National Health Amendment Act 1985

Administered by Department of Health, Disability and Ageing

Legislation au C2004A03092 Not in force Act

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No. 53 of 1985

An Act to amend the National Health Act 1953, and for related purposes

[Assented to 4 June 1985]

BE IT ENACTED by the Queen, and the Senate and the House of Representatives of the Commonwealth of Australia, as follows:

Short title, &c.

1. (1) This Act may be cited as the National Health Amendment Act 1985.

(2) The National Health Act 19531 is in this Act referred to as the Principal Act.

Commencement

2. This Act shall come into operation on 1 July 1985.

3. After section 85a of the Principal Act the following section is inserted:

Determination of special patient contribution in respect of certain drugs, &c.

“85b. Where—

(a) either of the following sub-paragraphs apply in relation to a pharmaceutical benefit:

(i) in a case where the pharmaceutical benefit is a form of a drug or medicinal preparation to which a substance has, or substances have, been added in accordance with a

determination in force under sub-section 85 (3) relating to the drug or medicinal preparation—the Minister and the manufacturer of the form of the drug or medicinal preparation have been unable to agree on an amount that is, for the time being, to be taken to be, for the purposes of this Part, the appropriate maximum price for sales of the form of the drug or medicinal preparation to approved pharmaceutical chemists;

(ii) in any other case—the Minister and the manufacturer of the pharmaceutical benefit have been unable to agree on an amount that is, for the time being, to be taken to be, for the purposes of this Part, the appropriate maximum price for sales of the pharmaceutical benefit to approved pharmaceutical chemists; and

(b) the pharmaceutical benefit is a drug or medicinal preparation in respect of which a determination under sub-section 85 (6) is in force,

the Minister may, by notice in writing published in the Gazette, determine that this section applies in relation to the pharmaceutical benefit and, if the Minister does so, the Minister shall also, by notice in writing published in the Gazette, determine—

(c) the amount that is, for the purposes of this Part, to be taken to be the special patient contribution in relation to the pharmaceutical benefit; and

(d) the amount that is, for the purposes of this Part, to be taken to be—

(i) in a case to which sub-paragraph (a) (i) applies—the manufacturer’s price for sales of the form of the drug or medicinal preparation to approved pharmaceutical chemists; or

(ii) in a case to which sub-paragraph (a) (ii) applies—the manufacturer’s price for sales of the pharmaceutical benefit to approved pharmaceutical chemists.”.

Limited charges for pharmaceutical benefits

4. Section 87 of the Principal Act is amended—

(a) by omitting from sub-section (2) “his approval may, in respect of each supply by him of a pharmaceutical benefit (including each repeated supply)” and substituting “his or her approval may, in respect of each supply (including each repeated supply) by the approved pharmaceutical chemist or approved medical practitioner, as the case may be, of a pharmaceutical benefit (other than a pharmaceutical benefit in respect of which there is in force a determination under section 85b)”;

(b) by omitting from paragraph (2) (b) “$4.00” and substituting “$5.00”;

“(2a) An approved pharmaceutical chemist or an approved medical practitioner acting in accordance with his or her approval may, in respect of each supply (including each repeated supply) by the

approved pharmaceutical chemist or approved medical practitioner, as the case may be, of a pharmaceutical benefit in respect of which there is in force a determination under section 85b—

(a) upon a pensioner benefit prescription—charge the person to whom the pharmaceutical benefit is supplied the amount (in paragraphs (b) and (c) referred to as the ‘special patient contribution’) determined, for the time being, under that section to be the amount that is, for the purposes of this Part, to be taken to be the special patient contribution in relation to the pharmaceutical benefit;

(b) upon a concessional benefit prescription—charge the person to whom the pharmaceutical benefit is supplied the sum of the special patient contribution and $2.00; or

(c) upon a general benefit prescription—charge the person to whom the pharmaceutical benefit is supplied the sum of the special patient contribution and $5.00.”;

(d) by inserting in sub-section (3) “or (2a), as the case requires,” after “sub-section (2)” (first occurring);

(e) by inserting in sub-section (3) “or (2a), as the case may be,” after “sub-section (2)” (last occurring); and

(f) by inserting in sub-section (5) “or (2a), as the case requires,” after “sub-section (2)” (first occurring).

Cancellation by Secretary of approval of pharmaceutical chemists, &c.

5. Section 98 of the Principal Act is amended by omitting from sub-section (2) “, medical practitioner or hospital authority” and substituting “or medical practitioner”.

