Supply of Medical Radioisotopes series

As a result of the work undertaken to-date, the NEA has released seven reports under The Supply of Medical Radioisotopes series, subtitled:

2015 Medical Isotope Supply Review: 99Mo/99mTc Market Demand and Production Capacity Projection, 2015-2020
This report provides an updated review of the 99Mo/99mTc market demand and provides projections for future production capacity based upon a number of different scenarios during 2015-2020; a period when some existing capacity will leave the supply chain and a number of new production facilities using both conventional and newly developed alternative technologies are planned to be introduced. The market supply is presently under control, with the present supply chain adding some capacity, but the need for the on-time introduction of additional capacity from both conventional and alternative technologies is clear. The possible provision of contingency capacity in the 2017 and early 2018 period is also discussed.

Results from the Second Self-assessment of the Global 99Mo/99mTc Supply Chain
This report presents the findings of the second self-assessment of the global 99Mo/99mTc supply chain. The report evaluates progress made by 99Mo/99mTc producers with the implementation of the HLG-MR policy principles, with a focus on the principles of full-cost recovery, outage reserve capacity, the role of governments in the 99Mo/99mTc market, and conversion to low-enriched uranium targets. It also makes a comparison with the results from the first self-assessment in 2012. Further, the report discusses the current state of the 99Mo/99mTc market and identifies major issues that prevent the market from achieving long-term sustainability.

Medical Isotope Supply in the Future: Production Capacity and Demand Forecast for the 99Mo/99mTc Market, 2015-2020
This document presents a forecast of 99Mo/99mTc production capacity and demand in 2015-2020, when two major irradiators – the OSIRIS and NRU reactors in France and Canada – are expected to exit the global supply chain and new alternative technology projects may be commissioned. The forecast does not attempt to predict shortages, but identify periods when there is an increased risk of disrupted supply, to inform policy makers and other stakeholders.

Progress and Future Challenges in Implementing the HLG-MR Policy Principles: Final Report of the Second Mandate of the HLG-MR (2011-2013)
The final report of the second HLG-MR mandate presents the findings and analysis of detailed studies, undertaken over two years, to help market participants implement the HLG-MR policy approach to ensure the long-term supply of molybdenum-99 (99Mo) and technetium-99m (99mTc). It outlines methodologies to calculate full costs at irradiating facilities and pay for outage reserve capacity by the 99Mo/99mTc supply chain.

Implementation of the HLG-MR Policy Approach: Results from a Self-assessment by the Global 99Mo/99mTc Supply Chain
This report presents the findings of a self-assessment by the global 99Mo/99mTc supply chain, which was conducted as a direct action to implement the HLG-MR policy principle related to the need for periodic reviews of the supply chain. The report evaluates progress made by 99Mo/99mTc producers with the implementation of the HLG-MR policy approach and, in particular, the principles relating to full-cost recovery, outage reserve capacity and the role of governments in the 99Mo/99mTc market. The report also identifies major issues preventing the 99Mo/99mTc market from achieving sustainability.

Market Impacts of Converting to Low-enriched Uranium Targets for Medical Isotope Production
This study provides the findings and analysis from an extensive examination of the 99Mo/99mTc supply chain by the OECD/NEA High-level Group on the Security of Supply of Medical Radioisotopes (HLG-MR). It presents a comprehensive evaluation of the potential impacts from conversion to using LEU targets for 99Mo production on the global market for 99Mo/99mTc in terms of costs and available production capacity, and the corresponding implications for long-term supply reliability. In this context, the study also discusses briefly the need for policy action by governments in their efforts to ensure a stable and secure long-term supply of 99Mo/99mTc.

The Path to Reliability
This report provides the findings and analysis of two years of extensive examination of the 99Mo/99mTc supply chain by the HLG-MR. It puts forth a comprehensive policy approach that would help ensure long-term supply security of 99Mo/99mTc, detailing the essential steps to be taken by governments, industry and the health community to address the vulnerabilities of the supply chain, including its economic structure. This report serves as the final report of the HLG-MR.
Summary in English | Synthèse en français

An Assessment of Long-term Global Demand for Technetium-99m
As a result of the uncertainty and the lack of a long-term comprehensive demand overview that includes recent changes in the supply chain, the HLG‑MR sought to better understand future demand for 99Mo/99mTc and related nuclear medicine procedures. This report provides the findings and analysis of the data obtained from a global online survey on the future demand for 99mTc and diagnostic imaging out to 2020 and 2030. Based on analysis of the data, the report presents a future demand scenario for 99Mo/99mTc, indicating ongoing long-term demand.

An Economic Study of the Molybdenum-99 Supply Chain
This report offers a unique analysis of the 99Mo/99mTc supply chain, finding that the recent shortages are linked to insufficient capital investment, brought about by an economic structure that does not provide sufficient remuneration for producing 99Mo or support for developing additional production and processing infrastructure. To assist decision makers in their efforts to ensure long-term, reliable 99Mo/99mTc supply, the study presents options for creating a sustainable economic structure.
Summary in English | Synthèse en français

Interim Report of the OECD/NEA High-level Group on Security of Supply of Medical Radioisotopes
This report presents findings related to the main issues affecting security of supply including reactor and processing capacity constraints, transport, demand management, communications and other supply chain problems. The report makes: key recommendations, including on the need to continue the improved communications between suppliers and end users, especially during an unexpected reactor shutdown; suggestions to streamline and harmonise transport approvals by the industry and regulator; and highlights the importance of understanding future demand. It provides a comprehensive look at these and other topics and the other findings of the HLG-MR work to date.

Review of Potential Molybdenum-99/Technetium-99m Production Technologies
In this report, potential alternatives for the production of 99mTc and its parent isotope, 99Mo, are presented and reviewed. The report serves two purposes. First, it provides criteria for objectively assessing alternative technologies. Second, the report provides an assessment of the technical and economic merits of the available technologies, dividing the technologies into short-, medium-, and long-term opportunities. The developed criteria and the assessment of alternative technologies could be used by decision makers examining possible infrastructure for new production of 99Mo/99mTc.

Last reviewed: 21 August 2015