Solving The Medical Isotope Crisis

The ongoing medical isotope supply crisis is affecting more than Canadians' health. It not only puts at risk our aspirations to nurture a leading-edge innovative industry, it severely limits our options to help reduce the burden on future health care budgets. What got us into this mess is a tale of high minded optimism, missed opportunities and bureaucratic bungling. The more important question, however, is: how can we re-establish Canada's prominence, and secure at reasonable cost the potential benefits that medical isotopes will deliver for our future health'. Addressed in this collection are provocative essays from some of the world's top experts in nuclear physics and nuclear medicine.

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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.