The Supply of Medical Isotopes

An Economic Diagnosis and Possible Solutions

image of The Supply of Medical Isotopes

This report explores the main reasons behind the unreliable supply of Technetium-99m (Tc-99m) in health-care systems and policy options to address the issue. Tc-99m is used in 85% of nuclear medicine diagnostic scans performed worldwide – around 30 million patient examinations every year. These scans allow diagnoses of diseases in many parts of the human body, including the skeleton, heart and circulatory system, and the brain. Medical isotopes are subject to radioactive decay and have to be delivered just-in-time through a complex supply chain. However, ageing production facilities and a lack of investment have made the supply of Tc-99m unreliable. This report analyses the use and substitutability of Tc-99m in health care, health-care provider payment mechanisms for scans, and the structure of the supply chain. It concludes that the main reasons for unreliable supply are that production is not economically viable and that the structure of the supply chain prevents producers from charging prices that reflect the full costs of production and supply.


NM Diagnostic activity by country – Data sources and comparability

Estimates of the number of procedures in Chapter 2 are collated from various sources described in the table below. Some estimates include all NM diagnostic procedures for which the use of Tc-99m is possible (single- and multi-phase planar scintigraphies, SPECT and SPECT/CT), irrespective of the radioisotope actually used, while some estimates only include procedures using Tc-99m. All estimates exclude NM diagnostic procedures for which the use of Tc-99m can be ruled out (e.g. PET).


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