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EXECUTIVE SUMMARY The following table shows the range of expected impacts from the various stages of the supply chain, when compared to the reference case of full-cost recovery. It is clear from this study that LEU-based 99Mo from a converted facility is more expensive than HEU-based 99Mo from the same facility. The price increase, however, is less than 8% from the radiopharmacy, but is higher upstream. Table E1. Range of percentage increases in costs of a 6-day curie of 99Mo from the full-cost recovery reference case as a result of LEU-target conversion From irradiator From processor From generator manufacturer From radiopharmacy % increase in costs: range 3.6-36.8 6.3-42.8 5.4-36.6 1.1-7.8 Comparing the values in this table to those presented in the previous economic study related to the move to full-cost recovery (OECD/NEA, 2010) shows that the impacts from moving to full-cost recovery under any capital replacement scenario are expected to be larger than the impacts of LEU-target conversion. This means that LEU-based 99Mo from a converted facility may in fact be less expensive than 99Mo from a new facility with full- cost recovery (depending on the infrastructure scenario). The price increases translate to a reasonably small increase in relation to the reimbursement rate of the final diagnostic procedure. Based on a reimbursement rate of EUR 245 (a weighted average of global rates), the value of the radiopharmaceutical 99mTc increases from 4.46% of the reimbursement rate up to maximum of 4.8%. This translates to less than a EUR 1 increase7 on a EUR 245 test. It is necessary to realise, however, that this small increase must be funded because it is important to support the changes necessary upstream. In a separate paper, the NEA has discussed how unbundling the reimbursement for the isotope from the radiopharmaceutical and the diagnostic procedure could be a tool for greater transparency on necessary price changes (OECD/NEA, 2012b). Need for policy action Current experience in the supply chain, unfortunately, seems to demonstrate that end payers have difficulty supporting even small changes in price. However, this support is necessary to ensure that the supply chain will have sufficient resources (and motivation) to convert to producing 99Mo from LEU targets and to have sufficient capacity to ensure security of supply. In addition, the capacity study demonstrated that over the first few years of the conversion period, HEU-based 99Mo will be available in sufficient quantities, and thus, with the price differences, it may be difficult to sell LEU-based 99Mo. These two factors point to a need for governments to encourage non-HEU based 99Mo production and consumer uptake, while always respecting the HLG-MR policy approach to ensure a long-term secure supply of 99Mo/99mTc (OECD/NEA, 2011a). The HLG-MR has developed a discussion paper that provides various options for governments to consider (OECD/NEA, 2012a). Broadly speaking, the policy options examined and described in that document have one of three roles: making the option of purchasing or producing non-HEU-based 99Mo and/or 99mTc more attractive; making the 7. It is important to note that these values are based on global averages; the values may vary between procedures and regions such that the isotope cost increases could be much higher for specific procedures or in certain regions. MARKET IMPACTS OF CONVERTING TO LOW-ENRICHED URANIUM TARGETS FOR MEDICAL ISOTOPE PRODUCTION, ISBN 978-92-64-99197-2, © OECD 2012 13PDF Image | Market Impacts of Converting to Low-enriched Uranium Targets for Medical Isotope Production
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