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Hospital Circular 08/2008

Date Issued: 3 March 2008

Subject: Criteria for the use of Intravenous Immunoglobulin (IVIg)

Distribution: Public Hospitals, Private Hospitals

Purpose:

Background

The document “Criteria for the Clinical Use of Intravenous Immunoglobulin (IVIg) in Australia” (the Criteria) has been developed to assist clinicians and transfusion medicine professionals to identify the conditions and circumstances for which the use of intravenous immunoglobulin (IVIg) is appropriate and funded under the National Blood Agreement. The Criteria supersedes the AHMAC IVIg Guidelines published in 2000.

In early February 2008, the NBA contacted 1200 stakeholders including hospitals, professional colleges, governments and contributors to provide preliminary information regarding the release of the Criteria. Further information is available on the NBA website at www.nba.gov.au

Access to Subsidised IVIg

From 3 March 2008 only those conditions that satisfy the Criteria will be subsidised under the National Blood Agreement. For those conditions, treating clinicians should continue to order IVIg from the Australian Red Cross Blood Service Victoria (ARCBS-Vic) in the usual way.

Clinicians who were treating patients with IVIg, prior to 3 March 2008, for conditions that do not meet the Criteria will be contacted by Transfusion Medicine Service (TMS) at ARCBS-Vic to discuss treatment options. To facilitate the transition to alternative therapy or hospital funded IVIg for such patients, subsidised use, under the National Blood Agreement is available until 31 August 2008.

Alternative Access to IVIg – Jurisdictional Direct Orders (JDO)

From 3 March 2008 new patients requiring IVIg for conditions that do not meet the Criteria will not have the IVIg subsidised under the National Blood Agreement. It is anticipated that very few if any patients will fall into this category. Clinicians in public hospitals will need to work with their Drug and Therapeutics Committees in making any such decisions.

The National Blood Authority has contracts with two companies to provide IVIg for the treatment of conditions not satisfying the Criteria. The Octapharma product Octagam® is available through Clifford Hallam Healthcare Pty Ltd by telephoning 1800 133 627 and the CSL Limited product Sandoglobulin NF Liquid® is available by telephoning 1800 063 892.

Until 30 June 2008, in cases of extreme emergency, clinicians who choose to treat a patient with IVIg for a condition that falls outside the Criteria may contact TMS at ARCBS-Vic for an emergency supply.

Departmental contact:
Michael Furey (03) 9096 2506

DR C W BROOK
Executive Director
Rural and Regional Health and Aged Care Services