* Medical isotope shortage brings delayed, canceled tests
* Shortage could hit drug company clinical trials
By Julie Steenhuysen
CHICAGO, June 12 A North American shortage of
medical isotopes has forced many U.S. hospitals to begin
rationing scores of diagnostic tests, and doctors said on
Friday they see no quick solution.
Last month, Canadian health officials shut down a nuclear
reactor in eastern Ontario that produces a third of the world's
supply of medical isotopes, used in scans to check for an
impending heart attack or see if cancer has spread.
Repairs of a leak of heavy water at the Chalk River
reactor, first estimated to take a month, may now take three,
and Canadian officials say they eventually may leave the
isotope business altogether. [ID:nN10440068]
The Canadian plant is one of five aging reactors worldwide
-- none located in the United States -- to produce
molybdenum-99, the most commonly used medical isotope. The
rapidly decaying substance has a shelf life of just 67 hours,
making it impossible to stockpile.
"We are seeing a shortage," said Dr. Peter Conti of the
University of Southern California in Los Angeles.
Conti said the university's three hospitals have begun
rationing supplies, and they are not alone.
Conti said a prolonged shortage could threaten clinical
trials for cancer drugs because patients may not be able to get
needed scans on schedule, forcing them to drop out.
The Society of Nuclear Medicine said 91 percent of 375
members including doctors and nuclear medicine technicians at
hospitals across the nation reported in an e-mail survey this
week that they had been affected by the shortage, with 60
percent postponing procedures and 31 percent canceling some.
At the University of Chicago Medical Center, doctors are
recommending alternative diagnostic tests that do not rely on
this medical isotope but may not be as good and may cost more.
"Pretty much every reasonable-sized medical center is going
to have a nuclear medicine department that relies very heavily
on this isotope," said Dr. Daniel Appelbaum, who heads the
university's nuclear medicine department.
'GONE BY THE WAYSIDE'
Conti said doctors at USC are performing only the most
urgent tests, typically for heart scans. He said tests to check
if cancer has spread to bones "have gone by the wayside."
He said some cancer patients will be switched to more
expensive positron emission tomography scans, known as PET
scans. The test is approved by the U.S. Food and Drug
Administration, but is not covered by Medicare, the federal
health insurance program for the elderly and disabled.
"For Medicare, we're going to have to eat some of those
costs. We'll try to bill on the private side," he said.
The shortage has taken a toll on Toronto-based MDS Inc
MDS.TO, which distributes medical isotopes worldwide from the
Canadian reactor. MDS on Thursday said it lost $17 million in
the second quarter. [ID:nN11267505]
Privately held Lantheus Medical Imaging of Massachusetts,
which processes isotopes for medical use, got most of its
supply from Chalk River. The company last month cut a deal with
other suppliers to cope with the impact of the shutdown.
Covidien COV.N, another major U.S. supplier, gets most of
its isotopes from a reactor in Petten, the Netherlands, which
has shielded its clients somewhat from the Canadian shutdown.
But that may change next month when the Dutch reactor goes off
line for a four-week maintenance shutdown.
In a May 22 letter on the FDA website, Covidien said, "Even
with numerous global efforts and collaborations now underway,
there will be challenges meeting full market need."
Dr. Robert Atcher, president of the Society of Nuclear
Medicine, said the nearest-term solution would be to accelerate
a U.S. Department of Energy plan to convert a research reactor
at the University of Missouri to medical isotopes production.
Without added capacity and a stable domestic supply, he
said, patients will be at risk.
(Editing by Maggie Fox and Will Dunham)