National Health (Highly specialised drugs program for public hospitals) Special Arrangements Amendment Instrument 2010 (No. 2) (No. PB 83 of 2010)

Administered by Department of Health, Disability and Ageing

Legislation au F2010L02266 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

INSTRUMENT NUMBER PB 83 of 2010

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (HIGHLY SPECIALISED DRUGS PROGRAM FOR PUBLIC HOSPITALS) SPECIAL ARRANGEMENTS AMENDMENT INSTRUMENT 2010 (No. 2)

 

 

Summary

This legislative instrument in giving effect to recommendations of the Pharmaceutical Benefits Advisory Committee (PBAC) amends Highly Specialised Drugs Program Arrangements under subparagraph 100(b)(i) made by legislative instrument number
PB 63 of 2010 which came into effect on 1 July 2010.  The amendments provide for changes to highly specialised drugs available at public hospitals to non-admitted patients, day admitted patients or patients on discharge.  The amendments are set out in the items of Schedule 1 to the instrument.

Purpose and operation

Part VII of the National Health Act 1953 (the Act) is the legislative basis of the Pharmaceutical Benefits Scheme (PBS) by which the Commonwealth provides reliable, timely, and affordable access to a wide range of medicines for all Australians.

Subsection 85(1) provides that benefits are to be provided by the Commonwealth in accordance with Part VII in respect of pharmaceutical benefits.

Drugs and medicinal preparations to which Part VII applies are (with the exception of some medicinal preparations with additives) declared by the Minister by legislative instrument to be so under subsection 85(2). These are listed drugs as defined in subsection 84(1).

Subsection 100(1) of the Act provides that the Minister may make special arrangements for providing that an adequate supply of special pharmaceutical products will be available to persons:                

(a) who are living in isolated areas; or

(b) who are receiving medical treatment in such circumstances that pharmaceutical
benefits: 

(i) cannot be conveniently or efficiently supplied in accordance with Part VII of the Act; or

(ii) are inadequate for that medical treatment.

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) provides that Part VII of the Act has effect subject to a special arrangement made under subsection 100(1).

The declaration made under subsection 85(2) of the Act sets out the drugs and medicinal preparations to which Part VII of the Act applies.  Under subsection 100AA(1)(c) a special pharmaceutical product, for which special arrangements may be made under section 100, includes a drug or medicinal preparation declared under  subsection 85(2) of the Act.  Schedule 6 of the declaration under subsection 85(2) lists those drugs and medicinal preparations that may be made available under arrangements provided for by section 100 of the Act.

The Highly Specialised Drugs Program is a set of Arrangements made under subparagraph 100(b)(i) of the Act for the purpose of providing that an adequate supply of special pharmaceutical products will be available to persons who are receiving treatment with highly specialised drugs at public hospitals as non-admitted patients, day admitted patients or patients on discharge.

These Arrangements constitute a legislative instrument for the purposes of the Legislative Instruments Act 2003.

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

This instrument, expressed to commence on 1 September 2010, was made on 6 August 2010.


Consultations

The Pharmaceutical Benefits Advisory Committee (PBAC) is the independent expert body, established by section 100A of the Act, which makes recommendations to the Minister for Health and Ageing about which drugs and medicinal preparations should be available as pharmaceutical benefits.  Under subsection 101(4) of the Act, a drug or medicinal preparation may not be declared to be a drug or medicinal preparation to which Part VII of the Act applies unless the PBAC has recommended that it be so declared.  When recommending a medicine be listed on the PBS, the 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.

PBAC members are selected 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 the PBAC, and that would enable them to contribute meaningfully to the deliberations of the PBAC.

The Commonwealth/State Highly Specialised Drugs Working Party (HSDWP) is a non-statutory body established by the Australian Health Ministers Advisory Council (AHMAC).  The HSDWP makes recommendations to the PBAC on the suitability of certain drugs for listing under the Highly Specialised Drugs Program.  The HSDWP considers the funding and administrative aspects of supply through the hospital system, and a recommendation for listing must be supported by a majority of Working Party members.  The HSDWP consists of representatives from State and Territory Health Departments and the Australian Private Hospitals Association, and is chaired by a representative of the Commonwealth Department of Health and Ageing.


