[Exclusive] Latest Cancer Treatment Costs Rise by 40 Million Won... War Disrupts Raw Material Supply, Domestic Production Stalled Without Budget

Raw Isotope Actinium Price Surge Drives 30% Rise in Treatment Costs
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Due to the prolonged Russia-Ukraine war, disruptions in the distribution of raw materials for radiopharmaceuticals have caused a significant rise in the cost of cutting-edge cancer treatments in Korea. Efforts to establish domestic production to reduce reliance on imports have been stalled for a year, as the government budget did not allocate the 2 billion won needed for facility construction required for approval.

According to the Korea Institute of Radiological and Medical Sciences on April 21, the raw material cost for four sessions of domestic alpha-emitting radionuclide targeted therapy, which was 120 million won as of July last year, has now surged to 160 million won, representing an increase of about 30%. This therapy is used for patients who do not respond to conventional chemotherapy or radiation therapy, and the price of the radionuclide required for a single treatment has soared by about 10 million won, from 30 million won to 40 million won per session.

Alpha-emitting radionuclide targeted therapy is a next-generation radiopharmaceutical treatment method that destroys cancer cells by binding the alpha-emitting radionuclide Actinium-225 to them. For patients with castration-resistant prostate cancer and advanced neuroendocrine tumors, it is the only treatment option. In Korea, this therapy is administered as a compassionate use treatment, where the attending physician obtains approval from the Ministry of Food and Drug Safety and the patient bears the cost.

A special glove box installed at the Actinium-225 production facility of the Korea Institute of Radiological and Medical Sciences. It is a device designed to safely handle the radioactive material Radium-226 while separating and purifying Actinium, allowing simultaneous work from both sides. Photo by Jungyeon Park

The sharp price increase is attributed to the Russia-Ukraine war. The international price of Actinium was 680 euros (about 1.17 million won) per megabecquerel (MBq) in the first half of 2025, but rose to 840 euros (about 1.45 million won) in the second half of last year as the war dragged on. Because the production and purification of Actinium-225 require highly advanced nuclear facilities, Russia has effectively served as the world’s largest supplier. However, following the war, intensified Western sanctions against Russia have virtually cut off supply routes.

Another factor is that some Russian financial institutions have been excluded from the SWIFT international payment system, making it difficult to process payments. Kang Keonwook, professor of nuclear medicine at Seoul National University Hospital, stated, “Although supply from Russia is technically possible, it is extremely difficult to conduct transactions because there is no way to pay in dollars.” The price of Nickel-64, which is used in Actinium production, has also soared from about 60 million won per gram before the Russia-Ukraine war to over 100 million won per gram now.

The instability of raw material supply has resulted in patients missing the optimal window for treatment. Actinium-225 has a short half-life of about 10 days, so it must be administered immediately after production. However, repeated notifications from suppliers of shortages just before delivery deadlines have caused treatment schedules to be delayed. Most patients eligible for alpha-emitting radionuclide therapy are already in advanced stages of disease, and any delay in treatment can be fatal. It has been reported that some patients’ conditions have worsened while waiting, causing them to miss their chance for treatment altogether.

Domestic Actinium production facilities, which were established to break away from dependence on overseas supplies, have not been operational for a year despite having received production approval, as they have not yet obtained facility approval. In May of last year, the Korea Institute of Nuclear Safety (KINS) granted conditional facility approval for Actinium-225 production to the Korea Institute of Radiological and Medical Sciences, but final facility approval was not granted due to insufficient radiation shielding equipment.

The production method used by the Institute involves irradiating Radium-226 with a proton beam to generate Actinium. To provide radiation shielding, an additional 2 billion won is needed for the construction of about 70 tons of lead shielding, exhaust facilities to prevent the external release of radioactive gases generated during the radium handling process, and environmental monitoring equipment.

Lee Gyochul, head of the RI Application Division at the Korea Institute of Radiological and Medical Sciences, said, “We have received production approval, but without facility approval, we are left with a half-permission that allows us to do nothing in practice. The separation and purification equipment we installed has not been in operation for three years, and some equipment is now experiencing issues.” The shielding construction costs requested by the Institute were not included in this year’s government budget.

Once the domestic production facility is completed, it will be possible to supply raw materials for dozens of treatments each month. With each batch, 1 to 3 millicuries (mCi) can be obtained, covering the amount needed for a single session for 2 to 3 adult patients. If solid target technology is adopted in the future, large-scale production in the range of several dozen millicuries per batch will also become possible.

Stability of isotope supply is also considered a key factor for the development of next-generation radiopharmaceuticals from an industrial perspective. Hwang Seongwan, Vice President of SK Biopharmaceuticals, stated at last year’s “Field Meeting for Promoting Self-Reliance in Medical Isotope Production and Radiopharmaceutical Development,” “Even in basic research and development, the lack of Actinium is hindering active research. Since the half-life means we are forced to compete under unfavorable conditions with large pharmaceutical companies when sourcing from overseas, establishing a stable domestic supply system would be a great help.”

This content was produced with the assistance of AI translation services.