Guidance for NHS trusts on how to manage the demand of intravenous immunoglobulin (IVIG) and maintain the supply of immunoglobulin products has been issued by the Department of Health.
For some time, there has been concern over the availability of immunoglobulin to the NHS, due to a global supply shortage and issues specific to the UK.
The DoH set up an expert group in August 2006 to formulate a Demand Action Plan, which prioritises patients so that the most appropriate cases receive immunoglobulin at all times.
As part of the plan, Trusts, SHAs and Specialised Commissioning Groups (SCGs) will set up an immunoglobulin assessment panel to approve applications and monitor use of immunoglobulin – either a Trust level panel or SHA/SCG level panel.
Clinical guidelines on the use of IVIG have also been developed; approximately 100 conditions are discussed and for each it is stated whether immunoglobulin is a recommended form of treatment (with grading of the supporting evidence).
Some indications are not included, either due to lack of supporting evidence and/or the rarity of the condition; rarer indications can however be approved by a panel if it is felt that the circumstances are exceptional.
The guidelines have been submitted to the British Medical Journal and will be reviewed annually.
A national database will be set up to provide a UK model of immunoglobulin use to allow forecasts so that accurate demand planning can take place.
It will also allow information to be collected on the use of IVIG by indication so that priority volumes can be identified.
A database pilot is currently being rolled out to five centres.
From April 2008, all trusts will need to ensure that all immunoglobulin used is entered into the database.
