On October 27, 2026, Rachelle Davis, Assistant Secretary, Community Access Programs Branch, Department of Health, Disability and Ageing, as delegate of the Minister for Health and Ageing, made PB 125 of 2026, the National Health (Highly Specialised Drugs Program) Special Arrangement Amendment (Nurse Practitioner Prescribing) Instrument 2026, registered as F2026L01430. It is made under sections 85, 85A, 88 and 100 of the National Health Act 1953 and amends the National Health (Highly Specialised Drugs Program) Special Arrangement 2021. Section 2 commences the whole instrument on November 1, 2026.
Australian public hospitals supplying Section 100 Highly Specialised Drugs, Australian private hospitals supplying Section 100 Highly Specialised Drugs, authorised nurse practitioners prescribing PBS Highly Specialised Drugs, PBS-approved hospital pharmacies claiming Highly Specialised Drugs benefits, and sponsors of PBS-listed iron chelators deferasirox, deferiprone and desferrioxamine must, by November 1, 2026, align authorised-prescriber and eligible-patient processes so an authorised nurse practitioner may prescribe a Highly Specialised Drugs benefit only where Schedule 1 shows NP, and for HIV or AIDS medicines only if the practitioner is also approved by the relevant State or Territory. Otherwise a supply that misses those conditions is not a PBS benefit, and an HIV or AIDS prescription by a nurse practitioner without that State or Territory approval is not authorised under the instrument.
What does PB 125 of 2026 change in the HSD arrangement?
Substituted subsection 7(6) makes an authorised nurse practitioner an authorised prescriber for an HSD pharmaceutical benefit only if the initials "NP" appear in the column headed "Nurse prescribing" in Schedule 1 for that benefit. Those initials do not exclude other authorised prescribers. Substituted subsection 7(6A) adds a further condition when the benefit is a medication for the treatment of HIV or AIDS: the nurse practitioner must also be approved by a State or Territory to prescribe that medication in accordance with the instrument.
Item 1 removes ", or an authorised nurse practitioner," from the section 6 definition of accredited prescriber of medication for the treatment of HIV or AIDS, and notes point that prescribing to subsection 7(6A). Section 6 defines iron chelating agent as deferasirox, deferiprone or desferrioxamine, and subsection 7(4) gains that benefit plus an ODT pharmaceutical benefit. Subclause 1(3) of Schedule 1 inserts "nurse prescribing,". Subsections 8(8) to 8(11) are repealed without the old text being restated.
Who may prescribe, and which patients qualify, on November 1, 2026?
From November 1, 2026 the "NP" column gates nurse practitioner prescribing, and subsection 7(6A) is a second gate for HIV or AIDS medicines. That hits hospitals supplying Section 100 Highly Specialised Drugs, authorised nurse practitioners, PBS-approved hospital pharmacies, and sponsors of deferasirox, deferiprone and desferrioxamine.
Subsection 8(2) is the public-hospital test, only for an "NP" benefit: an eligible person treated by an authorised nurse practitioner at or from a public hospital as a non-admitted patient, a day admitted patient, or a patient on discharge. Subsection 8(5) is the private-hospital test for the same benefits: an eligible person treated by an authorised nurse practitioner in, at or from a private hospital, with no separate discharge limb.
| Rule | From November 1, 2026 |
|---|---|
| General HSD benefit | "NP" in Schedule 1, subsection 7(6) |
| HIV or AIDS benefit | "NP" plus State or Territory approval, subsection 7(6A) |
| Public hospital | Non-admitted, day admitted, or on discharge, subsection 8(2) |
| Private hospital | Treatment in, at or from the hospital, subsection 8(5) |
| Iron chelating agent | Deferasirox, deferiprone, desferrioxamine, subsection 7(4) |
What must be in place by November 1, 2026?
- Limit authorised nurse practitioner prescribing to Schedule 1 rows that show "NP" in the Nurse prescribing column.
- For an HIV or AIDS HSD medicine, hold the State or Territory approval in subsection 7(6A), and do not rely on the old section 6 accredited-prescriber wording.
- Apply subsection 8(2) to public-hospital supplies: non-admitted, day admitted, or on discharge, and only when the treating prescriber is an authorised nurse practitioner at or from that hospital.
- Apply subsection 8(5) to private-hospital supplies: treatment by an authorised nurse practitioner in, at or from the private hospital, on an "NP" row.
- Instruct PBS claim teams that a supply outside those conditions is not a PBS benefit.
- Sponsors of deferasirox, deferiprone and desferrioxamine should match the new definition and the subsection 7(4) limb to the Schedule 1 "NP" column.
Per-jurisdiction monitoring of the Federal Register surfaces an instrument like PB 125 of 2026 on the registration day, ahead of the November 1, 2026 commencement.
What is the supply worth if the conditions are missed?
A supply that misses the new authorised-prescriber or eligible-patient conditions is not a PBS benefit. An HIV or AIDS prescription by a nurse practitioner without State or Territory approval is not authorised under the instrument. PB 125 of 2026 sets no dollar penalty: the supply is outside the special arrangement and is not an HSD pharmaceutical benefit. The Department of Health, Disability and Ageing administers the instrument. Section 2 still commences it on November 1, 2026 unless a later instrument changes that date.
Before November 1, 2026, check which HSD lines show "NP", confirm subsection 7(6A) approval for HIV or AIDS prescribing, and brief pharmacy, credentialing and PBS claiming on the two hospital tests. Sponsors of the three iron chelators should read the new definition against their listings. Obsidian follows this Federal Register entry so the next amendment of these subsections is visible when it is registered.
