{"id":"F2020L00057","name":"National Health (Pharmaceutical Benefits) (Subsection 84C(7) Price) Determination 2019","slug":"national-health-pharmaceutical-benefits-subsection-84c-7-price-determination-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":100611,"registerId":"commonwealth-F2020L00057-current","compilationNumber":null,"startDate":"2026-04-02","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Name","content":"#### 1 Name\n\n  (1) This instrument is the National Health (Pharmaceutical Benefits) (Subsection 84C(7) Price) Determination 2019.\n  (2) This instrument may also be cited as PB 113 of 2019.","sortOrder":0},{"sectionNumber":"3","sectionType":"section","heading":"Authority","content":"#### 3 Authority\n\n  This instrument is made under subsection 84C(7) of the National Health Act 1953.","sortOrder":1},{"sectionNumber":"5","sectionType":"section","heading":"Definitions","content":"#### 5 Definitions\n\n  In this instrument:\n\n> Act means the National Health Act 1953.\n\n> additional patient charge has the same meaning as in the National Health (Pharmaceutical Benefits) Regulations 2017.\n\n> approved pharmacist has the meaning given by subsection 84(1) of the Act.\n\n> extemporaneously‑prepared pharmaceutical benefit means a pharmaceutical benefit that is not a ready‑prepared pharmaceutical benefit.\n\n> pharmaceutical benefit has the meaning given by subsection 84(1) of the Act.\n\n> ready‑prepared pharmaceutical benefit means a brand of a pharmaceutical item determined under subsection 85(6) of the Act.","sortOrder":2},{"sectionNumber":"6","sectionType":"section","heading":"Manner of ascertaining price for pharmaceutical benefits","content":"#### 6 Manner of ascertaining price for pharmaceutical benefits\n\n  (1) For the purposes of subsection 84C(7) of the Act, the price for a pharmaceutical benefit (of a particular quantity or number of units) is to be ascertained by adding:\n    (a) the Commonwealth price for the supply of the benefit by an approved pharmacist, worked out in accordance with the Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Determination 2020 (PB 66 of 2020); and\n    (b) the amount of the additional patient charge; and\n    (c) either:\n    (i) if the pharmaceutical benefit is a ready‑prepared pharmaceutical benefit—$1.48; or\n    (ii) if the pharmaceutical benefit is an extemporaneously‑prepared pharmaceutical benefit—$1.91.\n\n> Note: This subsection complies with subsection 84C(8) of the Act because, to comply with subsection 98B(2) of the Act, the Commonwealth price (Pharmaceutical benefits supplied by approved pharmacists) Determination 2020 (PB 66 of 2020):\n\n    (a) uses as a basis the approved ex‑manufacturer price, a proportional ex‑manufacturer price or the basic wholesale price; and\n    (b) provides for the addition of other fees and amounts determined by the Tribunal that made the determination.\n  (2) However, the price for the pharmaceutical benefit must not be more than the amount that an approved pharmacist may charge for the supply of the benefit under subsection 87(2) or (3) of the Act.","sortOrder":3}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument remains tightly focused on its original purpose: prescribing the method for ascertaining prices for pharmaceutical benefits under subsection 84C(7) of the National Health Act 1953. It has not expanded beyond this specific technical pricing function."},"complexity_factors":["Only 6 defined terms in the interpretation section, all referencing external instruments or the parent Act","Single operative provision (section 6) with straightforward arithmetic formula: A + B + C","Simple binary condition in paragraph (c): two flat dollar amounts ($1.48 or $1.91) depending on medicine type","One cross-reference to external Determination (PB 66 of 2020) for Commonwealth price calculation","Single exception/limitation in subsection (2) — a price cap referencing subsections 87(2) and (3) of the parent Act","Explanatory note provides helpful context about compliance with subsection 98B(2) but does not add operational complexity","Total length: 6 short sections, approximately 250 words of substantive content"],"plain_english_summary":"This Determination sets how the retail price of PBS‑subsidised medicines is calculated at the pharmacy: the Commonwealth price plus any additional patient charge and a fixed dispensing fee ($1.48 for standard products; $1.91 for extemporaneously prepared medicines). It affects patients, approved pharmacists and the Department of Health, ensuring consistent pricing and a legal cap so the final price cannot exceed the maximum charge under the National Health Act."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument does not expand or narrow who is covered or what counts as a pharmaceutical benefit; it prescribes the arithmetic method for ascertaining the price under s 84C(7) and links to PB 66 of 2020 for the Commonwealth price (s 6(1); s 6(2))."},"complexity_factors":["Cross-references to multiple statutory provisions (s 84C(7), s 84C(8), s 98B(2), ss 87(2)–(3)) and to another instrument (PB 66 of 2020) increase interpretive dependency","Defined term distinctions (ready‑prepared v. extemporaneously‑prepared) affect which flat fee applies (s 5; s 6(1)(c))","Dependence on PB 66 of 2020 for the Commonwealth price means practical calculation relies on a separate, possibly complex determination and Tribunal-set components (note to s 6(1))","A statutory cap limits price outcomes, requiring pharmacists to check parallel charging rules (s 6(2))","Low operational complexity overall: fixed numeric additions and a simple cap make arithmetic straightforward"],"plain_english_summary":"This determination sets how the retail price for a pharmaceutical benefit is calculated under subsection 84C(7) of the National Health Act 1953. It requires adding the Commonwealth price (per PB 66 of 2020), any additional patient charge, and a fixed dispensing amount — $1.48 for ready‑prepared items or $1.91 for extemporaneously‑prepared items (s 6(1)). The calculated price is subject to an upper limit: it cannot exceed the maximum an approved pharmacist may charge under ss 87(2)–(3) (s 6(2))."},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/national-health-pharmaceutical-benefits-subsection-84c-7-price-determination-2019","history":"/api/acts/national-health-pharmaceutical-benefits-subsection-84c-7-price-determination-2019/history","analysis":"/api/acts/national-health-pharmaceutical-benefits-subsection-84c-7-price-determination-2019/analysis","conflicts":"/api/acts/national-health-pharmaceutical-benefits-subsection-84c-7-price-determination-2019/conflicts","importantCases":"/api/acts/national-health-pharmaceutical-benefits-subsection-84c-7-price-determination-2019/important-cases","documents":"/api/acts/national-health-pharmaceutical-benefits-subsection-84c-7-price-determination-2019/documents"}}