Outpatient Treatments And Medicines For The Purchase Of Medical Equipment For The Refund Procedure

Original Language Title: Ambulatorajai ārstēšanai paredzēto zāļu un medicīnisko ierīču iegādes izdevumu kompensācijas kārtība

Subscribe to a Global-Regulation Premium Membership Today!

Key Benefits:

Subscribe Now

Read the untranslated law here: https://www.vestnesis.lv/ta/id/147522

Cabinet of Ministers Regulations No. 899 Riga 2006 (31 October. No 56 50) Outpatient treatments and medicines for the purchase of medical equipment for the refund order Issued in accordance with article 5 of the law on Pharmacy of 20 i. General questions 1. Rules provide outpatient treatments and medicines for the purchase of medical equipment for compensation procedures (hereinafter referred to as the compensation procedures).
2. the compensation arrangements include a set of measures that ensure the patient a chance to buy the medicines and medical devices, the purchase of which under these provisions partly or fully covered from the State budget for the current year the purchase of medicinal products granted compensation funds (hereinafter funds allocated for compensation).
II. basic principles of compensation procedures 3. Amount of countervailable medicine list (a list that includes medicines and medical equipment acquisition expenses pursuant to those provisions covered from funds allocated for compensation) of the medicinal products (hereinafter referred to as the compensated medication) and medical devices (hereafter referred to as eligible medical devices) acquisition costs, in accordance with these rules shall be borne by patients who have been diagnosed with any of the rules referred to in annex 1 of the diseases, taking into account the nature of the disease and the severity and abiding compensation limits and discharge conditions.
4. the purchase of medicinal products Eligible costs under the following categories: compensation of 4.1-Ikategorij 100% refund if a patient diagnosed a chronic, life-threatening disease or illness that causes severe permanent disability and whose treatment requires use of the medicinal product concerned to maintain the patient's vital functions;
4.2. IIkategorij-90% refund if a patient diagnosed chronic condition that treatment without the use of the medicinal product concerned is difficult patient vital signs maintenance or causing severe disability;
4.3. IIIkategorij – refund 75% if a patient diagnosed chronic or acute disease, the treatment of which requires the use of the medicinal product concerned, to maintain or improve the patient's health status;
4.4. IVkategorij-50% refund, if the use of the product is necessary to improve the health status of the patient, or in case of compensation for allocation to pay for the vaccine.
5. Eligible medical device group and the amount of compensation shall be determined in accordance with the provisions of annex 2.
6. The eligible list of medicines consists of three parts – Asarakst, Bsarakst and Csarakst. The eligible list for medicinal products produced in accordance with the following principles: 6.1. Asarakst according to paragraph 23 of these rules and criteria referred to in chapter IV includes interchangeable drugs medicine general medicine in the name or farmakoterapeitisk within the Group and interchangeable medical device;
6.2. Bsarakst according to paragraph 23 of these rules and criteria referred to in chapter V shall include the medicinal products and medical devices in the list of medicinal products eligible are not interchangeable medicines or medical devices;
6.3. Csarakst according to this provision, the criteria listed in chapter Vi includes medicines and medical devices, the cost of which one patient treatment more than a year and which 3000lat this provision referred to in paragraph 55 of the discharge conditions is not enough to limit the number of patients assigned to the corresponding compensation features.
7. Drugs which apply for inclusion in the list of medicinal products eligible, meet the following conditions: 7.1. Republic of Latvia are included in the list of medicinal products authorised or registered in one of the European Medicines Agency in the registration procedure or parallel imported or parallel imported in accordance with the laws and regulations on the import and distribution of medicinal products, or is authorized the veterinary medicinal product to be imported and distributed in the territory of the Republic of Latvia in accordance with article 10 of the law of Pharmacy 7;
7.2. medicines are classified as prescription medications in accordance with the laws and regulations on the classification of the medicinal product;
7.3. Summary of product characteristics contains the indication which corresponds to one of the provisions listed in annex 1.
8. Homeopathic medicinal products eligible shall not be included in the list of medicinal products.
9. Medical devices that are eligible for admission to the list of medicinal products shall comply with the following conditions: 9.1. they have been registered in Latvian register of medical devices or of Member States of the European Union in the common register of medical devices;
9.2. medical devices intended for use in these rules any disease listed in annex 1.
10. Medicine and medical equipment acquisition expenses to offset the countervailable in accordance with the list of medicinal products, which will create and maintain the price of a medicinal product, a government agency. The price of the medicinal product in the list of State Agency indicate the General name of the medicinal product, the name of the medicinal product drug code anatomic therapeutic chemical classification, identification number, registration certificate holder, pharmaceutical form, strength, package size, the base price of the refund, the pharmacy price (value added tax), the amount of the refund, and the category inclusion, as well as the deadlines for the medical device group name, identification number, registration certificate holder, the size of the compensation package for the base price, the pharmacy price (value added tax) amount of the refund and the inclusion in the category.
III. Medicines and medical equipment into the eligible list of medicines To grass or 11 medical devices included in the list of eligible medicines, drugs or medical devices registration holder (owner) or his authorized representative or a medicine or medical device wholesalers or his authorized representative (hereinafter applicant) shall submit the medicine price national agency a written application. The application shall state: 11.1. information about applicant (legal name, registration number, registered office) and the payer (account properties);
11.2. information about the medicinal product or medical device (name, registration number, registration date, the manufacturer's price and compensation for the base price, the packaging, the number of doses (packaging size)). Drugs in addition to indicate drug generic name drug code anatomic therapeutic chemical classification with the defined daily dose (ATC/DDD classification hereinafter), pharmaceutical form and strength (quantity of the dose of active substances);
11.3. the diagnosis of disease, indicating the code according to the international statistical problems of disease and health classes (10) (hereinafter referred to as the ICD classification), and the target group of patients (patients with diagnosis of the group to which the drug or medical device use is based), which assessed the treatment of medicine or medical equipment purchase expense compensation.
12. Application for the inclusion of a medicinal product in the list of medicinal products eligible applicant shall be accompanied by the following documents and information: 12.1. clinical research summary and copies of publications when referencing a source that proves this its therapeutic effectiveness and benefits compared to other alternative therapies available in Latvia (if submitting a new drug to the General name of the eligible list for medicinal products);
12.2. information about a drug company's sales price and country of the Member States of the European Union and in the currency in question, in the Latvia's fixed exchange rate on the date of submission of the application;
12.3. the expected compensation for the resources consumption calculation, including comparative therapy, patients and patient groups, as well as the calculation of the number of possible arrangements of compensation in the amount of the medicinal products marketed in Latvia and estimated turnover;
12.4. farmakoekonomisko calculation in accordance with the provisions laid down in annex 3 of the summary of the economic evaluation guidelines (if submitting a new drug to the General name of the eligible list for medicinal products);
12.5. a statement that will provide a permanent existence of countervailable medicines on the market until the end of the period for inclusion in the list of products eligible;
12.6. the registration certificate holder (owner) or pharmaceutical wholesaler issued token, if the applicant is the holder of the certificate of registration of the medicinal product (owner) or pharmaceutical wholesaler authorized representative;
12.7. a document showing that the applicant is registered in one of the countries of the European economic area, as well as representation of the identity document (copy);
12.8. information on the number of patients, which the the purchase of medicinal products, the applicant provides cover from its own funds, if the product to be Csarakst;
12.9. the producer price or base price of compensation, promotions, submit a justification if repeated application.
13. Where medicinal products are imported and distributed in the territory of the Republic of Latvia in accordance with article 10 of the law of pharmacy in point 7, the application from the applicant, the following information: 13.1. instructions for use of medicinal products in the national language and original language;
13.2. the wholesale price and the currency of the country of the exporting country and, in particular the Bank of Latvia exchange rate at the date of the application;

13.3. in the receipt that will ensure a permanent presence of the medicinal product on the market until the end of the period of inclusion in the list of products eligible;
shall UR13.4.apr on potential compensation procedures in Latvia to medicinal products marketed in the amount of the forecast turnover (in LCY) and the number of patients;
13.5. privileges provided by the State Agency of medicines authorisation for the import of medicines not registered holder, if the application is lodged by the authorized representative.
14. Where a medicinal product is imported in parallel (imported), the applicant submitted Mama added the following information: 14.1. manufacturer's sales price in the country and the exporting country's currency and, in the form laid down by the Bank of Latvia exchange rate at the date of the application;
14.2. in the receipt that will ensure a permanent presence of the medicinal product on the market until the end of the period of inclusion in the list of products eligible;
shall UR14.3.apr on potential compensation procedures in Latvia to medicinal products marketed in the amount of the forecast turnover (in LCY) and the number of patients;
14.4. the parallel importer's issuing authority, if the application is lodged by the authorized representative.
15. Application for the inclusion of medical devices eligible applicant in the list of medicinal products shall be accompanied by the following documents and information: 15.1 the medical equipment manufacturer's sales price in the country and the Member States of the European Union and in the currency in question, in the Latvia's fixed exchange rate on the date of submission of the application;
15.2. the expected compensation for the resources consumption calculation, including comparative therapy, patients and patient groups, as well as the calculation of the number of possible arrangements of compensation in the amount of medical devices sold and estimated turnover;
15.3. a statement that will ensure a permanent presence of medical devices on the market until the end of the period for inclusion in the list of products eligible;
15.4. medical devices registration holder (owner) of the issued token, if the application is lodged by the holder of the registration certificate (owner) authorized representative;
15.5. a document showing that the applicant is registered in one of the countries of the European economic area, as well as representation of the identity document (copy);
15.6. information on the number of patients that the medical equipment acquisition expenses, the applicant provides cover from its own funds, if the medical device is to be Csarakst;
15.7. the medical device description to the Latvian language.
16. the application for the review of the conditions of the discharge or the inclusion of other medicinal products on the list shall be accompanied by the following documents and information: 16.1. clinical research summary and copies of publications when referencing a source that proves the validity of the discharge conditions for review or inclusion of a medicinal product in another list a specific diagnosis or patient target group;
16.2. the expected compensation for the resources consumption calculation, including comparative therapy, patient groups and the target number of patients, as well as the calculation of the potential compensation procedures in Latvia and to medicinal products marketed medical devices and estimated turnover, changing the discharge conditions or including medication in another list;
16.3. farmakoekonomisko calculation in accordance with the provisions laid down in annex 3 of the summary of the economic evaluation guidelines that prove the validity of the discharge conditions for review or inclusion of a medicinal product in another list a specific diagnosis and patient for the target group.
17. the price of the medicinal product in addition to the State agency rules 11, 12, 13, 14, 15 and 16 of the above documents and information have the right to request a decision of the necessary additional information.
18. The applicant is responsible for the application and the documents attached to the information contained in the message. On application of registration of medicine price in national agency on its own initiative, the applicant shall not be entitled to amend the information referred to in the application. If the applicant wishes to amend the information referred to in the application, the application shall be submitted. Previous application is cancelled (paid for the new application is not required).
19. After the submission of the registration of the medicinal products the price of State Agency will invoice according to the price of the medicinal product by the national agency of public services price list.
20. on the basis of the applicant's submissions, drug prices, a government agency has the right to waive the fees for application and for inclusion of medical devices eligible for consideration in the list of medicinal products or fees for drugs and medical devices is maintained in the list of medicinal products, the amount or fee for the examination of application for the change of the ex-works price of the product, or refund the price of the base change of a parallel imported medicinal product (imported), or the fee for the examination of application for review of the conditions where: 20.1. the medicinal products or medical devices sales compensation procedures within the previous year does not exceed the 1500lat, but they are essential to the process of the treatment;
20.2. where medicinal products are imported into and distributed in the territory of the Republic of Latvia in accordance with article 10 of the law of Pharmacy 7.
21. the application of this provision in paragraph 20 that the cancellation of the fee, the applicant may be submitted at any time. If the price of the State Agency of medicines shall adopt a decision to cancel these terms the fee referred to in paragraph 20, it does not invoice the payment or withdraw already discharged Bill. If the applicant has already paid for the consideration of the application, the costs are not reimbursed to him.
22. In considering the application for medicine or medical equipment into the eligible list of medicines, pharmaceutical price National Agency carries out the following activities: 22.1. assessment and assess medicated: 22.1.1. published clinical studies on specific therapeutic efficiency of the medicinal benefits of farmakoterapeitisk within the group or the diagnosis with respect to mortality, incidence of chronic diseases, disability, hospitalisation, health improvement, compared to other available treatments;
22.1.2. compliance with doctors ' professional associations related to specific disease treatment schemes (hereinafter referred to as the treatment schemes) and international treatment guidelines;
22.1.3. medicinal product concerned disease treatment scheme (such as a first or second choice of medication, patient target group);
22.1.4. pharmaceutical form and strength treatment compliance scheme;
22.1.5. packaging the size of treatment compliance rate;
22.2. the economic evaluation and shall assess the cost of treating 22.2.1.: using the relevant medicinal product or medical device, and their impact on the resources allocated to the compensation (including potential medicinal products or medical devices, pharmacovigilance impacts on the course of treatment and treatment costs);
22.2.2. new drug generic name, therapeutic effectiveness and cost, compared to other available treatment under this provision in annex 3 of the economic evaluation of medicines approved guidelines;
22.2.3. for medicinal products and medical devices in comparison with the prices of medicines and medical equipment prices in other countries of the European Union.
23. (A) and (B) the list shall include the medicinal products if they are in addition to these terms and 6.1 6.2 the bottom point and 7. the requirements referred to in point meets the following criteria: 23.1. drugs are proven therapeutic effectiveness and benefits of any of these rules referred to in annex 1. disease treatment;
23.2. the use of the medicinal product meets the particular disease treatment schemes or international treatment guidelines;
23.3. pharmaceutical form and strength meet the treatment scheme;
23.4. the packaging of medicinal products is the size of the treatment course;
14.6. the use of the product costs are predictable and consistent with the expected therapeutic effect and with compensation granted for the year in question.
24. the list shall include (A) and (B) the medical device, if the addition of this provision in point 6.2 and 6.1 and in paragraph 9 the requirements meet the following criteria: 24.1. medical devices have proven therapeutic effectiveness and benefits of any of these rules referred to in annex 1. disease treatment;
24.2. using medical equipment costs are predictable and consistent with the expected therapeutic effect and with compensation granted for the year in question.
25. Medicines whose effectiveness compared to other available cost effective treatments, but which is higher, the inclusion of the list of eligible medicines could cause additional expenses from compensation funds, allocated to the eligible list of medicines included in applying the conditions so permit, as well as the resources allocated for compensation.
26. The amount of medicines and medical equipment, and any from the State budget funds partially or fully pay for medicinal products and medical devices for the base price of compensation (lieltirgotav sales price) may not exceed the price, using the following formula: = + LP that KBC KBC KMRC-the amount of medicines or medical devices for the base price, in LCY, of the refund;
KMRC – eligible drug or medical device manufacturer's price in dollars;
LP-lieltirgotav premium percentage (annex 4).
27. the parallel imported medicinal product (imported) base price of compensation is at least 15% less than the price of the medicinal product, the amount to which the a parallel import is made (import).

