# Isotope supply

Source: https://nuclide.cc/fronts/f-isotope-supply/  
Nuclide record `f-isotope-supply` (Front). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.cc)"; commercial use needs a licence.

## TL;DR

The radioactive ingredients in these medicines are made in a small number of ageing reactors and accelerators worldwide, and demand is now growing faster than that supply.

## Summary

Every radiopharmaceutical begins as an isotope made in a reactor or accelerator, and the whole field sits on a genuinely fragile production base. Roughly 95% of the world's molybdenum-99 (the parent of technetium-99m, used in about 30 million SPECT scans a year, 80% of all nuclear medicine imaging) comes from a handful of research reactors in South Africa, the Netherlands, Belgium and Australia; because Mo-99's half-life is 66 hours it cannot be stockpiled, so a reactor outage cancels scans within days (OECD-NEA, 2025 review of medical radioisotope supply).

Lutetium-177 demand rose sharply after Pluvicto's approval, and the OECD-NEA and IAEA both project that non-carrier-added Lu-177 production capacity will not keep pace with clinical demand; a key bottleneck is enriched ytterbium-176 target material, historically sourced mainly from Russia. New capacity is being built to close the gap: Canada's Darlington reactor began isotope production runs (Mo-99, Lu-177, Y-90) from 2025; India's Dhruva reactor supplies domestic Lu-177 and imports the shortfall from Russia; SHINE Technologies (Chrysalis facility, Wisconsin) is targeting over 75% of US Mo-99 demand with a $263 million DOE conditional loan commitment, and is already producing Lu-177; and Eden Radioisotopes has filed a US NRC construction permit for a new Mo-99/Lu-177 facility aiming to supply up to 50% of global Mo-99 demand.

Actinium-225 has its own, much tighter, constraint (see the alpha-therapy front): global supply of roughly 63 GBq/year against rising clinical trial demand. Ideas circulating to fix the underlying fragility include a coordinated international reserve and shared production schedule across the world's medical isotope reactors, Western enrichment capacity for ytterbium-176 so Lu-177 has more than one supplier, and a global isotope supply observatory that forecasts shortages before they hit clinics.

## Fields

- Kind: Front
- Last checked: 2026-09-22

## Notes

- Mo-99's 66-hour half-life means it cannot be stockpiled; the physics of decay, not inventory management, sets the logistics of the whole Tc-99m supply chain.
- Enriched ytterbium-176, the target material for non-carrier-added Lu-177, has historically depended heavily on Russian supply; Western enrichment capacity is only now being built out.
- PALLAS/OECD-NEA modelling projects Lu-177 demand outpacing available capacity from around 2025 onward without new reactor investment.

## Sources

- OECD-NEA: Current trends in the supply and utilisation of medical radioisotopes (2025): https://www.oecd-nea.org/upload/docs/application/pdf/2025-10/7743_medical_radioisotopes_supply_rev.pdf
- Eden Radioisotopes files NRC construction permit for Mo-99/Lu-177 facility (ANS, May 2026): https://www.ans.org/news/2026-05-08/article-8016/eden-targets-domestic-medical-radioisotope-production/
- IAEA/OECD-NEA: Towards a robust supply chain for medical radioisotopes: https://inis.iaea.org/records/06vmc-y0w54

## Connected records

- fronts: [Radiochemistry & manufacturing](https://nuclide.cc/fronts/f-radiochemistry/), [Radioligand therapy](https://nuclide.cc/fronts/f-radioligand-therapy/), [Regulation & reimbursement](https://nuclide.cc/fronts/f-regulation-reimbursement/), [Targeted alpha therapy](https://nuclide.cc/fronts/f-alpha-therapy/)
- isotopes: [Actinium-225](https://nuclide.cc/isotopes/ac-225/), [Lutetium-177](https://nuclide.cc/isotopes/lu-177/), [Molybdenum-99](https://nuclide.cc/isotopes/mo-99/), [Technetium-99m](https://nuclide.cc/isotopes/tc-99m/), [Yttrium-90](https://nuclide.cc/isotopes/y-90/)
- technologies: [Actinium-225 supply: thorium stocks, accelerators and radium targets](https://nuclide.cc/technologies/actinium-225-supply/), [Cyclotron isotope production (F-18, Ga-68, Cu-64, Zr-89, At-211)](https://nuclide.cc/technologies/cyclotron-isotope-production/), [Radiopharmacy and cyclotron networks](https://nuclide.cc/technologies/radiopharmacy-network/), [Research reactors for medical isotopes (Mo-99, Lu-177, I-131)](https://nuclide.cc/technologies/research-reactor-isotope-production/), [Therapeutic isotope supply chain (Mo-99, Lu-177, Ac-225)](https://nuclide.cc/technologies/therapy-isotope-supply-chain/)
- companies: [ANSTO (Australian Nuclear Science and Technology Organisation)](https://nuclide.cc/companies/ansto/), [Curium](https://nuclide.cc/companies/curium/), [IRE (Institut national des Radioéléments)](https://nuclide.cc/companies/ire/), [Isotopia Molecular Imaging](https://nuclide.cc/companies/isotopia/), [Nordion (Sotera Health)](https://nuclide.cc/companies/nordion/), [NorthStar Medical Radioisotopes](https://nuclide.cc/companies/northstar-medical-radioisotopes/), [SHINE Technologies](https://nuclide.cc/companies/shine-technologies/), [TerraPower Isotopes](https://nuclide.cc/companies/terrapower-isotopes/)
- institutions: [International Atomic Energy Agency: Rays of Hope](https://nuclide.cc/institutions/iaea/)

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