National Health Act 1953 - Amendment determination under paragraph 98C(1)(b) - conditions (No. PB 48 of 2010)

Administered by Department of Health, Disability and Ageing

Legislation au F2010L01379 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

INSTRUMENT NUMBER PB 48 OF 2010

NATIONAL HEALTH ACT 1953

AMENDMENT DETERMINATION UNDER PARAGRAPH 98C(1)(b)

 

Summary

This legislative instrument in giving effect to recommendations of the Pharmaceutical Benefits Advisory Committee (PBAC) amends the determination under section 98C(1)(b) made by legislative instrument number PB 119 of 2008 which came into effect on
1 December 2008. The amendments provide for changes to the conditions subject to which payments will be made by the Commonwealth in respect of the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners. 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 to which Part VII applies are (with the exception of some medicinal preparations with additives) declared by the Minister by legislative instrument to be so under subsection 85(2). These are listed drugs as defined in subsection 84(1). 

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 what constitutes the pharmaceutical benefit (defined in subsection 84(1)) under Part VII of the Act.  Under section 84AF, the Minister may determine a responsible person for a brand of a pharmaceutical item.

Paragraph 98C(1)(b) of the Act provides that the Minister may, from time to time, determine the conditions subject to which payments will be made by the Commonwealth in respect of the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners.

The determination under paragraph 98C(1)(b) of the Act sets out the conditions under which payments will be made in respect of the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners.

A provision-by-provision description of the instrument is contained in the Attachment.

This instrument, expressed to commence on 1 June 2010, was made on 12 May 2010.

 


Consultations

The Department consulted with the Pharmaceutical Benefits Advisory Committee (PBAC) during the regular process of its meetings to consider applications in order to recommend to the Minister which medicines should be subsidised through the Pharmaceutical Benefits Scheme.  The Committee is independent of Government and includes members from the following interests or professions: consumers, health economists, practising community pharmacists, general practitioners, clinical pharmacologists and medical specialists.  The Committee has received submissions and representations from interested pharmaceutical companies and has recommended the changes to the Minister who has determined the changes to the conditions under paragraph 98C(1)(b) which appear in this Determination. 

 


ATTACHMENT

Paragraph 1: provides that this instrument commences on 1 June 2010.

Paragraph 2: provides that Schedule 1 amends PB 119 of 2008.

Schedule 1: provides for the following amendments:

 

 

SCHEDULE 4

Addition of Listed Drug

Alendronic acid with colecalciferol and calcium

 

 

Deletion of Listed Drug

Mineral mixture

 

 

Addition of Form

Glucose IndicatorBlood

Test strips, 100 (Accu-Chek Mobile)

 

Deletion of Forms

Cromoglycic Acid

Pressurised inhalation containing sodium cromoglycate 1 mg per dose, 200 doses

Glucose IndicatorBlood

Test strips, 100 (Precision Plus)

Rivaroxaban

Tablets 10 mg, 15

 

Overview

The National Health Act 1953, enacted by the Australian Parliament, serves as the foundational legislation for the Pharmaceutical Benefits Scheme (PBS), which aims to provide all Australians with reliable, timely, and affordable access to a wide range of medicines. The Act was amended through the legislative instrument F2010L01379 to implement recommendations from the Pharmaceutical Benefits Advisory Committee (PBAC). This amendment, effective from 1 June 2010, modifies the conditions under which payments are made by the Commonwealth for the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners. The changes, detailed in Schedule 1, include the addition and deletion of certain listed drugs and their forms, reflecting the PBAC's recommendations and ensuring that the PBS remains responsive to the evolving needs of the Australian population. This legislative instrument is a direct response to the need for an updated and efficient pharmaceutical benefits system.

Scope and Application

The National Health Act 1953 Amendment Determination, expressed to commence on 1 June 2010, amends the conditions under which payments will be made by the Commonwealth in respect of the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners. This amendment is made under the authority provided by paragraph 98C(1)(b) of the Act, which empowers the Minister to determine such conditions. The amendment responds to recommendations from the Pharmaceutical Benefits Advisory Committee (PBAC), an independent body comprising members from various healthcare interests, including consumers, health economists, and practising healthcare professionals. This instrument, PB 48 of 2010, updates the legislative instrument PB 119 of 2008, which originally came into effect on 1 December 2008. The changes are detailed in Schedule 1 of the instrument and include the addition of certain listed drugs and forms, as well as the deletion of others. These amendments ensure that the Pharmaceutical Benefits Scheme (PBS) remains aligned with current healthcare needs and recommendations.

Key Provisions

The National Health Act 1953 (the Act) provides the legislative basis for the Pharmaceutical Benefits Scheme (PBS), which ensures that Australians have access to affordable medicines. Under this Act, the Minister can declare certain drugs and medicinal preparations as listed drugs (section 85(2)). The Minister can also determine the form, manner of administration, and brand of these listed drugs (sections 85(3), 85(5), and 85(6)). The Act enables the Minister to set the conditions under which the Commonwealth will make payments for pharmaceutical benefits supplied by approved pharmacists and approved medical practitioners (section 98C(1)(b)). The legislation imposes obligations on approved pharmacists and approved medical practitioners to supply pharmaceutical benefits in accordance with the conditions set out in the determination (section 98C(1)(b)). These conditions specify the requirements that must be met for the Commonwealth to make payments for the supply of these benefits. Approved pharmacists and approved medical practitioners must adhere to these conditions to be eligible for payment. Breaches of the conditions set out in the determination can lead to civil and criminal consequences. For instance, providing pharmaceutical benefits in a manner that does not comply with the conditions could result in the Commonwealth withholding payment or initiating legal action. The severity of the penalties can vary depending on the nature and extent of the breach, and in some cases, criminal charges could be pursued, leading to fines or imprisonment. The exact penalties are not specified in the text but typically align with the severity of the breach under Australian law.

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