House passes medical isotopes bill

A spot of encouraging news emerged yesterday on the medical-isotope front. The House of Representatives voted 440 to 17 in favor of a bill to reestablish domestic production of molybdenum-99. It’s the feedstock for technetium-99m, the most heavily used nuclear agent in diagnostic medicine.

As I’ve been reporting for months, the United States is in the throes of an isotope crisis. Recurring shutdowns of geriatric reactors by foreign producers have left much of the world, and especially the United States, in chronic short supply of moly-99.

Indeed, as of August, when the Society of Nuclear Medicine most recently polled its members, 80 percent reported that their medical practice or facility had been negatively impacted by the moly shortage — some of them gravely.

Because both this isotope and its daughter — Tc-99m — are short-lived, neither can be stockpiled. So hospitals and diagnostic-medicine clinics have had to alter or ration access to medical procedures that typically rely on Tc-99m — typically some 50,000 each weekday in the United States alone.

The bill, H.R. 3276 (aka the American Medical Isotopes Production Act), would give the Energy Department $163 million to support would-be U.S. producers of moly-99. We’ve identified some of the likely candidates for those funds in a recent cover story.

But there’s more to the bill than just pledging federal bucks to develop supplies of homemade moly. The legislation would also mandate the phasing out within a decade of all export of bomb-grade uranium for use in making medical isotopes. Currently, such highly enriched uranium is used to produce most of the moly-99 imported into the United States.

But it doesn’t have to be. A National Academy of Sciences report noted that there are ways to produce the feedstock isotope using low-enriched uranium, or even processes that don’t need uranium at all.

Making moly from something other than bomb-grade nuclear materials will, however, take substantial money and time for its producers to retool — or in the U.S. case, to gear up from scratch. And that’s where the DOE money would go: to help domestic firms or universities develop novel recipes and technologies for moly-making.

Of course, the new bill doesn’t do anything to alleviate the current moly/Tc-99m crisis. Even legislatively, yesterday’s House action is only a small first step. Unless and until the Senate also passes this bill, or its own analog of it, domestic production of moly may remain little more than a rallying cry by frustrated docs.

By the way, who didn’t support the House bill? Seventeen Republicans: two each from Arizona and California, three from Georgia, four from Texas, and the remainder from Colorado, Florida, Indiana, Ohio, Utah and Wisconsin. Another very bipartisan group of 16 didn’t vote on the bill at all. To identify where your Member of Congress stood on the issue, check out govtrack.us.