease 41120005Fluconazole 2Mg / Ml

InjectionBottle 100Ml

Infectious disease 411050103 Fluconazole 50Mg Capsules Box 7 Capsules

Ophthalmology 1340071609Fluorescein 10% Sodium


Psychiatry - Neurology 1260020103 Fluoxetine 20Mg CapsulesBox Of 20

Capsules

Psychiatry - Neurology 1210050301Fluphenazine Decanoate

Injection 25MgBox Of 50 Bulbs

Pneumology 1200100506Fluticasone + Salmeterol 100 /

50Μg Inhalation

60 Single Dose

Containers

Pneumology 1200250506Fluticasone + Salmeterol 250 /

50Μg Inhalation

60 Single Dose

Containers



Fumarate Ferrous 200Mg

Tablet

Box Of 100

Tablets

Cardiology - Medicines 770020501 Furosemide Injection 20Mg Box Of 25 Bulbs

Cardiology - Medicines 7700250501 Furosemide 250Mg Injection Box 5 Bulbs

Cardiology - Medicines 770030103 40Mg Tablets FurosemideBox Of 100

Tablets

Cardiology - Medicines 7700500103 Furosemide 500Mg TabletBox Of 50

Tablets

Ophthalmology 1310071609 Gentamicin 0.3% Eye DropsBox Of 10

Bottles 5Ml

Infectious disease 410551205 Gentamicin 120Mg Injection Box Of 6 Bulbs

Infectious disease 410550501 Gentamicin 160Mg Injection Box Of 25 Bulbs

Infectious disease 410190501 Gentamicin Injection 20Mg Box Of 25 Bulbs

53








Diabetes --Nutrition920010103 Glibenclamide 5Mg Tablet

Box Of 100

Tablets


Diabetes --Nutrition920030103 30Mg Tablets Gliclazide

Box Of 60

Tablets


Diabetes --Nutrition920060103 80Mg Tablets Gliclazide

Box Of 60

Tablets


Diabetes --Nutrition1500100103 Glimepiride Tablets 1Mg

Box Of 30

Tablets


Diabetes --Nutrition1500200103 Glimepiride 2Mg Tablet

Box Of 30

Tablets


Diabetes --Nutrition1500300103 Glimepiride 3Mg Tablets

Box Of 30

Tablets


Diabetes --Nutrition1500400103 Glimepiride 4Mg Tablets

Box Of 30

Tablets


Diabetes --Nutrition1700100501 Glucagon 1Mg Injection Box 1 Bottle

Infectious disease 450020103 Griseofulvin 125Mg TabletBox Of 100

Tablets

Infectious disease DMP57 Griseofulvin 250Mg TabletBox Of 30

Tablets

Dermatology DMP56 Griseofulvin 5% Ointment Tube 15 G

Infectious disease 450030103 Griseofulvin 500Mg TabletBox Of 30

Tablets

Psychiatry - Neurology 1210080901 Haloperidol 5Mg Injection Box Of 50 Bulbs

Psychiatry - Neurology 1210070109 Haloperidol 0.2% Oral SolBox Of 25

Bottles 15Ml

54





Anesthesia - Resuscitation 220031310Halothane Suspension 250Mg

InhalationBottle 250Ml

Cardiology - Medicines DMP108Heparin Sodium Injection 25

000Ui

Box De 10

Bottles Or 10

Bulbs

Cardiology - Medicines DMP1009

Heparin To Bas Weight

Molecular 2000 To3000Ui

Anti-Xa, Injection

Box 2 Needle




Anti-Xa, Injection

Box 2 Needle




Anti-Xa, Injection

Box 2 Needle

Other 650010107 Paraffin Oil

Carton Of 15

Bottles Of 1

Litre

Cardiology - Medicines 770070103DHydrochlorothiazide 25Mg

Tablets

Box Of 20

Tablets

Cardiology - Medicines 770070103Hydrochlorothiazide 50Mg +

Amiloride 5Mg Tablets

Box Of 28

Tablets



Hydrocortisone 100Mg



Anti- Inflammatory910080103 10Mg Tablets Hydrocortisone

Box Of 25

Tablets

Gastroenterology 610010101Hydroxide Aluminum And De

Magnesium Suspension OralBottle 250Ml

Anesthesia - Resuscitation 300060501 Hydroxyzine 100Mg Injection Box Of 6 Bulbs

Analgesics --Antipyretics -- DMP122 Ibuprofen 100Mg / 5Ml Syrup Bottle 150Ml

55





Anti- Inflammatory

Infectious disease 4052502505Imipenem 250Mg + Cilastatin

250Mg Injection

Box Of 10

Bottles

Infectious disease 4055005005Imipenem 500Mg + Cilastatin

500Mg InjectionBox 1 Bottle

Psychiatry - Neurology DMP58 25Mg Tablets ImipramineBox Of 100

Tablets

Cardiology - Medicines 78008001 Indapamide 1.5 Mg Tablets LpBox Of 30

Tablets

Cardiology - Medicines 78008002 Indapamide 2.5 Mg TabletsBox Of 30

Tablets

Ophthalmology 1340051609 Indomethacin 0.1% Eye DropsBox Of 10

Bottles



Indomethacin 100Mg

Suppositories

Box Of 20

Suppositories


Anti- Inflammatory1000050103 Indomethacin 25Mg Capsules

Box Of 30

Capsules

Anesthesia - Resuscitation 100090201 Isoprenaline 0.2Mg Injection Box Of 50 Bulbs

Infectious disease 405250105Josamycin 250Mg Powder For

Oral Susp

Box D1 'Bottle

60Ml

Infectious disease 405500105Josamycin 500Mg Powder For

Oral Susp

Box 1 Bottle

60Ml

Anesthesia - Resuscitation 400010101 Ketamine 10Mg / Ml Injection Box Of 25 Bulbs

Anesthesia - Resuscitation 400050101 Ketamine 50Mg / Ml Injection Box Of 25 Bulbs


