National Health (Paraplegic and Quadriplegic Program) Special Arrangement 2021
14Payment from Commonwealth
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14 Payment from Commonwealth
(1) An authorised association that supplies a pack quantity of a pharmaceutical benefit is entitled to be paid by the Commonwealth for the supply the amount worked out under subsection (2). (2) For subsection (1), the amount is: (a) if there is no claimed price for the pack quantity of the pharmaceutical benefit: (i) the price to pharmacists for the pack quantity worked out under the determination under paragraph 98B(1)(a) of the Act; and (ii) a handling fee of 2.75% of that amount; or (b) if there is a claimed price for the pack quantity of the pharmaceutical benefit: (i) the claimed price for the pack quantity plus a wholesale mark‑up calculated in accordance with subsection (3); and (ii) a handling fee of 2.75% of that amount. (3) For paragraph (2)(b), the wholesale mark‑up for the pack quantity of the pharmaceutical benefit is to be worked out using the methodology for calculating the wholesale mark‑up for ready‑prepared pharmaceutical benefits in the determination under paragraph 98B(1)(a) of the Act, subject to the following: (a) for the purposes of identifying the appropriate wholesale mark‑up formula in Step 2 of the methodology, the ex‑manufacturer price for the relevant quantity is to be worked out proportionately from the approved ex‑manufacturer price or proportional ex‑manufacturer price for the pack quantity of the pharmaceutical benefit; and (b) otherwise, the methodology is to be applied as if the claimed price for the pack quantity of the pharmaceutical benefit were the approved ex‑manufacturer price or proportional ex‑manufacturer price for the pack quantity.