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Drugs are not the only thing needed in the NHS.
This essential item has an extremely short shelf life and cannot be stockpiled.
Unlike many medicines, radioactive isotopes cannot be stockpiled. As soon as they are produced they begin to decay. The longer the delay, the smaller the dose of useful isotope that remains.
Technetium-99m (99mTc). This extremely useful element has a half-life of just six hours, and so is transported to hospitals and radiopharmacies in the form of ‘technetium-99m generators’. These devices contain the decaying parent element, molybdenum-99 (99Mo) which has a half-life of sixty-six hours.
Approximately one million UK patients each year rely on radioisotope procedures. The UK is not self-sufficient in these materials, importing around 80% of the medical radioisotopes we use. Most of these come from the Netherlands, Belgium, and France.
Dr Dickson noted that if imported radioisotopes suffered delays then “the guarantee of supply will not be there and what comes out at the other end will not be, essentially, what we paid for. f you delay that at customs or through border issues, you have paid for 100 but you get 50 doses. You therefore cannot treat patients adequately…and you are incurring a massive cost for the NHS”.
Dr Dickson also cast doubt on the government’s plan to transport radioisotopes into the country by air, pointing to the lack of specialist handlers and airport capacity.
Medical Radioisotopes and No-Deal Brexit
Since the UK has no reactors capable of producing Mo-99, British hospitals have so far relied on weekly supplies by lorry from reactors in France, Belgium and the Netherlands.
Five nuclear reactors in Europe provide around 60% of the world’s production of Mo-99, which is used to produce Technetium 99, the most widely used diagnostic isotope.
BMA Euratom and ensuring the continued uninterrupted cross-border supply of nuclear materials, including for medical use, post-Brexit
Also falling into the short shelf life/no stockpiling category are most radioisotopes for oncology.
The UK also imports Radium-223 from Norway to treat bone tumours, Iodine-123 from Belgium to treat thyroid cancer, and both Iridium-192 to treat cervical and prostate cancer, and Lutetium-177, to treat neuroendocrine tumours, from the Netherlands.
“The problem is, our supply chains are built around lorries from the Channel,” Dickson says. “It would take a substantial, expensive and time-consuming process to reorganise all those supply chains, but we can’t consider the process until we have a clear picture on the post-Brexit deal.”
Brexit's latest no-deal crisis? Decaying radioactive medicine
Iodine 123 - Half life 13.2 hours
Lutetium-177 - half Life 6.7 days
Radium 223 - half life 11.4 days
Iridium-192 - half life 74 days |
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