Anti- Inflammatory1000100501 Ketoprofen 100Mg Injection Box Of 60 Bulbs


Anti- Inflammatory1000200501 Ketoprofen 100Mg Tablet

Box Of 30

Tablets

56





Anesthesia - Resuscitation 300300301

Lactate De Sodium Chloride

De Sodium Chloride De

Potassium, Chloride De

Calcium

Carton Of 12

Bottles 500Ml

Gastroenterology 600500501 Lactulose 50% Oral Solution Bottle 200Ml



Lenograstim 33.6 MIU

InjectionBox 5 Bottles



Lenograstim 34 MIUMIU


Psychiatry - Neurology 1210100103Levomepromazine 100Mg

Tablet

Box Of 100

Tablets

Psychiatry - Neurology 121012010325Mg Tablets

Levomepromazine

Box Of 100

Tablets

Psychiatry - Neurology 1210110301Levomepromazine Injection

25MgBox 5 Bulbs



Levothyroxine Sodium 100

Micrograms Tablets Scored

Box Of 50

Tablets



Levothyroxine Sodium Tablets

50Μg

Box Of 28

Tablets

Anesthesia - Resuscitation 210060407 Lidocaine 1% InjectionBox Of 10

Bottles

Anesthesia - Resuscitation 210020607Lidocaine 2% + Adrenaline

Injection

Box Of 10

Bottles

Anesthesia - Resuscitation 210030607 Lidocaine 2% InjectionBox Of 10

Bottles

Anesthesia - Resuscitation 210040701 Lidocaine 5% + Naphazoline Bottle 24Ml

Anesthesia - Resuscitation 210040407 Lidocaine 5% Contact Bottle 24Ml

Psychiatry - Neurology 1270250103 Lithium 250Mg Tablet Box Of 100

57





Tablets

Psychiatry - Neurology 1270400103 Lithium 400Mg TabletBox Of 60

Tablets

Gastroenterology 6004002001 Loperamide 2Mg CapsuleBox Of 20

Capsules

Allergology DMP123 10Mg Tablets LoratadineBox Of 15

Tablets

Allergology DMP124 Loratadine 5Mg / 5Ml Syrup Bottle 60Ml

Cardiology - Medicines 730060503 50Mg Tablets Losartan Box 30 Tablets


Diabetes --NutritionDMP129 Magnesium Sulfate Injection Box 5 Bulbs

Cardiology - Medicines 2220040407 10% Mannitol InjectionBox Of 12

Bottles 500Ml

Cardiology - Medicines 2220040807 20% Mannitol Injection Pocket 500Ml

Anesthesia - Resuscitation 640200103 Mebeverine 200Mg TabletBox 30 Scored

Tablets


-Immunology1010050201 Melphalan 2Mg Tablet

Box Of 50

Tablets

Psychiatry - Neurology 1230050301 Meprobamate 400Mg Injection Box Of 10 Bulbs

Allergology 300040006Mequitazine 0.06 G / Syrup

120MlBottle 120Ml

Gastroenterology 600600501Mesalazine 1% Rectal

SuspensionBox 5 Bottles

Gastroenterology 6006001003 Mesalazine 1G SuppositoriesBox 15

Suppositories

Gastroenterology 6006050103 Mesalazine 500Mg TabletBox Of 100

Tablets

Oncology --Hormone Therapy - 1010060401 Mesna 400Mg Injection Box Of 15 Bulbs

58





-Immunology


Diabetes --Nutrition9200510103 Metformin 1000Mg Tablets

Box Of 30

Tablets


Diabetes --NutritionDMP59 Metformin 500Mg Tablet

Box Of 50

Tablets


Diabetes --Nutrition920050103 Metformin 850Mg Tablets

Box Of 60

Tablets


-Immunology1010070201 Methotrexate Injection 25Mg Box 1 Bottle

Cardiology - Medicines 730020103 Methyldopa 250Mg TabletBox Of 30

Tablets

Gynecology - Obstetrics 1630010501Methylergometrine 0.2Mg




Methylprednisolone 120Mg

Injection

Box Of 10

Bottles



Methylprednisolone Injection

40Mg

Box Of 10

Bottles



Methylprednisolone 500Mg

Injection

Box Of 10

Bottles

Gastroenterology 620020103 10Mg Tablets MetoclopramideBox Of 500

Tablets

Gastroenterology 620010501Metoclopramide Injection

10MgBox Of 50 Bulbs

Gastroenterology 620020502Metoclopramide 20Mg

Suppositories

Box 10

Suppositories

Gastroenterology 620030109Metoclopramide 260Mg / Sol

100Ml Oral

Box 1 Flaconde

60Ml

Gastroenterology 620016503 Metoclopramide Delay 16Mg Box Of 30

59





Capsule Capsules

Gastroenterology 620004504Metopimazine 0.4% Oral

SolutionBottle 30Ml

Gastroenterology 6007010501Metopimazine 10Mg / Ml


Gastroenterology 6007050003Metopimazine 5Mg

Suppositories

Box 10

Suppositories

Infectious disease 440080103 Metronidazole 250Mg TabletBox Of 100

Tablets

Infectious disease 440070106 4% Metronidazole SyrupBox Of 25

Bottles 120Ml

Infectious disease 440280103 Metronidazole 500Mg TabletBox Of 100

Tablets

Infectious disease DMP60Metronidazole 500Mg

InjectionPocket 100Ml

Gynecology - Obstetrics 440091514 Metronidazole 500Mg Ova Box 50 Ova

Psychiatry - Neurology 220100201Midazolam 5Mg / 5Ml

Injection

Box Of 6 Bulbs

5Ml

Anesthesia - Resuscitation 1010030709 Morphine 100Mg Tablets LpBox Of 14

Tablets

Anesthesia - Resuscitation 1010030701 10Mg Tablets Morphine LpBox Of 14

Tablets


Tablets


Tablets


Tablets

60





Anesthesia - Resuscitation 1010030601Morphine Hydrochloride

Injection 10MgBox 100 Bulbs


Anti- Inflammatory810020201 Nefopam Injection 20Mg Box Of 15 Bulbs

Anesthesia - Resuscitation 100120201 Neostigmine 0.5Mg Injection Box Of 60 Bulbs

Cardiology - Medicines 710080501 Nicardipine Injection 10Mg Box Of 10 Bulbs

Cardiology - Medicines 710080105 Nicardipine 50Mg CapsulesBox Of 60

Capsules

Cardiology - Medicines 730060103 20Mg Tablet NifedipineBox Of 50

Tablets

Cardiology - Medicines 730060303 30Mg Tablets NifedipineBox Of 30

Tablets

Infectious disease DMP64 Nifuroxazide 100Mg CapsuleBox Of 30

Capsules

Infectious disease DMP65 Nifuroxazide 200Mg CapsuleBox Of 30

Capsules

Infectious disease DMP66 Nifuroxazide Oral Suspension Bottle 90Ml

Infectious disease 455100103 Nitroxoline 100Mg TabletBox Of 50

Tablets

Infectious disease 4500100106Nystatin 000Ui 100 / Ml Oral

Suspension

Bottle Of 24

Doses

Gastroenterology 6100410103 10Mg Capsule OmeprazoleBox Of 28

Capsules

Gastroenterology 610040103 20Mg Capsule OmeprazoleBox Of 28

Capsules

Gastroenterology 6100440501 Omeprazole Injection 40Mg Box 5 Bottles

Gastroenterology 6008040005Ondansetron 4Mg / 2Ml

InjectionBox 5 Bulbs

61





Ophthalmology DMP68

Oxytetracycline +

Dexamethasone Ointment

Ophthalmic

Box 12 Unidoses

Gynecology - Obstetrics 1630020401 Oxytocin 5 IU Injection Box 3 Bulbs

Anesthesia - Resuscitation 220010201Pancuronium 4Mg Bromide




Paracetamol 100Mg

Suppositories

Box 100

Suppositories



Paracetamol 125Mg

Suppositories

Box 100

Suppositories


Anti- InflammatoryDMP125 Paracetamol 150Mg Bags Box 12 Packs



Paracetamol 150Mg

Suppositories

Box 100

Suppositories



Paracetamol 170Mg

Suppositories

Box 100

Suppositories


Anti- InflammatoryDMP126 Paracetamol 1G Injection

Box Of 12

Bottles


Anti- Inflammatory1000090103 Paracetamol 1G Tablets

Box Of 10

Tablets





Paracetamol 200Mg

Suppositories

Box 100

Suppositories



Paracetamol 250Mg

Suppositories

Box 100

Suppositories


Anti- Inflammatory1000010418 Paracetamol Syrup 3% Bottle 90Ml

62









Paracetamol 300Mg

Suppositories

Box 100

Suppositories



Paracetamol 350Mg

Suppositories

