National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 10) (PB 105 of 2015)

Administered by Department of Health, Disability and Ageing

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EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (EFFICIENT FUNDING OF CHEMOTHERAPY) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2015 (No. 10)

PB 105 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:

  • amends the circumstance codes and associated circumstances for the related pharmaceutical benefits, ‘Bacillus Calmette and Guerin, Connaught Strain’; and ‘Bacillus Calmette and Guerin, Tice Strain’; and
  • amends the inaccurate descriptions in the October 2015 amending instrument.

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

 

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 November 2015.

 

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


ATTACHMENT B

PROVISION BY PROVISION DESCRIPTION OF THE NATIONAL HEALTH (EFFICIENT FUNDING OF CHEMOTHERAPY) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2015 (No. 10)

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.10) and that it may also be cited as PB 105 of 2015.

Section 2  Commencement

This section provides that this Instrument commences on 1 November 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 ‘Docetaxelin the form ‘Solution concentrate for I.V. infusion 140 mg in 7 mL and brand ‘Oncotaxel 140’ by changing the responsible person code from ‘GN’ to ‘EA.

Item 2 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Docetaxelin the form ‘Solution concentrate for I.V. infusion 80 mg in 4 mL and brand ‘Oncotaxel 80’ by changing the responsible person code from ‘GN’ to ‘EA.

Item 3 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Doxorubicinin the form Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 200 mg in 100 mL single dose vial and brand ‘Accord Doxorubicin’ by changing the responsible person code from ‘GN’ to ‘EA.

Item 4 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Irinotecanin the form I.V. injection containing irinotecan hydrochloride trihydrate 500 mg in 25 mL and brand ‘Irinotecan Actavis 500 by changing the responsible person code from ‘UA’ to ‘EA.

Item 5 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Paclitaxelin each of the forms Solution concentrate for I.V. infusion 100 mg in 16.7 mL’; ‘Solution concentrate for I.V. infusion 150 mg in 25 mL; ‘Solution concentrate for I.V. infusion 30 mg in 5 mL; and ‘Solution concentrate for I.V. infusion 300 mg in 50 mL and brand ‘Paclitaxel Actavis’ by changing the responsible person code from ‘UA’ to ‘EA.

Item 6 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Paclitaxelin each of the forms Solution concentrate for I.V. infusion 100 mg in 16.7 mL’; ‘Solution concentrate for I.V. infusion 150 mg in 25 mL; ‘Solution concentrate for I.V. infusion 30 mg in 5 mL; and ‘Solution concentrate for I.V. infusion 300 mg in 50 mL and brand ‘Plaxel’ by changing the responsible person code from ‘GN’ to ‘ED.

Item 7 amends the entry in Schedule 2 of the Special Arrangement for the pharmaceutical benefit, ‘Bacillus Calmette and Guerin, Connaught Strain’ and brand ‘ImmuCyst’ by removing the circumstance code ‘C1419’ and adding the new circumstance code ‘C5598’.

Item 8 amends the entry in Schedule 2 of the Special Arrangement for the pharmaceutical benefit, ‘Bacillus Calmette and Guerin, Tice Strain’ and brand ‘OncoTICE’ by removing the circumstance code ‘C1290’ adding the new circumstance code ‘C5597.

Item 9 removes the entry in Schedule 4 of the Special Arrangement for the pharmaceutical benefits, ‘Bacillus Calmette and Guerin, Connaught Strain’; and ‘Bacillus Calmette and Guerin, Tice Strain, and the associated circumstances for pharmaceutical benefits.

Item 10 inserts the entry in Schedule 4 of the Special Arrangement for the pharmaceutical benefits, ‘Bacillus Calmette and Guerin, Connaught Strain’; and ‘Bacillus Calmette and Guerin, Tice Strain and the associated circumstances for pharmaceutical benefits.

