National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 7) (PB 68 of 2018) (Cth)

Case

PB 68 of 2018

National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 7)

National Health Act 1953

___________________________________________________________________________

I, JULIANNE QUAINE, Assistant Secretary, Pharmacy Branch, Technology Assessment and Access Division, Department of Health, delegate of the Minister for Health, make this Instrument under subsection 100(2) of the National Health Act 1953.

Dated   30 JULY 2018

JULIANNE QUAINE

Assistant Secretary

Pharmacy Branch

Technology Assessment and Access Division

Department of Health

___________________________________________________________________________

  1. Name of Instrument

(1)This Instrument is the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 7).

(2)This Instrument may also be cited as PB 68 of 2018.

  1. Commencement

This Instrument commences on 1 August 2018.

  1. Amendment of National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011)

Schedule 1 amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011).

Schedule 1       Amendments

  1. Schedule 1, Part 1, entry for Nivolumab in each of the forms: Injection concentrate for I.V. infusion 40 mg in 4 mL; and Injection concentrate for I.V. infusion 100 mg in 10 mL

(a)insert in numerical order in the column headed “Circumstances”: C6996

(b)omit from the column headed “Circumstances”: C7567

(c)insert in numerical order in the column headed “Circumstances”: C7787 C7802 C7864

  1. Schedule 1, Part 1, entry for Pembrolizumab in each of the forms: Powder for injection 50 mg; and Solution concentrate for I.V. infusion 100 mg in 4 mL

insert in numerical order in the column headed “Circumstances”: C7773

  1. Schedule 1, Part 1, entry for Vinblastine

omit:

Vinblastine Teva DZ MP D
  1. Schedule 1, Part 2, entry for Nivolumab [Maximum Amount: 360; Number of Repeats: 8]

(a)insert in numerical order in the column headed “Purposes”: P6996

(b)omit from the column headed “Purposes”: P7567

(c)insert in numerical order in the column headed “Purposes”: P7864

  1. Schedule 1, Part 2, entry for Nivolumab [Maximum Amount: 360; Number of Repeats: 11]

insert in numerical order in the column headed “Purposes”: P7787 P7802

  1. Schedule 1, Part 2, entry for Pembrolizumab [Maximum Amount: 200; Number of Repeats: 6]

insert in numerical order in the column headed “Purposes”: P7773

  1. Schedule 4, entry for Nivolumab

(a)insert in numerical order for the column headed “Circumstances Code”:

C6996 P6996

Locally advanced or metastatic non-small cell lung cancer

Initial treatment

Patient must not have received prior treatment with a programmed cell death-1 (PD-1) inhibitor for this condition; AND
Patient must have a WHO performance status of 0 or 1; AND
The treatment must be the sole PBS-subsidised treatment for this condition; AND
The condition must have progressed on or after prior platinum based chemotherapy.
The patient's body weight must be documented in the patient's medical records at the time treatment is initiated.

Compliance with Authority Required procedures - Streamlined Authority Code 6996

(b)omit:

C7567 P7567

Locally advanced or metastatic non-small cell lung cancer

Initial treatment

Patient must not have received prior treatment with a programmed cell death-1 (PD-1) inhibitor or a programmed cell death ligand-1 (PD-L1) inhibitor for this condition; AND
Patient must have a WHO performance status of 0 or 1; AND
The treatment must be the sole PBS-subsidised treatment for this condition; AND
The condition must have progressed on or after prior platinum based chemotherapy.
The patient's body weight must be documented in the patient's medical records at the time treatment is initiated.

Compliance with Authority Required procedures - Streamlined Authority Code 7567

(c)insert in numerical order after existing text:

C7787 P7787

Recurrent or metastatic squamous cell carcinoma of the oral cavity, pharynx or larynx

Continuing treatment

Patient must have previously received PBS-subsidised treatment with this drug for this condition; AND
Patient must have stable or responding disease; AND
The treatment must be the sole PBS-subsidised therapy for this condition.

Compliance with Authority Required procedures - Streamlined Authority Code 7787
C7802 P7802

Recurrent or metastatic squamous cell carcinoma of the oral cavity, pharynx or larynx

Grandfather treatment

Patient must have received non-PBS subsidised treatment with this drug for this condition prior to 1 August 2018; AND
Patient must have had a WHO performance status of 0 or 1; AND
The condition must have progressed within 6 months of the last dose of prior platinum based chemotherapy, prior to commencing non-PBS-subsidised treatment with this drug for this condition; AND
Patient must not have developed disease progression while receiving non-PBS-subsidised treatment with this drug for this condition; AND
The treatment must be the sole PBS-subsidised therapy for this condition.
A patient may qualify for PBS-subsidised treatment under this restriction once only. For continuing PBS-subsidised treatment, a Grandfathered patient must qualify under the Continuing treatment criteria.

Compliance with Authority Required procedures - Streamlined Authority Code 7802
C7864 P7864

Recurrent or metastatic squamous cell carcinoma of the oral cavity, pharynx or larynx

Initial treatment

Patient must have a WHO performance status of 0 or 1; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
The condition must have progressed within 6 months of the last dose of prior platinum based chemotherapy; AND
Patient must not have received prior treatment with a programmed cell death-1 (PD-1) inhibitor for this condition.
The patient's body weight must be documented in the patient's medical records at the time treatment is initiated.

Compliance with Authority Required procedures - Streamlined Authority Code 7864
  1. Schedule 4, entry for Pembrolizumab

insert in numerical order after existing text:

C7773 P7773

Relapsed or Refractory Hodgkin lymphoma

Initial treatment - Grandfathered patients

Patient must have previously received non-PBS-subsidised treatment with a programmed cell death 1 (PD-1) inhibitor for this condition prior to 1 May 2018; AND
Patient must have undergone an autologous stem cell transplant (ASCT) for this condition and have experienced relapsed or refractory disease post ASCT prior to receiving treatment with a PD-1 inhibitor for this condition; OR
Patient must not have been suitable for ASCT for this condition and have experienced relapsed or refractory disease following at least 2 prior treatments for this condition prior to receiving treatment with a PD-1 inhibitor for this condition; AND
Patient must not have developed disease progression while receiving treatment with this drug for this condition; AND
The treatment must be the sole PBS-subsidised therapy for this condition; AND
The treatment must not exceed a total of 35 cycles in a lifetime.
A patient may qualify for PBS-subsidised treatment under this restriction once only. For continuing PBS-subsidised treatment, a Grandfathered patient must qualify under the Continuing treatment criteria.
Applications for authorisation of initial treatment must be in writing and must include:
(a) a completed authority prescription form;
(b) a completed Hodgkin lymphoma pembrolizumab PBS Authority Application for Grandfathered patients.

Compliance with Written Authority Required procedures
Actions
Download as PDF Download as Word Document


Cases Citing This Decision

0

Cases Cited

0

Statutory Material Cited

0