EXPLANATORY STATEMENT
INSTRUMENT NUMBER PB 67 OF 2010
NATIONAL HEALTH ACT 1953
AMENDMENT DECLARATION UNDER SUBSECTIONS 85(2) AND 85(2AA)
AMENDMENT DETERMINATION UNDER SUBSECTION 85(2A)
Summary
This legislative instrument in giving effect to recommendations of the Pharmaceutical Benefits Advisory Committee (PBAC) amends declarations under subsections 85(2) and 85(2AA) and the determination under subsection 85(2A) made by legislative instrument number PB 14 of 2010 which came into effect on 1 April 2010. The amendments declare additions and changes to the list of drugs and medicinal preparations available as pharmaceutical benefits and the circumstances in which the pharmaceutical benefits may be prescribed. The amendments are set out in the items of Schedule 1 to the instrument.
Purpose and operation
Part VII of the National Health Act 1953 (the Act) is the legislative basis of the Pharmaceutical Benefits Scheme (PBS) by which the Commonwealth provides reliable, timely, and affordable access to a wide range of medicines for all Australians.
Subsection 85(1) provides that benefits are to be provided by the Commonwealth in accordance with Part VII in respect of pharmaceutical benefits.
Drugs and medicinal preparations in relation to which Part VII applies are declared by the Minister by legislative instrument as such under subsection 85(2). These are listed drugs as defined in subsection 84(1). Part VII also applies to certain extemporaneously-prepared medicinal preparations as a result of declarations under paragraph 85(2)(b).
The Minister by legislative instrument can determine the form or forms of a listed drug by reference to strength, type of unit, size of unit or otherwise (subsection 85(3)); the manner of administration of the form of the listed drug so determined (subsection 85(5)); and a brand of the pharmaceutical item (defined in subsection 84(1)) that has the listed drug in that form with that manner of administration (subsection 85(6)). These determinations govern (except for certain extemporaneously-prepared pharmaceutical benefits) what constitutes the pharmaceutical benefit (defined in subsection 84(1)) under Part VII of the Act.
Subsection 85(2AA) empowers the Minister, by legislative instrument, to revoke or vary a declaration under subsection 85(2) in relation to a drug or medicinal preparation.
Where a revocation or variation would have the result that a drug or medicinal preparation would cease to be a listed drug, the Minister must under subsection 85(2AB) obtain the advice in writing of the PBAC. Under subsection 85(2AC), this PBAC advice is to be tabled in Parliament with the relevant declaration under subsection 85(2AA). Subsection 101(4) further provides that a drug or medicinal preparation cannot be declared under paragraph 85(2)(a) to be a drug or medicinal preparation in relation to which Part VII applies unless the PBAC has recommended to the Minister that it be so declared.
A provision-by-provision description of the instrument is contained in the Attachment.
This instrument, expressed to commence on 1 August 2010, was made on 5 July 2010.
Consultations
The involvement of interested parties through the membership of the PBAC constitutes a formal and ongoing process of consultation. The PBAC is an independent expert body established by section 100A which makes recommendations to the Minister about which drugs and medicinal preparations should be available as pharmaceutical benefits. PBAC members are appointed following nomination by prescribed organisations and associations from consumers, health economists, practising community pharmacists, general practitioners, clinical pharmacologists and specialists, with at least one member selected from each of those interests or professions. Remaining members are persons whom the Minister is satisfied have qualifications and experience in a field relevant to the functions of the PBAC, and that would enable them to contribute meaningfully to the deliberations of the PBAC. When recommending the listing of a medicine on the PBS, the PBAC takes into account the medical conditions for which the medicine has been approved for use in Australia, its clinical effectiveness, safety and cost-effectiveness compared with other treatments.
ATTACHMENT
Paragraph 1: provides that this instrument commences on 1 August 2010.
Paragraph 2: provides that Schedule 1 amends PB 14 of 2010.
Schedule 1: provides for the following amendments:
SCHEDULE 1
Addition of Listed Drugs
Amino acid formula with fat, carbohydrate, vitamins, minerals, and trace elements, without methionine and supplemented with docosahexanoic acid |
Brinzolamide with timolol |
Certolizumab pegol |
Exenatide |
Golimumab |
Vildagliptin |
Alteration of Circumstances
Adalimumab | [circumstances amended for the treatment of adult patients with severe active rheumatoid arthritis, severe active psoriatic arthritis and active ankylosing spondylitis] |
Anakinra | [circumstances amended for the treatment of adult patients with severe active rheumatoid arthritis] |
Aprepitant | [additional availability for the management of nausea and vomiting associated with moderately emetogenic cytotoxic chemotherapy, in combination with a 5HTe antagonist and dexamethasone] |
Capecitabine | [additional availability for the treatment of a patient with advanced (Stage III or IV) oesopho-gastric cancer] |
Etanercept | [circumstances amended for the treatment of active ankylosing spondylitis, severe active psoriatic arthritis and severe active rheumatoid arthritis] |
Imatinib | [circumstance amended for the initial treatment of metastatic or unresectable malignant gastrointestinal stromal tumour] |
Mesalazine | [addition of the tablet 1 g (prolonged release)] |
Methylphenidate | [addition of the capsule (modified release) containing methylphenidate hydrochloride 10 mg] |
Oxaliplatin | [circumstances amended to include the listed drug capecitabine in the treatment of a patient with metastatic colorectal cancer] |
Pramipexole | [addition of the tablet (extended release) containing pramipexole hydrochloride 375 micrograms, tablet (extended release) containing pramipexole hydrochloride 750 micrograms, tablet (extended release) containing pramipexole hydrochloride 1.5 mg, tablet (extended release) containing pramipexole hydrochloride 3 mg and , tablet (extended release) containing pramipexole hydrochloride |
Triglycerides — medium chain, formula | [change of pack size of the sachets containing oral powder 16 g (MCT Pro-Cal) from 25 to 30] |
SCHEDULE 2A
Addition of Listed Drug
Brinzolamide with Timolol |
SCHEDULE 3
Addition of Listed Drug
Brinzolamide |
Addition of Allowable Compound
Brinzolamide with Timolol |
SCHEDULE 6
Addition of Listed Drug
Tocilizumab |
Deletion of Listed Drug
Delavirdine |