National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 9) (PB 86 of 2018)

Administered by Department of Health, Disability and Ageing

Legislation au F2018L01362 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. 9)

PB 86 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 October 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. 9)

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. 9) and may also be cited as PB 86 of 2018.

Section 2 Commencement

This section provides that this Instrument commences on 1 October 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 Added

Cisplatin

I.V. injection 50 mg in 50 mL (Cisplatin Accord)

 

I.V. injection 100 mg in 100 mL (Cisplatin Accord)

Fluorouracil

Injection 500 mg in 10 mL (Fluorouracil Accord)

Alteration of Circumstances

Bendamustine

Bortezomib

Obinutuzumab

 


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. 9)

(PB 86 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. 9) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, aiming to enhance the efficiency of funding for chemotherapy medicines provided to cancer patients. This amendment was necessary to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, ensuring that the Special Arrangement remains current and effective. The purpose of the Special Arrangement is to streamline the payment process for chemotherapy pharmaceutical benefits, which are medicines administered through injection or infusion, and related pharmaceutical benefits that manage the side effects of cancer and its treatment at public hospitals. This initiative was introduced by the Australian Government under the authority granted by the National Health Act 1953, specifically through the Minister's power to make special arrangements for the supply of pharmaceutical benefits. The policy objective is to improve the efficiency of funding arrangements, thereby better supporting cancer patients with necessary treatments and reducing the burden on the healthcare system.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 9) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, which establishes arrangements for the efficient funding of chemotherapy drugs as a pharmaceutical benefit under the National Health Act 1953. This Instrument applies to the supply of injected or infused chemotherapy medicines and related pharmaceutical benefits to eligible patients being treated for cancer in certain public hospitals, aiming to reflect changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The amendments ensure that the Special Arrangement accurately reflects these changes, which include the addition of specific drugs such as Cisplatin and Fluorouracil, and alterations to prescribing circumstances for other drugs like Bendamustine, Bortezomib, and Obinutuzumab. The Instrument is designed to enhance the efficiency of funding for chemotherapy treatments while maintaining alignment with the broader National Health Act and its associated instruments. The changes take effect from 1 October 2018, and the legislative process involved ongoing consultations with relevant stakeholders, including the Pharmaceutical Benefits Advisory Committee, to ensure the recommendations and amendments are evidence-based and aligned with the broader objectives of the National Health Act.

Key Provisions

The main operative sections of this Legislative Instrument, specifically the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2018 (No. 9), involve amendments to the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (the Special Arrangement) (Sections 2 and 3). These amendments are designed to update and reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (Section 3, Schedule 1). The amendments cover additions, deletions, and changes to drugs, forms, and prescribing circumstances, as well as alterations in the authority requirements for various pharmaceutical benefits (Schedule 1, Amendments). The purpose of these amendments is to ensure that the Special Arrangement accurately reflects the latest changes in the Pharmaceutical Benefits Scheme (PBS), specifically in relation to the efficient funding of chemotherapy and related pharmaceutical benefits. The obligations and requirements imposed by this Act on the parties or entities it governs primarily revolve around ensuring that the Special Arrangement remains current with the PBS listings. Pharmaceutical companies, healthcare providers, and patients are required to adhere to the updated pharmaceutical benefits list, which includes the newly added drugs and modified prescribing conditions. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in recommending which drugs should be listed on the PBS, ensuring these decisions are evidence-based and take into account clinical effectiveness, safety, and cost-effectiveness. Additionally, healthcare providers must ensure that they are prescribing and supplying chemotherapy and related pharmaceutical benefits in accordance with the updated Special Arrangement and the PBS. The Legislative Instrument also outlines potential offences, penalties, and civil or criminal consequences for breaches of the amended Special Arrangement. While the specific penalties are not detailed in the provided text, it is implied that non-compliance with the updated pharmaceutical benefits list and prescribing conditions could result in legal consequences. Such breaches might include supplying unlisted or incorrectly prescribed drugs, which could lead to penalties under the National Health Act 1953 or other relevant legislation. The exact nature and severity of these penalties would depend on the specific circumstances and the extent of the breach. However, the overarching goal of these provisions is to ensure that the efficient funding of chemotherapy and related pharmaceutical benefits is maintained, thereby protecting patient access to necessary treatments and ensuring the integrity of the PBS.

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