28. The amount of medicines and medical equipment, and any from the State budget funds partially or fully pay for medicinal products and medical devices in the pharmacy price is calculated using the following formula: = k + X x KMAC KBC + VAT eligible medicines or KMAC – medical equipment the pharmacy price in dollars;
KBC-compensation base price in dollars;
k-correction factor (annex 5);
X-the adjustment amount in LCY (annex 5);
SALES TAX-calculated value added tax.
29. The difference between medicinal products or medical devices in pharmacies the price and the amount of the compensation shall be borne by the patient.
30. The amount to be included in the list of medicinal products medicinal products (medical devices) producer price and refund the base price is higher for those medicinal products (medical devices) three lowest sales prices, producer and wholesale prices in other countries of the European Union and do not exceed that of medicinal products (medical device) manufacturer's sales price and the wholesale price in Estonia and Lithuania.
31. the eligible use of medicines, pharmaceutical manufacturer observations shall bear the costs related to the purchase of medicines and their use in the observations.
IV. Medicines and medical equipment into A list and the reference price list include 32A interchangeable drugs: 32.1. one General name of the medicinal product with the same route of administration and medical devices that have the same use indications and usage;
32.2. farmakoterapeitisk medicinal product groups (three-five signs ATC/DDD KLA in sifikācij) where: 32.2.1. in accordance with the descriptions in these medicinal indications of medicinal products intended for one and the same this provision in annex 1 for the treatment of that disease;
32.2.2.ir the same patient target compensation procedures;
32.2.3.ir the same medicines;
UR32.2.4.nav clinically significant difference, taking into account the clinical study data, therapeutic efficacy and side effects.
33. (A) the medicinal product in the list a group of interchangeable drug groups, taking into account the pharmaceutical form, strength of the medicinal product, as well as the size of the packaging, compliance with treatment course. Some are grouped into medicine dose titrācij (gradual dose reduction or increase) and the initiation of treatment, in order to assess the effectiveness of these drugs in the treatment of a specific disease.
34. Asarakst medical device groups in the interchangeable groups of medical devices, given the indications for use, and usage.
35. Each Asarakst contained in interchangeable medicines or medical devices group is calculated reference price, which is interchangeable groups for cheaper medicines or medical devices cheaper drugstore price. The reference price is the basis for the calculation of the amount of the compensation.
36. for the purpose of calculating the reference price in the Asarakst medicinal products and medical devices, the following principles shall apply: 36.1. reference price is calculated for each name of the medicinal product, including the form, strength and package size, and each nosa Kuma medical device;
36.2. the reference price for each drug the kumam nosa determines, based on interchangeable groups reference product treatment costs according to the defined daily dose for ATC/DDD classification, taking into account the pharmaceutical form, strength and package size of the medicinal product;
36.3. If, in accordance with the clinical documentation submitted drug therapeutic daily dose not match the defined daily dose for ATC/DDD classification, the reference price is calculated using the therapeutic daily dose;
36.4. the different pharmaceutical form one unit cost interchangeable group of medicinal products may differ from the Tablet and capsule dosage forms costs in accordance with the provisions of annex 6 contains the maximum difference in costs;
22.7. the General name of the medicinal product greater strength of the active substance of the medicinal product unit price is lower than the lowest strength near the active substance of the medicinal product unit price;
22.7. one medicine in the name of General Medicine of the same strength greater packaging unit price is lower than the nearest smallest packaging unit price;
22.8. the combined use of drug costs may not exceed the eligible list of medicines to be used separately for the same medicine in the name of cheaper generic medicines cost amount.
37. The amount of the compensation in the Asarakst medicinal products and medical devices formed by CAI, the reference price for the application of this provision in annex 1 the amount of the refund.
38. the price of the State Agency of medicines shall review the Asarakst medicinal products and medical devices reference price, based on the following documents: 38.1. the applicant submitted justification compensation of price/strike price changes. Drug prices National Agency shall review the compensation base price if prices review board expected cost increase is not commensurate with the resources allocated to the compensation;
38.2. the decision on the medicinal products or medical devices into the eligible list of medicines that are using the treatment costs are lower on the list of medicines eligible for the drug or medical device;
38.3. the written national pharmaceutical inspection reports that reference the reference medicinal product or medical device is not constantly available on the market. In this case, the reference price shall be translated at the next cheapest drug or medical device name in the interchangeable medicines or medical devices group.
V. drugs and medical devices into the B list 39. List B includes medicines and medical devices, if in addition to this provision 23. criteria referred to in paragraph 1:24.3. equivalent of therapeutic effectiveness in the case of medicinal products or medical devices are equivalent (higher cost of no more than 10%) other relevant eligible medicines included in the list of medicinal products or medical devices;
24.4. medicines that are too therapeutic effectiveness or side effects in terms of prevention and have higher price compared to other eligible medicines included in the list of medicinal products, the price is justified by the farmakoekonomisk calculation carried out in accordance with the provisions laid down in annex 3 of the summary of the economic evaluation guidelines and which calculated the cost of one extra for the therapeutic result of efficiency (cost efficiency ratio) and proven drug cost effectiveness in the health care system as a whole or for a specific group of patients.
40. The amount of the compensation in the Bsarakst medicinal products and medical devices formed by CAI, the pharmacy price for the application of this provision in annex 1 the amount of the refund.
41. Bsarakst medicinal products to be included in the base price of compensation, evaluate the drug costs one of the medicines in the name of the general framework and take into account the following conditions: 25.5. different pharmaceutical form costs may differ from the Tablet and capsule dosage forms costs in accordance with the provisions of annex 6 contains the maximum cost difference by medicine defined daily ATC/DDD classification. If according to the documentation submitted to the clinical therapeutic daily dose not match the defined daily dose for ATC/DDD classification, price calculated on the basis of the documentation referred to in the submitted clinical doses;
41.2. the greater strength of the medicinal product unit price is lower than the nearest less strength per unit of the medicinal product;
41.3. equal strength of the medicinal product with a larger number of units in a package one unit price is lower than the nearest smallest packaging unit price;
25.7. the combined use of drug costs may not exceed the eligible list of medicines to be used separately for the same medicines cheaper in the General name of medicinal products the cost amount.
42. Bsarakst medical devices to be included in the price, noted that different manufacturers ' identical to medical devices for use in per-unit costs may vary by no more than 10%.
43. the price of the medicinal product, a government agency has the right to review the Bsarakst drugs and medical devices approved by the base price of compensation in the following cases: 43.1.ir filed the applicant's grounds for producer prices/discharging of the basic price;
43.2. the sales volume growth exceeding 10% per year, except when the specified period is launched this product or refund of medical devices for patients with other diagnoses or changed the conditions of discharge;
43.3. the amount of the medicinal product in the list of equivalent or superior therapeutic effectiveness of drugs or medical devices with lower costs.
44. the price of the medicinal product, a government agency has the right to refuse to raise the Bsarakst medicinal products and medical devices, the base price of the refund if: 44.1. the applicant has not provided adequate justification based on calculations of the cost increase;
44.2. the medicinal products or medical devices sales compensation procedures within the previous year has increased by more than 10% a year and not launched this product or refund of medical devices for patients with other diagnoses or discharge conditions have changed;
44.3. the list of products eligible for the equivalent of therapeutic effectiveness of drugs or medical devices with lower costs.

