Hospitals and diagnostic services providers were forced to turn away patients, many critically ill, due to short supply of a radioactive substance during the last two weeks, courtesy Indian Government’s changed regulations.
The radioactive substance, technetium 99m, is used for nuclear scans for multiple conditions including cancer, heart and kidney issues. The substance is given to a patient underging a scan to detect lesions and other abnormalities in organs which are scanned. It is amongst the widely used substances in nuclear imaging and its short supply had been forcing hospitals to turn away patients.
Procedures rescheduled
“We have had to put off scans of many patients, mainly those who come for thyroid related conditions including cancer. In some cases, substitutes are available but technetium 99 is widely used and irreplaceable,” said Jyotsna Rao, a consultant in nuclear medicine at Apollo Hospital. Nuclear medicine specialists at KIMS Hospital too said the substance is in short-supply.
“Over 100 patients come everyday for these scans. We were told our supply will reach on Monday. Until then these scans have been put on hold,” said C. Sairam of MNJ Hospital.
Technetium 99m is obtained from a parent radioactive substance called molybdenum 99, which is packaged in a generator or a kit for transport. The generator allows for decay of molybdenum into technetium. Given that technetium 99m is a short-lived radioactive substance as it decays rapidly into an isotope that is not of use in imaging, the generator has to be transported quickly to hospitals and diagnostic centres. A significant portion of generators used in India are manufactured outside the country.
Affecting nuclear medicine departments across the country, Drug Controller General of India issued orders in February that required importers of generators to send samples to government facilities like Bhabha Atomic Research Centre for testing and obtaining an NOC. For last two weeks the importers have stopped procuring the generators citing inability to comply with the changed rules. The authorities have now given a 45-day window to comply with the norms.
Make in India
“There should be a robust policy to ensure uninterrupted supply of this life-saving substance. The Government should consider setting up its own reactor for producing quality molybdenum, given the importance of technetium 99m,” said K. Kumaresan, a city-based nuclear medicine expert who has also been affected by the short supply.
