National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2013 (No. 1) (No. PB 51 of 2013)

Administered by Department of Health, Disability and Ageing

Legislation au F2013L01481 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

National Health Act 1953

National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2013 (No.1)

PB 51 of 2013

Authority

Subsection 100(1) of the National Health Act 1953 (the Act) enables the Minister to make special arrangements for the supply of pharmaceutical benefits.  Subsection 100(2) of the Act provides that the Minister may vary or revoke a special arrangement made under subsection 100(1).

Subsection 100(3) of the Act provides that Part VII of the Act, and instruments made for the purposes of Part VII, have effect subject to a special arrangement made under subsection 100(1).

Purpose

The purpose of this legislative instrument, made under subsections 100(1) and (2) of the Act, is to amend the National Health (Paraplegic and Quadriplegic Program) Special Arrangement 2010 (PB 118 of 2010) (the Special Arrangement) to make changes to the special arrangement relating to the Paraplegic and Quadriplegic Program.

To be eligible to receive a supply of pharmaceutical benefits from a specified paraplegic and quadriplegic association under this Special Arrangement (an ‘eligible person’ under this Special Arrangement), a person with paraplegia or quadriplegia must be a member of the authorised association. The person must also be an ‘eligible person’ within the meaning of the Health Insurance Act 1973, that is, eligible to receive Medicare benefits.

The amendment made by this Instrument reflects changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which commence on the same day.

This instrument adds a new listed brand of the listed drug Macrogol 3350, LaxaCon, to Schedule 1 of the Special Arrangement and the responsible person associated with that pharmaceutical benefit, Ascent Pharma Pty Ltd, to Schedule 2 of the Special Arrangement.

Consultation

The amendments made by this Instrument accord with recommendations made by the Pharmaceutical Benefits Advisory Committee (PBAC). 

An ongoing and formal process of consultation in relation to matters relevant to the Special Arrangement includes the involvement of interested parties through the membership of the PBAC. 

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 Pharmaceutical Benefits Scheme (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 were consulted throughout the process of changes to the listings on the PBS and for this Instrument. This includes consultation through the PBAC process, and agreement to final listing details.

This instrument commences on 1 August 2013.

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


Statement of Compatibility with Human Rights

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

 

National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2013 (No.1)

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 purpose of this legislative instrument, made under subsections 100(1) and (2) of the Act, is to amend the National Health (Paraplegic and Quadriplegic Program) Special Arrangement 2010 (PB 118 of 2010) (the Special Arrangement) to make changes to the special arrangement relating to the Paraplegic and Quadriplegic Program.

This instrument amends the Special Arrangement by inserting the brand LaxaCon and the responsible person for that brand, Ascent Pharma Pty Ltd.

Human rights implications

This legislative instrument engages Article 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.

 

Steve Dunlop

Acting Assistant Secretary

Pharmaceutical Access Branch

Pharmaceutical Benefits Division

Department of Health and Ageing

Overview

The National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2013 (No.1) was enacted to amend the National Health (Paraplegic and Quadriplegic Program) Special Arrangement 2010. This instrument was introduced to address the need for updating the special arrangement concerning the Paraplegic and Quadriplegic Program in line with recent changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The amendment was enacted by the Minister for Health under the authority of subsections 100(1) and (2) of the National Health Act 1953. The policy objective of this amendment is to ensure that the Special Arrangement remains current and effective in providing pharmaceutical benefits to eligible individuals with paraplegia or quadriplegia. The amendments reflect recommendations made by the Pharmaceutical Benefits Advisory Committee (PBAC), ensuring that the changes are evidence-based and take into account the clinical effectiveness, safety, and cost-effectiveness of the pharmaceutical products.

Scope and Application

The National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2013 (No. 1) pertains to the National Health Act 1953, specifically addressing amendments to the National Health (Paraplegic and Quadriplegic Program) Special Arrangement 2010. This instrument applies to individuals with paraplegia or quadriplegia who are members of an authorised association and are eligible to receive Medicare benefits under the Health Insurance Act 1973. The amendment extends to the inclusion of the pharmaceutical product LaxaCon, a new listed brand of Macrogol 3350, administered by Ascent Pharma Pty Ltd, within the pharmaceutical benefits schedule. The instrument is applicable across the Commonwealth of Australia and is subject to the provisions of the National Health Act, with its authority stemming from subsection 100(1) of the Act, which allows the Minister to create special arrangements for the supply of pharmaceutical benefits. The changes made by this instrument are intended to align with the recommendations of the Pharmaceutical Benefits Advisory Committee, ensuring that the pharmaceutical benefits provided are evidence-based and cost-effective. This legislative instrument commenced on 1 August 2013 and is compatible with human rights as it supports the progressive realisation of the right to the highest attainable standard of physical and mental health.

Key Provisions

The National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2013 (No.1) amends the existing special arrangement for the Paraplegic and Quadriplegic Program, as set out in the National Health (Paraplegic and Quadriplegic Program) Special Arrangement 2010. The key provisions of this instrument include the addition of the pharmaceutical product LaxaCon, a brand of Macrogol 3350, to Schedule 1 of the Special Arrangement, and the responsible entity, Ascent Pharma Pty Ltd, to Schedule 2 (sections 3 and 4). This amendment reflects changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012, which also took effect on the same day. Eligibility for these pharmaceutical benefits remains tied to membership of an authorised association and eligibility under the Health Insurance Act 1973. The obligations imposed by this Act on the parties it governs primarily include the requirement for individuals with paraplegia or quadriplegia to be members of an authorised association and eligible to receive Medicare benefits to access the pharmaceutical benefits listed in the Special Arrangement. Pharmaceutical companies, such as Ascent Pharma Pty Ltd, must ensure that their products listed under the Special Arrangement are available and meet the specified criteria. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a crucial role in advising the Minister on which drugs should be included on the Pharmaceutical Benefits Scheme (PBS), ensuring that decisions are evidence-based and consider factors such as clinical effectiveness, safety, and cost-effectiveness. Breach of the obligations set out in the Special Arrangement may result in civil or criminal penalties, depending on the nature and severity of the breach. The Act provides for various penalties for non-compliance, which may include fines or other sanctions. The Pharmaceutical Society of Australia Act 1994 and the Health Insurance Act 1973 also contain provisions that could be applicable in the context of breaches related to the supply of pharmaceutical benefits under this Special Arrangement. It is essential for all parties involved to adhere to the requirements and obligations set out in the Act to avoid any potential penalties or consequences.

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