National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 1) (PB 4 of 2015)

Administered by Department of Health, Disability and Ageing

Legislation au F2015L00083 Not in force Legislative Instrument

Legislation content

EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (EFFICIENT FUNDING OF CHEMOTHERAPY) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2015 (No. 1)

PB 4 of 2015

 

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 3 listed brands for the listed drugsIrinotecan, ‘Methotrexate’, and ‘Oxaliplatin’ and;
  • amends the circumstance codes,  purpose codes and the associated circumstances for the listed drugs ‘Arsenic’, ‘Bevacizumab’, ‘Cabazitaxel’,Cetuximab’, ‘Doxorubicin-Pegylated Liposomal’, ‘Ipilimumab’, ‘Panitumumab, ‘’Pemetrexed’ and ‘Rituximab’.

 

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 February 2015.

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 2015 (No. 1)

Section 1  Name of Instrument

This section provides that this Instrument is the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 1) and that it may also be cited as PB 4 of 2015.

Section 2  Commencement

This section provides that this Instrument commences on 1 February 2015.

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 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Arsenic’ in the form ‘Injection concentrate containing arsenic trioxide 10 mg in 10 mL with manner of administration ‘Injection’ by removing the circumstance codes C3150’ ‘C3891’ and adding a new circumstance code ‘C4793’.

Item 2 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Bevacizumabin each of the forms ‘Solution for I.V. infusion 100 mg in 4 mL and ‘Solution for I.V. infusion 400 mg in 16 mL’ with manner of administration ‘Injection’ by removing the circumstance codes C4585’ ‘C4588’ ‘C4589’ ‘C4597’.

Item 3 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Cabazitaxel’ in the form ‘Concentrated injection 60 mg (as acetone solvate) in 1.5 mL, with diluent’ with manner of administration ‘Injection’ by removing the circumstance codes C4661.

Item 4 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Cetuximab’ in each of the forms ‘Solution for I.V. infusion 100 mg in 20 mL’ and ‘Solution for I.V. infusion 500 mg in 100 mL’ with manner of administration ‘Injection’ by removing the circumstance codes C2713’ ‘C2714’ ‘C2715’ ‘C3919’ ‘C3920’ ‘C3921’ ‘C4775’ ‘C4780’ and adding new circumstance codes ‘C4785’ ‘C4788’ ‘C4794’.

Item 5 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Doxorubicin – Pegylated Liposomal’ in each of the forms ‘Suspension for I.V. infusion containing pegylated liposomal doxorubicin hydrochloride 20 mg in 10 mL’ and ‘Suspension for I.V. infusion containing pegylated liposomal doxorubicin hydrochloride 50 mg in 25 mL’’ with manner of administration ‘Injection’ by removing the circumstance codes C1568’ ‘C1795’ ‘C1796’ ‘C3905’ ‘C3910’ ‘C3911’ and adding new circumstance codes ‘C4786’ ‘C4787’ ‘C4791’.

Item 6 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Ipilimumab’ in each of the forms ‘Injection concentrate for I.V. infusion 50 mg in 10 mL’ and ‘Injection concentrate for I.V. infusion 200 mg in 40 mL’ with manner of administration ‘Injection’ by removing the circumstance codes C4235’ ‘C4236’ ‘C4256’ ‘C4265’.

Item 7 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Irinotecan’ by adding the pharmaceutical benefit, which is the listed drug ‘Irinotecanin the form ‘I.V injection containing irinotecan hydrochloride trihydrate 100 mg in 5 mL with manner of administration ‘Injection’ and brand ‘Irinotecan MYX.

Item 8 and 9 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Methotrexate’ by adding the pharmaceutical benefits, which is the listed drug ‘Methotrexatein each of the formsInjection 50 mg in 2 mL vial’ and Solution concentrate for I.V. infusion 1000 mg in 10 mL vial with manner of administration ‘Injection’ and brand ‘Methotrexate MYX.

Item 10 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Oxaliplatin’ by adding the pharmaceutical benefit, which is the listed drug ‘Oxaliplatin’ in the form ‘Solution concentrate for I.V. infusion 100 mg in 20 mL with manner of administration ‘Injection’ and brand ‘Oxaliplatin MYX.

