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.