National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2021 (No. 1) (PB 5 of 2021)

Administered by Department of Health, Disability and Ageing

Legislation au F2021L00081 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 2021 (No. 1)

PB 5 of 2021

 

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 addition of two brands of existing pharmaceutical items and the alteration of circumstances in which a prescription may be written for the supply of the listed drug carfilzomib.  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 February 2021.

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 2021 (No. 1)

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 2021 (No. 1) and may also be cited as PB 5 of 2021.

Section 2 Commencement

This section provides that this Instrument commences on 1 February 2021.

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 of brands, and the alteration of circumstances for prescribing a pharmaceutical benefit 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

Brands Added

Listed Drug

Form

Ondansetron

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

 

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

Alteration of Circumstances in Which a Prescription May be Written

Listed Drug

Carfilzomib

 

 


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 2021 (No. 1)

(PB 5 of 2021)

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 of brands, and the alteration of circumstances for prescribing a pharmaceutical benefit 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 2021 (No. 1) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, which itself was designed to enhance the efficiency of payments for chemotherapy medicines and related treatments for cancer patients. This amendment was necessitated by changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, ensuring that the Special Arrangement reflects current legislative updates. The Instrument was made under subsection 100(2) of the National Health Act 1953, enabling the Minister to vary or revoke special arrangements. The primary objective of this amendment is to incorporate the updated listings and prescription conditions into the Special Arrangement, thereby maintaining the scheme's alignment with current healthcare standards and requirements.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2021 (No. 1) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011, implementing changes to the efficient funding of chemotherapy medicines. This Instrument applies to the supply of injected or infused chemotherapy medicines and medicines associated with the side effects of cancer and cancer treatment at certain public hospitals. The amendments ensure the Special Arrangement accurately reflects changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which also commence on the same day. Specifically, the Instrument adds two brands of existing pharmaceutical items and alters the circumstances under which a prescription may be written for the supply of the listed drug carfilzomib. This legislative instrument is applicable nationally, under the purview of the National Health Act 1953, and is subject to any specific exclusions, exemptions, or thresholds outlined within the Act. The application of this Instrument may be further refined or extended through subordinate instruments made under the authority of the Act.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2021 (No. 1) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (the Special Arrangement) to enhance the efficiency of funding for chemotherapy treatments and related pharmaceutical benefits (sections 1, 3). The Special Arrangement aims to improve the payment process for chemotherapy drugs, reflecting changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. Specifically, the Instrument modifies the Special Arrangement to include two new brands of pharmaceutical items and alter the circumstances under which a prescription may be written for the listed drug carfilzomib (Schedule 1). The obligations imposed by the Act on the relevant parties include ensuring that the supply of chemotherapy drugs and related pharmaceutical benefits is efficient and reflects the changes in the Pharmaceutical Benefits Scheme (PBS). This involves adhering to the recommendations of the Pharmaceutical Benefits Advisory Committee (PBAC) and ensuring that the Special Arrangement is updated to align with the latest amendments in the PBS listing (sections 100(1), 100(2), 100(3)). The Instrument does not explicitly outline specific offences, penalties, or consequences for breaches. However, non-compliance with the provisions of the Special Arrangement could potentially result in legal consequences under the broader framework of the National Health Act 1953. The Act provides for various enforcement mechanisms, including administrative actions, fines, and other penalties for non-compliance with the Act’s provisions (sections 100(2), 100(3)). The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in ensuring that the decisions regarding the listing of medicines on the PBS are evidence-based, thereby safeguarding the integrity of the Scheme.

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