The Supply of medical isotopes an economic diagnosis and possible solutions
This report explores the main reasons behind the unreliable supply of Technetium-99m (Tc-99m) in health-care systems and policy options to address the issue. Tc-99m is used in 85% of nuclear medicine diagnostic scans performed worldwide - around 30 million patient examinations every year. These scan...
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| Autores Corporativos: | , |
| Formato: | Libro electrónico |
| Idioma: | Inglés |
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Paris, France :
Organisation for Economic Co-Operation and Development
[2019]
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| Materias: | |
| Ver en Biblioteca Universitat Ramon Llull: | https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009704654306719 |
Tabla de Contenidos:
- Intro Foreword Acknowledgements Abbreviations and acronyms Executive summary Key findings Some health systems rely heavily on Tc-99m and substitution would be costly Technetium-99m supply is a complex and just-in-time activity, and supply remains unstable The main barrier to price increases is found in the supply chain Health care provider payment must not be neglected, but provider incentives to contain the cost of Tc-99m are likely to be weak in most cases and are not the main barrier to price increases Policies could catalyse price increases in the supply chain Notes 1 Health care systems require Tc-99m to maintain patient care 1.1. Introduction 1.2. Clinical overview of NM and other diagnostic imaging modalities 1.2.1. NM diagnostics are used for a wide range of indications 1.2.2. Hybrid imaging techniques have improved diagnosis 1.2.3. The evidence base for traditional Tc-99m-based NM diagnostics is relatively weak 1.3. There are alternatives to Tc-99m but substitutability may be limited 1.3.1. Substitution of Tc-99m-based scans is possible for some indications but may encounter practical difficulties 1.3.2. Strategies to respond to shortages Canada United States 1.4. The future of Tc-99m-based nuclear medicine procedures 1.4.1. Radiation dose 1.4.2. Innovation in Tc-99m-based products lags behind other fields of NM 1.5. Conclusion References Notes 2 The use of nuclear medicine diagnostics and Tc-99m varies significantly across countries 2.1. Introduction 2.2. Global demand for Mo-99/Tc-99m has been flat since 2012 2.3. A small number of populous countries and countries with high scan rates account for a large share of utilisation References Notes 3 Health care providers have varying incentives to contain the cost of Tc-99m 3.1. Introduction 3.2. Three main health care provider types deliver nuclear medicine diagnostic services 3.3. Provider payment mechanisms and attendant financial incentives vary by provider type 3.3.1. There are three main payment mechanisms for NM diagnostic services 3.3.2. Most countries do not compensate providers directly for the actual cost of Tc-99m 3.3.3. Country Details United States Medicare and Medicaid Private insurers Canada Alberta British Columbia Manitoba Newfoundland and Labrador and Nova Scotia Japan Germany Specialist Offices Hospitals France Specialist Offices and Other Outpatient Providers Hospitals United Kingdom (England) Belgium Australia Other countries 3.4. What financial incentives arise from these payment mechanisms? 3.5. Conclusion References Notes 4 The Tc-99m supply chain is technically complex and characterised by market imperfections.
