Radiology and nuclear medicine groups have urged U.K. Prime Minister Boris Johnson to provide some answers to outstanding questions about radioisotope supply ahead of a potential no-deal Brexit. They've demanded assurances about product supply and costs to the National Health Service (NHS).
On 1 August, leaders of the Royal College of Radiologists (RCR), the British Nuclear Medicine Society (BNMS), and the UK Radiopharmacy Group (UKRG) issued a joint letter to Johnson, asking for his help addressing specific questions about contingency of supply of these products.
"We remain apprehensive about supplier readiness, and the impact shipment changes and/or delays are likely to have on hospital planning and expenditure, and ultimately, on patients," stated the authors. They added that because nuclear materials are constantly decaying, their transport and use needs to be meticulously planned to ensure they reach patients in time -- e.g., flutemetamol, used in the diagnosis of Alzheimer's disease, is imported from the European Union (EU) and has a half-life of less than two hours.
Some radioactive tracer products used in PET/CT scans can be created in particle accelerators in the U.K., but most of the U.K.'s supply comes from nearby reactors in the EU, particularly from Belgium and the Netherlands. Currently, radioisotopes enter the U.K. via road and air freight, with most coming by road through the Channel Tunnel. In the event of a no-deal Brexit and increased road transport delays, suppliers have been asked by government to ensure they can fly in all of their consignments.
The authors of the letter noted that importing radiopharmaceuticals via air freight was successfully tested earlier this year, but at least one supplier faced customs delays at East Midlands Airport, near Nottingham. This has given rise to questions about whether industry has enough qualified drivers to cover changes or delays to shipment timings from airports on to hospitals around the U.K.
They have also voiced concern that increased transport costs for flying in radioisotopes will be passed on to hospitals.
"We appreciate the bulk of contingency planning rests with goods suppliers but, given the crucial nature of these materials, we believe the government has a clear responsibility to update the health sector about outstanding concerns," the authors wrote.
They have asked for urgent clarification on these three issues relating to radioisotope supply:
- What guarantees can be given that reported customs delays at East Midlands Airport will not happen in future, and which minister will have direct responsibility for this?
- What clear actions have been taken to ensure industry has sourced enough trained drivers to ensure timely delivery of medical radioisotopes to the North of England, the South West of England, Wales, Scotland, and Northern Ireland?
- What action has been taken to ensure future tariff reimbursements for nuclear medicine tests and brachytherapy cancer treatment (both regarding individual and contract tariff rates) reflect increased costs caused by Brexit?"
You can read the full letter on the RCR website.
