National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2012 (No. 6) (No. PB 48 of 2012)

Administered by Department of Health, Disability and Ageing

Legislation au F2012L01616 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. 6)

PB 48 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 pharmaceutical benefit containing the new listed drug ‘Cabazitaxel’;
  • amends the circumstances for pharmaceutical benefits with the listed drug ‘Docetaxel’; and
  • adds 1 new listed brand with the listed drug ‘Topotecan’.

 

This Instrument also amends the definition of ‘participating hospital authority’ and inserts a definition for ‘National Health Reform Agreement’. This amendment reflects amendments to the Federal Financial Relations Act 2009 that commenced 25 June 2012. The Federal Financial Relations Act 2009 refers to the National Health Reform Agreement as agreed to by the Council of Australian Governments on 2 August 2011 as amended from time to time. A copy of the National Health Reform Agreement can be obtained at the Council of Australian Governments (“COAG”) website at http://www.coag.gov.au.

 

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 August 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. 6)

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. 6) and that it may also be cited as PB 48 of 2012.

Section 2  Commencement

This section provides that this Instrument commences on 1 August 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 inserts a definition for ‘National Health Reform Agreement’ into section 3 of the Special Arrangement.

Item 2 amends the definition of ‘participating hospital authority’ in section 3 of the Special Arrangement by replacing the reference to the National Healthcare Agreement with a reference to the National Health Reform Agreement. 

Item 3 inserts a new listed drug ‘Cabazitaxel’ into Schedule 1 Part 1 of the Special Arrangement by adding a new pharmaceutical benefit, which is the listed drug ‘Cabazitaxel’ in the form ‘Concentrated injection 60mg (as acetone solvate) in 1.5 mL, with diluent’ with the manner of administration ‘Injection’ and brand ‘Jevtana.

Item 4 amends the entry in Schedule 1 Part 1 of the Special Arrangement for Docetaxel in the form Injection set containing 1 single use vial concentrate for I.V. infusion 20 mg (anhydrous) in 0.5 mL with solvent with the manner of administration ‘Injection’ and brand ‘Taxotere’ by removing the circumstances code ‘C3884 and adding the circumstances code ‘C7002’.

Item 5 amends the entry in Schedule 1 Part 1 of the Special Arrangement for Docetaxel in the form Injection set containing 1 single use vial concentrate for I.V. infusion 80 mg (anhydrous) in 2 mL with solventwith the manner of administration ‘Injection’ and brand ‘Taxotere’ by removing the circumstances code ‘C3884 and adding the circumstances code ‘C7002’.

Item 6 amends the entry in Schedule 1 Part 1 of the Special Arrangement for Docetaxel in the form ‘Powder for I.V. infusion 20 mg with solvent’ with manner of administration ‘Injection’ and brand ‘Docetaxel SUNby removing the circumstances code ‘C3884 and adding the circumstances code ‘C7002’.

Item 7 amends the entry in Schedule 1 Part 1 of the Special Arrangement for Docetaxel in the form Powder for I.V. infusion 80 mg with solvent’ with manner of administration ‘Injection’ and brand ‘Docetaxel SUN’ by removing the circumstances code ‘C3884 and adding the circumstances code ‘C7002’.

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 140 mg in 7 mL’ with manner of administration ‘Injection’ and brand ‘Oncotaxel 140’ by removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 9 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 mLwith manner of administration ‘Injection’ and brand ‘DBL Docetaxel Concentrated Injection’ by removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 10 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 1 mL’ with manner of administration ‘Injection’ and brand ‘Oncotaxel 20’ by removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 11 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 1 mL with manner of administration ‘Injection’ and brand ‘Taxotere’ by removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 12 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 removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 13 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 ‘Docetaxel Ebeweby removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 14 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 ‘Docetaxel Sandozby removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 15 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 4 mL’ with manner of administration ‘Injection’ and brand Oncotaxel 80by removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 16 amends the entry in Schedule 1 Part 1 for Docetaxel in the form ‘Solution concentrate for I.V. infusion 80 mg in 4 mL’ with manner of administration ‘Injection’ and brand ‘Taxotereby removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 17 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 removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 18 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 ‘Docetaxel Ebewe’ by removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 19 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 ‘Docetaxel Sandoz’ by removing the circumstances code’ C3884’ and adding the circumstances code ‘C7002’.

