Intravenous Immunoglobulin (IVIG)
LOCAL GUIDANCE AND REQUEST FORMS
NHSE commissions the use of Immunoglobulin products to ensure use is evidence based and treatment is available for urgent clinical use.
Treatment must follow National guidelines with approved commissioning criteria.
NHSE have set up regional panels of experts to review use of Immunoglobulin locally and to review requests in conditions where there is a lack of published evidence (grey indications).
The Kent and Medway Sub-Regional Immunoglobulin Assessment Panel is hosted by MTW.
Prescribing for new patients
An immunoglobulin request form must be completed for all new Immunoglobulin prescriptions. When completing the form, check the diagnosis on the new NHSE diagnosis list. If the diagnosis is not on the list, then refer to the old diagnosis list.
"No panel required" (new guidelines) and Red/Blue indications (old guidelines) can be dispensed by pharmacy after the immunoglobulin request form has been completed and sent to the HCD team for processing.
Email the request form to (MTW Requests Only): firstname.lastname@example.org
Panel prior approval (new guidelines) or Grey (old grey) indications need ‘Panel Approval’ before treatment can be dispensed by Pharmacy. In addition to the form above, complete a separate panel form electronically with as much clinical detail as possible. All yellow boxes on the form must be completed, incomplete forms will be returned as the panel will not have the correct information to make a decision. The panel reviews the request virtually within 24 hours of receipt (Monday-Friday).
Out of hours, contact the on call Pharmacist for advice via switchboard.
Email the panel form to your local pharmacy for processing. Once reviewed, your pharmacy will send to the KMSRIAP:
For MTW: email@example.com
Both forms must include patient height and weight and doses must be calculated using the Ontario dose calculator.
Prescribing for patients previously approved for Immunoglobulin use
Contact the pharmacy team to confirm that the approval for immunoglobulin use is still valid.
Patients transferring from another Trust or receiving Immunoglobulin (Ig) treatment locally under the recommendation of a specialist centre/Trust
- Repatriation or transfer to MTW if the patient will be under full care of MTW: the pharmacy procurement team must be informed to ensure the Ig allocation for that patient is transferred from the initiating Trust to MTW.
- Repatriation or transfer to MTW if the patient will receive Ig treatment at MTW but will be followed up at the referring Trust: the pharmacy procurement team must be informed to ensure the Ig allocation for that patient is transferred from the initiating Trust to MTW and in addition, the pharmacy High Cost Drug team should amend the patient’s MDSAS record to indicate that MTW is a treating site only.
- Patients starting treatment at MTW for an Ig panel required indication, where the patient is under the care of an external Trust or where treatment has been recommended by an external Trust (e.g. recommendation from King's but treated at MTW): the Ig panel treatment request must be made through the referring Trust’s panel. Speak to the Ig/HCD team for advice.
Pharmacy must be sent details of follow up/ outcome for all patients.