National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2014 (No. 1) (No. PB 5 of 2014)

Administered by Department of Health, Disability and Ageing

Legislation au F2014L00079 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 2014 (No. 1)

PB 5 of 2014

 

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 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 entitled ‘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 Special Arrangement for the efficient funding of chemotherapy. These changes reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 made under sections 84AF, 84AK, 85, 85A, 88 and 101 of the Act, which commence on the same day.

This Instrument removes one listed brand for the listed drug ‘Paclitaxel’.  Item 1 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Paclitaxel’ by removing a pharmaceutical benefit, which is the listed drug ‘Paclitaxel’ in the form ‘Solution concentrate for I.V. infusion 300mg in 50mL’ with manner of administration ‘Injection’ and brand ‘Paclitaxel Pfizer.

 

Consultations

An ongoing and formal process of consultation in relation to matters relevant to the Special Arrangement 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 February 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 (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2013 (No. 4)

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 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:

  • adds 4 new listed brands for the listed drugsDoxorubicin’, and ‘Gemcitabine’;
  • adds 1 new listed form for the listed drug ‘Aprepitant’;
  • removes 2 listed brands for the listed drug ‘Docetaxel’; and
  • adds new circumstance codes and the associated circumstances for  the listed drug ‘Aprepitant’.

Human rights implications

This legislative instrument engages Article 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 Pharmaceutical Benefits Scheme (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.

 

Kim Bessell

 Assistant Secretary

Pharmaceutical Access Branch

Principal Pharmacy Advisor

       Pharmaceutical Benefits Division
   Department of Health and Agein

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2014 (No. 1) was enacted to address the need for efficient funding of chemotherapy and related pharmaceutical benefits under the National Health Act 1953. This legislative instrument was introduced by the Australian Government in response to the 2010 budget measure that aimed to improve the efficiency of funding for chemotherapy drugs and medicines associated with cancer treatment side-effects at public hospitals. The purpose of this amendment is to make changes to the pharmaceutical benefits available under the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, ensuring that the benefits reflect the most recent updates in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This amendment involves the removal of specific pharmaceutical benefits for certain drugs and the addition of new ones, as well as adjustments to circumstance codes for some listed drugs. The process of enacting this amendment involved consultations with the Pharmaceutical Benefits Advisory Committee (PBAC), an independent body that recommends which drugs should be available as pharmaceutical benefits under the National Health Act 1953. The policy objective of this amendment is to ensure that the pharmaceutical benefits provided under the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 are efficient, effective, and reflect the latest updates in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The involvement of the PBAC ensures that the decisions made are evidence-based and consider the medical conditions for which the medicines have been approved, their clinical effectiveness, safety, and cost-effectiveness compared to other treatments. This legislative instrument is compatible with human rights, as it assists with the progressive realisation of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, in line with Article 2 and 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR).

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2014 (No. 1) is an amendment to the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, made under the authority of the National Health Act 1953. This amendment applies to the efficient funding of chemotherapy pharmaceutical benefits and related pharmaceutical benefits, which are administered through the Pharmaceutical Benefits Scheme (PBS) and supplied to eligible patients receiving cancer treatment at certain public hospitals. The instrument targets pharmaceutical benefits specifically related to chemotherapy drugs and their side-effect treatments, ensuring that the funding arrangements are both efficient and reflective of the latest budgetary measures and health needs. It involves the removal and addition of certain pharmaceutical benefits, such as specific brands and forms of drugs like Paclitaxel, Doxorubicin, Gemcitabine, and Aprepitant. The changes are designed to align with broader modifications to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This legislative instrument is applicable across the Commonwealth of Australia and is subject to review and potential further amendment by the Minister for Health, with decisions informed by the Pharmaceutical Benefits Advisory Committee (PBAC).

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2014 (No. 1) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (the Special Arrangement) (sections 1 and 2). This instrument primarily focuses on updating the pharmaceutical benefits available under the Special Arrangement to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (section 3). It makes specific changes to the list of chemotherapy pharmaceutical benefits by adding new brands and forms of certain drugs, while also removing some brands for specific drugs. For example, it removes the listed brand 'Paclitaxel Pfizer' from the list of benefits for the drug 'Paclitaxel' (Item 1). The Act imposes several obligations on the parties involved, including the Minister for Health, the Pharmaceutical Benefits Advisory Committee (PBAC), and healthcare providers. The Minister is responsible for making special arrangements under the Act and can vary or revoke these arrangements as necessary (subsections 100(1) and 100(2)). PBAC, an independent expert body, provides recommendations to the Minister regarding the listing of pharmaceutical benefits on the Pharmaceutical Benefits Scheme (PBS) (section 100A). Healthcare providers must comply with the provisions of the Special Arrangement when supplying chemotherapy pharmaceutical benefits to eligible patients. The Act does not specify any criminal or civil penalties for breach of the Special Arrangement. However, failure to comply with the provisions of the Special Arrangement could lead to financial consequences for healthcare providers, as they may not be reimbursed by the Commonwealth for services provided under the arrangement if they do not adhere to the specified conditions. Additionally, if the Minister determines that a special arrangement is no longer necessary or appropriate, they may vary or revoke the arrangement, which could result in changes to the benefits available to patients and healthcare providers.

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