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PB 82 of 2012 Determinations/Health as made
This determination amends the Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Determination 2010 to reflect amendments to the Act made by the National Health Amendment (Pharmaceutical Benefits Scheme) Act 2012.
Administered by: Health
Registered 26 Sep 2012
Tabling HistoryDate
Tabled HR09-Oct-2012
Tabled Senate09-Oct-2012
Date of repeal 19 Mar 2014
Repealed by Health (Spent and Redundant Instruments) Repeal Regulation 2014

PB 82 of 2012

Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Amendment Determination 2012 (No. 2)1

National Health Act 1953

We, the members of the Pharmaceutical Benefits Remuneration Tribunal, make this Determination under paragraph 98B(1)(a) of the National Health Act 1953.

Dated 7 September 2012

 

IAN ROBERT WATSON

Chairperson

 

 

 

BARRY FROST

Member

 

 

 

LEONIE SEGAL

Member

 

 

 

 


1          Name of Determination

(1)       This Determination is the Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Amendment Determination 2012 (No. 2).

(2)        This Determination may also be cited as PB 82 of 2012.

2          Commencement

            This Determination commences 1 October 2012.

3          Amendment

Schedule 1 amends the Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Determination 2010.

 

 


Schedule 1     Amendments

[1]       Subsection 6(1) (definition of agreed purchase quantity)

Omit:

means the quantity agreed under paragraph (2) (c)

Substitute:

, in relation to an ingredient of an extemporaneously‑prepared pharmaceutical benefit, means the quantity of the ingredient that is agreed upon between the Secretary and the Pharmacy Guild of Australia as the quantity for which the basic wholesale price is to be ascertained

[2]       Subsection 6(1) (definition of approved price to pharmacists)

Omit the definition.

[3]       Subsection 6(1)

Insert:

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

[4]       Subsection 6(1)

Insert:

determined quantity of a listed brand of a pharmaceutical item has the same meaning as in subsection 84(1) of the Act.

[5]       Subsection 6(1) (definition of manufacturers’ packs)

Omit the definition.

[6]       Subsection 6(1)

Insert:

maximum quantity of a brand of a pharmaceutical item, or a pharmaceutical benefit that has a pharmaceutical item, means a quantity or number of units of the pharmaceutical item determined under paragraph 85A(2)(a) of the Act in relation to that brand of pharmaceutical item.

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.

 

[7]       Subsection 6(1)

Insert:

price to pharmacists means the approved ex-manufacturer price or proportional ex-manufacturer price for the particular quantity, plus the wholesale mark-up worked out under section 11A.

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

[8]       Subsection 6(2)

Omit the subsection.

[9]       Subsection 9(1)

After the words in paragraph (b), insert:

; and

(c)  if a dangerous drug fee applies, only one such fee.

[10]     Subsection 11(1)

Omit the subsection.

Substitute:

(1)      The Commonwealth price for the supply of a quantity of a ready‑prepared pharmaceutical benefit is:

(a)    if the quantity of the benefit 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 wholesale mark‑up, worked out under section 11A; and   

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

(ii)      a ready‑prepared dispensing fee; or

(b)    if the quantity of the benefit 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 the quantity of the benefit 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 wholesale mark‑up, worked out under section 11A; and   

(C)      the pharmacy 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.

[11]     After section 11

Insert:

11A             Ready‑prepared pharmaceutical benefits — wholesale mark‑up

(1)      For sub-subparagraphs 11(1)(a)(i)(B) and 11(1)(c)(i)(B), and Step 1 of section 14, the wholesale mark‑up for a pack quantity of a ready‑prepared pharmaceutical benefit is the amount added to the approved ex‑manufacturer price (AEMP) or the proportional ex‑manufacturer price (PEMP) for the pack quantity, to calculate the price to pharmacists for that pack quantity, as set out in this section.

Step 1—Identify the approved ex-manufacturer price (AEMP) or the proportional ex-manufacturer price (PEMP) for the pack quantity

(2)      Identify the AEMP or the PEMP for the pack quantity for which a mark-up is to be calculated under this section.

Step 2—Identify the appropriate wholesale mark-up formula

(3)      List any maximum quantity or determined quantity of each listed brand of that pharmaceutical item (other than any maximum quantity that relates to a supply of any of those brands in section 100 only circumstances).

(4)      From that list, identify the quantity (the relevant quantity) of the brand of the pharmaceutical item, which is:

(a)    the quantity that is the highest whole number multiple of the pack quantity of the brand of the pharmaceutical item from:

(i)     any maximum quantity on the list; or

(ii)    if subparagraph (a)(i) does not apply—any determined quantity on the list; or

(b)    if paragraph (a) does not apply—the quantity that is the closest to the pack quantity of the brand of the pharmaceutical item (or, if two quantities are equally close, the higher of those quantities) from:

(i)     any maximum quantity on the list; or

(ii)    if subparagraph (b)(i) does not apply—any determined quantity on the list.

(5)      Work out proportionately the ex-manufacturer price for the relevant quantity of the brand of the pharmaceutical item.

