National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 1) (PB 7 of 2018)

Administered by Department of Health, Disability and Ageing

Legislation au F2018L00066 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 2018 (No. 1)

PB 7 of 2018

 

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 drugs Bortezomib, and Rituximab;

        removes forms of the listed drug Gemcitabine;

        removes the brand Accord Doxorubicin for the listed drug Doxorubicin; and the brand Oxaliccord for the listed drug Oxaliplatin;

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. 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 February 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 2018 (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 2018 (No. 1) and that it may also be cited as PB 7 of 2018.

Section 2 Commencement

This section provides that this Instrument commences on 1 February 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, number of repeats, the circumstances for prescribing various pharmaceutical benefits (including authority requirements) and section 100 only status.  These changes are summarised below.

SUMMARY OF CHANGES

Forms Deleted

Gemcitabine

Powder for I.V. infusion 200 mg (as hydrochloride)
Powder for I.V. infusion 1 g (as hydrochloride)
Solution concentrate for I.V. infusion 200 mg (as hydrochloride) in 20 mL
Solution concentrate for I.V. infusion 500 mg (as hydrochloride) in 50 mL
Solution concentrate for I.V. infusion 1000 mg (as hydrochloride) in 100 mL

Brands Deleted

Doxorubicin

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

Oxaliplatin

Solution concentrate for I.V. infusion 100 mg in 20 mL (Oxaliccord)

Alteration of Maximum Amount

Listed Drug

Maximum Amount

Rituximab

From: 1100
To: 800

 


Alteration of Number of Repeats
Schedule 1, Part 2

Listed Drug

Number of Repeats

Rituximab

From: 3
To: 7

Schedule 2

Listed Drug

Number of Repeats

Rituximab

From: 6
To: 5

 

From: 2
To: 6

Alteration of Circumstances

Bortezomib

Rituximab


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 2018 (No. 1)

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, 2 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.

Natasha Ploenges

Acting 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 2018 (No. 1) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, ensuring the arrangements remain current with changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This legislative instrument was made under the authority of subsection 100(2) of the National Health Act 1953, which empowers the Minister to make special arrangements for the supply of pharmaceutical benefits and to vary or revoke such arrangements. The policy objective of this amendment is to maintain efficient funding for the supply of chemotherapy and related pharmaceutical benefits to eligible cancer patients. It ensures that the Special Arrangement continues to reflect the most recent budget measures and amendments to the Pharmaceutical Benefits Scheme, thereby supporting the progressive realisation of the right to the highest attainable standard of physical and mental health, 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 2018 (No. 1) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, which aims to enhance the efficiency of payment for chemotherapy pharmaceutical benefits provided to eligible cancer patients. This instrument specifically applies to the supply of injected or infused chemotherapy medicines, as well as related pharmaceutical benefits for side-effects of cancer and cancer treatment at designated public hospitals. By making changes to the Special Arrangement, this legislative instrument ensures the arrangement aligns with updates to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which also commences on 1 February 2018. This amendment applies to the Commonwealth of Australia and involves modifications to Schedules 1, 2 and 4 of the Special Arrangement, including alterations to circumstance codes, purpose codes, forms, brands, and maximum quantities for certain drugs. The instrument is compatible with human rights as it supports the progressive realisation of the right to the highest attainable standard of physical and mental health, facilitated through the Pharmaceutical Benefits Scheme (PBS).

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 1) (the Instrument) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (the Special Arrangement) to reflect changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The Special Arrangement is designed to improve the efficiency of payment for chemotherapy drugs and related pharmaceutical benefits supplied to eligible cancer patients (sections 1 and 2). This is achieved through amendments to Schedules 1, 2, and 4 of the Special Arrangement, which include changes to the forms, brands, maximum quantities, number of repeats, and prescribing circumstances for various drugs (Schedule 1). Specifically, the Instrument removes certain forms of Gemcitabine, brands of Doxorubicin and Oxaliplatin, and adjusts the maximum quantity and number of repeats for Rituximab. It also modifies the circumstances for prescribing Bortezomib and Rituximab, including their associated circumstances and purposes (Schedules 1 and 4). The obligations imposed by the Instrument primarily concern the accurate implementation and application of the changes detailed in the amended Special Arrangement. This includes ensuring that the new specifications for drug forms, brands, quantities, and prescribing conditions are adhered to by healthcare providers and pharmacies. The Instrument requires these entities to update their records and practices to comply with the new requirements, ensuring that the changes are effectively integrated into the provision of chemotherapy and related pharmaceutical benefits (Schedule 1). Additionally, the Instrument mandates that these changes are reflected in the Pharmaceutical Benefits Scheme (PBS) and the overall funding arrangements for chemotherapy drugs. Failure to comply with the provisions of the Instrument may result in legal consequences. While the Instrument itself does not explicitly state specific penalties for non-compliance, breaches of the National Health Act 1953 (the Act) or the Special Arrangement could lead to enforcement actions by the Minister. These may include fines, legal proceedings, or other administrative sanctions. The maximum penalties for breaches of the Act or related instruments can vary, but they are typically significant, reflecting the importance of ensuring proper and efficient funding of chemotherapy and related treatments. In summary, the Instrument amends the Special Arrangement to reflect updates in drug listings, thereby ensuring that the efficient funding of chemotherapy and related pharmaceutical benefits remains aligned with current medical practices and requirements. It imposes obligations on healthcare providers and pharmacies to update their practices in line with these changes, and non-compliance may lead to legal and administrative consequences under the Act.

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