National Health Act 1953 - Amendment determinations under sections 85, 85A and 88 - pharmaceutical benefits (No. PB 88 of 2010)

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Legislation au F2010L02527 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

INSTRUMENT NUMBER PB 88 OF 2010

NATIONAL HEALTH ACT 1953

AMENDMENT DETERMINATIONS UNDER SECTIONS 85, 85A and 88

 

Summary

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 68 of 2010 which came into effect on
1 August 2010.  The amendments provide for additions and changes to the names, forms and brands of listed drugs on the Pharmaceutical Benefits Scheme (PBS) and the conditions for prescribing pharmaceutical benefits.  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 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 constitutes a legislative instrument for the purposes of the Legislative Instruments Act 2003.

This instrument determines matters under subsections 85(3), 85(5), 85(6), 85A(2), and 88(1A).    

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

This instrument, expressed to commence on 1 October 2010, was made on 17 September 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 October 2010.

Paragraph 2: provides that Schedule 1 amends PB 68 of 2010.

Schedule 1: provides for the following amendments:

 

SCHEDULE 1 PART 1

Listed Drug Added

Eletriptan

 

Brands Added

Amoxycillin with Clavulanic Acid

Tablet containing 500 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate) (Amoxycillin/Clavulanic Acid 500/125 generichealth)

Tablet containing 875 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate) (Amoxycillin/Clavulanic Acid 875/125 generichealth)

Lamotrigine

Tablet 50 mg (APO-Lamotrigine)

Memantine

Tablet containing memantine hydrochloride 10 mg (APO-Memantine)

Metformin

Tablet containing metformin hydrochloride 500 mg (Glucohexal)

Tablet containing metformin hydrochloride 850 mg (Glucohexal)

Tablet containing metformin hydrochloride 1 g (Glucohexal)

Omeprazole

Tablet 20 mg (Omeprazole generichealth)

Pantoprazole

Tablet (enteric coated) 20 mg (as sodium sesquihydrate) (Pantofast 20, Pantoprazole generichealth)

Tablet (enteric coated) 40 mg (as sodium sesquihydrate) (Pantofast 40, Pantoprazole generichealth)

Ranitidine

Tablet 300 mg (as hydrochloride) (Ranitidine Sandoz)

Terbinafine

Tablet 250 mg (as hydrochloride) (Terbinafine-DRLA)

 

Brands Deleted

Lisinopril

Tablet 5 mg (Lisinobell)

Tablet 10 mg (Lisinobell)

Tablet 20 mg (Lisinobell)

Metformin

Tablet containing metformin hydrochloride 500 mg (Metforbell)

Tablet containing metformin hydrochloride 850 mg (Metforbell)

Simvastatin

Tablet 5 mg (Simvabell)

Tablet 10 mg (Simvabell)

Tablet 20 mg (Simvabell)

Tablet 40 mg (Simvabell)

Tablet 80 mg (Simvabell)

Terbinafine

Tablet 250 mg (as hydrochloride) (Terbinafine-DP)

 


SCHEDULE 1  PART 2

Brands Added

Omeprazole

Tablet 20 mg (Omeprazole generichealth)

Pantoprazole

Tablet (enteric coated) 40 mg (as sodium sesquihydrate) (Pantofast 40, Pantoprazole generichealth)

Terbinafine

Tablet 250 mg (as hydrochloride) (Terbinafine-DRLA)

 

Brands Deleted

Simvastatin

Tablet 5 mg (Simvabell)

Tablet 10 mg (Simvabell)

Tablet 20 mg (Simvabell)

Tablet 40 mg (Simvabell)

Tablet 80 mg (Simvabell)

Terbinafine

Tablet 250 mg (as hydrochloride) (Terbinafine-DP)

 

 

SCHEDULE 3  PART 1

 

Brands Added

Amoxycillin with Clavulanic Acid

Tablet containing 500 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate) (Amoxycillin/Clavulanic Acid 500/125 generichealth)

