Nicholas Fowler, the CEO of Northwest Medical Isotopes, calls it “a catastrophe in the making.”
The United States is about to run extremely low on Molybdenum-99, a vital element in nuclear medicine used to diagnose cancer and other life-threatening disease. The radioisotope is used in about 50,000 medical procedures a day.
“All but 5 percent of the U.S. supply is going to be either taken offline or at risk between late-2016 and late-2018,” Fowler said.
Northwest Medical Isotopes announced in May that it intends to create a reliable supply of the radioactive material by building a $50 million radioisotope production facility in Columbia near the MU Research Reactor. Through nuclear fission, Mo-99 will be recovered from irradiated targets using low-enriched uranium.
There are a limited number of producers of this radioisotope; globally, there are nine irradiators, many approaching the end of their life-cycle, and six processors, companies like Northwest. None of the producers are located in the United States. This creates two problems: the supply is undependable, and the isotope with a short shelf life has a long way to travel.
“The U.S. represents the largest market, and it represents the market most at risk from a supply chain perspective,” Fowler said.
About three quarters of the isotope consumed in the United States is produced in Canada at a reactor slated to be shut down in 2016. The rest is produced in Europe. The suppliers are essentially operating at capacity, Fowler said.
“There is no upward flexibility or elasticity to see how much market demand there actually would be if there was sufficient supply to potentially satisfy everyone’s need day in and day out,” he said.
The other problem is the isotope’s short shelf life. It is a race against time because it loses its efficacy after just days. Each hour spent in transit is time lost for medical diagnoses.
The time crunch is a major impediment for doctors and their patients because they don’t always know when they will need the isotope, and it’s not something you can grab off the shelf.
This is one of the key reasons Northwest Medical Isotopes picked a central U.S. location for its operations. From mid-Missouri, the transient isotope is much more accessible to hospitals around the country.
The company plans to start building at the Discovery Ridge Research Park in 2016 and a year later start producing about half of the U.S. supply needs, according to Fowler.
Columbia is home to the nation’s most powerful university-owned research reactor, with an output of 10 megawatts, as well as a workforce highly skilled in nuclear engineering. These factors were crucial in determining the production site, but the scientific breakthrough that made domestic commercial production possible happened in another college town in the Northwest.
Where it all began
The idea emerged after a chance encounter between a cardiologist and a nuclear scientist in the wine department at a Costco in Corvallis, the home of Oregon State University.
The cardiologist was expressing his frustrations; the lack of Mo-99 impacted his ability to conduct certain tests. The nuclear scientist happened to be working on a project that used research university-class reactors to create the isotope the cardiologist desperately desired.
At this moment they knew they were onto something. The idea made its way to Fowler, and he took on the role of turning it into a business.
Many of the current producers of Mo-99 use highly enriched uranium, but Northwest’s technology uses low-enriched uranium. Fowler said highly enriched uranium is often used because it’s easier and cheaper to extract isotopes than low-enriched uranium, which requires more material to get the same amount of Mo-99.
The drawback is this material can also be used to build nuclear weapons.
To address this risk and transform the marketplace, there are two global initiatives taking place. One effort is to convert all current facilities from using highly enriched uranium to low-enriched uranium. The second, called full cost recovery, aims to phase out subsidies to producers by 2014. The idea is to create a reliable and safe supply of the isotope in a competitive market.
Because the cheaper uranium is still used and subsidies continue to exist, “the current price of [the isotope] is artificially low,” Fowler said.
When asked how Northwest Medical Isotopes will be able to remain competitive, he said the company has a few distinct advantages.
“The first is…we don’t have to build a nuclear reactor,” Fowler pointed out. Reactors can cost upwards of $250 million to construct. They plan to use the research reactors at MU and Oregon State to irradiate their material.
Also, the company has developed intellectual property related to the Mo-99 production. It has a novel design for its targets that were developed at Oregon State University and licensed exclusively to Northwest. Targets containing the uranium are placed in the reactor for irradiation.
“Low enriched uranium is less than 20 percent uranium,” Fowler said. “And so it makes the extraction and purification process of Mo-99 more challenging than it does if you’re starting out with much a higher concentration of uranium. So one of the things the nuclear scientist was working on and we’ve now engaged with the University of Missouri and others is the extraction chemistries enable us to use, from the very beginning low enriched uranium.”
The next step for Northwest Medical Isotopes is to get a construction permit from the Nuclear Regulatory Commission.