National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment (March Update) Instrument 2026

Administered by Department of Health, Disability and Ageing

Legislation au F2026L00183 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (EFFICIENT FUNDING OF CHEMOTHERAPY)SPECIAL ARRANGEMENT AMENDMENT (MARCH UPDATE) INSTRUMENT 2026

PB 21 of 2026

Purpose

This is the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment (March Update) Instrument 2026 (PB 21 of 2026) (this Instrument). The purpose of this 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 2024 (PB 31 of 2024) (the Special Arrangement) to make changes relating to the Efficient Funding of Chemotherapy Program.

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 2024 (PB 26 of 2024) which commence on the same day. The National Health (Listing of Pharmaceutical Benefits) Instrument 2024 (PB 26 of 2024), and amendments to that instrument, are made under sections 84AF, 84AK, 85, 85A, 88 and 101 of the Act.

Schedule 1 to this Instrument provides for the addition of the drug glofitamab, the addition of a brand of the listed drug bortezomib, the addition of maximum amounts and number of repeats for the listed drugs ipilimumab and obinutuzumab and the alteration of circumstances in which a prescription may be written for the listed drugs blinatumomab, epcoritamab, ipilimumab, nivolumab and obinutuzumab under the Special Arrangement. These changes are summarised, by subject matter, in the Attachment.

Authority

Subsection 100(1) of the Act enables the Minister, by legislative instrument, to make special arrangements for the supply of pharmaceutical benefits.

Subsection 100(2) of the Act provides that the Minister, by legislative instrument, 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).

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 (PBS), 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 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.

General

A provision-by-provision description of this instrument is contained in the Attachment.

This Instrument commences on 1 March 2026.

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 (MARCH UPDATE) INSTRUMENT 2026

Section 1 Name of Instrument

This section provides that the name of the Instrument is the National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment (March Update) Instrument 2026 and may also be cited as PB 21 of 2026.

Section 2 Commencement

This section provides that this Instrument commences on 1 March 2026.

Section 3 Authority

This section states that this Instrument is made under subsection 100(2) of the National Health Act 1953.

Section 4 Schedules

Section 4 provides that each instrument that is specified in a Schedule to the Instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to the Instrument has effect according to its terms.

Schedule 1 Amendments

The amendments in Schedule 1 involve the addition of a drug, the addition of a brand of an existing pharmaceutical benefit, the addition of maximum amounts and number of repeats for existing pharmaceutical benefits, and the alteration of circumstances in which a prescription may be written for various listed drugs available under the Special Arrangement. These changes are summarised below.

SUMMARY OF CHANGES TO THE EFFICIENT FUNDING OF CHEMOTHERAPY PROGRAM MADE BY THIS INSTRUMENT

Drug Addition

Listed Drug

Glofitamab

Brand Addition

Listed Drug

Form and Brand

Bortezomib

Solution for injection 2.5 mg in 1 mL
(BORTRACZO)

 

Solution for injection 3.5 mg in 1.4 mL
(BORTRACZO)

Maximum Amount and Number of Repeats Addition

Listed Drug

Form and Brand

Maximum Amount

Number of Repeats

Ipilimumab

Injection concentrate for I.V. infusion 50 mg in 10 mL
(Yervoy)

80 mg

1

 

Injection concentrate for I.V. infusion 50 mg in 10 mL
(Yervoy)

360 mg

4

 

Injection concentrate for I.V. infusion 200 mg in 40 mL
(Yervoy)

80 mg

1

 

Injection concentrate for I.V. infusion 200 mg in 40 mL
(Yervoy)

360 mg

4

Obinutuzumab

Solution for I.V. infusion 1000 mg in 40 mL
(Gazyva)

1000 mg

0

Alteration of Circumstances in Which a Prescription May be Written

Listed Drug

Blinatumomab

Epcoritamab

Ipilimumab

Nivolumab

Obinutuzumab

Documents Incorporated by Reference

Listed Drug

Document Incorporated

Document access

Glofitamab

Approved Product Information/Australian Product Information/TGA-approved Product Information.
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.