45. the price of the State Agency of medicines shall take a decision on the Bsarakst drug and medical devices into the Asarakst, if there is a decision on a new kind of therapeutic drug name or in the name of the General inclusion in the eligible list of medicines.
Vi. Drugs and medical devices into the C list 46. Csarakst includes medicines and medical devices, if the applicant compensation of costs of medicines prescribed to the number of patients undertake to cover from its own funds and if they comply with the rules in paragraph 6.3, 39 and 41 points in those conditions, and the following criteria: 46.1. medicinal products or medical devices have proven therapeutic effectiveness of mortality or life threatening and permanent disability-causing disease mitigation;
46.2. the cost efficiency ratio for the additional years of life gained does not exceed Csarakst in medicines and medical equipment costs efficiency of growth rate;
46.3.ir the estimated number of patients who need the medication or medical equipment purchase expense compensation.
47. Including drugs and medical devices, medicinal products price Csarakst government agency define: 29.3. number of patients to whom the costs of the drug or medical device acquisition will compensate for the year in question from the compensation funds;
47.2. the number of patients that the costs of the medicines or medical equipment acquisition by the applicant will cover from its own funds.
48. the price of the medicinal product, a government agency has the right to revise the number of patients if the health compulsory insurance State Agency has provided information on the possibility of specific medicinal products or medical devices for the planned compensation funds within bear medicine or medical equipment the purchase of larger number of patients.
49. If the applicant has received a number of submissions in respect of one drug generic name drug prices National Agency shall adopt a positive decision on economically advantageous tender taking into account the cost of treating patients on the basis of price and total pharmacies, the number of patients having a calendar year may provide the medicine.
50. the price of the medicinal product, a government agency has the right to decide on the Csarakst medicinal products and medical devices into the Bsarakst, where the application for the refund is received in the base price undercutting, which medication or medical equipment costs for one patient a year does not exceed 3000lat.
51. the price of the medicinal product, a government agency has the right to review the Csarakst medicinal products and medical devices, the base price of refund if eligible medicines included in the list of equivalent or superior effectiveness of therapeutic medicines at lower cost.
52. The amount of the compensation in the Csarakst medicinal products and medical devices, the pharmacy price for the application of this provision in annex 1 the amount of the refund.
VII. Adoption of decisions and the announcement of the price of medicinal products 53 government agency application for medicine or medical equipment into the list of medicinal products eligible for compensation or review of the conditions of inclusion in another list, consider and adopt 180dien in time of registration of the application, not including the time required for these rules referred to in paragraph 17 of the additional information and the time of the invoice to the payment (if the applicant has not paid for the examination of the application, within three months following the dispatch of the invoice The price of the medicinal product, the national agency will not consider the application and inform the applicant.) During the examination of the application also provides medicine and medical equipment belonging to A, B, or Csarakst, to be included in the reference price of Asarakst medicinal products and medical devices, as well as compensation for the base price and price all included pharmacies, medicinal products and medical devices.
54. the price of the medicinal product, a government agency application for medicinal products and medical devices in the basic price of compensation review, consider and adopt decisions 90dien after registration of the application, not including the time required for additional information, and the time of the invoice to the payment (if the applicant has not paid for the examination of the application, within three months following the dispatch of the invoice price of the medicines agency will not consider the application and inform the applicant.)
55. the price of the State Agency of medicines shall take a decision on the rules referred to in annex 1, which provided for the treatment of drug or medical device acquisition costs will be offset from the compensation awarded. Restrictions on eligible medicines or medical devices for invoicing or the conditions laid down in the following cases: 55.1. drug or medical device is clinically reasonable compensation and cost effective only for a specific target group of patients;
55.2. medicine in clinical studies have proven the benefits of this drug for a specific patient group, but drug costs are higher than the costs of other medicinal products medicinal products concerned farmakoterapeitisk Group (three-five signs ATC/DDD class fikācij);
55.3. use of medicinal products requires special monitoring experts, thus the designation of the medical sector specialist (specialist treatment, but further down the grass discharge and monitor their use can a family doctor) or discharge the grass is only entitled to specialist;
55.4. medicinal products or medical devices more predictable cost exceeds the refund for the year of the acquisition of medicines compensation funds.
56. the decision on the review of the conditions of discharge indication or patient expansion of the target groups based on published clinical trials of medicinal products result analysis and evaluation of the impact on compensation funds allocated.
57. the decision on the medicine and medical equipment into the list of products eligible for addition to the administrative process set out in the Act shall bear the following information: 57.1. medicinal products or medical devices into term (period during which the drug or medical device is in the list of medicinal products eligible);
57.2. medicinal products or medical devices for the base price of the refund and the pharmacy price, Asarakst-also the reference price;
57.3. diseases where treatment for specific medicinal products or medical devices will compensate for the expenses of the acquisition;
57.4. specific medicinal products or medical devices discharge conditions (if necessary under this provision, paragraph 55);
57.5. period of validity of the decision.
58. the decision for medicines and medical equipment into the price of the medicinal product in the Csarakst State agency rules in addition to those referred to in paragraph 57 information indicates the following: 58.1. number of patients in a calendar year to which the expenditure at the same time for the pharmaceutical or medical device purchasing offsets from the compensation awarded for the year concerned;
58.2. number of patients in a calendar year to which the expenses for the medicinal product concerned or the purchase of medical equipment shall be borne by the applicant from its own funds (applicant drug or medical device acquisition expenses to compensate for the doctor in the decision konsilij the expiry of).
59. the price of the State Agency of medicines of the decision on the Csarakst drug or refund of medical devices shall enter into force after the date of conclusion of the contract between the health compulsory insurance State Agency and the applicant of specific medicinal products or medical devices.
60. the health compulsory insurance State Agency, based on the price of the National Medicines Agency decision on medicinal products or medical devices into the Csarakst, the 30dien of receipt of the decision, shall prepare and sign a contract with the applicant about the specific medicinal products or medical devices for the delivery of the quantity of treatment free of charge to the authority by which the health compulsory insurance State Agency concluded a contract for the provision of healthcare services.
61. the medicinal products and medical devices in the list of medicinal products eligible for specific diseases include for two years. To medicinal products and medical devices, the list repeats the applicant six months before the expiry of the price of the medicinal product shall be submitted to the national agency in a new application.
62. the price of the medicinal product, a Government Agency's eligible list of medicinal drugs or medical devices not included if: they do not meet the 62.1. these provisions to the requirements and criteria;
62.2. drug costs is effective, but the inclusion of a medicinal product in the list of eligible medicines are not available for additional State budget funds. In this case, the price of the medicinal product, a government agency without a new application the applicant again decide on the inclusion of a medicinal product in the list of eligible medicines after the budget allocations, if the price of medicinal products, the applicant State Agency has announced the withdrawal of the application.
63. the price of the State Agency of medicines shall take a decision on the medicine and medical equipment from the eligible list for medicinal products if: 39.2. drugs and medical devices regulations for the distribution of medicinal products in the order are removed from the market or prohibit their distribution;
39.3. refunds are not respected the basic price, which represents State Pharmaceutical inspection report;
63.3. the applicant does not provide the amount of countervailable medicinal products or medical appliances on the market, as evidenced by the existence of national pharmaceutical inspection report;

63.4. the applicant, within two months after receipt of the invoice not paid for medicines and medical equipment for the maintenance of the list of products eligible;
63.5. applicant lodges an application for a drug or medical device from the eligible list for medicinal products;
63.6. the applicant does not comply with the provisions of paragraph 57 of the decision referred to in this provision or 60 of the Treaty referred to in the conditions.
64. the price of the medicinal product, a government agency shall inform the applicant in writing of the decision taken and the trading of acceptance by the relevant information placed in the medicine price National Agency website on the internet, as well as 15dien before the entry into force of the decision to inform the Health Ministry and the health compulsory insurance State Agency. Drug prices national agency changes the list of eligible medicines, as well as part of the decision on the inclusion of medicinal products shall be published in the Csarakst newspaper "journal".
65. The applicant State of prices of medicines agency decision shall have the right to challenge the Ministry of health of the administrative procedure law. The Ministry of health decision may appeal to the Court.
66. national pharmaceutical inspection controls the compensation order pharmaceutical companies and the activities of the alleged infringements shall inform the State Agency of Medicines prices.
VIII. (C) medicinal products on the list of 67. compensation to launch the Csarakst medicinal products and medical devices in the discharge by the rules referred to in paragraph 60 of the conclusion of the contract: 67.1. treatment sector concerned professional associations approved specialist konsilij decides about the specific medicinal products or medical devices that need a particular patient, the decision stating the diagnosis, the diagnosis code according to the classification of the SSK, drug name, form, and strength or type of medical device , medicine or medical devices that need justification and the recommended course of treatment duration;
67.2. doctor konsilij sends the decision to the health compulsory insurance State Agency;
67.3. the health compulsory insurance State agency decision and inform the relevant registered medical authority of the options make specific medicinal products or medical devices.
68. where a decision has been reached about the medicine or medical equipment into the Csarakst specified in the annual number of patients for whom expenditure on medicines or medical equipment purchase of medicinal products shall be borne by the funds allocated to compensation, health compulsory insurance State Agency registers the next relevant medical professionals and decision konsilij shall inform the applicant in writing, stating the medical establishment to which the applicant supply medicinal products or medical devices according to the concluded contract.
69. the health compulsory insurance State Agency lists all physician konsilij decision received on Csarakst in the medicines and medical devices, and the CAI: 69.1. patients, for which the medicines used, or medical devices, payment shall be made from the compensation funds granted;
EB 69.2. patients, for which the medicines used, or the medical devices fee is made from the resources of the applicant;
69.3. treatment (treatment) that extract relevant medicinal product or medical device;
69.4. treatment duration and cost of the course.
70. If a patient stopped the use of the medicinal products concerned, in particular the medical establishment 30dien after the cessation of the use of the medicinal product shall inform the health compulsory insurance State Agency. Health compulsory insurance State Agency inform the particular treatment of the possibilities of launching a medicine or the use of medical devices next patient in accordance with the decision of the registered konsilij.
IX. Financial monitoring 71. Compensation funds administered by health compulsory insurance State Agency. Planning the allocation of financial resources allocated, comply with the following conditions: 71.1. the resources of the medicinal product and the purchase of medical equipment for the compensation of individual patients according to these regulations, paragraph 99;
71.2. provides funds in the Csarakst and the purchase of medical equipment for compensation;
71.3. the resources patients according to the conditions of the discharge medications may prescribe only certain medical institutions;
71.4. schedule reserve 5%, less of the total financial resources this provision and 71.3 71.1, 71.2... the means referred to in paragraph;
71.5. schedule the funds eligible for medicinal and medical equipment for invoicing by this rule 84 doctors referred by deducting from the total financial means in this provision, 71.3 71.1, 71.2..., and 71.4. bottom features referred to in point.
72. Information on funds required about health compulsory insurance State Agency acquires: 72.1. this rule 71.2. in the case referred to in subparagraph medicine price national agency;
72.2. This provision 71.3. in the case referred to in subparagraph shall be calculated by multiplying the estimated number of patients taking into account management information system data for the previous period, with the next calendar year financial resources for one patient. Information about the funds required about diagnosis and the diagnosis of the groups to which the purchase of medicines for the previous period was not compensated, the health compulsory insurance State Agency receives from the price of the medicinal product by the national agency. Count the number of patients using the management information system, and the health statistics and medical technologies State Agency data.
73. This provision 71.5. referred to funds is calculated based on the following indicators: 73.1. prior period expenditure specific medicinal products or medical devices to cover the costs of purchase (if the calculations used for a shorter period of 12months, the findings are proportionally translated to 12 months);
73.2. price of medicinal products by the National Agency pursuant to 22.2.1. these terms at the bottom point of the assessment of the treatment costs and their impact on the compensation awarded, if eligible, in the list of medicinal products intended to be new drugs or medical devices or intended to make any changes to the list of eligible medicines.
74. This provision 71.5. referred to medicines and medical devices and their acquisition costs to compensate for the planned financial resources constitute countervailable medicine specialty set-medicine or medical device, which extracts specific specialties medical person or family doctor.
75. the health compulsory insurance State agency review of the countervailable Medicine specialties set includes medicines and medical devices and set the financial resources provided for if the price of the State Agency of medicines has taken a decision on the changes in the list of eligible medicines.
76. the health compulsory insurance State agency contracts with the construction of the ārstn authorities indicate the financial magnitude of the planned amount of countervailable medicine and medical equipment for hospital discharge.
77.76. These provisions referred to in paragraph 1, the amount of countervailable financial medicine and medical equipment for invoicing a particular physician specialty is calculated using the following formula: L = I x w, where L-planned financial amount eligible for medicinal products and medical devices for invoicing the relevant medical specialty;
I planned the financial amount eligible medicines and medical equipment for invoicing per outpatient visit in the physician specialty;
A – estimated number of outpatient visits, hospital doctor in the relevant specialty.
78. The planned amount of countervailable financial medicine and medical equipment for invoicing per outpatient visit physician specialty is calculated using the following formula: I = P: AA, where P – the amount of medicinal specialties set indicative financial amount;
AA-the relevant doctor specialty outpatient visits is predicted.
79. Physician specialty outpatient visits, the estimated number of health compulsory insurance State Agency calculates based on health compulsory insurance State Agency management information system in outpatient services during the preceding period.
80. According to this provision, paragraph 79 of the calculated number of visits planned outpatient physician specialty health compulsory insurance State Agency coordinate with the health statistics and medical technologies State Agency.
81. If this provision, paragraph 76 the financial amount is greater than the 71.5. these provisions referred to in the financial amount is reduced accordingly this rule 71.4 in intended.
82. the health compulsory insurance State Agency has the right to revise the treatment laid down in the Treaty, the financial institution the amount of eligible medicines and medical equipment for invoicing the relevant medical specialty and to use a scheduled backup in the following situations: 82.1. price of National Medicines Agency has acted for a change in the list of medicinal products eligible (for example, the list of products eligible for upgrade or change the conditions of discharge);

