National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 12) (PB 122 of 2015)

Administered by Department of Health, Disability and Ageing

Legislation au F2015L02132 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. 12)

PB 122 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:

  • removes the brand Hospira Pty Limited for the listed drug ‘Irinotecan’;
  • adds the brands Pemetrexed MYX and Pemetrexed Sandoz for the listed drug ‘Pemetrexed; and
  • adds new circumstance and purpose codes for the listed drug ‘Trastuzumab’.

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 January 2016.

 

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. 12)

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. 12) and that it may also be cited as PB 122 of 2015.

Section 2  Commencement

This section provides that this Instrument commences on 1 January 2016.

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 the listed drug ‘Irinotecan’ in the form ‘I.V. injection containing irinotecan hydrochloride trihydrate 40 mg in 2 mL’ by removing the brand ‘Hospira Pty Limited’.     

Item 2 amends the entry in Schedule 1 Part 1 of the Special Arrangement for the listed drug Pemetrexed in the form ‘Powder for I.V. infusion 100 mg (as disodium heptahydrate)’ by adding the brand Pemetrexed MYX’. 

Item 3 amends the entry in Schedule 1 Part 1 of the Special Arrangement for the listed drug Pemexetred in the form ‘Powder for I.V. infusion 500 mg (as disodium heptahydrate)’ by adding the brands ‘Pemetrexed MYX and ‘Pemetrexed Sandoz’. 

Item 4 amends the entry in Schedule 1 Part 1 of the Special Arrangement for the listed drug Trastuzumab in each of the forms ‘Powder for I.V. infusion 150 mg and ‘Powder for I.V. infusion 60 mg’ by adding the new circumstance codes ‘C5825’, ‘C5834’ and ‘C5844’.   

Item 5 amends the entry in Schedule 1 Part 2 of the Special Arrangement for the listed drug ‘Trastuzumabby adding the new purpose codes ‘P5825’, ‘P5834’ and ‘P5844’ and the associated maximum amounts and number of repeats. 

Item 6 amends the entry in Schedule 4 of the Special Arrangement for the listed drug ‘Trastuzumab’ by adding the new circumstance codes ‘C5825’, ‘C5834’ and ‘C5844’and the associated circumstances.

 

 

 

 

 

 

 

 

 

 

 

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 drugs ‘Doxorubicin’, 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. 12) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011. This legislative instrument was made under subsections 100(1) and 100(2) of the National Health Act 1953, allowing the Minister to make special arrangements for the supply of pharmaceutical benefits. The primary aim of this amendment was to address the efficient funding of chemotherapy by updating the pharmaceutical benefits available under the Special Arrangement. This change reflects the 2010 budget measure, which was intended to enhance the efficiency of payments for chemotherapy drugs provided to cancer patients. The instrument removes certain brands for specific drugs, adds new brands, and introduces new circumstance and purpose codes, ensuring that the Special Arrangement aligns with the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The changes are set to commence on 1 January 2016, ensuring that the amendments are effective from that date.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 12) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, which facilitates efficient funding for chemotherapy medicines and related pharmaceutical benefits provided to eligible patients treated for cancer in public hospitals. This amendment applies to the supply of these pharmaceutical benefits and is intended to align with changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The changes include modifications to the brands listed for certain drugs, such as the removal of Hospira Pty Limited for Irinotecan, and the addition of brands for Pemetrexed and new circumstance and purpose codes for Trastuzumab. These adjustments reflect the ongoing efforts to streamline the efficient funding of chemotherapy drugs as part of the broader National Health Act 1953. This legislative instrument operates within the Commonwealth jurisdiction and applies to entities and individuals involved in the supply and administration of chemotherapy medicines under the Pharmaceutical Benefits Scheme. The amendments do not introduce new exclusions or exemptions but rather refine the existing arrangements. The instrument is a legislative instrument under the Legislative Instruments Act 2003 and commences on 1 January 2016. The Pharmaceutical Benefits Advisory Committee plays a crucial role in the ongoing consultation process, providing recommendations based on clinical effectiveness, safety, and cost-effectiveness.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 12) (the Instrument) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011). This Instrument introduces changes to the pharmaceutical benefits available under the Special Arrangement for the efficient funding of chemotherapy, which is designed to enhance efficiency in payment for the supply of chemotherapy medicines to eligible patients being treated for cancer. It also pertains to the supply of medicines associated with the side-effects of cancer and cancer treatment at certain public hospitals. The changes made by this Instrument include the removal of the brand Hospira Pty Limited for the drug Irinotecan, the addition of the brands Pemetrexed MYX and Pemetrexed Sandoz for the drug Pemetrexed, and the addition of new circumstance and purpose codes for the drug Trastuzumab. The Instrument imposes obligations on the Minister for Health and relevant stakeholders to ensure the efficient and effective implementation of the amended special arrangement. It requires the Minister to make the amendments effective from 1 January 2016, ensuring that the changes are integrated into the existing framework governing the supply of pharmaceutical benefits. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in this process by providing recommendations on which drugs should be available as pharmaceutical benefits. PBAC's recommendations are based on the medical conditions for which the medicines have been approved, their clinical effectiveness, safety, and cost-effectiveness compared to other treatments. The Minister is required to consider these recommendations when making decisions about the listing of medicines on the Pharmaceutical Benefits Scheme (PBS). The Instrument also outlines the consequences for breaches of the provisions within the amended special arrangement. While the Instrument itself does not specify detailed penalties, breaches of the National Health Act 1953 (the Act) or regulations made under it may lead to civil or criminal penalties, depending on the nature and severity of the breach. Civil penalties can include fines, while criminal penalties may involve imprisonment or fines, depending on the specific provisions of the Act. The exact penalties are determined by the courts based on the particular circumstances of each case. The Minister has the authority to vary or revoke special arrangements under subsection 100(2) of the Act, providing a mechanism for ensuring compliance with the amended special arrangement. In summary, the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 12) introduces changes to the pharmaceutical benefits available under the Special Arrangement for the efficient funding of chemotherapy. It imposes obligations on the Minister and relevant stakeholders to implement these changes effectively and ensures that decisions about the listing of medicines on the PBS are evidence-based. While the Instrument does not specify detailed penalties for breaches, the Act provides for civil and criminal consequences, with the exact penalties determined by the courts based on the specific circumstances of each case.

Legal classification tags

Area of Law
Health Law
Instrument
Legislative Instrument
Concepts
Definitions & Interpretation
Regulatory Standards
Reporting & Disclosure Obligations
Consultation Requirements
Catchwords
Pharmaceutical Benefits Advisory Committee

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.