Step 3—Apply the appropriate formula to work out the price to pharmacists for the pack quantity

(6)      If the ex-manufacturer price for the relevant quantity of the brand of the pharmaceutical item is less than, or equal to, $930.06, then the price to pharmacists for the pack quantity of the brand of the pharmaceutical item is the amount worked out as follows:

        PTP  =  AEMP or PEMP  x  1.0752

where:

PTP means the price to pharmacists for the pack quantity.

AEMP or PEMP means the approved ex-manufacturer price or the proportional ex-manufacturer price for the pack quantity.

(7)      If:

(a)    the ex-manufacturer price for the relevant quantity of the brand of the pharmaceutical item is more than $930.06; and

(b)    the relevant quantity and the pack quantity of the brand of the pharmaceutical item are the same;

then the price to pharmacists for the pack quantity of the brand of the pharmaceutical item is the amount worked out as follows:

        PTP  =  AEMP or PEMP  +  $69.94

where:

PTP means the price to pharmacists for the pack quantity.

AEMP or PEMP means the approved ex-manufacturer price or the proportional ex-manufacturer price for the pack quantity.

 

(8)      If:

(a)    the ex-manufacturer price for the relevant quantity of the brand of the pharmaceutical item is more than $930.06; and

(b)    the relevant quantity and the pack quantity of the brand of the pharmaceutical item are not the same;

then the price to pharmacists for the pack quantity of the brand of the pharmaceutical item is the amount worked out as follows:

        PTP  =  AEMP or PEMP  +  ($69.94  x   PQ)

                                                                         RQ)

where:

PTP means the price to pharmacists for the pack quantity.

AEMP or PEMP means the approved ex-manufacturer price or the proportional ex-manufacturer price for the pack quantity.

PQ means the pack quantity of the brand of the pharmaceutical item.

RQ means the relevant quantity of the brand of the pharmaceutical item.

[12]     Section 12

Omit the heading and the section.

Substitute:

12                Ready‑prepared pharmaceutical benefits — pharmacy mark‑up

(1)      For sub-subparagraphs 11(1)(a)(i)(C) and 11(1)(c)(i)(C), and Step 1 of section 14, the pharmacy mark‑up for a pack quantity of a ready‑prepared pharmaceutical benefit is:

(a)    if the pack quantity for which a mark-up is to be calculated under this section is equal to a maximum quantity of the pharmaceutical benefit, the mark-up is the amount mentioned in the table below for the price to pharmacists for that quantity. 

Item

Price to Pharmacists for Maximum Quantity

Mark‑up for Maximum Quantity

1

≤ $30

15%

2

> $30, ≤ $45

$4.50

3

> $45, ≤ $180

10% of  price to pharmacists

4

> $180, ≤ $450

$18.00

5

> $450, ≤ $1 750

4% of price to pharmacists

6

> $1 750

$70.00

 

 

 

 

 

 

 

(b)     if the pack quantity for which a mark-up is to be calculated under this section is not equal to a maximum quantity of the pharmaceutical benefit, the mark-up is calculated as follows:

(i)      calculate the price to pharmacists for the maximum quantity by applying the following formula:

 

PTP for PQ  x  MQ

       PQ

where:

PTP for PQ is the price to pharmacists for the pack quantity (calculated in section 11A);

PQ is the pack quantity; and

MQ is the maximum quantity;

(ii)    if the mark-up that would apply to the maximum quantity is shown in the table in paragraph (a) as a monetary amount - the mark-up for the pack quantity is that monetary amount reduced proportionately for the relative quantities; and

(iii)   if the mark-up that would apply to the maximum quantity is shown in the table in paragraph (a) as a percentage of price to pharmacists – the mark-up for the pack quantity is that percentage of the price to pharmacists for the pack quantity.

[13]     Section 14

Omit:

subparagraph 11(b)(i) or (c)(iii)

Substitute:

subparagraph 11(1)(b)(i) or (1)(c)(ii)

[14]     Section 14

Omit:

the quantity contained in a standard or non‑standard pack

Substitute:

a pack quantity

[15]     Section 14, Step 1

Omit the words in the step.

Substitute:

Add the mark‑ups worked out under sections 11A and 12 to the approved ex‑manufacturer price or the proportional ex‑manufacturer price for the pack quantity.

[16]     Section 14, Step 2

Omit:

standard or non‑standard pack

Substitute:

pack quantity

[17]     Section 15

Omit the words after ‘Commonwealth price’ (2nd occurring).

Substitute:

for the pack quantity, the Commonwealth price for the pack quantity is the Commonwealth price for the broken quantity

[18]     Section 16

Omit the heading 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 Commonwealth price is the price worked out as if a complete pack was supplied.

[19]     Section 20

Omit:

benefit

Substitute:

ingredient

[20]     Section 20, table, column headed Mark-up

Omit each mention of:

approved price to pharmacists

Substitute:

basic wholesale price

 

 

1Note

All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. 

See http://www.frli.gov.au