National Health (Pharmaceutical Benefits – early supply) Amendment Instrument 2019 (No. 1) (PB 2 of 2019)

Administered by Department of Health, Disability and Ageing

Legislation au F2019L00076 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (PHARMACEUTICAL BENEFITS – EARLY SUPPLY) AMENDMENT INSTRUMENT 2019 (No. 1)

PB 2 of 2019

 

Purpose

The purpose of this legislative instrument, made under subsection 84AAA(2) of the National Health Act 1953 (the Act) is to amend the National Health (Pharmaceutical Benefits—early supply) Instrument 2015 (PB 120 of 2015) (the Principal Instrument).

PB 120 of 2015 specifies the pharmaceutical items that are in pharmaceutical benefits for which Pharmaceutical Benefits Scheme (PBS) safety net entitlements will not apply for early supplies, and to specify the period following previous supply.

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.

Authority

Subsection 84AAA(1) of the Act provides that a supply of a pharmaceutical benefit (whether or not the supply is of a kind described in paragraph 84C(4A)(a) of the Act) to a person is an early supply of a specified pharmaceutical benefit if:

(a)           The supply is made within 20 days after the day of a previous supply to the person of:

(i)                  the same pharmaceutical benefit; or

(ii)               another pharmaceutical benefit that has the same pharmaceutical item as the pharmaceutical benefit; or

(iii)             another pharmaceutical benefit that is Schedule equivalent to the pharmaceutical benefit;

whether or not the previous supply is a supply of a kind described in paragraph 84C(4A)(a) of the Act; and

(b)           The pharmaceutical item in the pharmaceutical benefit is specified in an instrument under subsection 84AAA(2); and

(c)           The supply does not result from a prescription originating from a hospital.

Subsection 84AAA(2) of the Act provides that the Minister may specify, by legislative instrument, pharmaceutical items for the purposes of paragraph 84AAA(1)(b) of the Act.

Subsection 84AAA(3) provides that the instrument may specify a pharmaceutical item by reference to the circumstances in which a pharmaceutical benefit that has the pharmaceutical item is supplied or any other circumstances in relation to a pharmaceutical benefit that has the pharmaceutical item.

Paragraph 84C(4A) of the Act refers to repatriation pharmaceutical benefits supplied under the schemes established under section 91 of the Veterans Entitlements Act 1986 or section 18 of the Australian Participants in British Nuclear Tests (Treatment) Act 2006 or supplied in accordance with a determination made under paragraph 256(1)(c) of the Military Rehabilitation and Compensation Act 2004.

Subsection 101(3AA) of the Act requires the Pharmaceutical Benefits Advisory Committee (PBAC) to make recommendations to the Minister about what should be specified in the instrument under subsection 84AAA(2).

Changes to PB 120 of 2015 made by this instrument

Schedule 1 to the Principal Instrument is amended by the addition, deletion and alteration of listed pharmaceutical items and associated periods and circumstances.  These changes are summarised, by subject matter, in the Attachment.

The ‘listed drug’, ‘form’, ‘manner of administration’, ‘maximum quantity or number of units’ and ‘maximum number of repeats’ for a pharmaceutical item are the same as declared and determined under the Act for pharmaceutical benefits that have a pharmaceutical item.  These declarations and determinations are made in the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012).

Therefore, a supply of a pharmaceutical benefit that has this pharmaceutical item will be an early supply of a specified pharmaceutical benefit providing the requirements of subsection 84AAA(1) are met.

Variation and revocation

Unless there is an express power to revoke or vary PB 120 of 2015 cited in this Instrument and explanatory statement, subsection 33(3) of the Acts Interpretation Act 1901 is relied upon to revoke or vary PB 120 of 2015.

Consultation

The involvement of PBAC constitutes a formal and ongoing process of consultation.  The PBAC is the 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 to Australians as pharmaceutical benefits.  PBAC members are selected 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.  The Committee also includes a pharmaceutical industry nominee.  Remaining members are persons whom the Minister is satisfied have qualifications and experience in a field relevant to the functions of the PBAC, and that would enable them to contribute meaningfully to the deliberations of the Committee.  The PBAC has provided advice regarding what should be specified in this Instrument.

This amendment is minor and machinery in nature.

General

This Instrument commences on 1 February 2019.

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


ATTACHMENT

PROVISION-BY-PROVISION DESCRIPTION OF NATIONAL HEALTH (PHARMACEUTICAL BENEFITS – EARLY SUPPLY) AMENDMENT INSTRUMENT 2019 (No. 1)

Section 1 Name of Instrument

This section provides that the Instrument is the National Health (Pharmaceutical Benefitsearly supply) Amendment Instrument 2019 (No. 1) and may also be cited as PB 2 of 2019.

Section 2 Commencement

This section provides that the Instrument commences on 1 February 2019.

Section 3 Amendment of National Health (Pharmaceutical Benefits—early supply) Instrument 2015 (PB 120 of 2015)

This section provides that Schedule 1 amends the National Health (Pharmaceutical Benefits—early supply) Instrument 2015 (PB 120 of 2015).

Schedule 1 Amendments

The amendments in Schedule 1 involve additions, deletions and changes to pharmaceutical items listed in Schedule 1 of the Principle Instrument and the associated periods (days) and circumstances.  These changes are summarised below.

