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Mariia Bicher
The necessity of delivering medicine days after it’s produced drives decisions about where to build facilities and how to ship radioactive materials to healthcare providers.
Radiopharmaceutical supply chains are defined by a ticking clock. From the minute an isotope is made, it starts to decay, gradually emitting fewer cancer-killing radioactive particles.
The limited half-life of radiopharmaceuticals means the drugs “are like melting ice cubes,” Justin Butler, a partner at Eclipse Ventures, told
BioSpace
.
That countdown compels investments in manufacturing facilities and supply networks designed to quickly and reliably deliver the medicines to patients.
NorthStar Medical Radioisotopes approaches that challenge by working back from when a patient needs to receive treatment to ensure the drug is at the site of care in time, CEO Frank Scholz told
BioSpace
. The goal is to avoid a situation like that described by Nucleus RadioPharma CEO Steve Hahn, who described a patient who flew from Alaska to Mayo Clinic only to learn their radiopharmaceutical had yet to arrive.
Mitigating Risks
How companies structure their supply chains to mitigate such risks depends on the radioisotope. Scholz said NorthStar ships actinium-225 from its facility in Wisconsin to patients in Asia, Australia and Europe, reflecting the isotope’s relatively long 9.92-day half-life—meaning it takes that long for the radiation emitted by the isotope to fall by half. However, a decentralized approach may be required for isotopes such as yttrium-90, a liver cancer treatment with a 64-hour half-life.
Every hour matters even when shipping isotopes with half-lives measured in hours or days. NorthStar has based its manufacturing site close to five airports to ensure fast access to planes, which are the dominant form of transport of the medicines.
Air transport is essential to all global shipping and to reaching many patients in the U.S. However, there are risks to moving materials by plane. Radioactive materials can fail to take off at the scheduled time for a wide range of reasons, from bad weather to the unavailability of suitable aircraft to a pilot’s refusal to fly with the cargo, Scholz said. Flying materials on private planes, rather than commercial networks, mitigates some risks but is more expensive.
Hahn said Nucleus considers overland shipping to sites within six to eight hours of its facilities because it is more reliable than sending materials by air. Scholz said NorthStar uses trucks when radiopharmacies or treatment centers are within roughly six hours of its facilities, explaining that overland shipping can be a cheaper option with more predictable arrival times.
Manufacturers use tracking technology on these shipments, potentially providing healthcare facilities with early notice of delays. Hahn compared the technology to systems that allow consumers to track the products they buy online, adding that the tools are relatively novel in the pharma industry and that it is “not so common” for providers to be able to monitor shipments.
Companies can build extra time into the shipping schedule to increase the likelihood that the medicine will arrive by the patient’s appointment even if there are delays. There are downsides to that approach, though. If a buffer is built into the schedule and shipping goes as planned, the medicine will arrive early and spend time decaying at the healthcare facility before being administered. Using more reliable overland shipping can reduce the need for extra time in the schedule.
Designing Manufacturing Networks
Nucleus’ expansion plans will increase the number of sites that can be reached overland in eight hours. The company is based in Rochester, Minnesota, reflecting its ties to Mayo Clinic. Hahn said Nucleus is setting up a facility outside Philadelphia to serve the East Coast and plans to add a West Coast site in three to five years. The Philadelphia facility will also be capable of shipping to Europe, Hahn said.
The company will be “strategic in where we place any facilities or partnerships we form so we reach as many people as possible,” Hahn said. Such considerations are informing the company’s approach to serving the Asian market.
“I think it is very likely that an Asian presence for a company like Nucleus is going to be necessary,” Hahn said. “That could be in partnership with other companies, so that you can ship all over Asia. The transportation networks are very well developed there and that, probably, from a time point of view, is the best way to do it.”