Evidence of meeting #5 for Natural Resources in the 40th Parliament, 3rd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was isotopes.
A recording is available from Parliament.
9:35 a.m.
Conservative
The Chair Conservative Leon Benoit
Merci, Madame Brunelle.
We will go now to the New Democratic Party.
Mr. Hyer, you have up to seven minutes. Go ahead, please.
9:35 a.m.
NDP
Bruce Hyer NDP Thunder Bay—Superior North, ON
Thank you very much.
My questions are for Dr. Turcotte.
Dr. Turcotte, I have a short time. Please give brief answers if possible, because I have several questions. Let me do my first group of three questions, and then answer those, and if we have time, we'll do a little more.
I'm trying to understand why--this is in the broader context of the report of the expert panel, not all of which you touched on today--given the high cost, of at least $0.5 billion or maybe $1 billion, and the long timeline of a multi-purpose research reactor, the panel's report appeared to emphasize that option. Did the cost you considered include the permanent storage of nuclear waste?
Given the projected excess capacity in the longer term, as opposed to the short-term shortages that we have now, why is there such a long-term and expensive option, given the long lead time before production? Did the environmental and security risks posed by nuclear waste factor into the panel's decision? When considering the cost of a new reactor, did the panel look at the significant cost overruns that have traditionally occurred to a huge degree in reactor refurbishments or new reactors?
We've previously had other expert witnesses before this panel who have been much more sanguine about the thoughts of linear accelerators or cyclotrons rather than about using the traditional nuclear technology.
Could you answer those questions, please?
9:40 a.m.
Medical Specialist in Nuclear Medicine, Clinical Head of the Molecular Imaging Centre of Sherbrooke, As an Individual
With respect to the nuclear reactor, I remain convinced that the number one solution for us to have isotopes over the medium and long term remains the construction of a new nuclear reactor. But we mean a multi-purpose nuclear reactor, one that can also be used to do research. The problem with nuclear reactors lies with the operating costs and the cost of the infrastructure itself. To produce only isotopes in a nuclear reactor would offset approximately 10% of the investment costs, which is an unacceptable solution given the current economic context. But from a scientific standpoint the known way of producing technetium is with a nuclear reactor. It has been done in this way for 50 years, and it is certain that a new nuclear reactor built in Canada would be able to produce technetium.
As for other technology, like cyclotrons, linear accelerators, I think it is something we should investigate, to determine whether it is possible to produce isotopes with that technology, but it remains within the realm of research. It is unclear whether it can work and we should avoid putting all of our eggs in the same basket when it comes to this technology. We need to give these technologies the time to show they are effective, perhaps a year or two at most, but afterwards, if they have not proven their viability and usefulness, the nuclear reactor would be the best choice by far.
9:40 a.m.
NDP
Bruce Hyer NDP Thunder Bay—Superior North, ON
I do.
This is a combined question. Wait until I am finished, and then I'd love to hear a punchy answer.
Has the current minister or the previous minister contacted you or your panel with a response to the expert panel report, and what was that response? Is the delay in issuing a public response to that report acceptable, in your view? Are there any good reasons, in your view, for such a delay?
9:40 a.m.
Medical Specialist in Nuclear Medicine, Clinical Head of the Molecular Imaging Centre of Sherbrooke, As an Individual
The expert panel has yet to receive a response from the Department of Natural Resources. We certainly do hope to get one. Honestly, four men have spent an enormous amount of time studying the situation and preparing a very serious and in-depth report, so we are expecting to receive a response. I should point out that we are disappointed in the delay, that is for sure, and we are anxious to know the answer, because it will have a direct impact on the way in which physicians work and on the health of patients in Canada.
9:40 a.m.
NDP
Bruce Hyer NDP Thunder Bay—Superior North, ON
What are the impacts of this lack of leadership on patients?
9:40 a.m.
Medical Specialist in Nuclear Medicine, Clinical Head of the Molecular Imaging Centre of Sherbrooke, As an Individual
If at least there had been an answer or some energy had been expended, we would probably have solutions or possible avenues to get our spirits up in this time of crisis.
And that is not the case at all. At the moment, we are experiencing a crisis because we have no other choice but to experience it. We have no idea where to turn. So, in other words, we have no idea whether the situation will remain chronic or if it is simply acute. Honestly, the medical community is anxious to know the fate of isotopes in Canada.
Is this a problem we must be resigned to accepting for the rest of our days, or is there a light at the end of the tunnel?
9:45 a.m.
NDP
9:45 a.m.
