National Health (Pharmaceutical benefits – early supply) Amendment Instrument 2019 (No. 8) (PB 68 of 2019)

Administered by Department of Health, Disability and Ageing

Legislation au F2019L01128 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. 8)

PB 68 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 September 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. 8)

Section 1 Name of Instrument

This section provides that the Instrument is the National Health (Pharmaceutical benefitsearly supply) Amendment Instrument 2019 (No. 8) and may also be cited as PB 68 of 2019.

Section 2 Commencement

This section provides that the Instrument commences on 1 September 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 Added

Buprenorphine

Injection (modified release) 8 mg in 0.16 mL pre-filled syringe

 

Injection (modified release) 16 mg in 0.32 mL pre-filled syringe

 

Injection (modified release) 24 mg in 0.48 mL pre-filled syringe

 

Injection (modified release) 32 mg in 0.64 mL pre-filled syringe

 

Injection (modified release) 64 mg in 0.18 mL pre-filled syringe

 

Injection (modified release) 96 mg in 0.27 mL pre-filled syringe

 

Injection (modified release) 128 mg in 0.36 mL pre-filled syringe

Listed Drugs Deleted

Hydrochlorothiazide with triamterene

Tablet 25 mg-50 mg

Forms Deleted

Insulin isophane

Injection (bovine) 100 units per mL, 10 mL

Insulin neutral

Injection (bovine) 100 units per mL, 10 mL

Ribavirin

Tablet 200 mg

Addition of Maximum Number of Repeats

Listed Drug

Form

Maximum Quantity or Number of Units

Maximum Number of Repeats

Esomeprazole

Capsule (enteric) 20 mg (as magnesium)

30

1

 

Capsule (enteric) 40 mg (as magnesium)

30

1

 

Tablet (enteric coated) 20 mg (as magnesium trihydrate)

30

1

 

Tablet (enteric coated) 40 mg (as magnesium trihydrate)

30

1

Lansoprazole

Capsule 30 mg

28

1

 

Tablet 30 mg (orally disintegrating)

28

1

Omeprazole

Capsule 20 mg

30

1

 

Tablet 20 mg

30

1

 

Tablet 20 mg (as magnesium)

30

1

Pantoprazole

Sachet containing granules 40 mg (as sodium sesquihydrate)

30

1

 

Tablet (enteric coated) 40 mg (as sodium sesquihydrate)

30

1

Rabeprazole

Tablet containing rabeprazole sodium 20 mg (enteric coated)

30

1

 


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. 8)

(PB 68 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. 8) 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. 8) was enacted to amend the National Health (Pharmaceutical Benefits—early supply) Instrument 2015, which specifies the pharmaceutical items for which Pharmaceutical Benefits Scheme (PBS) Safety Net entitlements will not apply for early supplies. This instrument, made under subsection 84AAA(2) of the National Health Act 1953, aims to address the need for updating the list of pharmaceutical items and their associated periods and circumstances in line with changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The amendments reflect the ongoing adjustments to the PBS list and are intended to ensure that the Pharmaceutical Benefits Scheme continues to provide timely and efficient access to necessary medications. The Pharmaceutical Benefits Advisory Committee's recommendations were integral in guiding these changes, ensuring that decisions about pharmaceutical benefits are evidence-based and aligned with public health needs. This legislative instrument was developed by the Australian Parliament and is designed to facilitate the progressive realisation of the right to the highest attainable standard of physical and mental health, as outlined in the International Covenant on Economic, Social and Cultural Rights. It ensures that the PBS remains an effective mechanism for providing subsidised access to essential medications, thereby supporting the broader goal of improving public health outcomes.

