MTC SHANG BLDG.

ML QUEZON NAT’L HIGHWAY

PAJO, LAPU-LAPU CITY, PHILIPPINES
TELEFAX #: (032) 349 – 2016
EMAIL ADD: tamigapharmaceuticals@yahoo.com

PRODUCT EVALUATION FORM

PRODUCT INFORMATION

Description of Clinical Product

Sugammadex 100mg/ml Solution for Injection IV (SOGOMA 200)

Description of Clinical Application

Antidote

Brand Name: SOGOMA 200

Generic Name: Sugammadex 100mg/ml Solution for Injection IV
Price: 5,190.00

PRODUCT EVALUATION
PARAMETERS SATISFIED DISSATISFIED REMARKS
Efficacy
Price
Customers
Service

Evaluated by: _________________

 MTC SHANG BLDG. ML QUEZON NAT’L HIGHWAY
PAJO, LAPU-LAPU CITY, PHILIPPINES
TELEFAX #: (032) 349 – 2016
EMAIL ADD: tamigapharmaceuticals@yahoo.com

PRODUCT EVALUATION FORM

PRODUCT INFORMATION

Description of Clinical Product

Propofol 10mg/ml (1% w/v) Emulsion for Injection IV (PRIVAN)

Description of Clinical Application

General Anesthetic

Brand Name: PRIVAN

Generic Name: Propofol 10mg/ml (1% w/v) Emulsion for Injection IV
Price: 330.00

PRODUCT EVALUATION
PARAMETERS SATISFIED DISSATISFIED REMARKS
Efficacy
Price
Customers
Service

Evaluated by: ________________

 MTC SHANG BLDG. ML QUEZON NAT’L HIGHWAY
PAJO, LAPU-LAPU CITY, PHILIPPINES
TELEFAX #: (032) 349 – 2016
EMAIL ADD: tamigapharmaceuticals@yahoo.com

PRODUCT EVALUATION FORM

PRODUCT INFORMATION

Description of Clinical Product

NEOSTIGMINE 500 mcg/mL (NOSTIGMINE)

Description of Clinical Application

Cholinesterase Inhibitors/Anesthesia Department

Brand Name: NOSTIGMINE

Generic Name: NEOSTIGMINE 500 mcg/mL
Price: 240.00

PRODUCT EVALUATION
PARAMETERS SATISFIED DISSATISFIED REMARKS
Efficacy
Price
Customers
Service

Evaluated by: _________________

 MTC SHANG BLDG. ML QUEZON NAT’L HIGHWAY
PAJO, LAPU-LAPU CITY, PHILIPPINES
TELEFAX #: (032) 349 – 2016
EMAIL ADD: tamigapharmaceuticals@yahoo.com

PRODUCT EVALUATION FORM

PRODUCT INFORMATION

Description of Clinical Product

KETEROLAC TROMETAMOL 30mg/ml (KETOGEN)

Description of Clinical Application

Non-Opioid Analgesic/Anesthesia Department

Brand Name: KETOGEN

Generic Name: KETEROLAC TROMETAMOL 30mg/ml
Price: 140.00

PRODUCT EVALUATION
PARAMETERS SATISFIED DISSATISFIED REMARKS
Efficacy
Price
Customers
Service

Evaluated by: _________________