Ex-manufacturer pricing
June 4, 2012
PARLIAMENT is currently
considering proposed amendments
to the National Health Act 1953,
which would introduce
ex-manufacturer pricing for the
Pharmaceutical Benefits Scheme
from 01 October 2012.
Introduced into parliament at the
end of May, the proposal would see
prices to be agreed or determined
at the ex-manufacturer level rather
than the price to pharmacists level,
i.e, the approved ex-manufacturer
price (AEMP) would replace the
approved price to pharmacists
(APP) as the core price in the Act.
Other key elements of the policy
include the stipulation that there
may be only one AEMP for each
brand of pharmaceutical item and
that the AEMP for each brand
must be agreed or determined for
the pricing quantity, which is the
lowest PBS priced pack price of any
brand of the pharmaceutical item,
and that the AEMPs for every
brand of a particular pharmaceutical
item must be the same.
In addition, the ex-manufacturer
price for all other pack quantities
(i.e. PBS priced manufacturer pack
sizes) will be a multiple of the
AEMP for the lowest pack size
(these ex-manufacturer prices for
other pack prices will be known as
proportional ex-manufacturer
prices).
Under the proposal, claimed
prices for brands with resulting
special patient contributions/
premiums may still apply to any
pack quantity.
If the proposed amendments
come into effect, from 01 October
2012, statutory price reductions
and price disclosure price
reductions will be applied to the
AEMP, whilst the AEMP will also be
used as the basis for calculating all
PBS subsidies.
According to the Department of
Health, the use of the AEMP will
not affect the approach to the PBS
subsidy, and where appropriate to
the method for supply, the
wholesale markup will be added to
the AEMP using the 5CPA scales.
Patient premiums will also not be
affected by the changes.
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