National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 10) (PB 95 of 2018)

Administered by Department of Health, Disability and Ageing

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EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (EFFICIENT FUNDING OF CHEMOTHERAPY) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2018 (No. 10)

PB 95 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 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 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 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 November 2018.

This Instrument is a legislative instrument for the purposes of the Legislation Act 2003.


ATTACHMENT

PROVISION-BY-PROVISION DESCRIPTION OF NATIONAL HEALTH (EFFICIENT FUNDING OF CHEMOTHERAPY) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2018 (No. 10)

Section 1 Name of Instrument

This section provides that the Instrument is the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 10) and may also be cited as PB 95 of 2018.

Section 2 Commencement

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

Section 3 Amendment of National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (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).

Schedule 1 Amendments

The amendments in Schedule 1 of this Instrument provide for additions, deletions and changes to drugs, forms and circumstances for prescribing various pharmaceutical benefits (including authority requirements), as detailed in Schedules 1 and 4 of the Special Arrangement.  These changes are summarised below.

 

SUMMARY OF CHANGES

Brands Deleted

Pemetrexed

Powder for I.V. infusion 100 mg (as disodium) (Pemetrexed APOTEX)

Alteration of Circumstances

Pembrolizumab

 


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. 10)

(PB 95 of 2018)

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 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

Assistant Secretary (Acting)

Pharmacy Branch

Technology Assessment and Access Division

Department of Health

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 10) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, thereby addressing the need to make changes relating to the efficient funding of chemotherapy drugs. This Instrument was made under the authority provided by 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 policy objective behind this Instrument is to ensure that the Special Arrangement accurately reflects the changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, thus maintaining consistency and efficiency in the funding of chemotherapy drugs. The process of consultation involved the Pharmaceutical Benefits Advisory Committee (PBAC), an independent expert body that makes recommendations on which drugs should be available as pharmaceutical benefits, ensuring that decisions are evidence-based and consider clinical effectiveness, safety, and cost-effectiveness. The Instrument commenced on 1 November 2018, ensuring that the amendments to the Special Arrangement are implemented in alignment with the changes to the Pharmaceutical Benefits listing.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 10) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, under the authority granted by the National Health Act 1953. The Act applies to the efficient funding of chemotherapy and related pharmaceutical benefits for cancer patients, administered through the Pharmaceutical Benefits Scheme (PBS). This legislative instrument targets entities involved in the supply of chemotherapy medicines and related benefits, particularly in public hospitals. Geographically, it operates within the Commonwealth jurisdiction, impacting entities and individuals across Australia. The amendment reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, ensuring that the Special Arrangement remains current and effective. Exclusions or specific exemptions are not outlined in this particular amendment but generally align with the broader provisions of the National Health Act and the PBS guidelines. The instrument is compatible with human rights, particularly advancing the right to the highest attainable standard of physical and mental health, as it facilitates access to essential medications through the PBS.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 10) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (the Special Arrangement) (sections 3 and Schedule 1). The Special Arrangement provides for the efficient funding of chemotherapy drugs and related pharmaceutical benefits under the National Health Act 1953. The Instrument updates the Special Arrangement to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which commenced on the same day. This involves adding, deleting, and altering drugs, forms, and prescribing circumstances, as detailed in Schedule 1. The Act imposes specific obligations on parties governed by it. The Minister, under subsection 100(1), has the authority to make special arrangements for the supply of pharmaceutical benefits, which include the efficient funding of chemotherapy drugs. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in this process by recommending which drugs should be available as pharmaceutical benefits based on their clinical effectiveness, safety, and cost-effectiveness. The PBAC is composed of members with diverse expertise, including health economists, practising pharmacists, general practitioners, clinical pharmacologists, and specialists, ensuring a comprehensive evaluation of the drugs. Pharmaceutical companies are also involved in the consultation process regarding the listing of medicines on the Pharmaceutical Benefits Scheme (PBS). Breaches of the provisions under this Act may result in various civil and criminal consequences. Although the explanatory statement does not specify the exact offences or penalties, it is clear that any non-compliance with the Act or the Special Arrangement could lead to legal repercussions. The penalties could range from fines to more severe sanctions depending on the nature and severity of the breach. The exact penalties are typically outlined in the primary legislation or in specific regulations that implement the Act. It is important for all parties involved to adhere to the requirements set forth to avoid any potential legal consequences. The Instrument ensures that the Special Arrangement remains aligned with the changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, thereby maintaining the efficiency and effectiveness of the funding arrangements for chemotherapy drugs and related pharmaceutical benefits. By updating the Special Arrangement, the Instrument helps to ensure that eligible patients continue to receive the necessary treatments in a cost-effective manner, reflecting the ongoing commitment to improving healthcare outcomes in Australia.

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