Immunoglobulin Governance Program Updates

This page is updated quarterly to provide medical specialists, nurses, dispensers, consumers and other stakeholders a snapshot of the NBA’s current work program and priorities in the Immunoglobulin (Ig) space. Links to further information are provided as applicable.

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November 2020 Update

A snapshot of recent activity in the Immunoglobulin Governance Program is provided below.

Committee and stakeholder meetings

National Immunoglobulin Governance Advisory Committee (NIGAC). The NIGAC held its second meeting of the year on 22nd October. A wide range of issues were discussed, including a number of minor changes to the Criteria for the Clinical Use of Immunoglobulin in Australia (the Criteria). These were endorsed by the NIGAC and will now be progressed through the Jurisdictional Blood Committee (JBC).

Other issues discussed are noted in the key issues summary.

Jurisdictional Immunoglobulin Performance Improvement (JIPI) Group. The JIPI Group held its first meeting on 16th September. A key discussion point related to subcutaneous Ig (SCIg) usage and dispensing patterns across jurisdictions. The group acknowledged the need for medical officers and dispensers to ensure that dispense and usage is in accordance with the National Policy: Access to Government Funded Immunoglobulin Products in Australia, as this ensures an equitable supply of SCIg for all eligible patients by requiring that the amount of SCIg product dispensed to patients is not more than required for two months’ treatment. Group members undertook to examine this issue further within their own jurisdictions.

Immunoglobulin Specialist Working Groups (SWGs). All SWGs met in June, with more meetings occurring in November and December. Work on numerous issues affecting the program is also progressing out-of-session, with key issues including the prioritisation framework, educational material and minor changes to the Criteria for the Clinical Use of Immunoglobulin in Australia (the Criteria). (See below for further information.)

Key issue summary

Prioritisation framework. Work is ongoing to develop a prioritisation framework for Ig in times of product shortage. This is designed to operate alongside – and eventually become part of - the National Blood Supply Contingency Plan. There is currently no threat to supply in Australia.

Ig authorisation management through BloodSTAR. BloodSTAR is regularly updated to improve its functionality and usability. BloodSTAR v3.3 was released in March, and v3.4 was released in November. Changes include improvements to the user interface and to the way BloodSTAR calculates and displays the rounding of doses. Click here for statistics on BloodSTAR activity.

Usage data and statistics. Data collection and analysis is an important part of the NBA Ig Governance Program, informing the NBA’s performance improvement activities and ensuring that precious Ig product is used for those who gain the most benefit from it.

Recent data on Ig usage is revealing an encouraging trend: the last two years’ statistics show that Ig usage is currently increasing at a rate of 7% per annum. This is a substantial decrease in Ig’s rate of growth over the preceding decade and more; until 2018-19, Ig use had been rising at a rate of 10-12% per year. This decrease reflects the Program’s innovative ability to improve the use and management of government-funded Ig through nationally coordinated health sector governance arrangements.

See the latest Ig use statistics here. Our annual reports on the issue and use of immunoglobulin are available here. For more information on the Ig Governance Program’s performance improvement initiatives see: National Immunoglobulin Governance Program Performance Improvement Strategy, 2019-2022.

Ig health technology assessment (HTA) reviews by the Medical Services Advisory Committee (MSAC). In 2018, the NBA and Department of Health commenced a pilot HTA review of Ig use currently funded under the National Blood Agreement. Six medical conditions were prioritised: Acquired hypogammaglobulinaemia secondary to haematological malignancies, or post-haemopoietic stem cell transplantation (AHG), Chronic inflammatory demyelinating polyneuropathy (CIDP), Myasthenia gravis (MG), Mulitfocal motor neuropathy (MMN), Primary immunodeficiency disease (PID), Secondary hypogammaglobulinaemia unrelated to Haematological malignancy or haemopoeitic stem cell transplant. Progress of the six reviews was recently discussed by the NIGAC, and input is being provided by the relevant SWGs. Outcomes for the AHG and MG reviews are available in the public summary documents (PSDs)on the MSAC website.  Other PSDs will be published as they become available.

Education and training resources. BloodSafe eLearning Australia (BEA) is in the process of developing a series of Immunoglobulin eLearning courses for health care staff involved with the prescription, administration and reporting of Ig product use. These courses will provide an overview of Ig therapy in Australia including general information on Ig products, their role in treatment, governance arrangements and usage and administration. Five courses are being developed, with three expected to be released before the end of the year. They are:

  • Course 1 – Introduction to Immunoglobulin
  • Course 2 – Accessing Immunoglobulin
  • Course 3 – Prescribing Immunoglobulin
  • Course 4 – Administering Immunoglobulin
  • Course 5 – Adverse Events

The NBA is also working with the Department of Health and NPS Medicinewise to deliver the Value in Prescribing (ViP) Program, which aims to develop improvement in the prescription and use of Ig through education and training initiatives. The first initiatives released as part of this program were released in late October. These health professional-mediated consumer fact sheets are available here. They cover:

  • Immunoglobulin Governance and Consent
  • Choosing Wisely (provides information about why Ig is prescribed, and alternative treatment options)
  • Switching Immunoglobulin Products (helping consumers understand why they might be required to change product, and what to expect).

Other resources the Program will deliver to support clinicians and patients using immunoglobulin include webinars, clinical content articles, decision support tools and case studies.

Previous Ig Program Updates

Keep up to date

To keep up to date with the latest Immunoglobulin Governance Program Updates, create a BloodPortal account and from the home page click on ‘My Subscriptions’ and ‘Subscribe’ to Immunoglobulin.

For further information

Please contact the National Blood Authority on 13 000 BLOOD (13 000 25 663)  or email IgGovernance@blood.gov.au.