National Health (Highly specialised drugs program for hospitals) Special Arrangement Amendment Instrument 2011 (No. 4)(No. PB 34 of 2011)

Administered by Department of Health, Disability and Ageing

Legislation au F2011L00643 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

Issued by Authority of the Minister for Health and Ageing

 

NATIONAL HEALTH ACT 1953

 

NATIONAL HEALTH (HIGHLY SPECIALISED DRUGS PROGRAM FOR HOSPITALS) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2011 (No. 4)

 

PB 34 of 2011

Purpose

The purpose of this legislative instrument, made under subsections 100(1) and 100(2) of the National Health Act 1953 (the Act), is to amend the National Health (Highly specialised drugs program for hospitals) Special Arrangement 2010 (PB 116 of 2010) (the Special Arrangement), to make changes to the special arrangement relating to the highly specialised drugs program for hospitals.

The pharmaceutical benefits supplied under the Special Arrangement are for the treatment of chronic conditions which, because of their clinical use or other special features, may only be supplied to patients receiving treatment at or from a public or private hospital having access to appropriate specialised facilities.

Section 100 special arrangements and Part VII of the Act

Subsection 100(1) enables the Minister to make special arrangements for, or in relation to, providing that an adequate supply of pharmaceutical benefits will be available to persons:

(a)  who are living in isolated areas: or

(b) who are receiving treatment in circumstances in which generally available pharmaceutical benefits  are inadequate for that treatment; or

(c) if the pharmaceutical benefits covered by the arrangements can be more conveniently or efficiently supplied under the arrangements.

Subsection 100(3) provides that Part VII of the Act, and regulations and other legislative instruments made for the purposes of Part VII have effect subject to a special arrangement made under subsection 100(1).  A section 100 arrangement may thus modify the operation of Part VII, the regulations and other relevant instruments.

Subsection 100(2) provides that the Minister may vary or revoke a special arrangement made under subsection (1). 

Changes to the Special Arrangement made by this Instrument

This instrument adds a new highly specialised drug (Levodopa with Carbidopa) and related circumstances, maximum quantities and maximum number of repeats for the pharmaceutical benefit that has that drug.

This instrument also adds a new pharmaceutical benefit that has the drug Valaciclovir and a new responsible person code for the responsible person GlaxoSmithKline Pty Ltd.

This instrument also correct a typographical error in the entry for one pharmaceutical benefit that has the drug Tocilizumab.

Details of the amendments made by this instrument are set out in the Attachment.

 

Consultation

The amendments made by this Instrument accord with recommendations made by the Pharmaceutical Benefits Advisory Committee (PBAC). 

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 PBAC.  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.  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 those interests or professions. Remaining members are persons whom the Minister is satisfied have qualifications and experience in a field relevant to the functions of PBAC, and that would enable them to contribute meaningfully to the deliberations of PBAC.  When recommending the listing of a medicine on the Pharmaceutical Benefits Scheme (PBS), PBAC takes into account the medical conditions for which the medicine has been approved for use in Australia, its clinical effectiveness, safety and cost-effectiveness compared with other treatments.

Pharmaceutical companies were consulted throughout the process of changes to the prescribing circumstances for listings on the PBS and for this Instrument.  This includes consultation through the PBAC process, and agreement to final listing details.

General

This Instrument commences on 1 May 2011.

This Instrument is a legislative instrument for the purposes of the Legislative Instruments Act 2003.

 


ATTACHMENT

PROVISION BY PROVISION DESCRIPTION OF THE NATIONAL HEALTH (HIGHLY SPECIALISED DRUGS PROGRAM FOR HOSPITALS) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2011 (No.4)

 

Section 1  Name of Instrument

This section provides that this Instrument is the National Health (Highly specialised drugs program for hospitals) Special Arrangement Amendment Instrument 2011(No. 4) and that it may also be cited as PB 34 of 2011.

Section 2  Commencement

This section provides that this Instrument commences on 1 May 2011.

Section 3   Amendments to PB 116 of 2010

This section provides that Schedule 1 amends the National Health (Highly specialised drugs program for hospitals) Special Arrangement 2010 (PB 116 of 2010) (the Principal Instrument). 

Schedule 1

Item 1 amends Schedule 1 of the Principal Instrument to insert a new entry for a pharmaceutical benefit with the newly listed drug Levodopa with Carbidopa.

Item 2 amends Schedule 1 of the Principal Instrument to correct a typographical error in the maximum quantity column in the entry for the pharmaceutical benefit that has the listed drug Tocilizumab in the form Concentrate for injection 400 mg in 20 mL.