Item 11 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Panitumumab’ in the forms ‘Solution for I.V. infusion 100 mg in 5 mL’; and ‘Solution for I.V. infusion 400 mg in 20 mL’ with manner of administration ‘Injection’ by removing the circumstance codes ‘C4774’ ‘C4776’.

Item 12 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Pemetrexed’ in each of the forms ‘Powder for I.V. infusion 100 mg (as disodium heptahydrate)’ and ‘Powder for I.V. infusion 500 mg (as disodium heptahydrate)’ with manner of administration ‘Injection’ by removing the circumstance codes C2957’ ‘C2958’ ‘C3885’ ‘C3886’ and adding new circumstance codes ‘C4789’ ‘C4792.

Item 13 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Rituximab’ in the forms ‘Solution for I.V. infusion 100 mg in 10 mL’; and ‘Solution for I.V. infusion 500 mg in 50 mL’ with manner of administration ‘Injection’ by removing the circumstance codes ‘C4671’ ‘C4679’ ‘C4687’ ‘C4727’ ‘C4728’ ‘C4752’ ‘C4765’.

Item 14 amends Schedule 1 Part 2 of the Special Arrangement for ‘Bevacizumab by removing the purpose codes ‘P4585’ ‘P4588’ ‘P4589’ ‘P4597’.

Item 15 amends Schedule 1 Part 2 of the Special Arrangement for Cetuximab by removing the purpose codes P2713’ ‘P2714’ ‘P2715’ ‘P3919’ ‘P3920’ ‘P3921’ ‘P4775’ ‘P4780 and adding new purpose codes P4785’ ‘P4788’ ‘P4794’.

Item 16 amends Schedule 1 Part 2 of the Special Arrangement for ‘Rituximab’ by removing the purpose codes ‘P4671’ ‘P4679’ ‘P4687’ ‘P4727’ ‘P4728’ ‘P4752’ ‘P4765’.

Item 17 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance codesC3150’ ‘C3891’, and the associated circumstances; and adding a new circumstance code ‘C4793and the associated circumstances for pharmaceutical benefits with the listed drug ‘Arsenic’.

Item 18 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance codes C4585’ ‘C4588’ ‘C4589’ ‘C4597’, purpose codes and the associated circumstances for pharmaceutical benefits with the listed drug ‘Bevacizumab’.

Item 19 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance codesC4661, and the associated circumstances for pharmaceutical benefits with the listed drug ‘Cabazitaxel’.

Item 20 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance codesC2713’ ‘C2714’ ‘C2715’ ‘C3919’ ‘C3920’ ‘C3921’ ‘C4775’ ‘C4780’, purpose codes and the associated circumstances; and adding the new circumstance codes ‘C4785’ ‘C4788’ ‘C4794’, purpose codes and the associated circumstances for pharmaceutical benefits with the listed drug ‘Cetuximab.

 

Item 21 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance codesC1796’ ‘C3905’ ‘C3910’ ‘C3911’, purpose codes and the associated circumstances; and adding the new circumstance codes ‘C4786’ ‘C4787’ ‘C4791’, purpose codes and the associated circumstances for pharmaceutical benefits with the listed drug ‘Doxorubicin – Pegylated Liposomal.

Item 21 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance codesC4235’ ‘C4236’ ‘C4256’ ‘C4265’, purpose codes and the associated circumstances for pharmaceutical benefits with the listed drug ‘Ipilimumab.

Item 23 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance codes ‘C4774’ ‘C4776’, and the associated circumstances for pharmaceutical benefits with the listed drug ‘Panitumumab.

Item 24 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance codesC2957’ ‘C2958’ ‘C3885’ ‘C3886, and the associated circumstances; and adding the new circumstance codes C4789’ ‘C4792, and the associated circumstances for pharmaceutical benefits with the listed drug ‘Pemetrexed.

