National Health (Originator Brand) Amendment Determination (No. 5) 2025

Administered by Department of Health, Disability and Ageing

Legislation au F2025L00873 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

National Health Act 1953

National Health (Originator Brand) Amendment Determination (No. 5) 2025

PB 91 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 pharmaceutical items of three drugs included on the Pharmaceutical Benefits Scheme (PBS) F2 formulary on 1 August 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 the 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 the drugs that are moving from F1 and CDL to F2 (denosumab, ustekinumab and drospirenone with ethinylestradiol on 1 August 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.

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 companies with a PBS listed brand of the drugs moving from F1 and CDL to F2 were consulted on the potential originator brand determination. No comments were received from the affected companies. No additional consultation with experts was undertaken regarding this determination because consultation with the affected companies drew on the knowledge of persons with relevant expertise.

This instrument commences on 1 August 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. 5) 2025 (PB 91 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 brands of pharmaceutical items for three drugs new to the PBS F2 formulary on
1 August 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

PBS Listing, Pricing and Policy Branch

Technology Assessment and Access Division

Department of Health, Disability and Ageing

Overview

The National Health (Originator Brand) Amendment Determination (No. 5) 2025, enacted on 1 August 2025, amends the National Health (Originator Brand) Determination 2015 to address the issue of originator brand status for pharmaceutical items transitioning from the F1 formulary and the Combination Drug List to the F2 formulary on the Pharmaceutical Benefits Scheme (PBS). This amendment is necessary to implement the removal of originator brand data from price disclosure calculations, as outlined in the National Health (Pharmaceutical Benefits) Regulations 2017. The aim is to increase price disclosure-related price reductions since originator brands typically maintain higher prices than other brands. This amendment is made under the authority of subsection 99ADB(6B) of the National Health Act 1953, with the policy objective of enhancing the affordability and accessibility of necessary medicines for Australians by reducing out-of-pocket costs through improved price disclosure mechanisms. This legislative instrument is compatible with human rights, engaging Articles 2 and 12 of the International Covenant on Economic, Social and Cultural Rights by supporting the progressive realisation of the right to the highest attainable standard of physical and mental health. By determining originator brands and facilitating price disclosure reductions, the amendment assists in providing better value for money for PBS medicines, thereby contributing positively to the health of Australians.

Scope and Application

The National Health (Originator Brand) Amendment Determination (No. 5) 2025 applies to the Pharmaceutical Benefits Scheme (PBS) as governed by the National Health Act 1953. It specifically concerns the determination of originator brands for pharmaceutical items listed on the PBS F2 formulary, affecting three drugs transitioning from F1 or the Combination Drug List (CDL) to F2 on 1 August 2025. This legislative instrument amends the National Health (Originator Brand) Determination 2015 to implement the removal of originator brand data from price disclosure calculations in certain circumstances, as outlined in the National Health (Pharmaceutical Benefits) Regulations 2017. This amendment is aimed at potentially increasing price disclosure-related price reductions for these drugs, thereby reflecting the prices at which generic brands are sold and ultimately reducing out-of-pocket costs for consumers. The amendment applies nationally across Australia, as it is part of the Commonwealth’s regulatory framework for the PBS. There are no stated exclusions or exemptions in this legislative instrument, which is necessary for the progressive realisation of the right to the highest attainable standard of physical and mental health under the International Covenant on Economic, Social and Cultural Rights.

Key Provisions

The main operative sections of the National Health (Originator Brand) Amendment Determination (No. 5) 2025 (PB 91 of 2025) pertain to the amendment of the National Health (Originator Brand) Determination 2015 (PB 100 of 2015). This amendment sets out the originator brand status for three pharmaceutical drugs that will transition from the F1 formulary, or the single brand Combination Drug List (CDL), to the F2 formulary on 1 August 2025. These drugs include denosumab, ustekinumab, and drospirenone with ethinylestradiol (section 1). This determination is made pursuant to subsection 99ADB(6B) of the National Health Act 1953 (the Act) and is necessary to implement the removal of originator brand data from price disclosure calculations in certain circumstances as outlined in the National Health (Pharmaceutical Benefits) Regulations 2017 (the Regulations) (section 2). The Act imposes certain obligations and requirements on the parties and entities it governs. It mandates that the Minister (or delegate) must consider 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 when deciding whether to determine originator brands (subsection 99ADB(6C) of the Act). Furthermore, the determination of originator brands is made in accordance with the criteria set out in the Regulations, which include the price disclosure requirements for drugs on the F2 formulary. Additionally, the Act requires that the companies with a PBS listed brand of the drugs moving from F1 and CDL to F2 are consulted on the potential originator brand determination (section 3). There are no specific offences, penalties, or civil/criminal consequences outlined in the determination itself. However, breaches of the Regulations, which govern the operation of the Pharmaceutical Benefits Scheme (PBS) and the determination of originator brands, may result in civil or criminal penalties. The maximum penalties for breaches of the Regulations can vary depending on the nature and severity of the breach, and may include fines and/or imprisonment (section 5). It is important to note that the penalties for breaches of the Regulations are not specified in the determination, but rather in the relevant sections of the Act and Regulations.

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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.