Item 3 amends Schedule 1 of the Principal Instrument to add a new brand (Zelitrex) for the listed drug Valaciclovir in the form Tablet 500 mg (as hydrochloride).

Item 4 amends Schedule 2 of the Principal Instrument to insert a new responsible person code (RE) for the responsible person GlaxoSmithKline Pty Ltd. This responsible person will now be represented by both the codes ‘GK’ or ‘RE’ in the Principal Instrument.

Item 5 amends Schedule 3 of the Principal Instrument to insert circumstances in which pharmaceutical benefits with the newly listed drug Levodopa with Carbidopa may be prescribed under this Special Arrangement.

 

Overview

The National Health (Highly Specialised Drugs Program for Hospitals) Special Arrangement Amendment Instrument 2011 (No. 4) was enacted to amend the National Health (Highly Specialised Drugs Program for Hospitals) Special Arrangement 2010. This amendment was introduced to address the need for changes to the special arrangement relating to the highly specialised drugs program for hospitals, as provided under the National Health Act 1953. The Minister for Health and Ageing, who has the authority under subsections 100(1) and 100(2) of the National Health Act 1953, made this legislative instrument. The policy objective is to ensure that an adequate supply of pharmaceutical benefits is available for patients receiving treatment in circumstances where generally available pharmaceutical benefits are inadequate for their treatment. This legislative instrument introduces new highly specialised drugs, corrects typographical errors, and updates responsible person codes to ensure the continued provision of necessary treatments within the program.

Scope and Application

The National Health (Highly Specialised Drugs Program for Hospitals) Special Arrangement Amendment Instrument 2011 (No. 4) amends the National Health (Highly Specialised Drugs Program for Hospitals) Special Arrangement 2010, providing adjustments to the highly specialised drugs program for hospitals. The changes introduced by this instrument involve modifications to the pharmaceutical benefits available under the program, including the addition of a new drug, Levodopa with Carbidopa, and the correction of a typographical error in the listing for Tocilizumab. Furthermore, a new pharmaceutical benefit for Valaciclovir is introduced, and a new responsible person code is assigned to GlaxoSmithKline Pty Ltd. These amendments are made under the authority granted by subsections 100(1) and 100(2) of the National Health Act 1953, which allows the Minister to establish special arrangements for the provision of pharmaceutical benefits to individuals in specific circumstances, such as those receiving treatment in hospitals where generally available pharmaceutical benefits are inadequate. The instrument is applicable nationwide and comes into effect on 1 May 2011.

Key Provisions

The National Health (Highly specialised drugs program for hospitals) Special Arrangement Amendment Instrument 2011 (No. 4) amends the existing special arrangement to include changes concerning highly specialised drugs for hospital use, as outlined in the National Health Act 1953 (the Act). This amendment introduces new provisions to cater for the pharmaceutical benefit of Levodopa with Carbidopa, corrects a typographical error for Tocilizumab, and includes Valaciclovir and its associated responsible person GlaxoSmithKline Pty Ltd in the special arrangement. These amendments are made under the authority provided by sections 100(1) and 100(2) of the Act, enabling the Minister to make special arrangements for providing pharmaceutical benefits in specific circumstances. The Act imposes obligations on various parties involved in the highly specialised drugs program for hospitals. Pharmaceutical companies such as GlaxoSmithKline Pty Ltd, which are designated as responsible persons, must ensure that the drugs they supply comply with the special arrangement and the legislative requirements. Healthcare providers, including hospitals, must adhere to the prescribed circumstances, maximum quantities, and number of repeats for the pharmaceutical benefits as outlined in the amended special arrangement. The Pharmaceutical Benefits Advisory Committee (PBAC), an independent body appointed by the Minister, plays a crucial role in recommending which drugs should be included in the special arrangement based on factors like clinical effectiveness, safety, and cost-effectiveness. Failure to comply with the provisions of the special arrangement may result in civil or criminal consequences. While the exact penalties for breach are not specified in the explanatory statement, it is implied that breaches of the National Health Act 1953 and its associated regulations may lead to legal actions, fines, or other penalties as determined by the relevant authorities. The specific penalties would depend on the nature and severity of the breach, as well as the provisions of the Act and any applicable regulations or guidelines. In summary, the National Health (Highly specialised drugs program for hospitals) Special Arrangement Amendment Instrument 2011 (No. 4) amends the existing special arrangement to include new highly specialised drugs for hospital use, imposes obligations on pharmaceutical companies and healthcare providers, and may result in civil or criminal consequences for non-compliance with the provisions of the Act and the special arrangement. The changes are made in consultation with relevant stakeholders, including the PBAC, and are intended to improve the availability and efficiency of pharmaceutical benefits for patients requiring treatment in hospitals.

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