National Health (Originator Brand) Amendment Determination 2016 (No. 4) (PB 49 of 2016)

Administered by Department of Health, Disability and Ageing

Legislation au F2016L00869 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

Select Legislative Instrument No. 49 of 2016

 

National Health Act 1953

 

National Health (Originator Brand) Amendment Determination 2016 (No. 4)

 

Authority

This legislative instrument is made pursuant to subsection 99ADB(6B) of the National Health Act 1953 (the Act).

Purpose

This legislative instrument amends the National Health (Originator Brand) Determination 2015 (PB 100 of 2015) (the Principal Instrument) to:

  • determine the originator brand of a pharmaceutical item for three drugs new to the Pharmaceutical Benefits Scheme (PBS) F2 formulary on 1 June 2016.

The Principal Instrument determined originator brands of pharmaceutical items that have a drug on the F2 formulary.  On meeting certain criteria drugs move from the F1 formulary (see s 85AB of the Act), or the single brand Combination Drug List (CDL), to F2.  All drugs on F2 are subject to price disclosure.  The instrument is necessary to implement removal of originator brand data from price disclosure calculations in certain circumstances as set out in the National Health (Pharmaceutical Benefits) Regulations 1960 (the Regulations).  Removal of originator data will potentially increase price disclosure related price reductions because originator brands tend to maintain higher prices than other brands.

Amendments

An originator brand determination is set out in Schedule 1 of this amending instrument for three drugs that are moving from F1 to F2 (acarbose, azacitadine and eplerenone).

Subsection 99ADB(6C) of the Act provides that when deciding whether to determine originator brands the Minister (or delegate) must have regard to whether the brand was on F1 or CDL when it was first determined as a brand of pharmaceutical item under subsection 85(6) of the Act.  This would be brands that were PBS listed brands of pharmaceutical item while the drug was on F1 or the CDL, before its move to F2.

The main criteria used to decide to determine these brands as originators were that they were the listed brand(s) of the drug when it was on F1.

Basis for amendments

Subsection 33(3) of the Acts Interpretation Act 1901 is relied upon to vary or revoke the determination made under subsection 99ADB(6B) for the medicines affected by this amending instrument.

Consultation

The company with a PBS listed brand of the drug for which an originator brand has been determined was asked for comments in relation to the potential originator brand determination.  No comment was received.

This instrument commences on 1 June 2016. This instrument is a legislative instrument for the purposes 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 (Originator Brand) Amendment Determination 2016 (No. 4)

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 amends the National Health (Originator Brand) Determination 2015 (PB 100 of 2015) (the Principal Instrument) to determine an originator brand of a pharmaceutical item for three drugs new to the Pharmaceutical Benefits Scheme (PBS) F2 formulary.

The instrument is necessary to implement removal of originator brand data for price disclosure calculations in certain circumstances as set out in the National Health (Pharmaceutical Benefits) Regulations 1960 (the Regulations).  The removal of originator brand data during price disclosure calculations will potentially increase PBS price reductions as originator brands tend to maintain higher prices than other brands.  Removal of originator brand data means that the Government price would more closely reflect the prices at which generic brands of the medicine are being sold in the market, not the prices of all brands.

The PBS provides Australians with timely, reliable and affordable access to necessary and
cost-effective medicines.  The PBS operates under Part VII of the National Health Act 1953 (the Act) which regulates the listing, prescribing, pricing, charging and payment of subsidies for supply of drugs and medicinal preparations as pharmaceutical benefits.  The Regulations prescribe matters and set out details in relation to the operation of the PBS.

Human rights implications

This legislative instrument is compatible with 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 advancement of this human right by providing subsidised access to medicines for Australians.

The removal of the originator brand disclosed data from price disclosure calculations will improve the operation of the PBS by delivering better value for money for PBS medicines through price reductions.  This will assist consumers by reducing out-of-pocket costs for some PBS medicines.

Conclusion

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

 

Adriana Platona

Assistant Secretary, Pharmaceutical Evaluation Branch,

Pharmaceutical Benefits Division

Department of Health

Overview

The National Health (Originator Brand) Amendment Determination 2016 (No. 4) amends the National Health (Originator Brand) Determination 2015 to address a gap in the pharmaceutical pricing framework under the National Health Act 1953. Enacted by the Australian Government, this legislative instrument seeks to determine the originator brand of specific pharmaceutical items for three drugs that transition to the F2 formulary on the Pharmaceutical Benefits Scheme (PBS) as of 1 June 2016. This amendment is crucial for implementing the removal of originator brand data from price disclosure calculations, as outlined in the National Health (Pharmaceutical Benefits) Regulations 1960. By potentially increasing price disclosure-related price reductions, the determination aims to enhance the affordability and accessibility of PBS medicines, aligning with the overarching policy objective of providing Australians with reliable and cost-effective access to essential drugs.

Scope and Application

The National Health (Originator Brand) Amendment Determination 2016 (No. 4) is a legislative instrument that amends the National Health (Originator Brand) Determination 2015 to determine the originator brand of a pharmaceutical item for three drugs new to the Pharmaceutical Benefits Scheme (PBS) F2 formulary, which are acarbose, azacitadine, and eplerenone. The amendment is made pursuant to subsection 99ADB(6B) of the National Health Act 1953, which provides for the determination of originator brands of pharmaceutical items. The instrument is necessary to implement the removal of originator brand data from price disclosure calculations in certain circumstances as set out in the National Health (Pharmaceutical Benefits) Regulations 1960, which will potentially increase price disclosure-related price reductions as originator brands tend to maintain higher prices than other brands. The 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, as it assists with the progressive realisation of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

Key Provisions

The National Health (Originator Brand) Amendment Determination 2016 (No. 4) amends the National Health (Originator Brand) Determination 2015 (sections 3(1) and 3(2)). It determines the originator brand of a pharmaceutical item for three drugs new to the Pharmaceutical Benefits Scheme (PBS) F2 formulary on 1 June 2016, namely acarbose, azacitadine and eplerenone. This amendment is necessary to implement the removal of originator brand data from price disclosure calculations in certain circumstances as set out in the National Health (Pharmaceutical Benefits) Regulations 1960 (section 3(2)). Originator brands tend to maintain higher prices than other brands, and their removal from price disclosure calculations may result in increased price reductions for these drugs. The Act imposes obligations on the parties involved, including the Minister or delegate responsible for making the originator brand determinations. According to subsection 99ADB(6C) of the Act, when deciding whether to determine originator brands, the Minister (or delegate) must consider whether the brand was on F1 or the Combination Drug List (CDL) when it was first determined as a brand of pharmaceutical item under subsection 85(6) of the Act. This criterion is based on brands that were PBS listed brands of pharmaceutical items while the drug was on F1 or the CDL before its move to F2. The main criteria used to decide the originator brands for the three drugs in question was that they were the listed brand(s) of the drug when it was on F1. Failure to comply with the provisions of this amending instrument may result in potential price reductions for the three drugs, as the removal of originator brand data from price disclosure calculations may lead to lower prices for generic brands of these medicines. This is in line with the purpose of the PBS to provide Australians with timely, reliable and affordable access to necessary and cost-effective medicines. However, there are no specific offences, penalties, or civil/criminal consequences for breach mentioned in the legislation. It is important to note that this instrument is a legislative instrument for the purposes of the Legislation Act 2003, and it 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.

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