IMPLEMENTAÇÃO DO PET NO BRASIL:
NECESSIDADES E DESAFIOS
IMPLEMENTATION OF PETs IN BRAZIL:
NEEDS AND CHALLENGES
JUNHO- 2005
CLAUDIO MENEGHETTI
INCOR-FMUSP
PET SYMPOSIUM
SETTING UP A PET IMAGING CENTER
WFNMB & ALASBIMN
THE ECONOMICS BEHIND
CLAUDIO MENEGHETTI- BRAZIL
IAEA
DIRECTORY OF CYCLOTRONS USED FOR
RADIONUCLIDE PRODUCTION IN MEMBER STATES
206 ENTRIES FOR CYCLOTRONS OPERATING
IN 34 MEMBER STATES
USA
EUROPE
JAPAN
LATIN AMERICA
90
54
38
8*
BRAZILIAN HISTORICAL
INCOR-FMUSP -1998
COINCIDENCE HIBRID
SCINTILATION CAMERA
CNEN/IPEN ROLE
PET IN BRAZIL
OUR PROBLEM: CNEN/IPEN/SBBMN
RECOGNITION OF CNEN AND MC&T
MONOPOLIUM FLEXILILITY
MC&T , GOVERN , BRAZILIAN SOCIETY
APPROVED IN SENATE AND CONGRESS
PROBLEMS ??
FHC-LULA AND ???
PET DEDICADO
INCOR- 2003
DEDICATED PET
CYCLOTRON AND PET IN BRAZIL - 2005
RIO DE JANEIRO -
CYCLOTRON 11 MEV
SAO PAULO
CYCLOTRON 30 MEV – MULTIPLE USE
-
RIO DE JANEIRO - 2 PET
BARRA / SAMARITANO
SAO PAULO
INCOR/HSL/HCOR/EISNTEIN
- 4 PET
PLACE WITH A IMMEDIATE POTENCIAL INSTALLATION
RECIFE – BELO HORIZONTE – PORTO ALEGRE
PET IMAGING CENTER IN LATIN AMERICA
CYCLOTRONS IN LATIN AMERICA
ARGENTINA
2 CYCLOTRONS
BRAZIL
4 CYCLOTRONS*
CHILE
1 CYCLOTRON
MEXICO
1 CYCLOTRON
VENEZUELA
1 CYCLOTRON
LATIN AMERICA PERSPECTIVES
LIMITATIONS
Device / inhabitants
Distribution
Imported Devices/cost
Reimbursement
LATIN AMERICA PERSPECTIVES
BRAZIL LIMITATIONS
170.000.000 INHABITANTS
8 CAMERA BASED PET
6 DEDICATED PET
2 PRODUTIVE CYCLOTRON
2 CITIES – SÃO PAULO AND RJ
SNM AIM
* The Society of Nuclear Medicine is an international
scientific and professional organization founded in
1954 to promote the science, technology and
pratical application of nuclear medicine.
* The SNM and SNMTS are commited to providing
continuing education, opportunities, and other
professional development information to anyone
interested in the field of Nuclear Medicine .
HTTP:// WWW.SNM.ORG
WHAT CAN THE FIRST WORLD AND AIEA DO TO
IMPROVE THE PERSPECTIVES IN THE USE
OF PET IN LATIN AMERICA?
* To facilitate the participation of experts in
L.A. congress as to spread out the use of PET in
Oncology, Cardiology and Neurology.
* To facilitate the training of L.A. human resources.
* To promote political influence on National
Nuclear Energy Comissions and Governamental
Instituitions as to facilitate the introduction and
utilization of this technology in Latin America.
WHAT CAN THE ALASBIMN AND LOCAL
ASSOCIATIONS DO TO IMPROVE THE
PERSPECTIVES IN THE USE OF PET IN L.A ?
* To promote political influence on National Nuclear
Energy Comissions and Governamental Instituitions
as to facilitate the cyclotrons installation.
* To promote lectures about PET applications in the
main congress related to oncology, neurology and
cardiology.
CYCLOTRON FOR PET USE
PET IMAGING CENTER IN LATIN AMERICA
WHAT DO WE NEED?
PET IMAGING CENTER IN LATIN AMERICA
UNDERSTANDING LATIN AMERICA
WHY ECONOMY IS A BIG
PROBLEM IN LATIN AMERICA?
