National Health (Originator brand) Amendment Determination (No. 3) 2025

Administered by Department of Health, Disability and Ageing

Legislation au F2025L00533 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

National Health Act 1953

National Health (Originator Brand) Amendment Determination (No. 3) 2025

PB 51 of 2025

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 originator brand status for a new pharmaceutical item of a drug included on the Pharmaceutical Benefits Scheme (PBS) F2 formulary on 1 May 2025.

The Principal Instrument determines originator brands of pharmaceutical items that have a drug on the F2 formulary. On meeting certain criteria, drugs move from the F1 formulary (s85AB of the Act), or the single brand Combination Drug List (CDL), to F2. All drugs on F2 are subject to price disclosure. This instrument is necessary to implement removal of originator brand data from price disclosure calculations (originator removal) in certain circumstances as set out in the National Health (Pharmaceutical Benefits) Regulations 2017 (the Regulations). Originator removal will potentially increase price disclosure related price reductions because originator brands tend to maintain higher prices than other brands.

Amendment

An amendment to the originator brand determination is set out in Schedule 1 of this amending instrument for a new injectable form of the drug aripiprazole that is listing on the PBS on 1 May 2025. 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. It is also relevant that a brand is similar to an existing brand that meets the criteria in subsection 99ADB(6C). Abilify Maintena injection is listed as an originator brand in the current determination. The new injectable form of aripiprazole (Abilify Asimtufii) is a variant of the originator brand and therefore meets the criteria to be an originator brand.

Basis for amendments

Subsection 33(3) of the Act’s 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 new PBS listed injectable form and brand of the drug aripiprazole was consulted on the potential originator brand determination. No comments were received from the affected company. No additional consultation with experts was undertaken regarding this determination because consultation with the affected company drew on the knowledge of persons with relevant expertise.

This instrument commences on 1 May 2025.

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 (No. 3) 2025 (PB 51 of 2025)

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 originator brand status for a new pharmaceutical item of a drug included on the Pharmaceutical Benefits Scheme (PBS) F2 formulary on 1 May 2025.

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 2017 (the Regulations). Originator brand removal from price disclosure calculations will potentially increase PBS price reductions, as originator brands tend to maintain higher prices than other brands. Originator brand removal 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, 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 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 is a benefits scheme that assists with providing subsidised access to medicines for people. This is a positive and supportive step towards attaining the highest standard of health for all Australians.

Determining an originator brand will improve the operation of the PBS by delivering better value for money for PBS medicines through price disclosure 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.

 

Rebecca Richardson

Assistant Secretary

Pricing and PBS Policy Branch

Technology Assessment and Access Division

Department of Health and Aged Care

Overview

The National Health (Originator Brand) Amendment Determination (No. 3) 2025, which comes into effect on 1 May 2025, amends the National Health (Originator Brand) Determination 2015 to address the originator brand status for a new pharmaceutical item of a drug included on the Pharmaceutical Benefits Scheme (PBS) F2 formulary. This amendment is made under the authority of subsection 99ADB(6B) of the National Health Act 1953, with the purpose of implementing the removal of originator brand data from price disclosure calculations as stipulated in the National Health (Pharmaceutical Benefits) Regulations 2017. This change is expected to potentially increase price disclosure-related price reductions because originator brands typically maintain higher prices than other brands, thereby better aligning government prices with those of generic brands. The policy objective of this amendment is to improve the operation of the PBS by delivering better value for money for PBS medicines through price disclosure reductions, which will assist consumers by reducing out-of-pocket costs for some PBS medicines.

Scope and Application

The National Health (Originator Brand) Amendment Determination (No. 3) 2025 amends the National Health (Originator Brand) Determination 2015, affecting drugs listed on the Pharmaceutical Benefits Scheme (PBS) F2 formulary from 1 May 2025. This amendment determines the originator brand status for a new pharmaceutical item, specifically a new injectable form of the drug aripiprazole, which will be listed on the PBS on the specified date. The Act applies to pharmaceutical items that meet certain criteria, allowing them to move from the F1 formulary or the Combination Drug List to F2, where they are subject to price disclosure requirements. This amendment ensures that the new injectable form of aripiprazole meets the criteria to be recognised as an originator brand, thereby affecting its pricing and the broader market dynamics for PBS-subsidised medications. The geographic reach of the Act is national, impacting all entities involved in the PBS across Australia. This legislative instrument does not exclude any specific entities or industries but operates within the broader framework set by the National Health Act 1953 and the National Health (Pharmaceutical Benefits) Regulations 2017. The instrument aims to potentially increase price disclosure-related price reductions by removing originator brand data from price disclosure calculations in certain circumstances, which is expected to lead to better value for money for PBS medicines and reduced out-of-pocket costs for consumers.

Key Provisions

The National Health (Originator Brand) Amendment Determination (No. 3) 2025 amends the National Health (Originator Brand) Determination 2015, focusing on the determination of originator brand status for a new pharmaceutical item on the Pharmaceutical Benefits Scheme (PBS) F2 formulary, effective from 1 May 2025 (section 1). This determination is crucial for implementing the removal of originator brand data from price disclosure calculations under the National Health (Pharmaceutical Benefits) Regulations 2017. Such removal is expected to increase price disclosure-related price reductions, as originator brands typically maintain higher prices than other brands (section 2). The amendment addresses a new injectable form of the drug aripiprazole, listing it as an originator brand due to its similarity to the existing brand Abilify Maintena injection (section 3). This amendment is grounded in the authority provided by subsection 99ADB(6B) of the National Health Act 1953 and is made under the authority conferred by subsection 33(3) of the Interpretation Act 1901 (section 4). The company with the new injectable form and brand of aripiprazole was consulted on the originator brand determination, and no comments were received (section 5). The Act imposes obligations on the Minister or their delegate to determine originator brand status based on specific criteria, such as whether the brand was on the F1 formulary or the Combination Drug List when it was first determined (subsection 99ADB(6B) of the Act). The determination must also consider whether the brand is similar to an existing brand that meets the criteria outlined in subsection 99ADB(6C) (subsection 99ADB(6C) of the Act). Additionally, the Regulations require the removal of originator brand data from price disclosure calculations in certain circumstances to facilitate potential price reductions (National Health (Pharmaceutical Benefits) Regulations 2017). The PBS, operating under Part VII of the National Health Act 1953, regulates the listing, prescribing, pricing, charging, and payment of subsidies for the supply of drugs and medicinal preparations as pharmaceutical benefits. The amendment does not explicitly outline specific offences, penalties, or civil or criminal consequences for breaches. However, under the general provisions of the National Health Act 1953, breaches of the PBS regulations or determinations may result in civil or criminal penalties. The specific penalties can vary depending on the nature and severity of the breach but could include fines, imprisonment, or both. For instance, subsection 109L(2) of the Act provides for penalties for breaches related to the supply of drugs, which may include fines up to $22,200 for individuals and $111,000 for bodies corporate, along with potential imprisonment for serious offences.

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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.