National Health (Listed Drugs on F1 or F2) Amendment Determination 2021 (No. 6)

Administered by Department of Health, Disability and Ageing

Legislation au F2021L01217 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

National Health Act 1953

 

National Health (Listed Drugs on F1 or F2) Amendment Determination 2021 (No. 6)

 

PB 93 of 2021

 

Authority

 

This instrument, made under subsection 85AB(1) of the National Health Act 1953 (the Act), amends the National Health (Listed Drugs on F1 or F2) Determination 2021 (PB 33 of 2021) (the Principal Determination).

 

The Principal Determination provides for the allocation of drugs to the F1 and F2 formularies of the Pharmaceutical Benefits Scheme (PBS).

 

Purpose

 

This instrument makes amendments to the Principal Determination.

 

The Act provides that PBS listed drugs may be assigned to formularies identified as F1 and F2. F1 is intended for single branded drugs and F2 for drugs that have multiple brands, or are in a therapeutic group with other drugs with multiple brands. Drugs on F2 are subject to the provisions of the Act relating to price disclosure and guarantee of supply.

 

Section 84AC of the Act provides that a drug is on F1 or F2 if there is a determination in force under section 85AB that the drug is on F1 or F2.

 

Subsection 85AB(1) of the Act empowers the Minister (or delegate) to determine by legislative instrument that a listed drug is on F1 or F2.  For a drug to be on F1, it must satisfy the criteria in subsection 85AB(4). This requires that there are no listed brands of pharmaceutical items that have the drug that are bioequivalent or biosimilar, and no listed brands of pharmaceutical items that have another drug in the same therapeutic group as the first drug that are bioequivalent or biosimilar. It also requires that the drug was not on F2 the day before the determination comes into effect. A drug may only be determined to be on F2 if it does not satisfy one or more of the criteria for F1 (subsection 85AB(3)).

 

When subsection 85AB(5) of the Act applies, which relates to listed drugs with a single brand combination item on the PBS, the listed drug is not placed on F1 or F2, but on the administrative combination drug list (CDL).

 

This Instrument amends the Principal Determination by adding to F1 three new drugs, cariprazine, obeticholic acid and prednisolone acetate and also removes one currently listed drug, interferon alfa-2a, from F1 as this drug will no longer be PBS listed. In addition, it also rectifies 10 administrative errors that occurred on 1 April 2021.  

 

 

 

 

 

Variation and revocation

 

Unless there is an express power to revoke or vary PB 33 of 2021 cited in this Instrument, subsection 33(3) of the Acts Interpretation Act 1901 is relied upon to revoke or vary PB 33 of 2021.

 

Consultation

 

This instrument affects pharmaceutical companies with new medicines listing on the PBS.  Cariprazine, obeticholic acid and prednisolone acetate meet the criteria for F1 under subsection 85AB(4). Interferon alfa-2a is being removed from the PBS at the request of the responsible person.

 

Before a drug is PBS listed and allocated to a formulary, there are detailed consultations about the drug with the responsible person and recommendations from the Pharmaceutical Benefits Advisory Committee (PBAC). Any PBAC recommendation is made following receipt of a submission made by the affected pharmaceutical company. Two-thirds of the PBAC membership is from the following interests or professions: consumers, health economists, practising community pharmacists, general practitioners, clinical pharmacologists and medical specialists.

 

No additional consultation with experts was undertaken regarding this determination because consultation with the affected responsible persons and the PBAC drew on the knowledge of persons with relevant expertise.

 

Commencement

 

This Instrument commences on 1 September 2021.

 

This Instrument constitutes a legislative instrument for the purpose of the
Legislation Act 2003.

 

 

 

 

 

 

 

Statement of Compatibility with Human Rights

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

National Health (Listed Drugs on F1 or F2) Amendment Determination 2021 (No. 6)
(PB 93 of 2021)

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

This Legislative Instrument is made pursuant to subsection 85AB(1) of the National Health Act 1953 (the Act), which relates to listed drugs on F1 or F2.  This Instrument amends the National Health (Listed Drugs on F1 or F2) Determination 2021 (PB 33 of 2021) (the Principal Determination) which provides for the allocation of drugs to the F1 and F2 formularies of the Pharmaceutical Benefits Scheme (PBS).

 

This Instrument amends the Principal Determination by adding to F1 three new drugs, cariprazine, obeticholic acid and prednisolone acetate and also removes one currently listed drug, interferon alfa-2a, from F1 as this drug will no longer be PBS listed. In addition, it also rectifies 10 administrative errors that occurred on 1 April 2021.

