National Health Act 1953 - Amendment special arrangements under subsection 100(1) - Chemotherapy Pharmaceuticals Access Program (No. PB 114 of 2009)

Administered by Department of Health, Disability and Ageing

Legislation au F2009L04291 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

INSTRUMENT NUMBER PB 114 OF 2009

NATIONAL HEALTH ACT 1953

AMENDMENT SPECIAL ARRANGEMENTS UNDER SUBSECTION 100(1)

CHEMOTHERAPY PHARMACEUTICALS ACCESS PROGRAM

 

Purpose and operation

The purpose of the Australian Pharmaceutical Benefits Scheme (PBS) is to provide timely, reliable and affordable access for the Australian community to necessary and cost-effective medicines.

The PBS is regulated by Part VII of the National Health Act 1953 (the Act), which provides for the supply of listed drugs and medicinal preparations as pharmaceutical benefits.

Subsection 85(1) of the Act provides that benefits shall be provided by the Commonwealth in accordance with Part VII of the Act in respect of pharmaceutical benefits.

Subsection 100(1) of the Act provides that the Minister may make special arrangements for providing that an adequate supply of special pharmaceutical products will be available to persons:                

(a) who are living in isolated areas; or

(b) who are receiving medical treatment in such circumstances that pharmaceutical benefits: 

(i) cannot be conveniently or efficiently supplied in accordance with Part VII of the Act; or

(ii) are inadequate for that medical treatment.

Subsection 100(2) of the Act provides that the Minister may vary or revoke a special arrangement made under subsection 100(1).

Subsection 100(3) provides that Part VII of the Act has effect subject to a special arrangement made under subsection 100(1).

The declaration made under subsection 85(2) of the Act sets out the drugs and medicinal preparations to which Part VII of the Act applies and the restrictions, if any, that apply to the prescribing of such drugs and medicinal preparations as pharmaceutical benefits. Schedule 6 of the declaration under subsection 85(2) lists those drugs and medicinal preparations that may be made available under arrangements provided for by section 100 of the Act.

The Chemotherapy Pharmaceuticals Access Program is a set of Arrangements made under subparagraph 100(b)(i) of the Act for the purpose of the supply of chemotherapy pharmaceuticals at public hospitals to non-admitted patients, day admitted patients and patients on discharge.

These Arrangements constitute a legislative instrument for the purposes of the Legislative Instruments Act 2003.

This legislative instrument in giving effect to recommendations of the Pharmaceutical Benefits Advisory Committee (PBAC) amends Chemotherapy Pharmaceuticals Access Program Arrangements under subparagraph 100(b)(i) made by legislative instrument number PB 55 of 2009 which came into effect on 1 July 2009.  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 December 2009, was made on 13 November 2009.

Consultations

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 December 2009.

Paragraph 2: provides that Schedule 1 amends PB 55 of 2009.

Schedule 1: provides for the following amendments:

 

 

SCHEDULE 2

Addition of Brands

Irinotecan

I.V. injection containing irinotecan hydrochloride trihydrate 40 mg in
2 mL (Irinotecan Alphapharm)

 

I.V. injection containing irinotecan hydrochloride trihydrate 100 mg in 5 mL (Irinotecan Alphapharm)

 

SCHEDULE 4

Price Decrease

The following chemotherapy pharmaceuticals reflect a price decrease in Column 5 — Approved price and Column 6 — Price claimed by manufacturer.

Folinic Acid

Injection containing calcium folinate equivalent to 50 mg folinic acid in 5 mL

Ondansetron

I.V. injection 4 mg (as hydrochloride dihydrate) in 2 mL

 

I.V. injection 8 mg (as hydrochloride dihydrate) in 4 mL

 

Overview

The National Health Act 1953 was enacted to provide for the supply of drugs and medicinal preparations as pharmaceutical benefits to the Australian community. A key problem it was introduced to address is ensuring equitable access to necessary and cost-effective medicines, particularly for those in remote areas or under special medical circumstances where the standard provisions of the Australian Pharmaceutical Benefits Scheme (PBS) may not apply efficiently or adequately. This Act is administered by the Parliament of Australia, and its policy objective is to facilitate timely, reliable, and affordable access to essential medications. Under subsection 100(1) of the Act, special arrangements can be made to ensure an adequate supply of specific pharmaceutical products, such as chemotherapy drugs, to patients in isolated areas or under unique medical conditions, thereby enhancing the overall effectiveness of the PBS.

Scope and Application

The National Health Act 1953, as amended by the legislative instrument numbered PB 114 of 2009, pertains to the Australian Pharmaceutical Benefits Scheme (PBS), which aims to ensure timely, reliable, and affordable access to necessary and cost-effective medicines for the Australian community. The Act applies to the Commonwealth and governs the supply of listed drugs and medicinal preparations as pharmaceutical benefits. Under this Act, the Minister has the authority to make special arrangements for providing an adequate supply of special pharmaceutical products, such as chemotherapy pharmaceuticals, to individuals living in isolated areas or those receiving medical treatment where pharmaceutical benefits under Part VII of the Act are either inadequate or cannot be conveniently or efficiently supplied. This Act allows for the creation of the Chemotherapy Pharmaceuticals Access Program, which facilitates the supply of chemotherapy pharmaceuticals at public hospitals to non-admitted patients, day admitted patients, and patients on discharge. The provisions of this Act are subject to the special arrangements made under subsection 100(1), which can be varied or revoked by the Minister. The Act’s application may be extended or restricted through subordinate instruments, such as the amendments made under PB 55 of 2009, which came into effect on 1 July 2009, and the subsequent amendments detailed in Schedule 1 to the instrument, effective from 1 December 2009.

Key Provisions

The key provisions of this legislation revolve around the amendments to the Chemotherapy Pharmaceuticals Access Program (paragraphs 2 and 3). This program, established under the National Health Act 1953 (subsection 100(1)), is designed to ensure the availability of chemotherapy drugs in isolated areas and where the standard provisions of the Act are inadequate (subsection 100(2)). Specifically, this legislative instrument amends the arrangements made in 2009 (PB 55 of 2009) by introducing new brands of irinotecan under Schedule 2 and reducing the prices of certain chemotherapy pharmaceuticals listed in Schedule 4. The amendments impose certain obligations on the parties involved. The Minister, who has the authority to make special arrangements for the supply of pharmaceutical products (subsection 100(1)), must now include the newly listed irinotecan brands in the Chemotherapy Pharmaceuticals Access Program. Additionally, the Minister must ensure that the revised prices for folinic acid and ondansetron are implemented and reflected in the approved pricing schedule. These changes aim to improve access to essential chemotherapy drugs and reduce the financial burden on patients and the healthcare system. Failure to comply with the requirements set out in this legislation could result in civil or criminal consequences. While the specific offences, penalties, or consequences are not detailed in the explanatory statement, breaches of the National Health Act 1953 or its regulations could lead to penalties under the relevant sections of the Act or other applicable laws. These penalties may include fines, imprisonment, or both, depending on the nature and severity of the breach. The Pharmaceutical Benefits Advisory Committee (PBAC), which makes recommendations to the Minister regarding the availability of pharmaceutical benefits, plays a crucial role in ensuring that the provisions of this legislation are effectively implemented and monitored.

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