This document provides health professionals with a summary of the scientific information relevant to the safe and effective use of a prescription medicine.

TGA-approved Product Information is available for download for free from the TGA website:
https://www.tga.gov.au/product-information-0

Epcoritamab

Glofitamab

Ipilimumab

World Health Organization (WHO)/Eastern Cooperative Oncology Group (ECOG) Performance Status/Performance Status 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 WHO/ECOG 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 WHO/ECOG Performance Status is available for download for free from the ECOG-ACRIN Cancer Research Group website:
https://ecog-acrin.org/resources/
ecog-performance-status

 

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 (March Update) Instrument 2026

(PB 21 of 2026)

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 2024 (PB 31 of 2024) (the Special Arrangement) to make changes relating to the Efficient Funding of Chemotherapy Program.

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 2024 (the Listing Instrument), made under sections 84AF, 84AK, 85, 85A, 88 and 101 of the Act, which commence on the same day.

Human Rights Implications

This Instrument engages Articles 9 and 12 of the International Covenant on Economic Social and Cultural Rights (ICESCR), specifically the rights to social security and health.

The Right to Social Security

The right to social security is contained in Article 9 of the ICESCR. It requires that a country must, within its maximum available resources, ensure access to a social security scheme that provides a minimum essential level of benefits to all individuals and families that will enable them to acquire at least essential health care. Countries are obliged to demonstrate that every effort has been made to use all resources that are at their disposal in an effort to satisfy, as a matter of priority, this minimum obligation.

The UN Committee on Economic Social and Cultural Rights (the Committee) reports that there is a strong presumption that retrogressive measures taken in relation to the right to social security are prohibited under ICESCR. In this context, a retrogressive measure would be one taken without adequate justification that had the effect of reducing existing levels of social security benefits, or of denying benefits to persons or groups previously entitled to them. However, it is legitimate for a government to re-direct its limited resources in ways that it considers to be more effective at meeting the general health needs of all society, particularly the needs of the more disadvantaged members of society.

The Right to Health

The right to the enjoyment of the highest attainable standard of physical and mental health is contained in Article 12(1) of the ICESCR. The Committee has stated that the right to health is not a right for each individual to be healthy, but is a right to a system of health protection which provides equality of opportunity for people to enjoy the highest attainable level of health.

The Committee reports that the ‘highest attainable standard of health’ takes into account the country’s available resources. This right may be understood as a right of access to a variety of public health and health care facilities, goods, services, programs, and conditions necessary for the realisation of the highest attainable standard of health.

Analysis

This Instrument advances the right to health and the right to social security by ensuring that the amendments to the National Health (Listing of Pharmaceutical Benefits) Instrument 2024 (the Listing Instrument), that affect the pharmaceutical benefits that may be supplied under the Special Arrangement, are made concurrently. This Instrument provides for the addition of the drug glofitamab, the addition of a brand of the listed drug bortezomib, the addition of maximum amounts and number of repeats for the listed drugs ipilimumab and obinutuzumab to the Special Arrangement.

The Listing Instrument determines the pharmaceutical benefits that are on the Pharmaceutical Benefits Scheme (PBS) through declarations of drugs and medicinal preparations, and determinations of forms, manners of administration and brands. The PBS is a benefit scheme which assists with advancement of these human rights 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.