 

SUMMARY OF CHANGES

Listed Drugs Deleted

Paritaprevir with ritonavir with ombitasvir and dasabuvir

Paritaprevir with ritonavir with ombitasvir and dasabuvir and ribavirin

Forms Deleted

Glyceryl trinitrate

Transdermal patch 40 mg

Glyceryl trinitrate

Transdermal patch 80 mg

Glyceryl trinitrate

Transdermal patch 120 mg

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Statement of Compatibility with Human Rights

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

National Health (Pharmaceutical Benefits – early supply) Amendment Instrument 2019 (No. 1)

(PB 2 of 2019)

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 National Health (Pharmaceutical Benefits – early supply) Amendment Instrument 2019 (No. 1) amends the National Health (Pharmaceutical Benefits—early supply) Instrument 2015 which specifies the pharmaceutical items that are pharmaceutical benefits for which the Pharmaceutical Benefits Scheme (PBS) Safety Net entitlements will not apply for early supplies.

Schedule 1 to the Principal Instrument is amended by the addition, deletion and alteration of listed pharmaceutical items and associated periods and circumstances.

Human rights implications

This Legislative Instrument engages Articles 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.

 

 

 

Thea Daniel

Assistant Secretary

Pricing and PBS Policy Branch

Technology Assessment and Access Division

Department of Health

Overview

The National Health (Pharmaceutical Benefits – early supply) Amendment Instrument 2019 (No. 1) was enacted to amend the National Health (Pharmaceutical Benefits—early supply) Instrument 2015. This amendment aims to update the list of pharmaceutical items for which Pharmaceutical Benefits Scheme (PBS) Safety Net entitlements do not apply for early supplies, aligning with recent changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The instrument was made under the authority of subsection 84AAA(2) of the National Health Act 1953, allowing the Minister to specify pharmaceutical items through legislative instruments. The policy objective of this amendment is to ensure that the PBS remains aligned with the most current therapeutic guidelines and to maintain appropriate access to medication for patients while managing costs effectively. The Pharmaceutical Benefits Advisory Committee provided recommendations that informed these amendments, ensuring that decisions are evidence-based and consider patient access to necessary medications.

Scope and Application

The National Health (Pharmaceutical Benefits – early supply) Amendment Instrument 2019 (No. 1) amends the National Health (Pharmaceutical Benefits—early supply) Instrument 2015, which specifies the pharmaceutical items for which Pharmaceutical Benefits Scheme (PBS) Safety Net entitlements do not apply for early supplies. The amendment involves modifications to listed pharmaceutical items and associated periods and circumstances. The instrument applies to pharmaceutical items specified under the National Health Act 1953, affecting suppliers and beneficiaries of pharmaceutical benefits within the PBS framework. It operates nationally, given the federal nature of the PBS. The amendments made by this instrument are minor and machinery in nature, reflecting changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. This amendment does not introduce new exclusions or exemptions but rather aligns the early supply provisions with recent updates to the pharmaceutical benefits list. The instrument is set to commence on 1 February 2019 and operates under the authority granted by subsection 84AAA(2) of the National Health Act 1953.

Key Provisions

The National Health (Pharmaceutical Benefits – early supply) Amendment Instrument 2019 (No. 1) amends the National Health (Pharmaceutical Benefits—early supply) Instrument 2015 (sections 2 and 3). It specifies the pharmaceutical items for which Pharmaceutical Benefits Scheme (PBS) safety net entitlements will not apply for early supplies (subsection 84AAA(2) of the Act). The Instrument provides for the addition, deletion and alteration of listed pharmaceutical items and associated periods and circumstances (Schedule 1). It is intended to reflect changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012). The Act imposes several obligations and requirements on parties and entities it governs. Firstly, the Pharmaceutical Benefits Advisory Committee (PBAC) must make recommendations to the Minister about what should be specified in the instrument (subsection 101(3AA) of the Act). Secondly, the Minister must specify pharmaceutical items by legislative instrument, taking into account the recommendations of the PBAC (subsection 84AAA(2) of the Act). Thirdly, the Act requires that the supply of a pharmaceutical benefit be an early supply of a specified pharmaceutical benefit if the requirements of subsection 84AAA(1) are met (subsection 84AAA(1) of the Act). This means that if a supply of a pharmaceutical benefit meets the criteria set out in the Act, it will be considered an early supply. Breaches of the Act may result in civil or criminal consequences. The maximum penalties for breaches of the Act are not specified in the Explanatory Statement. However, it is important to note that the Act provides for the imposition of fines and imprisonment for certain offences (subsection 101(3AA) of the Act). Additionally, the Act provides for the revocation or variation of the Principal Instrument (subsection 33(3) of the Acts Interpretation Act 1901). This means that the Minister has the power to revoke or vary the Principal Instrument if necessary. In summary, the National Health (Pharmaceutical Benefits – early supply) Amendment Instrument 2019 (No. 1) amends the National Health (Pharmaceutical Benefits—early supply) Instrument 2015 by adding, deleting and altering listed pharmaceutical items and associated periods and circumstances. The Act imposes obligations and requirements on parties and entities it governs, including the PBAC, the Minister and suppliers of pharmaceutical benefits. Breaches of the Act may result in civil or criminal consequences, including fines and imprisonment. The Instrument is compatible with human rights 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.

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