National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 7) (PB 62 of 2019)

Administered by Department of Health, Disability and Ageing

Legislation au F2019L01025 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.7)

PB 62 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 August 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. 7)

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. 7) and may also be cited as PB 62 of 2019.

Section 2 Commencement

This section provides that this Instrument commences on 1 August 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).

SUMMARY OF CHANGES

Listed Drugs Deleted

Aprepitant

Brands added

Trastuzumab

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

Alteration of Circumstances

Bevacizumab

Pembrolizumab


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. 7)

(PB 62 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. 7) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, introduced to enhance the efficiency of funding for chemotherapy medicines and related pharmaceutical benefits supplied to patients undergoing cancer treatment. Enacted under subsection 100(2) of the National Health Act 1953, the Instrument ensures that the Special Arrangement aligns with changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The purpose is to reflect the 2010 Budget measure titled ‘Revised arrangements for the efficient funding of chemotherapy drugs’, ensuring that payments for chemotherapy pharmaceutical benefits and related benefits remain efficient and effective. This legislative amendment facilitates the progressive realisation of the right to the highest attainable standard of physical and mental health, as recognised in the International Covenant on Economic, Social and Cultural Rights, through the provision of subsidised access to essential medicines via the Pharmaceutical Benefits Scheme.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 7) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to refine the efficient funding of chemotherapy drugs and related pharmaceutical benefits, aligning with changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This amendment applies to entities and individuals involved in the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits at certain public hospitals, ensuring the efficient and effective funding of treatments for cancer patients in Australia. The amendments reflect modifications in the listing of pharmaceutical benefits and commence on 1 August 2019. The National Health Act 1953 authorises the Minister to make such special arrangements, with the Pharmaceutical Benefits Advisory Committee providing expert recommendations on the listing of medicines on the Pharmaceutical Benefits Scheme. This legislative instrument is compatible with human rights as it assists in the progressive realisation of the right to the highest attainable standard of physical and mental health through the provision of subsidised access to essential medicines.

Key Provisions

The main operative sections of this legislative instrument (F2019L01025) are sections 1 to 3. Section 1 identifies the instrument as the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 7) and gives it the citation PB 62 of 2019. Section 2 sets the commencement date of this instrument as 1 August 2019. Section 3 provides for amendments to the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011. These sections establish the framework and purpose of the amendments, ensuring that the Special Arrangement accurately reflects recent changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The obligations and requirements imposed by this Act include the amendment of the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to ensure it aligns with the changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This involves updating the list of pharmaceutical benefits and their associated conditions for supply, particularly focusing on chemotherapy medicines and related treatments for cancer patients. The Act mandates that the Pharmaceutical Benefits Advisory Committee (PBAC) plays a central role in recommending which drugs and medicinal preparations should be available as pharmaceutical benefits, taking into account factors such as clinical effectiveness, safety, and cost-effectiveness. Furthermore, it requires that any amendments are made in consultation with relevant stakeholders, although the Act notes that further consultation for this specific instrument was deemed unnecessary due to the nature of previous consultations. Breach of the obligations and requirements set out in this Act could result in civil or criminal consequences. While specific penalties are not detailed in the provided text, breaches of similar legislative instruments often involve fines or other financial penalties for non-compliance. Additionally, failure to adhere to the provisions regarding the efficient funding of chemotherapy could potentially impact the accessibility and affordability of essential medications for cancer patients, indirectly affecting their health outcomes. The maximum penalties for such breaches would depend on the specific nature of the violation and would be determined in accordance with the broader legislative framework governing health and pharmaceutical regulations in Australia.

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