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IG Supply Update #2

June 18, 2019

 June 18, 2019

Update on Immune Globulin Supply in Canada

Dear IG patient/caregiver,

As we informed you in a letter dated May 14th, Canadian Blood Services is currently experiencing a shortage of the SCIg product Cuvitru. As previously stated, this shortage will affect predominantly patients with immunodeficiency, and patients with neuromuscular disease. This shortage should not interfere with the treatment of patients currently on SCIg.

As a result of the Cuvitru shortage, a working group consisting of Canadian neurologists, hematologists, immunologists and patient groups have been meeting weekly by teleconference to recommend short-term management to mitigate the risk to patients and their access to SCIg. The following strategies to manage the SCIg shortfall have been recommended:

Patients currently receiving SCIG (Cuvitru)

Currently treated patients should continue with NO changes to their current access to SCIg. Patients will be given no more than a 3 months’ supply. However, in some regions of the country, patients will be given only 1 months’ supply.

Some patients in targeted clinics may be given an alternate product (Hizentra or Cutaquig), in order to assist in the current supply challenges. This will be discussed with you by your healthcare provider before any changes occur.

Vial Substitutions

Given the supply limitation of larger vial sizes (4g and 8g), we have recommended this supply should be preferentially available to neurology patients who require higher dosage. Due to this recommendation and limited supply of larger vial sizes, patients can expect vial size substitutions.

We are expecting the vial substitutions to be short term only, and for patients to have a return to normal vial sizes by the fall.

Patients currently receiving SCIG (alternate)

Patients currently receiving Gamunex, Cutaquig or Hizentra through the named patient program will continue on these products without disruption.

Patients currently receiving IVIG

Patients currently receiving IVIG will continue without disruption.

Patients waiting for SCIG

Patients currently in the queue to start SCIG can expect a delay.

Moving Forward

Takeda stated that they hope to have sufficient product by “late-summer/early fall”, most likely Sep-2019. CBS has secured a small amount of alternate SCIG, which will be allocated to a few specific clinics across the country. You will be notified by your clinic if an alternate product is being arranged for you.

Hema Quebec has an alternative supplier and is not affected.

A Customer Letter from CBS and an explanatory letter from Takeda Canada can be found on the CBS website (https://blood.ca/en/hospital-services/customer-service/communications/customer- letters

If you have any questions or concerns about your treatment or how these changes affect you, please contact your healthcare provider.

We will continue to update you throughout this process, and work with Canadian Blood Services and industry, for the patient, ensuring that patient care is the primary concern to all involved.

CIPO National                                         

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