National Health (Additional Community Supply Support Payment – Second Assessment) Amendment Determination 2025

Explanatory Statement

National Health Act 1953

National Health (Additional Community Supply Support Payment – Second Assessment) Amendment Determination 2025

PB 145 of 2025

Authority

Paragraph 98B(1)(b) of the National Health Act 1953 (Act) provides that a function of the Pharmaceutical Benefits Remuneration Tribunal (Tribunal) is to determine, by legislative instrument:

• the kinds of supplies by approved pharmacists of pharmaceutical benefits (if any) that are Additional Community Supply Support (ACSS) eligible supplies; and
• the amount of the ACSS payment for any or all ACSS eligible supplies, or the manner in which that amount is to be worked out.

Subsection 98BAA(1A) of the Act requires that, where the Commonwealth and the Pharmacy Guild of Australia (Guild) have entered into an agreement relating to the kinds of supplies made by approved pharmacists that are ACSS eligible supplies, and the amount of the ACSS payment for ACSS eligible supplies, or the manner in which that amount is to be worked out, the Tribunal, when making a determination pursuant to paragraph 98B(1)(b) of the Act, is to give effect to the terms of that agreement, while the agreement is in force.

Under subsection 33(3) of the Acts Interpretation Act 1901, where an Act confers a power to make, grant or issue any instrument of a legislative or administrative character (including rules, regulations or by-laws), the power shall be construed as including a power exercisable in the like manner and subject to the like conditions (if any) to repeal, rescind, revoke, amend, or vary any such instrument.

Purpose

The National Health (Additional Community Supply Support Payment – Second Assessment) Amendment Determination 2025 (PB 145 of 2025) (Amendment Determination) amends the National Health (Additional Community Supply Support Payment) Determination 2024 (PB 94 of 2024) (Principal Determination) to adjust, from 1 January 2026, the amounts of payments for ACSS eligible supplies, in accord with adjustment provisions for ACSS payments, as set out under clause 4.1.4, clause 5 and Appendix A of the Eighth Community Pharmacy Agreement (Eighth Agreement). ACSS payments may be adjusted twice annually by assessment period provisions under Appendix A of the Eighth Agreement. A copy of the Eighth Agreement can be found on the Department of Health, Disability and Ageing’s website at: https://www.health.gov.au/topics/primary-care/what-we-do/8cpa

The Eighth Agreement between the Commonwealth and the Guild, which commenced on 1 July 2024 and expires on 30 June 2029, includes an agreement between the Commonwealth and the Guild for the purposes of subsection 98BAA(1A) of the Act, setting out the manner in which the ACSS payment is to be calculated.

This Amendment Determination amends the amounts payable by the Commonwealth to approved pharmacists for ACSS eligible supplies from 1 January 2026, in accordance with provisions for the second assessment period as set out in Appendix A under the Eighth Agreement as follows:

• the amount at paragraph 6(1)(b)(ii) of $4.91 payment, will remain unchanged, for each Commonwealth subsidised supply, at the maximum quantity, of a ‘section 85 medicine’ with increased dispensing quantity; and
• the amount at paragraph 6(1)(a) will be adjusted from $1.57 to $1.21 for each Commonwealth subsidised supply of a ‘section 85 medicine’.

Consultation

The Eighth Agreement includes an agreement between the Commonwealth and the Guild, for the purposes of subsection 98BAA(1A) of the Act, regarding the kinds of supplies that are ACSS eligible supplies, and the amount of the ACSS payment for ACSS eligible supplies. The Guild has been consulted in relation to the content of this Amendment Determination as it relates to that agreement. Services Australia has also been consulted in relation to implementation of the PBS payment systems changes managed by Services Australia, to support making ACSS payments to approved pharmacists, as provided for by this Amendment Determination.

Commencement

This Amendment Determination commences on 1 January 2026.

General

This Amendment Determination is a legislative instrument for the purposes of the Legislation Act 2003.

Details of this Amendment Determination are outlined in Attachment A.

