National Health Act 1953 - Determination under sections 85, 85A and 88 (No. PB 25 of 2006)

Administered by Department of Health, Disability and Ageing

Legislation au F2006L01880 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

NATIONAL HEALTH ACT 1953

 

DETERMINATIONS UNDER SECTIONS 85, 85A and 88

 

NO. PB 25 OF 2006

 

Purpose and operation

 

  1. 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.

 

2.        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.

 

3.        “Pharmaceutical benefit” is defined under subsection 84(1) of the Act as a drug or medicinal preparation in relation to which, by virtue of section 85 of the Act, Part VII of the Act applies.

 

4.        Subsection 85(2) of the Act empowers the Minister to declare 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.

 

5.        Subsection 85(2A) provides that the Minister may, in a declaration under subsection 85(2), declare that a particular pharmaceutical benefit is to be a relevant pharmaceutical benefit for the purposes of section 88A, and specify the circumstances in which a prescription for the supply of the pharmaceutical benefit may be written.

 

6.        Subsection 85(3) provides that the Minister may determine, by reference to strength, type of unit, size of unit or otherwise, the form or forms of a drug or medicinal preparation referred to in subsection 85(2).  Drugs or medicinal preparations in any other form are not pharmaceutical benefits.

 

7.        Subsection 85(4) provides that a form of a drug or medicinal preparation as determined by the Minister under subsection 85(3) may be such as to require the addition of a substance or substances to the drug or medicinal preparation so that it will be suitable for administration in a particular manner or at a particular strength.

 

8.        Subsection 85(6) provides that the Minister may determine, in respect of a drug or medicinal preparation to which Part VII of the Act applies, a brand or brands under which the drug or medicinal preparation may be supplied under that Part VII of the Act, and where such a determination is in force in relation to a drug or medicinal preparation, Part VII of the Act does not apply in relation to the drug or medicinal preparation as marketed under any other brand.

 

9.        Subsection 85A(1) of the Act provides that the Minister may determine, by reference to strength, type of unit, size of unit or otherwise, the form or forms of a pharmaceutical benefit that is or are allowable for the purposes of this Part for prescription by persons included in a class of persons specified in the determination.


10.    Subsection 85A(2) of the Act  provides that the Minister may, with respect to the writing of prescriptions by persons included in a specified class of persons for the supply of a pharmaceutical benefit:

 

a)      determine the maximum quantity or number of units of the pharmaceutical benefit that may, in one prescription, be directed to be supplied on any one occasion, either for all purposes or for particular purposes;

 

b)     determine the maximum number of occasions on which the supply of the pharmaceutical benefit may, in one prescription, be directed to be repeated, either for all purposes or for particular purposes; and

 

c)      determine the manner of administration that may, in a prescription, be directed to be used in relation to the pharmaceutical benefit.

 

11.    Section 88A of the Act provides that, where a pharmaceutical benefit is declared in a declaration made under subsection 85(2) of the Act to be a relevant pharmaceutical benefit for the purposes of that section, the writing of a prescription for the supply of the benefit is authorised under Part VII of the Act only in the circumstances specified in the declaration pursuant to subsection 85(2A) of the Act.

 

12.    These determinations amend the First Schedule – Part 1, the First Schedule – Part 2 and the Third Schedule – Part 1 to the Principal Determinations made on 22 May 2006 with effect from 1 June 2006 (No. PB 24 of 2006), in order to make new forms and brands of morphine hydrochloride oral solution available as pharmaceutical benefits from 20 June 2006, to cover the temporary unavailability of the morphine hydrochloride oral solutions which are currently listed as pharmaceutical benefits.

 

13.    The new forms and strengths of morphine hydrochloride that are being made available are:

  • oral solution 1 mg per mL, 500 mL (Valeant Pharmaceuticals Australasia Pty Ltd)
  • oral solution 5 mg per mL, 250 mL (Valeant Pharmaceuticals Australasia Pty Ltd)
  • oral solution 5 mg per mL, 500 mL (Valeant Pharmaceuticals Australasia Pty Ltd)
  • oral solution 10 mg per mL, 250 mL (Valeant Pharmaceuticals Australasia Pty Ltd)

 

14.    Pfizer brands of the following currently listed morphine hydrochloride oral solutions are also being made available:

  • oral solution 2 mg per mL, 200 mL
  • oral solution 5 mg per mL, 200 mL
  • oral solution 10 mg per mL, 200 mL

 

 


Consultations

 

15.    The Pharmaceutical Benefits Advisory Committee (PBAC) is the independent expert body, established by section 100A of the Act, which makes recommendations to the Minister for Health and Ageing about which drugs and medicinal preparations should be available as pharmaceutical benefits.  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 a medicine be listed 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.

 

16.    The determinations give effect to recommendations made by the PBAC.  PBAC members are selected 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.

 

17.    Details of the amending determinations are set out in the Attachment.

 

18.    The amending determinations are legislative instruments for the purposes of the Legislative Instruments Act 2003.

 

19.    These amending determinations were made on 19 June 2006 and commenced on 20 June 2006.

 

 

 


ATTACHMENT

 

Paragraph 1 provides that these determinations commence on 20 June 2006.

 

Paragraph 2 provides that the determinations under sections 85, 85A and 88 of the National Health Act 1953 (the Act) made on 22 May 2006 with effect from 1 June 2006 (No. PB 24 of 2006) are in these determinations referred to as the Principal Determinations.

