National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2012 (No. 5) (No. PB 40 of 2012)

Administered by Department of Health, Disability and Ageing

Legislation au F2012L01332 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (EFFICIENT FUNDING OF CHEMOTHERAPY) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2012 (No. 5)

PB 40 of 2012

Authority

Subsection 100(1) of the National Health Act 1953 (the Act) enables the Minister to make special arrangements for the supply of pharmaceutical benefits. Subsection 100(2) of the Act provides that the Minister may vary or revoke a special arrangement made under subsection 100(1).

 

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

Purpose

The purpose of this legislative instrument, made under subsections 100(1) and 100(2) of the Act, is to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011) (the Special Arrangement), to make changes to the special arrangement relating to the efficient funding of chemotherapy.

The Special Arrangement achieves greater efficiency in payment for the supply of injected or infused chemotherapy medicines (“chemotherapy pharmaceutical benefits”) to eligible patients being treated for cancer, to reflect the 2010 budget measure titled ‘Revised arrangements for the efficient funding of chemotherapy drugs’. This Special Arrangement also relates to the supply of medicines associated with the side-effects of cancer and cancer treatment (“related pharmaceutical benefits”) at certain public hospitals.

This instrument makes changes to the pharmaceutical benefits available under the section 100 special arrangement for the efficient funding of chemotherapy. These changes reflect changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2010 (the main listing instrument) made under sections 84AF, 85, 85A, 88 and 101 of the Act, which commence on the same day.

This Instrument:

  • adds a circumstance for 3 pharmaceutical benefits with the listed drug ‘Docetaxel’;
  • adds 5 new listed brands with the listed drugs ‘Irinotecan’ and ‘Ondansetron’; and
  • amends the form for the pharmaceutical benefit with the listed drug ‘Bortezomib’;

This instrument also amends the responsible person for responsible person code ‘GZ’ to reflect the correct responsible person for that responsible person code as determined in the main listing instrument, amends the definitions for ‘diluent fee’, ‘dispensing fee’, ‘distribution fee’ and ‘preparation fee’ to reflect the indexation of these fees for 1 July 2012 and adds the responsible person code ‘GM’ and the associated responsible person ‘Ascent Pharma Pty Ltd’ to the Special Arrangement.

 

 

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.

This Instrument commences on 1 July 2012.

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 (EFFICIENT FUNDING OF CHEMOTHERAPY) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2012 (No. 5)

Section 1  Name of Instrument

This section provides that this Instrument is the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2012 (No. 5) and that it may also be cited as PB 40 of 2012.

Section 2  Commencement

This section provides that this Instrument commences on 1 July 2012.

Section 3   Amendments to PB 79 of 2011

This section provides that Schedule 1 amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011) (the Special Arrangement). 

Schedule 1

Item 1 revises the diluent fee to reflect that the fee is $4.83 on and from 1 July 2012.

Item 2 revises the dispensing fee to reflect that the fee is $6.52 on and from 1 July 2012.

Item 3 revises the distribution fee to reflect that the fee is $24.38 on and from 1 July 2012.

Item 4 revises the preparation fee to reflect that the fee is $40.64 on and from 1 July 2012.

Item 5 amends the entry in Schedule 1 Part 1 of the Special Arrangement for the pharmaceutical benefit with the listed drugBortezomib’ by amending the form to be ‘Powder for Injection 3.5 mg’.

Item 6 amends the entry in Schedule 1 Part 1 of the Special Arrangement for Docetaxel’ in the form ‘Solution concentrate for I.V. infusion 160 mg in 16 mL’ with manner of administration ‘Injection’ and brand ‘DBL Docetaxel Concentrated Injection by adding the circumstance code ‘C3892’.

Item 7 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Docetaxel’ in the form ‘Solution concentrate for I.V. infusion 20 mg in 2 mL’ with manner of administration ‘Injection’ and brand ‘DBL Docetaxel Concentrated Injection’ by adding the circumstance code ‘C3892’.

Item 8 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Docetaxel’ in the form ‘Solution concentrate for I.V. infusion 80 mg in 8 mL’ with manner of administration ‘Injection’ and brand ‘DBL Docetaxel Concentrated Injection’ by adding the circumstance code ‘C3892’.

Item 9 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Irinotecan’ by adding a new pharmaceutical benefit, which is the listed drug ‘Irinotecan’ in the form ‘I.V. injection containing irinotecan hydrochloride trihydrate 500 mg in 25 mL’ with manner of administration ‘Injection’ and brand ‘Irinotecan Alphapharm’.

Item 10 amends the entry in Schedule 2 of the Special Arrangement for ‘Ondansetron’ by adding a new pharmaceutical benefit, which is the listed drug ‘Ondansetron’ in the form ‘Tablet 4 mg (as hydrochloride dihydrate)’ with manner of administration ‘Oral’ and brand ‘Zondan’.