Box 100

Suppositories



Paracetamol 400Mg + Codeine

20Mg Tablets

Box Of 16

Tablets



Paracetamol 400Mg +

Dextropropoxyphene

30Mg Capsules

Box Of 18

Capsules


Anti- Inflammatory1000070103 Paracetamol 500Mg Tablet

Box Of 100

Tablets


Anti- Inflammatory1000070301 Paracetamol 500Mg Injection

Box Of 12

Bottles 50Ml



Paracetamol 500Mg

Suppositories

Box 100

Suppositories



Paracetamol 80Mg

Suppositories

Box 100

Suppositories

Psychiatry - Neurology 1240050103 10Mg Tablets PhenobarbitalBox Of 80

Tablets

Psychiatry - Neurology 1240020501 Phenobarbital 200Mg Injection Box 5 Bulbs

Psychiatry - Neurology 1240060801 Phenobarbital Injection 40MgBox Of 50

Bottles + Solvent

Psychiatry - Neurology 1240070103 50Mg Tablets PhenobarbitalBox Of 30

Tablets

Infectious disease 410310105Phenoxymethylpenicillin 0.25

MIU / 5Ml Syrup

Box Of 25

Bottles 100Ml

63





Infectious disease 410300103Phenoxymethylpenicillin 1

MIUMIU Tablets

Box Of 12

Tablets

Ophthalmology DMP35 Phenylephrine 10% Eye Drops Bottle 10Ml

Anesthesia - Resuscitation 2220Serum Glucose 10% Hypert

500 Ml Pocket

Cardboard 12

Pockets 500Ml

Anesthesia - Resuscitation 2220020407Serum Glucose 15% 500 Ml

Bottle

Carton Of 12

Bottles 500Ml


Bottle

Carton Of 12

Bottles 125Ml


Bottle

Carton Of 12

Bottles 250Ml


Pocket

Cardboard 12

Pockets 250Ml

Cardiology - Medicines 790020103 Simvastatin 20Mg TabletsBox Of 60

Tablets

Cardiology - Medicines 790040103 Simvastatin 40Mg TabletsBox Of 60

Tablets

Anesthesia - Resuscitation 2220060407Sodium Bicarbonate 1.4% 250

Ml Bottle

Carton Of 12

Bottles 250Ml

Anesthesia - Resuscitation 2220100407Sodium Chloride 0.9% 500 Ml

Bottle

Carton Of 12

Bottles 500Ml

Anesthesia - Resuscitation 2220100407Sodium Chloride 0.9% 500 Ml

Pocket

Cardboard 12

Pockets 500Ml

Anesthesia - Resuscitation 222018Sodium Chloride Injection

10%Box 100 Bulbs

Gynecology - Obstetrics DMP75F

Solution Antiseptic To

Application Local In

Gynecology

Bottle 250Ml

64





Anesthesia - Resuscitation DMP121

Solution De Filling Vascular

To Base

De Gelatin Or Dextran Or

Pocket Or Bottle

500Ml

Infectious disease 410620105 Spiramycin 0.375 MIU Syrup Bottle 150Ml

Infectious disease DMP114Spiramycin 0.75 MIU Tablets

Or Bag

Box De 20

Tablets Or Bags

Infectious disease 410390103Spiramycin 1.5 MIU +

Metronidazole 250Mg Tablets

Box Of 15

Tablets

Infectious disease DMP115Spiramycin 1.5 MIU Tablets

Or Bag

Box De 16

Tablets Or Bags

Infectious disease 4103000103 Spiramycin 3 MIU TabletsBox Of 10

Tablets

Cardiology - Medicines 7700602501Spironolactone 25Mg +

Altizide 15Mg Tablets

Box Of 20

Tablets

Cardiology - Medicines 770060501 50Mg Tablets SpironolactoneBox Of 20

Tablets

Cardiology - Medicines 100140201Streptokinase 1500 000Ui


Anesthesia - Resuscitation 333030201 Sufentanil 250Μg Injection Box Of 10 Bulbs

Anesthesia - Resuscitation 333010201 Sufentanil 50Μg Injection Box 5 Bulbs

Dermatology 1980021701 Sulfadiazine Silver Cream 1% Tube 50 G


Sulfamethoxazole 100Mg +

Trimethoprim

20Mg Tablet

Box Of 200

Tablets


Sulfamethoxazole 4G +

Trimethoprim 800Mg

Suspension Oral

Carton Of 10

Bottles 100Ml

65






Sulfamethoxazole 800Mg +

Trimethoprim

160Mg Tablet

Box Of 20

Tablets


Sulphametoxazole 400Mg +

Trimethoprim

80Mg Tablet

Box Of 200

Tablets

Gastroenterology DMP77 Sulfasalazine 500Mg TabletBox Of 100

Tablets

Products Contrast 2200020105Barium Sulfate Sol. Oral Or

RectalBottle 150Ml

Dermatology 1890021202

Sulfate De Copper + Sulfate

De Zinc + Oxide De Zinc +

Camphor Ointment

Box Of 25 Tubes

20G



Ferrous Sulphate 80Mg

Tablets

Box Of 30

Tablets



20Mg Tablets Or Capsules

Tenoxicam

Box De 10

Tablets Or

Capsules



Tenoxicam 20Mg

Suppositories

Box Of 6

Suppositories


Diabetes --NutritionDMP78 Tetracosactide 1Mg Injection Box 1 Bulb

Infectious disease 410350103 Tetracycline 500Mg TabletBox Of 100

Tablets

Pneumology DMP144Theophylline 300Mg Tablets

Lp

Box Of 30

Tablets



Thiamine + Pyridoxine +

Cyanocobalamin Tablets

Box Of 20

Tablets

Infectious disease 410360505 Thiamphenicol 750Mg Box Of 8 Bottles

66





Injection + Solvent

Infectious disease DMP79Thiamphenicol 125Mg Powder

For Oral SuspBottle 60Ml

Infectious disease 410540103 Thiamphenicol 250Mg TabletBox Of 16

Tablets

Infectious disease 410500103 Thiamphenicol 500Mg TabletBox Of 16

Tablets

Anesthesia - Resuscitation DMP145Thiocolchicoside 4Mg


Anesthesia - Resuscitation 220070205Thiopental 1G Sodium

Injection

Box Of 50

Bottles

Anesthesia - Resuscitation 640101418Tiemonium Simple 20Mg

Suppositories

Box 100

Suppositories

Anesthesia - Resuscitation 640080501Tiemonium Single Injection

5MgBox Of 10 Bulbs

Anesthesia - Resuscitation 640070101Tiemonium Simple 10Mg /

5Ml SyrupBottle 150Ml

Ophthalmology 1320031609 Timolol 0.50% Eye Drops Bottle 5Ml



Tramadol 100Mg

Suppositories

Box 5

Suppositories



Tramadol 50Mg Tablets Or

Capsules

Box De 20

Tablets Or

Capsules

Psychiatry - Neurology 1250030103 Trihexyphenidyl 5Mg TabletBox Of 20

Tablets

Anesthesia - Resuscitation 710010103 Trimebutine Oral Suspension Bottle 250Ml

Anesthesia - Resuscitation 710050101Trimebutine 150Mg Tablet Or

Capsule

Box De 30

Tablets Or

67





Capsules

Cardiology - Medicines 790060201Trimetazidine Dihydrochloride

20Mg Tablets

Box Of 60

Tablets

Cardiology - Medicines DMP96Nitroglycerin 0.3Mg / Spray

AerosolBottle 300 Doses

Cardiology - Medicines 710050501 Nitroglycerin Injection 15Mg Box Of 50 Bulbs

Cardiology - Medicines 710050301 Nitroglycerin 3Mg Injection Box Of 50 Bulbs

Cardiology - Medicines DMP81 Nitroglycerin 6,5Mg CapsuleBox Of 60

Capsules

Ophthalmology DMP82 Tropicamide 0.5% Eye DropsBox Of 10

Bottles 10Ml

Psychiatry - Neurology DMP83 Valproate Sodium Syrup Bottle 150Ml

Psychiatry - Neurology 1240100103Valproate Sodium Tablets

200Mg

Box Of 40

Tablets

Psychiatry - Neurology 1240090107Valproate De Sodium 200Mg /

Ml Solution OralBottle 40Ml

Infectious disease 430500501 Vancomycin 500Mg Injection Box 1 Bottle

Other 1890051202 White Vaseline Pack Of 1 Kg

Anesthesia - Resuscitation 220080201Vecuronium 4Mg Bromide



-Immunology1010081001 Vincristine 1Mg Injection Box 1 Bottle

68



6.4 Reimbursement of anti-cancer drugs (in MAD)

Table 14: Reimbursements of anti-cancer drugs

Special or trade name

CommonInternational

nameForm of drug Presentation

Public Pricein Morocco

(PPM)

Price base for reimbursement

(PPM)

Price in Hospital Morocco (PHM)

Price for reimburse

ment (PHM)

