National Health Act 1953 - Amendment determination under sections 93 and 93AA - pharmaceutical benefits supplied by medical practitioners (No. PB 110 of 2010)

Administered by Department of Health, Disability and Ageing

Legislation au F2010L03135 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

INSTRUMENT NUMBER PB 110 OF 2010

 

NATIONAL HEALTH ACT 1953

 

AMENDMENT DETERMINATION UNDER SECTIONS 93 AND 93AA

 

 

Summary

This legislative instrument in giving effect to recommendations of the Pharmaceutical Benefits Advisory Committee (PBAC) amends the determination under sections 93 and 93AA (PB 103 of 2010) which came into effect on 1 November 2010. The amendments provide for changes to the pharmaceutical benefits obtained by medical practitioners and authorised nurse practitioners to be supplied as emergency treatment and are supplied free of charge to patients. The amendments are set out in the items of Schedule 1 to this 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) of the Act 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) of the Act.  These are listed drugs as defined in subsection 84(1) of the Act.

Sections 93 and 93AA of the Act provide for certain pharmaceutical benefits to be obtained by medical practitioners and authorised nurse practitioners and be supplied by medical practitioners and authorised nurse practitioners to patients for treatment.  These pharmaceutical benefits are supplied as emergency treatment supplies (so-called ‘emergency bag’) and are supplied free of charge to patients.

Subsections 93(1) and 93AA(1) of the Act provide that medical practitioners, except as prescribed, and authorised nurse practitioners, except as prescribed by the regulations, are authorised to supply such pharmaceutical benefits as the Minister determines to persons who are entitled under Part VII of the Act to receive those pharmaceutical benefits.

Subsection 93(2) of the Act provides that the Minister may determine the maximum quantity or number of units of a pharmaceutical benefit which may be obtained by a medical practitioner during a specified period and that the medical practitioner shall obtain the pharmaceutical benefit as prescribed.

Subsection 93AA(2) of the Act provides that, the Minister may determine the maximum quantity or number of units of a pharmaceutical benefit which may be obtained by an authorised nurse practitioner during a specified period.

These determinations under sections 93 and 93AA of the Act set out the conditions under which medical practitioners and authorised nurse practitioners are authorised to supply pharmaceutical benefits.

The Schedule to the determination lists the names of the pharmaceutical benefits to which sections 93 and 93AA applies, together with the form (strength type, size etc.) and maximum quantity of those pharmaceutical benefits.

This legislative instrument amends the determination under sections 93 and 93AA made by legislative instrument number PB 103 of 2010 which came into effect on 1 November 2010.  The amendments are set out in the items of Schedule 1 to this instrument.

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

This instrument commences on 1 December 2010.


Consultations

This determination gives effect to recommendations made by the Pharmaceutical Benefits Advisory Committee (PBAC), an independent expert body, established by section 100A of the Act, to make 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.

Under subsection 101(4) of the Act, a drug or medicinal preparation may not be declared to be a drug or medicinal preparation to which Part VII of the Act applies unless the PBAC has recommended that it be so declared.  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.

Consultation regarding implementation of arrangements for nurse practitioners as PBS prescribers occurred via advisory groups established to advise on specific issues and technical aspects.  The advisory groups included practitioners from medical and allied health professions, with experience in midwifery, nursing, general practice, obstetrics, and representatives from registration bodies, state and territory health services, regional and remote health services, Indigenous populations, and consumers.  Advice was provided on Medicare eligibility, collaborative arrangements with other health professionals, authorisation as PBS prescribers, and medicines for PBS prescribing.

The PBAC provided advice on pharmaceutical benefits suitable for listing for nurse practitioners.  Medicare Australia, the Department of Veterans’ Affairs, the Medical Software Industry Association, and the Pharmacy Guild of Australia were also consulted. 

The involvement of interested parties through the membership of the PBAC constitutes a formal and ongoing process of consultation.

 


ATTACHMENT

Paragraph 1:  provides that this determination commences on 1 December 2010.

Paragraph 2: provides that Schedule 1 amends PB 103 of 2010.

