Good morning, everyone. Thank you very much for the invitation to appear before the committee.
I am here as a representative of nuclear medicine specialists. I am an associate professor of nuclear medicine at the Université de Sherbrooke. I am also the clinical head of the Molecular Imaging Centre of Sherbrooke. Finally, I hold a licence for producing medical research isotopes, as well as a licence for producing private isotopes. In short, I am a professor in nuclear medicine, as well as a user and producer of medical isotopes. I am involved in all the stages of the isotope-use system.
In 2009, I was a member of the Expert Review Panel on Medical Isotope Production, which was created at the request of Minister Raitt of the Canadian government. That panel considered plans for developing isotopes in Canada. I am also part of a research group on the use of cyclotrons as a way of replacing nuclear reactors in the production of technetium.
Between 2009 and today—so since my last appearance before this parliamentary committee—a number of events have occurred. I would like to summarize them very quickly to establish context.
From 2009 to 2016, the National Research Universal, or NRU, reactor resumed its activities, much to the relief of all. Its presence helped put an end to the isotope crisis we experienced in 2009. Afterwards, a number of international committees were created to manage the supply. Those committees did excellent work to standardize production and the supply chains, as well as to ensure that no shortages would occur in the future.
Changes to nuclear reactors have been made slowly. Let's remember that reactors must shift from using highly enriched uranium to low enriched uranium. For some reactors, the change has already been made. The same will have to be done for other reactors, since the United States will no longer provide highly enriched uranium.
The Canadian government has made investments in developing alternatives for the production of medical isotopes without the use of nuclear reactors. Among those solutions are projects carried out using linear accelerators and cyclotrons. I expect those technologies to become operational by the spring and summer of 2018.
I also want to remind you that many changes have occurred among isotope providers in Canada. The radiopharmacies of Lantheus Medical Imaging were sold to Isologic. That group is now the primary provider of isotopes in Canada. In addition, the NRU reactor was shut down in October 2016. It will have to remain dormant until March 2018.
I will speak on my behalf, and probably on behalf of a number of individuals involved in the medical field, when it comes to medical aspects. We do not anticipate a lack of medical isotopes over the short term given the striking and organized coordination of various nuclear reactors around the world. Unfortunately, that by no means makes us immune to a major failure. Such a failure could occur at any time and would destabilize the supply chain.
I would like to highlight a reality specific to Canada. Although we think that the supply should remain stable, we are headed toward another problem, that of supply costs and isotope use. With the shutdown of the NRU reactor, isotopes are no longer abundant. A few nuclear reactors are responsible for world production, and that is why there is no longer much surplus. In addition, the reactors that were heavily subsidized, such as the NRU one, are withdrawing from the market. As a result, the path is much clearer for smaller reactors to recover the full cost of isotope production in order to be profitable. We really expect that to lead to a cost increase.
We should add the drop in the production efficiency of low enriched uranium, and that means that the technology creates additional costs. Moreover, the withdrawal of Canadian distributors, following the creation of mega groups, could greatly encourage the appearance of monopolies in the supply of isotopes in Canada.
So we see that all the ingredients are there to increase the cost of isotopes in Canada. Some could drive up the costs by 10$ or 20$ per patient. Individually speaking, those amounts may seem trivial, but when we multiply them by the hundreds of thousands of procedures done annually, they turn into millions of dollars. Canada's health system cannot absorb such a rapid increase.
I yield the floor to you.