AVASTIN BEVACIZUMABCONCENTRATION OF SOLUTION FOR INFUSION AT 100 MG

1 BOX 1 BOTTLE 3,983.00 3,983.00 3,689.00 3,689.00

AVASTIN BEVACIZUMABINFUSION AT 400 MG POWDER FOR SOLUTION

1 BOX 1 BOTTLE 13,417.00 13,417.00 13,161.00 13,161.00

BLUCIN BLEOMYCINEINJECTION 15 MG POWDER FOR SOLUTION

1 BOX 1 BOTTLE 215.00 215.00 134.40 134.40

BLEOMYCINE BELLON BLEOMYCINE INJECTION 15 MG 1 BOX 1 BOTTLE 345.00 215.00 229.00 134.40

XELODA CAPECITABINE FILM-COATED TABLETS 150 MG 1 BOX 60 TABLETS 559.70 559.70

XELODA CAPECITABINE FILM-COATED TABLETS 500 MG

1 BOX 120 TABLETS 3,696.00 3,696.00 3,393.00 3,393.00

CARBOPLATINE DBL CARBOPLATINE SOLUTION FOR

INFUSION AT 50 MG 1 BOX 1 BOTTLE 272.00 272.00 181.00 181.00

CARBOPLATINE MYLAN CARBOPLATINE SOLUTION FOR


CARBOPLATINE AGUETTANT 50 MG

CARBOPLATINE SOLUTION FOR INFUSION AT 50 MG 1 BOX 1 BOTTLE 467.00 467.00 310.00 310.00

OKA-CARBOPLATIN CARBOPLATINE SOLUTION FOR







CARBOPLATINE SOLUTION FOR INFUSION AT 150 MG 1 BOX 1 BOTTLE 1,096.00 1,096.00 820.00 820.00

OKA-CARBOPLATIN CARBOPLATINE SOLUTION FOR

INFUSION AT 450 MG 1 BOX 1 BOTTLE 1,175.00 1,175.00 900.00 900.00


INFUSION AT 450 MG 1 BOX 1 BOTTLE 1,493.00 1,493.00 1,228.00 1,228.00


INFUSION AT 450 MG 1 BOX 1 BOTTLE 1,577.00 1,577.00 1,315.00 1,315.00


CARBOPLATINE SOLUTION FOR INFUSION AT 50 MG 1 BOX 1 BOTTLE 2,713.00 2,713.00 2,381.00 2,381.00

PARAPLATINE CARBOPLATINE SOLUTION FOR INFUSION AT 450 MG 1 BOTTLE 5 ML 835.30 835.30 552.50 552.50

CARBOPLATINE COOPER CARBOPLATINE SOLUTION FOR

INFUSION AT 150 MG 1 BOTTLE 15 ML 686.00 686.00 456.00 456.00

69




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

PARAPLATINE CARBOPLATINE SOLUTION FOR INFUSION AT 150 MG 1 BOTTLE 15 ML 1,871.00 686.00 1,237.70 456.00

CARBOPLATINE COOPER CARBOPLATINE SOLUTION FOR

INFUSION AT 450 MG 1 BOTTLE 45 ML 1,553.00 1,553.00 1,289.00 1,289.00

PARAPLATINE CARBOPLATINE SOLUTION FOR INFUSION AT 450 MG 1 BOTTLE 45 ML 5,586.80 1,553.00 3,695.70 1,289.00

ZAREX CARBOPLATINEPOWDER FOR SOLUTION INJECTION 150 MG

1 BOX 1 BOTTLE 968.00 968.00 687.00 687.00

ZAREX CARBOPLATINEPOWDER FOR SOLUTION INJECTION 450 MG

1 BOX 1 BOTTLE 2,289.00 2,289.00 1,944.00 1,944.00

SANDIMMUN CICLOSPORINE SOLUTION FOR INFUSION AT 50 MG 10 AMPULE 1 ML 327.80 327.80

SANDIMMUN CICLOSPORINE SOLUTION FOR INFUSION AT 50 MG 10 AMPULE 5 ML 1,820.40 1,820.40

SANDIMMUN CICLOSPORINE ORAL SOLUTION 100 MG 1 BOTTLE 10 ML 550.40 550.40

NEORAL CICLOSPORINE ORAL SOLUTION 100 MG 1 BOTTLE 20 ML 931.30 931.30

EQUORAL CICLOSPORINE ORAL SOLUTION 100 MG 1 BOTTLE 50 ML 1,736.00 1,736.00 1,452.00 1,452.00

NEORAL CICLOSPORINE ORAL SOLUTION 100 MG 1 BOTTLE 50 ML 1,736.00 1,736.00 1,452.00 1,452.00

SANDIMMUN CICLOSPORINE ORAL SOLUTION 100 MG 1 BOTTLE 50 ML 1,755.00 1,736.00 1,472.00 1,452.00

EQUORAL CICLOSPORINE CAPSULES 25 MG 1 BOX 30 CAPSULE 338.00 338.00 224.00 224.00


EQUORAL CICLOSPORINE CAPSULES 100 MG 1 BOX 30 CAPSULE 1,110.00 1,110.00 810.00 810.00

IMUSPORIN CICLOSPORINE CAPSULES 25 MG 1 BOX 50 CAPSULE MOLLE 544.00 544.00 360.00 360.00

IMUSPORIN CICLOSPORINE CAPSULES 50 MG 1 BOX 50 CAPSULE MOLLE 1,063.00 1,063.00 762.00 762.00

IMUSPORIN CICLOSPORINE CAPSULES 100 MG 1 BOX 50 CAPSULE MOLLE 1,691.00 1,691.00 1,406.00 1,406.00


SANDIMMUN CICLOSPORINE CAPSULES 25 MG 1 BOX 50 CAPSULE 565.00 544.00 374.00 360.00

EQUORAL CICLOSPORINE CAPSULES 50 MG 1 BOX 50 CAPSULE 1,063.00 1,063.00 762.00 762.00

70




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

SANDIMMUN CICLOSPORINE CAPSULES 50 MG 1 BOX 50 CAPSULE 1,123.00 1,063.00 823.00 762.00

EQUORAL CICLOSPORINE CAPSULES 100 MG 1 BOX 50 CAPSULE 1,638.00 1,638.00 1,351.00 1,351.00

SANDIMMUN CICLOSPORINE CAPSULES 100 MG 1 BOX 50 CAPSULE 1,746.00 1,691.00 1,463.00 1,406.00

NEORAL CICLOSPORINE CAPSULES 25 MG 1 BOX 60 CAPSULE 653.00 653.00 432.00 432.00

NEORAL CICLOSPORINE CAPSULES 50 MG 1 BOX 60 CAPSULE 1,213.00 1,213.00 915.00 915.00

NEORAL CICLOSPORINE CAPSULES 100 MG 1 BOX 60 CAPSULE 1,966.00 1,966.00 1,688.00 1,688.00

CEPLATIN CISPLATINE SOLUTION FOR INFUSION AT 10 MG 1 BOX 1 BOTTLE 37.80 37.80 23.60 23.60

CISPLATINE EBEWE CISPLATINE SOLUTION FOR


CISPLATINE COOPER CISPLATINE SOLUTION FOR


CISPLATINE MYLAN CISPLATINE SOLUTION FOR


PLATAMINE CISPLATINE SOLUTION FOR INFUSION AT 10 MG 1 BOX 1 BOTTLE 67.70 51.40 42.30 32.10



CEPLATIN CISPLATINE SOLUTION FOR INFUSION AT 50 MG 1 BOX 1 BOTTLE 117.90 117.90 73.70 73.70

CISPLATINE EBEWE CISPLATINE SOLUTION FOR


CISPLATINE COOPER CISPLATINE SOLUTION FOR




PLATAMINE CISPLATINE SOLUTION FOR INFUSION AT 50 MG 1 BOX 1 BOTTLE 197.70 154.20 123.60 96.40

CYCLOMIDE NOVOPHARMA 1000 MG

CYCLOPHOSPHAMIDE

POWDER FOR PARAENTERAL USE À 1 G

1 BOX 1 BOTTLE 51.00 51.00 31.90 31.90

ENDOXAN 1 G CYCLOPHOSPHAMIDE INJECTABLE IV À 1 G 1 BOX 1 BOTTLE 89.40 51.00 55.90 31.90

CYCLOMIDE NOVOPHARMA 500 MG

CYCLOPHOSPHAMIDE

POWDER FOR PARAENTERAL USE À 500 MG

1 BOX 1 BOTTLE 34.20 34.20 21.40 21.40

ENDOXAN 500 MG CYCLOPHOSPHAMIDE

POWDER FOR SOLUTION INJECTABLE IV À 500 MG

1 BOX 1 BOTTLE 56.10 34.20 35.10 21.40

71




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)


