AstraZeneca’s recent $2 billion acquisition of a radiopharmaceutical partner was the latest sign that the market for these new therapies is growing quickly — and that the competition among pharma giants for dominance in the space is heating up. The global market for radiopharmaceuticals was estimated at $5.7 billion last year, and is expected to reach $13.7 billion by 2032.

This presents a hopeful, potentially life-saving development, particularly for patients suffering from certain types of cancer. “Radiopharmaceutical therapies (RPTs) are systemic treatments that target cancer cells with a radioactive drug,” Johns Hopkins Medicine explains. They “can be used to treat cancers that have spread (metastasized) or recurred after other treatments.”

Discussions around the advancements in radiopharmaceuticals have largely focused on efficacy. But there are additional, pressing challenges pharma companies must consider when investing in and administering radiopharma drugs — specifically, challenges in the delivery of radioligand therapy (RLT), a type of targeted cancer therapy that delivers radiation to specifically targeted cancer cells.

Considerations when delivering RLT at scale 

What makes RLT so promising — the radioactive elements — also creates massive challenges in delivering them. These challenges often require new infrastructure. Considerations include: 

Diagnostics: RLT targets specific receptors or antigens on cancer cells. Accurate diagnostic tests need to be highly specific and sensitive in order to identify patients who are likely to benefit from RLT.

Half-life: These medicines have short half-lives. From the moment they are created, they begin to decay. As the International Atomic Energy Agency reports, the half-lives of radiopharmaceuticals can be anywhere from several days to just a matter of seconds. So some drugs need to be created with exponentially more isotopes than will ultimately be administered to a patient.

Logistics: The treatment needs to be packaged, tracked, delivered, and administered to the patient at exactly the right time. There’s virtually no wiggle room, no opportunity for delays or cancellations, or for earlier administration. This means pharma companies need to create precise systems to ensure timely delivery to healthcare facilities before the radioactivity diminishes and becomes unusable.

With multiple companies on the brink of offering similarly effective therapies, the focus for pharmaceutical companies will now be on delivery and differentiation. 

In order to remain competitive, companies operating in the radiopharmaceutical space must consider how they will navigate and support the upscaling of broader healthcare systems to enable the delivery of RLT. Healthcare providers will need training and support in implementing this process, from patient identification to ordering, storing and administering treatments. 

The stakes are high. Not only do lives hang in the balance, but the expenses can be tremendous. A single dose of a radiopharmaceutical drug can cost tens of thousands of dollars. Delivering these new, promising treatments at scale will require pharmaceutical companies to evaluate their processes and areas of focus, and transform their operations accordingly. 

These changes will take focused effort and significant investment. Whichever company shows the most leadership in this space will be at the forefront in the new era of radiopharmaceuticals.