The reliable supply of molybdenum-99 (Mo-99) and its decay product, technetium-99m (Tc-99m), is a vital component of modern medical diagnostic practices. Disruptions in the supply chain of these radioisotopes – which cannot be effectively stored – can suspend important medical testing services. Unfortunately, supply reliability has declined over the past decade, due to unexpected or extended shutdowns at the few ageing, Mo-99 producing, research reactors and processing facilities. These shutdowns have created global supply shortages.
This study offers a unique analysis of the economic structure and present state of the Mo-99/Tc-99m supply chain. It finds that the shortages are a symptom of a longer-term problem linked to insufficient capital investment, which has been brought about by an economic structure that does not provide sufficient remuneration for producing Mo-99 or support for developing additional production and processing infrastructure. To assist governments and other decision makers in their efforts to ensure long-term, reliable supply of these important medical isotopes, the study presents options for creating a sustainable economic structure. The study will also enhance understanding amongst stakeholders of the costs of supplying Mo-99 and ultimately contribute to a better functioning market.