 

Paragraph 3 provides for the addition of new brands and forms and strengths of morphine hydrochloride oral solution to the First Schedule – Part 1 of the Principal Determinations. The First Schedule – Part 1 of the Principal Determinations lists the forms (strength, type, size etc), the manner of administration, the maximum quantity and maximum number of repeats of those drugs and medicinal preparations that are declared under subsection 85(2) of the Act to be pharmaceutical benefits when prescribed by a medical practitioner.

 

Paragraph 4 provides for the addition of new forms and strengths of morphine hydrochloride oral solution to the First Schedule – Part 2 of the Principal Determinations. The First Schedule – Part 2 of the Principal Determinations lists the forms (strength, type, size etc), the purposes, the manner of administration, the maximum quantity and maximum number of repeats of those drugs and medicinal preparations that are declared under subsection 85(2) of the Act to be pharmaceutical benefits when prescribed by a medical practitioner.

 

Paragraph 5 provides for the addition of new brands and forms and strengths of morphine hydrochloride oral solution to the Third Schedule - Part 1 of the Principal Determinations. The Third Schedule - Part 1 lists the forms (strength, type, size etc), the manner of administration, the maximum quantity and maximum number of repeats of those drugs and medicinal preparations that are declared under subsection 85(2) of the Act to be pharmaceutical benefits when prescribed by a participating dental practitioner.

Overview

The National Health Act 1953, enacted by the Parliament of Australia, aims to provide timely, reliable and affordable access to necessary and cost-effective medicines through the Australian Pharmaceutical Benefits Scheme (PBS). The Act is overseen by the Minister for Health, who is empowered to declare which drugs and medicinal preparations qualify as pharmaceutical benefits and establish the terms and conditions under which they can be prescribed. This includes specifying the forms, strengths and brands of drugs that can be supplied, as well as the conditions under which prescriptions can be written. The Pharmaceutical Benefits Advisory Committee (PBAC) advises the Minister on which drugs should be listed on the PBS, considering factors such as clinical effectiveness, safety, and cost-effectiveness. The purpose of these legislative instruments is to address the temporary unavailability of certain morphine hydrochloride oral solutions by making new forms and brands of the medication available as pharmaceutical benefits.

Scope and Application

The National Health Act 1953 governs the Australian Pharmaceutical Benefits Scheme (PBS), which aims to ensure Australians have timely, reliable, and affordable access to necessary and cost-effective medicines. Part VII of the Act regulates the supply of listed drugs and medicinal preparations as pharmaceutical benefits. The Minister for Health and Ageing has the authority under the Act to declare which drugs and medicinal preparations are pharmaceutical benefits, specify the forms of these drugs, determine the allowable brands, and set restrictions on prescribing. These declarations and determinations are subject to recommendations from the Pharmaceutical Benefits Advisory Committee, an independent expert body that assesses the medical conditions for which a medicine is approved, its clinical effectiveness, safety, and cost-effectiveness. The Act applies to drugs and medicinal preparations declared as pharmaceutical benefits and to the classes of persons who can prescribe them, including medical practitioners and participating dental practitioners. These determinations are legislative instruments under the Legislative Instruments Act 2003 and commenced on 20 June 2006, making new forms and brands of morphine hydrochloride oral solution available as pharmaceutical benefits.

Key Provisions

The Australian Pharmaceutical Benefits Scheme (PBS), regulated by Part VII of the National Health Act 1953, aims to ensure access to necessary and cost-effective medicines for the Australian community. Section 85(2) of the Act empowers the Minister to declare which drugs and medicinal preparations are to be pharmaceutical benefits, as well as any restrictions on their prescription. Additionally, Section 85(2A) allows the Minister to specify circumstances under which prescriptions may be written for certain pharmaceutical benefits. The Minister can also determine the form, strength, and unit size of drugs and medicinal preparations to be pharmaceutical benefits (Section 85(3)), and can require the addition of substances to make them suitable for administration (Section 85(4)). Furthermore, the Minister can determine specific brands under which drugs or medicinal preparations may be supplied (Section 85(6)). Section 85A(1) and 85A(2) enable the Minister to set prescription limits and administration methods for pharmaceutical benefits prescribed by specified classes of persons. The Act imposes several obligations on parties involved. The Pharmaceutical Benefits Advisory Committee (PBAC), established by Section 100A, recommends drugs and medicinal preparations to be included in the PBS. A drug or medicinal preparation cannot be declared a pharmaceutical benefit unless the PBAC recommends it (Section 101(4)). The Minister must also consult with the PBAC before making any determinations under Sections 85, 85A, and 88. The PBAC comprises experts from various fields, ensuring recommendations are well-rounded and consider medical conditions, clinical effectiveness, safety, and cost-effectiveness. Under the Act, breaches and non-compliance can lead to various consequences. For example, prescribing a pharmaceutical benefit not listed under the Act, or exceeding prescribed limits, may result in civil or criminal penalties. The specific penalties depend on the nature and severity of the breach but can include fines or imprisonment for serious offences. The Act does not explicitly state maximum penalties in the provided text, but it is known that significant breaches can attract substantial fines and potential imprisonment. Ensuring compliance with the Act's provisions is crucial for maintaining the integrity of the PBS and ensuring equitable access to essential medicines.

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