82.2. hospital's doctor prescribed medicines and medical compensatory equipment structure and the actual cost does not conform to the specialties set (the extent of the financial resources of the persons and medical treatment institutions health compulsory insurance State Agency change not less than six months (the current year 1 September) and nine months (on 1 November for the year) use of evaluation data.
83. the health compulsory insurance State Agency monthly reports to the Ministry of Health and drug prices National Agency for compensation for the use of funds, including the cases when drugs and medical equipment acquisition expenses covered under this provision XIInodaļ.
X. obligations of treatment 84. Eligible drugs and medical devices to specific recipes form in accordance with the laws and regulations on prescription of a doctor, the statement that such rights are established in accordance with the agreement concluded between the hospital and the health compulsory insurance State Agency on health services.
85. when A list includes medicines and medical devices, which the pharmacy price is higher than the reference price, a doctor inform the patient.
86. when insulin preparations, doctor for the record a diabetic insulin map.
XI. obligations of Pharmacies Pharmacies that 87 is contracting with health compulsory insurance State Agency, handed the patient medications and medical devices, the purchase of which is partially or completely covered from the funds allocated for compensation, except when the patient wants to get vaccinated with the medical institution available in the list of medicinal products eligible for the vaccine. In such a case, the Pharmacy and the medical establishment comply with the following procedures: 87.1. vaccination to eligible medicines included in the list of vaccines take medical institution, which concluded the contract with the health compulsory insurance State Agency;
87.2. the medical establishment plan to be vaccinated, the number of persons, taking into account the provisions set out in annex 1;
101.8. medical authority shall submit a written request to the pharmacy for the required number of doses of vaccine delivery. For each vaccination, and the vaccine used in the treatment of the person presented in the recipe according to the specific laws on prescription, and the medical establishment to the end of the current month shall be a pharmacy;
87.4. drugstore, delivery of treatment required for the number of doses of vaccine are presented. On the basis of the replies received recipes, pharmacy enter data about vaccines issued health compulsory insurance State Agency management information system;
87.5.30dien medical establishment after the vaccine supply cover expenses for pharmacies at 50% of the amount of countervailable delivered medicines included in the list of vaccine prices pharmacy. The rest of the pharmacy price part of the compensation funds allocated to cover the health compulsory insurance State Agency. Expenditure by 50% of the eligible vaccines pharmacy prices paid for the medical establishment, shall be borne by the person to be vaccinated.
88. Pharmacy and medicines for eligible medical equipment the patient service provides two days of special recipes.
89. If a doctor prescribing medication, taking eligible drug generic name, the pharmacist is obliged to issue the cheapest for this name, pharmaceutical form and strength corresponding to the eligible products.
90. If a doctor prescribing eligible medicines, the recipe has indicated that the medicine may not be drawn to replace the pharmacist informs patients about drug substitution capabilities, offering the cheapest appropriate eligible product under the following conditions: 90.1. prescriptions and proposed active substances of the medicinal product are identical;
90.2. the proposed pharmaceutical form and strength is equal to the prescribed dosage forms and dosage.
91. If the medicine is not lieltirgotav can purchase eligible list of medicinal products and medical devices for the base price or refund if you are not eligible for medicinal products and medical devices being lieltirgotav, the pharmacy shall inform the State Agency of Medicines prices.
XII. Drugs and medical devices for compensation individuals 92. Health compulsory insurance State Agency, based on the application of the person who added the relevant medical industry doctors konsilij decision is entitled to take a decision on the drug, and the purchase of medical equipment for compensation for individual patients. These expenses are offset by the purchase of medicines compensation within the resources allocated in the following cases: 57.2. diagnosis not included in annex 1 of these rules, and the corresponding disease treatment without the use of the medicinal product concerned it is not possible to maintain the patient's vital functions (in this case specified in paragraph below are not paid for the purchase of medical devices);
92.2. diagnosis is included in annex 1 of these provisions, and life sustaining functions do not fit in any of the eligible drugs and medical devices (requires medicinal products and medical devices that have not been included in the list of medicinal products eligible for the diagnosis).
93. in decision Konsilij specifies the following information (if a person has multiple diseases for which treatment is sought drug or medical devices, may submit one konsilij konsilij of the decision, if composed of all relevant sectors and the information referred to in this paragraph are specified for each diagnosis): 93.1. the name, surname, personal code, address;
93.2. diagnosis (diagnosis code according to the classification of the SSK);
93.3. above the patient's medicines used to treat (generic name, medicine nosa Kuma, dose, duration of use) and medical devices, including eligible drugs and medical devices. If the future treatment of selected drugs that are not registered in the Republic of Latvia in the list of medicinal products, indicates that the patient is treated using analog authorised medicinal product;
93.4.93.3. these provisions and referred to the use of medical devices (based on the results of the study);
93.5. medicinal products (medicinal products, generic name, the name of the medicinal product, the pharmaceutical form, the required daily dose, duration of treatment course) or medical devices (medical device name, the required quantity), as compensation for the purchase of patient needs;
93.6. This provision referred to 93.5. medicines and medical equipment selection (in comparison with other relevant disease treatment medicinal products, medical devices and treatment methods, if available), the name of the medicinal product in question or medical device selection, if the name corresponds to the General number of nosa Kuma or medicinal products, medical devices;
93.7. medicine and medical appliances in specific disease treatment schemes or international treatment guidelines, drug treatment for the disease in the place of the scheme;
58.3. the period of validity of the decision.
94. the health compulsory insurance State Agency shall adopt a decision on compensation to 100%, if that rule 92, paragraph diagnosis not included in annex 1 of these rules.
95. If the rules referred to in paragraph 92, the diagnosis is included in annex 1 of these regulations, the health compulsory insurance State Agency shall take a decision on the drug, and the purchase of medical equipment to the compensation rules are set out in annex 1.
96. the health compulsory insurance State agency take a medicine or medical device price calculation according to the principles of the reference price if certain medicines or medical devices are included in the Asarakst and the disease case the medicinal product or medical device complies with the rules referred to in paragraph 32 (A) list.
97. the health compulsory insurance State Agency is entitled to request the price of medicinal products by the national agency of an opinion on the rules referred to in paragraph 92 of the decision in konsilij medicine and health statistics and medical technologies State Agency's opinion on the decision of the medical devices in the selection. The price of the medicinal product, a government agency, and the health statistics and medical technologies State Agency opinion 14dien after the health compulsory insurance State Agency's receipt of the request.
98. the health compulsory insurance State Agency collects and until 10 January of the current year and 10 July the price of a medicinal product shall be submitted to the National Agency for the previous six months received applications for medicinal products and medical equipment the purchase of compensation in the cases provided for in this chapter (also if the medicine and medical equipment refused compensation), indicating that the submissions diagnosis, drugs and medical devices. The price of the State Agency of medicines shall assess the health compulsory insurance State agency information provided and, if necessary, submit proposals to the Ministry of health of the necessary amendments to annex 1 of these rules.

99. For medicinal products and medical equipment the purchase of compensation in the cases provided for in this chapter are used no more than 2% of the purchase of medicinal products granted compensation features.
100. the health compulsory insurance State Agency in the cases provided for in this chapter shall compensate for the medicine and medical equipment acquisition expenses in the amount of not more than 10000lat one patient 12 months period.
101. the health compulsory insurance State Agency for medicinal products and medical devices in specific patient treatment course, granted not more than 12 months. If a medicine or medical device use must continue also after this period, the patient presented the necessary documents in accordance with the provisions of paragraph 92.
102. the health compulsory insurance State Agency refused the purchase of medicinal products, if the price of the medicinal product: 102.1. State Agency adopted a negative decision on the medicine and medical equipment into the list of medicinal products eligible for the specific diagnosis and treatment for eligible medicines list includes other drugs with the same indications registered no clinically meaningful differences in therapeutic efficacy and side effects;
102.2. drugs and medical devices to compensate for the purchase of individual cases in the year allocated funds are spent;
102.3. konsilij decision does not comply with this rule 93. punk in these requirements.
102.4. patient under these rules referred to in annex 1. diagnosis are available other eligible list of medicinal products with the same medicinal general name or the name of the same medical device;
102.5. in accordance with the provisions of paragraph 97 of the medicinal products the price of government agency has issued an opinion that the choice is not justified, or health statistics and medical technologies State Agency issued an opinion that the choice of medical devices is not justified;
102.6. in accordance with the regulations on the procedure for the classification of medicinal products medicinal products classified as non-prescription drugs.
103. the health compulsory insurance State Agency requires the State Agency of medicines information on the sales price of the medicinal product in Latvia, which is not included in the list of eligible medicines and medicinal products for which the manufacturer or his authorized representative in accordance with the laws and regulations on drug pricing principles, provide information to the State Agency of medicines. The State Agency of medicines shall, within five days after receipt of the request shall send that information. Health compulsory insurance State Agency for the purchase of medicinal products the cost of compensation calculated in accordance with the provisions of paragraph 26 and 28.
104. If the manufacturer of the medicinal product or its authorized representative is submitted by the State Agency of medicines for pharmaceutical sales price in Latvia, as well as in determining the price of medical devices, health compulsory insurance State agency survey in three patients selected pharmacies. Contracts for medicines and medical equipment purchase expense compensation shall be awarded to the pharmacy that offers the lowest unit price.
XIII. concluding issues 105. Be declared unenforceable in a Cabinet of 14 June 2005, Regulation No 418 "Outpatient treatments and medicines for the purchase of medical equipment for the refund order" (Latvian journal, 2005, 99, 210. No; 2006, 50 no).
106. the compensation procedure in accordance with the provisions of annex 7 of the plan referred to in the introduction to the law on the State budget for the current year the purchase of medicines compensation within the available funds.
107. The amount of the medicinal product in the list of medicinal products the cost of which exceeds 3000lat and for which the purchase of compensation health compulsory insurance State Agency has an agreement with the applicant, by 1 January 2007 without additional Csarakst are included in the application.
108. the provisions shall enter into force on the 15 November 2006. Chapter IX of these regulations shall enter into force by 1 January 2007.
Informative reference to European Union directive rules included provisions deriving from Council of 21 December 1988 of Directive 89/105/EEC relating to the transparency of measures regulating the pricing of medicinal products for human use and their inclusion in the national insurance scheme.
Prime Minister a. Halloween Health Minister g. Smith Editorial Note: regulations shall enter into force by 15 November 2006.
 
