National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 7) (PB 73 of 2015)

Administered by Department of Health, Disability and Ageing

Legislation au F2015L01200 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 2015 (No. 7)

PB 73 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 a new pharmaceutical benefit ‘Obinutuzumab’; and the associated circumstances;
  • amends the circumstance code and the associated circumstance for the listed drug ‘Mesna.

 

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 August 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. 7)

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. 7) and that it may also be cited as PB 73 of 2015.

Section 2  Commencement

This section provides that this Instrument commences on 1 August 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 inserts a new listed drug ‘Obinutuzumab’ into Schedule 1 Part 1 of the Special Arrangement by adding new pharmaceutical benefit, which is the listed drug ‘Obinutuzumab’ in the form ‘Solution for I.V. infusion 1000 mg in 40 mL’ with the manner of administration ‘Injection’ and brand ‘Gazyva.

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

Item 3 amends Schedule 2 of the Special Arrangement for ‘Mesna by removing the circumstance code ‘C1618’ and adding the new circumstance code ‘C5130’.

Item 4 amends the entry in Schedule 4 of the Special Arrangement by removing circumstance code ‘C1618’ and the associated circumstance; and adding the new circumstance code ‘C5130and the associated circumstance for pharmaceutical benefits with the listed drug ‘Mesna’.

Item 5 amends Schedule 4 of the Special Arrangement by a adding a circumstance code, and the associated circumstances for pharmaceutical benefits with the listed drug ‘Obinutuzumab’.

 

 

 

 

 

 

 

 

 

 

 


 

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. 7) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, which was introduced to achieve greater efficiency in the payment for the supply of injected or infused chemotherapy medicines to eligible cancer patients and medicines associated with the side-effects of cancer and cancer treatment at certain public hospitals. This amendment was made under the authority of the National Health Act 1953, specifically subsections 100(1) and 100(2), which enable the Minister to make special arrangements for the supply of pharmaceutical benefits and to vary or revoke these arrangements. The policy objective of this instrument is to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 and to align the Special Arrangement with updated clinical and economic considerations. The instrument introduces several amendments, including adding the pharmaceutical benefit for the drug 'Obinutuzumab' and modifying the circumstance code for the drug 'Mesna'. These changes aim to enhance the efficiency of funding for chemotherapy treatments by ensuring that the benefits listed are aligned with the most current therapeutic practices and economic evaluations. The Pharmaceutical Benefits Advisory Committee (PBAC), an independent expert body that advises the Minister on which drugs should be available as pharmaceutical benefits, was involved in the consultation process to ensure that the recommendations were evidence-based and reflective of best practices. This legislative instrument commenced on 1 August 2015 and is compatible with human rights, particularly those recognised under the International Covenant on Economic, Social and Cultural Rights, by facilitating access to essential health services through the Pharmaceutical Benefits Scheme (PBS).

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 7) is an amendment to the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, which aims to enhance the efficient funding of chemotherapy drugs and related pharmaceutical benefits for cancer patients. This instrument applies to the supply of chemotherapy medicines and associated side-effect treatments at public hospitals and is made under the authority of the National Health Act 1953. The Act provides the Minister with the power to establish special arrangements for pharmaceutical benefits, with these arrangements subject to modifications or revocations as needed. This particular instrument introduces changes such as the addition of the drug 'Obinutuzumab' and modifications to the circumstances for 'Mesna', aligning with updates to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The instrument also reflects recommendations from the Pharmaceutical Benefits Advisory Committee, ensuring evidence-based decisions about pharmaceutical benefits on the Pharmaceutical Benefits Scheme (PBS). The changes made by this instrument commenced on 1 August 2015, and it is consistent with human rights obligations by supporting the progressive realisation of the right to health through improved access to essential medicines.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2015 (No. 7) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (the Special Arrangement). The Special Arrangement, as amended, sets out the efficient funding of chemotherapy for eligible patients treated for cancer, and related pharmaceutical benefits at certain public hospitals (sections 1, 2 and 3). It adds a new pharmaceutical benefit ‘Obinutuzumab’; and the associated circumstances; and amends the circumstance code and the associated circumstance for the listed drug ‘Mesna’ (section 3, Schedule 1 and 2). The amendments to the Special Arrangement commence on 1 August 2015 (section 2). The Special Arrangement imposes obligations on parties including the Minister for Health, the Secretary of the Department of Health, and suppliers of chemotherapy medicines. It requires these parties to adhere to the funding arrangements outlined in the Special Arrangement for the supply of chemotherapy medicines and related pharmaceutical benefits (section 100(3) of the National Health Act 1953). Suppliers must provide chemotherapy medicines and related pharmaceutical benefits to eligible patients under the terms specified in the Special Arrangement. There are no specific offences, penalties, or consequences outlined in the text for breaches of the Special Arrangement itself. However, breaches of the National Health Act 1953, which governs the Special Arrangement, may result in civil or criminal penalties. For example, under section 114 of the Act, a person who contravenes a direction given under the Act may be liable for a penalty of up to $22,200. The maximum penalties for offences under the Act can vary depending on the specific offence and jurisdiction.

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