Overview
Participants of the July 17-18, 2017, symposium titled Opportunities and Approaches for Supplying Molybdenum-99 and Associated Medical Isotopes to Global Markets examined current trends in molybdenum-99 production, prospects for new global supplies, and technical, economic, regulatory, and other considerations for supplying molybdenum-99 to global markets. The symposium was co-hosted by the National Academies of Sciences, Engineering, and Medicine and the Russian Academy of Sciences in cooperation with the International Atomic Energy Agency. It was intended to promote the establishment of working relationships among global experts, especially U.S. and Russian experts, and a common understanding of global supply chain needs and requirements. The symposium was attended by about 85 individuals from 17 countries. Discussions can be summarized as follows:
Molybdenum-99/Technetium-99m Demand (Chapter 2). The decay product of molybdenum-99, technetium-99m, is used in about 80 percent of all nuclear medicine procedures worldwide. Utilization of technetium-99m has declined globally. In the United States, the largest consumer of molybdenum-99/technetium-99m, several factors have contributed to the decline, including changes in medical insurance reimbursement policies, increased preference for competing imaging modalities, widespread acceptance and further development of appropriate use criteria, radiation exposure concerns, and more efficient use of technetium-99m. Apart from China, no other country represented at the symposium indicated a projected increase in molybdenum-99 demand in the near future.
Current Molybdenum-99 Supply (Chapter 3). As of July 2017, almost all molybdenum-99 for medical use is produced by irradiating solid uranium targets in six research reactors, and is supplied to the global market by four companies in Australia, Belgium, Netherlands, and South Africa. Existing smaller suppliers, with plans to expand production, are located in Argentina and Russia. All of these suppliers, except Russia, are either in the final stages of converting production from using highly enriched uranium (HEU) to low-enriched uranium (LEU) targets or already produce molybdenum-99 using LEU targets.
A representative of the Russian State Atomic Energy Corporation, Rosatom, noted that Russia realizes that selling non-HEU-sourced molybdenum-99 is a recognized requirement for producers aspiring to capture a share of the global market. The representative added that Rosatom, for economic reasons, has chosen not to prioritize conversion of production from using HEU to LEU targets in existing reactors but instead to invest in alternative non-HEU production methods with a goal of capturing up to a 20 percent share of the global market in the future.
Conversion from HEU- to LEU-Sourced Molybdneum-99 Production Challenges (Chapter 4). Conversion from HEU- to LEU-sourced molybdenum-99 production has been a challenging process. Target manufacturers, reactor operators, and molybdenum-99 suppliers have had to resolve several technical problems related to LEU target fabrication and processing, target validation, and radioactive waste management. Conversion has taken two of the existing global producers about 6-7 years, and one global producer is still resolving conversion-related technical challenges. These challenges were described by several participants as greater than anticipated and requiring large capital investments. The transition to an all-LEU-sourced production has been challenging for other members of the supply chain including generator manufacturers and nuclear pharmacy operators.
The challenges of conversion from HEU- to LEU-sourced molybdenum-99 production have generated several opportunities for research and development to improve production and processing efficiencies and radioactive waste management. Three such activities were described at the symposium: Korea’s high-density LEU target development, Germany’s FRM-II reactor research group’s proposed extraction process, and Australia’s radioactive waste treatment technology.
Molybdenum-99 Supply Reliability (Chapter 5). Since the 2009-2010 molybdenum-99 supply shortages, governments and industry have taken several actions to improve the reliability of the molybdenum-99/technetium-99m supply chain. These actions include increasing production capacity and outage reserve capacity, monitoring and reviewing the supply chain to identify periods of potential risk, investing in the durability of the supply, coordinating reactor schedules, enhancing communications among supply chain participants, and developing backup agreements between producers and reactor operators. Many symposium participants noted that the supply market is more reliable today as a result of these actions. However, according to the Organisation for Economic Co-operation and Development’s Nuclear Energy Agency, bringing new capacity to the market is important to reduce risks of future shortages.
Prospects for Molybdenum-99 Future Supply (Chapter 6). Several countries are planning to develop new capabilities to produce molybdenum-99. These countries include the United States, Russia, Argentina, Brazil, Canada, China, Egypt, India, Netherlands, and South Korea. All of these new capabilities involve non-HEU-based technologies. Representatives of the planned projects provided information on the current status of capability development and the projected dates when molybdenum-99 would be supplied to the market. These dates ranged from 2018 to about 2025. Representatives of Russia’s three new projects that involve alternative, non HEU-based molybdenum-99 production methods, did not provide similarly detailed projections. One explanation given was that these Russian projects are at initial stages of development and it is too early to predict their success or provide a schedule for completion.
Some of the projects discussed at the symposium rely on technologies not yet proven for large-scale commercial molybdenum-99 production. Symposium participants, including some current producers, commented that the schedules for molybdenum-99 production provided by some potential producers were ambitious and do not account for the time needed for development, industrialization, and validation of the different molybdenum-99 production methods. In addition to the market-readiness challenge, other participants raised the market penetration challenge: If all aspirant molybdenum-99 producers were to enter the market, global production capacity would far exceed current demand and needed outage reserve capacity. Without an indication that global demand for molybdenum-99 is likely to increase substantially in the next few years, this additional global production capacity cannot be absorbed by the market.
It is possible, however, that introduction of new production capacity from countries that previously relied on imports to cover domestic molybdenum-99 needs has a different market effect. That is, molybdenum-99 produced by smaller local/regional producers may be preferred over molybdenum-99 purchased from global producers owing to favorable transportation logistics that improve supply reliability, possible cost advantages, and other factors. As several countries become self-sufficient for molybdenum-99 supply, existing global producers could lose part of their current supply share.
Molybdenum-99 Supply Sustainability (Chapter 7). The historic pattern of government subsidization of medical isotope production has proven to lead to market sustainability issues. To create a sustainable molybdenum-99/
technetium-99m market, the High-Level Group on the Security of Supply of Medical Isotopes agreed on six principles in 2011; full cost recovery is one of these principles. Currently, the methodology for estimating molybdenum-99 production costs used by the different producers is not publicly disclosed and implementation of full cost recovery is self-assessed without an independent review of the assessment.
Several symposium participants offered comments on their company’s or organization’s views on adoption of the full cost recovery principle. These comments highlight the range of existing and anticipated differences in estimating molybdenum-99 production costs and interpreting full cost recovery.
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