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National Health Amendment (Pharmaceutical Benefits Scheme) Bill 2010

Schedule 1 Increasing the 12.5% price reduction to 16%

   

National Health Act 1953

1  Subsection 84(1)

Insert:

subject to a 12.5% price reduction : see subsection 99ACA(2).

2  Subsection 84(1)

Insert:

subject to a 16% price reduction : see subsection 99ACA(2A).

3  Section 99AC

Omit “12.5%” (wherever occurring), substitute “16%”.

4  Paragraph 99ACA(2)(a)

After “applied”, insert “before 1 February 2011”.

5  After subsection 99ACA(2)

Insert:

          (2A)  A listed component drug contained in a drug in a combination item has been subject to a 16% price reduction if:

                     (a)  any of the following has applied to a brand of a pharmaceutical item that has the listed component drug and has the same manner of administration as the combination item:

                              (i)  section 99ACB;

                             (ii)  subsection 99ACF(1) or (2) because of item 1 of the table in section 99ACF; or

                     (b)  a pharmaceutical item that has the listed component drug and has the same manner of administration as the combination item is in a class of pharmaceutical items to which a 16% administrative price reduction has applied.

6  Subdivision B of Division 3A of Part VII (heading)

Repeal the heading, substitute:

Subdivision B 16% price reductions for new brands of pharmaceutical items that are not combination items

7  Paragraphs 99ACB(2)(a) to (c)

After “12.5%”, insert “or 16%”.

Note 1:    The heading to section 99ACB is altered by omitting “ 12.5% ” and substituting “ 16% ”.

Note 2:    The heading to subsection 99ACB(4) is altered by omitting “ 12.5% ” and substituting “ 16% ”.

8  Subsection 99ACB(5)

Omit “12.5%”, substitute “16%”.

9  Paragraphs 99ACD(1A)(a) to (c)

After “12.5%”, insert “or 16%”.

Note 1:    The heading to section 99ACD is altered by omitting “ 12.5% ” and substituting “ 16% ”.

Note 2:    The heading to subsection 99ACD(4) is altered by omitting “ 12.5% ” and substituting “ 16% ”.

10  Subsection 99ACD(5)

After “(6)”, insert “, (6A), (6B)”.

11  Subsection 99ACD(5)

Omit “12.5%”, substitute “16%”.

12  Subsection 99ACD(6)

Repeal the subsection, substitute:

Adjustment for prior price reductions to component drugs

             (6)  If, on a day before the determination day:

                     (a)  one or more of the listed component drugs (the component ) contained in the drug in the existing item had been subject to one of the following (the prior price reduction of the component ):

                              (i)  a 12.5% price reduction;

                             (ii)  a 16% price reduction; and

                     (b)  because of the prior price reduction of the component, the approved price to pharmacists of the existing brand of the existing item was reduced;

then the reduction referred to in subsection (5) is to be adjusted to reflect:

                     (c)  the percentage (the flowed-on percentage ) of the prior price reduction of the component that was taken into account in working out the amount of the reduction to the approved price to pharmacists of the existing brand of the existing item; and

                     (d)  the quantity of the component contained in the drug in the existing item.

          (6A)  For the purposes of subsection (6), if:

                     (a)  the prior price reduction of the component was a 12.5% price reduction; and

                     (b)  the flowed-on percentage was 100%;

then the reduction referred to in subsection (5) is to be adjusted so that there is no further reduction in relation to the component.

          (6B)  For the purposes of subsection (6), if:

                     (a)  the prior price reduction of the component was a 12.5% price reduction; and

                     (b)  the flowed-on percentage was less than 100%;

then the reduction referred to in subsection (5) is to be adjusted so that the percentage worked out as follows is taken into account in relation to the component:

13  Subparagraph 99ACE(3)(a)(ii)

Repeal the subparagraph, substitute:

                             (ii)  subject to subsections (5), (5A) and (5B), does not exceed the agreed price in force, on the day before that day, for the related brand of the related item, reduced by 16%; or

Note 1:    The heading to section 99ACE is altered by omitting “ 12.5% ” and substituting “ 16% ”.

Note 2:    The heading to subsection 99ACE(2) is altered by omitting “ 12.5% ” and substituting “ 16% ”.

14  Subparagraph 99ACE(3)(b)(ii)

Repeal the subparagraph, substitute:

                             (ii)  subject to subsections (5), (5A) and (5B), does not exceed the agreed price in force, on the day before that day, for the related brand of the related item, reduced by 16%.

15  Subparagraph 99ACE(4)(a)(ii)

Repeal the subparagraph, substitute:

                             (ii)  subject to subsections (5), (5A) and (5B), do not exceed those respective prices in force on the day before that day, reduced by 16%; or

16  Subparagraph 99ACE(4)(b)(ii)

Repeal the subparagraph, substitute:

                             (ii)  subject to subsections (5), (5A) and (5B), does not exceed the determined price in force, on the day before that day, for the related brand, reduced by 16%.

17  Subsection 99ACE(5)

Repeal the subsection, substitute:

Adjustment for prior price reductions to component drugs

             (5)  If, on a day before the reduction day:

                     (a)  one or more of the listed component drugs (the component ) contained in the related item had been subject to one of the following (the prior price reduction of the component ):

                              (i)  a 12.5% price reduction;

                             (ii)  a 16% price reduction; and

                     (b)  because of the prior price reduction of the component, the approved price to pharmacists of the related brand of the related item was reduced;

then the reduction referred to in subsection (3) or (4) is to be adjusted to reflect:

                     (c)  the percentage (the flowed-on percentage ) of the prior price reduction of the component that was taken into account in working out the amount of the reduction to the approved price to pharmacists of the related brand of the related item; and

                     (d)  the quantity of the component contained in the drug in the related item.

          (5A)  For the purposes of subsection (5), if:

                     (a)  the prior price reduction of the component was a 12.5% price reduction; and

                     (b)  the flowed-on percentage was 100%;

then the reduction referred to in subsection (3) or (4) is to be adjusted so that there is no further reduction in relation to the component.

          (5B)  For the purposes of subsection (5), if:

                     (a)  the prior price reduction of the component was a 12.5% price reduction; and

                     (b)  the flowed-on percentage was less than 100%;

then the reduction referred to in subsection (3) or (4) is to be adjusted so that the percentage worked out as follows is taken into account in relation to the component:

18  Subsection 99ACF(1) (table item 1)

Omit “12.5%”, substitute “16%”.

Note 1:    The heading to section 99ACG is altered by inserting “ or 16% ” after “ 12.5% ”.

Note 2:    The heading to section 99ACH is altered by omitting “ 12.5% ” and substituting “ 16% ”.