Document ID: chunk:federal_register_of_legislation:C2025C00090:section:9:p1
Version: federal_register_of_legislation:C2025C00090
Segment Type: section
Provision Reference: s 9 (pt 1/3)
Character Range: 352697–355477

9                                 99ACP                  1.48%

Note: Subsection (1) does not apply if there is no determination under subsection 85(6) in respect of the pharmaceutical item in force on the specified day (whether or not the determination was revoked following a request by the responsible person for the pharmaceutical item).

Reduction cap
 (1A) If:
 (a) the approved ex‑manufacturer price of a listed brand of a pharmaceutical item is to be reduced under subsection (1) because of an item in the table in subsection (1); and
 (b) apart from this subsection, the reduced approved ex‑manufacturer price would be less than the amount (the capped price) equal to:
 (i) 40% of the approved ex‑manufacturer price of a listed brand of the pharmaceutical item on 1 January 2016; or
 (ii) if subparagraph (i) does not apply—40% of the original approved ex‑manufacturer price of the first listed brand of the pharmaceutical item;
the approved ex‑manufacturer price of the listed brand of the pharmaceutical item is taken to be reduced under subsection (1) because of that item to an amount equal to the capped price.
 (1B) If the approved ex‑manufacturer price mentioned in subparagraph (1A)(b)(i) or (ii) is by reference to a different pricing quantity than the pricing quantity on the reduction day, the approved ex‑manufacturer price mentioned in that subparagraph is taken to be the amount that the approved ex‑manufacturer price would have been had the pricing quantity been the same as the pricing quantity on the reduction day.

Reduction more than percentage
 (2) This subsection applies if:
 (a) a section or subsection referred to in column 2 of the table in subsection (1) applies to a listed brand of a pharmaceutical item on a reduction day; and
 (b) subject to subsection (2A), on the reduction day, the approved ex‑manufacturer price of the listed brand of the pharmaceutical item does not exceed:
 (i) the approved ex‑manufacturer price of the brand of the pharmaceutical item in force on the day before the reduction day, reduced by more than the percentage or method specified in column 3 of the table for the section or subsection referred to in column 2; or
 (ii) if subsection (1A) would have applied to the brand of the pharmaceutical item if paragraph (1)(b) were disregarded—the capped price of the brand of the pharmaceutical item that would be worked under subsection (1A) if paragraph (1)(b) were disregarded; and
 (c) if, on the day before the reduction day and on the reduction day, a determination under subsection 85B(3) was in force in relation to a particular pack quantity of the listed brand of the pharmaceutical item—the claimed price for that pack quantity of the brand of the pharmaceutical item does not exceed the claimed price for