National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 12) (PB 105 of 2017)

Administered by Department of Health, Disability and Ageing

Legislation au F2017L01640 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. 12)

PB 105 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 4 of the Special Arrangement to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012), which commences 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. 

 

A summary of changes, by subject matter, are included 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. In addition, an industry nominee has been appointed to the PBAC membership. 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.

 

It was considered that further consultation for this Instrument was unnecessary due to the nature of the consultation that has already taken place. 

 

This Instrument commences on 1 January 2018.

 

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. 12)

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. 12) and that it may also be cited as PB 105 of 2017.

Section 2 Commencement

This section provides that this Instrument commences on 1 January 2018.

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

The amendments in Schedule 1 involve additions, deletions and changes to forms, brands, responsible person codes, maximum quantities, the circumstances for prescribing various pharmaceutical benefits (including authority requirements), and claimed and approved ex-manufacturer price.  These changes are summarised below.

 

SUMMARY OF CHANGES

Listed Drug Added

Carfilzomib

Forms Deleted

Docetaxel

Solution concentrate for I.V. infusion 140 mg in 7 mL

Gemcitabine

Powder for I.V. infusion 2 g (as hydrochloride)

Irinotecan

I.V. injection containing irinotecan hydrochloride trihydrate 300 mg in 15 mL

 


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 2017 (No. 12)

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 subsection 100(2) of the National Health Act 1953 (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 provides for amendments to Schedules 1 and 4 of the Special Arrangement to ensure that the Special Arrangement accurately reflects changes 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.

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 the 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.

 

 

 

Julianne Quaine

Assistant Secretary

Private Health Insurance and Pharmacy Branch

Technology Assessment and Access Division
Department of Health

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 12) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, as part of the broader National Health Act 1953. This legislation was introduced to address the need for greater efficiency in payment for the supply of chemotherapy medicines to eligible patients being treated for cancer, reflecting a budget measure from 2010. The purpose of the amendment is to ensure that the Special Arrangement accurately reflects changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which also commenced on the same day. This ongoing legislative effort involves the Pharmaceutical Benefits Advisory Committee (PBAC), an independent expert body that recommends drugs and medicinal preparations for the Pharmaceutical Benefits Scheme (PBS), ensuring that decisions about access to medicines are evidence-based and consider clinical effectiveness, safety, and cost-effectiveness. The Instrument is compatible with human rights, particularly advancing the right to the highest attainable standard of physical and mental health as recognised in the International Covenant on Economic, Social and Cultural Rights. By ensuring efficient and effective funding of chemotherapy and related pharmaceutical benefits, the legislation supports the progressive realisation of this human right through the PBS, which provides subsidised access to medicines. This amendment was deemed necessary to align with recent changes in pharmaceutical listings and to maintain the integrity and efficacy of the chemotherapy funding arrangements within the National Health Act framework.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 12) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to update the efficient funding of chemotherapy drugs in Australia. This legislative instrument applies to the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits, specifically targeting medicines used in cancer treatment and associated side-effects, provided to eligible patients in public hospitals. The amendments made by this instrument are designed to align with changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, ensuring that the Special Arrangement accurately reflects the current listings of pharmaceutical benefits on the Pharmaceutical Benefits Scheme (PBS). The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in advising on which drugs and medicinal preparations should be available as pharmaceutical benefits, and its recommendations are integral to the operation of the PBS. The instrument commenced on 1 January 2018, and it is compatible with human rights as it supports the progressive realisation of the right to the highest attainable standard of physical and mental health by facilitating access to necessary medications.

Key Provisions

The main operative sections of the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 12) include the amendments to Schedules 1 and 4 of the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011). Section 3 of the Instrument amends PB 79 of 2011 to ensure that the Special Arrangement accurately reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012). These changes involve additions, deletions, and modifications to forms, brands, responsible person codes, maximum quantities, prescribing requirements, and the claimed and approved ex-manufacturer price of certain pharmaceutical benefits. The Instrument aims to enhance the efficiency of funding for chemotherapy medicines and related treatments, ensuring that the Special Arrangement remains current with the latest changes in the Pharmaceutical Benefits Scheme (PBS). The obligations and requirements imposed by this Act on the parties and entities it governs include the adherence to the updated Special Arrangement, which reflects the amendments to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. Pharmaceutical companies, healthcare providers, and patients must comply with the new forms, brands, responsible person codes, maximum quantities, and prescribing requirements as outlined in the amended Special Arrangement. Additionally, the Pharmaceutical Benefits Advisory Committee (PBAC) plays a critical role in recommending which drugs and medicinal preparations should be available as pharmaceutical benefits, taking into account clinical effectiveness, safety, and cost-effectiveness. Breaches of the provisions set out in this Instrument may lead to civil and criminal consequences. While specific penalties are not detailed in the text, breaches of the National Health Act 1953 and related instruments may result in fines or other legal actions under the relevant legislation. The precise penalties would depend on the nature and severity of the breach, and could potentially include administrative penalties, legal action, or other sanctions as deemed appropriate by the relevant authorities. It is essential for all parties to comply with the updated Special Arrangement to avoid any potential legal repercussions.

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