National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 7) (PB 68 of 2018)

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EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (EFFICIENT FUNDING OF CHEMOTHERAPY) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2018 (No. 7)

PB 68 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 August 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. 7)

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. 7) and may also be cited as PB 68 of 2018.

Section 2 Commencement

This section provides that this Instrument commences on 1 August 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

Vinblastine

Solution for I.V. injection containing vinblastine sulfate 10 mg in 10 mL (Vinblastine Teva)

Alteration of Circumstances

Nivolumab

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. 7)

(PB 68 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.

 

 

 

Julianne Quaine

Assistant Secretary

Pharmacy Branch

Technology Assessment and Access Division

Department of Health

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 7) is an amendment to the National Health Act 1953, enacted to enhance the efficiency of funding for chemotherapy medicines and related treatments in Australia. This amendment addresses the need for updated arrangements that reflect changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. It was introduced to ensure that the Special Arrangement accurately reflects these updates, facilitating more efficient payments for chemotherapy pharmaceutical benefits and related pharmaceutical benefits at certain public hospitals. The instrument was enacted by the Minister for Health under the authority granted by subsection 100(2) of the National Health Act 1953, with the policy objective of improving the accessibility and cost-effectiveness of chemotherapy drugs for patients undergoing cancer treatment. The amendment commenced on 1 August 2018, ensuring that the legislative framework remains current and effective in meeting the needs of patients and the broader healthcare system.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 7) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, which pertains to the efficient funding of chemotherapy medicines for cancer patients and related pharmaceutical benefits supplied at certain public hospitals. This special arrangement was established to reflect the 2010 Budget measure titled 'Revised arrangements for the efficient funding of chemotherapy drugs'. The amendment instrument ensures that the special arrangement aligns with the changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The changes include modifications to the drugs, forms, and circumstances for prescribing various pharmaceutical benefits, as detailed in the schedules of the special arrangement. The Pharmaceutical Benefits Advisory Committee, an independent expert body, plays a critical role in recommending drugs and medicinal preparations available as pharmaceutical benefits, ensuring decisions are evidence-based. The instrument is compatible with human rights as it assists in the progressive realisation of the right to the highest attainable standard of physical and mental health by providing subsidised access to medicines through the Pharmaceutical Benefits Scheme.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 7) (section 1) is an amendment to the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (section 3). This Instrument is designed to update the Special Arrangement to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (sections 84AF, 84AK, 85, 85A, 88, and 101). The Instrument aims to ensure that the Special Arrangement accurately reflects these changes, which also commence on the same day as the amendment (section 2). The amendments include additions, deletions, and changes to drugs, forms, and circumstances for prescribing various pharmaceutical benefits, as detailed in the schedules of the Special Arrangement (Schedule 1). The obligations imposed by this Instrument on the parties it governs primarily involve ensuring that the Special Arrangement remains consistent with changes to the Pharmaceutical Benefits Scheme (PBS). Specifically, entities involved in the supply and administration of chemotherapy pharmaceutical benefits and related pharmaceutical benefits must adhere to the updated listing details and requirements as outlined in the amended Special Arrangement. This includes ensuring that only eligible patients and prescribed circumstances are covered under the updated arrangements. There are no explicit offences, penalties, or civil/criminal consequences for breach detailed within the Instrument itself. However, the broader National Health Act 1953 (section 100) provides that any breach of a special arrangement made under the Act could potentially lead to civil or criminal penalties as prescribed by the Act. These could include fines or other sanctions, although specific maximum penalties are not detailed in the Instrument. Compliance with the updated Special Arrangement is therefore crucial to avoid any adverse consequences under the overarching legislation.

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