Commonwealth Consolidated Acts

NATIONAL HEALTH ACT 1953 - SECT 99ACE

When section applies

             (1)  This section applies if:

                     (a)  section 99ACD has applied to a brand (the new brand ) of a combination item (the new combination item ); and

                     (b)  the new agreed price for the new brand of the combination item comes into force on a day (the reduction day ); and

                     (c)  on that day, a price agreement or a determination under section 85B is in force in relation to any of the following listed brands (the related brand ) of a combination item (the related item ):

                              (i)  another listed brand of the new combination item;

                             (ii)  a brand of another combination item that has a drug that contains the same component drugs as the new brand of the new combination item and that has the same manner of administration as the new brand of the new combination item;

                            (iii)  if the drug in the new combination item is in a therapeutic group--a combination item that has another drug that is in that group and has the same manner of administration as the new brand of the new combination item; and

                     (d)  the related item is not an exempt item.

Note:          For the purposes of paragraph (c), the new brand and the related brand may be the same brand, or the new combination item and the related item may be the same pharmaceutical item.

16% price reduction

             (2)  The approved price to pharmacists of the related brand of the related item ceases to be in force at the end of the day before the reduction day. The claimed price (if any) for the related brand of the related item ceases to be in force at the end of the day before the reduction day.

             (3)  If a price agreement was in force on the day before the reduction day for the related brand of the related item, the Minister may:

                     (a)  in a price agreement, specify an agreed price for the related brand of the related item that:

                              (i)  comes into force on the reduction day; and

                             (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

                     (b)  in a determination under section 85B for the related brand of the related item, specify a determined price that:

                              (i)  comes into force on the reduction day; and

                             (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%.

             (4)  If a determination under section 85B was in force for the related brand of a related item on the day before the reduction day, the Minister may:

                     (a)  in a determination under section 85B for the related brand of the related item, specify a determined price and a claimed price for the related brand of the related item that:

                              (i)  come into force on the reduction day; and

                             (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

                     (b)  in a price agreement for the related brand of the related item, specify an agreed price for the related brand of the related item that:

                              (i)  comes into force on the reduction day; and

                             (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%.

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:

Section does not limit Minister's powers

             (6)  This section does not limit the Minister's powers, after the reduction day, to make:

                     (a)  further price agreements; or

                     (b)  further determinations under section 85B;

for the related brand of the related item.