I, TANYA PLIBERSEK, Minister for Health, make this Determination under subsection 99(4) of the National Health Act 1953.

Dated  24th September 2012

1 Name of Determination

 (1) This Determination is the National Health (Pharmaceutical benefits supplied by private hospitals) Amendment Determination 2012 (No. 1).

 (2) This Determination may also be cited as PB 83 of 2012.

2 Commencement

 This Determination commences on 1 October 2012.

3 Amendment of National Health (Pharmaceutical benefits supplied by private hospitals) Determination 2010

 Schedule 1 amends the National Health (Pharmaceutical benefits supplied by private hospitals) Determination 2010 made on 21 September 2010.

Schedule 1 Amendments

[1] Subsection 5(1)

insert

approved ex-manufacturer price has the same meaning as in subsection 84(1) of the Act.

[2] Subsection 5(1), definition of Approved Pharmacists Determination

  omit

the Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Determination 2010

  insert

the determination made under paragraph 98B(1)(a) of the Act

[3] Subsection 5(1), definition of approved price to pharmacists

  omit

[4] Subsection 5(1), definition of manufacturers’ packs

  omit

  insert

pack quantity has the same meaning as in subsection 84(1) of the Act.

Note: The Minister may determine one or more pack quantities for a brand of a pharmaceutical item under subsection 84AK(2) of the Act.  The quantities determined are the quantities in manufacturer’s PBS packs.

[5] Subsection 5(1) 

  insert

proportional ex-manufacturer price has the same meaning as in subsection 84(1) of the Act.

[6] Subsection 5(1), definition of storage and handling mark-up 

omit

the ex-manufacturer price of the benefit

  insert

the approved ex-manufacturer price or the proportional ex-manufacturer price of the pack quantity of the benefit

[7] Subsection 5(2)

  omit

[8] Subsection 11(1)

  omit

  substitute

(1) The dispensed price for the supply of a ready-prepared pharmaceutical benefit by an approved hospital authority to a patient receiving treatment in or at a private hospital for which the authority is approved is:

(a) if a quantity of the benefit that is ordered and supplied is equal to a multiple of a pack quantity of the benefit — the sum of:

(i)  for each pack quantity:

(A) the approved ex-manufacturer price or the proportional ex-manufacturer price for the pack quantity; and

(B) the storage and handling mark-up; and

(C) the mark-up, worked out under section 12; and

(ii) a ready-prepared dispensing fee; or

(b) if a quantity of the benefit that is ordered and supplied is less than a pack quantity of the benefit — the sum of:

(i) the amount worked out under section 14; and

(ii) a ready-prepared dispensing fee; and

(iii) an amount for the supply of a container, worked out under section 13; or

(c) if a quantity of the benefit that is ordered and supplied is more than a multiple of a pack quantity of the benefit— the sum of:

(i)  for each pack quantity:

 (A) the approved ex-manufacturer price or the proportional ex-manufacturer price for the pack quantity; and

(B) the storage and handling mark-up; and

(C) the mark-up worked out under section 12; and

(ii) for the remainder of the quantity that is less than a pack quantity— the amount worked out under section 14; and

(iii) a ready-prepared dispensing fee.

[9] Subsection 12(1) 

omit

subparagraph 11 (1) (a) (iii)

  substitute

sub-subparagraph 11(1)(a)(i)(C)

[10] Subsection 12(1)  

omit

subparagraphs 11 (1) (a) (i) and (ii)

insert

sub-subparagraphs 11(1)(a)(i)(A) and (B)

[11] Subsection 12(2)

omit

subparagraph 11 (1) (c) (iii)

  substitute

sub-subparagraph 11(1)(c)(i)(C)

[12] Subsection 12(2) 

omit

subparagraphs 11 (1) (c) (i) and (ii)

insert

sub-subparagraphs 11(1)(c)(i)(A) and (B)

[13] Section 14

  omit

If a ready-prepared pharmaceutical benefit is ordered and supplied in a quantity that is less than the quantity contained in a standard or non‑standard pack (the broken quantity), the amount mentioned in subparagraph 11 (1) (b) (i) or (c) (iv) is to be worked out using the following method statement.

  substitute

 If a ready-prepared pharmaceutical benefit is ordered and supplied in a quantity that is less than a pack quantity (the broken quantity), the amount mentioned in subparagraph 11 (1) (b) (i) or (c) (ii) is to be worked out using the following method statement.

[14] Section 14, Step 1

  omit

  substitute

Step 1 Add together, for a pack quantity:

(a) the approved ex-manufacturer price or the proportional ex-manufacturer price for the pack quantity; and

(b) the storage and handling mark-up; and

(c) the mark-up worked out under section 12.

[15] Section 14, Step 2

  omit

quantity or number of units in the standard or non-standard pack

  substitute

pack quantity

[16] Section 15

  omit

substitute

If the dispensed price worked out for the supply of a broken quantity of a ready-prepared pharmaceutical benefit exceeds the dispensed price for a pack quantity, the dispensed price for the pack quantity is the dispensed price for the broken quantity.

[17] Section 16 

  omit the heading to the section and the section

substitute

16 Pharmaceutical benefits mentioned in a determination under paragraph 98C (1) (b) of the Act

 If a prescription directs the supply of a quantity of a pharmaceutical benefit mentioned in a determination under paragraph 98C(1)(b) of the Act as a pharmaceutical benefit the complete pack of which shall be supplied regardless of any lesser quantity ordered, the dispensed price is the price worked out as if a complete pack was supplied.

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