National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 8) (PB 78 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. 8)

PB 78 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 September 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. 8)

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. 8) and may also be cited as PB 78 of 2018.

Section 2 Commencement

This section provides that this Instrument commences on 1 September 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

Form Added

Carfilzomib

Powder for injection 10 mg

Brands Added

Fluorouracil

Injection 1000 mg in 20 mL (Fluorouracil Accord)

 

Injection 2500 mg in 50 mL (Fluorouracil Accord)

 

Injection 5000 mg in 100 mL (Fluorouracil Accord)

Alteration of Circumstances

Nivolumab

 


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. 8)

(PB 78 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

Acting 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. 8) (PB 78 of 2018) was enacted to address the need for updated arrangements in the efficient funding of chemotherapy drugs, as reflected in the 2010 Budget measure titled ‘Revised arrangements for the efficient funding of chemotherapy drugs’. This instrument amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011), which focuses on the supply of chemotherapy and related pharmaceutical benefits to eligible patients being treated for cancer in certain public hospitals. The instrument was introduced to ensure that the special arrangements accurately reflect recent changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, thereby maintaining the efficiency and effectiveness of funding for these critical medications. The instrument was enacted by the Minister under the authority provided in the National Health Act 1953, with the policy objective of enhancing the equitable and efficient provision of pharmaceutical benefits to patients requiring chemotherapy treatment.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 8) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, aiming to enhance the efficiency of funding for chemotherapy medicines provided to eligible cancer patients, as well as medicines addressing the side-effects of cancer and cancer treatments at certain public hospitals. This Instrument is made under the authority granted 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 amendment ensures the Special Arrangement reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which also commence on 1 September 2018. This legislative instrument applies to all entities involved in the supply and funding of chemotherapy and related pharmaceutical benefits under the National Health Act, including pharmaceutical companies, public hospitals, and patients. The changes made by this Instrument are subject to the broader provisions of Part VII of the Act, which governs the supply of pharmaceutical benefits recommended by the Pharmaceutical Benefits Advisory Committee (PBAC). The PBAC, an independent expert body, consults with various stakeholders, including pharmaceutical companies, to recommend drugs and medicinal preparations available as pharmaceutical benefits, ensuring their clinical effectiveness, safety, and cost-effectiveness. This Amendment Instrument does not introduce any new exclusions or exemptions beyond those already specified in the Special Arrangement or the Act.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 8) primarily serves to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (Special Arrangement) to align with recent changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This amendment, effective from 1 September 2018, ensures that the Special Arrangement accurately reflects the latest modifications in the pharmaceutical benefits listed under the National Health Act 1953. Specifically, Section 3 of this Instrument amends the Special Arrangement to incorporate new drugs, forms, and prescribing circumstances, as detailed in Schedules 1 and 4 of the Special Arrangement. These amendments include adding new drugs, brands, and altering the circumstances under which certain pharmaceutical benefits are prescribed. Under this Act, parties and entities are obligated to adhere to the updated provisions regarding the supply and funding of chemotherapy pharmaceutical benefits and related pharmaceutical benefits at public hospitals. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in this context, recommending which drugs and medicinal preparations should be available as pharmaceutical benefits and ensuring that decisions about subsidised access to medicines are evidence-based. Pharmaceutical companies and other stakeholders are also expected to comply with these changes, ensuring that the supply of chemotherapy and related medicines aligns with the updated Special Arrangement. Breaches of the provisions outlined in this Instrument could result in various legal consequences. While the specific penalties are not detailed in the Explanatory Statement, violations of the National Health Act 1953 can generally lead to administrative penalties, civil suits, or criminal charges, depending on the nature and severity of the breach. For instance, non-compliance with the recommended pharmaceutical benefits or failure to adhere to the prescribed circumstances for drug supply could lead to legal actions aimed at enforcing compliance or seeking damages for any resultant harm. Additionally, entities that do not adjust their practices to align with the amended Special Arrangement may face regulatory scrutiny and enforcement actions by the relevant authorities.

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