Immunoglobulin adjusted body weight dosing will be the mandated default in BloodSTAR, Australia’s online system for accessing government-funded Ig products. If there is a clinical reason not to use adjusted body weight dosing, the clinician should select the appropriate option in BloodSTAR and provide a clinical justification in the authorisation request.
Due to this change, entering the patient’s height is now mandatory for all BloodSTAR authorisation requests.
The adjusted body weight dose may be lower than a dose based on actual body weight. For most patients, the difference is less than 5%. For patients with higher actual body weight, the difference might be more substantial. Adjusted body weight dosing is based on the underlying pharmacological properties and evidence for the use of therapeutic Ig. It is considered a safe and appropriate method for dosing calculation for most patients, except patients who:
In these cases, BloodSTAR will not apply the adjusted body weight dose and actual body weight dosing will be applied. Safeguards have been built into the BloodSTAR system to ensure patients in these groups are exempt. Prescribers can also elect to use actual body weight dosing if it is clinically justified for your patient.
What changes will look like in BloodSTAR
The process of prescribing Ig through BloodSTAR will be largely unchanged. However, you should note the following:
– Patient height will be a mandatory field
– The ‘Use adjusted body weight dose box will be selected by default
– The ‘approved dose’ will be the adjusted body weight dose by default, except in the circumstances discussed above. This is true even when requesting continuing authorisation for a patient previously approved for Ig.
These changes will bring Australian practice into line with standard dosing approaches used internationally and forms part of our ongoing commitment to promoting the safe and efficient use of blood products.