# Therapeutic isotope supply chain (Mo-99, Lu-177, Ac-225)

Source: https://onco.cc/technologies/therapy-isotope-supply-chain/  
OnCo record `therapy-isotope-supply-chain` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Where the radioactive atoms for imaging and therapy actually come from: ageing reactors, new accelerators, and a scramble for actinium.

## Summary

Mo-99/Tc-99m for SPECT still depends on a few research reactors (BR2, HFR Petten, OPAL, SAFARI) with accelerator alternatives from NorthStar and SHINE. Lu-177 (non-carrier-added) is supplied by ITM, SHINE, Eckert & Ziegler, Curium and NorthStar; Ac-225 supply is the binding constraint for alpha therapy, with US DOE, TerraPower Isotopes, Orano Med (Pb-212), NorthStar, Niowave, and ITM expanding. Supply agreements are now a competitive asset for radiopharma companies.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-08
- Tags: supporting
- Principle: Reactor neutron capture (Lu-176→Lu-177), Th-229 decay chains and accelerator spallation (Ac-225), and electron-accelerator photonuclear routes (Mo-99) produce isotopes that are purified, calibrated, and shipped against decay.
- Strengths: Multiple new non-reactor routes since 2020
- Limitations: Ac-225 shortage until late 2020s; Reactor outages cause global shortages; Regulatory licensing of new production sites is slow

## Sources

- US Department of Energy Isotope Program: https://www.isotopes.gov/

## Connected records

- fronts: [Radiopharmaceuticals & Theranostics](https://onco.cc/fronts/radiopharma/)
- technologies: [Actinium-225 supply: thorium stocks, accelerators and radium targets](https://onco.cc/technologies/actinium-225-supply/), [Lutetium-177 radioligand therapy](https://onco.cc/technologies/lu177-radioligand-therapy/), [Radio-antibody & radio-ADC](https://onco.cc/technologies/radioimmunotherapy/), [Radioligand therapy (beta emitters)](https://onco.cc/technologies/radioligand-therapy/), [Radiopharmaceutical GMP and releasing a drug that decays](https://onco.cc/technologies/radiopharmaceutical-gmp-release/), [Radiopharmacy and cyclotron networks](https://onco.cc/technologies/radiopharmacy-network/), [Research reactors for medical isotopes (Mo-99, Lu-177, I-131)](https://onco.cc/technologies/research-reactor-isotope-production/), [Targeted alpha therapy](https://onco.cc/technologies/targeted-alpha-therapy/)
- companies: [ANSTO (Australian Nuclear Science and Technology Organisation)](https://onco.cc/companies/ansto/), [Bruce Power](https://onco.cc/companies/bruce-power/), [Curium](https://onco.cc/companies/curium/), [Eckert & Ziegler](https://onco.cc/companies/eckert-ziegler/), [IRE (Institut national des Radioéléments)](https://onco.cc/companies/ire/), [Isotopia Molecular Imaging](https://onco.cc/companies/isotopia/), [ITM Isotope Technologies Munich](https://onco.cc/companies/itm/), [NorthStar Medical Radioisotopes](https://onco.cc/companies/northstar-medical-radioisotopes/), [NTP Radioisotopes](https://onco.cc/companies/ntp-radioisotopes/), [Nusano](https://onco.cc/companies/nusano/), [Orano Med](https://onco.cc/companies/orano-med/), [SHINE Technologies](https://onco.cc/companies/shine-technologies/), [TerraPower Isotopes](https://onco.cc/companies/terrapower-isotopes/)

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