Medical costs up as plant shuts down

The national nuclear regulator’s instruction to shut down production at the NTP radiochemicals complex has pushed up the costs and paperwork involved in providing medical radioisotopes for diagnostic imaging and treatment, it has emerged.

This stands in contrast to the assurances given by NTP acting MD Thabo Tselane that the shutdown had no cost implications for customers.

NTP is a subsidiary of the state-owned South African Nuclear Energy Corporation (Necsa) and is one of a handful of companies around the world that supply technetium-99 and radioactive iodine-131 to nuclear medicine specialists for diagnosing and treating cancer.

With local production at a standstill, NTP has had to source products for its customers from its competitors.

Supplies had not been disrupted, but the imported products were more expensive, said Lizette Louw, president of the South African Association of Nuclear Physicians.

The nuclear regulator ordered Necsa to halt production at NTP on November 17 due to safety concerns. NTP is the primary supplier to nuclear medicine practices of molybdenum-99, which generates the daughter product technetium99 used in imaging. It also supplies customers with iodine-131, which is used to treat hyperthyroidism and thyroid cancer.

Imported technetium generators cost about R800 more than those previously purchased from NTP, Louw said. A diagnostic scan typically cost between R6,000 and R10,000.

It was fortunate that the shutdown had occurred towards the end of the year when patient volumes dipped and nuclear medicine specialists took their summer holidays, she said.

The additional costs could be borne by medical schemes for the time being but were likely to pose a challenge if the shutdown persisted into 2018, she said.

NTP’s source of imported iodine-131 was creating an administrative burden for nuclear medicine practices, because the product was not registered in SA.

Doctors had to apply for what was known as a section 21 exemption from the Medicines and Related Substances Act to import the product on a patientby-patient basis, Louw said.

Neither the national nuclear regulator nor NTP have indicated how long the shutdown is expected to last.

Earlier this week, the regulator’s manager for nuclear waste projects, Thiagan Pather, said the regulator was concerned that NTP was prioritising production over safety. Its hydrogen-monitoring systems had failed on October 27, but it had delayed notifying the regulator until October 30, in breach of safety procedures, he said.