Current estimates of the projected demand for Mo-99/Tc-99m are based primarily on demographic factors. The U.S. population is aging, and the front edge of the baby boomer generation is reaching retirement age. As this population continues to age, its needs for diagnostic imaging will likely increase. For example, with respect to cardiovascular use of Tc-99m, as long as there are no major changes in the amounts of public and private insurance, it seems likely that patients will choose their individual cardiology providers, who will preferentially use the facilities that they are familiar with (such as Tc-99m radiotracers and gamma cameras) in the development of treatment plans. In part this is because of an inherent conservatism in regulatory patterns as well, which make it more difficult for new techniques, no matter how meritorious, to be widely accepted and reimbursed in less than about a 5-year timeframe.
With respect to the study charge to estimate current and future demand for Mo-99 in the United States, the committee finds that:
Demand for Mo-99 in the United States in 2006 fluctuated between 5000 and 7000 6-day curies (Sidebar 3.1) per week.
Estimates of future demand growth for Mo-99 evaluated by the committee range from about 3 percent to 10 percent. These estimates are for both U.S. and global demand. The committee judges that demand growth for Mo-99/Tc-99m in the United States could range from 0 percent to 5 percent per year for the next 5 years, with the most likely growth rate in the range of 3 percent to 5 percent per year. These estimates assume that there are no major disruptions in Mo-99/Tc-99m supplies and no major changes in health care policies or practices.
The demand growth for diagnostic imaging modalities will likely continue over the long term as the U.S. population ages. The extent that this will be reflected in demand for Mo-99/Tc-99m will depend strongly on whether other diagnostic imaging modalities take hold in the market.
During the next 5 years, imaging modalities (e.g., PET, CT, MR) that could potentially displace Tc-99m use for medical diagnostic imaging probably will not find widespread use in the United States. The current practice of favoring clinical use of Tc-99m radiopharmaceuticals will continue for the foreseeable future.
Note that global demand for Mo-99/Tc-99m could grow more rapidly than demand in the United States in the mid to long term as nuclear medi-