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Provision of Services for the Pharmaceutical Benefits Scheme Price Disclosure and Stockholding Services
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Under the Pharmaceutical Benefits Scheme (PBS), the Commonwealth subsidises the cost of a large number of prescription medicines (pharmaceutical items). For pharmaceutical items that have multiple different brands, PBS subsidy is periodically adjusted through a process known as Price Disclosure. The objective of Price Disclosure is to ensure that subsidy for PBS medicines reflects the average prices being charged by pharmaceutical manufacturers to their customers (wholesalers, pharmacies and hospitals) in the medicines supply chain. Where there is competition on price between multiple brands of the same pharmaceutical item, Price Disclosure reduces the ex-manufacturer portion of PBS subsidy (the Approved Ex-Manufacturer Price) to reflect the lower prices being charged for those medicines by manufacturers. This helps to achieve better value for money for taxpayers and Australians. Division 3B of Part VII of the National Health Act 1953 (Cth) (the Act) and Part 7, Division 2 of the National Health (Pharmaceutical Benefits) Regulation 2017 (Cth) (the Regulations) set out the requirements for Price Disclosure.
Division 3B of Part VII of the Act contains obligations for pharmaceutical manufacturers that supply brands of pharmaceutical items listed on the PBS (Responsible Persons), to provide prescribed information (Data) to a Price Disclosure Data Administrator. The Data is used to calculate a weighted average disclosed price. If the weighted average disclosed price is significantly lower than the Approved Ex-Manufacturer Price for Brands of Pharmaceutical Items, the Approved Ex-Manufacturer Price is reduced.
Amendments to the Act and the Regulations have been made to implement reforms that commence on 1 July 2022. (See National Health Amendment (Enhancing the Pharmaceutical Benefits Scheme) Act 2021 (Amendment Act) and National Health (Pharmaceutical Benefits) Amendment (2021 Measures No. 1) Regulations 2021 (the Amendment Regulations)).
From 1 July 2023, Division 3CAA of the Act will require Responsible Persons to maintain stockholdings of 4 to 6 months of usual demand for Pharmaceutical Items that have a floor price (section 99ADHC). These greater reserve supplies will buffer the Australian market against global medicines shortages and supply interruptions which have impacted commonly prescribed, older and low-cost medicines.
The Department is seeking Tenders to perform the functions of the Price Disclosure Data Administrator in accordance with the Regulations and the Amendment Regulations. This will include the following services:
- collect the required Data from Responsible Persons;
- process the Data received from Responsible Persons (including validation, quality assurance, and performing the required calculations);
- provide reports to the Department about the processed Data, in the form and at the times required by the Department;
- provide ancillary reports and services to the Department (including additional reporting, compliance monitoring in relation to the provision of Data, and assisting with any disputes that arise between the Department and a Responsible Person);
- from 1 July 2023, collect and process stockholding data, calculate usual demand and minimum stockholding requirements, and provide stockholding compliance reports;
in order to assist the Department to administer the PBS in accordance with the Act and the Regulations.
The successful tenderer will also be required to implement the required system changes to data collection and calculation processes to reflect the price disclosure and stockholding arrangements outlined in the Amendment Act and the Amendment Regulations.
Refer to Request for Tender (RFT)
1 July 2022 to 30 June 2026