Function of Tribunal

6. (1) Section 98b of the Principal Act is amended—

(a) by omitting from paragraph (2) (a) “agreed price” (wherever occurring) and substituting “approved price”;

(b) by omitting from sub-section (3) the definition of “agreed price to pharmaceutical chemists” and substituting the following definition:

“ ‘approved price to pharmaceutical chemists’ means—

(a) in relation to a pharmaceutical benefit that is not a special pharmaceutical benefit or a form of a drug or medicinal preparation referred to in sub-paragraph (2) (a) (ii)—the amount that the manufacturer of the pharmaceutical benefit and the Minister agree, from time to time, is to be taken to be, for the purposes of this Part, the appropriate maximum price for sales of the pharmaceutical benefit to approved pharmaceutical chemists;

(b) in relation to a pharmaceutical benefit that is a special pharmaceutical benefit, but is not a form of a drug or

medicinal preparation referred to in sub-paragraph (2) (a) (ii)—the amount determined, from time to time, under section 85b to be the amount that is, for the purposes of this Part, to be taken to be the manufacturer’s price for sales of the pharmaceutical benefit to approved pharmaceutical chemists;

(c) in relation to a pharmaceutical benefit that is a form of a drug or medicinal preparation referred to in sub-paragraph (2) (a) (ii), but is not a special pharmaceutical benefit—the amount that the manufacturer of the form of the drug or medicinal preparation and the Minister agree, from time to time, is to be taken to be, for the purposes of this Part, the appropriate maximum price for sales of the form of the drug or medicinal preparation to approved pharmaceutical chemists; or

(d) in relation to a pharmaceutical benefit that is a form of a drug or medicinal preparation referred to in sub-paragraph (2) (a) (ii) and also a special pharmaceutical benefit—the amount determined, from time to time, under section 85b to be the amount that is, for the purposes of this Part, to be taken to be the manufacturer’s price for sales of the form of the drug or medicinal preparation to approved pharmaceutical chemists;”; and

“ ‘special pharmaceutical benefit’ means a pharmaceutical benefit in respect of which there is in force a determination under section 85b.”.

(2) Where the manufacturer of a pharmaceutical benefit, or a form of a drug or medicinal preparation that is a pharmaceutical benefit, and the Minister have, before the commencement of this section, agreed that an amount is to be taken to be, for the purposes of Part VII of the Principal Act, the appropriate maximum price for sales of the pharmaceutical benefit or the form of the drug or medicinal preparation, as the case may be, to approved pharmaceutical chemists and the agreement is in force immediately before that commencement, the agreement has effect, after that commencement, as if it were an agreement made for the purposes of Part VII of the Principal Act as amended by this Act.

(3) A reference in a determination of the Tribunal in force immediately before the commencement of this section to the agreed price to pharmaceutical chemists of a pharmaceutical benefit shall, after that commencement, be taken to be a reference to the approved price to pharmaceutical chemists of the pharmaceutical benefit.

Payment for supply of benefits

7. Section 99 of the Principal Act is amended—

(a) by inserting in sub-sections (2) and (2a) “(other than a pharmaceutical benefit in respect of which there was in force, at the time of supply, a determination under section 85b)” after “a pharmaceutical benefit”;

(b) by omitting from sub-section (2a) “$4.00” (wherever occurring) and substituting “$5.00”;

(c) by inserting in sub-section (2b) “(other than a pharmaceutical benefit in respect of which there was in force, at the time of supply, a determination under section 85b)” after “a pharmaceutical benefit”; and

(d) by inserting after sub-section (2b) the following sub-section:

“(2c) An approved pharmaceutical chemist or approved medical practitioner who has supplied a pharmaceutical benefit in respect of which there was in force, at the time of supply, a determination under section 85b is, subject to the conditions determined under section 98c and applicable at the time of the supply, entitled to be paid by the Commonwealth the amount by which the Commonwealth price of the pharmaceutical benefit, as at the time of the supply, exceeded the amount that the pharmaceutical chemist or approved medical practitioner was entitled to charge under sub-section 87 (2a) or (3), as the case requires.”.

NOTE

1. No. 95, 1953, as amended. For previous amendments, see No. 68, 1955; Nos. 55 and 95, 1956; No. 92, 1957; No. 68, 1958; No. 72, 1959; No. 16, 1961; No. 82, 1962; No. 77, 1963; No. 37, 1964; Nos. 100 and 146, 1965; No. 44, 1966; Nos. 14 and 100, 1967; No. 100, 1968; No. 102, 1969; No. 41, 1970; No. 85, 1971; No. 114, 1972; Nos. 49 and 202, 1973; No. 37, 1974; Nos. 1, 13 and 93, 1975; Nos. 1, 60, 91, 99, 108, 157 and 177, 1976; Nos. 98 and 100, 1977; Nos. 36, 88, 132 and 189, 1978; Nos. 54, 91 and 122, 1979; Nos. 117 and 131, 1980; Nos. 40, 74, 92, 118, 163 and 176, 1981; Nos. 49, 80 and 112, 1982; Nos. 35, 54 and 139, 1983; and Nos. 46, 63, 72, 120, 135 and 165, 1984.

