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[{"$nulls":22},"Додаток 1                                                                                                                              до Методики розрахунку потреби в протитуберкульозних препаратах                                                                                 (пункт 1.8 розділу І)            "]
["Розрахункова форма для обчислення потреби у ПТП 1-2 рядів"]
["№ з/п","Назва предмета закупівлі, форма випуску, дозування ","Для якої категорії хворих ","Код","Визначе-на кількість хворих ","У тому числі кількість хворих, які лікую-ться за рахунок ГФ","Курсо-ва потре-ба на 1 хворо-го (од.)","Коефі-цієнт","Потреба на рік (100 %)","Потреба з резервом  (200 %)"," Залишок на 01.06.2014  (од.)","Поставле-но (не враховано у залишках) (од.)","Гарантова-ний розподіл комбі-препаратів ГФ","Фактична потреба (од.)","Орієнтовна ціна одиниці (грн)","Розрахунко-ва заявка на 2014 рік (од.)","Вартість розрахунко-вої заявки на 2014 рік (грн)","Заявка в межах квоти на 2014 рік (од.)","Вартість заявки в межах квоти на 2014 рік (грн)","Надлишок залишків відносно потреби з резервом (од.)","Надлишок залишків відносно потреби з резервом (грн.)","\"+\"                           відхилення заявки в межах квоти від розрахунко-вої (од.)","\"+\"                                                           відхилення заявки в межах квоти від розрахунко-вої  (грн)","\"-\"                                        відхилення заявки в межах квоти від розрахунко-вої (од.)","\"-\"                                            відхилення заявки в межах квоти від розрахунко-вої  (грн)","Відсоток забезпече-ння потреби з урахува-нням резерву"]
[1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26]
[{"$nulls":9},"ПРОТИТУБЕРКУЛЬОЗНІ ПРЕПАРАТИ 1-ГО РЯДУ"]
[1,"Ізоніазид (табл., капс., драже, 100 мг)","Кат. 1-3 діти","ТБ                               (Н/діти)",null,null,270,0.8,0,0]
[null,null,"Кат 2 (ІІ-Е) діти",null,null,null,360,0.8,0,0]
[null,null,"Кат. 5.1- діти  ","ХП                           (Н/діти)",null,null,135,0.8,0,0]
[null,null,"Кат. 5.2- діти ","ХП                           (Н/діти)",null,null,135,0.8,0,0]
[null,null,"Кат. 5.4.1 - діти  ","ХП                           (Н/діти)",null,null,135,0.8,0,0]
[null,null,"ВІЛ-інф. - діти ","ХП                           (Н/діти)",null,null,270,0.8,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,0.05,0,0,0,0,0,0,0,0,0,0,0]
[2,"Ізоніазид сироп (пляшки, фл., 4000 мг)","Для дітей                     0-3 роки","Н/сир.                           діти",null,null,null,0.2,0,0]
[null,null,"Кат 5.1.- діти  0-3рр.",null,0,null,null,null,0,0,null,null,null,0,null,0,null,0,null,0,null,0,null,0]
[null,null,"Кат 5.2.         (0-3рр.                             з МБТ \"+\")",null,0,null,null,null,0,0,null,null,null,0,null,0,null,0,null,0,null,0,null,0]
[null,null,"Кат 5.2.          ( 0-3рр.                          з МБТ \"-\")",null,0,null,null,null,0,0,null,null,null,0,null,0,null,0,null,0,null,0,null,0]
[null,null,"Кат 5.4. діти 0-3 рр.",null,0,null,null,null,0,0,null,null,null,0,null,0,null,0,null,0,null,0,null,0]
[null,"У с ь о г о"," ",null,"Х","Х","Х",null,0,0,0,0,0,0,35.59,0,0,0,0,0,0,0,0,0,0,0]
