National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2014 (No. 1)

Administered by Department of Health, Disability and Ageing

Legislation au F2014L00051 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (LISTING OF PHARMACEUTICAL BENEFITS) AMENDMENT
INSTRUMENT 2014 (No. 1)

PB 1 of 2014

 

Purpose

The purpose of this legislative instrument, made under sections 84AF, 84AK, 85, 85A, 88 and 101 of the National Health Act 1953 (the Act), is to amend the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012) to make changes to the pharmaceutical benefits listed on the Pharmaceutical Benefits Scheme (PBS) and related matters.

PB 71 of 2012 determines the pharmaceutical benefits that are on the PBS through declarations of drugs and medicinal preparations, and determinations of forms, manners of administration and brands.  It also provides for related matters (responsible persons, prescribing circumstances, maximum quantities, numbers of repeats, determined quantity and pack quantity, section 100 only status and prescriber bag only status).

Authority

This Instrument exercises various powers in Part VII of the Act, as set out below:

Pharmaceutical benefits listed on the PBS

Subsection 85(2) provides that the Minister may declare drugs and medicinal preparations to which Part VII applies.  A drug or medicinal preparation for which there is a declaration in force under subsection 85(2) is a ‘listed drug’ (subsection 84(1)).  Subsections 85(3) and 85(5) respectively provide that the Minister may determine the form or forms of a listed drug and the manner of administration of a form of a listed drug.  A listed drug in a determined form with a determined manner of administration for that form is a pharmaceutical item (section 84AB).  The Minister may also determine a brand of a pharmaceutical item (subsection 85(6)).  The Minister may also determine the responsible person for a brand of a pharmaceutical item (subsection 84AF(1)).  Under the provisions of section 84AK the Minister may determine the determined quantity and pack quantity for a brand of a pharmaceutical item.

Prescribing pharmaceutical benefits

Subsection 88(1) provides that a medical practitioner is authorised to prescribe a pharmaceutical benefit.  Section 88 provides that the Minister may determine the pharmaceutical benefits that may be prescribed by different classes of prescribers, including participating dental practitioners (subsection 88(1A)), authorised optometrists (subsection 88(1C)), authorised midwives (subsection 88(1D)) and authorised nurse practitioners (subsection 88(1E)).

Subsection 85(7) provides that the Minister may determine the circumstances in which a prescription may be written for the supply of a pharmaceutical benefit.

Paragraph 85A(2)(a) allows the Minister to determine the maximum quantity or number of units of the pharmaceutical item in a pharmaceutical benefit (or of the pharmaceutical benefit where there is no pharmaceutical item) that may, in one prescription, be directed to be supplied on one occasion.  Paragraph 85A(2)(b) also allows the Minister to determine the maximum number of occasions on which the supply of the pharmaceutical benefit may, in one prescription, be directed to be repeated.  The maximum quantities and repeats may be determined for all purposes or for particular purposes.

Supplying pharmaceutical benefits

Subsection 85(2A) provides that the Minister must declare that a particular listed drug can only be provided under a special arrangement under section 100 if the PBAC has recommended under subsection 101(4AAD) that the drug be made available only under special arrangements under section 100.

Paragraph 85(8)(a) provides that the Minister may determine that a particular pharmaceutical benefit may only be supplied under special arrangements under section 100. 

Paragraph 85(8)(b) provides that the Minister may determine that a particular pharmaceutical benefit may only be supplied under special arrangements under section 100 for one or more of the circumstances determined for that pharmaceutical benefit under subsection 85(7).

Subsection 85(2AA) provides that the Minister must declare that a particular listed drug can only be provided under one or more of the prescriber bag provisions if the PBAC has recommended under subsection 101(4AACA) that the drug be made available only under one or more of the prescriber bag provisions.

Paragraph 85(7A) provides that the Minister may determine that a particular pharmaceutical benefit may only be supplied under one or more of the prescriber bag provisions. 

Variation and revocation

Unless there is an express power to revoke or vary PB 71 of 2012 cited in this Instrument and explanatory statement, subsection 33(3) of the Acts Interpretation Act 1901 is relied upon to revoke or vary PB 71 of 2012.

Subsection 101(4AAA) allows the Minister to, by legislative instrument, revoke or vary a subsection 85(2) declaration in relation to a drug or medicinal preparation.  Advice from the Pharmaceutical Benefits Advisory Committee (PBAC) is required if the effect of the legislative instrument would be that a drug or medicinal preparation would cease to be a listed drug (subsection 101(4AAB)).

