National Health (Trastuzumab) Special Arrangement Amendment Instrument 2011 (No. 2) (No. PB 66 of 2011)

Administered by Department of Health, Disability and Ageing

Legislation au F2011L01775 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

Issued by Authority of the Minister for Health and Ageing

 

NATIONAL HEALTH ACT 1953

 

NATIONAL HEALTH (TRASTUZUMAB) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2011 (No. 2)

 

PB 66 of 2011

Purpose

The purpose of this legislative instrument, made under subsections 100(1) and 100(2) of the National Health Act 1953 (the Act), is to amend the National Health (Trastuzumab) Special Arrangement 2010 (PB 115 of 2010) (the Special Arrangement), to make changes to the Special Arrangement relating to the Trastuzumab program for hospitals.

The pharmaceutical benefits supplied under the Special Arrangement are for the treatment of chronic conditions which, because of their clinical use or other special features, may only be supplied to patients receiving treatment at or from a public or private hospital having access to appropriate specialised facilities.

Section 100 special arrangements and Part VII of the Act

Subsection 100(1) enables the Minister to make special arrangements for, or in relation to, providing that an adequate supply of pharmaceutical benefits will be available to persons:

(a)  who are living in isolated areas: or

(b) who are receiving treatment in circumstances in which generally available pharmaceutical benefits  are inadequate for that treatment; or

(c) if the pharmaceutical benefits covered by the arrangements can be more conveniently or efficiently supplied under the arrangements.

Subsection 100(3) provides that Part VII of the Act, and regulations and other legislative instruments made for the purposes of Part VII have effect subject to a special arrangement made under subsection 100(1).  A section 100 arrangement may thus modify the operation of Part VII of the Act, the regulations and other relevant instruments.

Subsection 100(2) provides that the Minister may vary or revoke a special arrangement made under subsection (1). 

Changes to the Special Arrangement made by this Instrument

This instrument:

  • omits any reference to ‘Medicare Australia CEO’ and substitutes ‘Chief Executive Medicare
  • omits any reference to ‘Medicare Australia’ and substitutes ‘Department of Human Services’ or ‘Chief Executive Medicare’

 

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 prescribing circumstances for listings on the PBS and for this Instrument.  This includes consultation through the PBAC process, and agreement to final listing details.

General

This Instrument commences on 1 September 2011.

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ATTACHMENT

 

PROVISION BY PROVISION DESCRIPTION OF THE NATIONAL HEALTH (TRASTUZUMAB) SPECIAL ARRANGEMENT AMENDMENT INSTRUMENT 2011 (No.2)

 

Section 1 Name of Instrument

This section provides that this Instrument is the National Health (Trastuzumab) Special Arrangement Amendment Instrument 2011 (No.2) and that it may also be cited as PB 66 of 2011.

Section 2 Commencement

This section provides that this Instrument commences on 1 September 2011.

Section 3 Amendments to PB 116 of 2010

This section provides that Schedule 1 amends the National Health (Trastuzumab) Special Arrangement 2010 (PB 115 of 2010) (the Principal Instrument).             

Schedule 1

Items 1 to 13 change references from ‘Medicare Australia CEO’ to the title ‘Chief Executive Medicare’. This change in title occurred on 1 July 2011 as a result of paragraph 99(2)(a) of Schedule 1 to the Human Services Legislation Amendment Act 2011 (‘HSLA Act), which provided that a reference to the Medicare Australia CEO in an instrument that was in effect prior to 1 July 2011 is to be read as a reference to the Chief Executive Medicare. Items 1 to 13 merely update the Principal Instrument to reflect the change that occurred on 1 July 2011.

Item 14 changes a reference to ‘Medicare Australia’ to ‘the Department of Human Services. This change occurred on 1 July 2011 as a result of paragraph 99(2)(b) of Schedule 1 to the HSLA Act, which provided that a reference to Medicare Australia in an instrument that was in effect prior to 1 July 2011 is to be read as a reference to the Department of Human Services. Item 14 merely updates the Principal Instrument to reflect the change that occurred on 1 July 2011.

 

Items 15 and 16 change references from ‘Medicare Australia’ to ‘Chief Executive Medicare’. Paragraph 99(2)(b) of Schedule 1 to the HSLA Act has the effect that from 1 July 2011 a reference to Medicare Australia in an instrument that was in effect prior to 1 July 2011 is to be read as a reference to the Department of Human Services. Items 15 and 16 amend the Principal Instrument so that particular references are to the Chief Executive Medicare rather than the Department of Human Services as it is considered more appropriate that these functions be performed by the Chief Executive Medicare.