[3,"Ізоніазид (табл., капс., драже, 300 мг)","Кат. 1-3 (дорослі)","ТБ                               (Н/стан-дарт)",null,null,180,0.82,0,0]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (Н/інд.)",null,null,270,0.62,0,0]
[null,null,"Кат. 4 (Б)              паліативне лікування","ТБ                               (Н/ паліатив)",null,null,90,0.7,0,0]
[null,null,"ВІЛ-інф. (дорослі)","ХП 1                              (Н/дор.)",null,null,180,0.73,0,0]
[null,null,"Кат 5.2. (дорослі)","ХП 2                              (Н/ дор.)",null,null,180,0.7,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,0.11,0,0,0,0,0,0,0,0,0,0,0]
[4,"Ізоніазид (фл., амп., шпр., 500 мг)","5%  від                     кат. 1-2 ","Н/Е                                      - розчин",0,null,30,0.05,0,0]
[null,"У с ь о г о"," ",null,0,0,"Х",null,0,0,0,0,0,0,0.88,0,0,0,0,0,0,0,0,0,0,0]
[5,"Рифампі-цин (табл., капс., драже, 150 мг)","Кат. 1-3 (дорослі)","ТБ                               (R/ станд.)",0,null,720,0.82,0,0]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (R/інд.)",0,null,720,0.9,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,0.26,0,0,0,0,0,0,0,0,0,0,0]
[6,"Рифабутин","Хв. ТБ/ВІЛ                     1-3 кат.           (для тих, хто отримує АРТ-2)","Rfb                       (ВІЛ)",null,null,720,0.03,0,0]
[null,null,"Кат. 1-3 (дорослі) для тих, хто отримує ЗПТ","Rfb                       (ЗПТ)",0,null,360,0.01,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,11.9,0,0,0,0,0,0,0,0,0,0,0]
[7,"Етамбутол (табл., капс., драже, 400 мг)","Кат. 1-3 (дорослі)","ТБ                               (Е/станд.)",0,null,180,0.82,0,0]
[null,null,"Кат. 1-2,      4.3 (А)             ПоліРезТБ ","х/р ТБ                               (R/ інд.)",0,null,720,null,0,0]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (Е/інд.)",0,null,1200,0.8,0,0]
[null,null,"Кат.4                         (4.1А-4.2А)     МР/РРТБ","МР                          (Е/інд.)",0,null,1140,0.4,0,0]
[null,null,"Для схем ХП у дітей","ХП                           (Е/ діти)",0,null,135,0.5,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,0.32,0,0,0,0,0,0,0,0,0,0,0]
[8,"Етамбутол (фл., амп., шпр., 2000 мг)","5% від                     кат. 1-2 ","Н/Е                                      - розчин",0,null,30,0.05,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,35.37,0,0,0,0,0,0,0,0,0,0,0]
[9,"Піразинамід (табл., капс., драже, 500 мг)","Кат. 1-3 (дорослі)","ТБ                               (Z/станд.)",0,null,240,0.82,0,0]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (Z/інд.)",0,null,1200,0.9,0,0]
[null,null,"Кат.4                         (4.1А-4.2А)     МР/РРТБ","МР                          (Z/станд.)",0,null,1440,1,0,0]
[null,null,"Для схем ХП у дітей","ХП                           (Z/ діти)",0,null,180,0.5,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,0.25,0,0,0,0,0,0,0,0,0,0,0]
[10,"Стрептоміцин (фл., амп., шпр., 1000 мг)","Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                       (S/інд.)",0,null,50,0.15,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,1.75,0,0,0,0,0,0,0,0,0,0,0]
["ПРОТИТУБЕРКУЛЬОЗНІ ПРЕПАРАТИ 2-ГО РЯДУ"]
["Ін'єкційні :"]
