Part Payment to supplier of highly specialise - National Health Act 1953 - Arrangements made under subparagraph 100(1)(b)(i) - Highly Specialised Drugs Program (No. PB 42 of 2006) - Payment to supplier of highly specialised drugs under these Arrangements

Payment to supplier of highly specialisePayment to supplier of highly specialised drugs under these Arrangements

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Turn the raw legal text into a practical explanation grounded in National Health Act 1953 - Arrangements made under subparagraph 100(1)(b)(i) - Highly Specialised Drugs Program (No. PB 42 of 2006).

Payment to supplier of highly specialised drugs under these Arrangements

An approved pharmacist or an approved hospital authority who has supplied a highly specialised drug is entitled to be paid by the Commonwealth the amount, if any, by which the dispensed price for the supply of the highly specialised drug exceeds the amount that the approved pharmacist or approved hospital authority was entitled to charge under paragraph 19.
The dispensed price for the supply of a highly specialised drug will be ascertained in accordance with paragraphs 22 to 28.
The dispensed price for the supply of a highly specialised drug will be —

(a) where a quantity of a highly specialised drug that is ordered and supplied is equal to the quantity contained in the manufacturer’s pack, the sum of:

(i) the price ex manufacturer of the manufacturer’s pack, plus mark-up as specified in paragraph 23, taken to the nearest cent, one half cent being counted as one cent; and

(ii) a dispensing fee equal to the dispensing fee for the supply of a ready-prepared pharmaceutical benefit, specified in the determination under paragraph 98B(1)(a) of the Act that is in force at the time of supply of the highly specialised drug; or

(b) where a quantity of a highly specialised drug that is ordered and supplied is less than the quantity contained in the manufacturer’s pack, the sum of:

(i) the amount calculated in accordance with paragraph 24; and

(c) where a quantity of a highly specialised drug that is ordered and supplied is more than the quantity contained in the manufacturer’s pack, the sum of:

(i) the price ex manufacturer, plus mark-up as specified in paragraph 23, taken to the nearest cent, one half cent being counted as one cent, for each complete manufacturer’s pack contained in the quantity supplied; and

(ii) the amount calculated in accordance with paragraph 24 in respect of that remainder, if any, of the quantity supplied that is less than the quantity contained in the manufacturer’s pack, as applicable; and

(iii) a dispensing fee equal to the dispensing fee for the supply of a ready-prepared pharmaceutical benefit, specified in the determination under paragraph 98B(1)(a) of the Act that is in force at the time of supply of the highly specialised drug.

The mark-up will be —

(a) 10 per cent, where the price ex manufacturer for the manufacturer’s pack is less than $40.00;