Changes to PB 71 of 2012 made by this instrument

Schedule 1 to this instrument provides for additions, deletions and changes to drugs, forms, brands, responsible person codes, maximum quantities, the circumstances for prescribing various pharmaceutical benefits (including authority requirements), determined quantities, pack quantities, section 100 only status and prescriber bag only status.  These changes are summarised, by subject matter, in the Attachment.

Consultation

The involvement of interested parties through the membership of PBAC constitutes a formal and ongoing process of consultation.  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 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 are consulted throughout the process of the listing of their medicines on the PBS and in relation to changes to those listings.  This includes the company submission to the PBAC and involvement throughout the PBAC process, negotiations or consultation on price, guarantee of supply and agreement to final listing details.

 

 

General

A provision by provision description of this Instrument is contained in the Attachment.

This Instrument commences on 1 February 2014.

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

 

 

 

ATTACHMENT

 

PROVISION BY PROVISION DESCRIPTION OF THE NATIONAL HEALTH (LISTING OF PHARMACEUTICAL BENEFITS) AMENDMENT INSTRUMENT 2014 (No. 1)

 

Section 1   Name of Instrument

This section provides that the Instrument is the National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2014 (No. 1) and may also be cited as PB 1 of 2014.

Section 2   Commencement

This section provides that this Instrument commences on 1 February 2014.

Section 3   Amendment of the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012)

This section provides that Schedule 1 amends the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012).

Schedule 1   Amendments

The amendments in Schedule 1 involve additions, deletions and changes to forms, brands, responsible person codes, maximum quantities, the circumstances for prescribing various pharmaceutical benefits (including authority requirements), determined quantities, pack quantities and section 100 only status.  These changes are summarised below.

 

 

 

SUMMARY OF CHANGES

Listed Drug Added

Alogliptin with metformin

Form Added

Budesonide

Rectal foam 2 mg per application, 14 applications, aerosol 16.8 g, 2

Brands Added

Cefaclor

Powder for oral suspension 125 mg (as monohydrate) per 5 mL, 100 mL
(APO-Cefaclor)
Powder for oral suspension 250 mg (as monohydrate) per 5 mL, 75 mL
(APO-Cefaclor)

Rosuvastatin

Tablet 5 mg (as calcium) (Crosuva 5)
Tablet 10 mg (as calcium) (Crosuva 10)
Tablet 20 mg (as calcium) (Crosuva 20)
Tablet 40 mg (as calcium) (Crosuva 40)

Sotalol

Tablet containing sotalol hydrochloride 80 mg (APO-Sotalol)
Tablet containing sotalol hydrochloride 160 mg (APO-Sotalol)

Temozolomide

Capsule 180 mg (Orion Temozolomide)

 

Brands Deleted

Alprazolam

Tablet 250 micrograms (Xanax)
Tablet 500 micrograms (Xanax)
Tablet 1 mg (Xanax)
Tablet 2 mg (Xanax Tri-Score)

Paclitaxel

Solution concentrate for I.V. infusion 300 mg in 50 mL (Paclitaxel Pfizer)

Quinapril

Tablet 10 mg (as hydrochloride) (Quinapril generichealth)

Risedronic Acid

Tablet containing risedronate sodium 35 mg (Chem mart Risedronate; Terry White Chemists Risedronate)

Alteration of Brand Name

Listed Drug

Form

Brand Name

Paracetamol

Tablet 500 mg

From: Paracetamol Sandoz

To: Paracetamol (Sandoz)

Alteration of Responsible Person (no change to Responsible Person Code)

From: Spirit Pharmaceuticals Pty Ltd [ZP]      To: Medis Pharma Pty Ltd [ZP]

Alteration of Circumstances

Listed Drug

Alteration

Sitagliptin with simvastatin

Circumstances amended to add SGLT2 inhibitors to the classes of anti-diabetic drugs mentioned

 


 

 

Statement of Compatibility with Human Rights

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

 

National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2014
(No. 1)

(PB 1 of 2014)

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

The National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2014
(No. 1) amends the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 which determines the pharmaceutical benefits that are on the Pharmaceutical Benefits Scheme (PBS) through declarations of drugs and medicinal preparations, and determinations of forms, manners of administration and brands.  It also provides for related matters (responsible persons, prescribing circumstances, maximum quantities, numbers of repeats, determined quantities, pack quantities, section 100 only status and prescriber bag only status).

