National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 9) (PB 76 of 2017)

Administered by Department of Health, Disability and Ageing

Legislation au F2017L01261 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. 9)

PB 76 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 5 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. 

 

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.  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 October 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. 9)

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. 9) and that it may also be cited as PB 76 of 2017.

Section 2 Commencement

This section provides that this Instrument commences on 1 October 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

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

Forms Deleted

Doxorubicin

Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 10 mg in 5 mL single dose vial
Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 100 mg in 50 mL single dose vial

Brands Added

Doxorubicin

Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 50 mg in 25 mL single dose vial (Adriamycin)
Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 200 mg in 100 mL single dose vial (Adriamycin)

Brands Deleted

Cisplatin

I.V. injection 100 mg in 100 mL (Cisplatin Ebewe)

Doxorubicin

Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 50 mg in 25 mL single dose vial (Hospira Pty Ltd)
Solution for I.V. injection or intravesical administration containing doxorubicin hydrochloride 200 mg in 100 mL single dose vial (Doxorubicin SZ)

Irinotecan

I.V injection containing irinotecan hydrochloride trihydrate 100 mg in 5 mL (Irinotecan Ebewe)
I.V injection containing irinotecan hydrochloride trihydrate 40 mg in 2 mL (Irinotecan Ebewe)
I.V injection containing irinotecan hydrochloride trihydrate 500 mg in 25 mL (Irinotecan Ebewe)

Alteration of Approved Ex-manufacturer Price

Listed Drug

Form

Approved Ex-manufacturer Price

Ondansetron

Wafer 4 mg

Wafer 8 mg

From: $4.17 To: $3.41

Alteration of Claimed Ex-manufacturer Price

Listed Drug

Form

Claimed Ex-manufacturer Price

Ondansetron

Wafer 4 mg

Wafer 8 mg

From: $6.54 To: $5.35

 

 


 

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 9) is an amendment made under subsection 100(2) of the National Health Act 1953 to modify the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011. This amendment aims to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which also commence on 1 October 2017. The policy objective of the Special Arrangement is to achieve greater efficiency in the payment for the supply of chemotherapy medicines and related pharmaceutical benefits to eligible patients being treated for cancer, in alignment with the 2010 Budget measure titled ‘Revised arrangements for the efficient funding of chemotherapy drugs.’ The amendment involves updates to Schedules 1 and 5 of the Special Arrangement, including changes to forms, brands, maximum quantities, prescribing circumstances, and prices of certain pharmaceutical benefits. These changes are necessary to ensure the efficient and effective funding of chemotherapy and related treatments under the Pharmaceutical Benefits Scheme.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 9) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to make changes relating to the efficient funding of chemotherapy. This legislative instrument operates under subsection 100(2) of the National Health Act 1953, which allows the Minister to vary or revoke special arrangements for the supply of pharmaceutical benefits. The amended Special Arrangement, effective from 1 October 2017, modifies the list of chemotherapy pharmaceutical benefits and related pharmaceutical benefits supplied at certain public hospitals, reflecting changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This adjustment ensures the efficient funding of chemotherapy aligns with current market conditions and therapeutic practices. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a critical role in this process, providing expert advice on the listing of pharmaceutical benefits and ensuring that the changes are clinically effective, safe, and cost-effective.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2017 (No. 9) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011). This amendment, which commences on 1 October 2017, aims to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012). These amendments primarily involve changes to forms, brands, responsible person codes, maximum quantities, prescribing circumstances for various pharmaceutical benefits, and adjustments to the claimed and approved ex-manufacturer price. For instance, certain forms of doxorubicin and cisplatin have been deleted, while new brands of doxorubicin have been added. Additionally, there have been alterations to the approved and claimed ex-manufacturer prices for ondansetron wafers. This Act imposes specific obligations on pharmaceutical companies and healthcare providers. Pharmaceutical companies must ensure that their listed drugs comply with the amendments outlined in the Schedules. This includes updating their records to reflect any changes in the brands, forms, or maximum quantities of the drugs they supply. Healthcare providers, such as doctors and pharmacists, must be aware of these amendments to ensure they prescribe and supply the correct pharmaceutical benefits to eligible patients. They must also adhere to the new prescribing circumstances and authority requirements specified in the Act. Failure to comply with the requirements of this Act can lead to various civil or criminal consequences. While the Act does not explicitly state maximum penalties, non-compliance with pharmaceutical regulations can result in fines, sanctions, or other legal actions. For example, supplying a drug that does not meet the specifications outlined in the Act could lead to civil penalties, while knowingly supplying a drug that is not listed on the Pharmaceutical Benefits Scheme could result in criminal charges. Additionally, healthcare providers who fail to adhere to the prescribing requirements may face disciplinary actions from professional bodies or regulatory authorities. The Act also mandates that pharmaceutical companies and healthcare providers are kept informed about changes to the Pharmaceutical Benefits Scheme through the Pharmaceutical Benefits Advisory Committee (PBAC). The PBAC, an independent expert body established under section 100A of the National Health Act 1953, plays a crucial role in recommending which drugs and medicinal preparations should be available as pharmaceutical benefits. Pharmaceutical companies are consulted throughout the process for additions and changes to listings on the PBS, and this consultation process ensures that the Act remains up-to-date with the latest medical and pharmaceutical advancements. Failure to adhere to the recommendations and decisions made by the PBAC could result in non-compliance with the Act, potentially leading to the aforementioned civil or criminal consequences.

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