This Amendment Determination is compatible with the human rights and freedoms recognised or declared under section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011. A full statement of compatibility is set out in Attachment B.

ATTACHMENT A

Details of the National Health (Additional Community Supply Support Payment – Second Assessment) Amendment Determination 2025

Section 1 – Name

Section 1 - provides that the name of the instrument is the National Health (Additional Community Supply Support Payment – Second Assessment) Amendment Determination 2025, which may also be cited as PB 145 of 2025.

Section 2 – Commencement

Section 2 - provides that the Amendment Determination commences on 1 January 2026.

Section 3 – Authority

Section 3 - provides that Amendment Determination is made under paragraph 98B(1)(b) of the National Health Act 1953 (Act).

Section 4 – Schedules

Section 4 – provides that the National Health (Additional Community Supply Support Payment) Determination 2024 (PB 94 of 2024) is amended as set out in Schedule 1 of the Amendment Determination.

Schedule 1 – Amendments

National Health (Additional Community Supply Support Payment) Determination 2024 (PB 94 of 2024)

Item 1 – Subsection 6(1)

Item 1 amends paragraph 6(1)(a) of the National Health (Additional Community Supply Support Payment) Determination 2024 to adjust the fee from $1.57 to $1.21. This fee may be adjusted twice annually with provisions for assessment periods under the Eighth Agreement.

ATTACHMENT B

Statement of Compatibility with Human Rights

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

National Health (Additional Community Supply Support Payment – Second Assessment) Amendment Determination 2025

PB 145 of 2025

This disallowable legislative instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Overview of the legislative instrument

The National Health (Additional Community Supply Support Payment – Second Assessment) Amendment Determination 2025 (PB 145 of 2025) (Amendment Determination) amends the National Health (Additional Community Supply Support Payment) Determination 2024 (PB 94 of 2024) (Principal Determination), by which the Pharmaceutical Benefits Remuneration Tribunal (Tribunal) determines the kinds of supplies by approved pharmacists of pharmaceutical benefits that are Additional Community Supply Support (ACSS) eligible supplies and the amount of ACSS payment for any or all such supplies.

The basis for the ACSS payment is an agreement under the Eighth Community Pharmacy Agreement (Eighth Agreement) between the Commonwealth and the Pharmacy Guild of Australia to establish a payment to approved pharmacists, in addition to the Commonwealth price, to provide the necessary level of support for the dispensing of Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) medicines, including for increased dispensing quantities, to ensure continued access to these medicines while providing cheaper medicines to patients.

This Amendment Determination effects an adjustment to the amount payable by the Commonwealth to approved pharmacists for ACSS eligible supplies, in accord with the second assessment period under the Eighth Agreement. On this occasion, the fee for paragraph 6(1)(a) is calculated to be $1.21 and takes effect from 1 January 2026.

Human rights implications

This legislative instrument engages Articles 2, 7, 9 and 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR). The legislative instrument assists with the provision of favourable conditions of work to ensure remuneration for workers with fair wages. In addition, it also assists in the progressive realisation by all appropriate means of the right of everyone to social security, and the enjoyment of the highest attainable standard of physical and mental health.

The PBS is a benefit scheme which assists with providing subsidised access for people to medicines. This is a positive step towards attaining the highest standard of health for all Australians. Efficient operational arrangements for the PBS support effective administration of the scheme.

The ACSS payment included in the Eighth Agreement provides a means through which the Commonwealth is able to provide the necessary level of financial support to community pharmacies for the dispensing of PBS medicines, without increasing the costs of medicines for some patients.

The amendments made by the Amendment Determination are only in relation to the additional amounts for ACSS eligible supplies described above and in relation to continuation of existing provisions for ACSS eligible supplies. It does not change the protection of human rights to health and social security by all Australians under the PBS implemented under the Principal Determination.

Conclusion

This Instrument is compatible with human rights because it promotes the protection of human rights to health and social security, and favourable work conditions.