[11,"Канаміцин (фл., амп., шпр., 1000 мг)","Кат. 4 (4.1А-4.2А) МР ТБ         ","МР ТБ/14",null,null,150,0.75,0,0]
[null,null,null,"МР ТБ/13",null,null,75,0.75,0,0]
[null,null,null,"МР ТБ/12"]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (Km/інд.)",0,0,115,0.35,0,0]
[null,null,"НЛ-2 ризик","НЛ 2         ризик (Km)",null,null,45,1,0,0]
[null,null,"Контакти МРТБ","Конт-ризик (Km)",null,null,200,0.85,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,7.88,0,0,0,0,0,0,0,0,0,0,0]
[12,"Капреоміцин (фл., амп., шпр., 1000 мг)","Кат. 4 (4.1А-4.2А)  МР ТБ        ","МР ТБ/14",0,0,150,0.25,0,0]
[null,null,null,"МР ТБ/13",0,0,75,0.25,0,0]
[null,null,null,"МР ТБ/12",0,0]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (Сm/інд.)",0,0]
[null,null,"НЛ-2 ризик","НЛ 2         ризик (Сm)",0,0]
[null,null,"Контакти МРТБ","Конт-ризик (Сm)",0,0,200,0.15,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,103,0,0,0,0,0,0,0,0,0,0,0]
["Фторхінолони:"]
[13,"Левофлоксацин (табл., капс., драже, 250 мг)","Кат. 4 (4.1А) МРТБ       ","МРТБ/14 (Lfx)",0,0,180,0.85,0,0]
[null,null,null,"МРТБ/13 (Lfx)",0,0,360,0.85,0,0]
[null,null,null,"МРТБ/12 (Lfx)",0,0,90,0.85,0,0]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (Lfx/ інд.)",0,0,360,1,0,0]
[null,null,"НЛ-2 ризик","НЛ 2         ризик (Lfx)",0,0,46.666666666666664,1,0,0]
[null,null,"Контакти МРТБ","Конт-ризик (Lfx)",0,0,360,0.85,0,0]
[null,"в с ь о г о:",null,null,0,0,"Х",null,0,0,0,0,0,0,0.41,0,0,0,0,0,0,0,0,0,0,0]
[13,"Левофлоксацин (табл., капс., драже, 500 мг)","Кат. 4                  (4.1А-4.2А)                                         МР ТБ       ","МР ТБ/14 (Lfx)",0,0,270,0.75,0,0]
[null,null,null,"МР ТБ/13 (Lfx)",0,0,540,0.75,0,0]
[null,null,null,"МР ТБ/12 (Lfx)",0,0,135,0.75,0,0]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (Lfx/інд.)",0,0,540,1,0,0]
[null,null,"НЛ-2 ризик","НЛ 2         ризик (Lfx)",0,0,70,1,0,0]
[null,null,"Контакти МРТБ","Конт-ризик (Lfx)",0,0,540,0.85,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,0.75,0,0,0,0,0,0,0,0,0,0,0]
[14,"Левофлоксацин (табл., капс., драже, 250 мг)","Кат. 4                  (4.1А-4.2А) МР ТБ       ","МР ТБ/14 (Lfx)",0,0,180,0.75,0,0]
[null,null,null,"МР ТБ/13 (Lfx)",0,0,360,0.75,0,0]
[null,null,null,"МР ТБ/12 (Lfx)",0,0,90,0.75,0,0]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (Lfx/інд.)",0,0,540,1,0,0]
[null,null,"НЛ-2 ризик","НЛ 2         ризик (Lfx)",0,0,70,1,0,0]
[null,null,"Контакти МРТБ","Конт-ризик (Lfx)",0,0,540,0.85,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,0.41,0,0,0,0,0,0,0,0,0,0,0]
[15,"Гатифлоксацин (пляшки, фл., 400 мг)","Кат. 4                  (4.1А-4.2А)                                                МР ТБ       ","МР ТБ/14 (Gfx)",0,0,45,0.15,0,0]
[null,null,null,"МР ТБ/13 (Gfx)",0,0,15,0.15,0,0]
[null,null,null,"МР ТБ/12 (Gfx)",0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,48.36,0,0,0,0,0,0,0,0,0,0,0]
[16,"Моксифлоксацин (табл., капс., драже, 400 мг)","Кат. 4                  (4.1А-4.2А)          МР  ТБ       ","МР ТБ/14 (Mfx)",0,0,180,0.25,0,0]
[null,null,null,"МР ТБ/13 (Mfx)",0,0,360,0.25,0,0]
[null,null,null,"МР ТБ/12 (Mfx)",0,0,90,0.25,0,0]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (Mfx/інд.)",0,0]
[null,null,"НЛ-2 ризик","НЛ 2         ризик (Mfx)",0,0]