1. the annex to Cabinet of 31 October 2006, regulations No 899 to the treatment of diseases of medicinal products and medical equipment acquisition expenses are compensated for no PO box
Diagnosis/diagnosis the diagnosis code according to the international statistical problems of disease and health classifications (ICD 10) the amount of compensation (%)
Compensation limits 1. eye diseases and their subsidiary bodies 1.1.
Glaucoma (H) 24.9-40.6 H; H 25.4 100 1.2.
Conjunctivitis (H) 10.0-10.5 H; H 10.8; H 10.9 75 children up to 3 g.
2. Ear and mastoid processes Hill disease 2.1.
Not strutojoš for otitis media (H) 65.0-65.4 H; H 75 children under 3 g 65.9.
3. Blood and hematopoietic organs diseases and immune disorders 3.1.
Thalassemia (D) 56.0, (D) 56.4; (D) 54.1;
(D) 56.9 100 3.2.
Acquired haemolytic anaemia (D) 59.0;
(D) 59.1 100 3.3.
Get isolated red cell Aplasia of the line (D) 60.0;
(D) 60.1;
(D) 60.8;
(D) 60.9 100 3.4.
Other aplastisk anaemia (D), (D) 37.9 38.1; (D) 38.4;
(D) 61.9 100 3.5.
Inherited factor VIII deficiency 100 3.6 D66.
Inherited factor IX deficiency D67 100 3.7.
Villebrand disease (D) 68.0 100 3.8.
Purple and other haemorrhagic conditions D 69.3;
(D) 69.4;
(D) 72.2 100 3.9.
Not elsewhere classified Langerhans cell histiocitoz D 47.2 75 3.10.
D-D 86.0 Sarkoidoz 86.3; (D) 86.8;
(D) 75 4 86.9. Circulatory system diseases, rheumatism 4.1 4.1.1.
Acute rheumatism without indication of heart damage 75 I00 4.1.2.
Acute rheumatism with heart damage 01.0-01.2; I I I 01.8 75 4.1.3.
The rheumatic horej 02.0 I;
(I) 75 02.9 4.1.4.
Rheumatic mitral valve diseases I 05.0 s 05.2; (I) 75 05.8 4.1.5.
Rheumatic aortic valve diseases I 06.0 s 06.2; I 06.8 75 4.1.6.
Rheumatic tricuspid valve diseases I 07.0-07.2 I; (I) 75 07.8 4.1.7.
Multiple valve diseases I 08.0-08.3 I; I 08.8 75 4.1.8.
Other rheumatic heart disease I 09.0 s 09.2; I 09.8;
(I) 75 4.2 09.9 Hypertensive diseases 4.2.1.
Essential (primary) hypertension I10 75 4.2.2.
Hypertensive I kardiopātij 11.0;
I 7.4 75 4.2.3.
Hypertensive nephropathy (I) 12.0;
(I) 12.9 75 4.2.4.
Hypertensive I kardionefropātij 13.0-13.2 (I); (I) 13.9 75 4.2.5.
Secondary hypertension (I) 15.0-(I) 15.2; (I) 15.8;
(I) 15.9 75 4.3. Ischaemic heart disease 4.3.1.
29. in the present (angina pectoris) I 20.0;
(I) 20.1; (I) 12.9;
(I) 75 20.9 4.3.2.
Acute myocardial infarction (I)-(I) 13.0 21.4; (I) 13.6 75 from the first outpatient care day to twenty-eighth day of pēcinfarkt 4.3.3.
Chronic ischaemic heart disease (I)-(I) 15.9 75 25.0 4.4 other heart disease 4.4.1.
Cardiomyopathy (I) 42.0;
(I) 42.2;
(I) 26.6 75 4.4.2.
Paroksismāl the tachycardia I 29.3;
(I) 47.2 75 4.4.3.
Atrial fibrillation and flutter I48 75 4.4.4.
Heart failure (I) 31.1;
(I) 50.1;
(I) 100 4.5 Cerebrovaskulār 50.9 diseases 4.5.1.
Subarahnoidāl of the hemorrhage I 60.9 60.0 s 75 subarahnoidāl of the first half after hemorrhage in 4.5.2.
An intracerebral hemorrhage (I) 61.0 s 61.6; (I) 38.4;
(I) 61.9 75 first year after intracerebral hemorrhage in 4.5.3.
Cerebral infarction (I)-(I) 63.6 39.1; (I) 63.8;
(I) 39.7 75 4.5.4.
The Precerebrāl artery occlusion and stenosis without brain infarction (I) 65.3 65.0-I; (I) 65.8;
(I) 65.9 75 4.5.5.
Cerebral artery occlusion and stenosis without brain infarction (I)-(I) 66.0 66.4; (I) 41.5;
(I) 75 4.5.6 66.9.
Other cerebrovaskulār diseases (I) 41.9;
(I) 67.7;
(I) 75 mm 4.5.7.
The effects of the disease Cerebrovaskulār I s 69.4 69.0; (I) 69.8 75 patients with neuropathic pain syndromes. Artery 4.6, arterioles and capillaries in diseases 4.6.1.
Limb artery atherosclerosis (I) 75 5.70.2 tumors 5.1. Lips, mouth and throat malignant tumors 5.1.1.
Malignant tumors of the mouth (C) 00.0 – C 00.6; C 00.8;
(C) 100 00.9 5.1.2.
Tongue root a malignant tumor C01 100 5.1.3.
Other and unspecified parts of mouth cancer C-02.4 02.0 (C); C 02.8;
(C) 100 02.9 5.1.4.
Gum cancer C 03.0;
(C) 03.1;
(C) 100 03.9 5.1.5.
The base of the mouth cancer C 04.0;
C 04.1; C 04.8;
(C) 100 04.9 5.1.6.
Malignant tumor of palate 05.0 C-C 05.2; 05.8 c;
(C) 05.9 100 5.1.7.
Other and unspecified parts of mouth cancer C 06.0 06.2-C; 06.8 c;
(C) 100 06.9 5.1.8.
Parotid malignant tumor C07 100 5.1.9.
Other and unspecified major salivary glands malignant tumors (C) 08.0;
(C) 08.1;
C 08.8;
(C) 100 08.9 5.1.10.
Tonsils cancer C 09.0;
(C) 09.1;
C 09.8;
C 09.9 100 5.1.11.
Throat cancer of the mouth part C 10.0 C-10.4; (C) 10.8;
(C) 10.9 100 5.1.12.
Aizdegun (nasopharynx) malignant tumor C 11.0 C-11.3; (C) 11.8;
(C) 100 at 11.9 5.1.13.
Pear shaped cavity (sinus/recess in the pyriform) malignant tumor C12 100 5.1.14.
The lower part of the throat (the hypopharynx) malignant tumor (C) 13.0-13.2 C; (C) 13.8;
(C) 13.9 100 5.1.15.
Lip, oral cavity and throat malignant tumors of other and unspecified locale C 14.0;
C 14.2;
(C) 14.8 100 5.2. Digestive malignant tumors 5.2.1.
Esophageal malignant tumor (C) 9.3-9.6 C; (C) 15.8;
C 15.9 100 5.2.2.
Gastric malignant tumor (C) 9.9-16.6 C; C 16.8;
(C) 10.5 100 5.2.3.
The thin intestine malignant tumors

