Document ID: chunk:federal_register_of_legislation:F2024C00583:reg:11:p1
Version: federal_register_of_legislation:F2024C00583
Segment Type: reg
Provision Reference: reg 11 (pt 1/3)
Character Range: 11451–14239

11  Ready‑prepared pharmaceutical benefits—wholesale mark‑up
 (1) For sub‑subparagraphs 10(1)(a)(i)(B) and 10(1)(c)(i)(B), and Step 1 of section 14, the wholesale mark‑up for a pack quantity of a ready‑prepared pharmaceutical benefit is the amount added to the approved ex‑manufacturer price (AEMP) or the proportional ex‑manufacturer price (PEMP) for the pack quantity, to calculate the price to pharmacists for that pack quantity, as set out in this section.

Step 1—Identify the approved ex‑manufacturer price (AEMP) or the proportional ex‑manufacturer price (PEMP) for the pack quantity
 (2) Identify the AEMP or the PEMP for the pack quantity for which a mark‑up is to be calculated under this section.

Step 2—Identify the appropriate wholesale mark‑up formula
 (3) List any maximum quantity or determined quantity of each listed brand of that pharmaceutical item (other than any maximum quantity that relates to a supply of any of those brands in section 100 only circumstances).
 (4) From that list, identify the quantity (the relevant quantity) of the brand of the pharmaceutical item, which is:
 (a) the quantity that is the highest whole number multiple of the pack quantity of the brand of the pharmaceutical item from:
 (i) any maximum quantity on the list; or
 (ii) if subparagraph (a)(i) does not apply—any determined quantity on the list; or
 (b) if paragraph (a) does not apply—the quantity that is the closest to the pack quantity of the brand of the pharmaceutical item (or, if two quantities are equally close, the higher of those quantities) from:
 (i) any maximum quantity on the list; or
 (ii) if subparagraph (b)(i) does not apply—any determined quantity on the list.
 (5) Work out proportionately the ex‑manufacturer price for the relevant quantity of the brand of the pharmaceutical item.

Step 3—Apply the appropriate formula to work out the price to pharmacists for the pack quantity
 (6) If:
 (a) the ex‑manufacturer price for the relevant quantity of the brand of the pharmaceutical item is less than, or equal to, $5.50; and
 (b) the relevant quantity and the pack quantity of the brand of the pharmaceutical item are the same;
then the price to pharmacists for the pack quantity of the brand of the pharmaceutical item is the amount worked out as follows:

PTP  =  AEMP or PEMP  +  $0.41
where:
PTP means the price to pharmacists for the pack quantity.
AEMP or PEMP means the approved ex‑manufacturer price or the proportional ex‑manufacturer price for the pack quantity.
 (7) If:
 (a) the ex‑manufacturer price for the relevant quantity of the brand of the pharmaceutical item is less than, or equal to, $5.50; and
 (b) the relevant quantity and the pack quantity of the brand of the pharmaceutical item are not the same;
then the price to pharmacists for