National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 3) (PB 21 of 2017)

Administered by Department of Health, Disability and Ageing

Legislation au F2017L00376 Not in force Legislative Instrument

Legislation content

EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

National Health (Efficient Funding of Chemotherapy)

Special Arrangement Amendment Instrument 2017 (No. 3)

PB 21 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 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:

        amends the circumstance codes and associated circumstances and purposes codes and associated purposes for the listed drugs ‘Brentuximab Vedotin’ and Pembrolizumab;

        adds the brand ‘Epirubicin Accord’ for the listed drug ‘Epirubicin and the brand ‘Methotrexate Accord’ for the listed drug ‘Methotrexate’;

        deletes the brand ‘Irinotecan Alphapharm’ for the listed drug Irinotecan; and

        makes a minor machinery change to section 60(1), the transitional arrangements for existing medication chart prescribing, to allow the utilisation of previously approved medication charts until the PBS Hospital Medication Chart is available in most prescribing software packages.

 

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.

 

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 April 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. 3)

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. 3) and that it may also be cited as PB 21 of 2017.

Section 2 Commencement

This section provides that this Instrument commences on 1 April 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 amends section 60(1) by extending the period of time, from 1 April 2017 to 1 March 2019, for which prescribers may use previously approved medication charts while software vendors complete necessary changes to facilitate the adoption of the PBS Hospital Medication Chart. 

Item 2 amends the entry in Schedule 1, Part 1 of the Special Arrangement for the listed drug Brentuximab Vedotin’ in the form ‘Powder for I.V. Infusion 50 mg’ and brand ‘Adcetris by adding the circumstance codes ‘C6800’, ‘C6816’, ‘C6826’ and ‘C6838’.

Item 3 amends the entry in Schedule 1, Part 1 of the Special Arrangement for the listed drug Epirubicin in the form Solution for injection containing epirubicin hydrochloride 200 mg in 100 mL’ by adding the brand ‘Epirubicin Accord’ with a responsible person code of ‘OC.

Item 4 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’, manner of administration ‘Injection’ and brand ‘IRINOTECAN ACT’ by deleting the brand ‘Irinotecan Alphapharm’ with a responsible person code of ‘AF.

Item 5 amends the entry in Schedule 1, Part 1 of the Special Arrangement for the listed drug ‘Methotrexate’, in the form ‘Injection 50 mg in 2 mL vial, and manner of administration ‘Injection’ by adding the brand ‘Methotrexate Accord’ with a responsible person code of ‘OD’.

Item 6 amends the entry in Schedule 1, Part 1 of the Special Arrangement for the listed drug ‘Methotrexate’, in the form ‘Solution concentrate for I.V. infusion 1000 mg in 10 mL vial’ and manner of administration ‘Injection’ by adding the brand ‘Methotrexate Accord’ with a responsible person code of ‘OD’.

Item 7 amends the entry in Schedule 1, Part 1 of the Special Arrangement for the listed drug ‘Pembrolizumab’ in the form Powder for injection 50 mg’ and the manner of administration ‘Injection’, by removing the circumstance codes ‘C5362’, ‘C6093’, ‘C6103’ and ‘C6104’; and adding circumstance codes ‘C6801’, ‘C6806’, ‘C6817’, ‘C6828’ and ‘C6829’.

Item 8 amends the entry in Schedule 1, Part 2 of the Special Arrangement for the listed drug ‘Brentuximab vedotin’ by adding purpose codes ‘P6800’, ‘P6816’, ‘P6826’, and ‘P6838’.

Item 9 amends the entry in Schedule 1, Part 2 of the Special Arrangement for the listed drug ‘Pembrolizumab’ by removing purpose codes ‘P5362’, ‘P6093’, ‘P6094’, ‘P6103’ and ‘P6104’; and adding purpose codes ‘P6801’, ‘P6806’, ‘P6817’, ‘P6828’ and ‘P6829’.

Item 10 amends the entry in Schedule 4 of the Special Arrangement for the listed drug ‘Bretuximab vedotin’ by adding circumstance codes ‘C6800’, ‘C6816’, ‘C6826’ and ‘C6838’, purpose codes ‘P6800’, ‘P6816’, ‘P6826’ and ‘P6838’and their associated circumstances and purposes.

Item 11 amends the entry in Schedule 4 of the Special Arrangement for the listed drug ‘Pembrolizumab’ by:

  • removing circumstance codes ‘C5362’, ‘C6093’, ‘C6094’, ‘C6103’ and ‘C6104’, and purpose codes ‘P5362’, ‘P6093’, ‘P6094’, ‘P6103’ and ‘P6104’ and their associated circumstances and purposes; and
  • adding circumstance codes ‘C6801’, ‘C6806’, ‘C6817’, ‘C6828’ and ‘C6829’, and purpose codes ‘P6801’, ‘P6806’, ‘P6817’, ‘P6828’ and ‘P6829’ and their associated circumstances and purposes.