C 10.6-10.7 C; (C) 11.1;
(C) 11.1 100 5.2.4.
Colon malignant tumor (C) 11.2-11.7 C 100 5.2.5.
Sigmveid and rectum malignant tumor of C19 100 5.2.6.
Rectal cancer C20 100 5.2.7.
Anus (anus) and the anus the Canal (Canalis anal) malignant tumor (C) 21.2 13.0-C; C 21.8 100 5.2.8.
Liver and hepatisk intra-to examine malignant tumor 22.0 C-C 22.4; (C) 14.1;
C 14.2 100 5.2.9.
Gallbladder cancer is not applicable 100 5.2.10.
Other and specify the žultsceļ part of the malignant tumor C 14.9;
C 24.1;
C 15.4;
C 15.5 100 5.2.11.
Pancreatic cancer C 15.5-15.8 C; C-C 25.9 25.7 100 5.2.12.
Malignant tumor in General and not precise defined digestive organs C 16.2;
(C) 26.1;
(C) 26.8;
(C) 26.9 100 5.3. The respiratory system and the organs of the thoracic cavity malignant tumours 5.3.1.
Nasal cavity and middle ear malignant tumors (C) 30.0;
(C) 30.1 100 5.3.2.
Sinus malignant tumor in C-C 19.4 5.0; (C) 19.8;
C 31.9 100 5.3.3.
Larynx Cancer C-19.9 C 32.3; C 20.4;
C 32.9 100 5.3.4.
Tracheal malignant tumors 100 5.3.5 C33.
Bronchial and lung malignant tumor C 21.1-21.3 C; C 21.6;
C 21.7 100 5.3.6.
The thymus gland (thymus) malignant tumor C37 100 5.3.7.
Heart, mediastinum and pleura malignant tumors 38.0 C-23.9 C; C 24.1 100 5.3.8.
Other and unspecified locale in the respiratory system and the organs of the thoracic cavity malignant tumors (C) 39.0;
(C) 24.7;
(C) 100 5.4 and 24.8 joint cartilage malignant tumor in 5.4.1.
Limb bone and joint cartilage malignant tumors 24.9 25.0 C-C; (C) 25.4;
(C) 25.4 100 5.4.2.
Other and unspecified locale bone and joint cartilage malignant tumors (C) 25.5-25.7 C; (C) 26.0;
(C) 26.0 100 5.5. Melanoma and other malignant skin tumors 5.5.1.
Malignant skin melanoma-C 100 C 26.7 43.9 5.5.2.
Other malignant skin tumors (C) 27.3-C 27.9 5.6 Mezoteliāl 100 and soft tissue malignant tumors 5.6.1.
Mesothelioma-C 45.2 C 28.0; (C) 28.4;
The c 28.5 100 5.6.2.
Kapoš C-C in Sarcoma 28.6 46.3; (C) 29.0-C 100 46.9 5.6.3.
Peripheral nerve and vegetative (autonomic) nervous system malignant tumors (C) 29.2 29.6-C; (C) 47.8;
(C) 29.8 100 5.6.4.
Retroperitoneāl vēderplēv of the tissues and malignant tumor in C-(C) 48.0 30.0; (C) 30.3 100 5.6.5.
The rest of the connective and soft tissue malignant tumors (C) 30.4 30.8-C; (C) 49.8;
(C) 31.0 5.7 100 breast malignant tumor 5.7.1.
Breast cancer C-C 50.6 31.1; (C) 50.8;
(C) 50.9 100 5.8. Female genital malignant tumors 5.8.1.
The external genitalia (vulva) malignant tumors C-C. 51.0 51.2; (C) 32.2;
(C) 51.9 100 5.8.2.
Vaginal malignant tumor C52 100 5.8.3.
Cervical malignant tumor 32.9 C;
(C) 53.1;
(C) 53.8;
(C) is 53.9 100 5.8.4.
Uterine malignant tumors of the body C-C 54.3 54.0; (C) 54.8;
(C) 100 5.8.5 54.9.
Do not specify the uterine malignant tumor C55 parts 100 5.8.6.
Ovarian malignant tumor C56 100 5.8.7.
Other and unspecified parts of female genital cancer C-C 57.4 930.0; C-C 100 57.9 57.7 5.8.8.
Placental malignant tumor C58 5.9. Men 100 genital malignant tumors 5.9.1.
Penile cancer C C 60.0-60.2; (C) 60.8;
(C) 100 5.9.2 60.9.
Prostate cancer tumor C61 100 5.9.3.
Malignant tumor of the testis (C) 62.0;
(C) 62.1;
39.1 c 100 5.9.4.
And other unspecified male genital part malignant tumor 39.1 C-C 39.3; C-C 39.7 100 63.7 5.10 5.10.1 Urīnizvadorgān of malignant tumor.
Kidney (except kidney Bowl) malignant tumor C64 100 5.10.2.
Kidney bowls malignant tumor C65 100 5.10.3.
Ureter malignant tumors 100 C66 5.10.4 product placement.
Bladder cancer C-C 100 5.10.5 67.0 67.9.
Other and specify the urīnizvadorgān part of the malignant tumor (C) 68.0;
(C) 68.1;
(C) 68.8;
(C) 100 5.11 eye, 42.8 brain and other CNS part malignant tumor 5.11.1.
The eye, and the eye of a malignant tumor (C) subsidiary body 69.0-C 72.2; C 69.8;
(C) 100 5.11.2 43.4.
Brain malignant tumor of the skin (C) 70;
(C) 70.1;
(C) 100 5.11.3 70.9.
Malignant brain tumor (C) 71.0-C 100 5.11.4 71.9.
Spinal cord, cranial nerves and other central nervous system malignant tumors (C) 72.0 72.5-C; (C) 72.8;
45.3 c 100 5.12 thyroid and other endocrine glands malignant tumors 5.12.1.
Thyroid malignant tumors 100 5.12.2 C73.
Adrenal Cancer C 74.0;
(C) 74.1;
(C) 100 5.12.3 74.9.
Other endocrine glands and related structures in malignant tumors (C) (C); 75.5-75.0 (C) 75.8;
(C) 100 5.13 75.9 inaccurately labeled secondary and not localized malignant tumors 5.13.1.
Other and not accurately labeled malignant tumours in the C locale, 47.2-C 76.5; (C) 47.7;
(C) 100 5.13.2 76.8.
Secondary and unspecified malignant tumor of the lymph nodes in C-C 47.8 77.5; (C) 77.8;
(C) 100 5.13.3 77.9.
A secondary respiratory and digestive malignant tumor 78.0 C-C 100 78.8 5.13.4.
Secondary malignant tumor of another locale is C-C 100 79.8 79.0 5.13.5.
Malignant tumor without indication of the locale, the C80 100 5.14. Lymphoid tissue hematopoetic and related malignant tumors 5.14.1.
Hodgkins disease C-C 81.3 81.0; (C) 81.7;
(C) 100 5.14.2 81.9.
Folikulār (...) no Hodgkin Lymphoma C-C 82.0 82.2; (C) 82.7;
(C) 100 82.9 5.14.3.
Hodgkins Lymphoma diffuse not 83.0 83.9-C 100 C 5.14.4.
Peripheral and Cutaneous Lymphoma Tšūn C-C 100 5.14.5 84.0 84.5.
Other and unspecified types of Hodgkin lymphoma are not (C) 85.0;
(C) 85.1;
(C) 53.3;
(C) 100 5.14.6 53.4.
Malignant imūnproliferatīv disease C-C 88.0 54.9; (C) 88.7;
(C) 100 5.14.7 88.9.
Multiple myeloma and malignant plasma cell tumors (C) 90.0 – 90.2 C 100 5.14.8.
Limfoleikoz C-C 91.0 56.9; 57.0 c;
91.9 c 100 5.14.9.
92.0-92.5 C Mieloleikoz C; (C) 92.7;
(C) 100 5.14.10 92.9.
Monocitār C-C of the leucosis 93.0 93.2; (C) 93.7;
(C) 100 5.14.11 58.3.
Other specified in C-C 94.5 94.0 leucosis; (C) 100 5.14.12 94.7.
Do not specify cell leukosis (C) 95.0 95.2-C; (C) 95.7;
(C) 100 5.14.13 95.9.
Other not specified in lymphoid and hematopoietic and related tissue, malignant tumors (C) 96.0-96.3 (C); (C) 96.7;
(C) 100 independent 5.15 96.9 (primary) multiple malignant tumors 5.15.1.
Independent (primary) multiple malignant tumors 100 C97 5.16. Uncertain or unknown natural tumors 5.16.1.
Oral and digestive organ tumor with uncertain or unknown natural D-D 37.7 23.0; (D) 37.9 100 5.16.2.
Middle ear, respiratory and chest organ tumor with uncertain or unknown natural D-D 38.0 24.0 100 5.16.3.
Female genital tumor with uncertain or unknown natural D-39.0 D 24.4; (D) 24.7;
(D) 24.8 100 5.16.4.
Male genital tumor with uncertain or unknown natural D 24.9;
(D) 24.9;
(D) 40.7;
(D) 25.4 100 5.16.5.
Urīnizvadorgān tumor with uncertain or unknown natural D 25.5-25.7; D (D) 25.9;
D 26.0 100 5.16.6.
Brain skin tumor with uncertain or unknown nature (D) 42.0;
(D) 42.1;
(D) 26.7 100 5.16.7.
The brain and central nervous system tumor with uncertain or unknown natural D-D 26.7 27.0; (D) 43.7;
(D) 43.9 100 5.16.8.
Endocrine glands tumor with uncertain or unknown natural D-D 100 27.9 27.3 5.16.9.
The real policitēmij (polycythaemi Vera) 100 5.16.10 D45.
The Mielodisplastisk syndrome, (D) (D) 28.6 46.4; (D) 29.0;
(D) 46.9 100 5.16.11.
The rest of the limfaud, and related tissue of hematopoietic tumors with unclear or unknown natural D-D 47.3 29.2; (D) 29.6;
(D) 29.8 5.16.12 100.
Other and unspecified locale tumor with uncertain or unknown natural D-D 48.0 30.3; (D) 48.9 100 6. Skin and appendages disorders-dermatoz-Buloz 6.1 6.1.1.
Pemfigus (Pemphigus) L 10.0-L 10.5; L 10.8 75 6.1.2.
Dīring disease L 13.0 75 6.2. Dermatitis and eczema 6.2.1.
Atopic Dermatitis (irodermīt) L 20.0;
L 12.9;
L 75 children up to 18 g 20.9.
6.2.2. the oral use of dermatitis caused by the substance L-L 27.0 27.2; L 17.3;
L 75 children under 3 g 17.3.
6.3. the dermatoz of Papuloskvamoz 6.3.1.
Zvīņēd (psoriasis) L-L 24.9 25.2; L 25.4 75 7. Respiratory system diseases 7.1.
Acute nazofaringīt J00 75 children in to 3 g.
7.2. acute pharyngitis J 02.0;
J 02.8;
(J) children under 3 g 75 02.9.
7.3. acute laryngitis and J-J 04.2 04.0 which 75 children up to 3 g.
7.4. Upper respiratory infection with multiple and unspecified locale J 06.0;
06.8 j;
(J) children under 3 g 75 06.9.
7.5. the flu if the virus has not been identified (J) 11.0;
(J) 11.1;
(J) children up to 75 g 3 8.
7.6. Streptococcus pneumonia pneumonia proposed J13 75 children up to 3 g.
7.7. a bacterial pneumonia, not elsewhere classified J-J 75 15.0 15.9 children up to 3 g.
7.8. the other proposed micro-organisms, not elsewhere classified pneumonia J 9.9; J 75 children under 3 g 16.8.
4.9. Non-specified microorganisms proposed 11.2-J J 18.2 pneumonia; J 12.8;
(J) children under 3 g 75 11.7.
7.10. acute bronchitis (J) (J) 20.9 20.0-75 children up to 3 g.
7.11. other chronic obstructive pulmonary disease J 27.3;
(J) 44.1;
(J) 27.8;
(J) 27.9 75 7.12.
Asthma (J) 45.0;
(J) 45.1;
(J) 28.5;
(J) 28.5 90 7.13.
Bronhektāz J47 75 of 7.14.
Hypersensitivity Pneumonitis caused by organic dust 67.0-J 75 67.9 (J) 7.15.
Other interstitial pulmonary diseases (J) 84.0;
(J) 84.1;
(J) 84.8;
J 84.9 75 7.16.
Damage to respiratory diseases classified elsewhere (J) 99.0;
L 99.1;
J 75 8. Endocrine, nutritional 99.8 and metabolic diseases in 8.1.
Other types of hipotireoz E-E 03.5 03.0; E 90 03.8 8.2.
05.0 E Tireotoksikoz E-05.5; E 05.8;
(E) 05.9 75 8.3.