Item 25 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance codes ‘C4671’ ‘C4679’ ‘C4687’ ‘C4727’ ‘C4728’ ‘C4752’ ‘C4765’, purpose codes and the associated circumstances for pharmaceutical benefits with the listed drug ‘Rituximab.

 

 

 

 


 

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

 

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 1) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, aiming to enhance the efficiency of funding for chemotherapy treatments. The Act was introduced by the Parliament of Australia to address gaps in the funding arrangements for chemotherapy drugs, ensuring more effective and cost-efficient access to necessary treatments for cancer patients. The policy objective of this legislative instrument is to align the funding arrangements with the 2010 budget measure "Revised arrangements for the efficient funding of chemotherapy drugs," focusing on improving the provision of chemotherapy pharmaceutical benefits and related treatments in public hospitals. This instrument is part of a broader effort to ensure that the Pharmaceutical Benefits Scheme provides optimal support for patients undergoing cancer treatment, reflecting changes in medical practices and the introduction of new drugs.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 1) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011) under the authority granted by subsection 100(1) of the National Health Act 1953 (the Act). The purpose of this amendment is to adjust the pharmaceutical benefits available under the special arrangement, ensuring efficient funding of chemotherapy for eligible patients being treated for cancer and related side-effects at certain public hospitals. This amendment reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which commenced on the same day as this instrument. The Act applies to all Commonwealth areas and territories and involves entities and persons engaged in the supply and administration of pharmaceutical benefits under the special arrangement. This legislative instrument introduces specific amendments to the listed drugs and their associated circumstance codes and purpose codes. For example, it adds new listed brands for drugs such as 'Irinotecan', 'Methotrexate', and 'Oxaliplatin', and modifies circumstance codes and purpose codes for various drugs including 'Arsenic', 'Bevacizumab', 'Cabazitaxel', 'Cetuximab', 'Doxorubicin-Pegylated Liposomal', 'Ipilimumab', 'Panitumumab', 'Pemetrexed', and 'Rituximab'. The changes reflect a broader initiative to align the funding of chemotherapy drugs with the 2010 budget measure for the efficient funding of chemotherapy drugs. The Pharmaceutical Benefits Advisory Committee (PBAC), an independent expert body appointed by the Minister, plays a crucial role in advising on which drugs should be available as pharmaceutical benefits. PBAC's recommendations ensure that decisions about which medicines are subsidised under the Pharmaceutical Benefits Scheme (PBS) are evidence-based and consider clinical effectiveness, safety, and cost-effectiveness. The instrument commenced on 1 February 2015 and is compatible with human rights as it advances the protection of the right to the highest attainable standard of physical and mental health by facilitating access to essential medicines.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 1) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011) to enhance the efficiency of funding for chemotherapy drugs. This amendment reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. Specifically, it adds new listed brands for certain drugs and amends circumstance codes, purpose codes, and associated circumstances for various listed drugs. The changes include adding three new listed brands for the drugs Irinotecan, Methotrexate, and Oxaliplatin, and modifying the circumstance and purpose codes for several other drugs such as Arsenic, Bevacizumab, and Rituximab. The obligations under this Act require that the listed drugs and their associated circumstance and purpose codes be updated to reflect the latest arrangements. Healthcare providers and entities involved in the supply of these chemotherapy pharmaceutical benefits must comply with the new specifications and codes as outlined in the amended Special Arrangement. This includes adhering to the new circumstance and purpose codes that dictate how and under what conditions these drugs can be administered and funded under the National Health Act. Failure to comply with the provisions of this Amendment Instrument may result in legal consequences. While the exact penalties are not detailed in the text, non-compliance with the National Health Act generally could lead to civil or criminal penalties, depending on the severity and intent of the breach. For example, violations of the Act could potentially result in fines or other sanctions as prescribed by the relevant authorities. Additionally, entities that do not adhere to the updated arrangements might face financial penalties or be subject to corrective actions by the government or relevant health authorities.

Legal classification tags

Area of Law
Health Law
Instrument
Legislative Instrument
Concepts
Definitions & Interpretation
Regulatory Standards
Reporting & Disclosure Obligations

Interactions

Authorises

All Versions

Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.