National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2014 (No. 9) (No. PB 78 of 2014)

Administered by Department of Health, Disability and Ageing

Legislation au F2014L01291 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. 9)

PB 78 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:

  • adds a pharmaceutical benefit ‘Eribulin’ and the associated circumstances;
  • adds the responsible person Eisai Australia Pty Ltd (EI).

 

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

 

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 October 2014.

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


ATTACHMENT

PROVISION BY PROVISION DESCRIPTION OF THE NATIONAL HEALTH (EFFICIENT FUNDING OF CHEMOTHERAPY) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2014 (No. 9)

Section 1  Name of Instrument

This section provides that this Instrument is the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2014 (No. 9) and that it may also be cited as PB 78 of 2014.

Section 2  Commencement

This section provides that this Instrument commences on 1 October 2014.

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).

 

Item 1 inserts a new listed drug ‘Eribulin’ into Schedule 1 Part 1 of the Special Arrangement by adding a new pharmaceutical benefit, which is the listed drug ‘Eribulin’ in the form ‘Solution for I.V. injection containing eribulin mesilate 1 mg in 2 mL’ with the manner of administration ‘Injection’ and brand ‘Halaven’.

 

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

Item 3 amends Schedule 3 of the Special Arrangement by adding a new responsible person Eisai Australia Pty Ltd.

 

Item 4 amends Schedule 4 of the Special Arrangement by adding circumstance codes and the associated circumstances for pharmaceutical benefits with the listed drug ‘Eribulin’.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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. 9) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, made under the National Health Act 1953. This instrument was introduced to address the need for efficient funding of chemotherapy drugs and associated side-effect treatments for cancer patients in Australia. Enacted by the Australian Parliament, the policy objective is to enhance the efficiency and effectiveness of pharmaceutical benefits for cancer treatment through the Pharmaceutical Benefits Scheme (PBS). This amendment specifically adds the drug Eribulin and associated circumstances, as well as the responsible entity Eisai Australia Pty Ltd, to the special arrangement. The changes reflect broader updates to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 and are designed to align with the 2010 budget measure on efficient funding of chemotherapy drugs. The amendments to the Special Arrangement are made to accommodate the evolving landscape of cancer treatment pharmaceuticals and to ensure that the PBS remains responsive to the needs of patients and healthcare providers. Consultations with relevant stakeholders, including the Pharmaceutical Benefits Advisory Committee (PBAC), ensure that the decisions are evidence-based and aligned with the highest standards of clinical effectiveness, safety, and cost-effectiveness. This legislative instrument is intended to commence on 1 October 2014 and is recognised as compatible with human rights, particularly in the context of economic, social, and cultural rights, by providing accessible and affordable access to essential medications for cancer treatment.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2014 (No. 9) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to make changes to the efficient funding of chemotherapy. This instrument applies to the efficient funding of chemotherapy pharmaceutical benefits and related pharmaceutical benefits, which are medicines used in the treatment of cancer and its side-effects at certain public hospitals. The changes introduced by this instrument include the addition of a new pharmaceutical benefit for the drug 'Eribulin' and its associated circumstances, along with the responsible person 'Eisai Australia Pty Ltd'. This instrument operates nationally within Australia, affecting all eligible patients and entities involved in the supply of chemotherapy medicines under the Special Arrangement. The changes are subject to the overarching provisions of the National Health Act 1953 and the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The instrument commenced on 1 October 2014 and is a legislative instrument under the Legislative Instruments Act 2003.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2014 (No. 9) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, which deals with the efficient funding of chemotherapy medicines for cancer patients. This legislative instrument introduces new provisions to better reflect the 2010 budget measure on chemotherapy drug funding. Specifically, it adds a new pharmaceutical benefit for 'Eribulin', updates the responsible person to include 'Eisai Australia Pty Ltd', and adjusts the maximum amounts and repeats for certain drugs. These amendments ensure that the Special Arrangement remains current and effective in providing necessary treatments to patients. The Act imposes certain obligations on the parties involved, including the responsible person 'Eisai Australia Pty Ltd' and the patients receiving chemotherapy treatments. For instance, Eisai Australia Pty Ltd must ensure that the specified chemotherapy medicines are available and appropriately administered according to the terms of the Special Arrangement. Patients, on the other hand, must meet the eligibility criteria to receive the benefits provided under the arrangement. The Act also mandates the involvement of the Pharmaceutical Benefits Advisory Committee (PBAC), which plays a critical role in recommending the inclusion of new drugs on the Pharmaceutical Benefits Scheme (PBS), ensuring that decisions are evidence-based and align with the highest standards of clinical effectiveness and cost-efficiency. Failure to comply with the provisions of the Special Arrangement may result in various consequences. For the responsible parties, such as Eisai Australia Pty Ltd, there may be administrative penalties or sanctions if they do not adhere to the terms of the arrangement. Patients who misuse the benefits or do not meet the eligibility criteria may face financial penalties or loss of access to the funded treatments. The exact penalties are not specified in the text but are generally governed by the broader provisions of the National Health Act 1953 and other related regulations. The overarching aim is to ensure that the efficient funding of chemotherapy is maintained and that access to necessary treatments is both fair and sustainable.

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