Scope and Application

The National Health (Pharmaceutical Benefits – Early Supply) Amendment Instrument 2019 (No. 8) amends the National Health (Pharmaceutical Benefits—early supply) Instrument 2015, which specifies pharmaceutical items for which Pharmaceutical Benefits Scheme (PBS) Safety Net entitlements will not apply for early supplies. This amendment applies to the Commonwealth of Australia and affects pharmaceutical items listed in Schedule 1 of the Principal Instrument. It involves the addition, deletion, and alteration of listed pharmaceutical items and associated periods and circumstances. The changes include additions such as buprenorphine injection forms, deletions such as hydrochlorothiazide with triamterene, and the addition of maximum number of repeats for certain drugs like esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole. The Pharmaceutical Benefits Advisory Committee (PBAC) is involved in the decision-making process, ensuring evidence-based recommendations. The instrument is compatible with human rights as it assists in the progressive realisation of the right to the highest attainable standard of physical and mental health by providing access to subsidised medicines through the PBS. The scope of this legislative instrument is limited to pharmaceutical items specified in the National Health (Pharmaceutical Benefits—early supply) Instrument 2015 and their associated periods and circumstances. It does not extend to pharmaceutical benefits supplied under repatriation schemes or those originating from a hospital prescription. The instrument is made under the authority of the National Health Act 1953 and commences on 1 September 2019. The Pharmaceutical Benefits Advisory Committee plays a pivotal role in advising on the pharmaceutical items to be specified in the instrument, ensuring that the decisions align with evidence-based practices. The instrument does not contain any explicit exclusions or exemptions beyond those already defined in the Principal Instrument and related instruments.

Key Provisions

The main operative sections of the National Health (Pharmaceutical Benefits – Early Supply) Amendment Instrument 2019 (No. 8) are concerned with amending the National Health (Pharmaceutical benefits—early supply) Instrument 2015 (PB 120 of 2015) to specify the pharmaceutical items that are pharmaceutical benefits for which the Pharmaceutical Benefits Scheme (PBS) Safety Net entitlements will not apply for early supplies (section 3). The amendments made by this Instrument are reflected in the changes to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012 (PB 71 of 2012), which also commence on 1 September 2019. The Schedule to the Principal Instrument is amended by the addition, deletion, and alteration of listed pharmaceutical items and associated periods and circumstances. The obligations imposed by the Act on parties or entities it governs include specifying pharmaceutical items for the purposes of paragraph 84AAA(1)(b) of the Act, ensuring that early supplies of pharmaceutical benefits meet the requirements of subsection 84AAA(1), and adhering to the changes outlined in the amendments. The Pharmaceutical Benefits Advisory Committee (PBAC) plays a key role in this process by providing advice to the Minister about which drugs and medicinal preparations should be available to Australians as pharmaceutical benefits. The PBAC is composed of members from various relevant fields, including consumers, health economists, practising community pharmacists, general practitioners, clinical pharmacologists, specialists, and a pharmaceutical industry nominee. These amendments require the PBAC to consider and recommend changes to the list of pharmaceutical items to ensure that the PBS continues to provide appropriate access to medicines for patients. Offences, penalties, or consequences for breach are not explicitly detailed in the text, but the Act does provide for penalties in other sections. Generally, under the National Health Act 1953, breaches of the Act or regulations can result in fines or imprisonment, depending on the nature and severity of the offence. For example, subsection 101(5) of the Act provides that a person who contravenes a provision of a regulation is liable to a penalty not exceeding 50 penalty units. In addition, subsection 101(5A) provides that a person who contravenes a provision of a regulation that is also an offence under a State or Territory law is liable to a penalty not exceeding the maximum penalty prescribed by that law. Furthermore, civil consequences may include compensation for any loss or damage resulting from the breach. This legislative instrument is compatible with human rights as it 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 the advancement of this human right by providing for subsidised access by patients to medicines. The recommendatory role of the PBAC ensures that decisions about subsidised access to medicines on the PBS are evidence-based, further protecting human rights.

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Area of Law
Health Law
Instrument
Legislative Instrument
Concepts
Definitions & Interpretation
Licensing & Registration
Reporting & Disclosure Obligations
Compliance Obligations
Catchwords
Pharmaceutical items
Early supply
Pharmaceutical Benefits Scheme

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