Item 20 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Topotecan’ by adding a new pharmaceutical benefit, which is the listed drug ‘Topotecan’ in the form ‘Powder for I.V. infusion 4 mg (as hydrochloride)’ with manner of administration ‘Injection’ and brand ‘Topotecan Kabi.

Item 21 amends Schedule 1 Part 2 of the Special Arrangement by adding the maximum amount and number of repeats for the new listed drug ‘Cabazitaxel’.

Item 22 amends Schedule 4 of the Special Arrangement by adding circumstances codes and associated circumstances for the new listed drug ‘Cabazitaxel’.

Item 23 amends the entry in Schedule 4 of the Special Arrangement for “Docetaxel’ by removing circumstances code ‘C3884’ and the circumstances associated with it and inserting circumstances code ‘C7002’ and the circumstances associated with it.

 

 


 

 

 

 

 

 

 

 

 

 

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2012 (No. 6) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, addressing the need for more efficient funding of chemotherapy medicines. This amendment was introduced by the Minister for Health under subsections 100(1) and 100(2) of the National Health Act 1953, which allows for special arrangements for the supply of pharmaceutical benefits. The policy objective is to achieve greater efficiency in the payment for chemotherapy medicines, reflecting the 2010 budget measure 'Revised arrangements for the efficient funding of chemotherapy drugs'. The changes introduced by this instrument include adding a new pharmaceutical benefit for the drug Cabazitaxel, amending the circumstances for the drug Docetaxel, adding a new brand for the drug Topotecan, and updating definitions in line with the National Health Reform Agreement. This amendment is effective from 1 August 2012, and consultations were undertaken with the Pharmaceutical Benefits Advisory Committee (PBAC) to ensure a balanced and expert-informed approach to the changes.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2012 (No. 6) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, providing for changes to the special arrangement relating to the efficient funding of chemotherapy. This legislative instrument applies to the supply of chemotherapy medicines and related pharmaceutical benefits to eligible patients being treated for cancer in public hospitals, specifically those participating in the Pharmaceutical Benefits Scheme (PBS) under the National Health Act 1953. The changes reflect amendments to the National Health (Listing of Pharmaceutical Benefits) Instrument 2010 and amendments to the Federal Financial Relations Act 2009, particularly concerning the National Health Reform Agreement. The Act applies nationally across Australia, and the changes come into effect on 1 August 2012. The amendment introduces a new pharmaceutical benefit for the drug Cabazitaxel, modifies the circumstances for the drug Docetaxel, and adds a new listed brand for the drug Topotecan. Additionally, the definitions of 'participating hospital authority' and 'National Health Reform Agreement' are updated to reflect legislative changes. There are no specific exclusions or exemptions stated in this instrument, and it does not extend or restrict application through subordinate instruments.

Key Provisions

The primary operative sections of the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2012 (No. 6) are sections that amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011). These sections add the pharmaceutical benefit for the drug 'Cabazitaxel', modify the circumstances for the drug 'Docetaxel', and add a new listed brand for the drug 'Topotecan'. The amendments also include the definition of 'participating hospital authority' and the definition of 'National Health Reform Agreement' to align with recent changes in federal legislation. These provisions require updates to the Special Arrangement to reflect the changes in the pharmaceutical benefits and agreements that govern the supply and funding of chemotherapy medicines in Australia. The Act imposes several obligations on the parties involved, primarily those who administer and supply chemotherapy medicines under the Special Arrangement. Hospitals and healthcare providers must ensure they are adhering to the updated definitions and provisions in the Special Arrangement when administering and funding chemotherapy treatments. Pharmaceutical suppliers must be aware of the new drugs and brands listed in the Special Arrangement and ensure they are appropriately coded and billed according to the new circumstances. The Minister for Health is responsible for overseeing the implementation of these changes and ensuring that the Special Arrangement remains aligned with broader health policy objectives. Failure to comply with the provisions of the Special Arrangement may result in civil or administrative penalties. For example, if a participating hospital authority or healthcare provider fails to adhere to the updated definitions and provisions, they may face financial penalties or other corrective actions. Pharmaceutical suppliers who do not comply with the new listings and circumstances codes may also face penalties, including fines or other administrative sanctions. These penalties are intended to ensure that the Special Arrangement effectively achieves its purpose of providing efficient funding for chemotherapy medicines while maintaining high standards of care for patients.

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