National Health (Highly specialised drugs program) Special Arrangement Amendment Instrument 2017 (No. 4) (PB 39 of 2017)

Administered by Department of Health, Disability and Ageing

Legislation au F2017L00634 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

NATIONAL HEALTH ACT 1953

 

NATIONAL HEALTH (HIGHLY SPECIALISED DRUGS PROGRAM) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2017 (No. 4)

 

PB 39 of 2017

 

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

This is the National Health (Highly specialised drugs program) Special Arrangement Amendment Instrument 2017 (No. 4) (the Amending Instrument).  The purpose of the Amending Instrument is to amend the National Health (Highly specialised drugs program) Special Arrangement 2010 (PB 116 of 2010) (the Special Arrangement), to make changes to the Special Arrangement relating to the Highly Specialised Drugs (HSD) program.

The amendment made by this Instrument reflects amendments to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which commence on the same day.

The amendments in PB 39 of 2017 include addition and deletion of brands, changes to circumstances for prescribing, delisting a listed drug and amendments to the criteria for eligibility for drugs for the treatment of chronic hepatitis C. 

These changes are summarised, by drug name, in the Attachment.

A provision by provision Description of this instrument is contained 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), 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.

Pharmaceutical companies were consulted throughout the process of changes to the listings on the PBS.  This includes consultation through the PBAC process.  Further consultation for this Instrument was considered unnecessary due to the nature of the consultation that had already taken place in the decision to list the medication. 

Details of the instrument are set out in the Attachment.

This Instrument commences on 1 June 2017.

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


ATTACHMENT

Details of the National Health (Highly specialised drugs program) Special Arrangement Amendment Instrument 2017

PART 1 PRELIMINARY

Section 1 Name of Instrument
This section provides the name of this instrument as the National Health (Highly specialised drugs program) Special Arrangement Amendment Instrument 2017 (No. 4).  It can also be cited as PB 39 of 2017.

 

Section 2 Commencement
This section provides that this instrument commences on 1 June 2017.

 

Section 3 Amendment
This section provides that the Schedule amends the National Health (Highly specialised drugs program) Special Arrangement 2010 (PB 116 of 2010).

 

SCHEDULE

 

Items 1 to 9 Schedule 1 and Schedule 3

Items 1 to 9 provide for addition and deletion of brands, changes to circumstances for prescribing and deletion of a listed drug. 

 

Listed Drug

Type of Change

Abatacept

Remodelled restrictions

Baclofen

Addition of new brand; remodelled restrictions

Infliximab

Remodelled restrictions

Nevirapine

Deletion of brand

Ribavirin and Peginterferon Alfa-2b

Deletion of listed drug

 

Item 10 Schedule 3 Part 1—General statement for drugs for the treatment of  

                             hepatitis C

Item 10 amends Schedule 3 Part of 1 of the Special Arrangement to reinsert the requirement for a stated specialist to have experience in treating patients with chronic hepatitis C infection and to remove the existing error requiring a medical practitioner to be one of the stated specialists. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Overview

The National Health (Highly Specialised Drugs Program) Special Arrangement Amendment Instrument 2017 (No. 4) was enacted to make changes to the National Health (Highly specialised drugs program) Special Arrangement 2010, which governs the Highly Specialised Drugs (HSD) program under the National Health Act 1953. This legislation was introduced to align the HSD program with amendments to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, ensuring consistency and effectiveness in the supply of pharmaceutical benefits. The instrument was authorised by the Minister under subsection 100(1) of the National Health Act 1953 and was developed following recommendations from the Pharmaceutical Benefits Advisory Committee (PBAC), an independent expert body established to advise the Minister on the listing of drugs as pharmaceutical benefits. The policy objective of these amendments is to reflect changes in the Pharmaceutical Benefits Scheme (PBS) listings, including the addition and deletion of drug brands, changes in prescribing circumstances, and updates to eligibility criteria for certain treatments such as chronic hepatitis C. This legislative instrument commenced on 1 June 2017.

Scope and Application

The National Health (Highly Specialised Drugs Program) Special Arrangement Amendment Instrument 2017 (No. 4) amends the National Health (Highly Specialised Drugs Program) Special Arrangement 2010, affecting the supply of certain pharmaceutical benefits under the National Health Act 1953. This legislation applies to the Highly Specialised Drugs (HSD) program, which is part of the Pharmaceutical Benefits Scheme (PBS). It is intended to modify the eligibility criteria and prescribing conditions for specific drugs listed under the HSD program, reflecting updates to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The changes include the addition and deletion of drug brands, modifications to prescribing circumstances, and adjustments to the criteria for chronic hepatitis C treatment. These amendments are designed to ensure that the HSD program remains aligned with the latest clinical and cost-effectiveness recommendations. The Instrument applies nationally, as it is an amendment under the Commonwealth's legislative framework. The changes are effective from 1 June 2017 and are subject to potential variation or revocation by the Minister under the authority granted by the National Health Act 1953.

Key Provisions

The main operative sections of the National Health (Highly Specialised Drugs Program) Special Arrangement Amendment Instrument 2017 (No. 4) (the Instrument) are found in the Schedule, which amends the National Health (Highly Specialised Drugs Program) Special Arrangement 2010 (the Special Arrangement) (Schedule, items 1 to 9). These amendments involve the addition and deletion of brands, changes to the circumstances for prescribing, and the delisting of certain drugs (Schedule, items 1 to 9). The Instrument also amends the criteria for eligibility for drugs for the treatment of chronic hepatitis C (Schedule, item 10). This includes reinstating the requirement for a stated specialist to have experience in treating patients with chronic hepatitis C infection and correcting a requirement that a medical practitioner must be one of the stated specialists (Schedule, item 10). The Instrument imposes specific obligations and requirements on the parties and entities it governs. For instance, pharmaceutical companies and healthcare providers must adhere to the new restrictions and criteria outlined in the amended Special Arrangement. This includes ensuring that only eligible patients receive the highly specialised drugs listed under the program, subject to the specified conditions for prescribing. The amendments also require healthcare professionals to update their practices to align with the new criteria for treating chronic hepatitis C, such as ensuring that a stated specialist has the necessary experience in treating patients with chronic hepatitis C infection. Breaching the provisions of the amended Special Arrangement could result in various consequences. While the Instrument does not explicitly state specific offences, penalties, or civil/criminal consequences, violations of the National Health Act 1953 (the Act) or the amended Special Arrangement could lead to legal action. This could include civil penalties for non-compliance, such as fines, or criminal penalties if the breach is deemed serious enough. The maximum penalties for breaches of the Act are not specified in the Instrument, but they could include fines and imprisonment, depending on the severity of the breach and the discretion of the court. In summary, the National Health (Highly Specialised Drugs Program) Special Arrangement Amendment Instrument 2017 (No. 4) introduces amendments to the Special Arrangement that affect the provision and prescription of highly specialised drugs, particularly for the treatment of chronic hepatitis C. These changes impose specific obligations on pharmaceutical companies and healthcare providers to ensure compliance with the new criteria and restrictions. While the Instrument does not specify detailed penalties for breaches, violations of the Act or the amended Special Arrangement could lead to legal consequences, including fines and imprisonment.

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Pharmaceutical Law
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