National Health (Prescriber bag supplies) Amendment Determination 2020 (No. 3) (PB 71 of 2020)

Administered by Department of Health, Disability and Ageing

Legislation au F2020L00966 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

NATIONAL HEALTH ACT 1953

NATIONAL HEALTH (PRESCRIBER BAG SUPPLIES) AMENDMENT DETERMINATION 2020 (No. 3)

PB 71 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 the addition a form of the listed drug salbutamol to 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 August 2020.


ATTACHMENT

PROVISION-BY-PROVISION DESCRIPTION OF NATIONAL HEALTH (PRESCRIBER BAG SUPPLIES) AMENDMENT DETERMINATION 2020 (No. 3)

Section 1 Name of Instrument

This section provides the name of this Instrument as the National Health (Prescriber bag supplies) Amendment Determination 2020 (No. 3) and may also be cited as PB 71 of 2020.

Section 2 Commencement

This section provides that this Instrument commences on 1 August 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 amendment in Schedule 1 involves the addition of a form of a listed drug to 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

Form Added

Listed Drug

Form

Salbutamol

Pressurised inhalation 100 micrograms (as sulfate) per dose with dose counter, 200 doses (CFC-free formulation)

 


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. 3)

(PB 71 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. 3) 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 addition of a form of a listed drug to 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.

 

 

 

Nikolai Tsyganov

Assistant Secretary (Acting)

Pricing and PBS Policy Branch

Technology Assessment and Access Division

Department of Health

Overview

The National Health (Prescriber bag supplies) Amendment Determination 2020 (No. 3) was enacted to amend the National Health (Prescriber bag supplies) Determination 2012, which determines the pharmaceutical benefits that may be supplied by medical practitioners and authorised nurse practitioners directly to patients, and specifies the maximum quantity of these benefits that may be obtained by these practitioners during a calendar month. This determination was made under sections 93 and 93AB of the National Health Act 1953, with the objective of aligning the list of pharmaceutical benefits supplied by prescribers with recent amendments to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012. The purpose of these amendments is to reflect changes recommended by the Pharmaceutical Benefits Advisory Committee, an independent expert body established to advise the Minister on the listing of pharmaceutical benefits on the Pharmaceutical Benefits Scheme. This legislative instrument commenced on 1 August 2020. This Amendment Determination involves the addition of a form of the listed drug salbutamol to the list of pharmaceutical benefits that may be supplied directly to patients as a prescriber bag supply. The Pharmaceutical Benefits Scheme, which is the basis for this legislation, aims to provide affordable access to a wide range of medicines for all Australians, ensuring the progressive realisation of the right to the highest attainable standard of physical and mental health, as recognised in the International Covenant on Economic, Social and Cultural Rights. This determination is compatible with human rights, as it advances the protection of human rights by providing evidence-based, subsidised access to medicines through the PBS.

Scope and Application

The National Health (Prescriber bag supplies) Amendment Determination 2020 (No. 3) amends the National Health (Prescriber bag supplies) Determination 2012, which is made under sections 93 and 93AB of the National Health Act 1953 (the Act). This amendment pertains to the list of pharmaceutical benefits that can be supplied directly to patients by medical practitioners and authorised nurse practitioners as prescriber bag supplies. The Act applies to medical practitioners and authorised nurse practitioners who provide direct pharmaceutical benefits to patients. The Amendment Determination specifies the maximum quantity of these pharmaceutical benefits that can be obtained by medical practitioners and authorised nurse practitioners during any calendar month. These pharmaceutical benefits are free of charge to patients and are intended for patient treatment. The geographic and jurisdictional reach of the Act is national, as it applies throughout Australia under the Commonwealth's authority. There are no stated exclusions or exemptions in this Amendment Determination, but it does specify thresholds for the maximum quantity of pharmaceutical benefits that can be obtained. The application of the Act can be extended or restricted through subordinate instruments, as evidenced by the Schedule 1 amendments that add a form of the listed drug salbutamol to the list of pharmaceutical benefits that can be supplied directly to patients as a prescriber bag supply. This change reflects amendments to the National Health (Listing of Pharmaceutical Benefits) Instrument 2012.

Key Provisions

The National Health (Prescriber bag supplies) Amendment Determination 2020 (No. 3) amends the National Health (Prescriber bag supplies) Determination 2012 (PB 73 of 2012) under sections 93 and 93AB of the National Health Act 1953. The main operative sections of the Amendment Determination involve the addition of a form of the drug salbutamol to the list of Pharmaceutical Benefits that can be supplied directly to patients by medical practitioners and authorised nurse practitioners as prescriber bag supplies. This change is outlined in Schedule 1 of the Amendment Determination. The Amendment Determination imposes obligations on medical practitioners and authorised nurse practitioners to ensure they are aware of and comply with the updated list of pharmaceutical benefits that can be supplied as prescriber bag supplies. It also obligates them to adhere to the maximum quantities specified for each pharmaceutical benefit, ensuring that the total quantity of any drug and form with the same Group Number in their possession does not exceed the maximum quantity for that drug and form. The changes in the Amendment Determination are aligned with recommendations from the Pharmaceutical Benefits Advisory Committee (PBAC), an expert body that advises the Minister on which drugs should be available as pharmaceutical benefits. The National Health Act 1953 does not explicitly outline specific offences, penalties, or consequences for breaches of the provisions set out in the Amendment Determination. However, non-compliance with the Pharmaceutical Benefits Scheme (PBS) regulations could potentially lead to civil or criminal consequences under broader health legislation or other related Acts. The maximum penalties for breaches of health-related legislation can vary widely, but they may include fines and, in severe cases, imprisonment. The Amendment Determination is compatible with human rights, particularly Articles 2 and 12 of the International Covenant on Economic, Social and Cultural Rights, as it facilitates access to affordable and effective medicines, thereby advancing the right to the highest attainable standard of physical and mental health. The involvement of the PBAC in the decision-making process ensures that recommendations for the PBS are evidence-based and take into account the clinical effectiveness, safety, and cost-effectiveness of the medicines.

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