November 6, 2009
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The shut-down of Ontario’s Chalk River reactor, which used to supply 30% of the world’s medical isotope requirements, and 60% of U.S. isotope needs, has prompted Congressional action in the U.S.
Yesterday, the House passed H.R. 3276 — the American Medical Isotopes Production Act of 2009 — finding that “[t]he United States should move expeditiously to ensure that an adequate and reliable supply of molybdenum-99 can be produced in the United States, without the use of highly enriched uranium.”
Both parts of that finding are important:
- supply of molybdenum-99 produced in the United States, because of the heavy impact on U.S. patients (16 million medical procedures annually); and
- without the use of highly enriched uranium, because reducing the need for highly enriched uranium is part of the U.S.’ nuclear security agenda.
The bill would provide funding of $163,000,000 (over FYs 2010-2014) for a program to evaluate and support projects for domestic production of medical isotopes.
In Canada, the latest plan is to spin off and privatize the “reactor business” unit of Atomic Energy of Canada Ltd. (AECL). The Chalk River reactor is facing $70 million of repairs and/or an uncertain long-term future.
June 9, 2009
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The shut-down of Ontario’s Chalk River reactor, one of the few sources of medical isotopes for imaging in the world, is now predicted to last at least three months, and the resulting isotope shortage has been noted by the WSJ’s Health Blog as likely to get “a whole lot worse.”
Meanwhile, in Quebec, Sherbrooke University Hospital is substituting a sodium fluoride isotope for bone scans (about 20-40% of the scans done in a day). It’s a 40-year-old technology that they make in-house using a cyclotron. Cyclotrons, you may have noticed, are much easier to come by than nuclear reactors.
April 30, 2009
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Well…it could be worse, but one could argue it’s the beginning of a slow decline for the medical imaging market in the U.S. On Tuesday, Senator Baucus (D-Montana) and Senator Grassley (R-Iowa), Chairman and Ranking Member of the Senate Finance Committee, released a description of policy options for healthcare reform.
The options included “Transparency and Evidence-Based Decision-Making for Imaging Services,” proposing a system that sets ”national appropriateness criteria” for imaging procedures (see page 7). Good so far. The system also includes standarized reporting to monitor rates of adherence to appropriateness criteria. Uggh, but fine. Then, in 2013, the Secretary would designate the imaging procedures for which reporting and differential payment will be mandatory and imaging procedures for which reporting will be voluntary based on baseline rates and amount of progress toward goals. This creates a system whereby access to specific imaging services and reimbursement can be further curtailed, and it will. Soon, we might see the term “medically necessary” thrown around in the U.S., a term many Canadians waiting months for an MRI have learned to hate.