 

Human rights implications

This Legislative Instrument engages Articles 2 and 12 of the International Covenant on Economic, Social and Cultural Rights by assisting with the progressive realisation by all appropriate means of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

The PBS assists with the advancement of this human right by providing for subsidised access of medicines to patients. The recommendatory role of the Pharmaceutical Benefits Advisory Committee ensures that decisions about subsidised access to medicines on the PBS are evidence-based.

Conclusion

This Legislative Instrument is compatible with human rights. Human rights continue to be protected by retaining clinically important medicines on the PBS and placing them in formularies that ensure the most cost effective pricing for supply of each medicine to Australians.

 

 

Nikolai Tsyganov

  Acting Assistant Secretary

Pricing and PBS Policy Branch

Technology Assessment and Access Division

Department of Health

 

Overview

The National Health (Listed Drugs on F1 or F2) Amendment Determination 2021 (No. 6) was enacted to amend the National Health (Listed Drugs on F1 or F2) Determination 2021, addressing administrative errors and adjusting the allocation of drugs within the Pharmaceutical Benefits Scheme (PBS) formularies. This legislative instrument, made under subsection 85AB(1) of the National Health Act 1953 by the Minister for Health or their delegate, adds three new drugs to the F1 formulary and removes one drug from it, ensuring that the PBS continues to provide access to essential medicines while maintaining cost-effective pricing. The determination rectifies errors and updates the list of drugs in response to the criteria specified in the Act, which governs the assignment of drugs to the F1 and F2 formularies. This amendment is part of a broader effort to enhance the efficiency and accuracy of the PBS, ensuring that patients have access to necessary medications at the most economical prices.

Scope and Application

The National Health (Listed Drugs on F1 or F2) Amendment Determination 2021 (No. 6) is a legislative instrument that amends the National Health (Listed Drugs on F1 or F2) Determination 2021, which provides for the allocation of drugs to the F1 and F2 formularies of the Pharmaceutical Benefits Scheme (PBS). This instrument applies to the Minister for Health and their delegate, as well as pharmaceutical companies with new medicines listed on the PBS. The amendment adds three new drugs—cariprazine, obeticholic acid, and prednisolone acetate—to the F1 formulary, while removing interferon alfa-2a from F1 as it will no longer be PBS listed. Additionally, it rectifies 10 administrative errors that occurred on 1 April 2021. The amendment is made under subsection 85AB(1) of the National Health Act 1953, and it is compatible with human rights as it supports the right to the highest attainable standard of physical and mental health through the provision of subsidised access to medicines via the PBS. The instrument commenced on 1 September 2021.

Key Provisions

The National Health (Listed Drugs on F1 or F2) Amendment Determination 2021 (No. 6) (PB 93 of 2021) amends the National Health (Listed Drugs on F1 or F2) Determination 2021 (PB 33 of 2021). This amendment pertains to the allocation of drugs to the F1 and F2 formularies of the Pharmaceutical Benefits Scheme (PBS). Under this amendment, three new drugs are added to F1: cariprazine, obeticholic acid, and prednisolone acetate. Additionally, interferon alfa-2a is removed from F1 as it will no longer be listed on the PBS. This amendment also corrects ten administrative errors that occurred on 1 April 2021. These changes are intended to ensure the accurate and effective management of drugs within the PBS framework. Entities governed by this Act, particularly pharmaceutical companies, must comply with the new allocations of drugs to the F1 and F2 formularies. Pharmaceutical companies must ensure that their drugs meet the criteria for placement in either F1 or F2. They must also ensure that any changes in their drug listings are properly communicated and reflected in the PBS. The determinations by the Pharmaceutical Benefits Advisory Committee (PBAC) play a crucial role in the recommendation process, ensuring that decisions about the PBS listings are evidence-based and consider various health interests. Breaches of the requirements set out in this Act may lead to various consequences. While specific penalties are not detailed in the Act, non-compliance could result in legal actions being taken against the offending party. This could include fines, revocation of PBS listings, or other administrative penalties. Additionally, failure to meet the criteria for drug placement in F1 or F2 could lead to higher costs for consumers or disruptions in the supply of essential medications. Ensuring compliance is therefore critical for maintaining the integrity and effectiveness of the PBS. In summary, this legislative instrument requires pharmaceutical companies to align their drug listings with the criteria for F1 and F2 formularies. Compliance with these provisions ensures that the PBS can continue to provide cost-effective and accessible medication to Australians. The amendments correct previous errors and reflect the most current and accurate allocations of drugs, thereby supporting the overall goals of the National Health Act 1953.

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