Home » IVIG/SCIG » Requesting Immunoglobulins (Ig) in Ontario – Changes coming!

Requesting Immunoglobulins (Ig) in Ontario – Changes coming!

Year-over-year growth in immunoglobulin (Ig) demand has averaged 8-11% since the COVID-19 pandemic, and without intervention, the rate of growth is expected to continue at pace over the next 3-5 years. The increase in Ig demand, coupled with the associated rising costs and global shortages of this limited resource, has become a critical area of focus for the health system.

In 2020, the Office of the Auditor General of Ontario (OAGO) performed an audit of Ontario’s blood management system. The report made several high-level recommendations for the Ontario Ministry of Health to address gaps in Ig product management, including:

  • Strengthen Ig utilization monitoring and guidelines adherence
  • Advance Canada’s plasma self-sufficiency strategy
  • Promote evidence-based alternatives to blood products
  • Improve preparedness and equitable allocation during Ig shortages

Recommendation three, bullet one, specifically stated:

OAGO Recommendation 3

To better manage the demand and supply of immunoglobulins so that they are available for Ontarians who need them most and to avoid costs of wasted product, we recommend that the MOH, in consultation with Ontario Health:

– Collect more complete data from hospitals on how immunoglobulins are being used and identify emerging conditions that may warrant inclusion in provincial utilization guidelines.

In Ontario, Ig requests are currently completed by the prescriber and sent to Transfusion Medicine Laboratories (TMLs) on three different paper requisitions (MOH IG Request Forms- Neurology, Non-Neurology and SCIG). These paper forms do not leave the hospital TMLs to which they were submitted. This limits access to comprehensive provincial Ig utilization data and makes it difficult to understand how Ig is being used in Ontario.

To address this situation, the Ontario Ministry of Health, in partnership with Canadian Blood Services and health system partners across Ontario, is developing a new Ig information technology (IT) system within Canadian Blood Services’ Hospital Portal to enhance understanding of Ig utilization across Ontario and to support controlled access to Ig in alignment with Ontario’s Ig Utilization Management Guidelines.

Key System Benefits

Key System Benefits

Project information, FAQs, training materials, and implementation updates will be shared as they become available in the Project Communications and Resources section below.

  • Ministry of Health – Funder of CBS’s Ig IT project, provincial blood coordinating program (ORBCoN), and all blood components and products in Ontario, including Ig.
  • Canadian Blood Services – Leading development of IT infrastructure to support central collection and review of Ig requests from Ontario prescribers. Wholesaler of Ig products to Ontario hospitals.
  • ORBCoN – Facilitator of provincial Ig utilization information from various stakeholders to support best practice in utilization of blood components and products.
display image

The Ig IT System project would not be possible without the input from various stakeholders across the province. Core and extended working groups have been established to support this project throughout the development and implementation phases. Members include:

➢ Ontario Ministry of Health Representatives

➢ Ontario hospital TML staff including: Transfusion Medicine Physicians, Laboratory Leadership, and Technologists

➢ Ontario Ig prescribers across various specialities including: immunology, neurology, hematology, pediatrics

➢ Ontario Health Representative(s)

➢ ORBCoN

➢ Canadian Blood Services staff

Anticipated timeline