National Health (Indigenous Chronic Disease - PBS Co-payment Measure) Special Arrangements Instrument 2010 (No. PB 66 of 2010)

Administered by Department of Health, Disability and Ageing

Legislation au F2010L01724 Not in force Legislative Instrument

Legislation content

EXPLANATORY STATEMENT

 

Issued by the Authority of the delegate of the Minister for Health and Ageing

 

National Health Act 1953

 

National Health (Indigenous Chronic Disease – PBS Co-payment Measure) Special Arrangements Instrument 2010 (PB66 of 2010)

 

 

Authority

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

 

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).

 

Purpose

The National Health (Indigenous Chronic Disease – PBS Co-payment Measure) Special Arrangements Instrument 2010 (PB66 of 2010) (the Instrument) makes special arrangements to assist eligible Aboriginal and Torres Strait Islander patients to access PBS medicines with reduced patient co-payments under the PBS Co-payment Measure (the Measure).

 

The Measure has been established to benefit Aboriginal and Torres Strait Islander people of any age who present with an existing chronic disease or are at risk of chronic disease, and in the opinion of the prescriber:

a. would experience setbacks in the prevention or ongoing management of chronic disease if the person did not take the prescribed medicine; and

b.  are unlikely to adhere to their medicines regimen without assistance through the Measure.

 

Background

In November 2008, the Council of Australian Governments (COAG) agreed to a
$1.6 billion National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes to address the first of the COAG Closing the Gap targets – to close the life expectancy gap between Indigenous and non-Indigenous Australians within a generation. 

 

As part of this Agreement, the Australian Government is contributing $805.5 million over four years from 2009-10 to 2012-13 through the Indigenous Chronic Disease Package (ICDP) to tackle chronic disease risk factors, improve chronic disease management in primary care and follow up treatment, and increase the capacity of the primary care workforce to deliver effective health care to Aboriginal and Torres Strait Islander people.  The Measure is one of 14 measures in the ICDP.

 

The cost of medicine has been identified as a significant barrier to improving access to medicines for Aboriginal and Torres Strait Islander people.  Access to PBS medicines is an important aspect of preventing and treating illness.  Despite two to three times higher levels of illness, PBS expenditure for Aboriginal and Torres Strait Islander people is about half that of the non-Indigenous average.

 

Instrument Description

The Instrument, expressed to commence on 1 July 2010, was made on 21 June 2010, the Instrument sets out the parameters of the Measure, in particular:

  • Section 1 – sets out the name of the Special Arrangements Instrument and how it should be cited;
  • Section 2 – states that the commencement date is 1 July 2010;
  • Section 3 – defines the meaning of important terms;
  • Section 4 – indicates that the Instrument applies to pharmaceutical products listed in the Schedule of Pharmaceutical Benefits;
  • Section 5 – establishes who may write prescriptions under the Measure;
  • Section 6 – establishes which general practices are eligible to participate in the Measure;
  • Section 7 – establishes which Indigenous Health Services are eligible to participate in the Measure;
  • Section 8 – establishes which patients are eligible to participate in the Measure and outlines how eligible patients may be registered;
  • Section 9 – establishes how prescriptions should be annotated under the Measure;
  • Section 10 – establishes the co-payment relief applying to those eligible Aboriginal and Torres Strait Islander patients under the Measure;
  • Section 11 – establishes how the Measure applies in relation to the operation of the PBS Safety Net provisions of the Act;
  • Section 12 – establishes how indexation applies to the Measure;
  • Section13 – establishes how payments are made for the supply of special pharmaceutical supplies under the Measure; and
  • Section 14 – establishes how approved suppliers can claim for payment under the Measure.

 

The Special Arrangements Instrument provides that eligible Aboriginal and Torres Strait Islander patients who would normally pay the full PBS co-payment (currently $33.30 per item) will pay the concessional rate ($5.40 currently per item).  Those who would normally pay the concessional price will receive their PBS medicines without making a patient co-payment.  Mandatory premiums for a small number of medicines may still need to be paid by the patient.  Prescriptions for all of an eligible patient’s PBS medicines will be covered under the Measure whether the medicines are being used to treat chronic or acute medical conditions. 

 

Impact and Effect

Increased access to PBS will help improve the prevention and management of chronic disease for Aboriginal and Torres Strait Islander people.  Over 70,000 Aboriginal and Torres Starit Islander people are expected to benefit by the end of 2012-13.

 

Consultations

The PBS Co-payment Measure – Indigenous Health National Partnership Technical Reference Group (TRG) is a Department of Health and Ageing (the Department) non-statutory committee established in June 2009 to provide timely technical advice to the Department on the development and implementation of the Measure.

 

In particular, the TRG has provided technical advice on the Measure, including:

  • administrative requirements for prescribers and community pharmacists;
  • software requirements for prescription writing and dispensing;
  • culturally appropriate implementation;
  • effective communication and education strategies; and
  • evaluation strategies.

 

The parameters for the Measure as outlined in this Special Arrangements Instrument were developed through consultation with the TRG.

