Nuclear medicine and its prospects in Russia and across the globe

2019-02-06

Nuclear medicine and its prospects in Russia and across the globe

As anticipated by analysts at National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), the global market value of nuclear medicine would have reached $24 bn by 2020 and even $43 bn in 2030. Meanwhile, the Russian market would have grown to $1.2 bn by 2020 and $3.5–4 bn by 2030. Both local government and independent businesses show interest in nuclear medicine development.

What nuclear medicine is

Nuclear medicine is one of the branches of clinical medicine that involves the application of radioactive substances and radiation therapy in the diagnosis and treatment of diseases. RT is mainly used for cancer diagnosis and treatment.

Modern nuclear medicine is represented in three main directions:

  • radiologic exclusion (positron emission tomography, or PET);
  • radiation therapy (direct cancer radiation);
  • radionuclide therapy (a radioactive isotope is inserted into a tumor).

Radioactive isotopes are applied in the three directions thus making nuclear medicine a consumer of 50% of their global reserves. Radiopharmaceuticals are an example of such isotopes, particularly fludeoxyglucose. It is used in positron emission tomography for 95% of cancers. Nuclear medicine allows to investigate all human organs. It is also helpful in cardiology, endocrinology, pulmonology, and other medical spheres.

Accuracy of medical investigation involving radionuclides helps detect early cancer stages as well as effectively treat this disease. What is more, radiopharmaceuticals have a short half-life period that is not so harmful to human (their damage to health is not that heavy compared to treatment efficiency they produce). One injection of radiopharmaceuticals and PET-CT will be enough to detect a small metastasis.

The market of nuclear medicine services is divided into several segments. They are radiopharmaceuticals manufacturing, diagnostic and therapeutic devices engineering, establishment of nuclear medicine institutes as well as services delivery to people.

Global experience in nuclear medicine

The US with its 40% share is a major market that influences global figures in the sphere of nuclear medicine. Besides, Japan and some European countries also show good results in the industry. Russia appears among the leaders of raw medical isotopes manufacturing.

World’s top manufacturers in the field of nuclear medicine are GE Healthcare, Bayer Diagnostics, Toshiba, Siemens, and Philips. As reported by the representatives of the Rosatom State Corporation, there are three key trends across the globe:

  • Molybdenum production shift from high to low enriched Uranium. It is not cheap but safer. South Africa, Australia, and the USA now mainly use low enriched Uranium.
  • Medical products manufacturing in accordance with international standard GMP. These regulations should be followed when creating readymade products.
  • Investigation of alpha-emitting isotopes that help deal with difficult oncological cases: tumors that are difficult to excise and unresponsive to radiation therapy.

Nuclear medicine in Russia

A Russian market share in the field of nuclear medicine accounts for 4.9% while an annual average growth rate is 5%. According to the forecast of National Research Nuclear University MEPhI, due to this dynamics, the market of nuclear medicine of the Russian Federation would have reached $15 bn by 2020.

As far as 2009, the Russian government initiated the national project ‘Health’ and launched the National Oncology Program. The latter implied oncological diseases recording, further training of medical staff, building of new oncology centers. However, Russia is still to launch the program ‘Development of medical medicine’.

Notwithstanding, last year, Russian authorities approved a plan of nuclear medicine development elaborated by the Ministry of Health and the Ministry of Industry and Trade. It was included in the program of development of health care of the Russian Federation. The key direction of a roadmap in the sphere of nuclear medicine is the creation of new radiopharmaceuticals, development of proton and carbon therapy. This domain is expected to obtain 1 bn RUB.

Russian companies in nuclear medicine

Representatives of the Russian nuclear market are the Rosatom State Corporation, the Federal Biomedical Agency, the Ministry of Health of the Russian Federation, and LLC Radiopreparat.

One of the key industry players is the Rosatom State Corporation focused on the development of nuclear technologies, nuclear power, and nuclear medicine. It develops radiopharmaceuticals, radiotherapeutic centers, and is involved in the creation of nuclear medicine centers across Russia. The company intends to obtain at least 12% of the global market by 2030. It is also focused on imports phase-out.

Rusnano is a Russia-based company that works with positron emission tomography. As far as 2014, it started implementing PET diagnosis into various state regions by opening nuclear medicine centers called PET-Technology. They are currently establishing a network of 11 centers across the country, including Kursk, Ekaterinburg, Ufa, Tambov, Samara, and Moscow. What is more, the company produces radiopharmaceuticals for PET and CT.

Since 2014, 73 thousand patients attended the network of these centers. 90% of them came with compulsory medical insurance OMS.

Russian nuclear medicine in 2019

Several state programs support nuclear medicine. For example, medical institutes got financing from the national project ‘Health’ for cutting-edge devices. Federal program ‘The Development of Pharmaceutical and Medical Industry in 2013-2020’ allocates money for manufacturing modernization. What is more, special centers and hospitals that deal with nuclear medicine and oncology are currently being built across the country.

Nuclear Cancer Center in Primorye. The center to diagnose and treat cancer patients is planned to build on Russky Island in 2019. Five hectares of land are reserved by the government of Primorsky Krai for the construction of the object. It is planned to accept about 6 thousand patients per year. Project participants are the Rosatom State Corporation, the Ministry of Health of the Russian Federation, and Vnesheconombank.

Federal High-Technology Center of Nuclear Medicine in Dimitrovgrad. A proton cancer center is planned to open in Dimitrovgrad, Ulyanovsk region, in spring 2019. It obtained a license and is ready for work with 1.2 thousand patients per year. It is unique for the delivery of all achievements of nuclear medicine: from primary cancer diagnostics to rehabilitation. Medical advisory, a proton center, a radionuclide therapy building, and a 24/7 hospital will be offered to patients.

Nuclear Cancer Center in Novosibirsk. Its building is scheduled for this spring. As commented by the project representatives, equipment is already delivered and is undergoing pre-testing. The center will consist of a diagnostics department and a treatment section. There will be a cyclotron to produce radiopharmaceuticals (30 000 per year). Another distinctive feature of the center will be a surgical device called gamma knife. It will help treat head cancer without surgical excision and trepanning.

Conclusions

Nuclear medicine is one of key directions of the Russian economy. What remains a problem in this segment, is a lack of hi-quality home equipment as well as medical staff to work with radioactive technologies. Some institutions now offer special training, particularly Center of Nuclear Medicine at National Research Nuclear University MEPhi.

Russian companies, for example, the Rosatom State Corporation embarked on a course of imports phase-out and development of equipment for nuclear medicine. However, batch production of equipment depends on demand.

The current legal framework has to be amended. This is a task for an interdepartmental working group created within a roadmap of the program of development of health care of the Russian Federation. The expert group consists of representatives of various state departments as well as Rusnano, the Rosatom State Corporation, and Rostec.

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