National Health (Prescriber bag supplies) Amendment Determination 2020 (No. 2) (PB 59 of 2020)

Administered by Department of Health, Disability and Ageing

Legislation au F2020L00846 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (PRESCRIBER BAG SUPPLIES) AMENDMENT DETERMINATION 2020 (No. 2)

PB 59 of 2020

 

Authority

Subsections 93(1) and 93AB(1) of the National Health Act 1953 (the Act) provide for the Minister to determine the pharmaceutical benefits that may be supplied by medical practitioners and authorised nurse practitioners, respectively, directly to patients.

Subsections 93(2) and 93AB(2) of the Act provide for the Minister to determine the maximum quantity or number of units of a pharmaceutical benefit which may be obtained during a specified period, by a medical practitioner and an authorised nurse practitioner, respectively.

The National Health (Prescriber bag supplies) Determination 2012 (PB 73 of 2012) (the Principal Determination) determines the pharmaceutical benefits and maximum quantities of those pharmaceutical benefits for this purpose.

Purpose

The purpose of this legislative instrument, made under sections 93 and 93AB of the National Health Act 1953 (the Act), is to amend the National Health (Prescriber bag supplies) Determination 2012 (PB 73 of 2012) to make changes to the list of pharmaceutical benefits that may be supplied by medical practitioners and authorised nurse practitioners, respectively, directly to patients (prescriber bag supplies) and to the maximum quantity or number of units of these pharmaceutical benefits which may be obtained during a specified period by a medical practitioner and an authorised nurse practitioner.

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.

Schedule 1 to this Instrument provides for deletion of the drug diazepam from the list of pharmaceutical benefits that may be supplied directly to patients as a prescriber bag supply.  This change is summarised, by subject matter, in the Attachment.

Variation and revocation

Unless there is an express power to revoke or vary PB 73 of 2012 cited in this Instrument and explanatory statement, subsection 33(3) of the Acts Interpretation Act 1901 is relied upon to revoke or vary PB 73 of 2012.

Background

Part VII of the Act is the legislative basis of the Pharmaceutical Benefits Scheme (PBS) by which the Commonwealth provides reliable, timely, and affordable access to a wide range of medicines for all Australians.

Subsection 85(1) of the Act provides that benefits are to be provided by the Commonwealth in accordance with Part VII in respect of pharmaceutical benefits.

Drugs and medicinal preparations to which Part VII applies are declared by the Minister by legislative instrument to be so under subsections 85(2) and (2AA) of the Act.  These are listed drugs as defined in subsection 84(1) of the Act.

Sections 93 and 93AB of the Act provide for certain pharmaceutical benefits to be obtained by medical practitioners and authorised nurse practitioners for direct supply for patient treatment.  These pharmaceutical benefits are obtained as prescriber bag supplies and use is free of charge to the patient.  Section 93AA of the Act provides for supply by authorised midwives, but that power is not exercised in the Principal Determination and has not been exercised to date.  For each drug and form identified in the Schedule of the Principal Determination, the pharmaceutical benefits that may be obtained as prescriber bag supplies are all brands of pharmaceutical benefits, determined by legislative instrument under subsections 85(2), (3), and (6) of the Act, having that drug in that form.

For subsections 93(2) and 93AB(2) of the Act, the maximum quantity of each pharmaceutical benefit is the maximum quantity that a medical practitioner and an authorised nurse practitioner, respectively, may obtain during a calendar month.  Where there is more than one drug and form with the same Group Number, the maximum quantity may be obtained for a pharmaceutical benefit having only one drug and form with the Group Number.

A quantity up to the maximum quantity may be obtained during a month, only if the total quantity of pharmaceutical benefits of any drug and form having the same Group Number in the possession of the prescriber bag supplier is less than the maximum quantity for the drug and form.  Several Groups have two or more drugs and forms.

Consultation

This determination gives effect to recommendations made by the Pharmaceutical Benefits Advisory Committee (PBAC), an independent expert body, established by section 100A of the Act, to make 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 the PBAC, and that would enable them to contribute meaningfully to the deliberations of the PBAC.

Under subsection 101(4) of the Act, a drug or medicinal preparation may not be declared to be a drug or medicinal preparation to which Part VII of the Act applies unless the PBAC has recommended that it be so declared.  When recommending the listing of a medicine on the PBS, the 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.

The involvement of interested parties through the membership of the PBAC constitutes a formal and ongoing process of consultation.

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

This Amendment Determination commences on 1 July 2020.


ATTACHMENT

PROVISION-BY-PROVISION DESCRIPTION OF NATIONAL HEALTH (PRESCRIBER BAG SUPPLIES) AMENDMENT DETERMINATION 2020 (No. 2)

Section 1 Name of Instrument

This section provides the name of this Instrument as the National Health (Prescriber bag supplies) Amendment Determination 2020 (No. 2) and may also be cited as PB 59 of 2020.

Section 2 Commencement

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

Section 3 Amendment of National Health (Prescriber bag supplies) Determination 2012 (PB 73 of 2012)

This section provides that Schedule 1 amends the National Health (Prescriber bag supplies) Determination 2012 (PB 73 of 2012).

Schedule Amendments

The amendments in Schedule 1 involve the deletion of a drug from the list of pharmaceutical benefits that may be supplied directly to patients as a prescriber bag supply.  This change is summarised below.

