In-house hospital radiopharmacy compounding to cut dose waste

Lutetium-177 decays with a roughly 6.6-day half-life, so every day a finished dose spends in transit from a centralised commercial manufacturer to a treating hospital is activity permanently lost, and the further a treatment centre is from that manufacturer, the more waste and scheduling risk it faces. An alternative model is for individual hospitals to compound doses themselves from bulk shipments of the raw isotope, using compact automated synthesis units designed to fit inside an existing hospital radiopharmacy hood. A 2025 paper describes one such unit, 'MiniLu', a cassette-based, self-contained radiosynthesis platform that achieved greater than 99% radiochemical purity and about 95% final dose yield for two PSMA-targeting therapeutic ligands, explicitly designed for hospital-resident compounding rather than centralised manufacturing.

This decentralisation is already happening at small scale in some markets: a 2026 market analysis reports that hospital radiopharmacy units in Mexico City, Monterrey and Guadalajara have grown from an estimated 3-5 to 8-12 sites capable of onsite GMP labelling since 2022, explicitly to reduce logistical waste from short-half-life lutetium-177, with domestically compounded lutetium-177 dotatate capturing an estimated 20-30% of treatment volume in that market. The joint EANM/SNMMI/IAEA guide to setting up a theranostics centre documents the radioactive-material licensing and radiation-safety steps a hospital needs to run in-house compounding.

This is a narrower, single-institution version of the regional cyclotron-hub policy idea already in this graph (a national or multi-country network of shared hubs); this idea is specifically about individual hospitals building their own point-of-care compounding capability, which trades a larger upfront capital and licensing cost per site for less dependence on shipping schedules and less decay-related waste. No controlled study quantifying the waste or access benefit of this decentralised model over centralised commercial dose manufacturing was found.