POWDER FOR SOLUTION INJECTABLE IV À 500 MG

1 BOX 10 BOTTLE 184.30 184.30 115.20 115.20


COATED TABLETS 50 MG 2 BOX 50 TABLETS 87.20 87.20 54.50 54.50

ANDROCUR CYPROTERONE COATED TABLETS 50 MG 1 BOX 20 TABLETS 201.00 201.00 125.70 125.70

CYTARABINE EBEWE CYTARABINE SOLUTION FOR


CYTARABINE EBEWE CYTARABINE SOLUTION FOR


ARACYTINE CYTARABINEPOWDER FOR SOLUTION INJECTION 1 G

1 BOTTLE 5 ML 436.00 436.00 290.00 290.00

ARACYTINE CYTARABINEPOWDER FOR SOLUTION INJECTION 100 MG

1 BOX 1 AMPULE INJECTION 54.40 54.40 34.00 34.00

ARACYTINE CYTARABINEPOWDER FOR SOLUTION INJECTION 500 MG

1 BOTTLE 5 ML 232.00 232.00 145.40 145.40

D-BLASTIN DAUNORUBICINE POWDER FOR INFUSION AT 20 MG 1 BOX 1 BOTTLE 126.00 126.00 78.70 78.70

CERUBIDINE DAUNORUBICINE POWDER FOR INFUSION AT 20 MG 1 BOX 10 BOTTLE 1,050.00 1,050.00 772.00 772.00

DOCEWIN 20 MG/0.5 ML DOCETAXEL

CONCENTRATION OF SOLUTION FOR INFUSION AT 20 MG

1 BOTTLE 0,5 ML 800.00 800.00 532.00 532.00

DOCETAXEL COOPER 21 DOCETAXEL


1 BOTTLE 0,5 ML 842.00 842.00 560.00 560.00

OKA-DOCETAXEL DOCETAXEL


1 BOTTLE 0,5 ML 922.00 922.00 640.00 640.00

LEXUS DOCETAXELCONCENTRATION OF SOLUTION FOR INFUSION AT 20 MG

1 BOTTLE 0,5 ML 1,348.00 1,348.00 1,079.00 1,079.00

TAXOTERE 20 MG/0.5 ML DOCETAXEL


1 BOTTLE 0,5 ML 1,348.00 1,348.00 1,079.00 1,079.00

DOCETAXEL HOSPIRA 11 MG/ML

DOCETAXELCONCENTRATION OF SOLUTION FOR INFUSION AT 20 MG

1 BOTTLE 2 ML 804.00 804.00 531.80 531.80

DOCEWIN 80 MG/2 ML DOCETAXEL


1 BOTTLE 2 ML 2,467.00 2,467.00 2,128.00 2,128.00

DOCETAXEL COOPER 80 MG DOCETAXEL


1 BOTTLE 2 ML 2,575.00 2,575.00 2,239.00 2,239.00

OKA-DOCETAXEL DOCETAXEL


1 BOTTLE 2 ML 2,877.00 2,877.00 2,550.00 2,550.00

LEXUS DOCETAXELCONCENTRATION OF SOLUTION FOR INFUSION AT 80 MG

1 BOTTLE 2 ML 3,177.00 3,177.00 2,858.00 2,858.00

TAXOTERE 80 MG/2 ML DOCETAXEL


1 BOTTLE 2 ML 3,177.00 3,177.00 2,858.00 2,858.00

72




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

DOCETAXEL HOSPIRA 10 DOCETAXEL


1 BOTTLE 8 ML 2,572.00 2,572.00 1,701.40 1,701.40

DOXORUBICINE EBEWE DOXORUBICINE SOLUTION FOR


D-RUBICIN-10 DOXORUBICINE SOLUTION FOR INFUSION AT 10 MG 1 BOX 1 BOTTLE 95.30 95.30 59.60 59.60

ADRIBLASTINE DOXORUBICINE LYOPHILASATE FOR INFUSION 10 MG 1 BOX 1 BOTTLE 109.50 95.30 68.40 59.60

DOXORUBICINE EBEWE DOXORUBICINE SOLUTION FOR


D-RUBICIN-50 DOXORUBICINE SOLUTION FOR INFUSION AT 50 MG 1 BOX 1 BOTTLE 412.00 412.00 273.00 273.00

ADRIBLASTINE RD DOXORUBICINE LYOPHILASATE FOR

INFUSION 50 MG 1 BOX 1 BOTTLE 454.00 412.00 302.00 273.00

DOXORUBICINE COOPER DOXORUBICINE LYOPHILASATE FOR

INFUSION 50 MG 1 BOTTLE 10 ML 93.00 93.00 58.10 58.10

DOXORUBICINE COOPER DOXORUBICINE LYOPHILASATE FOR

INFUSION 10 MG 1 BOTTLE 50 ML 429.00 429.00 285.00 285.00

OKARUBICIN DOXORUBICINELYOPHILASATE FOR INFUSION INJECTION 10 MG

1 BOX 1 BOTTLE 90.00 90.00 56.20 56.20

OKARUBICIN DOXORUBICINELYOPHILASATE FOR INFUSION INJECTION 50 MG

1 BOX 1 BOTTLE 407.00 407.00 270.00 270.00

EPIRUBICINE MYLAN 2 MG/ML EPIRUBICINE

SOLUTION FOR INFUSION AT 10 / 5 MG/ML

1 BOX 1 BOTTLE 74.40 74.40 46.50 46.50

FARMORUBICINE EPIRUBICINEPOWDER FOR INFUSION AT 10 / 5 MG/ML

1 BOX 1 BOTTLE 110.10 74.40 68.80 46.50

EPIRUBICINE MYLAN 2 MG/ML EPIRUBICINE

SOLUTION FOR INFUSION AT 50 / 25 MG/ML

1 BOX 1 BOTTLE 325.00 325.00 216.00 216.00

FARMORUBICINE EPIRUBICINEPOWDER FOR INFUSION AT 50 / 25 MG/ML

1 BOX 1 BOTTLE 495.00 325.00 329.00 216.00

ESTRACYT ESTRAMUSTINE CAPSULE 140 MG 1 BOX 100 CAPSULE 1,471.00 1,471.00 1,206.00 1,206.00

ETOPOSIDE COOPER ETOPOSIDE


1 BOX 1 BOTTLE 118.00 118.00 73.70 73.70

OKA-ETOPOSIDE ETOPOSIDECONCENTRATION OF SOLUTION FOR INFUSION AT 100 MG

1 BOX 1 BOTTLE 126.00 126.00 78.70 78.70

ETOPOPHOS ETOPOSIDE POWDER FOR INFUSION AT 100 MG 1 BOX 1 BOTTLE 494.10 126.00 326.80 78.70

ETOPOSIDE COOPER ETOPOSIDE


1 BOX 5 BOTTLE 529.00 529.00 352.00 352.00

VEPESIDE ETOPOSIDECONCENTRATION OF SOLUTION FOR INFUSION AT 100 MG

1 BOX 5 BOTTLE 874.70 352.00

73




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

ETOPOSIDE EBEWE ETOPOSIDE


1 BOTTLE 5 ML 118.00 118.00 73.70 73.70

ETOPOSIDE MYLAN ETOPOSIDE


10 BOTTLE 5 ML 1,013.00 1,013.00 734.00 734.00

ETOPOSIDE MYLAN ETOPOSIDE


10 BOTTLE 10 ML 1,465.00 1,465.00 1,200.00 1,200.00

ETOPOSIDE EBEWE ETOPOSIDE


1 BOTTLE 2,5 ML 62.00 62.00 38.70 38.70

ETOPOSIDE COOPER ETOPOSIDE CAPSULE À 50 MG 1 BOX 4 CAPSULE 190.00 190.00

ETOPOSIDE COOPER ETOPOSIDE CAPSULE À 50 MG 1 BOX 10

CAPSULE 425.00 425.00

AROMASINE EXEMESTANE COATED TABLETS 25 MG 1 BOX 30 TABLETS 969.00 969.00 689.00 689.00

FLUDARA FLUDARABINE FILM-COATED TABLETS 10 MG 1 BOX 15 TABLETS 3,606.00 3,606.00 3,301.00 3,301.00

FLUDARA FLUDARABINE FILM-COATED TABLETS 10 MG 1 BOX 20 TABLETS 4,940.00 4,940.00 4,673.00 4,673.00

FLUOROURACILE MYLAN FLUOROURACIL SOLUTION FOR


FLUOROURACIL EBEWE FLUOROURACIL SOLUTION FOR

INFUSION AT 250 MG INJECTION 69.00 69.00 43.10 43.10

FLUORO URACILE ICN FLUOROURACIL SOLUTION FOR

INFUSION AT 250 MG 1 BOX 12 VIALS 257.00 257.00 161.00 161.00

PHARMAURACIL 250MG/10ML FLUOROURACIL SOLUTION

INJECTION 250 MG 1 BOX 1 BOTTLE 16.60 16.60 10.40 10.40

PHARMAURACIL FLUOROURACIL SOLUTION INJECTION 500 MG 1 BOTTLE 20 ML 25.00 25.00 16.50 16.50

ANDRAXAN FLUTAMIDE COATED TABLETS250 MG

1 BOX 30 TABLETS ENROBE 250.00 250.00 156.20 156.20

EULEXINE FLUTAMIDE TABLETS 250 MG 1 BOX 30 TABLETS 283.00 283.00 188.40 188.40

FLUTAM FLUTAMIDE TABLETS 250 MG 1 BOX 30 TABLETS 283.00 283.00 188.40 188.40

LEDERFOLINE FOLINATE DE CALCIUM

SOLUTION INJECTION 5 MG 1 BOX 1 AMPULE 17.70 17.70 11.70 11.70

LEDERFOLINE FOLINATE DE CALCIUM TABLETS 25 MG 1 BOX 6 TABLETS 104.50 104.50 65.10 65.10



74




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

ELVORINE FOLINATE DE CALCIUM

PREPARATION INJECTION 25 MG 1 BOX 1 BOTTLE 52.00 52.00 32.40 32.40



FOLINATE DE CALCIUM AGUETTANT 100 MG

FOLINATE DE CALCIUM

POWDER FOR SOLUTION INJECTION 100 MG

1 BOX 1 BOTTLE 115.00 115.00 71.60 71.60


POWDER FOR SOLUTION INJECTION 100 MG

1 BOX 1 BOTTLE 195.00 115.00 121.50 71.60



FOLINATE DE CALCIUM AGUETTANT 50 MG

FOLINATE DE CALCIUM


LEDERFOLINE FOLINATE DECALCIUM TABLETS 25 MG 1 BOX 6 TABLETS 104.50 104.50 65.10 65.10



CITAFINE 1G MODIFIEE GEMCITABINE

POWDER FOR SOLUTION FOR INFUSION AT 1 G

