Intravenous Immunoglobulin (IVIG)
LOCAL GUIDANCE AND REQUEST FORMS
There is currently a national shortage of immunoglobulin, all use must follow the following processes to ensure stock is available for patients.
NHSE commissions the use of immunoglobulin to ensure use is evidence based and treatment is available for urgent clinical use.
All treatment must follow NHSE commissioning criteria for prescribing and monitoring effectiveness.
To assess effectiveness: All Trusts must provide outcome data on all patients to ensure treatment is and remains effective. It is the consultant's responsibility to ensure that outcome data is recorded for all immunoglobulin use in the patients’ healthcare records.
NHSE have set up regional expert panels to review use of immunoglobulin and assess requests for certain conditions in the commissioning criteria. The Kent and Medway Immunoglobulin Assessment Panel (KMSRIAP) is hosted by MTW.
1. Prescribing for new patients
An immunoglobulin request form must be completed for all new patient/treatment episodes and for all patients whose treatment has been started at another Trust and being repatriated to MTW.
The form indicates once diagnosis and short/long term has been entered, if a KMSRIAP panel decision is required before treatment is given.
Forms must include patient's height and weight and doses must be calculated using the Ontario dose calculator.
Can treatment be started without panel approval?
"No panel required" – treatment can start and be dispensed by pharmacy after the immunoglobulin request form has been completed and emailed to pharmacy at email@example.com
“SRIAP Required” - treatment cannot start until panel authorisation has been given. The panel reviews requests virtually within 24 hours of receipt (Monday-Friday). Outside these hours, an urgent decision to initiate treatment should be made by the Chief Pharmacist or deputy. For panel requests, it is essential that plenty of detail is included (patient’s clinical condition, alternative treatments already tried and the outcome of those) on the form for the panel to be able to make a decision. Email the form to firstname.lastname@example.org
For further information on the commissioned treatments refer to, Commissioning Criteria Policy for the use of therapeutic immunoglobulin (Ig) England, 2021.
Out of hours, contact the on-call Pharmacist for advice via switchboard.
2. Prescribing for patients previously approved for Immunoglobulin use
Contact the pharmacy team to confirm that the approval for immunoglobulin use is still valid.
3. Patients transferring from another Trust or receiving Immunoglobulin (Ig) treatment locally under the recommendation of a specialist centre/Trust
- The pharmacy procurement team must be informed to ensure the immunoglobulin allocation for that patient is transferred from the initiating Trust to MTW.
- If the patient will receive treatment at MTW but be reviewed by the referring Trust, pharmacy must amend the patient’s MDSAS record to indicate that MTW is a treating site only.
- If a patient’s treatment requires panel approval, the Ig panel treatment request must be made through the referring Trust’s panel. Speak to the Pharmacy team for advice.
- The Ig request form must still be completed and sent to the High Cost Drug Team via email.