EXPLANATORY STATEMENT
INSTRUMENT NUMBER PB 21 OF 2009
NATIONAL HEALTH ACT 1953
DETERMINATIONS UNDER SECTIONS 85, 85A and 88
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 declared by the Minister by legislative instrument to be so 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).
Subsection 85(3) authorises the Minister by legislative instrument to determine by reference to strength, type of unit, size of unit, or otherwise, the form or forms of a listed drug.
Subsection 85(5) authorises the Minister by legislative instrument to determine the manner of administration of a form of a listed drug where the form has been determined under subsection 85(3).
Subsection 85(6) authorises the Minister by legislative instrument to determine a brand of a pharmaceutical item. A “brand” is defined in subsection 84(1) to mean the trade name which the person who is or will be the “responsible person” supplies the pharmaceutical item, or if there is no trade name, the name of the responsible person. The responsible person for a brand of a pharmaceutical item is determined by the Minister by legislative instrument under section 84AF.
Subsection 85A(2) authorises the Minister to determine various matters with respect to the writing of prescriptions by persons included in a specified class of persons for the supply of a pharmaceutical benefit. Paragraph 85A(2)(a) authorises the determination of the maximum quantity or number of units that may in one prescription be directed to be supplied for all purposes or for a particular purpose. Paragraph 85A(2)(b) authorises the determination of the maximum number of occasions in which the supply may in one prescription be directed to be repeated for all purposes or a particular purpose. Paragraph 85A(2)(c) authorises the determination of the manner of administration that may in a prescription be directed to be used.
Section 88 provides for various matters relating to the prescribing of pharmaceutical benefits. Subsection 88(1A) authorises the Minister to determine the pharmaceutical benefits for the supply of which a dental practitioner is authorised to write a prescription.
This instrument determines matters under subsections 85(3), 85(5), 85(6), 85A(2), and 88(1A).
This legislative instrument in giving effect to recommendations of the Pharmaceutical Benefits Advisory Committee (PBAC) amends determinations under sections 85, 85A and 88 made by legislative instrument number PB 114 of 2008 which came into effect on 1 December 2008. The amendments are set out in the items of Schedule 1 to the instrument.
A provision-by-provision description of the instrument is contained in the Attachment.
This instrument, expressed to commence on 1 April 2009, was made on 3 March 2009.
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 April 2009.
Paragraph 2: provides that Schedule 1 amends PB 114 of 2008.
Schedule 1: provides for the following amendments:
SCHEDULE 1 ― PART 1
Listed Drug Added
Zonisamide |
Forms Added
Amino acid formula with vitamins and minerals without phenylalanine | Sachets containing oral powder 18.2 g, 60 (add-ins) [*see below — “Listed Drug Deleted”] Oral liquid 62.5 mL, 60 (Lophlex LQ 10) Oral liquid 125 mL, 36 (PKU Anamix Junior LQ) |
Amino acid formula with vitamins and minerals without phenylalanine and tyrosine | Sachets containing oral powder 29 g, 30 (TYR Anamix Junior) |
Desmopressin | Wafer 120 micrograms (as acetate) |
Gemcitabine | Solution concentrate for I.V. infusion 200 mg (as hydrochloride) in 20 mL Solution concentrate for I.V. infusion 1000 mg (as hydrochloride) in 100 mL |