1 BOTTLE 50 ML 971.00 971.00 691.00 691.00

GEMCITABINE HOSPIRA 1 G GEMCITABINE

POWDER FOR SOLUTION FOR INFUSION AT 1 G

1 BOTTLE 50 ML 971.00 971.00 691.00 691.00

ONGECIN GEMCITABINEPOWDER FORSOLUTION FOR INFUSION AT 1 G

1 BOTTLE 50 ML 971.00 971.00 691.00 691.00

GEMZAR GEMCITABINE POWDER FOR INFUSION AT 1 G 1 BOTTLE 50 ML 1,200.00 971.00 927.00 691.00

GEMCITABINE HOSPIRA 200 MG GEMCITABINE

POWDER FOR SOLUTION FOR INFUSION AT 200 MG

1 BOTTLE 10 ML 257.00 257.00 161.20 161.20

ONGECIN GEMCITABINEPOWDER FOR SOLUTION FOR INFUSION AT 200 MG

1 BOTTLE 10 ML 257.00 257.00 161.20 161.20

GEMZAR GEMCITABINEPOWDER FOR SOLUTION FOR INFUSION AT 200 MG

1 BOTTLE 10 ML 369.00 257.00 245.00 161.20

ZOLADEX 10.8 MG GOSERELINE IMPLANT INJECTION

10.8 MG 1 KIT 1 IMPLANT 3,340.00 3,340.00 3,026.00 3,026.00

ZOLADEX 3.6 MG GOSERELINE IMPLANT INJECTION 3.6 MG 1 BOX 1 SYRINGE 1,346.00 1,346.00 1,077.00 1,077.00

HYDREA HYDROXYCARBAMIDE CAPSULE 500 MG 1 BOX 20

CAPSULE 66.20 66.20 41.40 41.40

ZAVEDOS IDARUBICINEPOWDER FOR SOLUTION FOR INFUSION AT 5 MG

1 BOTTLE 1 ML 994.00 994.00 715.00 715.00

ZAVEDOS IDARUBICINEPOWDER FOR SOLUTION FOR INFUSION AT 10 MG

1 BOTTLE 1 ML 1,320.00 1,320.00 1,050.00 1,050.00

75




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

HOLOXAN IFOSFAMIDE POWDER FOR INFUSION AT 1 G 1 BOX 1 BOTTLE 409.00 409.00 272.00 272.00

HOLOXAN IFOSFAMIDE POWDER FOR INFUSION AT 2 G 1 BOX 1 BOTTLE 826.00 826.00 549.00 549.00

HOLOXAN IFOSFAMIDE POWDER FOR INFUSION AT 500 MG 1 BOX 1 BOTTLE 258.00 258.00 161.20 161.20

GLIVEC IMATINIB FILM-COATED TABLETS 100 MG

1 BOX 60 TABLETS PELLICULE 11,940.00 3,800.00 11,714.00 3,500.00

IMATEC IMATINIB CAPSULE 100 MG 1 BOX 120 CAPSULE 3,800.00 3,800.00 3,500.00 3,500.00

IMATINIB COOPER IMATINIB CAPSULE 100 MG 1 BOX 120

CAPSULE 3,800.00 3,800.00 3,500.00 3,500.00

GLIVEC IMATINIB CAPSULE 100 MG 1 BOX 120 CAPSULE 20,399.00 3,800.00 20,007.00 3,500.00

REMICADE INFLIXIMAB 1 BOTTLE 20 ML 6,340.00 6,340.00 6,067.00 6,067.00

TECAN IRINOTECANCONCENTRATION OF SOLUTION FOR INFUSION AT 100 MG

1 BOX 1 BOTTLE 1,313.00 1,313.00 1,043.00 1,043.00

IRINOTECAN COOPER IRINOTECAN


1 BOTTLE 2 ML 506.00 506.00 336.00 336.00

CAMPTO IRINOTECANCONCENTRATION OF SOLUTION FOR INFUSION AT 40 MG

1 BOTTLE 2 ML 533.00 533.00 354.00 354.00

IRINOCYT 40 MG/2ML IRINOTECAN


1 BOTTLE 2 ML 533.00 533.00 354.00 354.00

IRINOTECAN COOPER IRINOTECAN


1 BOTTLE 5 ML 1,096.00 1,096.00 819.00 819.00

CAMPTO IRINOTECANCONCENTRATION OF SOLUTION FOR INFUSION AT 100 MG

1 BOTTLE 5 ML 1,313.00 1,313.00 1,043.00 1,043.00

IRINOCYT 100 MG/5ML IRINOTECAN


1 BOTTLE 5 ML 1,313.00 1,313.00 1,043.00 1,043.00

TYKERB LAPATINIB TABLETS 250 MG 1 BOX 70 TABLETS 11,182.00 11,182.00 10,971.00 10,971.00

ARAVA LEFLUNOMIDE FILM-COATED TABLETS 100 MG 1 BOX 3 TABLETS 365.00 365.00 242.00 242.00



FEMARA LETROZOLE FILM-COATED TABLETS 2.5 MG

1 BOX 30 TABLETS PELLICULE 1,021.00 713.00 742.00 474.00

LETROZOLE GT LETROZOLE TABLETS 2.5 MG 1 BOX 30 TABLETS SECABLE 713.00 713.00 474.00 474.00

76




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

LETROZOL GT LETROZOLE TABLETS 2.5 MG 1 BOX 60 TABLETS SECABLE 1,110.00 1,110.00 834.00 834.00

ALKERAN 2 MG MELPHALAN FILM-COATED TABLETS 2 MG

1 BOX 50 TABLETS PELLICULE 100.40 100.40 62.70 62.70

PURINETHOL MERCAPTOPURINE TABLETS 50 MG 1 BOX 25 TABLETS 47.50 47.50 29.70 29.70

PENTASA MESALAZINE TABLETS 500 MG 1 BOX 100 TABLETS 587.00 587.00 389.00 389.00

PENTASA MESALAZINE RECTAL SUSPENSION 1 G 5 BOTTLE 100 ML 256.00 256.00 159.80 159.80

PENTASA MESALAZINE SUPPOSITORY 1 G 1 BOX 15 SUPPOSITORY 337.00 337.00 223.00 223.00

UROMITEXAN MESNA SOLUTION FOR INFUSION AT 400 MG 15 AMPULE 4 ML 339.00 339.00 224.00 224.00

LEDERTREXATE METHOTREXATEPOWDER FOR SOLUTION INJECTION 1 G

1 BOX 1 BOTTLE 492.50 492.50 325.60 325.60

METHOTREXATE MYLAN 100MG/ML

METHOTREXATE INJECTION 5 G 10 BOTTLE 50 ML 11,067.00 11,067.00 10,858.00 10,858.00

METHOTREXATE MYLAN METHOTREXATE INJECTION 5 G 1 BOTTLE 200 ML 1,392.00 1,392.00 1,124.00 1,124.00

LEDERTREXATE METHOTREXATE INJECTION 5 G 1 BOTTLE 200 ML 2,491.30 1,392.00 1,648.00 1,124.00

METHOTREXATE BELLON METHOTREXATE INJECTION 25 MG 1 BOTTLE 1 ML 36.30 36.30 22.70 22.70

METHOTREXATE BIODIM METHOTREXATE INJECTION 25 MG 1 BOTTLE 1 ML 47.10 47.10 29.40 29.40

METHOTREXATE BELLON METHOTREXATE INJECTION 5 MG 1 BOTTLE 2 ML 21.20 21.20 13.20 13.20

METHOTREXATE BIODIM METHOTREXATE INJECTION 5 MG 1 BOTTLE 2 ML 30.70 30.70 19.20 19.20

LEDERTREXATE 50 MG METHOTREXATE INJECTION 50 MG 1 BOTTLE 2 ML 81.90 81.90 51.20 51.20

METHOTREXATE MYLAN METHOTREXATE INJECTION 5 MG 10 BOTTLE 2 ML 178.00 178.00 111.20 111.20

METHOTREXATE MYLAN 50 MG/2 ML

METHOTREXATE INJECTION 50 MG 10 BOTTLE 2 ML 486.00 486.00 323.00 323.00

METHOTREXATE MYLAN METHOTREXATE INJECTION 500 MG 10 BOTTLE 20 ML 1,340.00 1,340.00 1,071.00 1,071.00

METHOTREXATE BELLON (H) METHOTREXATE INJECTION 500 MG 10 BOTTLE 20 ML 2,465.60 1,340.00 1,631.00 1,071.00

MITOXANTRONE EBEWE MITOXANTRONE


1 BOX 1 BOTTLE 1,199.00 1,199.00 926.00 926.00

77




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

MITOXANTRONE EBEWE MITOXANTRONE


1 BOX 1 BOTTLE 2,099.00 2,099.00 1,852.00 1,852.00

NOVANTRONE MITOXANTRONE SOLUTION FOR INFUSION AT 10 MG 1 AMPULE 5 ML 2,247.30 2,247.30 1,486.60 1,486.60

NOVANTRONE MITOXANTRONE SOLUTION FOR INFUSION AT 20 MG 1 AMPULE 10 ML 4,167.40 4,167.40 2,756.70 2,756.70

NOVANTRONE MITOXANTRONE SOLUTION FOR INFUSION AT 25 MG 1 AMPULE 12,5 ML 4,948.70 4,948.70 3,273.60 3,273.60

CELLCEPT MYCOPHENOLATE MOFETIL

FILM-COATED TABLETS 500 MG 1 BOX 50 TABLETS 1,203.00 1,203.00 905.00 905.00

CELLCEPT MYCOPHENOLATE MOFETIL CAPSULE 250 MG 1 BOX 100

CAPSULE 1,203.00 1,203.00 905.00 905.00

ELOXATINE 5 MG/ML OXALIPLATINE


1 BOX 1 BOTTLE 10 ML 1,203.00 1,203.00 929.00 929.00



1 BOX 1 BOTTLE 20 ML 2,206.00 2,206.00 1,859.00 1,859.00



1 BOX 1 BOTTLE 40 ML 2,882.00 2,882.00 2,555.00 2,555.00

OLIPLAT OXALIPLATINE POWDER FOR INFUSION AT 50 MG 1 BOX 1 BOTTLE 1,203.00 1,203.00 929.00 929.00

OLIPLAT OXALIPLATINEPOWDER FOR SOLUTION FOR INFUSION AT 100 MG

1 BOX 1 BOTTLE 2,206.00 2,206.00 1,859.00 1,859.00

OXALISIN 5 MG/ML OXALIPLATINE


1 BOTTLE 10 ML 1,089.00 1,089.00 812.00 812.00

