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["附件2"]
["2025年12月新药、参比制剂和过评药品申报需提供成本和价格构成表产品清单"]
["序号","招采药品代码","药品名称","规格名称","转换比","生产企业名称","申报企业名称","批准文号","药品类别","最小制剂申报价格（元）","拟包装挂网价格（元）","备注"]
[1,"XJ01FAK067N001030104172","克拉霉素颗粒","0.125g/5ml,每瓶含克拉霉素1.5g",1,"新华制药(高密)有限公司","新华制药（高密）有限公司","国药准字H20010616","一致性评价药品",75,75,"附件3"]
[2,"XA03AXJ096A022010184106","间苯三酚口崩片","80mg(以C₆H₆O₃•2H₂O计)",4,"湖南先施制药有限公司","湖南先施制药有限公司","国药准字H20249511","一致性评价药品",17.29,69.16,"附件3"]
[3,"XA03AXJ096A022010284106","间苯三酚口崩片","80mg(以C₆H₆O₃•2H₂O计)",6,"湖南先施制药有限公司","湖南先施制药有限公司","国药准字H20249511","一致性评价药品",17.035,102.21,"附件3"]
[4,"XA03AXJ096A022010384106","间苯三酚口崩片","80mg(以C₆H₆O₃•2H₂O计)",10,"湖南先施制药有限公司","湖南先施制药有限公司","国药准字H20249511","一致性评价药品",16.721,167.21,"附件3"]
[5,"XS01GXY079G010010184784","盐酸依匹斯汀滴眼液","0.05%(5ml:2.5mg)",1,"润尔眼科药物(广州)有限公司","润尔眼科药物（广州）有限公司","国药准字H20253568","一致性评价药品",70,70,"附件3"]
[6,"XB02BAW055X004010182886","维生素K₁滴剂","1mg(按C₃₁H₄₆O₂计)",4,"广西铭磊维生制药有限公司","广西铭磊维生制药有限公司","国药准字H20253771","一致性评价药品",79.95,319.8,"附件3"]
[7,"XR06AXY065X001010185084","依巴斯汀口服溶液","120ml:120mg",1,"南京海纳制药有限公司","福建品腾药业有限公司","国药准字H20254099","一致性评价药品",97.8,97.8,"附件3"]
[8,"XA06ADF748P001010102544","复方聚乙二醇(3350)电解质维C散","每袋A剂含聚乙二醇3350100g、硫酸钠7.500g、氯化钠2.691g、氯化钾1.015g;每袋B剂含维生素C4.700g、维生素C钠5.900g",2,"杨凌科森生物制药有限责任公司","杨凌科森生物制药有限责任公司","国药准字H20254772","一致性评价药品",74,148,"附件3"]
[9,"XR03DAC011A010030104964","茶碱缓释片","0.1g(按C₇H₈N₄O₂计)",14,"湖南绅泰春制药股份有限公司","湖南绅泰春药业有限公司","国药准字H43020832","一致性评价药品",3.65,51.1,"附件3"]
[10,"XR03DAE030B002010184730","二羟丙茶碱注射液","2ml:0.3g",1,"成都市海通药业有限公司","成都市海通药业有限公司","国药准字H20253266","一致性评价药品",51.8,51.8,"附件3"]
[11,"XA06ADF748P001010101606","复方聚乙二醇(3350)电解质维C散","每袋A剂含聚乙二醇3350 100g、硫酸钠7.500g、氯化钠2.691g、氯化钾1.015g;每袋B剂含维生素C 4.700g、维生素C钠5.900g",2,"南京正大天晴制药有限公司","南京正大天晴制药有限公司","国药准字H20254017","一致性评价药品",74,148,"附件3"]
[12,"XG04BEX006X006010183242","枸橼酸西地那非干混悬剂","1.12g(按C₂₂H₃₀N₆O₄S计)",1,"南京海纳制药有限公司","南京海纳医药科技股份有限公司","国药准字H20244950","一致性评价药品",623.2,623.2,"附件3"]
[13,"XB05BBC177B002010100841","醋酸钠林格葡萄糖注射液","500ml",1,"扬子江药业集团上海海尼药业有限公司","扬子江药业集团上海海尼药业有限公司","国药准字H20244913","一致性评价药品",130.2,130.2,"附件3"]
[14,"XR06AAB058B002010106917","盐酸苯海拉明注射液","1ml:50mg",1,"上海朝晖药业有限公司","上海朝晖药业有限公司","国药准字H20258139","一致性评价药品",159.32,159.32,"附件3"]
[15,"XB02BAW055B002020105791","维生素K₁注射液","1ml:10mg",1,"海南倍特药业有限公司","海南倍特药业有限公司","国药准字H20253984","一致性评价药品",51.43,51.43,"附件3"]
[16,"XS02AAY040Q010010102562","氧氟沙星滴耳液","0.3%(5ml:15mg)",1,"山东光明药业有限公司","山东光明药业有限公司","国药准字H20249487","一致性评价药品",28.68,28.68,"附件3"]
[17,"XR06AXT061X001010183128","富马酸酮替芬口服溶液","150ml:30mg(按C₁₉H₁₉NOS计)",1,"海南合瑞制药股份有限公司","海口天行健药物研究有限公司","国药准字H20254155","一致性评价药品",98,98,"附件3"]
[18,"XA03FAJ085B002010183995","盐酸甲氧氯普胺注射液","2ml:10mg(以C₁₄H₂₂ClN₃O₂·HCl计)",1,"江苏九旭药业有限公司","南京赛瑞谱顿制药有限公司","国药准字H20255274","一致性评价药品",29.6,29.6,"附件3"]
[19,"XA03FAJ085B002010209592","盐酸甲氧氯普胺注射液","2ml:10mg(按C₁₄H₂₂ClN₃O₂·HCl计)",1,"朗天药业(湖北)有限公司","朗天药业（湖北）有限公司","国药准字H20255399","一致性评价药品",19.6,19.6,"附件3"]