Many healthcare centers and hospitals in Ho Chi Minh City are facing a severe shortage of radiopharmaceuticals for use in PET/CT scans to detect cancer, leaving patients undiagnosed and untreated.

The radioactive drug production facility of Cho Ray Hospital in District 5 is providing just a small volume of radiopharmaceuticals, while Rang Dong Medical JSC is halting its supply though it was licensed by the Ministry of Health.

The PET/CT scan systems at several hospitals in Ho Chi Minh City are either operating at low capacity or have halted operations entirely, leaving cancer patients facing long waits for PET/CT tests and treatment, which poses a threat to their lives.

Positron emission tomography (PET) is a technique that measures physiological function by looking at blood flow, metabolism, neurotransmitters, and radiolabeled drugs, while computed tomography (CT) is a noninvasive medical examination or procedure that uses specialized X-ray equipment to produce cross-sectional images of the body.

Due to the dearth of radioactive drugs, the Ho Chi Minh City Department of Health, Military Hospital 175, and Ho Chi Minh City Oncology Hospital have written to the Ministry of Science and Technology asking for help to rectify the situation.

Disrupted supply causes lack of radiopharmaceuticals 

Presently, only three hospitals in the southern metropolis, namely Cho Ray, Ho Chi Minh City Oncology Hospital, and Military Hospital 175, are operating PET/CT scanning systems that are used to diagnose and treat cancer. 

Dr. Diep Bao Tuan, deputy director of the Ho Chi Minh City Oncology Hospital, said that PET/CT scans provide detailed, high-resolution images to find and monitor tumors or abnormalities.

“This is a key technique to diagnose cancer promptly to treat patients effectively,” Dr. Tuan said.

To make PET/CT scans efficient, it is compulsory to use radiopharmaceutical 18F-FDG.

The hospital was previously supplied with the drug by Rang Dong Medical JSC, allowing for daily PET/CT scanning. However, the disruption in supply has brought operations to a near standstill.

The Ho Chi Minh City Oncology Hospital reported a high demand for PET/CT scans.

While it is equipped with two PET/CT scanners, each with a capacity of 30 cases per day, the insufficient supply of 18F-FDG has hindered the equipment's operations.

Although the hospital receives some radioactive drugs from Cho Ray Hospital, the quantity is minimal. 

The Cyclotron radioactive drug manufacturing system at Cho Ray Hospital is aging and has been in operation for nearly 15 years.

Cao Van Khanh, head of the nuclear medicine department of Military Hospital 175, told Tuoi Tre (Youth) newspaper that an average of seven patients undergo PET/CT scans each day at the hospital, which conducts scanning five days a week.

The figures fail to meet the demand at the hospital.

“I hope that Ho Chi Minh City will have one or two more Cyclotron radiopharmaceutical manufacturing systems in the coming time to supply enough drugs to hospitals to save more cancer patients,” Dr. Khanh said.

Obstacles in legal procedures are hindering drug production

Due to the prolonged disruptions in the supply of radioactive drugs, the municipal Department of Health had previously contacted the Drug Administration of Vietnam under the Ministry of Health for support in producing the drug.

The department noted that in addition to Cho Ray Hospital, Rang Dong Medical JSC is also capable of producing the radioactive drug 18F-FDG.

The company’s branch is located in the Research and Development Center for Radiation Technology, part of the Vietnam Atomic Energy Institute under the Ministry of Science and Technology, in Thu Duc City.

A representative of the firm informed Tuoi Tre on Sunday that its Cyclotron radiopharmaceutical manufacturing system was established in 2017 at a cost of VND 200 billion (US$8 million) and has the capacity to supply drugs for 10 PET/CT scanners.

Though the Ministry of Health granted a license for its operation in 2023, the system has been suspended due to obstacles over legal procedures.

“We spend over VND300 million [$12,000] in monthly paying maintenance fees and employee salaries,” the representative lamented.

The municipal health department has sent a dispatch to the Ministry of Science and Technology reporting the urgent demand for the 18F-FDG radiopharmaceutical.

Dr. Nguyen Hoai Nam, deputy head of the department, said that the drug has a short lifespan at below 12 hours, so it should be used right after production.

This makes the transport of the radioactive drugs from other localities to Ho Chi Minh City unfeasible.

Therefore, the best way to use the drugs effectively is to produce radiopharmaceuticals in the city.

The radiopharmaceutical production facility of Rang Dong is facing hindrances over public assets, so its production lines must not be put into operation, explained the municipal department.

The department proposed the ministry help the firm and relevant units remove obstacles over legal procedures to put the facility into service as soon as possible, for cancer patients are in dire need of radioactive drugs for PET/CT scans.

The representative of Rang Dong stated that the cooperation agreement between the firm and the center does not comply with the regulations of the 2017 law on public asset management and use, leading to the suspension of all drug production operations.

“The Ministry of Science and Technology has conducted an inspection of the licensing processes at the firm and is planning to gather feedback from the Ministry of Finance,” the representative added.

Tran Chi Thanh, head of the Vietnam Atomic Energy Institute, told Tuoi Tre that the institute had received a report from Rang Dong’s Ho Chi Minh City branch regarding delays in radiopharmaceutical production.

The main reason for the procrastination was related to legal procedures concerning public assets.

Thanh stated that the institute had informed the Ministry of Science and Technology of proceeding with the necessary procedures in accordance with current regulations.

He emphasized that producing 18F-FDG is crucial for patient treatment, and the institute is actively working to assist the firm in getting its manufacturing system operational.

Abundant supply to help local patients avoid traveling abroad for treatment

Amid the urgent need for radiopharmaceuticals, the municipal health department announced plans to build a Cyclotron production facility to provide the 18F-FDG drug for PET/CT scans. However, the plan remains on paper.

Increasing the supply of radiopharmaceuticals is expected to stabilize drug prices, reduce wait times for PET/CT scans, and prevent local patients from traveling abroad for treatment.

Some hospitals in Ho Chi Minh City are experiencing a surge in patients registering for PET/CT scans.

On July 19, the Ho Chi Minh City Oncology Hospital saw long lines of patients waiting to register. A consulting employee informed families that there would be at least a 15-day wait for a PET/CT scan.

T.H.H., a 36-year-old resident of Binh Thanh District, expressed concern for a family member showing signs of a cancer relapse.

“I waited nearly two hours to register, but we’ll have to wait over 15 days for the scan. How anxious!” H. said.

Many patients at Military Hospital 175 are also frustrated by the lengthy wait times to register for PET/CT scans.

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