Tablet containing 875 mg amoxycillin (as trihydrate) with 125 mg clavulanic acid (as potassium clavulanate) (Amoxycillin/Clavulanic Acid 875/125 generichealth)

 

Overview

The National Health Act 1953 was enacted to facilitate the provision of reliable, timely, and affordable access to a broad range of medicines for Australians, primarily through the Pharmaceutical Benefits Scheme (PBS). This Act provides the legislative foundation for the PBS, enabling the Commonwealth to offer pharmaceutical benefits to the public. Under this Act, the Minister for Health is authorised to declare drugs and medicinal preparations, determine their forms and brands, and set conditions for their prescription. The purpose of the legislative instrument F2010L02527, which amends determinations under sections 85, 85A, and 88 of the Act, is to incorporate the Pharmaceutical Benefits Advisory Committee's (PBAC) recommendations into the PBS. This includes updating the list of drugs, modifying the forms and brands of listed drugs, and altering the prescription conditions for these drugs. The amendments are designed to ensure the PBS remains responsive to medical needs, cost-effectiveness, and safety standards. The instrument was made on 17 September 2010 and commenced on 1 October 2010.

Scope and Application

The National Health Act 1953 Amendment Determinations under sections 85, 85A, and 88, implemented by legislative instrument number PB 88 of 2010, amend the Pharmaceutical Benefits Scheme (PBS) to reflect recommendations from the Pharmaceutical Benefits Advisory Committee (PBAC). These amendments involve adding and modifying the names, forms, and brands of drugs listed on the PBS and adjusting the conditions for prescribing these pharmaceutical benefits. The amendments, which took effect on 1 October 2010, pertain to the Minister’s authority to determine drug forms, brand names, and prescription conditions under the Act. This legislation applies to pharmaceutical benefits provided by the Commonwealth, affecting drugs and medicinal preparations listed under the PBS, including extemporaneously-prepared preparations. The amendments specify which drugs and brands are added or removed from the PBS and modify the prescription conditions, such as the maximum quantity, repetition, and administration methods allowed in prescriptions. This instrument operates within the Commonwealth jurisdiction, with no stated exclusions or thresholds, and extends to all listed drugs and brands within the scope of the PBS.

Key Provisions

The key provisions of this legislative instrument primarily revolve around amendments to determinations under sections 85, 85A, and 88 of the National Health Act 1953 (the Act). These sections pertain to the Pharmaceutical Benefits Scheme (PBS), which ensures Australians have reliable access to a range of medicines. The amendments, detailed in Schedule 1, involve the addition and modification of the names, forms, and brands of listed drugs on the PBS, along with changes to the conditions for prescribing pharmaceutical benefits. The changes include the addition of new brands and forms of specific drugs and the removal of certain brands from the PBS (subsections 85(3), 85(5), 85(6), 85A(2), and 88(1A)). The obligations and requirements imposed by the Act on the parties governed by it include ensuring that listed drugs meet the criteria set by the Minister regarding their form, brand, and the conditions for their prescription. The Minister, guided by the Pharmaceutical Benefits Advisory Committee (PBAC), determines these criteria based on factors such as clinical effectiveness, safety, and cost-effectiveness. The Act also mandates that the Minister must consult with the PBAC, an independent body composed of experts from various health-related fields, when making recommendations about which drugs should be available as pharmaceutical benefits. Failure to comply with the requirements set out in the Act can lead to various offences and penalties. While the specific civil or criminal consequences for breach are not detailed in the provided text, it is clear that non-compliance with the PBS regulations could result in legal repercussions. The penalties could potentially include fines or other sanctions as prescribed by law, though the exact nature and severity of these penalties would be determined by the relevant courts or regulatory authorities. The legislative instrument itself serves as a formal declaration of these amendments and is subject to the provisions of the Legislative Instruments Act 2003.

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