The Supply of Medical Radioisotopes. Progress and Future Challenges in Implementing the HLG-MR Policy Principles: Final Report of the Second Mandate of the HLG-MR (2011-2013)

At the request of its member countries, the Organisation of Economic Co-operation and Development (OECD) Nuclear Energy Agency (NEA) became involved in global efforts to ensure a secure supply of molybdenum-99 (99Mo)/technetium-99m ('99mTc). In April 2009, the High-level Group on the Security of Supply of Medical Radioisotopes (HLG-MR) was created and received an initial, two-year mandate from the NEA Steering Committee for Nuclear Energy to examine the causes of supply shortages of 99Mo/'99mTc and develop a policy approach to address those causes. In its second mandate (2011-2013), the HLG-MR has given priority to the implementation by supply chain participants of the first two policy principles - on full-cost recovery and outage reserve capacity for 99Mo production, in a timely and globally consistent manner. To that end, the NEA, in co-operation with key stakeholders, has created methodologies for calculating full costs and valuing and paying for outage reserve capacity. It issued reports on these methodologies and their implementation, which are particularly useful to the upstream segment of the industry (reactor operators and processors), where the most changes need to occur for long-term market sustainability (Sections 2 and 3 of this report). The NEA has also worked with key stakeholders to ensure that the methodologies are applied in a consistent manner. Additionally, in its second mandate, the HLG-MR has focused on working with governments to accelerate the withdrawal of public funds to support reactors and processors, thus helping drive the process towards full-cost recovery and the provision of outage reserve capacity. To better understand the transition from highly enriched uranium (HEU) to LEU targets for 99Mo production, the HLG-MR requested that the NEA undertake a project to study the impacts on the 99Mo/'99mTc supply chain and propose actions to support this transition. This work resulted in the release of two reports - one on the market impacts of conversion and one on potential policy options to encourage the conversion process (Section 4). A key project during the second HLG-MR mandate was a review of the 99Mo/'99mTc supply chain, based on input from key supply chain participants, provided through self- assessment questionnaires, the results of which were presented and analysed in a report (Section 5). The NEA also produced an update on 99Mo/'99mTc demand and supply (Section 6) and is currently working on a joint study with the International Atomic Energy Agency (IAEA) on the back end of 99Mo production, with a report expected later in 2013, which would enable a refinement of the full-cost recovery methodology by including waste management costs. This report concludes the second mandate of the HLG-MR