TRANSPORT OF RADIOPHARMACEUTICALS, CRADLE TO THE PATIENT

This presentation looks at the constraints and challenges of moving Radiopharmaceuticals, from the raw material to the end customer, the patient. Most Radiopharmaceuticals tend to be short half-life nuclides used to diagnose or treat disease. This paper will concentrate on the nuclide molybdenum-99 with the daughter product technetium- 99m and Iodine-123 Technetium-99m is mixed with inactive (cold) material, to prepare a radiopharmaceutical and injected into the patient, depending on the cold material; the radioactive material will concentrate in the organ(s) to be evaluated. After scanning the patient, the doctor can then make a diagnosis. Iodine-123 is a diagnostic agent used for the detection of tumors and other diseases. Many millions of scans across the globe are performed in a nuclear medicine department by administering a radiopharmaceutical to the patient. Through the supply and manufacturing chain for Molybdenum-99, from reactor to manufacturer, (including the chemical process to produce sterile material) and then from the manufacturer to the end user has to be well choreographed. Any delays in any of the logistics routes cause a loss due to decay of Molybdenum99. Molybdenum has a half-life of 66 hours and delay of one day means ~ 22% loss of material and therefore subsequent doses for use with the patient. In contrast Iodine-123 has a half-life of 13.2 hours, the process of making the raw material using a cyclotron, processing and transporting must happen on the same day. Any delay invariably means that the product will not be able to be used. To add to the challenges of the product being radioactive, it also has to meet the strict requirements of intravenously injectable drugs (GMP). Delays have an impact on the Healthcare system, not just monetary for the manufacturer but also the cost to Healthcare system for re-scheduling, loss of scanner time and of course the discomfort to the patient.