National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 2) (PB 13 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. 2)

PB 13 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,  purpose codes and the associated circumstances for the listed drugsBevacizumab’, and ‘Vinorelbine.

 

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 March 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. 2)

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. 2) and that it may also be cited as PB 13 of 2015.

Section 2  Commencement

This section provides that this Instrument commences on 1 March 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 ‘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 code ‘C4598 and adding the new circumstance code ‘C4814’.

Item 2 amends the entry in Schedule 1 Part 1 of the Special Arrangement for ‘Vinorelbine’ in each of the forms ‘Solution for I.V. infusion 10 mg (as tartrate) in 1 mL’ and ‘Solution for I.V. infusion 50 mg (as tartrate) in 5 mL’ with manner of administration ‘Injection’ by removing the circumstance codes C3890’ ‘C3907.

Item 3 amends Schedule 1 Part 2 of the Special Arrangement for ‘Bevacizumab by removing the purpose code ‘P4598 and adding the new purpose code ‘P4814’.

Item 4 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance code ‘C4598, purpose code and the associated circumstance; and adding the new circumstance code C4814, purpose code and the associated circumstance for pharmaceutical benefits with the listed drug ‘Bevacizumab’.

Item 5 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance codesC3890 and ‘C3907’, and the associated circumstances for pharmaceutical benefits with the listed drug ‘Vinorelbine’.

 

 

 

 


 

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. 2) was introduced to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, which aims to enhance the efficiency of funding for chemotherapy medicines supplied to eligible cancer patients. Enacted under subsections 100(1) and 100(2) of the National Health Act 1953, this instrument makes changes to the pharmaceutical benefits available under the Special Arrangement to better reflect the 2010 budget measure titled ‘Revised arrangements for the efficient funding of chemotherapy drugs’. It achieves this by amending the circumstance codes, purpose codes, and associated circumstances for certain listed drugs such as Bevacizumab and Vinorelbine. The policy objective is to ensure that the supply of chemotherapy medicines and those associated with the side-effects of cancer treatment are funded more efficiently while maintaining evidence-based decision-making through the involvement of the Pharmaceutical Benefits Advisory Committee.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 2) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to refine the efficient funding of chemotherapy and associated treatments. This special arrangement applies to the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits for cancer treatment at certain public hospitals. The amendments primarily involve changes to circumstance codes and purpose codes for specific drugs, such as Bevacizumab and Vinorelbine, ensuring that the special arrangement reflects updated listings in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The legislative instrument applies nationally under the authority of the National Health Act 1953, with specific amendments taking effect from 1 March 2015. The process of consultation with relevant stakeholders, including the Pharmaceutical Benefits Advisory Committee, ensures that the recommendations and amendments are evidence-based and consider clinical effectiveness, safety, and cost-effectiveness.

Key Provisions

The primary sections of the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 2) are contained within sections 1 to 5, which outline the name, commencement, and specific amendments to the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011). Section 1 identifies the instrument as the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 2), also referred to as PB 13 of 2015. Section 2 specifies the commencement date of 1 March 2015. Sections 3 and 4 detail the amendments to the Special Arrangement, which include modifications to the circumstance codes, purpose codes, and associated circumstances for specific chemotherapy drugs such as Bevacizumab and Vinorelbine. These changes reflect updates made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The Act imposes several obligations on the parties involved, particularly the Minister for Health, who is responsible for making and varying special arrangements under the National Health Act 1953. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in this process, providing expert recommendations on the listing of pharmaceutical benefits. PBAC's involvement ensures that decisions regarding the subsidy of medicines are evidence-based and consider factors such as clinical effectiveness, safety, and cost-effectiveness. The Act also requires the Minister to ensure that the special arrangement aligns with broader health policies and budgetary measures, as reflected in the 2010 budget measure on the efficient funding of chemotherapy drugs. Breaches of the provisions set out in this instrument could result in various civil or criminal consequences. For instance, if an entity fails to comply with the updated special arrangement or does not adhere to the recommendations of the PBAC, they may face penalties under the National Health Act 1953. These penalties could include fines or other sanctions, although specific maximum penalties are not detailed in this instrument. Additionally, entities that do not follow the updated listing of pharmaceutical benefits may face legal action for non-compliance, potentially leading to further financial or operational repercussions. The precise legal and financial consequences of non-compliance would be determined by the specific provisions of the National Health Act 1953 and any related regulations.

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