Commonwealth Consolidated Acts Commonwealth Consolidated ActsReduction equal to percentage etc.
(1) Subject to sections 99ACG and 99ADHC, if:
(a) a section or subsection referred to in column 2 of the table in this subsection applies to a listed brand of a pharmaceutical item on a day specified in the section or subsection (the reduction day ); and
(b) subsection (2) does not apply to the listed brand of the pharmaceutical item on the reduction day; and
(c) on the day before the reduction day, an approved ex - manufacturer price was, or one or more claimed prices were, in force for the listed brand of the pharmaceutical item;
then, subject to subsections (1A), (2A) and (3), the approved ex - manufacturer price is, and (if applicable) each of the claimed prices are, taken to be reduced, on the reduction day, by the percentage or method specified in column 3 of the table for the section or subsection referred to in column 2.
Statutory price reductions table | ||
Item | Section or subsection | Percentage or method |
2 | 99ACHA | 5% |
2A | 99ACHB | 5% |
3 | 99ACJ | 10% |
3A | 99ACJA | 5% |
4 | 99ACK | 5% |
4A | 99ACKA | 26.1% |
4B | 99ACKB | 30% |
5 | 99ACL(1) | 10% |
6 | 99ACL(2) | (a) first, 10%; and (b) second, using the price worked out under paragraph (a), by 5% |
7 | 99ACM | 5% |
8 | 99ACN | The percentage referred to in paragraph 99ACN(1)(c) |
9 | 99ACP | 1.48% |
Note: Subsection (1) does not apply if there is no determination under subsection 85(6) in respect of the pharmaceutical item in force on the specified day (whether or not the determination was revoked following a request by the responsible person for the pharmaceutical item).
Reduction cap
(1A) If:
(a) the approved ex - manufacturer price of a listed brand of a pharmaceutical item is to be reduced under subsection (1) because of an item in the table in subsection (1); and
(b) apart from this subsection, the reduced approved ex - manufacturer price would be less than the amount (the capped price ) equal to:
(i) 40% of the approved ex - manufacturer price of a listed brand of the pharmaceutical item on 1 January 2016; or
(ii) if subparagraph (i) does not apply--40% of the original approved ex - manufacturer price of the first listed brand of the pharmaceutical item;
the approved ex - manufacturer price of the listed brand of the pharmaceutical item is taken to be reduced under subsection (1) because of that item to an amount equal to the capped price.
(1B) If the approved ex - manufacturer price mentioned in subparagraph (1A)(b)(i) or (ii) is by reference to a different pricing quantity than the pricing quantity on the reduction day, the approved ex - manufacturer price mentioned in that subparagraph is taken to be the amount that the approved ex - manufacturer price would have been had the pricing quantity been the same as the pricing quantity on the reduction day.
Reduction more than percentage
(2) This subsection applies if:
(a) a section or subsection referred to in column 2 of the table in subsection (1) applies to a listed brand of a pharmaceutical item on a reduction day; and
(b) subject to subsection (2A), on the reduction day, the approved ex - manufacturer price of the listed brand of the pharmaceutical item does not exceed:
(i) the approved ex - manufacturer price of the brand of the pharmaceutical item in force on the day before the reduction day, reduced by more than the percentage or method specified in column 3 of the table for the section or subsection referred to in column 2; or
(ii) if subsection (1A) would have applied to the brand of the pharmaceutical item if paragraph (1)(b) were disregarded--the capped price of the brand of the pharmaceutical item that would be worked under subsection (1A) if paragraph (1)(b) were disregarded; and
(c) if, on the day before the reduction day and on the reduction day, a determination under subsection 85B(3) was in force in relation to a particular pack quantity of the listed brand of the pharmaceutical item--the claimed price for that pack quantity of the brand of the pharmaceutical item does not exceed the claimed price for the same pack quantity of the brand of the pharmaceutical item in force on the day before the reduction day, reduced by more than the percentage or method specified in column 3 of the table for the section or subsection referred to in column 2.
Apportioning if pricing quantity changes
(2A) If the pricing quantity of the listed brand of the pharmaceutical item on the day before the reduction day is different from the pricing quantity of the listed brand of the pharmaceutical item on the reduction day, then, for the purposes of subsection (1) and paragraph (2)(b), the approved ex - manufacturer price of the listed brand of the pharmaceutical item on the day before the reduction day is taken to be the amount worked out as follows:
where:
"AEMP1" means the amount that was the approved ex - manufacturer price of the listed brand of the pharmaceutical item on the day before the reduction day.
"PQ1" means the pricing quantity of the listed brand of the pharmaceutical item on the day before the reduction day.
"PQ2" means the pricing quantity of the listed brand of the pharmaceutical item on the reduction day.
Ministerial discretion not to apply, or to reduce, statutory price reduction
(3) In relation to a listed brand of a pharmaceutical item, the Minister may, by notifiable instrument, determine that:
(a) the approved ex - manufacturer price is, or (if applicable) one or more claimed prices are, not to be reduced under a provision mentioned in an item of the table in subsection (1) (the specified provision ) in relation to a particular reduction day; or
(b) the approved ex - manufacturer price is, or (if applicable) one or more of the claimed prices are, to be reduced by a lower percentage than would otherwise apply under a provision mentioned in an item of the table in subsection (1) (the specified provision ) in relation to a particular reduction day.
(3A) In making a determination in relation to the application of an item of the table in subsection (1):
(a) the Minister must take into account what the approved ex - manufacturer price, and (if applicable) each of the claimed prices, of the listed brand of the pharmaceutical item would otherwise be under this section in relation to the particular reduction day if a determination were not made; and
(b) the Minister may take into account any other matter that the Minister considers relevant.
(3B) If the Minister makes a determination in relation to a specified provision, the approved ex - manufacturer price is, and (if applicable) each of the claimed prices are, not to be further reduced under that specified provision on any reduction day that occurs after the reduction day specified in the determination made under subsection (3).
Section does not limit Minister's powers
(4) This section does not limit the Minister's powers, on or after the reduction day, to make:
(a) further price agreements; or
(b) further determinations under section 85B;
for the listed brand of the pharmaceutical item.