National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2020 (No. 1) (PB 5 of 2020)

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 2020 (No. 1)

PB 5 of 2020

 

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 February 2020.

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 2020 (No. 1)

Section 1 Name of Instrument

This section provides that the Instrument is the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2020 (No. 1) and may also be cited as PB 5 of 2020.

Section 2 Commencement

This section provides that this Instrument commences on 1 February 2020.

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

Listed Drug

Form and Brand

Pemetrexed

Powder for I.V. infusion 100 mg (as disodium) (PEMETREXED-DRLA)

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

 


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 2020 (No. 1)

(PB 5 of 2020)

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 2020 (No. 1) was introduced to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 under subsection 100(2) of the National Health Act 1953. This amendment was necessary to ensure the Special Arrangement accurately reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which also commence on 1 February 2020. The Special Arrangement originally aimed to achieve greater efficiency in the payment for the supply of injected or infused chemotherapy medicines to eligible patients being treated for cancer, aligning with the 2010 Budget measure titled 'Revised arrangements for the efficient funding of chemotherapy drugs'. It also concerns the supply of medicines associated with the side effects of cancer and cancer treatment at certain public hospitals. The instrument maintains the ongoing and formal process of consultation involving interested parties through the Pharmaceutical Benefits Advisory Committee, ensuring decisions about access to medicines are evidence-based and aligned with the progressive realisation of the right to the highest attainable standard of physical and mental health under the International Covenant on Economic, Social and Cultural Rights.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2020 (No. 1) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to reflect changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This Instrument is made under subsection 100(2) of the National Health Act 1953 and applies nationally, affecting the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits at public hospitals. The changes pertain to the efficient funding of chemotherapy drugs, aligning with the 2010 Budget measure for revised arrangements. The Instrument does not specify exclusions or thresholds but ensures the Special Arrangement remains consistent with recent amendments to the Pharmaceutical Benefits Scheme. The Pharmaceutical Benefits Advisory Committee's recommendations and consultations with pharmaceutical companies are integral to this process. This legislative instrument, commencing on 1 February 2020, ensures that the Special Arrangement continues to efficiently fund chemotherapy treatments in line with current health policies and international human rights obligations.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2020 (No. 1) (PB 5 of 2020) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011) to update and refine the arrangements for efficient funding of chemotherapy drugs and related pharmaceutical benefits. The amendments reflect changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, ensuring that the Special Arrangement accurately mirrors these updates. This is achieved through a formal process of consultation with relevant parties, including the Pharmaceutical Benefits Advisory Committee (PBAC), which provides expert recommendations on the listing of pharmaceutical benefits. The amendments are designed to ensure that the funding arrangements remain efficient and effective in providing necessary treatments to eligible patients. The Act imposes specific obligations on the Minister for Health to make special arrangements for the supply of pharmaceutical benefits and to vary or revoke these arrangements as necessary. These obligations are detailed in subsections 100(1) to 100(3) of the National Health Act 1953. The Minister must ensure that the Special Arrangement aligns with the current legislative and budgetary measures, as well as the recommendations of the PBAC. The PBAC’s role includes recommending which drugs should be available as pharmaceutical benefits, considering factors such as clinical effectiveness, safety, and cost-effectiveness. The Minister’s oversight ensures that the Special Arrangement is kept up-to-date with any changes in the Pharmaceutical Benefits Scheme (PBS). Failure to comply with the requirements set out in the Special Arrangement may result in legal consequences, including penalties. Although the explanatory statement does not specify the exact nature of these penalties, it is implied that breaches of the Act or the Special Arrangement could lead to legal action. The National Health Act 1953 provides a framework for enforcement, and penalties could include fines or other sanctions as deemed appropriate by the relevant authorities. Given the critical nature of the services provided under the Special Arrangement, non-compliance could also impact the availability and accessibility of essential cancer treatments for patients. Overall, the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2020 (No. 1) is a legislative measure designed to enhance the efficiency and effectiveness of funding for chemotherapy drugs and related treatments. It ensures that the Special Arrangement remains current with the latest changes in the PBS and recommendations from the PBAC, thereby supporting the provision of high-quality healthcare services to eligible patients. The involvement of the PBAC and ongoing consultation processes highlight the commitment to evidence-based decision-making in healthcare funding arrangements.

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