Tulchinsky said that as he had feared, the V/Q scan is now unavailable in most centers in the evenings and on weekends. Typically, doctors can get "on-call" doses of MAA and DTPA that can last until around 11 p.m. during normal business hours. Before the price increase, they would make doses in the hospital's hot lab during off hours, but this would use the whole vial for just one patient, which is now a considerable expense.

"On the weekends it is not at all available," Tulchinsky said. "I think it is pretty much the standard of practice now across the country. The availability of V/Q lung scan has dramatically decreased since the price went up."

Tulchinsky said he is concerned that with the decreased availability of the scan, more facilities will favor CT Pulmonary Angiogram, increasing radiation exposure to patients and putting young women at an increased risk of breast cancer.

Jubilant DraxImage could not be reached for comment. In an FAQ about the price increase posted to its website May 15, the company said that the price hike was not about just profits, but about making sure the radiotracers remained available.

"If this were a matter of profits alone, as the sole manufacturer of MAA and DTPA for more than two years, Jubilant DraxImage has had ample opportunity to raise prices," the company wrote. "However, this is a far broader issue than just profits. Our deep, abiding commitment to our customers and the patients they serve led us to remain in the market long after the only other North American manufacturer halted production of MAA and DTPA. Everyone at Jubilant DraxImage has taken the time to consider and reflect upon this commitment, and what it would take to remain in this business as a successful, viable company that is ready and able to support the nuclear medicine community. Long-term Nuclear medicine viability and sustainability are the issues here, not individual product pricing."

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