 


-          

 

 

 

 

 

 

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.

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 3) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011) and address the efficient funding of chemotherapy drugs. The National Health Act 1953 empowers the Minister to make special arrangements for the supply of pharmaceutical benefits, including chemotherapy drugs, to eligible patients being treated for cancer. This legislative instrument aligns with the 2010 Budget measure titled 'Revised arrangements for the efficient funding of chemotherapy drugs' and reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012). The instrument updates circumstance and purpose codes, adds new brands for certain drugs, and makes a machinery change to extend the period for using previously approved medication charts. The policy objective of this instrument is to ensure that the Special Arrangement achieves greater efficiency in payment for the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits at certain public hospitals. The Australian Parliament enacted this legislative instrument to facilitate efficient funding arrangements for chemotherapy drugs, thereby contributing to the progressive realisation of the right to the highest attainable standard of physical and mental health, as outlined in Article 2 and 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR). The Pharmaceutical Benefits Advisory Committee (PBAC), an independent expert body, is involved in the consultation process for the Special Arrangement, taking into account medical conditions, clinical effectiveness, safety, and cost-effectiveness of medicines. The amendments made by this instrument ensure that the Special Arrangement remains current with changes to the Pharmaceutical Benefits Scheme (PBS).

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 3) applies to the administration and funding of chemotherapy and related pharmaceutical benefits provided to eligible patients under the National Health Act 1953. It specifically pertains to the efficient funding arrangements for chemotherapy drugs and related pharmaceutical benefits, which are subject to the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011. This legislative instrument amends the special arrangement to update the listing of drugs, brands, and circumstance and purpose codes, thereby reflecting changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The amendments extend the use of previously approved medication charts and modify the listing details of specific drugs, including the addition and removal of certain brands and codes. The Act applies to the Commonwealth and extends its jurisdiction to regulate the efficient funding of chemotherapy drugs and related benefits across Australia. The Special Arrangement applies to entities such as pharmaceutical companies, healthcare providers, and prescribers involved in the supply and administration of chemotherapy and related pharmaceutical benefits to eligible cancer patients. The amendments made by this Instrument are applicable to all public hospitals and entities engaged in the provision of these pharmaceutical benefits. There are no specific exclusions or exemptions stated in the text; however, the changes are confined to the listed drugs and brands specified in the amendment. The Instrument does not extend or restrict its application through subordinate instruments beyond the amendments listed in Schedule 1.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 3) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to refine the efficient funding of chemotherapy. This legislative instrument introduces several amendments to the Special Arrangement, primarily focusing on adjusting circumstance codes and purposes codes for listed drugs, adding new brand names for certain drugs, and deleting others. It also includes a minor machinery change to allow prescribers to use previously approved medication charts until the PBS Hospital Medication Chart is widely available. These amendments aim to ensure that the funding of chemotherapy drugs remains efficient and aligned with the latest recommendations and technological advancements (Sections 2 and 3). The obligations under this Act require pharmaceutical companies and prescribers to comply with the updated listing details, circumstance codes, and purposes codes as specified in Schedules 1 and 4 of the Special Arrangement. Pharmaceutical companies must ensure that the drugs listed in the Special Arrangement are supplied according to the new codes and purposes. Prescribers, on the other hand, must transition to using the PBS Hospital Medication Chart by the specified date, 1 March 2019, and adhere to the new circumstance and purpose codes when prescribing chemotherapy drugs. Additionally, the Pharmaceutical Benefits Advisory Committee (PBAC) must continue its role in recommending drugs and medicinal preparations that should be available as pharmaceutical benefits, ensuring that the recommendations are based on clinical effectiveness, safety, and cost-effectiveness (Sections 100(1), 100(2), and 100(3)). Non-compliance with the requirements set out in this Instrument may lead to civil or criminal penalties. For example, pharmaceutical companies that fail to supply drugs according to the updated codes could face fines or other civil penalties. Prescribers who do not adhere to the transitional arrangements for medication charts may also face professional disciplinary actions. The precise penalties are not detailed in this specific Instrument but are generally governed by the National Health Act 1953 and related regulations, which could include fines up to certain statutory maximums or other penalties as deemed appropriate by the courts. The Minister also has the authority to vary or revoke special arrangements if they find that compliance is not being met (Section 100(2) and 100(3)). In summary, this legislative instrument aims to ensure the efficient funding of chemotherapy drugs by updating the Special Arrangement with new circumstance and purpose codes, adding and removing brand names, and facilitating the transition to new medication charts. Compliance with these changes is mandatory for pharmaceutical companies and prescribers, with potential civil or criminal consequences for non-compliance, although specific penalties are not detailed in this Instrument.

Legal classification tags

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

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.