 

Members of the TRG were drawn from nominations from the following organisations:

  • Australian General Practice Network (AGPN);
  • Australian Indigenous Doctors Association (AIDA);
  • Medical Software Industry Association (MSIA);
  • National Aboriginal Community Controlled Health Organisation (NACCHO);
  • Pharmaceutical Society of Australia (PSA);
  • Pharmacy Guild of Australia (PGA);
  • Royal Australian College of General Practitioners (RACGP); and
  • Departmental officers from the Community Pharmacy Branch (including the Chair and Secretariat) and the Office of Aboriginal and Torres Strait Islander Health (OATSIH).

 

The Office of Best Practice Regulation has been consulted regarding the need for a Regulation Impact Statement (RIS).  As these arrangements are considered of a minor and machinery nature, a RIS is not required.

Overview

The National Health (Indigenous Chronic Disease – PBS Co-Payment Measure) Special Arrangements Instrument 2010, made under the authority of the Minister for Health and Ageing, was enacted to address the significant barrier of medicine cost to improving access to medicines for Aboriginal and Torres Strait Islander people. This Instrument, which commenced on 1 July 2010, is part of a broader initiative to tackle chronic disease risk factors and improve chronic disease management in primary care, as agreed upon by the Council of Australian Governments in November 2008. The policy objective is to enhance the prevention and management of chronic diseases among Aboriginal and Torres Strait Islander people by providing them with reduced patient co-payments under the Pharmaceutical Benefits Scheme (PBS), thereby facilitating better access to necessary medications. The Instrument allows eligible Aboriginal and Torres Strait Islander patients who would normally pay the full PBS co-payment to pay the concessional rate, thereby significantly reducing their out-of-pocket expenses. This measure is expected to benefit over 70,000 Aboriginal and Torres Strait Islander people by the end of 2012-13, thereby contributing to the broader goal of closing the life expectancy gap between Indigenous and non-Indigenous Australians. The development of this Instrument involved extensive consultation with relevant stakeholders, including medical associations, health service providers, and departmental officers, to ensure effective and culturally appropriate implementation.

Scope and Application

The National Health (Indigenous Chronic Disease – PBS Co-Payment Measure) Special Arrangements Instrument 2010, made under the authority of the Minister for Health and Ageing, is designed to address the specific needs of eligible Aboriginal and Torres Strait Islander patients in accessing the Pharmaceutical Benefits Scheme (PBS) with reduced co-payments. The Instrument applies to eligible patients who have a chronic disease or are at risk of chronic disease and would otherwise face barriers in adhering to their prescribed medication regimens. The reduced co-payment aims to make PBS medicines more accessible and affordable for this demographic, ultimately helping to improve the prevention and management of chronic diseases within these communities. The Instrument also outlines provisions for eligible prescribers, general practices, and Indigenous Health Services, and it specifies the registration process for patients, the annotation of prescriptions, and the payment mechanisms for approved suppliers. The Instrument is in effect as of 1 July 2010 and is subject to any variations or revocations by the Minister under the National Health Act 1953.

Key Provisions

The National Health (Indigenous Chronic Disease – PBS Co-Payment Measure) Special Arrangements Instrument 2010 (PB66 of 2010) outlines specific provisions under the National Health Act 1953 to reduce the cost burden of PBS medicines for eligible Aboriginal and Torres Strait Islander patients. Section 10 of the Instrument (section 10) provides that eligible patients will pay a concessional co-payment rate of $5.40 per item, down from the full rate of $33.30 per item. This reduced co-payment aims to improve access to PBS medicines for Indigenous patients, which is crucial for preventing and managing chronic diseases. Section 5 (section 5) specifies that only certain medical practitioners can prescribe under this Measure, and Section 6 (section 6) and Section 7 (section 7) detail the eligibility of general practices and Indigenous Health Services to participate in the Measure. The Act imposes several obligations on the parties involved. Medical practitioners must adhere to the specific requirements for prescribing under this Measure, including ensuring their patients meet the eligibility criteria outlined in Section 8 (section 8). General practices and Indigenous Health Services must also meet certain criteria to participate, as detailed in Sections 6 (section 6) and 7 (section 7). Furthermore, prescriptions must be annotated in accordance with Section 9 (section 9), and approved suppliers must follow the payment procedures outlined in Sections 12 (section 12) and 14 (section 14). Breach of the obligations outlined in the Instrument may lead to civil or criminal consequences, though specific penalties are not detailed in the explanatory statement. However, under the general provisions of the National Health Act 1953, penalties for non-compliance can include fines and other legal repercussions. The exact penalties would depend on the nature and severity of the breach, but the Instrument aims to ensure compliance through clear guidelines and consultation with relevant stakeholders to avoid such breaches.

Legal classification tags

Area of Law
Health Law
Indigenous Peoples & Native Title Law
Instrument
Statutory Instrument
Concepts
Definitions & Interpretation
Reporting & Disclosure Obligations
Regulatory Standards
Offence Provisions

Interactions

Authorises

All Versions

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.