National Health Determination under paragraph 98C(1)(b) Amendment 2014 (No. 5) (No. PB 38 of 2014)

Administered by Department of Health, Disability and Ageing

Legislation au F2014L00593 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

National Health Determination under paragraph 98C(1)(b)
Amendment 2014 (No. 5)

PB 38 of 2014

 

Authority

Paragraph 98C(1)(b) of the National Health Act 1953 (the Act) provides that the Minister may determine the conditions subject to which payments will be made by the Commonwealth in respect of the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners.  Determination under paragraph 98C(1)(b) of the National Health Act 1953 (PB 119 of 2008) (the Principal Determination) sets out the conditions subject to which these payments will be made.

Purpose

This Amendment Determination amends the Principal Determination to reflect the changes made by the National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2014 (No. 5), commencing on 1 June 2014.  Schedule 3 of the Principal Determination is amended by the addition of the listed drug tapentadol, which is classified as a dangerous drug for the purpose of payment of a dangerous drug fee.  Schedule 4 is amended by the addition of glucose indicator―blood in the form test strips, 100 (GoodLife).  Schedule 4 is further amended by removing phenoxybenzamine as a result of a change of pack quantity.

Variation and revocation

Unless there is an express power to revoke or vary PB 119 of 2008 cited in this Instrument and explanatory statement, subsection 33(3) of the Acts Interpretation Act 1901 is relied upon to revoke or vary PB 119 of 2008.

Background

Part VII of the National Health Act 1953 (the Act) is the legislative basis of the Pharmaceutical Benefits Scheme (PBS) by which the Commonwealth provides reliable, timely, and affordable access to a wide range of medicines for all Australians.

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

Paragraph 98C(1)(b) of the Act provides that the Minister may, from time to time, determine the conditions subject to which payments will be made by the Commonwealth in respect of the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners.

The determination under paragraph 98C(1)(b) of the Act sets out the conditions under which payments will be made in respect of the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners.


 

 

Consultation

The Department consulted with the Pharmaceutical Benefits Advisory Committee (PBAC) during the regular process of its meetings to consider applications in order to recommend to the Minister which medicines should be subsidised through the Pharmaceutical Benefits Scheme.  The Committee is independent of Government and includes members from the following interests or professions: consumers, health economists, practising community pharmacists, general practitioners, clinical pharmacologists and medical specialists.  The Committee has received submissions and representations from interested pharmaceutical companies and has recommended the changes to the Minister who has determined the changes to the conditions under paragraph 98C(1)(b) which appear in this Determination. 

 

This Instrument commences on 1 June 2014.

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

 


Statement of Compatibility with Human Rights

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

 

National Health Determination under paragraph 98C(1)(b) Amendment 2014
(No. 5)
(PB 38 of 2014)

 

This 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 determination under paragraph 98C(1)(b) of the National Health Act 1953 sets out the conditions under which payments will be made in respect of the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners.

This legislative instrument amends the Determination under paragraph 98C(1)(b) of the National Health Act 1953 (PB 119 of 2008).  The amendments provide for changes to the conditions subject to which payments will be made by the Commonwealth in respect of the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners.  This instrument adds one drug to Schedule 3 of the Principal Instrument.  This instrument also adds one form of a listed drug to Schedule 4 of the Principal Instrument and removes one listed drug following a pack quantity change.

Human rights implications

This legislative instrument engages Articles 2 and 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) by assisting with the progressive realisation by all appropriate means of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

The PBS is a benefit scheme which assists with advancement of this human right by providing for subsidised access by patients to medicines.  The recommendatory role of the Pharmaceutical Benefits Advisory Committee (PBAC) ensures that decisions about subsidised access to medicines on the PBS are evidence-based.

Conclusion

This Legislative Instrument is compatible with human rights because it advances the protection of human rights.

 

Felicity McNeill

First Assistant Secretary

Pharmaceutical Benefits Division

Department of Health

 

Overview

The National Health Determination under paragraph 98C(1)(b) Amendment 2014 (No. 5) (PB 38 of 2014) amends the conditions under which payments are made by the Commonwealth for the supply of pharmaceutical benefits, as set out in the Principal Determination under paragraph 98C(1)(b) of the National Health Act 1953. Enacted by the Australian Parliament, this legislative instrument aims to update the conditions to align with the changes introduced by the National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2014 (No. 5), which commenced on 1 June 2014. This includes the addition of tapentadol to Schedule 3, classifying it as a dangerous drug for the purpose of payment of a dangerous drug fee, and adjustments to Schedule 4 by adding a specific form of glucose indicator test strips and removing phenoxybenzamine due to a change in pack quantity. The amendments reflect the evolving needs of the Pharmaceutical Benefits Scheme (PBS), ensuring the scheme continues to provide reliable, timely, and affordable access to medicines for Australians.

Scope and Application

The National Health Determination under paragraph 98C(1)(b) Amendment 2014 (No. 5) amends the conditions under which payments will be made by the Commonwealth in respect of the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners, pursuant to the National Health Act 1953. This determination applies to approved pharmacists and approved medical practitioners who supply pharmaceutical benefits, ensuring that they meet the specified conditions for Commonwealth payments. The amendments are effective across Australia, given the national scope of the Pharmaceutical Benefits Scheme (PBS) under the National Health Act 1953. The changes involve updating the lists of drugs eligible for PBS subsidies, including adding tapentadol to Schedule 3 and glucose indicator―blood in the form test strips, 100 (GoodLife) to Schedule 4, while removing phenoxybenzamine due to a change in pack quantity. This instrument revokes and varies the Principal Determination (PB 119 of 2008) based on subsection 33(3) of the Acts Interpretation Act 1901, and it is compatible with human rights as it supports the progressive realisation of the right to the highest attainable standard of physical and mental health, consistent with the International Covenant on Economic, Social and Cultural Rights.

Key Provisions

The key provisions of the National Health Determination under paragraph 98C(1)(b) Amendment 2014 (No. 5) (PB 38 of 2014) involve amendments to the Principal Determination (PB 119 of 2008) under the National Health Act 1953, which governs the conditions for Commonwealth payments for pharmaceutical benefits supplied by approved pharmacists and medical practitioners. Specifically, section 1 of the Amendment amends the Principal Determination by adding tapentadol to Schedule 3, classifying it as a dangerous drug subject to a dangerous drug fee, and adding glucose indicator―blood in the form test strips, 100 (GoodLife) to Schedule 4. Additionally, it removes phenoxybenzamine from Schedule 4 due to a change in pack quantity. These changes reflect the adjustments made by the National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2014 (No. 5), effective from 1 June 2014. The obligations imposed by this Amendment Determination on parties such as approved pharmacists and medical practitioners include compliance with the updated conditions for making payments for pharmaceutical benefits. Pharmacists and practitioners must adhere to the new classifications and requirements as outlined in the amended schedules. This includes the correct billing and documentation for the dangerous drug fee for tapentadol and ensuring the proper listing and payment conditions for the newly added glucose indicator test strips and the removal of phenoxybenzamine due to its changed pack quantity. These changes necessitate updated records, billing practices, and compliance with the new fee structure and listings. Failure to comply with the conditions set forth in this Amendment Determination may result in civil or criminal consequences. While specific penalties are not detailed in the provided text, breaches of conditions under the National Health Act 1953 typically involve penalties that can include fines and other sanctions. The exact penalties would depend on the nature and severity of the breach, as outlined in the relevant sections of the Act and associated regulations. Pharmacists and medical practitioners must ensure they are aware of and comply with the new requirements to avoid any potential penalties.

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