National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2021 (No.4)

Administered by Department of Health, Disability and Ageing

Legislation au F2021L00526 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. 4)

PB 43 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 deletion 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 trastuzumab emtansine.  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 May 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. 4)

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. 4) and may also be cited as PB 43 of 2021.

Section 2 Commencement

This section provides that this Instrument commences on 1 May 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 deletion 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 Deleted

Listed Drug

Form

Epirubicin

Solution for injection containing epirubicin hydrochloride 50 mg in 25 mL (Epirubicin ACT)

 

Solution for injection containing epirubicin hydrochloride 200 mg in 100 mL (Epirubicin ACT)

Alteration of Circumstances in Which a Prescription May be Written

Listed Drug

Trastuzumab emtansine

 

 


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. 4)

(PB 43 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 deletion 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. 4) (PB 43 of 2021) was enacted to amend the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011) under subsection 100(2) of the National Health Act 1953. This legislative instrument aims to make changes to the efficient funding of chemotherapy, reflecting updates to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The purpose of this amendment is to ensure that the Special Arrangement accurately mirrors recent changes to the Pharmaceutical Benefits Scheme, which includes deleting certain brands and altering the circumstances under which certain drugs can be prescribed. The policy objective is to enhance the efficiency of funding for chemotherapy treatments and related pharmaceutical benefits in public hospitals. The amendments, detailed in Schedule 1, involve the removal of specific brands of chemotherapy drugs and changes to the prescribing criteria for trastuzumab emtansine. The instrument was developed following extensive consultation with the Pharmaceutical Benefits Advisory Committee, which includes experts from various relevant fields, ensuring that recommendations for changes to the Pharmaceutical Benefits Scheme are evidence-based. This process ensures that the amendments align with the broader objective of providing efficient and effective healthcare funding, while also being compatible with human rights as recognised in the International Covenant on Economic, Social and Cultural Rights.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2021 (No. 4) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 to update the efficient funding of chemotherapy drugs. The Instrument operates under the authority of the National Health Act 1953, specifically subsection 100(2) of the Act, which allows the Minister to vary or revoke special arrangements for the supply of pharmaceutical benefits. This amendment reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which also commence on the same day. The changes include the deletion of two brands of pharmaceutical items and the alteration of circumstances in which a prescription may be written for the supply of trastuzumab emtansine. These modifications are intended to ensure the Special Arrangement accurately reflects the current state of pharmaceutical benefits. The Special Arrangement applies to the supply of injected or infused chemotherapy medicines and related pharmaceutical benefits for the treatment of cancer and its side-effects at certain public hospitals. The changes introduced by the Instrument are designed to enhance the efficiency of payments under the Pharmaceutical Benefits Scheme (PBS), ensuring that eligible patients receive appropriate and timely access to necessary treatments. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a key role in recommending which drugs and medicinal preparations should be available as pharmaceutical benefits, ensuring that decisions are evidence-based and take into account clinical effectiveness, safety, and cost-effectiveness. The amendments do not extend beyond what is necessary to align with the changes to the listing of pharmaceutical benefits, and there are no stated exclusions or exemptions within this specific Instrument. The amendments commence on 1 May 2021, as per the commencement section of the Instrument.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2021 (No. 4) (PB 43 of 2021) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2011 (PB 79 of 2011), which relates to the efficient funding of chemotherapy drugs and medicines associated with the side-effects of cancer and cancer treatment at certain public hospitals. The purpose of the Instrument is to ensure that the Special Arrangement accurately reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012). This amendment involves the deletion of two brands of chemotherapy drugs and altering the circumstances under which a prescription may be written for the supply of the drug trastuzumab emtansine. The Instrument imposes several obligations and requirements on the parties it governs. Firstly, it requires the deletion of two brands of chemotherapy drugs from the Special Arrangement, ensuring that only the updated brands are available for supply. Secondly, it mandates the alteration of prescribing circumstances for the drug trastuzumab emtansine, providing clear guidelines on the conditions under which this drug can be prescribed. These changes aim to streamline the process of funding and supplying chemotherapy drugs, ensuring that only the most effective and updated treatments are available to patients. Regarding consequences for breach, the Act does not specify any specific offences, penalties, or consequences for non-compliance with the Instrument. However, as a legislative instrument, any failure to adhere to the requirements of this amendment could potentially result in legal actions under the broader provisions of the National Health Act 1953. Non-compliance might lead to disputes or claims regarding the funding and supply of chemotherapy drugs, which would be addressed through the relevant legal frameworks and judicial processes. In summary, the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2021 (No. 4) modifies the Special Arrangement to reflect changes in the pharmaceutical benefits listing, ensuring the efficient funding of chemotherapy drugs and associated medicines. It mandates the deletion of outdated brands and alters prescribing conditions for certain drugs. While specific penalties for non-compliance are not detailed in the Instrument, any breaches could be addressed under the general provisions of the National Health Act 1953.

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