NDP
Bruce Hyer NDP Thunder Bay—Superior North, ON
This question is to Monsieur Villeneuve.
If your company doesn't resolve your differences and sign a new contract, how's that going to affect the supply to Canadian hospitals? What source of isotopes could be or would be used? How will this impact the costs of isotopes? What have been the pricing impacts of the repeated delays of the Chalk River NRU now?
Can you provide the committee with any figures related to the questions that I've just asked? And have you ever seen a supply crisis like the one you are now experiencing?
9:45 a.m.
Conservative
The Chair Conservative Leon Benoit
You have a whole minute to answer all those questions. Go ahead, please.
9:45 a.m.
NDP
Bruce Hyer NDP Thunder Bay—Superior North, ON
You could follow up with the figures perhaps later, if that's possible.
9:45 a.m.
William Dawes Vice-President, Manufacturing and Supply Chain, Lantheus Medical Imaging
Thank you.
Maybe to sum it all up, we don't really disclose the information specific to our contracts. But as it applies to the Canadian customer and patients, ultimately we're working to diversify our supply chain and establish the best approach to supply all of North America in an equitable fashion. We've been doing that over the past year or so and we'll continue to do that in the future. We expect that it will be more difficult perhaps in an environment without NRU or perhaps without HFR. But we'll continue to endeavour to do that in whatever environment we ultimately land in as a community and as a business.
9:45 a.m.
Conservative
The Chair Conservative Leon Benoit
Thank you.
To the Conservative side now, Mike Allen for up to seven minutes. Go ahead.
9:45 a.m.
Conservative
Mike Allen Conservative Tobique—Mactaquac, NB
Thank you, Chair.
My first few questions are for Lantheus. I just want to continue on with the supply chain. I guess, Mr. Dawes, you'd be the one to talk about this.
Give us an overview of that supply chain from the point where you get the product from an NRU. Where are you getting your product from in that context? Let's assume some of it would be coming from the NRU and other reactors.
Can you take us through the timeframe from the time you get that until you actually produce a product? How do you guarantee, or is there any guarantee of supply for Canada? We know that a predominant amount of the world's supply can come from the NRU, but it doesn't all come back to Canada. I'd like to understand if there is a guarantee on the guaranteed supply.
Then the third question would be, what other technologies of these others you've talked about, like GLUDEF, for example...? How do you see that impacting that supply chain going forward?
9:45 a.m.
Vice-President, Manufacturing and Supply Chain, Lantheus Medical Imaging
Let me start with the where and with a kind of timeframe for production. I think many who have studied this topic are familiar with the global supply chain. There are global suppliers of molybdenum around the world. These are the reactor producers or reactor-based suppliers. They include Nordion, through their relationship with AECL in Canada; IRE, through their relationship with three reactors in Europe; and Covidien, through their relationship with a number of reactors in Europe. Also, there are folks down in South Africa operating the SAFARI reactor, and the name of that firm is NTP.
There's a new reactor that has come online in Poland and is offering some promise of additional supply to the global medical isotope community. Also, there's a new reactor that has been built and is in the process of having its production ramped up so that it can also be a contributor to the global supply of molybdenum.
That's what the reactor supply chain looks like today.
As we look at the medium term, we see a number of solutions that we hope will come online in the future. There are solutions in various geographic locations, with some proposed in the United States that are in the medium term to the long term. Others are proposed in other geographies of the world. Either these exist today and will go online in the future to potentially produce molybdenum, or they are others that will be built in new geographies.
Looking at the timeframe for molybdenum production, or technetium production, as in our case, it is really a real-time supply chain. At Lantheus, what we see during normal times is a five-times weekly basis, and during less than normal times, it's something less than that. What we see is ourselves sourcing material from these global suppliers. In the event the materials come in from Canada, it takes about an hour and a half for us to transport material to our site from the finishing site at Nordion. In the case of NTP and South Africa, it takes in excess of 24 hours to transport that material from the reactor site following the finishing process to our site just outside of Boston.
Once that material is delivered to our site, at either eight o'clock in the morning or eight o'clock in the evening, depending on the run time or the start time of our run, it then takes us about eight to twelve hours, depending on the size of the run and different parts of the manufacturing process, to produce, perform quality testing, and then release those generators. Those then go into our distributional logistics system and are then distributed to locations throughout North America--to include Canada--and then also to some small number of international locations.
That supply chain, and the logistics portion of the supply chain, brings us full circle in most cases to where, ideally, we can see a patient dose being delivered to a patient only 24 hours after our first manufacturing step conducted at the home office at the Billerica site. Doses that started being manufactured as a generator at eight o'clock in the morning on a Monday, as an example, could go into a patient as early as eight o'clock in the morning on Tuesday.