 

Overview

The National Health (Trastuzumab) Special Arrangement Amendment Instrument 2011 (No. 2) was enacted to make adjustments to the National Health (Trastuzumab) Special Arrangement 2010, specifically addressing the Trastuzumab program for hospitals. The National Health Act 1953, administered by the Parliament of Australia, established this special arrangement to ensure an adequate supply of pharmaceutical benefits for patients with chronic conditions requiring specialised facilities, which are often only available in hospitals. The primary objective of this legislative instrument is to update references to reflect organisational changes, such as the renaming of Medicare Australia to the Department of Human Services and the retitling of the Medicare Australia CEO to Chief Executive Medicare, both effective from 1 July 2011. These amendments ensure the legislation remains current and accurately reflects the entities involved in administering the pharmaceutical benefits scheme. This legislative instrument was developed in consultation with the Pharmaceutical Benefits Advisory Committee (PBAC), an independent expert body that recommends which drugs should be available as pharmaceutical benefits. The PBAC ensures that the recommendations consider the clinical effectiveness, safety, and cost-effectiveness of the medicines. The amendments made by this instrument align with PBAC's recommendations, highlighting a commitment to evidence-based decision-making in health policy. Pharmaceutical companies were also consulted throughout the process, ensuring that the changes to prescribing circumstances for listings on the Pharmaceutical Benefits Scheme (PBS) are well-coordinated and agreed upon by all relevant stakeholders.

Scope and Application

The National Health (Trastuzumab) Special Arrangement Amendment Instrument 2011 (No. 2) amends the National Health (Trastuzumab) Special Arrangement 2010, providing changes to the arrangement relating to the Trastuzumab program for hospitals. The Trastuzumab program, which provides pharmaceutical benefits for the treatment of chronic conditions, applies to patients receiving treatment in public or private hospitals with appropriate specialised facilities. The legislative instrument is made under the National Health Act 1953, specifically subsections 100(1) and 100(2), enabling the Minister to make special arrangements for providing an adequate supply of pharmaceutical benefits to specified groups, including those receiving treatment in circumstances where generally available benefits are inadequate. The amendment instrument updates references to reflect changes in organisational titles resulting from the Human Services Legislation Amendment Act 2011, substituting references to the 'Medicare Australia CEO' with 'Chief Executive Medicare' and 'Medicare Australia' with 'Department of Human Services' or 'Chief Executive Medicare'. This instrument commenced on 1 September 2011 and is subject to the provisions of the Legislative Instruments Act 2003.

Key Provisions

The National Health (Trastuzumab) Special Arrangement Amendment Instrument 2011 (No. 2) amends the National Health (Trastuzumab) Special Arrangement 2010, primarily by updating references to reflect changes in organisational titles. Specifically, it changes references from "Medicare Australia CEO" to "Chief Executive Medicare" and from "Medicare Australia" to "Department of Human Services" or "Chief Executive Medicare" (sections 3 and 4). This update ensures that the Special Arrangement remains current with the administrative structure established by the Human Services Legislation Amendment Act 2011. The changes, which came into effect on 1 September 2011, are designed to ensure the continued smooth operation of the Special Arrangement for Trastuzumab, which provides pharmaceutical benefits for the treatment of chronic conditions in hospital settings. The amended Special Arrangement imposes obligations on hospitals, pharmaceutical companies, and the Department of Human Services to ensure that the Trastuzumab program operates effectively. Hospitals must ensure they have access to appropriate specialised facilities and comply with the prescribing and supply conditions outlined in the Special Arrangement. Pharmaceutical companies are responsible for supplying Trastuzumab in accordance with the terms set forth, including adhering to the clinical and safety standards. The Department of Human Services, or the Chief Executive Medicare, must oversee the implementation and compliance of the Special Arrangement, ensuring that the program meets its intended objectives. Failure to comply with the obligations and requirements set out in the amended Special Arrangement may result in legal consequences. While the explanatory statement does not specify the exact penalties, breaches of provisions under the National Health Act 1953 can generally lead to civil or criminal penalties, including fines. The severity of the penalties would depend on the nature and extent of the breach, and could potentially result in significant financial repercussions for the entities involved. It is essential for all parties to adhere strictly to the requirements to avoid any adverse legal outcomes.

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