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Brexit: nuclear medicine at risk from no-deal, The Conversation, ManMohan S Sodhi

A no-deal Brexit will disrupt the supply chains that bring medicines to the UK and take goods from the UK to continental Europe. About 45m packs of medicine travel from the UK to Europe every month and the UK receives 37m packs in return. Even if a deal is reached, supply chains will continue to be disrupted long after the event.

Healthcare professionals are particularly concerned about the impact this could have on nuclear medicine. This branch of medicine mostly involves using radioactive dyes to perform diagnostic tests, which can be used to check if cancer has spread or to see how well the heart or kidneys are working. Therapies are also used to treat hyperthyroidism or thyroid cancer with radioactive iodine.

According to the British Nuclear Medicine Society, 60% of the radiopharmaceuticals the UK uses come from the EU and are used during the treatment of as many as 600,000 patients per year. These are transported mostly by road and rail across the English Channel.

Danger of delays

All medicines have expiration dates, but with radioactive pharmaceuticals there is the added problem of radioactive decay. This happens as the radioactive substance changes into one that is more stable. While this process releases the radiation needed for scans and therapies, it also means they don’t last forever.

A measure of how quickly a radioactive substance decays is its half-life. This is the time taken for the strength (or activity) of the measured radiation to decrease by half. For example, the radioactive iodine used in therapies, iodine-131, has a half-life of only eight days. After two days the strength is reduced by 15% and after eight days, by 50%.

The speed of decay means that unplanned delays of only a couple of days at a border could render the nuclear medicine unusable. The shelf life of nuclear medicines is therefore often low compared with other drugs. Extensive stockpiles simply cannot be kept……..

For UK taxpayers, the government depending on the pharamaceutical industry, either domestic or foreign, for supply of medicines is an expensive option. The NHS can use its vast purchasing power to source drugs much more cheaply than healthcare providers can in most other countries, including the US. Indeed, UK sale prices of the top 20 selling medicines are only one-third of the US equivalent.

For specialised areas such as nuclear medicine, the cost difference compared with the US is probably much more. Brexit, especially without a deal, places the NHS in a precarious position and will mean suppliers are in an advantageous position to close this price gap, driving up prices in the UK. Also, the US administration may offer a poisoned chalice in the form of a US free-trade agreement that includes the NHS, meaning higher prices like in the US.

Patients and the NHS may end up paying much higher prices for nuclear medicine, if they can get the supplies at all.  https://theconversation.com/brexit-nuclear-medicine-at-risk-from-no-deal-121139