National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 3) (PB 21 of 2019)

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 2019 (No.3)

PB 21 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 April 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. 3)

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. 3) and may also be cited as PB 21 of 2019.

Section 2 Commencement

This section provides that this Instrument commences on 1 April 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 deleted

Epirubicin

Solution for injection containing epirubicin hydrochloride 50 mg in 25 mL (Epirubicin SZ)

Alteration of circumstances

Brentuximab vedotin

 


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. 3)

(PB 21 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. 3) (PB 21 of 2019) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to enhance the efficiency of funding for chemotherapy and related pharmaceutical benefits. Enacted under subsection 100(2) of the National Health Act 1953, this Instrument ensures that the Special Arrangement accurately reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The policy objective is to streamline payment processes for chemotherapy drugs and associated medicines, aiming to improve access and efficiency in cancer treatment. The amendments are intended to align with the broader goals of the National Health Act, particularly in facilitating better health outcomes through regulated pharmaceutical benefits. Consultation with stakeholders, including through the Pharmaceutical Benefits Advisory Committee (PBAC), has been an integral part of the process, ensuring that the amendments are evidence-based and consider expert recommendations. The Instrument is compatible with human rights, particularly by advancing the right to the highest attainable standard of physical and mental health as outlined in 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. 3) is an amendment to the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, made under subsection 100(2) of the National Health Act 1953. It aims to adjust the Special Arrangement to reflect changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This Instrument affects the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits for patients being treated for cancer, ensuring the Special Arrangement aligns with updated pharmaceutical listings. The amendment applies to the efficient funding of chemotherapy drugs and the supply of related pharmaceutical benefits in certain public hospitals. This Instrument is compatible with human rights, as it supports the progressive realisation of the right to the highest attainable standard of physical and mental health by ensuring access to subsidised medicines through the Pharmaceutical Benefits Scheme. This is facilitated by the Pharmaceutical Benefits Advisory Committee, which recommends evidence-based inclusion of medicines on the Scheme.

Key Provisions

The main operative sections of this legislation are Sections 1 and 3 (subsections 100(1) and 100(2) of the National Health Act 1953). Section 1 identifies the Instrument as the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 3) (PB 21 of 2019). Section 3, through Schedule 1, amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to incorporate changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. These changes include additions, deletions, and alterations to drugs, forms, and circumstances for prescribing various pharmaceutical benefits, as detailed in the Special Arrangement. The obligations and requirements imposed by this Act primarily revolve around ensuring that the Special Arrangement accurately reflects the changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This includes updating the list of chemotherapy pharmaceutical benefits and related pharmaceutical benefits to be funded efficiently under the National Health Act 1953. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in this process by recommending which drugs and medicinal preparations should be available as pharmaceutical benefits, taking into account their clinical effectiveness, safety, and cost-effectiveness. Breaches of the requirements outlined in this Act may result in civil or criminal consequences, although specific penalties are not detailed in the explanatory statement. The Pharmaceutical Benefits Scheme (PBS) is designed to ensure that decisions about subsidised access to medicines are evidence-based, thereby protecting human rights by providing subsidised access to medicines. However, the explanatory statement does not detail any specific offences, penalties, or consequences for breach, except that it is compatible with human rights as it advances the protection of human rights. The Instrument ensures that the Special Arrangement remains current and accurate by reflecting changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. It is important for entities governed by this Act to stay updated with these changes to ensure compliance with the legislative requirements. While specific penalties for non-compliance are not detailed, adherence to the Act is crucial for maintaining the efficiency and effectiveness of the funding arrangements for chemotherapy and related pharmaceutical benefits.

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