Intravenous Immunoglobulin (IVIG)

REGIONAL IMMUNOGLOBULIN GUIDANCE AND REQUEST FORMS 

As immunoglobulin products are dependent on human donations there is the possibility of national and international shortages. Therefore 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 treatments 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 one of the four trusts in the Kent and Medway catchment area. 

The form will indicate 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 ideal body weight. 

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: 

MTW: mtw-tr.ivigrequests@nhs.net 

DGT: dgn-tr.pharmacy-admin@nhs.net 

EKHUFT: ekh-tr.medicinesinformation@nhs.net 

MFT: medwayft.ivigrequest@nhs.net  

“SRIAP Required” - treatment cannot start until panel authorisation has been given.  The panel reviews requests virtually within 24 hours of receipt (Monday-Friday) for urgent cases, and within 5 working days for non urgent. Outside these hours, an urgent decision to initiate treatment should be made by the Chief Pharmacist or deputy for the requesting Trust. 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 the relevant local Trust email as above. 

For further information on the commissioned treatments refer to, Clinical Commissioning Policy for the use of therapeutic immunoglobulin (Ig) England (2025).

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 the repatriated trust. 
• If the patient will receive treatment at the repatriated Kent trust but be reviewed by the referring Trust, local pharmacy team must amend the patient’s MDSAS record to indicate that they are the  treating site only. 
• If a patient’s treatment requires panel approval, the Ig panel treatment request must be made through the referring Trust’s immunoglobulin management team.  Speak to the Pharmacy team for advice.