Suppliers of medical isotopes are dramatically hiking their prices amid a worldwide shortage of a tool used to detect cancer and heart illnesses, resulting in higher costs for cash-strapped hospitals and longer waiting times for patients.
The cost of each bone scan performed in Canadian hospitals has soared as much as 50 per cent, to $30, since May, when a major supplier began adding surcharges on medical isotopes.
Costs are set to escalate again when the same supplier, Dublin-based health-care giant Covidien, raises its prices another 40 per cent, effective Aug. 1.
The price increases are forcing hospitals to absorb additional unforeseen costs at a time when they are under financial strain during the economic recession.
The situation is unsustainable, as hospitals cannot meet their budgets when they are paying higher prices and doing fewer tests because crucial materials are in short supply, said Jean-Luc Urbain, president of the Canadian Society of Nuclear Medicine.
"The implication of this is basically that jobs are being lost in nuclear medicine," he said.
The crisis also means longer waiting times for patients who need tests to detect heart and cancer problems, and delays in surgeries, Ontario Health Minister David Caplan said in an interview Wednesday.
"It backs up the whole system," he said.
In a letter to federal Health Minister Leona Aglukkaq last month, Mr. Caplan says he is concerned about the mounting costs the province's health-care sector is facing as a result of the disruption in the supply of isotopes. He has asked the federal government to compensate the province for the additional costs, but he has not had a response.
The supply is shaky because of the shutdown of the nuclear reactor at Chalk River, Ont., which, until a few weeks ago, produced a third of the world's medical isotopes. The aging reactor was taken offline in May after it was found to be leaking heavy water, and won't be back in operation until at least late 2009. The planned, month-long shutdown of a Dutch reactor scheduled for this weekend will place greater strain on the global supply.
After the shutdown of Chalk River, the federal and provincial governments advised health-care providers to ration their supply of medical isotopes, use alternative diagnostic tools such as X-rays and ultrasounds, and schedule patient appointments to make the most effective use of the limited amount of isotopes. Medical isotopes have a shelf life of only a few days, so they are more effective if used immediately after production.
But those contingency plans were designed as stop-gap measures, not for long-term shortages. Christopher O'Brien, president of the Ontario Association of Nuclear Medicine, said he is not sure hospitals can continue providing nuclear medicine services for the next few months without financial help from the government.
"We have been bringing up this issue of costing since Chalk River closed down in May, and it's only getting worse," he said.
Philippe Hébert, an executive at Covidien's Canadian subsidiary, informed customers in a letter last April - before the most recent shutdown of Chalk River - that the company would raise its prices "in the near future" because of the rising costs of molybdenum 99, the raw material used to produce the isotopes for medical imaging tests.
In a second letter dated June 1, Mr. Hébert says Covidien will raise its price by 40 per cent, effective Aug. 1.
"As you can imagine, the Chalk River shutdown has now made the Mo 99 [molybdenum 99]supply and cost situation even more unstable," his letter said.
The extended shutdown of Chalk River reveals that the worldwide supply of medical isotopes is vulnerable to the limited number of aging reactors in five countries - Canada, Belgium, the Netherlands, South Africa and France.
An expert committee set up by the Harper government to explore ways of securing a long-term supply of medical isotopes will meet for the first time Thursday.