[null,null,"Контакти МРТБ","Конт-ризик (Mfx)",0,0,360,0.15,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,24.05,0,0,0,0,0,0,0,0,0,0,0]
["Пероральні МБТ-статики:"]
[17,"Натрію аміносаліцилат                                      (гранули,                                         кишково-розчинні,                          1000 мг)","Кат. 4                  (4.1А-4.2А) МР ТБ       ","МР ТБ/14 (PAS)",0,0,1440,0.6,0,0]
[null,null,null,"МР ТБ/13 (PAS)",0,0,2880,0.6,0,0]
[null,null,null,"МР ТБ/12 (PAS)",0,0,720,0.6,0,0]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (PAS/інд.)",0,0]
[null,null,"НЛ-2 ризик","НЛ 2         ризик (PAS)",0,0]
[null,null,"Контакти МРТБ","Конт-ризик (PAS)",0,0,3600,0.6,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,2.88,0,0,0,0,0,0,0,0,0,0,0]
[18,"Протіонамід (табл., капс., драже, 250 мг)","Кат. 4                  (4.1А-4.2А) МР ТБ       ","МР ТБ/14 (Pt)",0,0,540,1,0,0]
[null,null,null,"МР ТБ/13 (Pt)",0,0,1080,1,0,0]
[null,null,null,"МР ТБ/12 (Pt)",0,0,270,1,0,0]
[null,null,"Кат. 1-2, 4.3 (А) ПоліРезТБ ","х/р ТБ                               (Pt/ інд.)",0,0,1080,0.15,0,0]
[null,null,"НЛ-2 ризик","НЛ 2         ризик (Pt)",0,0,135,1,0,0]
[null,null,"Контакти МРТБ","Конт-ризик (Pt)",0,0,1080,1,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,1.29,0,0,0,0,0,0,0,0,0,0,0]
[19,"Циклосерин (табл., капс., драже, 250 мг)","Кат. 4                  (4.1А-4.2А) МР ТБ       ","МР ТБ/14 (Cs)",0,0,540,1,0,0]
[null,null,null,"МР ТБ/13 (Cs)",0,0,1080,1,0,0]
[null,null,null,"МР ТБ/12 (Cs)",0,0,270,1,0,0]
[null,null,"Кат. 1-2, 4.3 (А)             ПоліРезТБ ","х/р ТБ                               (Cs/інд.)",0,0]
[null,null,"НЛ-2 ризик","НЛ 2         ризик (Cs)",0,0,135,1,0,0]
[null,null,"Контакти МРТБ","Конт-ризик (Cs)",0,0,1080,1,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,5.28,0,0,0,0,0,0,0,0,0,0,0]
["Препарати з невизначеною ефективністю:"]
[20,"Клофазимін (табл., капс., драже, 100 мг)","Кат. 4                  (4.1А-4.2А) МР ТБ       ","МР ТБ/14 (Cfz)",0,0,360,0.075,0,0]
[null,null,null,"МР ТБ/13 (Cfz)",0,0,720,0.075,0,0]
[null,null,null,"МР ТБ/12 (Cfz)",0,0,720,0.075,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,4.33,0,0,0,0,0,0,0,0,0,0,0]
[21,"Лінезолід (табл., капс., драже, 600 мг)","Кат. 4                  (4.1А-4.2А) МРТБ       ","МР ТБ/14 (Lzd)",0,0,180,0.075,0,0]
[null,null,null,"МР ТБ/13 (Lzd)",0,0,360,0.075,0,0]
[null,null,null,"МР ТБ/12 (Lzd)",0,0,90,0.075,0,0]
[null,"У с ь о г о",null,null,0,0,"Х",null,0,0,0,0,0,0,24.69,0,0,0,0,0,0,0,0,0,0,0]
[null,"Вартість загалом (грн)",{"$nulls":6},0,0,0,0,0,null,null,null,0,null,0,null,0,null,0,null,0]
[null,"у тому числі ПТП 1 ряду",{"$nulls":6},0,0,0,0,0,null,null,null,0,null,0,null,0,null,0,null,0]
[null,"у тому числі ПТП 2 ряду",{"$nulls":6},0,0,0,0,0,null,null,null,0,null,0,null,0,null,0,null,0]
[null,"Квота",{"$nulls":14}," ",null," ",null," ",null," ",null," "," "]
["Звертаємо Вашу увагу!"]
[null,null,"   Заповнюються лише графи 11,12, 13, 18 та ячейки з граф 5, 6, позначені жовтим кольором."]
[]
[]
[]
["Керівник ТООЗ _________________________________________________________",{"$nulls":9}," "]
["Головний фтизіатр ТООЗ_________________________________________________  ",{"$nulls":9}," "]