It is very, very much a real-time supply chain. It is one where we carry no inventory because of the half-life and decay of the product and one that needs to be very reliable in order to ensure that we're getting the patients what they need and getting the doctors, ultimately, what they need to do their job for the medical imaging community.
When we look at how we guarantee the supply to Canada, I think it's important for everyone to understand that we have a very, very significant Canadian business as part of our portfolio at Lantheus. That part of the business in Canada is a very, very important part of our business. We work extremely hard across our customer base, both in the United States and in Canada, and for some of those global locations that I described, to ensure that we are equitably distributing the material that we are able to source from these global reactor producers.
We have that approach of equitability regardless of where that supply is coming from. We're really working to ensure that the maximum number of our customers and, ultimately, their patients can be supplied under any of the supply chain circumstances that may exist at any given time.
Could you restate the last question for me?
9:50 a.m.
Conservative
Mike Allen Conservative Tobique—Mactaquac, NB
It was on some of these other technologies you were talking about, like GLUDEF, for example. You're starting to explore some of these. How do you see that changing your supply chain going forward?
9:50 a.m.
Vice-President, Manufacturing and Supply Chain, Lantheus Medical Imaging
I think the F18-labelled products will change things very significantly. They will facilitate a change in the overall manufacturing logistics associated with these diagnostic imaging products. We'll see ourselves moving from an environment where we're sourcing as much material today from the reactors, to an environment where perhaps we're sourcing less material from reactors. As we look at our own pipeline, we're very focused on the development of F18-labelled compounds. The problem with them is the manufacturing infrastructure isn't in place today, nor is there the camera infrastructure in place to really be able to support significant deployment of that imaging modality, especially for cardiac in the future.
So there will continue to be a significant reliance on molybdenum-99 in these reactor producers while this F18 network is being deployed in the future. At the same time, as we look at our own products, we don't see those necessarily being a replacement for the current mo-99-based products, or the tc-99m-based products. We see them being a solution that maybe sits in the middle between that SPECT scan and the more invasive cardiac catheterization that Dr. Turcotte spoke about, to decrease and deal with the issues such as co-morbidities associated with those more invasive procedures.
So we always see an environment where mo-99 is required and is an important isotope, but we also see an environment where PET will play an increasing role as the products are developed and the infrastructure is developed to support them.
9:50 a.m.
Conservative
9:50 a.m.
Conservative
The Chair Conservative Leon Benoit
You have no time at all, Mr. Allen. Aren't you sorry you asked?
We will go now to a very short second round of about two minutes each, so keep the answers short as well.
Mr. Regan, go ahead, please.
9:55 a.m.
Liberal
Geoff Regan Liberal Halifax West, NS
Thank you, Mr. Chair.
Mr. Dawes, in response to Mr. Allen's question you indicated that you spread out the isotopes you receive, and basically that could be around the world. So it sounds to me as if you're saying there's no guarantee, when the NRU gets back up and running at Chalk River, any of that will come to Canada. Certainly there's no guarantee that all of it will come to Canada. What you get you will distribute equally.
Do you have a contract with MDS or MDS Nordion right now for supply when the NRU comes back up? Am I right in saying there's no guarantee? Surely as a private corporation your responsibility is to your shareholders. I presume you will be selling those isotopes where you can get the best bang for your buck, so to speak, or best buck for your bang.
9:55 a.m.
Vice-President, Manufacturing and Supply Chain, Lantheus Medical Imaging
Let me start by answering the Nordion question. As I said to Mr. Hyer, we don't comment publicly about the status of our contracts and relationships, so unfortunately I can't do that in this forum. But I'd like to turn things over to Cyrille to talk about how we would allocate those materials to the Canadian customers, and how we really think about equity as it applies to the Canadian market when we have supply of molybdenum-99.
9:55 a.m.
Vice-President and General Manager, International, Lantheus Medical Imaging
Mostly what we have done and will continue to do is really look at the global market and specifically at North America to make sure that every market gets its fair share. I would say that it's a bit strong to say there's no guarantee that Canada will get anything, because if we were only looking at the money, we could have decided now to not supply Canada. Canada has a very fair proportion of what we were able to get from the different suppliers.
So I can tell you that we will continue to supply Canada. Canada will get its fair share of material. It will not be disadvantaged compared to other markets, for sure. But we cannot give you a guarantee that everything from NRU will come to Canada.
9:55 a.m.
Conservative