ATTACHMENT

Paragraph 1:  provides that this instrument commences on 1 September 2010.

Paragraph 2:  provides that Schedule 1 amends PB 63 of 2010.

Schedule 1: provides for the following amendments: 

 

SCHEDULE 2

Deletion of Form

Ritonavir

Capsule 100 mg

 

Overview

The National Health (Highly Specialised Drugs Program for Public Hospitals) Special Arrangements Amendment Instrument 2010 (No. 2), enacted by the Australian Government, amends the Highly Specialised Drugs Program Arrangements under the National Health Act 1953 to update the list of drugs available to non-admitted patients, day admitted patients, or patients on discharge at public hospitals. This amendment was introduced in response to the recommendations of the Pharmaceutical Benefits Advisory Committee (PBAC) and aims to ensure that patients have access to necessary highly specialised drugs. The amendments are set out in Schedule 1 to the instrument and commenced on 1 September 2010. The PBAC, an independent expert body established under the Act, plays a crucial role in recommending which drugs should be included in the Pharmaceutical Benefits Scheme, ensuring they meet criteria of clinical effectiveness, safety, and cost-effectiveness. This legislative instrument underscores the commitment to providing timely and affordable access to a wide range of medicines for all Australians, particularly those in need of highly specialised drugs.

Scope and Application

The National Health (Highly Specialised Drugs Program for Public Hospitals) Special Arrangements Amendment Instrument 2010 (No. 2) amends the Highly Specialised Drugs Program Arrangements under the National Health Act 1953, specifically targeting the provision of highly specialised drugs available at public hospitals to non-admitted patients, day admitted patients, or patients on discharge. This instrument applies to the Commonwealth, state, and territory jurisdictions as it is a legislative amendment under the National Health Act 1953. The amendments are made to align with the recommendations of the Pharmaceutical Benefits Advisory Committee (PBAC). The Act applies to drugs and medicinal preparations declared by the Minister under subsection 85(2) of the National Health Act 1953, which are listed drugs as defined in subsection 84(1). This instrument does not include any stated exclusions, exemptions, or thresholds but provides for the specific changes to the Highly Specialised Drugs Program. The amendments are detailed in Schedule 1 of the instrument, which came into effect on 1 September 2010.

Key Provisions

The National Health (Highly Specialised Drugs Program for Public Hospitals) Special Arrangements Amendment Instrument 2010 (No. 2) amends the Highly Specialised Drugs Program Arrangements under subparagraph 100(b)(i) of the National Health Act 1953 (the Act). These amendments, effective from 1 September 2010, adjust the list of highly specialised drugs available to non-admitted patients, day admitted patients, or patients on discharge at public hospitals. The changes are detailed in Schedule 1 to the instrument. This amendment follows recommendations from the Pharmaceutical Benefits Advisory Committee (PBAC) and updates the list of drugs available under the Highly Specialised Drugs Program. The Act, under section 100(1), allows the Minister to create special arrangements to ensure an adequate supply of special pharmaceutical products for certain patients. These arrangements are necessary when the standard pharmaceutical benefits under Part VII of the Act are either not conveniently or efficiently supplied or are inadequate for the medical treatment required. The Minister can also vary or revoke these arrangements as needed. The Highly Specialised Drugs Program is an example of such special arrangements, ensuring that patients in public hospitals receive the necessary highly specialised drugs. The amendments imposed by this instrument are designed to align the Highly Specialised Drugs Program with current medical needs and recommendations from the PBAC. By adjusting the list of available drugs, the Act ensures that patients receive the most effective and necessary treatments. The changes are detailed in Schedule 1, which specifies the drugs being added to or removed from the program. This ensures that the program remains up-to-date and effective in meeting the medical needs of patients in public hospitals. The Act does not explicitly outline specific offences, penalties, or consequences for breaches within this context. However, any failure to comply with the provisions of the Act or the special arrangements could potentially lead to legal consequences under the general provisions of the National Health Act 1953. These might include actions for non-compliance or failure to provide necessary treatments, which could result in civil or administrative penalties. The precise penalties would depend on the nature and severity of the breach, as well as the specific provisions of the Act that are contravened.

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