National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 5) (PB 40 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.5)

PB 40 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 June 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. 5)

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. 5) and may also be cited as PB 40 of 2019.

Section 2 Commencement

This section provides that this Instrument commences on 1 June 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

Forms added

Bleomycin

Powder for injection containing bleomycin sulfate 15,000 I.U. in 1 vial

Brands added

Pemetrexed

Powder for I.V. infusion 100 mg (as disodium) (Pemetrexed SUN)

Powder for I.V. infusion 500 mg (as disodium) (Pemetrexed SUN)

Powder for I.V. infusion 1 g (as disodium) (Pemetrexed SUN)

Brands deleted

Pemetrexed

Powder for I.V. infusion 500 mg (as disodium) (Pemetrexed Sandoz)

Addition of Responsible Person

Pro Pharmaceuticals Group Pty Ltd (QY)


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. 5)

(PB 40 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. 5) 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. This instrument was introduced to address the need for changes relating to the efficient funding of chemotherapy, reflecting the 2010 Budget measure titled ‘Revised arrangements for the efficient funding of chemotherapy drugs’. The purpose is to amend the Special Arrangement to ensure it accurately reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The instrument is enacted by the Minister for Health under the authority of the Act and is designed to achieve greater efficiency in payment for the supply of chemotherapy medicines and related pharmaceutical benefits to eligible patients at certain public hospitals. This amendment ensures that the Special Arrangement remains aligned with current legislative changes and maintains its effectiveness in providing efficient funding for chemotherapy treatments.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 5) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, which pertains to the efficient funding of chemotherapy and related pharmaceutical benefits for cancer patients. This Instrument applies to the supply of injected or infused chemotherapy medicines and medicines associated with the side-effects of cancer and cancer treatment, provided at certain public hospitals to eligible patients. It aims to reflect changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 and ensures that the Special Arrangement accurately aligns with these updates. The amendments include additions, deletions, and changes to drugs, forms, and prescribing circumstances, as detailed in the Special Arrangement. The Instrument is subject to the jurisdiction of the Commonwealth of Australia and is made under the authority of the National Health Act 1953. It commences on 1 June 2019 and is a legislative instrument for the purposes of the Legislation Act 2003. The Special Arrangement itself is part of the National Health Act 1953 and is subject to the involvement of the Pharmaceutical Benefits Advisory Committee (PBAC) for consultation. The PBAC, an independent expert body established under the Act, makes recommendations to the Minister about which drugs and medicinal preparations should be available as pharmaceutical benefits. The Instrument does not introduce new exclusions or exemptions but ensures the Special Arrangement is aligned with the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The human rights implications of this Instrument are considered to be positive, engaging with the International Covenant on Economic, Social and Cultural Rights by assisting with the progressive realisation of the right to the highest attainable standard of physical and mental health.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 5) (section 3) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (section 3 of Schedule 1). The changes include the addition of new forms and brands of chemotherapy pharmaceutical benefits, deletion of certain brands, and the addition of a responsible person, Pro Pharmaceuticals Group Pty Ltd. These amendments aim to ensure that the Special Arrangement accurately reflects the changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (sections 84AF, 84AK, 85, 85A, 88, and 101 of the Act), which also commence on the same day. The Act imposes several obligations on the parties governed by it. The Minister is responsible for making special arrangements for the supply of pharmaceutical benefits, including chemotherapy drugs, under subsection 100(1) of the Act. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in recommending which drugs should be available as pharmaceutical benefits and ensuring that decisions about access to medicines on the Pharmaceutical Benefits Scheme (PBS) are evidence-based. Pharmaceutical companies are also required to consult throughout the process for additions and changes to listings on the PBS, including through the PBAC process. Breaches of the provisions within the Act can result in various civil and criminal consequences. For example, failure to comply with the requirements of the Special Arrangement could lead to disputes over the funding and supply of chemotherapy drugs, potentially impacting patient access to necessary treatments. Additionally, non-compliance with the recommendations of the PBAC or failure to consult appropriately with the PBAC and other stakeholders could result in legal challenges or penalties. While specific penalties are not detailed within the explanatory statement, breaches of health-related legislation can often lead to fines, legal action, or other administrative consequences. The amendments made by this Instrument are designed to ensure that the Special Arrangement continues to achieve greater efficiency in the payment for the supply of chemotherapy pharmaceutical benefits to eligible patients being treated for cancer, as well as medicines associated with the side-effects of cancer and cancer treatment at certain public hospitals. By aligning the Special Arrangement with the changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, the Act aims to maintain an effective and efficient system for the funding and supply of essential medicines under the PBS.

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