[Minister’s second reading speech made in—

House of Representatives on 14 May 1985

Senate on 22 May 1985]

Overview

The National Health Amendment Act 1985, enacted by the Australian Parliament, serves to amend the National Health Act 1953. The primary purpose of this legislation is to address issues arising from the pricing and supply of pharmaceutical benefits, particularly in instances where the Minister and pharmaceutical manufacturers cannot agree on the appropriate maximum price for sales to approved pharmaceutical chemists. This gap in pricing agreements can impact the availability and affordability of certain medications for consumers. The Act introduces provisions to enable the Minister to determine a special patient contribution in such cases, ensuring that patients still have access to necessary medications while managing the financial aspects of pharmaceutical benefits more effectively. The policy objective of the National Health Amendment Act 1985 is to enhance the regulatory framework surrounding the pricing and supply of pharmaceutical benefits under the National Health Act 1953, thereby ensuring a balance between affordability, accessibility, and the financial sustainability of the pharmaceutical industry. This legislative amendment seeks to provide clarity and a structured approach to addressing pricing disputes, ultimately benefiting both consumers and the healthcare system.

Scope and Application

The National Health Amendment Act 1985 amends the National Health Act 1953 to introduce new provisions for the determination of special patient contributions for certain pharmaceutical benefits, particularly where there is a disagreement between the Minister and the manufacturer regarding the appropriate maximum price. This Act applies to pharmaceutical benefits provided under the National Health Act, which encompasses drugs and medicinal preparations supplied to approved pharmaceutical chemists. The amendments introduced by this Act affect the pricing and charging mechanisms for these pharmaceutical benefits. The Act applies across the Commonwealth of Australia, impacting all entities and individuals involved in the supply of pharmaceutical benefits under the National Health Act. It includes provisions for special patient contributions to be charged to patients for certain drugs, which are determined by the Minister if an agreement on the price cannot be reached with the manufacturer. Additionally, the Act modifies the function of the Tribunal and the payment processes for pharmaceutical benefits, ensuring that approved pharmaceutical chemists or medical practitioners can charge specific amounts based on the type of prescription provided. The Act does not specify exclusions or exemptions but operates under the broader framework of the National Health Act, allowing for further regulation and application through subordinate instruments.

Key Provisions

The National Health Amendment Act 1985 introduces several key provisions to the National Health Act 1953. Firstly, the Act allows the Minister to determine a special patient contribution for certain drugs and medicinal preparations when the Minister and the manufacturer cannot agree on the appropriate maximum price for sales to approved pharmaceutical chemists (section 85b). Additionally, it specifies that approved pharmaceutical chemists or medical practitioners can charge patients a special patient contribution for these drugs, with the amount varying based on the type of prescription (section 87). The Act also modifies the conditions under which the Secretary can cancel the approval of pharmaceutical chemists and updates the Tribunal’s function to include new definitions related to approved prices (section 98 and 98b). Lastly, it amends the payment process for pharmaceutical benefits, ensuring that suppliers are compensated for any difference between the Commonwealth price and the chargeable amount when a special patient contribution applies (section 99). The Act imposes obligations on several parties. Manufacturers of drugs and medicinal preparations must cooperate with the Minister to agree on appropriate maximum prices. Approved pharmaceutical chemists and medical practitioners must adhere to the pricing structures outlined in the Act, including charging the specified special patient contribution for certain drugs. The Minister is required to determine the special patient contribution and the manufacturer's price when necessary. The Secretary must follow the new conditions for cancelling approvals, and the Tribunal must apply the updated definitions and functions specified in the Act. Breaches of the Act may result in civil or criminal consequences. While the Act does not explicitly state penalties, violations of the National Health Act 1953 can typically incur penalties under other relevant legislation, such as fines for providing misleading information or failing to comply with pricing regulations. The specific penalties would depend on the nature and severity of the breach, and could potentially include substantial fines or other legal repercussions.

Area of Law: Health Law
Instrument: Act
Concepts: Definitions & Interpretation; Offence Provisions; Reporting & Disclosure Obligations; Regulatory Standards

Interactions

Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.

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