National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 10) (PB 88 of 2019)

Administered by Department of Health, Disability and Ageing

Legislation au F2019L01390 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 2019 (No. 10)

PB 88 of 2019

 

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 2019.

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 2019 (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 2019 (No. 10) and may also be cited as PB 88 of 2019.

Section 2 Commencement

This section provides that this Instrument commences on 1 November 2019.

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 the Special Arrangement.  These changes are summarised below.

SUMMARY OF CHANGES

Brands Added

Fludarabine

Powder for I.V. injection containing fludarabine phosphate
50 mg (Fludarabine Juno)

Ondansetron

Tablet (orally disintegrating) 4 mg (APO-Ondansetron ODT)

 

Tablet (orally disintegrating) 8 mg (APO-Ondansetron ODT)

Trastuzumab

Powder for I.V. infusion 150 mg (Herzuma)

Brands Deleted

Docetaxel

Solution concentrate for I.V. infusion 80 mg in 8 mL
(Docetaxel Sandoz)

Alteration of Circumstances

Ipilimumab

 

Nivolumab

 

Pembrolizumab

 

Addition of Responsible Person

Celltrion Healthcare Australia Pty Ltd (EW)

Juno Pharmaceuticals Pty Ltd (JO)

Link Medical Products Pty Ltd (LM)

Alteration of Responsible Person Code

Listed Drug

Form

Brand Name

Responsible Person

Etoposide

Powder for I.V. infusion

1 g (as phosphate)

Etopophos

From: BQ

To: LM


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 2019 (No. 10)

(PB 88 of 2019)

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.

 

 

 

Ben Sladic

Assistant Secretary

Pharmacy Branch

Technology Assessment and Access Division

Department of Health

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 10) (PB 88 of 2019) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011) in order to address changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which also commenced on 1 November 2019. This amendment ensures the efficient funding of chemotherapy and related pharmaceutical benefits for eligible patients receiving treatment for cancer in certain public hospitals. The Instrument was made under the authority of subsection 100(2) of the National Health Act 1953 and was introduced by the Australian Parliament to ensure the Special Arrangement accurately reflects the most recent changes to the listing of pharmaceutical benefits. The policy objective of this amendment is to maintain the efficiency of the pharmaceutical benefits provided to patients under the Special Arrangement, thereby supporting the progressive realisation of the right to the highest attainable standard of physical and mental health, as recognised under the International Covenant on Economic, Social and Cultural Rights.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 10) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to reflect changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This instrument applies to the supply of injected or infused chemotherapy medicines and medicines associated with the side-effects of cancer and cancer treatment at certain public hospitals. It ensures the Special Arrangement accurately reflects changes to the pharmaceutical benefits listed, which are provided under the National Health Act 1953. The amendments include the addition and deletion of specific brands of drugs, alterations to prescribing circumstances, and modifications to the responsible persons for certain drugs. The Instrument commenced on 1 November 2019 and is compatible with human rights, specifically engaging with Article 2 and 12 of the International Covenant on Economic, Social and Cultural Rights by advancing the right to the highest attainable standard of physical and mental health through the Pharmaceutical Benefits Scheme.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 10) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011). The purpose of this amendment is to reflect the changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012), which also commence on 1 November 2019. The Special Arrangement, as amended, achieves greater efficiency in payment for the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits at certain public hospitals. The obligations and requirements imposed by this Instrument include the amendment of the Special Arrangement to reflect changes in the listing of pharmaceutical benefits. This includes the addition of certain brands of chemotherapy medicines and related pharmaceutical benefits, the deletion of others, and changes to the responsible persons for specific drugs. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a key role in recommending changes to the Pharmaceutical Benefits Scheme (PBS), ensuring that decisions about which medicines are subsidised are evidence-based. Pharmaceutical companies are also consulted throughout the process for any additions or changes to listings on the PBS. The Instrument does not explicitly state any offences, penalties, or civil/criminal consequences for breach. However, the National Health Act 1953 (the Act) provides a framework within which the Minister can make, vary, or revoke special arrangements for the supply of pharmaceutical benefits. Breaches of the requirements under the Act could result in administrative or legal consequences, although these are not specified in this particular Instrument. In summary, this Amendment Instrument ensures that the Special Arrangement accurately reflects changes to the listing of pharmaceutical benefits, thereby maintaining efficiency in the funding of chemotherapy and related pharmaceutical benefits. The obligations are primarily focused on the amendment and administration of the Special Arrangement, with an emphasis on evidence-based decision-making through the involvement of the PBAC.

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