MRIP Assessing Radionuclide Use in NHS Diagnostics & Therapies

Global demand for medical radionuclides is on the increase, driven by demographic shifts, emerging healthcare challenges, and economic trends. The use of radiopharmaceuticals for diagnostic purposes is growing by approximately 10% each year. In the UK, over 700,000 nuclear medicine procedures are performed annually, with around 60% of the necessary radionuclides imported, mainly from the EU. Domestic production is limited, covering only the needs for PET-CT diagnostics. Since radionuclides cannot be stockpiled, the UK is highly dependent on a continuous and reliable supply chain of imported materials. Any supply disruptions, due to reactor shutdowns or technical failures, could lead to delayed diagnoses, increased healthcare costs, and pose significant health risks.

Looking ahead, the UK’s supply of medical radionuclides faces potential threats, including infrastructure delays, technological failures, exclusive supply agreements, and geopolitical changes. Many of these challenges are beyond the UK government's control but could severely impact the supply to medical services. To mitigate these risks, the Department for Energy Security and Net Zero (DESNZ) has set up the Medical Radionuclide Innovation Programme (MRIP). This aims to inform future government policies regarding radionuclide supply and stimulate innovative production methods with existing UK nuclear assets, through funding of 10 innovation projects.

As part of MRIP DESNZ looked to ascertain historical use of radionuclides. This paper provides a comprehensive overview of the use of diagnostic and therapeutic radionuclides across the four nations of the UK. The analysis reveals substantial differences in access to specific radionuclides, confirming anecdotal feedback and concerns raised by consulted stakeholders.

We introduce a method to standardise the various coding systems used for recording medical radionuclide procedures across nations, which is essential for accurately assessing demand based on current usage. Additionally, we emphasise the need for systematic therapeutic data collection, moving beyond the reliance on voluntary survey entries, which have proven insufficient. Collecting detailed information on doses administered to patients would significantly improve the analysis of radionuclide usage.

To fully understand the demand and supply dynamics, the paper stresses the crucial requirement for better data on the radionuclide supply landscape. Currently, much of this data is controlled by private entities, limiting public access to important datasets. Overall, enhancing data standardisation and collection practices across the UK is vital for informed decision-making in this critical sector of healthcare.