National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 2) (PB 17 of 2018)

Administered by Department of Health, Disability and Ageing

Legislation au F2018L00169 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. 2)

PB 17 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 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 is amended by the deletion of a circumstance code, a purpose code and their associated circumstances and purposes for the listed drug Bevacizumab.

 

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 March 2018.

 

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


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. 2)

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 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. Schedule 1 and 4 are amended by the deletion of a circumstances code and a purposes code and their related circumstances and purposes for the listed drug Bevacizumab.

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)

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. 2) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, addressing inefficiencies in the payment system for chemotherapy pharmaceutical benefits and related pharmaceutical benefits. Authorised by subsection 100(2) of the National Health Act 1953, the Instrument aims to align the Special Arrangement with recent changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, enhancing the efficiency and effectiveness of funding arrangements for chemotherapy treatments. This amendment reflects the 2010 Budget measure concerning the revised funding arrangements for chemotherapy drugs, ensuring that payments better reflect the actual cost and clinical need associated with cancer treatment. The policy objective of this amendment is to support the progressive realisation of the right to the highest attainable standard of physical and mental health by facilitating more efficient funding and access to essential chemotherapy medicines through the Pharmaceutical Benefits Scheme.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 2) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 under the authority granted by the National Health Act 1953. This instrument applies to the efficient funding of chemotherapy drugs and related pharmaceutical benefits supplied at certain public hospitals, specifically targeting the supply of chemotherapy medicines and medicines associated with side effects of cancer and its treatment. The amendments are designed to reflect changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The instrument operates under the Commonwealth jurisdiction and affects entities involved in the supply of these pharmaceutical benefits, including pharmaceutical companies, public hospitals, and patients eligible for chemotherapy treatment. It does not specify exclusions or exemptions, but it does note that the arrangements are subject to variations or revocations by the Minister as per subsections 100(2) and 100(3) of the Act. The instrument also mentions that the Pharmaceutical Benefits Advisory Committee plays a crucial role in recommending which drugs should be listed on the Pharmaceutical Benefits Scheme, ensuring that decisions are evidence-based and consider medical conditions, clinical effectiveness, safety, and cost-effectiveness. This legislative instrument commenced on 1 March 2018 and aligns with human rights by contributing to the highest attainable standard of health as recognised in the International Covenant on Economic, Social and Cultural Rights.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 2) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011. This amendment aims to ensure the Special Arrangement reflects the recent changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The Special Arrangement was initially created to enhance the efficiency of funding for chemotherapy drugs and related treatments, aligning with the 2010 Budget measure titled 'Revised arrangements for the efficient funding of chemotherapy drugs'. Specifically, it relates to the funding of chemotherapy pharmaceutical benefits, which are medicines used in the treatment of cancer through injection or infusion, and related pharmaceutical benefits, which are medicines used to treat the side effects of cancer and cancer treatments at certain public hospitals. The Instrument imposes obligations on various entities, primarily concerning the accurate reflection of changes in the listing of pharmaceutical benefits. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a critical role in advising the Minister on which drugs should be available as pharmaceutical benefits. The PBAC ensures that decisions regarding the listing of medicines on the Pharmaceutical Benefits Scheme (PBS) are evidence-based, considering factors such as clinical effectiveness, safety, and cost-effectiveness. Pharmaceutical companies are also involved in the consultation process regarding the listing of medicines on the PBS. These consultations are designed to ensure that the Special Arrangement aligns with the latest changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. Failure to comply with the provisions of the Special Arrangement could result in legal consequences. While the legislation does not explicitly detail specific offences, penalties, or consequences for non-compliance, breaches could potentially lead to disputes over funding allocations and eligibility for pharmaceutical benefits. The Minister has the authority to vary or revoke special arrangements, which could be exercised in cases of non-compliance. The precise nature of penalties or enforcement actions is not detailed within the text but could involve administrative or judicial reviews, depending on the context and severity of the breach. In summary, the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 2) aims to refine the funding mechanisms for chemotherapy and related treatments, ensuring they reflect current listings and recommendations. This legislative instrument is compatible with human rights, particularly the right to the highest attainable standard of physical and mental health, by facilitating access to necessary pharmaceutical benefits through the PBS.

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