 

SUMMARY OF CHANGES TO THE National Health (Prescriber bag supplies) Determination 2012 MADE BY THIS INSTRUMENT

Listed Drugs Deleted

Listed Drug

Diazepam


Statement of Compatibility with Human Rights

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

National Health (Prescriber bag supplies) Amendment Determination 2020 (No. 2)

(PB 59 of 2020)

This 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 (Prescriber bag supplies) Amendment Determination 2020 (No. 2) amends the National Health (Prescriber bag supplies) Determination 2012, made under sections 93 and 93AB of the National Health Act 1953 (the Act), which provides for certain pharmaceutical benefits to be obtained, and supplied, by medical practitioners and authorised nurse practitioners directly to patients for treatment (prescriber bag supplies) and specifies the maximum amount of these pharmaceutical benefits that may be obtained by medical practitioners and authorised nurse practitioners in any calendar month.  These pharmaceutical benefits are obtained for use for patient treatment as prescriber bag supplies and are free of charge to patients.

The amendment in Schedule 1 involves the deletion of a drug from the list of pharmaceutical benefits that may be supplied directly to patients as a prescriber bag supply.

Human Rights Implications

This 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 Pharmaceutical Benefits Scheme (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 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 (Prescriber bag supplies) Amendment Determination 2020 (No. 2) was enacted to amend the National Health (Prescriber bag supplies) Determination 2012, which specifies the pharmaceutical benefits that can be supplied directly to patients by medical practitioners and authorised nurse practitioners, and the maximum quantities of these benefits that can be obtained by these practitioners in any calendar month. This amendment was introduced to align the list of pharmaceutical benefits with the changes made to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The determination was made under sections 93 and 93AB of the National Health Act 1953 by the Minister for Health, and the policy objective is to ensure that decisions about the supply of medicines are evidence-based and contribute to the progressive realisation of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. This legislative instrument reflects the recommendations of the Pharmaceutical Benefits Advisory Committee, an independent expert body established by the Act to advise the Minister on which drugs and medicinal preparations should be available as pharmaceutical benefits. The Pharmaceutical Benefits Scheme, which is the legislative basis for the availability of affordable medicines for all Australians, is supported by this amendment, ensuring that the decisions made are in accordance with the highest standards of clinical effectiveness, safety and cost-effectiveness. The determination commenced on 1 July 2020 and 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.

Scope and Application

The National Health (Prescriber bag supplies) Amendment Determination 2020 (No. 2) amends the National Health (Prescriber bag supplies) Determination 2012, which was made under sections 93 and 93AB of the National Health Act 1953. The Act pertains to the Commonwealth's provision of reliable, timely, and affordable access to a range of medicines for all Australians through the Pharmaceutical Benefits Scheme (PBS). The Amendment Determination specifies certain pharmaceutical benefits that medical practitioners and authorised nurse practitioners can obtain and supply directly to patients for treatment, known as prescriber bag supplies, which are free of charge to patients. The Amendment Determination also outlines the maximum quantity of these pharmaceutical benefits that can be obtained by medical practitioners and authorised nurse practitioners in any calendar month. The amendment made by the Amendment Determination involves the deletion of a drug from the list of pharmaceutical benefits that can be supplied directly to patients as a prescriber bag supply. This change reflects updates to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The Amendment Determination is compatible with human rights, particularly advancing the protection of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, as it supports the PBS in providing subsidised access to medicines. The Amendment Determination applies to medical practitioners and authorised nurse practitioners who obtain and supply pharmaceutical benefits directly to patients as prescriber bag supplies. The scope of the Amendment Determination is national, as it pertains to the PBS, which is a Commonwealth scheme. There are no stated exclusions or exemptions in the Amendment Determination, but it should be noted that the determination is subject to the provisions of the National Health Act 1953 and any subordinate instruments made under it. The Amendment Determination is a legislative instrument for the purposes of the Legislative Instruments Act 2003 and commenced on 1 July 2020.

Key Provisions

The National Health (Prescriber bag supplies) Amendment Determination 2020 (No. 2) amends the National Health (Prescriber bag supplies) Determination 2012 (No. 73 of 2012) under sections 93 and 93AB of the National Health Act 1953. This legislative instrument governs the pharmaceutical benefits that can be directly supplied by medical practitioners and authorised nurse practitioners to patients as prescriber bag supplies, and specifies the maximum quantities that can be obtained by these professionals in any calendar month (sections 1 and 3). The primary change introduced by this Amendment Determination is the removal of the drug diazepam from the list of pharmaceutical benefits that can be supplied as prescriber bag supplies (Schedule 1). The Act imposes specific obligations on medical practitioners and authorised nurse practitioners, including obtaining pharmaceutical benefits within the specified maximum quantities, and ensuring that the total quantity of pharmaceutical benefits of any drug and form having the same Group Number in their possession is less than the maximum quantity for that drug and form (subsections 93(2) and 93AB(2)). These practitioners are required to use these pharmaceutical benefits solely for patient treatment and must not supply them for any other purpose. Failure to comply with the requirements of the Determination may result in civil or criminal consequences. However, the specific penalties for breach are not detailed in the text provided. The Pharmaceutical Benefits Advisory Committee (PBAC), an independent expert body established under the Act, plays a key role in recommending changes to the list of pharmaceutical benefits, ensuring that decisions about subsidised access to medicines on the Pharmaceutical Benefits Scheme (PBS) are evidence-based and take into account clinical effectiveness, safety, and cost-effectiveness. This Amendment Determination is compatible with human rights, particularly Articles 2 and 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR), as it assists with the progressive realisation of the right to the highest attainable standard of physical and mental health by ensuring evidence-based decisions regarding access to medicines. The involvement of the PBAC in the decision-making process further ensures that these decisions are human rights-compliant.

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