National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 9) (PB 79 of 2019)

Administered by Department of Health, Disability and Ageing

Legislation au F2019L01296 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. 9)

PB 79 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 October 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. 9)

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. 9) and may also be cited as PB 79 of 2019.

Section 2 Commencement

This section provides that this Instrument commences on 1 October 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 Added

Aprepitant

Brands Added

Rituximab

Solution for I.V. infusion 100 mg in 10 mL (Riximyo)

 

Solution for I.V. infusion 500 mg in 50 mL (Riximyo)

Brands Deleted

Ondansetron

I.V. injection 4 mg (as hydrochloride dihydrate) in 2 mL (Onsetron)

 

I.V. injection 8 mg (as hydrochloride dihydrate) in 4 mL (Onsetron)

 

Tablet 4 mg (as hydrochloride dihydrate) (Onsetron 4)

 

Tablet 8 mg (as hydrochloride dihydrate) (Onsetron 8)

Alteration of Circumstances

Atezolizumab

Bevacizumab

Blinatumomab

Inotuzumab ozogamicin

Pertuzumab

Rituximab

Trastuzumab

Trastuzumab emtansine

Deletion of Responsible Person Code

Medis Pharma Pty Ltd (ZP)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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. 9)

(PB 79 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. 9) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, thereby enhancing the efficiency of funding chemotherapy medicines and related pharmaceutical benefits provided to eligible patients in public hospitals. The Act was passed under the authority granted by subsection 100(2) of the National Health Act 1953, which allows the Minister to vary or revoke special arrangements for the supply of pharmaceutical benefits. The objective of this amendment is to align the Special Arrangement with recent changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, ensuring that funding reflects the latest updates in chemotherapy drug listings and associated treatments for cancer side effects. The instrument emphasises the importance of ongoing consultations with stakeholders, including the Pharmaceutical Benefits Advisory Committee, to maintain the integrity and efficacy of the Pharmaceutical Benefits Scheme in delivering high-quality healthcare services.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2019 (No. 9) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to make changes relating to the efficient funding of chemotherapy, reflecting the 2010 Budget measure titled ‘Revised arrangements for the efficient funding of chemotherapy drugs’. This special arrangement applies to the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits at certain public hospitals. The changes to the special arrangement are made to align with amendments to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which commenced on the same day. The special arrangement is applicable to entities and individuals involved in the supply of chemotherapy and related pharmaceutical benefits in the public health sector, and it operates under the authority of the National Health Act 1953. The Act, which is a Commonwealth statute, provides the legal framework for the efficient funding of chemotherapy drugs, and it is subject to the recommendation of the Pharmaceutical Benefits Advisory Committee (PBAC). The PBAC is an independent expert body established under the Act to make recommendations to the Minister about which drugs and medicinal preparations should be available as pharmaceutical benefits, taking into account factors such as medical conditions, clinical effectiveness, safety, and cost-effectiveness. The Instrument is compatible with human rights, as it advances the protection of human rights by ensuring access to subsidised medicines under the Pharmaceutical Benefits Scheme, contributing to 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. 9) (the Instrument) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (the Special Arrangement) to reflect changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This is achieved through amendments to the Special Arrangement as detailed in Schedule 1 of the Instrument (section 3). The Instrument ensures that the Special Arrangement accurately reflects the current list of pharmaceutical benefits, thus maintaining the efficiency in funding for chemotherapy and related pharmaceutical benefits for cancer patients. The Instrument imposes obligations on parties involved in the supply and funding of chemotherapy and related pharmaceutical benefits. Specifically, it mandates that the Special Arrangement be updated to align with the changes in the listing of pharmaceutical benefits on the Pharmaceutical Benefits Scheme (PBS) (section 3). This alignment ensures that payments for chemotherapy pharmaceutical benefits and related pharmaceutical benefits are efficiently managed and reflect the most current therapeutic guidelines and cost-effectiveness considerations. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in advising on the listing of these benefits, ensuring that decisions are evidence-based and aligned with clinical effectiveness and cost-effectiveness. Breaches of the requirements set out in the Instrument may have legal consequences. The National Health Act 1953 provides for the enforcement of the provisions of the Special Arrangement through administrative and legal actions. For instance, failure to comply with the funding arrangements could result in disputes over payments and potentially in legal proceedings. Additionally, any amendments or special arrangements must comply with the Human Rights (Parliamentary Scrutiny) Act 2011, ensuring that they do not infringe on the human rights and freedoms recognised in international instruments. The Instrument explicitly states that it is compatible with human rights, ensuring the protection and advancement of the right to health (section 3). The penalties for non-compliance with the National Health Act 1953 and the related special arrangements can be significant. While the Instrument itself does not specify penalties, the Act provides for substantial fines for breaches, which can extend up to several thousand dollars for individuals and significantly more for corporations. Furthermore, ongoing non-compliance can lead to further legal actions, including court orders to rectify the breaches, thereby ensuring adherence to the legislative requirements aimed at efficient and effective funding of chemotherapy and related treatments.

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