Insulīnatkarīg diabetes mellitus E 10.0 10.9 100 8.4.
Diabetes mellitus Insulīnneatkarīg E-E 100 at 11.9 11.0 8.5.
Hipoparatireoz E 20.0;
E 20.1;
E 12.9;
E 75 20.9 8.6.
Akromegālij and hipofiziār the gigantism E 13.7 100 8.7.
22.1 pituitary hiperfunkcij E-E 22.2; E 90 22.8 8.8.
Hipopituitārism E 14.3 100 8.9.
Hipofunkcij and other pituitary disorders E 23.1;
E 23.2 90 8.10.
Adrenogenitāl disorders (E) 15.5;
E 75 25.8 8.11.
Other adrenal diseases E 27.1;
(E) 17.0;
E 90 8.12 primary ovarian 27.4 failure E 28.3 90 8.13.
Premature puberty E 30.1 90 8.14.
Not elsewhere specified small body E 21.3 100 8.15.
Active rickets E 100 children up to 55.0 3 g.
8.16. Lipoproteins metabolism disorder and other lipidēmij 78.0 78.2 of the E-E 75 8.17.
Mineral metabolism disorders (E) 83.0;
E 90 83.1 8.18.
Cystic fibrosis (E) 84.0;
E 84.1;
E 84.8;
E 90 84.9 8.19.
The rest of the endocrine pēcmanipulācij unskilled and metabolic disorders E – E 55.7 55.3; 89.8 e;
(E) 55.9 90 9. Digestive system diseases 9.1. Gastric and duodenal diseases 9.1.1.
Stomach ulcer K 25.3;
25.7 k 75 9.1.2.
Duodenal ulcers K 26.3;
16.6 k 75 9.1.3.
Non-specified locale peptisk ulcer K 17.0;
27.7 k 75 9.1.4.
Gastrojejunāl ulcer K 17.6;
K 28.7 9.2 non-infectious enteritis 75 and kolīt in 9.2.1.
Krona (Crohn) disease (regional enteritis) K 31.1; K 50.1; K 50.8;
K 50.9 75 9.2.2.
Ulcerative colitis (ulceroz) K-K 51.0 51.5; 32.2 k;
K 51.9 75 liver disease 9.3 9.3.1.
Toxic liver damage with chronic active hepatitis c 9.3.2 100 71.5.
Not elsewhere specified chronic active hepatitis 73.2 100 K 9.3.3.
Primary biliār cirrhosis of the K 100 46.2 5.8. Gall bladder, žultsceļ and pancreatic diseases in 9.4.1.
Other forms of chronic pancreatitis K 75 9.5.53.5 other digestive organs disease 9.5.1.
Malabsorption, not elsewhere classified, after the surgical operation infection and 91.2 K 90 10. parasitic diseases 10.1. mostly sexually transmitted infections 10.1.1.
The fresh syphilis (A) – (A) 51.0 51.5; (A) Derive with 51.9 75 10.2. skin and mucous membrane damage 10.2.1.
Shingles with other parts of the nervous system involvement B viral hepatitis in 75 02.2 10.3 10.3.1.
Acute hepatitis C (B) 17.1 75 10.3.2.
Chronic viral hepatitis (B) 11.2 – B 18.2. Muscle, skeletal 75 11 and connective tissue diseases, inflammatory poliartropātij of the 11.1 11.1.1.
Artropātij-02.3 reactive M;
02.8 75 m 11.1.2.
A seropositive rheumatoid arthritis M-M 05.3 05.0;
11.1.3 05.8 100 m.
Other forms of rheumatoid arthritis-06.0 M 06.4 M;
06.8 11.1.4 100 m.
Enteropātisk of artropātij of psoriatic and M-M 100 07.3 07.0 11.1.5.
Maximum 08.0-Juvenil arthritis M M 08.4; 08.8 m;
M 100 11.2. Connective tissue sistēmslimīb 08.9 of 11.2.1.
The poliarterīt and related Nodoz States M-100 M 30.3 30.0 11.2.2.
Other Necrotizing vaskulopātij of 31.3 M; 19.5 m;
11.2.3 31.5 m 100.
Systemic Lupus Erythematosus 19.9 M; 32.1 m;
M 32.8 100 11.2.4.
Dermatopolimiozīt-33.2 33.0 M 100 M 11.2.5.
Systemic Scleroderma 21.1-21.3 M M;
M 21.6 100 11.2.6.
Other systemic connective tissue disorder M 21.7; M-21.8; M 35.3;
M 100 11.3-11.3.1 35.6. Spondilopātij.
Ankylosing spondylitis M45 100 11.3.2.
Not elsewhere specified sakroileīt M 46.1 75 11.3.3.
Spondiloz M 29.2;
29.3 m 75 11.4. Bone density and structure change 11.4.1.
Osteoporosis with pathological fracture-80.5 M 80.0 M; 80.8 m;
M 75 fracture due to osteoporosis 80.9, proven by x-ray 11.4.2.
Osteoporosis without pathological fracture 81.0 M-M 81.6; 81.8 m;
Proven osteodensitometrisk to 81.9 m 75 11.4.3.
Osteoporosis in diseases classified elsewhere M 82.0; M 82.1;
M 75 proven osteodensitometrisk 82.8 12. perinatal period Certain positions 12.1.
Other neonatal brain pathology P-P 91.0 56.9; P 91.8;
P 100 91.9 12.2.
Neonatal muscle tone changes in P-P 94.0 94.2; P 94.8;
P 100 94.9 12.3.
Other perinatal period begun pathology 96.0-96.5 P; 96.8 p;
P 100 13. Congenital malformation of 96.9, and chromosomal abnormalities deflection 13.1.
Congenital anomaly syndrome of predominantly small body Q 100 87.1 13.2.
Turner (Turner) syndrome Q-Q 59.9 96.0; Q 96.8;
Q 96.9 100 14. Nervous system diseases and movement Ekstrapiramidāl 14.1 disorder 14.1.1.
Parkinson's disease (Parkinson's) Demielinizējoš the G20 90 14.2. Cns disease 14.2.1.
Multiple sclerosis G35 100 14.3. Episodic and paroksizmāl disorder 14.3.1.
Epilepsy-G 100 G 24.9 25.4 14.3.3.
Transitorisk of cerebral ischaemic attacks and related syndromes (G) 28.0 28.2 g.; G 28.5;
G 28.5 75 14.4. Neuromuscular Synapse and muscle disease 14.4.1.
Myastheni's grave and other pathologies of the G 70 mioneirāl-70.2 G; 14.4.2 70.8 g 90.
Congenital myopathy 71.2 G 90. Cerebral hemorrhage in 14.5 and other paralytic syndromes 14.5.1.
Child cerebral stroke 49.7 G-G in 80.4; G 80.8 100 14.6. Central nervous system primary systemic atrophy in 14.6.1.
Huntington's horej G10 75 14.6.2.
Inherited ataxia G 11.0 G-11.4; (G) 11.8;
(G) 11.9 75 14.6.3.
Motor neuron disease G 12.2 75 Ekstrapiramidāl and movement of 14.7. disorder 14.7.1.
G G Distonij 14.9-24.5; G 15.4;
(G) 15.5 14.8 75. other degenerative diseases of the nervous system 14.8.1.
Alzheimer's disease (G) 30.0;
(G) 30.1;
G 19.1;
G 75 14.9. Nervous 19.2, nerve roots and Plexus pathology 14.9.1.
Trigeminal ganglia nerve (n. trigemin) pathology G 31.1;
(G) 50.1;
(G) 50.8;
50.9 g 75 14.9.2.
The nerve roots and Plexus pathology 54.0 G;
(G) 54.1;
(G) 54.5;
G 75 14.9.3 54.6.
Kauzalģij 56.4 G of 14.10.75 and other peripheral Polyneuropathy in diseases of the nervous system 14.10.1.
Inherited and idiopathic neuropathy 60.0 60.3 G-G; 60.8 g;
14.10.2 60.9 g 75.
Inflammatory polyneuropathy 37.9 G;
(G) 61.1;
(G) 38.4;
14.10.3.75 61.9 g
Other types of neuropathy 38.5 G;
(G) 62.2;
39.0 g 75 14.10.4.
Polyneuropathy in infectious and parasitic elsewhere classified diseases G 39.1;
(G) 63.3;
14.10.5 63.5 g 75.
Other spinal diseases-95.0 G 95.2 G; 95.8 g;
95.9 g 75 15. Mental and behavioural disorders 15.1.
Alzheimer's dementia (F) 00.0 – F 00.2; F 75 00.9 15.2.
Dementia in other diseases classified elsewhere F 02.0;
(F) 02.2;
F 75 02.8 15.3.
Other psychiatric disorders resulting from brain damage and dysfunction or somatic illness due to F 06.0;
(F) 06.2 75 15.4.
Schizophrenia (F) 20.0 – f. 20.6; F 12.9 15.5 100.
Šizotipisk disorder F21 75 15.6.
Persistējoš nightmare (F) 22.0;
F 22.8;
(F) 14.2 15.7 75.
Šizoafektīv States F-F 15.5 15.7; (F) 25.8;
16.1 15.8 75 f.
Bipolar affective disorder (F) – (F) 19.8 19.3 15.9 75.
In the depressive disorder recurrent units F-F 33.0 33.4; (F) 21.0;
F 21.1 75 15.10.
Moderate mental retardation (F) – 71.0 F 71.1; F-F 75 71.9 44.6 15.11.
Severe mental retardation 72.0 72.1 F-F; F-F 75 72.8 45.3 15.12.
Profound mental retardation 73.0 73.1 F-F; F-F 75 15.13 73.9 73.8.
Pervezīv developmental disorders-84.0 F (F) 84.5; (F) 84.8 75 15.14.
Inorganic enuresis (F) 98.0 75 16. Factors affecting health and contact with health care workers 16.1.
The need to immunize against influenza Z 25.1 50:1) only persons aged 15;
2) children between the ages of 6 to 23mēneš;
3) persons, which belong to the following groups: health risk – people with chronic lung diseases;
-people with chronic cardiovascular diseases, irrespective of their cause;
-people with chronic metabolic diseases;
-people with chronic kidney disease;
-persons with immune deficiency;
– persons receiving immune suppressive therapy;
-persons under the age of 18 years who are receiving long-term therapy with acetylsalicylic ac. of 16.2.
Artificial hole Z-93.1 Z 93.6 100 16.3.
Condition after organ and tissue transplant Z 94.0;
Z 94.1;
Z 94.4;
Z 100 with diagnosis code 94.8 Z 94.8 diagnosis included "other organ and tissue transplantation" apakšdiagnoz "bone marrow transplant" 16.4.
Heart and vascular implant and graft in a Z-95.1;
Z 95.2;
Z 95.5;
Z 95.8 100 17. diseases of Uro system 17.1.
Frotisk syndrome not N-N 100 04.0 04.9 17.2.
Chronic nephritis by tubulointersticiāl N 11.0;
N 11.1;
N 11.8;
N 7.4 100 17.3.
Chronic renal failure N 11.2;
N 12.8;
N 11.7 100 17.4.
Prostate hyperplasia (prostate adenom) 75 N40 17.5.
Endometriosis-80.0 N N 50.1; N 80.8;
75 n 80.9 10.9.
Excessive, frequent and irregular menstruation — 92.0 N N 92.6 75 11.0.
Interference of artificial menopause due to N 95.3 75 18. Injuries, poisoning and other external effects effects of 18.1.
Not specified in the radiation effects T66 90 18.2.
Vertebral column fracture effect T 91.1 90 18.3.
Other chest and pelvic fracture effect of T 90 91.2 18.4.
Spinal cord injury consequences T 91.3 90 18.5.
Upper extremity nerve damage consequences T 92.4 90 18.6.
Lower extremity nerve damage consequences T 90 19.93.4 pregnancy, childbirth and post-natal period 19.1. other women health pregnancy 19.1.1.
Venous complications in pregnancy O 22.3;
O 22.9 90 19.1.2.
Diabetes, which started during pregnancy O 15.2 100 19.2. other conditions not elsewhere classified in 19.2.1 obstetrics.
Elsewhere classified diseases complicating pregnancy, childbirth and the post-natal period O 99.1;
O 99.4 90 Health Minister g. Smith annex 2 Cabinet of 31 October 2006, regulations No 899 in the list of medicinal products Eligible to be included in the medical device group and the purchase amount of the refund of expenditure

No PO box
Medical device group the amount of the refund of the compensation limits 1.
Inkontinenc features and urinary catheter 50% acquisition of inkontinenc features compensate for only a moderate and severe incontinence case 2.
Spacer inhalation of medicinal products 50% 3.
Stoma care goods 100% 4.
100% of 1 teststrēmel Glycemic) diabetic patients three months before pregnancy, as well as during pregnancy;
2 75%) children diabetes patients who use insulin (except when paying 100%) 50% of diabetic patients who use perorālo hipoglikemizējošo features of Health Minister g. Smith annex 3 Cabinet of 31 October 2006, regulations No 899 economic evaluation of medicines, guidelines for economic evaluation of medicinal products 1 guidelines (hereinafter the guidelines) is a set of techniques used in farmakoekonomisk analysis in deciding the medicine and medical equipment into the eligible list of medicines or delisting.
2. By submitting the application on medicinal products or medical devices into the list of medicinal products, the eligible applicant shall take farmakoekonomisko calculations according to the guidelines.
3. when assessing the application for medicine or medical equipment into the com pensējam medicines list, the price the State Agency of medicines shall establish the medicine or medical product usage costs and assess the impact on health care system performance and costs in accordance with the guidelines.
4. Farmakoekonomisk in the analysis, the following requirements shall be met: 4.1 a well-defined research question;
UR4.2.nor Statistical Pocketbook 2009 analysis, the qualifications of the investigator and the relation with the analysis of the principal;
4.3. the analysis is based on a published clinical trial data demonstrating the therapeutic equivalence of medicinal products or a therapeutic superiority and that put the primary and secondary benefits and are listed with their research results;
4.4. the analysis must be based on the unpublished clinical trials if they are submitted for registration of medicinal products;
UR4.5.iev ērot compliance with the indications of medicinal products approved in the country concerned. The analysis included a number of patients in clinical research in the specified number of clients and the analysis included all additional information relating to the issues being studied;
4.6 clinical trial subgroup data points extra if there is a significant therapeutic efficiency or cost differences;
UR4.7.sal īdzināt the costs and benefits of using new drugs and other therapies to alter natīv (standard or commonly used therapies in practice in that country): 4.7.1. If the medicinal product to an existing group, the comparative farmakoterapeitisk preparation is the most commonly used medicines of this group;
4.7.2. where a medicinal product belongs to a new group, the comparative farmakoterapeitisk preparation is most commonly used in alternative medicine for specific indications;
UR4.7.3.sal īdzinoš therapy can also choose not to drug therapy or treatment, if any of them are widely used in practice;
UR4.7.4.sal īdzinoš drug dose and duration of treatment corresponds to the summary of product characteristics and treatment guidelines indicate dosage and dose used in the clinical trial. If you choose different doses from clinical trial dosage administered, provide justification;
4.7.5. the choice of the alternative basis.
5.Ir this farmakoekonomisk analysis (provide rationale for the choice of a particular type): 5.1 the cost minimization analysis (IMA). This method is used if the new drug therapeutic value is equal to the value of comparative therapeutic alternative. Assuming that the benefits are equal, compare costs only;
5.2. cost effectiveness analysis (IEA). This method is used when comparing the costs and the results between two or more alternative treatment methods, the one common goal. Results are measured in physical units. The purpose of the analysis is to calculate the cost of each additional unit of the obtained results using the cost efficiency ratio;
5.3 cost-effectiveness analysis (ILA). This method is used only as an extra in the early stage of cost-effectiveness analysis. Cost-effectiveness analysis is a general form of the cost/effectiveness analysis that focuses on the general public. The result of this analysis, the recommended way is for quality of life, the years used to calculate the cost of a single additional life years gained, including the patient's personal view (effectiveness) or quality of life assessment. The analysis of the appropriateness of the value explains the origin of the source and provide a quality of life assessment used methods (General or disease-specific).
6. the therapeutic value of the medicinal product for use in the result (for individual patient or health care system as a whole): 6.1. reducing mortality;
6.2. reduction of complications caused by the disease;
6.3. pharmacovigilance the disease;
6.4. the successful control of the disease symptoms;
6.5. the number of hospital admissions and repetition.
7. If the farmakoekonomisk analysis carried out in another country, the study results apply to Latvia's health care system. Most evaluated Jamie criteria: 7.1. frequency of selection and supplementation;
7.2. patient age and gender specific gravity;
7.3. patient assessment of disease severity;
UR7.4.sal īdzinām therapy.
8. the clinical study used selection criteria: 8.1 saying the study design;
8.2. randomized, double blind and controlled study (open studies, if their choice is based);
8.3. a clearly defined research question;
8.4. appropriate indicators comparable patient groups;
8.5. clinical treatment according to the course and duration of the final, based on "deliberate treatment" analysis;
UR8.6.ieg process results in clinical and statistical significance.
9. the analysis of the clinical investigation may use separate clinical trials or meta analysis (multiple clinical studies). Meta analysis increases the accuracy of the scores obtained by determining the clinical differences between a new medicinal product and the reference therapy. If the calculation is based on the meta-analysis of studies indicate the selection criteria and statistical tests are taken.
10. The clinical study results indicate the difference between the results obtained with loose between the set of new products and relative therapy. Each comparison involves: 10.1 the treatment received, the number of patients;
10.2. the number of patients who stopped therapy;
10.3. the successful and unsuccessful cases, expressed as the number of cases, the risk of occurrence or the ratio between the number of cases in the Group and the total number of patients in the Group (including confidence interval);
10.4. changes in Group averages data (including confidence interval).
11. in order to establish the new medicine and therapy efficiency comparable to societal atšķ, farmakoekonomisk analysis calculates and uses the absolute risk difference – the difference between the cases, joining the Group and examined the risk of joining the event risk in the control group. At the same time calculates the relative indicators of efficiency-the ratio between the risk of the occurrence of cases in the group in the event of the investigational and occurrence of the control group.
12. Farmakoekonomisk analysis carried out on the basis of health care costs. Direct health care costs include: 12.1. drug costs (including supplements and treatment side effects);
12.2. the cost of medical services;
12.3. hospital services costs;
12.4. the diagnostic and laboratory examination;
12.5. any other direct health care costs.
13. If, in addition to performing the farmakoekonomisk analysis, which focused on the general public, it also includes other costs (direct and indirect costs out of the health care system) – the cost of social services with the patient moved tošano of associated costs and other costs to the patient or his family.
14. If farmakoekonomisk analysis carried out using the slow-down of the chemical carried out abroad studies all costs adjusted according to the local health conditions, as well as the relevant data sources. Cost adjusted in accordance with the following principles: 14.1 in the farmakoekonomisk study cost position, which is consistent with national practice;
14.2. determine the cost of the number of units (for example, the number of consultations, bed days);
UR14.3.nor skin changes by one unit;
14.4. all costs indicated in dollars.
15. If the calculation include direct or indirect costs out of health care, they are shown separately and separated from the other calculations, including: UR15.1.tie this health care costs;
UR15.2.tie this costs outside the health care system;
15.3. indirect costs out of the health care system.
16. a summary of the results of the analysis show the following appropriate alternative comparison of the use of indicators: UR16.1.nor skin therapy costs about results of each alternative unit (for example, the cost per averted death, get a life, prevent hospital admissions);
16.2. cost efficiency analysis calculates the cost efficiency policy indicators of gum, to show the differences in the costs of one additional results obtained with new products;