Item 11 amends the entry in Schedule 2 of the Special Arrangement for ‘Ondansetron’ by adding a new pharmaceutical benefit, which is the listed drug ‘Ondansetron’ in the form ‘Tablet 8 mg (as hydrochloride dihydrate)’ with manner of administration ‘Oral’ and brand ‘Zondan’.

Item 12 amends the entry in Schedule 2 of the Special Arrangement for ‘Ondansetron’ by adding a new pharmaceutical benefit, which is the listed drug ‘Ondansetron’ in the form ‘Tablet (orally disintegrating) 4 mg’ with manner of administration ‘Oral’ and brand ‘Onsetron ODT 4’.

Item 13 amends the entry in Schedule 2 of the Special Arrangement for ‘Ondansetron’ by adding a new pharmaceutical benefit, which is the listed drug ‘Ondansetron’ in the form ‘Tablet (orally disintegrating) 8 mg’ with manner of administration ‘Oral’ and brand ‘Onsetron ODT 8’.

Item 14 amends Schedule 3 of the Special Arrangement by adding the responsible person code ‘GM’ and associated responsible person ‘Ascent Pharma Pty Ltd’.

Item 15 amends the entry in Schedule 3 of the Special Arrangement for ‘GZ’ by amending the associated responsible person to be ‘sanofi-aventis Australia Pty Ltd’.

 

 


 

 

 

 

 

 

 

 

 

 

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2012 (No. 5) was enacted to address inefficiencies in the funding of chemotherapy drugs and related treatments under the National Health Act 1953. This instrument, made under the authority of subsections 100(1) and 100(2) of the Act, amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to improve the efficiency of payments for chemotherapy pharmaceutical benefits, reflecting the 2010 budget measure titled ‘Revised arrangements for the efficient funding of chemotherapy drugs’. The purpose is to better align the funding of these treatments with the National Health (Listing of Pharmaceutical Benefits) Instrument 2010, including updates to fees and the addition of new pharmaceutical benefits and responsible persons. The instrument also involves consultation with the Pharmaceutical Benefits Advisory Committee, which recommends which drugs should be available as pharmaceutical benefits.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2012 (No. 5) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, applying to pharmaceutical benefits concerning the supply of injected or infused chemotherapy medicines and related pharmaceutical benefits at certain public hospitals. This instrument primarily targets healthcare providers, patients eligible for chemotherapy treatment, and pharmaceutical companies supplying these medicines, ensuring they adhere to the updated special arrangement for efficient funding of chemotherapy drugs as per the National Health Act 1953. The amendments reflect the 2010 budget measure titled ‘Revised arrangements for the efficient funding of chemotherapy drugs’ and are effective nationally across Australia. The Act does not explicitly state exclusions, but the application is limited to the circumstances and pharmaceutical benefits specified in the instrument. The instrument also incorporates changes to fees and responsible persons for specific drugs, aligning with the National Health (Listing of Pharmaceutical Benefits) Instrument 2010.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2012 (No. 5) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011. This amendment introduces changes to the efficient funding of chemotherapy, particularly for the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits for side-effect treatment at certain public hospitals. The primary objective is to reflect changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2010. This amendment specifically alters the pharmaceutical benefits available under the special arrangement for chemotherapy, adding new circumstances for listed drugs, updating fees, and adjusting definitions. The key sections of this amendment (section 3 of the Instrument) include updates to fees such as the diluent fee (item 1), dispensing fee (item 2), distribution fee (item 3), and preparation fee (item 4). These fees are revised to reflect the indexed values effective from 1 July 2012. The amendment also modifies the form of a pharmaceutical benefit associated with the drug ‘Bortezomib’ (item 5). Furthermore, the amendment adds new pharmaceutical benefits for listed drugs ‘Docetaxel’ (items 6 to 8) and ‘Irinotecan’ (item 9), and introduces new brands for the drug ‘Ondansetron’ (items 10 to 13). Additionally, the amendment includes changes to the responsible person for certain codes and adds a new responsible person code (items 14 and 15). The obligations imposed by this amendment on the parties governed by the Act include ensuring that the updated fees and forms are applied correctly in the provision of chemotherapy pharmaceutical benefits. Parties must also ensure that the new pharmaceutical benefits and responsible persons are incorporated into their operations. This involves updating records, ensuring that new drugs and brands are available for supply, and that the correct responsible persons are associated with the relevant codes. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in advising the Minister on these changes, ensuring that the recommendations align with the objectives of the Act. Failure to comply with the provisions of this amendment may lead to legal consequences. Although the Explanatory Statement does not explicitly detail specific offences or penalties, non-compliance with provisions under the National Health Act 1953 can generally result in civil or criminal penalties. These penalties can include fines, corrective actions, or other measures deemed appropriate by the relevant authorities. The exact nature and severity of penalties would be governed by the broader provisions of the National Health Act 1953 and any applicable regulations or subsidiary legislation.

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