 

 

 

 

 

 

 

 

 


 

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. 10) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011. This legislative instrument was introduced to address the need for greater efficiency in the funding of chemotherapy medicines supplied to eligible cancer patients under the National Health Act 1953. Enacted by the Australian government, the purpose of this amendment is to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, thereby ensuring that the Special Arrangement remains consistent with the broader objectives of the Pharmaceutical Benefits Scheme. This instrument also seeks to enhance the efficient funding of related pharmaceutical benefits associated with the side-effects of cancer and cancer treatment at certain public hospitals. This legislative instrument, made under the authority of subsections 100(1) and 100(2) of the National Health Act 1953, was developed through an ongoing consultation process involving the Pharmaceutical Benefits Advisory Committee (PBAC). PBAC, established by section 100A of the Act, comprises experts from various relevant fields, ensuring that the recommendations for the listing of medicines on the Pharmaceutical Benefits Scheme are evidence-based and take into account clinical effectiveness, safety, and cost-effectiveness. The amendment commenced on 1 November 2015, providing updated circumstances and codes for specific chemotherapy medicines and aligning them with the current regulatory framework.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 10) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011) to make changes relating to the efficient funding of chemotherapy, particularly focusing on the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits at certain public hospitals. This instrument applies to eligible patients undergoing cancer treatment, pharmaceutical companies responsible for these medicines, and public hospitals providing these treatments, thereby impacting the pharmaceutical industry and healthcare sector within Australia. The Act operates on a national level, as it is an amendment to a special arrangement made under the National Health Act 1953, which has Commonwealth jurisdiction. The changes introduced by this instrument reflect updates made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, ensuring alignment with the current legislative framework. The amendments include modifications to circumstance codes and associated circumstances for certain pharmaceutical benefits and adjustments to the responsible person codes for specific drugs. This legislative instrument does not explicitly state any exclusions, exemptions, or thresholds. However, its scope is inherently limited to the specific amendments outlined in the Schedule, which includes changes to listed brands, forms, and circumstance codes for certain chemotherapy and related pharmaceutical benefits. The application of this instrument is further refined through subordinate instruments, which may specify additional details or operational guidelines necessary for its implementation. This ensures that the amendments are effectively integrated into the existing healthcare funding arrangements under the National Health Act 1953.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 10) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (referred to as PB 79 of 2011), which itself relates to the efficient funding of chemotherapy drugs and medicines associated with the side effects of cancer and cancer treatment at certain public hospitals. The key changes introduced by this amendment include modifications to the circumstance codes and associated circumstances for certain pharmaceutical benefits, as well as the correction of inaccurate descriptions from a previous amending instrument. These changes reflect broader updates to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The obligations imposed by the Amendment Instrument on the parties involved primarily revolve around ensuring compliance with the updated circumstances and descriptions of pharmaceutical benefits. For instance, pharmaceutical companies supplying chemotherapy drugs must ensure that their products are listed accurately under the new circumstance codes and associated circumstances. Eligible patients and healthcare providers must be aware of these changes to ensure appropriate access to and administration of these pharmaceutical benefits. The instrument also addresses specific changes to the responsible person codes for various chemotherapy drugs, ensuring that the correct entities are accountable for the supply of these medicines. This includes updating the responsible person codes for drugs such as Docetaxel, Doxorubicin, Irinotecan, and Paclitaxel. Additionally, the instrument introduces new circumstance codes and associated circumstances for the pharmaceutical benefit 'Bacillus Calmette and Guerin, Connaught Strain' and 'Bacillus Calmette and Guerin, Tice Strain', ensuring that these medicines are appropriately categorised and funded. In terms of offences and penalties, the Amendment Instrument does not explicitly state penalties for non-compliance. However, any breaches of the National Health Act 1953, including non-compliance with special arrangements, could potentially result in legal consequences. This could involve civil or administrative penalties, depending on the nature and severity of the breach. The Minister also retains the authority to vary or revoke special arrangements, which could be exercised in response to non-compliance or other regulatory concerns.

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Health Law
Instrument
Statutory Instrument
Concepts
Definitions & Interpretation
Reporting & Disclosure Obligations
Regulatory Standards
Enforcement Powers
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Chemotherapy pharmaceutical benefits

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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.