From the June 2019 issue of DOTmed HealthCare Business News magazine
The basic nature of the supply chain issue can be found in the very fast radioactive decay of the isotope, which requires constant production and short inventory life. It’s also in regulatory issues, which surround the isotope’s production and transportation to U. S. shores. The vast majority of supply chain disruptions happen abruptly, with supplies vanishing days before a new product can be delivered.
Here are a few ways to prepare for possible disruptions in the current radiopharmaceutical supply chain:
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1. Stay in contact with your nuclear pharmacy provider on when to place orders. During a supply shortage, healthcare organizations should check with their nuclear pharmacy for the days when activity is highest for Technetium-99m. Tc-99m is the decay product of Mo-99 and is used in approximately two-thirds of all diagnostic medical isotope procedures in the U.S. Review the delivery schedule and see how you can best accommodate it. Communication is key to ensuring you will have the right radiopharmaceuticals with the highest radioactivity to safeguard diagnostic efficacy.
2. Order ahead. Plan to order unit doses of Tc-99m when the bulk material is known to face a cutback. When supply is interrupted, Tc-99m bulk doses are typically the first to be cut by nuclear pharmacies.
3. Adjust office hours. Because certain radiopharmaceuticals are unavailable during a shortage, it is critical to consider extending your office hours to account for patient reschedules. This may give the supply chain time to rebound and later in the week your nuclear pharmacy should have better insight on which days Tc-99m will be in greater abundance.
More companies entering the supply chain should inspire a healthy competition, creating better stability in the market. When that happens, look for reduced prices to follow.
High-energy materials gaining traction with theranostics, PET imaging
There’s good news for the other 20 percent of nuclear medicine — known as the “high energy” side of the radiopharmaceutical market. One of the industry’s latest buzz words is “theranostics” — a new type of treatment that integrates diagnostics and therapeutics in individualized disease management.
A study by Taiib, et al. (2016), outlines how nuclear medicine is ideally positioned to play a central role in theranostics by allowing visualization of molecular targets and thus enabling so-called in vivo immunohistochemistry. Once enabled, targeted drugs labeled with therapeutic radionuclides can be administered to patients and real-time monitoring of physical responses to them can be viewed.