XYLATIN 50 OXALIPLATINECONCENTRATION OF SOLUTION FOR INFUSION AT 100 MG

1 BOTTLE 10 ML 1,089.00 1,089.00 812.00 812.00

OXALISIN 5 MG/ML OXALIPLATINE


1 BOTTLE 20 ML 1,864.00 1,864.00 1,610.00 1,610.00

XYLATIN 100 OXALIPLATINEPOWDER FOR SOLUTION FOR INFUSION AT 100 MG

1 BOTTLE 20 ML 1,869.00 1,869.00 1,615.00 1,615.00

OXAPLATINE MYLAN 5 MG/ML OXALIPLATINE POWDER FOR

INFUSION AT 50 MG 1 BOTTLE 30 ML 1,203.00 1,203.00 929.00 929.00

OXALIPLATINE WIN 5 MG/ML OXALIPLATINE POWDER FOR


ELOXATINE 5 MG/ML OXALIPLATINE POWDER FOR


OXALIPLATINE WIN 5 MG/ML OXALIPLATINE POWDER FOR


ELOXATINE 5 MG/ML OXALIPLATINE POWDER FOR


OXAPLATINE MYLAN 5 MG/ML OXALIPLATINE POWDER FOR


78




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

SYNTOCINON OXYTOCINE INJECTION 5 UI 3 AMPULE 1 ML 17.20 17.20 10.70 10.70

ACUPAXIL-30 PACLITAXELCONCENTRATION OF SOLUTION FOR INFUSION AT 30 MG

1 BOTTLE 5 ML 430.00 430.00 285.00 285.00

PACLITAXEL MYLAN PHARMA 30 MG/5ML

PACLITAXELCONCENTRATION OF SOLUTION FOR INFUSION AT 30 MG

1 BOTTLE 5 ML 430.00 430.00 285.00 285.00

PACLITAXEL PHARMACHEMIE 6MG/ML


1 BOTTLE 5 ML 430.00 430.00 285.00 285.00

PACLITAXEL COOPER PACLITAXEL


1 BOTTLE 5 ML 452.00 452.00 300.00 300.00

OKA-PACLITAXEL PACLITAXEL


1 BOTTLE 5 ML 527.00 527.00 350.00 350.00

EBETAXEL PACLITAXELCONCENTRATION OF SOLUTION FOR INFUSION AT 30 MG

1 BOTTLE 5 ML 590.00 590.00 392.00 392.00

ANZATAX PACLITAXELCONCENTRATION OF SOLUTION FOR INFUSION AT 30 MG

1 BOTTLE 5 ML 619.00 619.00 411.00 411.00

PAXEL PACLITAXELCONCENTRATION OF SOLUTION FOR INFUSION AT 30 MG

1 BOTTLE 5 ML 619.00 619.00 411.00 411.00

TAXOL PACLITAXELCONCENTRATION OF SOLUTION FOR INFUSION AT 30 MG

1 BOTTLE 5 ML 619.00 619.00 411.00 411.00

OKA-PACLITAXEL PACLITAXEL


1 BOTTLE 20 ML 1,271.00 1,271.00 1,000.00 1,000.00



1 BOTTLE 25 ML 1,341.00 1,341.00 1,071.00 1,071.00


1 BOTTLE 25 ML 2,317.00 2,317.00 1,973.00 1,973.00

ANZATAX PACLITAXELCONCENTRATION OF SOLUTION FOR INFUSION AT 150 MG

1 BOTTLE 25 ML 2,476.00 2,476.00 2,137.00 2,137.00

PACLITAXEL MYLAN PHARMA 300 MG/50 ML


1 BOTTLE 50 ML 1,574.00 1,574.00 1,312.00 1,312.00



1 BOTTLE 50 ML 2,069.00 2,069.00 1,821.00 1,821.00


1 BOTTLE 50 ML 4,043.00 4,043.00 3,750.00 3,750.00

PACLITAXEL MYLAN PHARMA 100 MG/16.7 ML


1 BOTTLE 16,7 ML 823.00 823.00 547.00 547.00



1 BOTTLE 16,7 ML 823.00 823.00 547.00 547.00

PACLITAXEL COOPER PACLITAXEL


1 BOTTLE 16,7 ML 1,115.00 1,115.00 839.00 839.00


1 BOTTLE 16,7 ML 1,563.00 1,563.00 1,300.00 1,300.00

79




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

ALIMTA PEMETREXEDPOWDER FOR SOLUTION FOR INFUSION AT 100 MG

1 BOX 1 BOTTLE 2,974.00 2,650.00

ALIMTA PEMETREXEDPOWDER FOR SOLUTION FOR INFUSION AT 500 MG

1 BOX 1 BOTTLE 11,999.00 11,771.00

TOMUDEX RALTITREXED POWDER FOR INFUSION AT 2 MG 1 BOX 1 BOTTLE 1,715.00 1,456.00

MABTHERA RITUXIMABCONCENTRATION OF SOLUTION FOR INFUSION AT 100 MG

2 BOTTLE 10 ML 5,842.00 5,842.00 5,602.00 5,602.00

MABTHERA RITUXIMABCONCENTRATION OF SOLUTION FOR INFUSION AT 500 MG

1 BOTTLE 50 ML 13,737.00 13,737.00 13,475.00 13,475.00

NEXAVAR SORAFENIB FILM-COATED TABLETS 200 MG 1 BOX 60 TABLETS 21,152.00 21,152.00 20,745.00 20,745.00

SALAZOPYRIN SULFASALAZINE 141.70 141.70 88.30 88.30

PROGRAF TACROLIMUS CAPSULE 1 MG 1 BOX 100 CAPSULE 1,980.00 1,980.00 1,703.00 1,703.00

TAFEN TAMOXIFENE TABLETS 10 MG 1 BOX 20 TABLETS 50.00 50.00

TAMOXIFENE MYLAN TAMOXIFENE TABLETS 10 MG 1 BOX 30 TABLETS 78.60 78.60 49.10 49.10

NOLVADEX TAMOXIFENE FILM-COATED TABLETS 10 MG 1 BOX 30 TABLETS 132.50 78.60 87.60 49.10

NOLVADEX TAMOXIFENE COATED TABLETS 20 MG 1 BOX 30 TABLETS 124.30 124.30 77.70 77.70

TAFEN TAMOXIFENE TABLETS 20 MG 1 BOX 30 TABLETS 124.30 124.30 77.70 77.70

TAMOXIFENE GT 20 MG TAMOXIFENE TABLETS 20 MG 1 BOX 30 TABLETS 124.30 124.30 77.70 77.70

TAMOXIFENE MYLAN TAMOXIFENE TABLETS 20 MG 1 BOX 30 TABLETS 124.30 124.30 77.70 77.70

UFT TEGAFUR / URACILE

CAPSULE 100 / 224 MG / MG

1 BOX 21 CAPSULE 1,831.00 1,831.00 1,576.00 1,576.00



1 BOX 28 CAPSULE 2,442.00 2,442.00 2,102.00 2,102.00



1 BOX 35 CAPSULE 2,952.00 2,952.00 2,627.00 2,627.00



1 BOX 42 CAPSULE 3,463.00 3,463.00 3,153.00 3,153.00

TEMODAL TEMOZOLOMIDE CAPSULE 5 MG 1 BOTTLE 5 CAPSULE 219.00 219.00 137.00 137.00

TEMODAL TEMOZOLOMIDE CAPSULE 20 MG 1 BOTTLE 5 CAPSULE 840.00 840.00 558.00 558.00

80




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

TEMODAL TEMOZOLOMIDE CAPSULE 100 MG 1 BOTTLE 5 CAPSULE 3,156.00 3,156.00 2,837.00 2,837.00

TEMODAL TEMOZOLOMIDE CAPSULE 250 MG 1 BOTTLE 5 CAPSULE 6,392.00 6,392.00 6,168.00 6,168.00

THIOTEPA THIOTEPAPOWDER FOR PARAENTERAL USE À 15 MG

1 BOX 1 BOTTLE 191.90 191.90 126.90 126.90

HERCEPTIN TRASTUZUMABPOWDER FOR PARAENTERAL USE À 150 MG

1 BOX 1 BOTTLE 6,890.00 6,890.00 6,681.00 6,681.00

DECAPEPTYL LP TRIPTORELINEPOWDER FOR SUSPENSION INJECTION 3.75 MG

1 BOX 1 BOTTLE + AMPULE 1,456.00 1,456.00 1,190.00 1,190.00

DECAPEPTYL LP TRIPTORELINEPOWDER FOR SOLUTION INJECTION 11.25 MG

1 BOX 1 BOTTLE + AMPULE 3,546.00 3,546.00 3,239.00 3,239.00

DECAPEPTYL TRIPTORELINEPOWDER FOR SOLUTION INJECTION 0.1 MG

1 BOX 7 KIT 467.00 467.00 310.00 310.00

OKA-VINBLASTINVINBLASTINEPOWDER FOR SOLUTION INJECTION 10 MG

1 BOTTLE 10 ML 124.00 124.00 77.50 77.50

PHARMACRISTINE 1 MG/ML VINCRISTINE SOLUTION


VINCRISTINE COOPER VINCRISTINE SOLUTION


OKA-VINCRISTINE VINCRISTINE SOLUTION


VINCRISTINE COOPER VINCRISTINE SOLUTION


NAVELBINE VINORELBINE SOLUTION INJECTION 10 MG 1 BOTTLE 1 ML 246.00 246.00 154.00 154.00

NAVELBINE VINORELBINE SOLUTION INJECTION 10 MG 10 BOTTLE 1 ML 1,764.00 1,764.00 1,507.00 1,507.00

NAVELBINE VINORELBINE SOLUTION INJECTION 50 MG 1 BOTTLE 5 ML 1,022.00 1,022.00 743.00 743.00

NAVELBINE VINORELBINE SOLUTION INJECTION 50 MG 10 BOTTLE 5 ML 7,483.00 7,483.00 7,291.00 7,291.00

NAVELBINE VINORELBINE CAPSULES 20 MG 1 BOX 1 CAPSULE 771.00 771.00 512.00 512.00

NAVELBINE VINORELBINE CAPSULES 30 MG 1 BOX 1 CAPSULE 1,028.00 1,028.00 750.00 750.00

SOLUPRED PREDNISOLONE 1 BOX 30 TABLETS 33.30 28.00 20.80 17.50

ISOLONE PREDNISOLONE TABLETS 20 MG 1 BOX 30 TABLETS 57.10 57.10 35.70 35.70

ORAPRED PREDNISOLONE EFFERVESCENT TABLETS 20 MG 1 BOX 30 TABLETS 65.00 65.00 40.60 40.60

81




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)

