Global Technetium-99m Supply: Current Issues and Future Solutions

Learning Objectives 1. Learn the issues surrounding recent supply and price disruptions of Technetium-99m derived from Molybdenum-99 generators. 2. Understand potential near and medium term solutions and the limitations of each.

Methods: A review of the scientific literature and business press. Results: Recent supply disruptions and price increases of ^99mTc derived from ⁹⁹Mo generators highlight the need for a more comprehensive global policy to ensure a reliable and affordable supply for the future. A small number of enriched uranium nuclear power plants, some more than 50 years old, supply the vast majority of the world supply of ⁹⁹Mo used in commercially available generators. A single plant going offline has caused major disruptions in the supply chain, as there is essentially no reserve capacity in the system. Cost issues related to government subsidies and regulatory factors have further exacerbated problems. Furthermore, the concern of proliferation of highly enriched uranium, disposal of waste products, and unprofitability are limiting factors in the construction of new facilities. Although future demand for ^99mTc cannot be predicted with certainty, several plants that provide large portions of the global supply are likely to be retired in the near future. The result likely will be worsening shortages and markedly higher prices. A combination of existing and developing technologies, including low enriched uranium power plants, cyclotrons and accelerator-based systems must meet demand in the future. Various factors, including the economics of implementing these production technologies, regulatory barriers and delays, and the relative yields compared to current production methods may prove to be substantial. Conclusions: In the setting of supply disruptions and rising prices of the global supply of Technetium-99m, a combination of short and medium term solutions will need to be implemented to meet future demand.