Today, one of our members reported an isotope shortage of Choletec (technetium (99mTc) mebrofenin). After conducting further research as to the cause of the shortage, the Society learned that the culprit is a shortage of vials. This shortage is not unprecedented. Some time ago, there was a DTPA shortage because of a shortage of caps for the vials.
SNMMI President Dr. Vasken Dilsizian released the following statement addressing how the COVID-19 pandemic may affect the supply of Mo-99.
Dear Fellow SNMMI Members,
Much like you, the SNMMI leadership has been closely following the rapidly evolving COVID-19 situation—monitoring the latest recommendations provided by the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) to help address its inevitable impact on the nuclear medicine and molecular imaging community. In line with the SNMMI’s mission to improve human health by advancing nuclear medicine, molecular imaging, and radionuclide therapy; SNMMI’s primary focus is on how this issue may affect our ability to care for patients; more specifically, how the COVID-19 pandemic may affect the Mo-99 supply situation.
The SNMMI is particularly paying close attention to how the COVID-19 pandemic might affect different parts of the Mo-99 supply chain including production, target processing, and transportation. As you may imagine, many factors can affect this supply chain, including quarantines and closures of schools that result in the absence of key staff, as well as disruptions in the international transportation network. In order to keep our members as informed as possible, SNMMI is currently taking the following steps:
At this time, no Mo-99 shortages have been reported. Moving forward, SNMMI will remain in close contact with government agencies, trade organizations, and other stakeholders in the nuclear medicine and molecular imaging community to help to ensure an adequate supply of Mo-99.
Vasken Dilsizian, MD
A significant shortage of Mo-99 is expected for the first half of November. The NTP facility in South Africa, which has experienced problems since late last year, has not yet been able to return to service, and a technical issue has developed with the High-Flux Reactor (HFR) in the Netherlands, which is now on unplanned shutdown.
The unexpected HFR shutdown coincides with a planned 11-day shutdown of the OPAL reactor in Australia that began October 29, so significant shortages of Mo-99 are anticipated starting in early November. With significant shortages anticipated, it is essential that users contact their generator/nuclear pharmacy providers for advice about their local situation. The Association of Imaging Producers & Equipment Suppliers (AIPES) Emergency Response Team is closely following the situation. The group issued an update on October 30, and SNMMI will post updates as they become available.
NTP Radioisotopes in South Africa reports that they expect to meet with regulators this week regarding their request to resume Mo-99 production operations. With OPAL having a scheduled shutdown from July 16 – 20 will make things more challenging. The AIPES Emergency Response Team is scheduled to meet again on July 23, 2018.