Schedule 1: provides for the following amendments: 

 

 

THE SCHEDULE

Deletion of Item

Atropine 

Overview

The National Health Act 1953, as amended by the legislative instrument F2010L03135, provides the legislative basis for the Pharmaceutical Benefits Scheme (PBS). This scheme ensures Australians have reliable, timely, and affordable access to a wide range of medicines. The Act, enacted by the Australian Parliament, was amended to incorporate the recommendations of the Pharmaceutical Benefits Advisory Committee (PBAC). The policy objective of these amendments was to update the list of pharmaceutical benefits that medical practitioners and authorised nurse practitioners can supply as emergency treatments, free of charge to patients. The amendments, effective from 1 December 2010, were made in response to PBAC recommendations and consultations with various healthcare professionals, registration bodies, and consumer representatives, aiming to align the PBS with the latest clinical needs and cost-effectiveness considerations.

Scope and Application

The National Health Act 1953, as amended by the legislative instrument F2010L03135, governs the Pharmaceutical Benefits Scheme (PBS), under which the Commonwealth ensures Australians have reliable, timely, and affordable access to a wide range of medicines. Part VII of the Act provides the legal framework for the PBS, authorising the Commonwealth to supply pharmaceutical benefits in accordance with the provisions of the Act. The Minister declares drugs and medicinal preparations to be listed drugs, with certain exceptions, through legislative instruments. Sections 93 and 93AA of the Act allow medical practitioners and authorised nurse practitioners to obtain and supply pharmaceutical benefits to eligible patients free of charge for emergency treatment. The Act also empowers the Minister to set limits on the quantities of pharmaceutical benefits that medical practitioners and authorised nurse practitioners can obtain during specified periods. The amendments made by this legislative instrument, which came into effect on 1 December 2010, update the determination under sections 93 and 93AA made by PB 103 of 2010. These amendments reflect recommendations from the Pharmaceutical Benefits Advisory Committee (PBAC), an expert body established under the Act to advise on which drugs and medicinal preparations should be available as pharmaceutical benefits. The PBAC considers factors such as medical conditions, clinical effectiveness, safety, and cost-effectiveness when recommending the listing of medicines on the PBS. The changes outlined in Schedule 1 of this instrument include modifications to the list of pharmaceutical benefits and their associated quantities for emergency treatment.

Key Provisions

The main operative sections of this legislation (instrument number PB 110 of 2010) concern amendments to the National Health Act 1953, specifically under sections 93 and 93AA. These sections, as amended, provide for changes to the pharmaceutical benefits that can be obtained by medical practitioners and authorised nurse practitioners to supply as emergency treatment, and which are supplied free of charge to patients (sections 93(1), 93(2), 93AA(1), and 93AA(2)). The Schedule to this instrument lists the specific pharmaceutical benefits affected by these changes. The instrument amends the previous determination (PB 103 of 2010) that came into effect on 1 November 2010, and it commences on 1 December 2010. The obligations and requirements imposed by the Act on the parties it governs include that medical practitioners and authorised nurse practitioners must adhere to the conditions set out in the amended determination. Specifically, medical practitioners and authorised nurse practitioners are authorised to supply certain pharmaceutical benefits as emergency treatments, subject to the quantities determined by the Minister (subsections 93(1), 93(2), 93AA(1), and 93AA(2)). These benefits must be supplied free of charge to patients who are entitled to receive them under Part VII of the Act. The amendments reflect recommendations made by the Pharmaceutical Benefits Advisory Committee (PBAC) and involve changes to the list of pharmaceutical benefits available for emergency treatment. Offences and penalties for breach of the provisions of this legislation are not explicitly detailed in the explanatory statement. However, any breach of the conditions set out in the determination could potentially lead to civil or criminal consequences, depending on the nature and severity of the breach. For example, supplying pharmaceutical benefits outside the authorised conditions could be considered a violation of the Act. Penalties for such breaches could include fines or other sanctions, as determined by the relevant authorities under the broader framework of the National Health Act 1953. The exact penalties would be subject to the specific provisions of the Act and any relevant regulations or guidelines.

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