125 mg / 5 mL | Powder for oral suspension
The pharmacist has dispensed Broxil® 125 mg / 5 mL, powder for oral suspension to the patient. The health insurer will not reimburse the cost of this prescription in full. The producer of this medicine has therefore instructed TBR Nederland to reimburse to the patient the Personal Contribution charged.
|Dose||125 mg / 5 mL|
|Type||Powder for oral suspension|
|Active ingredient||FENETICILLIN (AS FENETICILLIN POTASSIUM)|
The Personal Contribution demonstrably charged to the patient by the health insurer for Broxil® 125 mg / 5 mL, powder for oral suspension, is eligible for full reimbursement from 1 August 2020 to a maximum of € 250,- per patient per year. The arrangement is limited to patients who are dependent on this drug for (functional) asplenia or recurrent erysipelas.
For this medicine a Doctor's Statement is required. The form can be downloaded here or below under 'Submit a claim by post'.
Only patients or their carer can submit a claim for the Personal Contribution paid for Broxil® 125 mg / 5 mL, powder for oral suspension online or by post. Online will be the fastest option. Pharmacists cannot submit claims on behalf of the patient for this medicine.
For the Reimbursement Scheme of this medicine no closing date has been determined yet.
Patients can claim online and will receive their reimbursement within 5 working days.
Patients can claim by post and will receive their reimbursement within 15 working days.
Please mail the Claim Form and attachments to:
1180 LA Amstelveen
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