Government of Newfoundland and Labrador

Lucinda Whitman Coordinating Program Manager, Provincial Blood Coordinating Daphne Osborne Program Author Melissa Leonard Effective Date 2019-04-29 Version 3.0 Review Due Date 2021-04-29 Review and Approval of Requests for IVIG for Adults Overview The purpose of this policy is to outline the process to be used for the review and approval of requests for intravenous immunoglobulin (IVIG) for adult. [...] Requests for IVIG to treat indicated conditions in the Atlantic Clinical Indications and Criteria for Intravenous and Subcutaneous Immunoglobulin (IVIG/SCIG) document shall be screened prior to dispensing product to ensure that all specific criteria have been met, and that the dose, duration and frequency of therapy are in accordance with the Commented [LM2]: Common Policy indications and criteria. [...] Requests for IVIG to treat possibly indicated conditions in the Atlantic Clinical Indications and Criteria document shall be screened prior to dispensing product to ensure that all specific criteria have been met, and that the dose, duration and frequency of therapy are in accordance with the indications and criteria established by the Atlantic clinical experts. [...] The PBCP shall review all requests that do not meet the Atlantic Clinical Indications and Criteria for Intravenous and Subcutaneous Immunoglobulin (IVIG/SCIG) to ensure request and approval process is consistent with the Common Policy. [...] Does the the order does physician and indicated or advise order does No product will No evidence support not meet the advise the order possibly indicated not meet the be dispensed the use? requirements does not meet conditions guideline the guideline Contact ordering Is ordering physician Yes Dose, duration Dispense product physician to willing to modify the and/or frequency Yes as per corrected a.