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Change in IVIg application process

January 31, 2019

Intravenous immunoglobulin (IVIg) is in very short supply nationally and it’s use varies from centre to centre.

NHSE have therefore established a Sub-Regional Immunoglobulin Advisory Panel (SRIAP) at UHNM and from 1 Feb 2019 the application process for IVIg will change.

This is to ensure IVIg is not used in conditions where there is no good evidence of efficacy and that recommended dosages are used.

  • A new application form will be used and can be downloaded from the IVIg Webpage https://connect2.swbh.nhs.uk/pharmacy/immunoglobulin-ivig/. This will have to be signed electronically.
  • The applicant must not just give a diagnosis but indicate why IVIg is the treatment of choice in accordance with NHSE guidelines.  http://www.igd.nhs.uk/wp-content/uploads/2016/04/dh_129666.pdf.
  • Outcome criteria must be included i.e. how do you intent to measure the effectiveness of IVIg treatment in this patient?
  • Guidance for Haematology, Immunology  and Neurology has been superseded and is available on the Website.
  • If the application is incomplete, there will be a delay in agreeing to and issuing IVIg.
  • For urgent, single course requests that are commissioned, the local IAP will agree if the correct information is supplied and the clinical indication is met. The SRIAP will audit these applications and over turn any decisions they find incorrect.
  • For urgent out of hours requests, the on call pharmacist will defer supplying IVIg if the application does not fulfil the above criteria.
  • Applications for non-commissioned indications and for continuous use will be forwarded to the SRIAP and a response will be given within 5 working days. There will be an appeals process.
  • The consultant responsible for requesting IVIg will be required to provide outcome data in a timely fashion.

Flowchart for clinicians

SRIAP Request Form F1

Note: Please make sure that if junior staff are completing the applications, they are aware of the need to provide all the data required.