National Health (Chemotherapy Pharmaceuticals Access Program) Special Arrangement Amendment Instrument 2011 (No. 8) (No. PB 63 of 2011)

Administered by Department of Health, Disability and Ageing

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EXPLANATORY STATEMENT

Issued by Authority of the Minister for Health and Ageing

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (CHEMOTHERAPY PHARMACEUTICALS ACCESS PROGRAM) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2011 (No. 8)

PB 63 of 2011

Purpose

The purpose of this legislative instrument, made under subsections 100(1) and 100(2) of the National Health Act 1953 (the Act), is to amend the National Health (Chemotherapy Pharmaceuticals Access Program) Special Arrangement 2010 (PB 117 of 2010) (the Special Arrangement), to make changes to the special arrangement relating to the chemotherapy pharmaceuticals access program.

The Special Arrangement deals with the supply of chemotherapy pharmaceutical benefits at certain public hospitals to non-admitted patients, day admitted patients and patients on discharge. 

Section 100 special arrangements and Part VII of the Act

Subsection 100(1) enables the Minister to make special arrangements for, or in relation to, providing that an adequate supply of pharmaceutical benefits will be available to persons:

(a)  who are living in isolated areas: or

(b) who are receiving treatment in circumstances in which generally available

                        pharmaceutical benefits are inadequate for that treatment; or

(c)                    if the pharmaceutical benefits covered by the arrangements can be more

                         conveniently or efficiently supplied under the arrangements.

 

Subsection 100(3) provides that Part VII of the Act, and regulations and other legislative instruments made for the purposes of Part VII have effect subject to a special arrangement made under subsection 100(1). 

 

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

 

Changes to the Special Arrangement made by this Instrument

This instrument changes all references to ‘Medicare Australia CEO’ in PB 117 of 2010 to ‘Chief Executive Medicare’. These changes are made as a consequence of the commencement of the Human Services Legislation Amendment Act 2011.

This instrument makes changes to the pharmaceutical benefits available under the section 100 special arrangement for the chemotherapy pharmaceuticals access program. The changes made by this instrument reflect changes to the National Health (Listing of Pharmaceutical Benefits) Instrument made under sections 84AF, 85, 85A, 88 and 101 of the Act, which commences on the same day.

This instrument:

  • inserts  2 new chemotherapy pharmaceutical benefits; and
  • makes changes to the circumstances and purposes for two chemotherapy pharmaceutical benefits.

Consultations

An ongoing and formal process of consultation in relation to matters relevant to this instrument includes the involvement of interested parties through the membership of the Pharmaceutical Benefits Advisory Committee (PBAC). PBAC is an independent expert body established by section 100A of the Act 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 PBAC, and that would enable them to contribute meaningfully to the deliberations of PBAC.  When recommending the listing of a medicine on the Pharmaceutical Benefits Scheme (PBS), 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.

Pharmaceutical companies were consulted throughout the process for additions and changes to listings on the PBS and for the Special Arrangement. This includes consultation through the PBAC process, and agreement to final listing details.

General

This Instrument commences on 1 September 2011.

This Instrument is a legislative instrument for the purposes of the Legislative Instruments Act 2003.

A provision by provision description of this Instrument is contained in the Attachment.

 

 

ATTACHMENT

PROVISION BY PROVISION DESCRIPTION OF THE NATIONAL HEALTH (CHEMOTHERAPY PHARMACEUTICALS ACCESS PROGRAM) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2011 (No. 8)

Section 1  Name of Instrument

This section provides that this Instrument is the National Health (Chemotherapy Pharmaceuticals Access Program) Special Arrangement Amendment Instrument 2011(No. 8) and that it may also be cited as PB 63 of 2011.

Section 2  Commencement

This section provides that this Instrument commences on 1 September 2011.

Section 3   Amendments to PB 117 of 2010

This section provides that Schedule 1 amends the National Health (Chemotherapy Pharmaceuticals Access Program) Special Arrangement 2010 (PB 117 of 2010) (the Principal Instrument). 

Schedule 1

Items 1 to 24 change all references to ‘Medicare Australia CEO’ in the Principal Instrument to the new title ‘Chief Executive Medicare’. These changes are made as a consequence of the commencement of the Human Services Legislation Amendment Act 2011.

Item 25 amends Schedule 1 of the Principal Instrument to substitute a new entry for the listed drug ‘Cetuximab’. This new entry inserts the new circumstance codes ‘C3843’ and ‘C3844’ as additional circumstance codes for the two chemotherapy pharmaceutical benefits with the listed drug ‘Cetuximab’. This new entry also inserts the new purpose codes ‘P3843’ and ‘P3844’ as additional purpose codes for the two chemotherapy pharmaceutical benefits with the listed drug ‘Cetuximab’ when there is a maximum number of repeats of 0.

Item 26 amends Schedule 1 of the Principal Instrument to substitute a new entry for the listed drug ‘Ondansetron’ in the form ‘I.V. injection 4 mg (as hydrochloride dihydrate) in 2 mL’. This new entry adds the new chemotherapy pharmaceutical benefit with that drug and form and the new brand ‘Ondansetron Alphapharm’.

Item 27 amends Schedule 1 of the Principal Instrument to substitute a new entry for the listed drug ‘Ondansetron’ in the form ‘I.V. injection 8 mg (as hydrochloride dihydrate) in 4 mL’. This new entry adds the new chemotherapy pharmaceutical benefit with that drug and form and the new brand ‘Ondansetron Alphapharm’.