ORAPRED 5 MG PREDNISOLONE EFFERVESCENT TABLETS 5 MG

1 BOX 60 TABLETS EFFERVESCENT 38.00 38.00 23.70 23.70

CORTANCYL PREDNISONE TABLETS 20 MG 1 BOX 20 TABLETS 45.80 45.80 28.60 28.60

ISONE PREDNISONE TABLETS 20 MG 1 BOX 20 TABLETS 57.10 57.10 35.70 35.70






CEKACORT

PREDNISONE / ACIDE ASCORBIQUE (VITAMINE C) / CHLORURE DE

GASTRO-RESISTANT COATED TABLETS 5 / 125 / 125 MG /

1 BOX 30 TABLETS 20.30 20.30 12.70 12.70

EFFIPRED PREDNISOLONE ORAL SOLUTION 1 MG 1 BOTTLE 50 ML 21.60 21.60 13.50 13.50

SOLUPRED PREDNISOLONE SOLUTION 1 MG 1 BOTTLE 50 ML 27.00 21.60 17.90 13.50

COTIPRED PREDNISOLONE EFFERVESCENT TABLETS 20 MG 1 BOX 20 TABLETS 48.50 48.50 30.30 30.30

PREDNISOLONE WIN PREDNISOLONE EFFERVESCENT

TABLETS 20 MG1 BOTTLE 20 TABLETS 35.50 35.50 22.20 22.20

HOSTACORTIN H PREDNISOLONE TABLETS 5 MG 1 BOX 20 TABLETS 21.70 21.70 13.60 13.60

SIPROZONE PREDNISOLONE TABLETS 20 MG 1 BOX 20 TABLETS 35.00 35.00 21.90 21.90

ISOLONE PREDNISOLONE EFFERVESCENT TABLETS 20 MG 1 BOX 20 TABLETS 40.00 40.00 25.00 25.00

PREDNI 20 PREDNISOLONE EFFERVESCENT TABLETS 20 MG 1 BOX 20 TABLETS 42.00 42.00 26.20 26.20

EFFIPRED PREDNISOLONE EFFERVESCENT TABLETS 20 MG 1 BOX 20 TABLETS 58.40 58.40 36.50 36.50

SOLUPRED PREDNISOLONE EFFERVESCENT TABLETS 20 MG 1 BOX 20 TABLETS 58.40 58.40 36.50 36.50

ISOLONE PREDNISOLONE TABLETS 50 MG 1 BOX 20 TABLETS 85.80 85.80 53.60 53.60

ORAPRED 5 MG PREDNISOLONE EFFERVESCENT TABLETS 5 MG 1 BOX 30 TABLETS 20.00 20.00 12.50 12.50

82




CommonInternational



(PPM)


(PPM)


Price for reimburse

ment (PHM)



EFFIPRED PREDNISOLONE EFFERVESCENT TABLETS 5 MG 1 BOX 30 TABLETS 28.00 28.00 17.50 17.50

83



6.5 Bibliography

1. book, C.T.W.F. Morocco. [cited 2014 24th July]; Available from: https://www.cia.gov/library/publications/the-world-factbook/fields/2102.html#138.

2. Bank, W. Data: Morocco. 15th April, 2014]; Available from: http://data.worldbank.org/country/morocco.

3. Reports, U.H.D. Morocco. 15th April, 2014]; Available from: http://hdr.undp.org/sites/default/files/Country-Profiles/MAR.pdf.

4. Sante, R.d.M.M.d.l., strategie sectorielle de sante maroc 2012-2016. 2012.

5. Solidarity, E.F.f.D.a. Coutry update-Morocco. 2014 [cited 2014 15th December]; Available from: http://www.europeanforum.net/country/morocco.

6. WHO. THE MOROCCO COUNTRY CASE STUDY: Positive Practice Environments. 18th April, 2014]; Available from: http://www.who.int/workforcealliance/knowledge/PPE_Morocco_CaseStudy.pdf?ua=1.

7. WHO. Country Cooperation Strategy for WHO and Morocco 2008–2013. 16th April, 2014]; Available from: http://www.who.int/countryfocus/cooperation_strategy/ccs_mar_en.pdf.

8. Observatory-WHO, R.H.S., Health System Profile-Morocco. 2006.

9. Ruger, J.P. and D. Kress, Health financing and insurance reform in Morocco. Health Aff (Millwood), 2007. 26(4): p. 1009-16.

10. CNSS, M. Key figures. 30th April, 2014]; Available from: http://www.cnss.ma/fr/content/chiffres-cl%C3%A9s-1.

11. ANAM, Roadmap 2014-18. 2014.

12. experts, D.w., Discussion with experts. 2014.

13. INTERNATIONALHEALTH, H.P.D.T.I.F. REGISTERING NEW DRUGS: THE AFRICAN CONTEXT. 6th April, 2014]; Available from: http://www.policycures.org/downloads/DNDi_Registering_New_Drugs-The_African_Context_20100108.pdf.

14. Dr Javier Guzman, Director of R., Health Policy Division, The George Institute for International Health. REGISTERING NEW DRUGS: THE AFRICAN CONTEXT New tools for new times. 6th April, 2014]; Available from: http://www.conceptfoundation.org/files/meeting/16.%20Guzman%20-%20Registering%20new%20drugs%20the%20African%20context.pdf.

15. Pharmaceutique, A.M.d.l.I. Loi n° 17-04 portant code du médicament et de la pharmacie. [cited 2014 18th July]; Available from: http://www.amip.ma/dynamicdata/Secteur_Codepharmacie.aspx.

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6.6 Methodology

6.6.1 Secondary research

In-depth and extensive secondary research was conducted to capture quantitative and qualitative information by a team of experienced consultants with advanced analytical skills and expertise in the pharmaceutical industry. The data was collected from multiple credible and authentic sources within public domain, including but not limited to:

• Websites of Ministry of Health and its affiliates as well as various regulatory and government bodies.

• Company websites, annual reports, investor presentations and press releases of various pharmaceutical companies and hospitals.

• Reports of various healthcare and pharmaceutical trade associations.• Reports published by various internationally recognized bodies such as World Health

Organization (WHO), United Nations (UN), and others.• Reports and articles published by globally accredited institutions such as the World Bank,

International Monetary Fund (IMF), Asian Development Bank (ADB), the Organization for Economic Cooperation and Development (OECD), Central Banks of respective countries and many more.

• News, press releases and bulletins of domestic as well as foreign newspapers and magazines.• Publications in various scientific, healthcare and other related journals.

6.6.2 Data validation

Both the primary and secondary data was validated by a panel of experts including industry experts, KOLs, thought leaders and members of phamax Dendron Network.

6.7 Disclaimer

All information contained in this publication has been thoroughly researched and compiled from various sources that are believed to be accurate and credible at the time of publishing. However, in view of the natural scope for human and/or mechanical error, either at source or during production, phamax accepts no liability whatsoever for any loss or damage resulting from errors, inaccuracies or omissions from any part of the publication. All information is provided without warranty, and phamax makes no representation of warranty of any kind as to the accuracy or completeness of any information hereto contained.

The information contained in this report is strictly confidential and has been provided to the client under a non-exclusive and non-transferable license for the client’s direct benefit and use only. The report should not be copied, electronically transmitted, sold or divulged to any other party without the prior written consent of phamax.

© 2015 phamax AG. All rights reserved.

85



6.8 Contact us

All communications pertaining to this report should be addressed to:

SWITZERLAND OFFICE

phamax AGPassage 6,4104 Oberwil (BL), SWITZERLANDPhone: +41 61821 5687Fax: +41 61821 5836E-mail: [email protected]

INDIA OFFICE

phamax Analytic Resources Pvt. Ltd.#19, “KMJ Ascend”, 1st Cross, 17th C Main,5th Block, Koramangala, Bangalore 560 095, INDIAPhone no: +91 80 6745 1100Fax no: +91 80 6745 1122E-mail: [email protected]

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