National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2020 (No. 1) (PB 7 of 2020)

EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (PARAPLEGIC AND QUADRIPLEGIC PROGRAM) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2020 (No. 1)

PB 7 of 2020

Purpose

This is the National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2020 (No. 1) (this Instrument).  The purpose of this Instrument, made under subsection 100(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.

The Paraplegic and Quadriplegic Program Special Arrangement provides for ‘authorised associations’ to supply pharmaceutical benefits available under the Special Arrangement to ‘eligible persons’.  A person is an ‘eligible person’ for the purposes of the Special Arrangement if they:

(a)           are an ‘eligible person’ within the meaning of the Health Insurance Act 1973, that is, eligible to receive Medicare benefits; and

(b)           have paraplegia or quadriplegia; and

(c)           are a member of an ‘authorised association’.

The amendments made by this Instrument reflect amendments to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012), which commence on the same day.  The National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012) is made under sections 84AF, 84AK, 85, 85A, 88 and 101 of the Act.

The amendments made by this Instrument include additions, deletions and changes to drugs, forms, manners of administration, brands, responsible person codes and maximum amounts for pharmaceutical benefits listed in Schedule 1 of the Special Arrangement.  The amendments also include additions, deletions and changes to responsible person codes, responsible persons and Australian Business Numbers listed in Schedule 2 of the Special Arrangement.

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

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).

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.  This includes consultation through the PBAC process.

Further consultation for this Instrument was considered unnecessary due to the nature of the consultation that had already taken place in the decision to list the medication.

This instrument commences on 1 February 2020.

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

ATTACHMENT

PROVISION-BY-PROVISION DESCRIPTION OF NATIONAL HEALTH (PARAPLEGIC AND QUADRIPLEGIC PROGRAM) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2020 (No. 1)

Section 1 Name of Instrument

This section provides that the Instrument is the National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2020 (No. 1) and may also be cited as PB 7 of 2020.

Section 2 Commencement

This section provides that this Instrument commences on 1 February 2020.

Section 3 Amendment of National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2018 (PB 118 of 2010)

This section provides that Schedule 1 amends the National Health (Paraplegic and Quadriplegic Program) Special Arrangement Amendment Instrument 2018 (PB 118 of 2010).

Schedule 1 Amendments

The amendments in Schedule 1 provide for additions, deletions and changes to drugs, forms, manners of administration, brands, responsible person codes and maximum amounts for pharmaceutical benefits listed in Schedule 1 of the Special Arrangement.  The amendments in Schedule 1 also provide for additions, deletions and changes to responsible person codes, responsible persons and their Australian Business Numbers in Schedule 2 of the Special Arrangement.  These changes are summarised below.

SUMMARY OF CHANGES

Brands Added

Addition of Responsible Person Code

Alteration of Responsible Person

Alteration of Responsible Person Australian Business Number

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 2020 (No. 1)

(PB 7 of 2020)

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 subsection 100(2) of the National Health Act 1953 (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.

The Paraplegic and Quadriplegic Program Special Arrangement provides for ‘authorised associations’ to supply pharmaceutical benefits available under the Special Arrangement to ‘eligible persons’ requiring treatment with bowel management medicines.  A person is an ‘eligible person’ for the purposes of the Special Arrangement if they:

(a)           are an ‘eligible person’ within the meaning of the Health Insurance Act 1973; and

(b)           have paraplegia or quadriplegia; and

(c)           are a member of an ‘authorised association’.

Restrictions on the provision of this treatment mean that these pharmaceutical benefits can more conveniently or efficiently be supplied under a special arrangement.

Schedule 1 to this Instrument provides for additions, deletions and changes to drugs, forms, manners of administration, brands, responsible person codes and maximum amounts for pharmaceutical benefits listed in Schedule 1 of the Special Arrangement.  It also provides for additions, deletions and changes to responsible person codes, responsible persons and their Australian Business Numbers listed in Schedule 2 of the Special Arrangement.

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 Pharmaceutical Benefits Scheme (PBS) is a benefit scheme which assists with the 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.

Ben Sladic

Assistant Secretary

Pharmacy Branch

Technology Assessment and Access Division

Department of Health