National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 1) (PB 6 of 2017)

Administered by Department of Health, Disability and Ageing

Legislation au F2017L00074 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 2017 (No. 1)

PB 6 of 2017

 

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 subsection 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 titled ‘Revised arrangements for the efficient funding of chemotherapy drugs’.  The 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 amendments to Schedules 1 and 3 of the Special Arrangement to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012), which commence on the same day.  The National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012) is made under sections 84AF, 84AK, 85, 85A, 88 and 101 of the Act.

 

This Instrument:

        Adds to Schedule 1 a new brand of the listed drug Pemetrexed in each of the forms Powder for I.V. infusion 100 mg (as disodium)’, ‘Powder for I.V. infusion 500 mg (as disodium)’ and ‘Powder for I.V. infusion 1 g (as disodium)’;

        Amends the responsible person code listed in Schedule 1 for one of the brands of the listed drug ‘Pemetrexed’ in the form Powder for I.V. infusion 1 g (as disodium)’; and

        Adds a new responsible person code and associated responsible person and Australian Business Number (ABN) to Schedule 3.

 

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).  The 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.  Part VII of the Act only applies to drugs or medicinal preparations recommended by the PBAC.  When recommending the listing of a medicine on the Pharmaceutical Benefits Scheme, the PBAC takes into account the medical conditions for which the medicine has been approved for use in Australia and its clinical effectiveness, safety and cost-effectiveness compared with other treatments.

 

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 these interests or professions.  Remaining members are persons whom the Minister is satisfied have qualifications and experience in a field relevant to the functions of the PBAC, and that would enable them to contribute meaningfully to the deliberations of the PBAC.

 

Pharmaceutical companies are consulted throughout the process for additions and changes to listings on the Pharmaceutical Benefits Scheme (PBS), including consultation through the PBAC process and agreement to final listing details.

 

This Instrument commences on 1 February 2017.

 

This Instrument is a legislative instrument for the purposes of the Legislation Act 2003.


ATTACHMENT

 

PROVISION BY PROVISION DESCRIPTION OF THE NATIONAL HEALTH (EFFICIENT FUNDING OF CHEMOTHERAPY) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2017 (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 2017 (No. 1) and that it may also be cited as PB 6 of 2017.

Section 2 Commencement

This section provides that this Instrument commences on 1 February 2017.

Section 3 Amendment of 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).

Schedule 1 Amendments

Item 1 adds a new brand of the listed drug Pemetrexed’ in the form Powder for I.V. infusion 100 mg (as disodium)to Schedule 1, Part 1, which is the brand ‘Pemetrexed Accord’, with a responsible person code of ‘OD’ and applicable circumstances codes of ‘C4789’ and ‘C4792’.

Item 2 adds a new brand of the listed drug Pemetrexed’ in the form ‘Powder for I.V. infusion 500 mg (as disodium)’to Schedule 1, Part 1, which is the brand ‘Pemetrexed Accord’ with a responsible person code of ‘OD’ and applicable circumstances codes of ‘C4789’ and ‘C4792’.

Item 3 adds a new brand of the listed drug Pemetrexed’ in the form ‘Powder for I.V. infusion 1 g (as disodium)’ to Schedule 1, Part 1, which is the brand ‘Pemetrexed Accord’ with a responsible person code of ‘OD’ and applicable circumstances codes of ‘C4789’ and ‘C4792’.

Item 4 amends the responsible person code detailed in Schedule 1, Part 1, for the brand Pemetrexed MYX of the listed drug Pemetrexed’ in the form ‘Powder for I.V. infusion 1 g (as disodium)’, by replacing the code ‘YN’ with the code ‘OC’.

Item 5 adds a new responsible person code to Schedule 3, which is the code ‘OD’ with the responsible person of ‘Accord Healthcare Pty Ltd’ and ABN of ’49 110 502 513’.


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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

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 1) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, introduced to address the efficient funding of chemotherapy drugs and associated side-effect treatments. Enacted under the authority of subsection 100(2) of the National Health Act 1953, this legislative instrument updates the special arrangement to reflect the 2010 budget measure. It aims to enhance the efficiency of payments for chemotherapy medicines and related pharmaceutical benefits at certain public hospitals. The amendments include adding new brands of listed drugs, amending responsible person codes, and introducing new circumstance codes. The policy objective is to ensure that the Pharmaceutical Benefits Scheme provides for the highest attainable standard of physical and mental health by facilitating access to subsidised medicines, as recognised under the International Covenant on Economic, Social and Cultural Rights.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 1) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, which is designed to achieve greater efficiency in payment for the supply of chemotherapy medicines and related pharmaceutical benefits to eligible patients being treated for cancer in certain public hospitals. This legislative instrument applies to the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits within the framework of the National Health Act 1953. The changes made by this Instrument include the addition of new brands of listed drugs to the arrangement, such as new forms of the drug Pemetrexed, and the amendment of responsible person codes. The Instrument also adds new circumstance codes and associated circumstances for certain drugs, such as Aprepitant. The amendments reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The Instrument is made under subsection 100(2) of the Act and is compatible with human rights as it contributes to the right to the highest attainable standard of physical and mental health by ensuring efficient funding and access to essential chemotherapy drugs through the Pharmaceutical Benefits Scheme. This Instrument commenced on 1 February 2017.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 1) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011. Section 1 of the Instrument establishes its name and citation as the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 1), also referred to as PB 6 of 2017. The Instrument commences on 1 February 2017, as per Section 2, and it amends the Special Arrangement through Schedule 1. This Instrument primarily updates the list of pharmaceutical benefits under the Special Arrangement to align with changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The Instrument imposes specific obligations on parties involved in the supply and funding of chemotherapy drugs. It mandates that eligible patients receiving cancer treatment should have access to certain chemotherapy medicines through the Pharmaceutical Benefits Scheme (PBS), with payments made more efficiently. The changes also include the supply of medicines for the side-effects of cancer treatment at certain public hospitals. Pharmaceutical companies and suppliers must comply with the updated listings and codes in Schedules 1 and 3 of the Instrument. They must ensure that the listed drugs and their forms, along with the specified responsible persons and Australian Business Numbers (ABNs), are correctly applied in the supply and funding processes. Failure to comply with the provisions of this Instrument may result in legal consequences. While the Instrument does not explicitly state specific offences or penalties, breaches of related provisions in the National Health Act 1953 may attract penalties. For example, under Section 100 of the Act, the Minister may impose financial penalties for non-compliance with special arrangements related to pharmaceutical benefits. Additionally, Section 100A of the Act allows for the imposition of fines for misleading or deceptive conduct in relation to pharmaceutical benefits, with penalties that can extend to significant monetary fines depending on the severity of the breach. These consequences underscore the importance of adhering to the updated special arrangement and its requirements.

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Area of Law
Health Law
Instrument
Legislative Instrument
Concepts
Reporting & Disclosure Obligations
Licensing & Registration
Compliance Obligations
Regulatory Standards
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Pharmaceutical Benefits

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