National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2020 (No. 9) (PB 107 of 2020)

Administered by Department of Health, Disability and Ageing

Legislation au F2020L01369 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 2020 (No. 9)

PB 107 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.

Schedule 1 to this Instrument provides for the alteration of circumstances in which a prescription may be written for the supply of the listed drugs atezolizumab, bevacizumab and topotecan.  It also provides for the addition of a form to the listed drug topotecan and for the deletion of a form from the listed drug oxaliplatin.  These changes are summarised, by subject matter, 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 November 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. 9)

Section 1 Name of Instrument

This section provides the name of this Instrument as the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2020 (No. 9) and may also be cited as PB 107 of 2020.

Section 2 Commencement

This section provides that this Instrument commences on 1 November 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 involve the addition and deletion of a form and the alteration of circumstances for prescribing various pharmaceutical benefits available on the Special Arrangement.  These changes are summarised below.

 

 

SUMMARY OF CHANGES TO THE NATIONAL HEALTH (EFFICIENT FUNDING OF CHEMOTHERAPY) SPECIAL ARRANGEMENT 2011 MADE BY THIS INSTRUMENT

Form Added

Listed Drug

Form

Topotecan

Solution concentrate for I.V. infusion 4 mg in 4 mL (as hydrochloride)

Form Deleted

Listed Drug

Form

Oxaliplatin

Solution concentrate for I.V. infusion 50 mg in 10 mL

Alteration of Circumstances in Which a Prescription May be Written

Listed Drug

Atezolizumab

Bevacizumab

Topotecan

 

 

 

 


Document/s incorporated by reference

Listed Drug

Document incorporated

Document access

Atezolizumab

Eastern Cooperative Oncology Group (ECOG) performance status/World Health Organization (WHO) performance status. The document is incorporated as in force on the day this Instrument takes effect, pursuant to paragraph 14(1)(b) of the Legislation Act 2003.

The ECOG/WHO performance status is a standard medical diagnostic tool used to measure how cancer impacts a patient’s daily living abilities, by evaluating a patient’s level of functioning in terms of their ability to care for themself, daily activity, and physical ability (walking, working, etc.).

The ECOG/WHO Performance Status is available for download for free from the ECOG-ACRIN Cancer Research Group website: https://ecog-acrin.org/resources/ecog-performance-status

Atezolizumab

Child Pugh Score. The document is incorporated as in force on the day this Instrument takes effect, pursuant to paragraph 14(1)(b) of the Legislation Act 2003.

The Child Pugh score assists health professionals to predict prognosis for people with chronic liver disease.

The Child Pugh Score is available for download for free from the NPS MedicineWise website: https://www.nps.org.au/australian-prescriber/articles/prescribing-in-liver-disease-1

 

 

 

 

 

 

 

 

 

 


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. 9)

(PB 107 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.

The amendments in Schedule 1 involve the addition and deletion of a form and the alteration of circumstances for prescribing various pharmaceutical benefits available on the Special Arrangement.

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. 9) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, addressing the need to update the funding mechanisms for chemotherapy drugs in light of recent changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This legislative instrument was created under subsection 100(2) of the National Health Act 1953, enabling the Minister to make special arrangements for the supply of pharmaceutical benefits. The policy objective is to enhance efficiency in the funding of chemotherapy treatments, ensuring they reflect contemporary clinical practices and patient needs. By aligning the special arrangement with the latest updates on the Pharmaceutical Benefits Scheme, the instrument aims to maintain the accessibility and affordability of essential cancer treatments for eligible patients. This amendment involves modifying the circumstances under which prescriptions for certain chemotherapy drugs can be written and includes the addition and deletion of specific drug forms, ensuring that the Special Arrangement remains consistent with the current listings on the Pharmaceutical Benefits Scheme. The amendments are designed to respond to the evolving landscape of cancer treatment and associated medications, facilitating effective and equitable access to necessary pharmaceutical benefits for patients undergoing cancer treatment.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2020 (No. 9) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, with the primary purpose of aligning the special arrangement for the efficient funding of chemotherapy with updates to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This amendment applies to the supply of chemotherapy pharmaceutical benefits and related pharmaceutical benefits, specifically those used in the treatment of cancer and its side-effects at certain public hospitals. The changes include the addition and deletion of pharmaceutical forms and the alteration of circumstances for prescribing specific drugs such as atezolizumab, bevacizumab, and topotecan, reflecting the broader adjustments in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The amendment is effective from 1 November 2020 and is designed to ensure that the special arrangement remains current and effective in meeting the health needs of eligible patients. The process involved extensive consultation with the Pharmaceutical Benefits Advisory Committee and relevant stakeholders, ensuring the recommendations and subsequent legislative changes are evidence-based and aligned with national health objectives.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2020 (No. 9) (section 3) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011) to ensure that the Special Arrangement accurately reflects changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (section 3). These amendments, detailed in Schedule 1, involve the addition and deletion of a form for specific drugs and the alteration of circumstances for prescribing certain pharmaceutical benefits available on the Special Arrangement. The obligations imposed by this Instrument on parties or entities include ensuring that the supply of chemotherapy pharmaceutical benefits to eligible patients, and related pharmaceutical benefits at certain public hospitals, aligns with the amended Special Arrangement (section 1). Pharmaceutical companies and healthcare providers must comply with the new prescription criteria for atezolizumab, bevacizumab, and topotecan, and adhere to the new form requirements for topotecan and the deletion of a form for oxaliplatin. Additionally, healthcare professionals must incorporate the Eastern Cooperative Oncology Group (ECOG) performance status and Child Pugh Score documents when prescribing atezolizumab, as specified in the amended arrangement (Schedule 1). Breach of the provisions of this Instrument may result in civil or criminal consequences, although specific penalties are not outlined in the text. Given the nature of the changes, non-compliance could potentially impact the efficiency of funding and the availability of necessary pharmaceutical benefits for cancer patients, thereby affecting the quality of patient care. The precise penalties for non-compliance would depend on the nature of the breach and the applicable laws governing the Pharmaceutical Benefits Scheme (PBS). The Instrument also emphasises the importance of consultation with relevant stakeholders, including the Pharmaceutical Benefits Advisory Committee (PBAC) and pharmaceutical companies, to ensure that the amendments reflect the latest evidence-based practices and are in line with the objectives of the National Health Act 1953 (subsection 100(1)). This ongoing consultation process ensures that the Special Arrangement remains effective and responsive to the needs of patients and healthcare providers.

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