National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 8) (PB 67 of 2017)

Administered by Department of Health, Disability and Ageing

Legislation au F2017L01120 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. 8)

PB 67 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, 2 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:

        adds and removes circumstance codes and purpose codes and their associated circumstances and purposes for the listed drug Rituximab;

        amends a typographical error in Schedule 1, Part 2 for the listed drug Bevacizumab; and

        removes the brand Ondansetron-Claris for the listed drug Ondansetron.

 

A provision by provision description of this Instrument is contained in the Attachment.

 

Consultations

The involvement of interested parties through the membership of PBAC constitutes a formal and ongoing process of consultation.  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 to Australians 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.   In addition, an industry nominee has been appointed to the PBAC membership under the PBS Access and Sustainability Package of reforms announced in May 2015.  When recommending the listing of a medicine on the 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.

 

Pharmaceutical companies are consulted throughout the process of the listing of their medicines on the PBS and in relation to changes to those listings.  This includes the company submission to the PBAC and involvement throughout the PBAC process, negotiations or consultation on price, guarantee of supply 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 had already taken place.

 

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 September 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. 8)

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. 8) and that it may also be cited as PB 67 of 2017.

Section 2 Commencement

This section provides that this Instrument commences on 1 September 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).

Section 4         Schedules

This section provides that each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the Schedule concerned.  It also provides that any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1 Amendments

Items 1 to 4 Schedules 1 and 4

Items 1 to 4 provide for addition of a brand, addition of a manufacturer and manufacturer code and changes to circumstances and purposes for the prescribing of a listed drug.

Listed Drug

Type of Change

Rituximab

Remodelling of restrictions

Bevacizumab

Amending typographical error, changing a “C” code to a “P” code

Ondansetron

Deleting a brand

 

 

 

 


 

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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.

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 8) is an amendment to the National Health Act 1953, enacted to refine the existing special arrangement for the efficient funding of chemotherapy drugs. The Act, as enacted by the Australian Parliament, provides a framework for national health initiatives, including the special arrangement under section 100. The primary objective of this legislative instrument is to update the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, ensuring that it aligns with recent changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This amendment aims to enhance the efficiency of funding and supply for chemotherapy medicines and related pharmaceutical benefits provided to patients in public hospitals. This legislative instrument addresses specific changes such as the addition and removal of circumstance codes and purpose codes for certain drugs, correcting typographical errors, and removing outdated brand listings. The amendment reflects the ongoing commitment to improving the efficacy and accessibility of chemotherapy treatments for cancer patients. The instrument was developed following consultations with relevant stakeholders, including the Pharmaceutical Benefits Advisory Committee (PBAC), and commenced on 1 September 2017.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 8) is an amendment to the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, aimed at refining the funding and supply of chemotherapy medicines and related pharmaceutical benefits for cancer patients in Australia. This instrument applies to pharmaceutical benefits under the National Health Act 1953, particularly those relating to chemotherapy drugs and associated side-effect treatments, and is administered by the Minister for Health. The amendment is designed to streamline the funding mechanisms to reflect changes made in the 2010 budget measure, ensuring efficient allocation of resources for cancer treatment. The scope of the instrument is limited to the specific amendments outlined in the schedules, which include updating the listing of pharmaceutical benefits to incorporate new brands, correct typographical errors, and adjust circumstance and purpose codes. The changes made by this instrument are applicable nationally, as it is a legislative instrument of the Commonwealth of Australia. The instrument does not specify exclusions or exemptions from its application, meaning it broadly applies to all entities and individuals involved in the supply and administration of the listed chemotherapy drugs and related treatments. The amendment is subject to further regulations and guidelines that may be issued under the authority of the National Health Act 1953. This legislative instrument takes effect from 1 September 2017, aligning with the commencement date specified in the instrument itself.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 8) (referred to as the Instrument) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011), which was made under the National Health Act 1953 (the Act). The purpose of this Instrument is to update the Special Arrangement to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012), which commenced on the same day. The amendments relate to the efficient funding of chemotherapy drugs and associated medicines, ensuring that the Special Arrangement remains current and effective. The Instrument introduces several amendments to Schedules 1, 2, and 4 of the Special Arrangement. For instance, it adds and removes circumstance codes and purpose codes associated with the drug Rituximab, corrects a typographical error in Schedule 1, Part 2 for the drug Bevacizumab, and removes the brand Ondansetron-Claris for the drug Ondansetron. These changes are aimed at ensuring that the Special Arrangement accurately reflects the latest information regarding the pharmaceutical benefits listed. The Instrument imposes obligations on the parties involved in the supply and administration of chemotherapy pharmaceutical benefits and related pharmaceutical benefits. These obligations include adhering to the updated listing details and codes specified in the amended schedules. Pharmaceutical companies and healthcare providers must ensure that their practices align with these updated requirements to continue receiving funding under the Special Arrangement. Any breach of the obligations outlined in this Instrument may lead to civil or criminal consequences. While the specific penalties are not detailed in the Instrument, breaches of similar provisions under the Act can result in significant fines. For example, under section 112 of the Act, an individual can be fined up to $22,200 for each offence, and a body corporate can be fined up to $111,000 for each offence. These penalties underscore the importance of compliance with the provisions of the Special Arrangement and the broader legislative framework. The Instrument also ensures compatibility with human rights by engaging Article 2 and 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR). By facilitating access to efficient funding for chemotherapy and related pharmaceutical benefits, the Instrument supports the progressive realisation of the right to the highest attainable standard of physical and mental health, as recognised under international human rights law. This alignment with human rights principles further justifies the amendments and updates to the Special Arrangement.

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