Item 28 amends the entry for the listed drug ‘Cetuximab’ in Schedule 3 of the Principal Instrument to insert descriptions for the two new circumstance codes ‘C3843’ and ‘C3844’ and the two new purpose codes ‘P3843’ and ‘P3844’.

 

 

 

Overview

The National Health (Chemotherapy Pharmaceuticals Access Program) Special Arrangement Amendment Instrument 2011 (No. 8) was enacted to address modifications required to the National Health (Chemotherapy Pharmaceuticals Access Program) Special Arrangement 2010. This amendment was necessary to reflect changes in the National Health (Listing of Pharmaceutical Benefits) Instrument and to update references following the commencement of the Human Services Legislation Amendment Act 2011. The purpose of this legislative instrument, made under subsections 100(1) and 100(2) of the National Health Act 1953, is to amend the special arrangement concerning the supply of chemotherapy pharmaceutical benefits at certain public hospitals to non-admitted patients, day admitted patients, and patients on discharge. The enactment body responsible for this amendment is the Minister for Health and Ageing, with the policy objective being to ensure an adequate supply of pharmaceutical benefits for those in need, particularly in treatment circumstances where generally available benefits are inadequate. The instrument incorporates consultations with the Pharmaceutical Benefits Advisory Committee and relevant pharmaceutical companies to ensure recommendations for drug listings on the Pharmaceutical Benefits Scheme are thoroughly considered.

Scope and Application

The National Health (Chemotherapy Pharmaceuticals Access Program) Special Arrangement Amendment Instrument 2011 (No. 8) amends the National Health (Chemotherapy Pharmaceuticals Access Program) Special Arrangement 2010. It applies to the supply of chemotherapy pharmaceutical benefits provided under the National Health Act 1953 at certain public hospitals to non-admitted patients, day admitted patients, and patients on discharge. The instrument updates references from "Medicare Australia CEO" to "Chief Executive Medicare" in response to legislative changes under the Human Services Legislation Amendment Act 2011. Additionally, it introduces two new chemotherapy pharmaceutical benefits, specifically for Cetuximab and Ondansetron in various dosages and forms, reflecting changes to the National Health (Listing of Pharmaceutical Benefits) Instrument. This amendment ensures that the special arrangement remains aligned with updated pharmaceutical listings and administrative roles within the health sector. The changes came into effect on 1 September 2011, and the instrument's provisions are subject to the broader legislative framework established by the National Health Act 1953.

Key Provisions

The National Health (Chemotherapy Pharmaceuticals Access Program) Special Arrangement Amendment Instrument 2011 (No. 8) amends the National Health (Chemotherapy Pharmaceuticals Access Program) Special Arrangement 2010. This amendment introduces changes to the special arrangement relating to the supply of chemotherapy pharmaceuticals at certain public hospitals to non-admitted patients, day admitted patients, and patients on discharge. The changes include updating references to the 'Medicare Australia CEO' to 'Chief Executive Medicare', a consequence of the Human Services Legislation Amendment Act 2011, and modifications to the pharmaceutical benefits available under the special arrangement to align with changes to the National Health (Listing of Pharmaceutical Benefits) Instrument. Specifically, the instrument inserts two new chemotherapy pharmaceutical benefits and alters the circumstances and purposes for two chemotherapy pharmaceutical benefits. These changes reflect updates to the National Health (Listing of Pharmaceutical Benefits) Instrument, which commenced on the same day as this amendment. The Act imposes obligations on the parties involved in the chemotherapy pharmaceuticals access program, ensuring that the supply of pharmaceutical benefits is adequate, convenient, and efficient for patients receiving treatment in certain circumstances. The Minister is responsible for making special arrangements under subsection 100(1) of the Act, which ensures that an adequate supply of pharmaceutical benefits is available to persons living in isolated areas, receiving treatment where generally available pharmaceutical benefits are inadequate, or when the pharmaceutical benefits can be more conveniently or efficiently supplied under the arrangements. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in this process by making recommendations to the Minister about which drugs and medicinal preparations should be available as pharmaceutical benefits. PBAC’s recommendations are based on 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. Pharmaceutical companies are also consulted throughout the process for additions and changes to listings on the Pharmaceutical Benefits Scheme (PBS) and for the Special Arrangement. Breaching the provisions of this Act or the special arrangement can result in various consequences. While the explanatory statement does not explicitly detail the specific offences, penalties, or civil/criminal consequences for breach, it is clear that any failure to comply with the requirements set out in the Act and the special arrangement can lead to legal repercussions. The National Health Act 1953 provides a framework for the administration of health-related services and benefits, and any deviation from the stipulated provisions can be subject to the penalties as outlined in the Act. These penalties could include fines, revocation of approvals, or other corrective measures to ensure compliance with the legislative requirements. The exact penalties would depend on the nature and severity of the breach, as well as any additional provisions or regulations under the Act. The changes introduced by the National Health (Chemotherapy Pharmaceuticals Access Program) Special Arrangement Amendment Instrument 2011 (No. 8) are designed to ensure that the chemotherapy pharmaceuticals access program remains effective and responsive to the needs of patients receiving treatment in public hospitals. By aligning the special arrangement with updates to the Pharmaceutical Benefits Scheme and addressing the specific needs of patients, the Act aims to provide a comprehensive and efficient system for the supply of necessary pharmaceutical benefits. The involvement of the Pharmaceutical Benefits Advisory Committee and consultation with pharmaceutical companies ensures that the recommendations and changes are based on expert advice and thorough consideration of clinical and cost-effectiveness factors.

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