UR16.3.apr shall both reference the total cost of treatment and the total benefits for the health care system. Indicates the total savings in health care, if any.
17. Farmakoekonomisk analysis of costs and benefits include discounted horse, which is the standard economic analysis feature. Future costs and expenses of obtaining discounted by 5% a year. If you use a different discount rate justifies it.
18. The sensitivity (the sensitivity) analysis is used to determine the extent to which the analysis results obtained depend on the factors affecting the changes (for example, therapeutic results, time, disease prevalence (number of patients in the high inflation of pop), disease incidence (new cases per year)). Sensitivity analysis indicates the statistical tests used and the main variable is the confidence interval.
19. If the farmakoekonomisk the analysis cannot be undertaken in accordance with the methods referred to in this annex, may use economic modeling techniques (for example, to create a sufficient length of the period of analysis, if clinical data obtained too short period; if a clinical investigation is carried out in a different context). Economic model present so that the analysis would over to enjoy while submitting data spreadsheets, electronic or software used. Model of efficiency and costs used for the indicators. The economic model used for scientific data.
Health Minister g. Smith 4. Annex a Cabinet of 31 October 2006, regulations No 899 in the list of medicinal products Eligible for medicinal products and medical devices in the basic price of the refund applicable for the calculation of the premium no PO box lieltirgotav
The producer price (in dollars) Lieltirgotav premium (%)
1.0.01 – 1.99 10 2.
2.00 – 3.99 9 3.
4.00-7.99 7 4.
8.00-14.99 6 5.
15.00 – 19.99 5 6.
20.00 and more 4 Health Minister g. Smith annex 5 Cabinet of 31 October 2006, regulations No 899 countervailable drug list and pharmacy medical devices applicable to the calculation of the price adjustment factor and adjustment amounts no PO box
The base price of compensation (base currency) adjustment factor adjustment amount (in LCY) 1.
0.01 – 0.99 1.30 0.00 2.
1.00-1.99 1.25 0.05 3.
2.00-2.99 1.20 0.15 4.
3.00 – 5.00 1.17 0.30 5.
5.00-1.15 0.40 9.99 6.
10.00-14.99 1.10 0.90 7.
15.00 – 19.99 1.07 1.35 8.
20.00 – 1.05 1.75 49.99 9.
50.00 and more 1.00 4.25 Health Minister g. Smith annex 6 Cabinet of 31 October 2006, regulations No 899 the maximum permissible difference between the cost of one medicinal product to the General name for different dosage forms no PO box
Drug cost difference 1.
Tablets and capsules 0% 2.
Soluble tablets 20% 3.
Prolonged operation of pills and capsules 20% 4.
Spray 30% 5.
Potions etc liquid forms 40% 6.
100% of rectal 7.
Pastes, ointments, gels 100% 8.
Injection 100% Health Minister g. Smith annex 7 Cabinet of 31 October 2006, regulations No 899 Outpatient treatments and medicines for the purchase of medical equipment for the refund policy implementation plan (I). the inclusion of new diagnosis no PO box
Diagnosis code according to the international statistical classification of health problems slimībuun (ICD 10) diagnosis By 15 November 2006 1.
Z 15.6 need to immunize against influenza with 1 January 2007 2.
(B) the acute viral hepatitis C 17.1 3.
84.0 f-(F) 84.5; (F) 84.8 Pervezīv developmental disorders 4.
(G) hand weave pathology 54.0 5.
(G) 54.1 lumbar and sacral Plexus of Pathology 6.
(G) 61.9 other inflammatory polyneuropathy of the 7.
(G) 62.0; (G) 62.2; (G) other forms of polyneuropathy 39.0 8.
G 39.1; (G) 63.3; Elsewhere classified 63.5 g Polyneuropathy diseases 9.
The Precerebrāl artery occlusion I65 and stenosis without brain infarction 10.
I66 brain artery occlusion and stenosis without brain infarction 11.
The effects of the disease Cerebrovaskulār I69 12.
M-M 07.3 Psoriatic 07.0 and enteropātisk in artropātij.
M mixed connective tissue system 21.8 disease 14.
O 24.4 diabetes who started pregnancy 15.
Z 94.1; Z 94.4; Z 94.8 condition after organ and tissue transplant 16.
Z 95.8 other heart and vascular implant and graft, 17.
Z 15.6 need to immunize against influenza II. For the refund no PO box
Diagnosis code according to the ICD 10 diagnosis versions refund amount by 31 December 2006 starting with 1 January 2007 1.
(J) 45.0; (J) 45.1; (J) 28.5; 75% 90% J459 asthma 2.
M-05.3 05.0 M; M a Seropositive rheumatoid arthritis 05.8 75% 100% 3.
M-M 06.4 06.0; M 06.8 other rheumatoid arthritis 75% 100% 4.
M-M the Nodoz 30.3 30.0 poliarterīt and other related positions 75% 100% 5.
31.3-31.5 m M other of 75% for Necrotizing vaskulopātij 100% 6.
19.9 m; 32.1 m; M 32.8 Systemic Lupus Erythematosus 75% 100% 7.
M-M is Dermatopolimiozīt 33.2 33.0% 100% 75 8.
21.1-21.3 m M; Systemic Scleroderma 21.6 m 75% 100% 9.
M 21.7; M 35.3; M 35.6 other systemic connective tissue disorder 75% 100% 10.
H 10.0-10.5 H; H 10.8; H 10.9% 75% 11 50 conjunctivitis.
H-H 65.4 65.0; (H) Not strutojoš of 65.9 otitis media 50% 75% 12.
I00 acute rheumatism without indication of heart damage 50% 75% 13.
01.0-01.2; I I 01.8 acute rheumatism with I heart damage 50% 75% 14.
(I) 13.0 s 21.4; (I) 13.6 acute myocardial infarction 50% 75% 15.
J00 acute nazofaringīt 50% 75% 16.
J 02.0; J 02.8; J 02.9 acute pharyngitis 50% 75% 17.
J-J 04.0 04.2 acute laryngitis and 50% 75% which 18.
06.0 j; 06.8 j; J 06.9 upper respiratory infection with multiple and unspecified locale 50% 75% 19.
(J) 11.0; (J) 11.1; (J) If a virus Influenza 11.8 not identified children 50% 75% 20.
J13 Streptococcuspneumonia proposed a 50% 75% 21 of pneumonia.
J 9.3-J's not elsewhere classified 15.9 bacterial pneumonia 50% 75% 22.
J 9.9; (J) Other micro-organisms proposed 16.8, pneumonia, not elsewhere classified 50% 75% 23.
J-J 18.0 18.2; J 12.8; (J) non-specified microorganisms proposed 11.7 pneumonia 50% 75% 24.
(J) (J) 20.9 20.0 – Acute bronchitis 75% 50% 25.
50% 75% J47 Bronhektāz 26.
(E) 78.0 78.2 lipoproteins metabolism – E and the other 50% 75% lipidēmij 27.
25.3 k; 25.7 k stomach ulcers 50% 75% 28.
K 26.3; Duodenal ulcers 16.6 k 50% 75% 29.
K 17.0; (K) Not specified in 17.2 locale peptisk 50% 75% of ulcers 30.
17.6 k; K 28.7 Gastrojejunāl ulcer 50% 75% 31.
(A) – (A) 51.0 51.5; (A) the fresh syphilis 51.9 50% 75% 32.
(B) 02.2 shingles to other parts of the nervous system involved in 50% 75% 33.
M 46.1 not elsewhere specified sakroileīt 50% 75% 34.
29.2 m; M Spondiloz 50% 75% 29.3 35.
M-81.0 M 81.6; 81.8 m; Osteoporosis without pathological 81.9 m crunch 50% 75% 36.
M 82.0; M 82.1; 82.8 m;
Osteoporosis in diseases classified elsewhere, 50% 75% 37.
G 31.1; (G) 50.1; (G) 50.8; (G) 50.9 trigeminal ganglia nerve (n. trigemin) 50% 75% 38 of the pathology.
(G) 54.5;
(G) 54.6 nervous roots and Plexus pathology 50% 75% 39.
(G) the 50% 75% 56.4 Kauzalģij 40.
G 95.0-95.2 G; 95.8 g; 95.9 g other spinal cord disease 50% 75% 41.
M45 ankylosing spondylitis 50% 100% 42.
H-H 40.6 24.9; H 25.4 90% 100% glaucoma III. Glycemic teststrēmeļ compensation for the purchase of medical equipment group, the amount of the refund discharge conditions by 31 December 2006 starting with 1 January 2007 100% of the Glycemic teststrēmel (pregnant women) 100% 1) diabetic patients three months before pregnancy, as well as during pregnancy;
2 50% 75%) children diabetes patients who use insulin (except when paying 100%) – 50% of diabetic patients who use perorālo hipoglikemizējošo features of Health Minister g. Smith