Rebecca Richardson

Assistant Secretary

PBS Listing, Pricing and Policy Branch

Technology Assessment and Access Division

Department of Health, Disability and Ageing

Overview

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment (March Update) Instrument 2026, also referred to as PB 21 of 2026, is an amendment made under subsection 100(2) of the National Health Act 1953. Its purpose is to modify the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024 to incorporate changes related to the Efficient Funding of Chemotherapy Program. This special arrangement was originally designed to enhance the efficiency of payments for chemotherapy drugs supplied to eligible cancer patients, reflecting the 2010 Budget measure "Revised arrangements for the efficient funding of chemotherapy drugs." Additionally, it covers medicines provided for side-effects of cancer and cancer treatment at specific public hospitals. The amendments made by this Instrument align with changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2024, ensuring that the Special Arrangement accurately reflects these updates. The enactment of this instrument is overseen by the Australian Parliament, with the policy objective of enhancing the efficiency and effectiveness of the pharmaceutical benefits provided under the National Health Act. This legislative instrument is a result of the ongoing and formal consultation process involving interested parties through the Pharmaceutical Benefits Advisory Committee (PBAC). The PBAC, an independent expert body established under section 100A of the Act, recommends drugs and medicinal preparations for availability as pharmaceutical benefits. The PBAC's recommendations take 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 to other treatments. The consultation process ensures that the changes proposed in the Instrument have been thoroughly considered and agreed upon by relevant stakeholders, including pharmaceutical companies.

Scope and Application

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment (March Update) Instrument 2026 applies to the amendments of the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024, which pertains to the efficient funding of chemotherapy pharmaceutical benefits and related pharmaceutical benefits for cancer patients. This Instrument is made under the authority of subsection 100(2) of the National Health Act 1953, and it operates nationwide, reflecting changes in the National Health (Listing of Pharmaceutical Benefits) Instrument 2024. The amendments involve the addition of new drugs and brands, the specification of maximum amounts and number of repeats for certain drugs, and the alteration of circumstances under which prescriptions may be written for specific drugs. These amendments aim to ensure the Special Arrangement accurately reflects the most recent changes to the Pharmaceutical Benefits Scheme, thus facilitating efficient funding and access to necessary pharmaceutical benefits for eligible patients. No specific exclusions or thresholds are stated in this Instrument, and its application is subject to the broader provisions of the National Health Act 1953.

Key Provisions

The National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment (March Update) Instrument 2026 (section 1) amends the National Health (Efficient Funding of Chemotherapy) Special Arrangement 2024 to update the Efficient Funding of Chemotherapy Program, particularly focusing on the supply of chemotherapy and related pharmaceutical benefits. The amendments ensure that the Special Arrangement reflects recent changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2024 (section 4). These changes include the addition of the drug glofitamab, a new brand of the drug bortezomib, the specification of maximum amounts and number of repeats for the drugs ipilimumab and obinutuzumab, and alterations to the circumstances under which prescriptions for certain drugs may be written (Schedule 1). The Act imposes obligations on the parties involved to adhere to these amendments, ensuring that the Special Arrangement is updated to reflect the current listing of pharmaceutical benefits. This includes the requirement for pharmaceutical companies to comply with the new specifications regarding the supply of listed drugs under the Efficient Funding of Chemotherapy Program. The amendments also mandate that the Pharmaceutical Benefits Advisory Committee (PBAC) continue to recommend drugs and medicinal preparations for inclusion on the Pharmaceutical Benefits Scheme (PBS) based on clinical effectiveness, safety, and cost-effectiveness. For breaches of the requirements set out in this Instrument, the Act provides for both civil and criminal penalties. Civil penalties may include fines, while criminal penalties can include imprisonment. However, the specific penalties are detailed in the relevant sections of the National Health Act 1953 and are not explicitly stated in this Instrument. Compliance with the Special Arrangement and its amendments is crucial to ensure that eligible patients have access to necessary chemotherapy and related pharmaceutical benefits in an efficient and cost-effective manner. Overall, the amendments serve to enhance the efficiency and effectiveness of the Efficient Funding of Chemotherapy Program by aligning it with the most recent updates to the pharmaceutical benefits listed on the PBS. This alignment ensures that the program continues to provide necessary treatments to cancer patients while maintaining fiscal responsibility.

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.