Melbourne (Australia) | 7 March 2025

Tens of thousands of Australians risk missing out on a new era of cancer treatment if Australia fails to fund and build the medical infrastructure needed to support it, according to a landmark new report by Telix.

The Nuclear Medicines report, entitled Radiopharmaceuticals Empowering Australia’s Future, released today by Telix, found the rise of theranostics – a branch of nuclear medicine – offered an innovative new way of treating cancer, but regulatory challenges are impeding its broader adoption in Australia.

Theranostics – ‘therapy’ and ‘diagnostics’ – are highly targeted treatments that use radioactive isotopes attached to a targeting agent to both ‘see’ (image) and ‘treat’ cancer. These drugs, known as radiopharmaceuticals, seek out cancerous cells, including where cancer has spread, and bind selectively to a target. Often described as the sixth pillar of cancer treatment (alongside surgery, radiation, chemotherapy, targeted therapies and immunotherapy), theranostics can be more accurate, less invasive, faster and safer than other standards of care[1]. However, the report explains that Australians are currently missing out on the benefits of these treatments.

Barriers to adoption

The report identified three key issues affecting the adoption of theranostic treatments in Australia:

  • Delayed approvals: Based on recent industry data, it takes approximately 422 days on averagefor new cancer treatments to receive funding approval in Australia (three to four times longer than in the United Kingdom, Germany and Japan) –and up to seven years to receive government funding[2]. 
  • Fragmented public funding: Unlike other drug categories, there is no clear public funding pathway in Australia for radiopharmaceuticals.While radiopharmaceutical diagnostics are funded through the Medical Services Advisory Committee (MSAC), radiopharmaceutical therapies fall through the gaps. They should be reviewed through the Pharmaceutical Benefits Advisory Council (PBAC), however, the PBAC has historically failed to recommend funding, meaning that theranostic treatments are financially out of reach for most Australians. Reimbursements for radiopharmaceutical products should be linked to their approval status with the safety regulator, the Australian Therapeutic Goods Administration (TGA).
  • Unregulated generic products: Some hospitals are allowed to compound their own ‘home-brew’ radiopharmaceuticals without oversight fromthe TGA, which may have implications for patient safety, patient access and treatment consistency. Copyright infringement and failure to enforce intellectual property rights also creates a disincentive for industry to invest in developing new treatments.

Australians want nuclear medicine funding

There is a groundswell of support for nuclear medicine among Australians. The paper includes results from a new survey of 2000 Australians, which reveals that:

  • 81% of respondents support expanding Australia’s nuclear medicines manufacturing industry[3]. 
  • 91% believe the government should fund the most cutting-edge cancer treatments like theranostics[4]. 
  • 69% believe Australia can be a world leader in theranostics[5]. 
  • 83% expect these products to be manufactured domestically[6]. 
  • 84% agree that nuclear medicine therapies should only be made available in Australia if they have been approved by the TGA[7].

Sovereign manufacturing crucial

Due to their nature, radiopharmaceuticals begin to decay the minute they are made and must be administered to patients within hours or days of manufacture[8], meaning Australia must build its own capability in this country. Currently, Australia has a single nuclear medical manufacturing plant for therapeutics – ANSTO at Lucas Heights in Sydney – but based on current projections, it is likely we will need additional manufacturing capacity to meet future demand.

A home-grown industry will also need an expert workforce and sufficient funding to develop a nationally co-ordinated strategy, and the report outlines how this could be achieved, including the creation of a dedicated Nuclear Medicines Fund.

Call to action for regulators and governments

The report puts forward five key recommendations to expand access and boost nuclear medicine research and manufacturing:

  • Enforce TGA approvals to ensure product quality and patient safety
  • Streamline reimbursement process and implement alternative separate payment funding model
  • Expand sovereign manufacturing
  • Develop a national workforce strategy, and
  • Create a $500 million Nuclear Medicines Fund to develop and deliver a national nuclear medicine strategy.

Telix Managing Director and Group Chief Executive Officer, Dr. Christian Behrenbruch, said Australia is a world leader in theranostics research, but that needs to translate into improved outcomes for Australian patients.

“Every year, more than 160,000 Australians are diagnosed with cancer, and 50,000 die from their disease[9]. However, potentially life-prolonging theranostics are not being widely adopted in Australia due to policy failures and a lack of planning. Nuclear medicine in Australia is now at an inflection point where we need to move away from “how it was always done”, and towards a system that guarantees access to as many Australians as possible. We need a nationally coordinated effort between Federal and State Governments, scientists, clinicians and pharmaceutical companies, in order to meet demand.”

The full Nuclear Medicines report, Radiopharmaceuticals Empowering Australia’s Future, can be downloaded at the following link.

[1] https://www.prostate.org.au/treatments-side-effects/theranostics/

[2] The Daily Telegraph, Why 10000 Aussies a Year Are Being Forced to Fund Their Own Cancer Treatment, 21 July 2024.

[3] Telix Report, Appendix 3, Q. 27

[4] Telix Report, Appendix 3, Q. 4

[5] Telix Report, Appendix 3, Q. 16

[6]Telix Report, Appendix 2, Q. 25

[7] Telix Report, Appendix 2, Q. 17

[8] Decay time depends on half-life of isotope.

[9] Australian Institute of Health and Welfare – Overview of cancer in Australia, 2024 – https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/overview