Schedule 1 to this instrument provides for additions, deletions and changes to drugs, forms, brands, responsible person codes, maximum quantities, the circumstances for prescribing various pharmaceutical benefits (including authority requirements), determined quantities, pack quantities, section 100 only status and prescriber bag only status.

Human rights implications

This legislative instrument engages Articles 2 and 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) 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 is a benefit scheme which assists with advancement of this human right by providing for subsidised access by patients to medicines. The recommendatory role of the Pharmaceutical Benefits Advisory Committee (PBAC) ensures that decisions about subsidised access to medicines on the PBS are evidence-based.

Conclusion

This Legislative Instrument is compatible with human rights because it advances the protection of human rights.

 

Felicity McNeill
First Assistant Secretary
Pharmaceutical Benefits Division
Department of Health

 

Overview

The National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2014 (No. 1) was enacted to amend the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which determines the pharmaceutical benefits available under the Pharmaceutical Benefits Scheme (PBS) in Australia. This legislative instrument was introduced to address the need for regular updates and adjustments to the list of pharmaceutical benefits to ensure that the PBS remains relevant and effective in providing access to necessary medications. The instrument was made under the authority of the National Health Act 1953 and exercises various powers specified within the Act. The policy objective of this legislative instrument is to enhance the provision of subsidised access to medicines, ensuring that decisions about which drugs and medicinal preparations are included on the PBS are based on evidence and expert advice from the Pharmaceutical Benefits Advisory Committee (PBAC). By updating the list of pharmaceutical benefits, the instrument aims to improve the availability of effective and cost-efficient medications to the Australian public.

Scope and Application

The National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2014 (No. 1) amends the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which is concerned with determining the pharmaceutical benefits listed on the Pharmaceutical Benefits Scheme (PBS) by declaring drugs and medicinal preparations and determining forms, manners of administration and brands. The Instrument also addresses related matters such as responsible persons, prescribing circumstances, maximum quantities, numbers of repeats, determined quantities, pack quantities, section 100 only status, and prescriber bag only status. This legislative instrument applies to the Commonwealth of Australia and extends to all drugs and medicinal preparations listed on the PBS. It is applicable to entities and individuals involved in the provision, prescription, and administration of these pharmaceutical benefits. The Minister for Health is empowered to make declarations and determinations under this instrument, and changes are implemented via the Schedule 1 amendments to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The instrument commenced on 1 February 2014 and operates under the authority granted by the National Health Act 1953.

Key Provisions

The National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2014 (No. 1) amends the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which governs the listing of pharmaceutical benefits on the Pharmaceutical Benefits Scheme (PBS) (section 3). The main provisions of this Amendment Instrument involve adding, deleting and modifying entries for drugs, forms, brands, responsible person codes, maximum quantities, prescribing circumstances, determined quantities, pack quantities, section 100 only status, and prescriber bag only status (section 3). Specific changes include adding Alogliptin with metformin, Budesonide in two new forms, and several new brands for Cefaclor, Rosuvastatin, Sotalol, and Temozolomide (Schedule 1). Conversely, certain brands of Alprazolam, Paclitaxel, Quinapril, and Risedronic Acid are deleted from the list (Schedule 1). Additionally, some brand names and responsible persons are altered (Schedule 1). The Act imposes several obligations on the parties and entities it governs. The Minister for Health, under subsections 85(2) to 85(8), is responsible for declaring drugs and medicinal preparations to be listed on the PBS, determining their forms, manners of administration, and brands, and establishing the responsible person for each brand (sections 84, 85). The Minister can also determine the prescribing circumstances, maximum quantities, and number of repeats for each pharmaceutical benefit (subsections 85(7), 88(1A) to 88(1E), 85A(2)). Furthermore, the Pharmaceutical Benefits Advisory Committee (PBAC) plays a critical role in advising the Minister on which drugs and medicinal preparations should be available as pharmaceutical benefits (section 100A). Failure to comply with the provisions of the National Health Act 1953 and the National Health (Listing of Pharmaceutical Benefits) Amendment Instrument 2014 (No. 1) can result in civil or criminal consequences. For example, subsection 101(4AAA) allows the Minister to revoke or vary a declaration in relation to a drug or medicinal preparation, and subsection 101(4AAB) requires PBAC advice if the effect of the legislative instrument would be that a drug or medicinal preparation would cease to be a listed drug. Additionally, penalties for breaches of the Act or the Instrument may be imposed under relevant sections of the Act or other applicable legislation. The precise penalties depend on the nature and severity of the breach, and can range from fines to imprisonment.

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