Oxycodone | Tablet containing oxycodone hydrochloride 15 mg (controlled release) Tablet containing oxycodone hydrochloride 30 mg (controlled release) |
Brands Added
Enalapril | Tablet containing enalapril maleate 5 mg (Enalapril generichealth) Tablet containing enalapril maleate 10 mg (Enalapril generichealth) Tablet containing enalapril maleate 20 mg (Enalapril generichealth) |
Fluvoxamine | Tablet containing fluvoxamine maleate 50 mg (APO-Fluvoxamine) Tablet containing fluvoxamine maleate 100 mg (APO-Fluvoxamine) |
Gliclazide | Tablet 30 mg (modified release) (Glyade MR) |
Lisinopril | Tablet 10 mg (APO-Lisinopril) |
Metformin | Tablet (extended release) containing metformin hydrochloride 500 mg Tablet containing metformin hydrochloride 1 g (Metformin-GA) |
Omeprazole | Tablet 20 mg (APO-Omeprazole) |
Listed Drug Deleted
Amino acid formula without phenylalanine, and vitamins with minerals [*due to reformulation now listed under Amino acid formula with vitamins and minerals without phenylalanine — see “Forms Added”] |
Form Deleted
Aluminium Hydroxide with Magnesium Hydroxide | Tablet 200 mg-200 mg |
Brands Deleted
Clarithromycin | Tablet 250 mg (APO-Clarithromycin) |
Methylphenidate | Tablet containing methylphenidate hydrochloride 10 mg (Attenta) |
Alteration of Listed Drug and Form
From: Carbomer 980 To: Carbomer |
Ocular lubricating gel 2 mg per g, 10 g
Eye gel 2 mg per g, 10 g | ||
From: Carbomer 980 To: Carbomer |
Eye drops 2 mg per g, single dose units 0.6 mL, 30
Eye gel 2 mg per g, single dose units 0.6 mL, 30 | ||
|
| ||
Alteration of Form
Interferon Beta-1b | From: Injection set comprising 1 vial powder for injection 8,000,000 I.U. To: Injection set including 1 vial powder for injection 8,000,000 I.U. |
Ranibizumab | From: Solution for intravitreal injection 3 mg in 0.3 mL To: Solution for intravitreal injection 2.3 mg in 0.23 mL |
Alteration of Brand
Carbomer | Eye gel 2 mg per g, 10 g From: Viscotears Liquid Gel To: Viscotears |
Alteration of Maximum Quantity
Enoxaparin | Injection containing enoxaparin sodium 20 mg (2,000 I.U. anti-Xa) in 0.2 mL From: 10 To: 20 |
| Injection containing enoxaparin sodium 40 mg (4,000 I.U. anti-Xa) in 0.4 mL From: 10 To: 20 |
| Solution for injection containing enoxaparin sodium 40 mg (4,000 I.U. anti-Xa) in 0.4 mL 10 To: 20 |
Alteration of Maximum Number of Repeats
Enoxaparin | Injection containing enoxaparin sodium 20 mg (2,000 I.U. anti-Xa) in 0.2 mL From: 1 To: . . |
| Injection containing enoxaparin sodium 40 mg (4,000 I.U. anti-Xa) in 0.4 mL From: 1 To: . . |
| Solution for injection containing enoxaparin sodium 40 mg (4,000 I.U. anti-Xa) in 0.4 mL 1 To: . . |
Pramipexole | Tablet containing pramipexole hydrochloride 250 micrograms From: 5 To: 2 |
SCHEDULE 1 ― PART 2
Listed Drug Added
Pramipexole |
Forms Added
Oxycodone | Tablet containing oxycodone hydrochloride 15 mg (controlled release) Tablet containing oxycodone hydrochloride 30 mg (controlled release)
|
Brand Added
Omeprazole | Tablet 20 mg (APO-Omeprazole) |
Listed Drug Deleted
Escitalopram |
Alteration of Purposes
Adalimumab [initial treatment of adult patients with severe active psoriatic arthritis]
Etanercept [initial treatment of adult patients with severe active psoriatic arthritis]
Alteration of Listed Drug and Form
From: Carbomer 980 To: Carbomer |
Ocular lubricating gel 2 mg per g, 10 g
Eye gel 2 mg per g, 10 g |
Alteration of Brand
Carbomer | Eye gel 2 mg per g, 10 g From: Viscotears Liquid Gel To: Viscotears |
SCHEDULE 3 ― PART 1
Forms Added
Oxycodone | Tablet containing oxycodone hydrochloride 15 mg (controlled release) Tablet containing oxycodone hydrochloride 30 mg (controlled release) |