General discontent followed a one-time, exponential price hike from Jubilant DraxImage (JDI) starting April 1 for the company’s exclusive MAA kit for the preparation of technetium-99m albumin, a lung perfusion agent. An industry forum on challenges in the radiopharmaceutical realm presented during the recent Society of Nuclear Medicine and Molecular Imaging (SNMMI) 2014 Annual Meeting in St. Louis featured a panel of speakers, including vice president of sales, marketing and business development for JDI, Kevin Brooks, who made a case for the company.
Brooks refused to speak on the topic of price, but mentioned that about 50 percent of the company’s profit comes from its cold kits and that as the cost of manufacturing and utilization per vial has gone up and procedure volume have gone down, the price must go up in order for a company to survive. The difficulties of regulatory compliance were also a concern. Brooks indicated that JDI was working from an uneven playing field and that there was “a disturbing trend” of radio-compounding in the presence of commercially available products. In his opinion, the value is disproportionate to the risk.
“There is limited investment back into nuclear medicine on many levels—in particular for infrastructure as well as product development,” he said.
The presentation also included details about the industry, appearing to pacify any accusation of wrongdoing on the part of JDI. Brooks asserted that in 2013, 16 of the 24 most common radiopharmaceuticals were “sole-sourced” products and 75 percent of these were proprietary. He went on to mention that competitors have gone by the wayside due to the difficulties involved in the business.
“We are seeing a consistent procedure decline in nuclear medicine,” remarked Brooks. “Also, radiopharmacies and our customers have become very skilled and efficient at increasing their vial utilization… Of course, I will steer away from any discussions of price, given that we have an audience of participants, of suppliers, competitors and customers. We do not want to get tripped up on any antitrust lines of confusion.”
An official statement dated April 17 from the immediate past president of SNMMI, Gary Dillehay, MD, made clear the position of the greater community.
“SNMMI has never endorsed this drastic price increase,” wrote Dillehay. “As soon as we heard about it, we strongly stated our opposition, and we will continue to ask JDI to reconsider its action, especially considering this is a single-source product for which there is no FDA-approved alternative. SNMMI is deeply concerned about the long-term effects of the increase on the volume of nuclear medicine lung scans… To best act on that concern, SNMMI needs to separate anger from action—we need to engage in constructive activities that will benefit our patients and nuclear medicine.”