Martin Bradley summarises the updated NHS England commissioning criteria for IVIg, and discusses the formation of new sub-regional panels
As this journal has previously highlighted, continuity of intravenous immunoglobulin (IVIg) supply is a long-standing issue for the NHS. There have been several significant supply problems with immunoglobulin in 2018/191,2 and usage has also been increasing.
There have been several significant supply problems with immunoglobulin in 2018/19 …
The Department of Health Clinical Guidelines for Immunoglobulin Use were published in 2008 to support demand management,3 aiming to protect access to immunoglobulin for those with the most severe and life threatening conditions in times of short supply. These guidelines were updated in 2011 and a colour coding system to triage indications was introduced:4
- red indications—conditions which have the highest priority for use
- blue indications—diseases for which there is a reasonable evidence base but where alternative treatments are available and usage should be modified in a national shortage
- grey indications—conditions for which the evidence base is weak, needing consideration on a case by case basis.4
Local hospital trust immunoglobulin assessment panels have reviewed and monitored usage of immunoglobulin and made decisions about the appropriateness of treatment. As a pass-through cost, immunoglobulin has been charged to NHS England when used in accordance with these guidelines, with some grey indications being routinely funded if approved by the local panel, and other grey indications requiring an Individual Funding Request to NHS England for consideration of funding.