PET IMAGING CENTER IN LATIN AMERICA
CAMERA BASED PET
$500,000
DEDICATED PET
$1,500,000
DEDICATED PET/CT
$2,200,000
SMALL CYCLOTRON
$2,000,000
PRODUCTION CYCLOTRON
$3,000,000
PET IMAGING CENTER IN LATIN AMERICA
USA
LATIN AMERICA
USA
LATIN AMERICA
BRAZIL
BRAZIL
BRAZIL
PET SCINTIGRAPHY
PET SCINTIGRAPHY
INTEREST RATE
INTEREST RATE
NATIONAL
INTERNATIONAL
TRANSPORT, INSURANCE AND TAXES
$2,000
$1,000
LOW
HIGH
19,75%/YR
8,5%/YR
30%
PET IMAGING CENTER IN LATIN AMERICA
PET SCINTIGRAPHY IN BRAZIL
PRICE OF SCINTIGRAPHY
1998
2003
2005
1 DOLAR = 1 REAL
1 DOLAR = 2,5 REAL
1998
2005
R$1800
R$3000
R$3000
YOU BUY THE MACHINE IN AMERICAM DOLLARS AND
HAVE TO PAY THE SAME PRICE WITH REAL, 250% HIGHER
WITH THE CHEAPER SCINTIGRAPHY.
PET IMAGING CENTER IN LATIN AMERICA
CYCLOTRON
UNITED STATE AND EUROPE START WITH $700 PER FDG DOSE.
NOWADAYS, WITH MORE PET BUYING DOSES, THE PRICE IS
BETWEEN $300 AND $400.
IN LATIN AMERICA YOU NEED TO START, EVEN WITH LESS
USERS, RANGING $300. REMEMBER, THE PET TEST
NEED TO BE NEAR $1000 AND THIS PRICE IS VERY EXPENSIVE
TO BRAZIL.
SO, YOU HAVE $600 OR $700 TO PAY DIRECT AND INDIRECT
COSTS, INCLUDING THE NATIONAL TAXES AND MACHINE. IF
YOU BOUGHT THE PET BY $1,500,000, YOU HAVE ONLY OF
INTEREST RATE AFTER ONE YEAR, TO PAY $127,500 OR 127
SCINTIGRAPHIES, MAINTENANCE MORE THAN 150 TEST/YR.
PET IMAGING CENTER IN LATIN AMERICA
PET SCINTIGRAPHY
PET SCINTIGRAPHY IS VERY IMPORTANT AND SHOWED TO BE
PROFIT TO THE PATIENTS AND TO THE MEDICAL DECISIONS.
PET SCINTIGRAPHY IMPROVE THE PATIENT TREATMENT AND THE
RESULTS ARE BETTER.
THE MEDICINE, IN ALL COUNTRIES OF THE WORLD, NEEDS A PET
FACILITIES.
THE COUNTRIES HAVE DIFFERENT POLITICS ABOUT HEALTH AND
DIFFERENT HEALTH ABOUT THE OWN ECONOMY.
THE ECONOMY IS CONCENTRATED IN THE DEVELOPED COUNTRIES
AND THEY DONT HAVE DIFFERENT TREATMENT TO DIFFERENT KIND
OF ECONOMY.
PET IMAGING CENTER IN LATIN AMERICA
WHAT CAN THE BIG COMPANIES
DO FOR LATIN AMERICA?
DIFFERENT PRICES?
DIFFERENT FINANCING?
DIFFERENT TAXES?
ALL THESE DIFERENCES AT THE SAME TIME ?
WHAT ARE OUR NEEDS AND CHALLENGES?
DO WE HAVE OTHER KIND OF PROBLEM?
THE PET OF INCOR, A PUBLIC HOSPITAL, WAS A
DONATION FROM THE MINISTRY OF HEALTH SINCE
2003.
DO THEY PAY THE PET SCINTIGRAPHY?
TODAY THE PRODUTION BELONGS TO THE GOVERN.
WE ARE 2005 AND, NOW THEY GAVE US 500 FDG
DOSE IN ORDER TO PROVE THAT PET IS A GOOD
TEST FOR THE POPULATION. THE WORLD PROVED
THAT MANY YEARS AGO.
PAULISTA SOLUTION
IPEN + FMUSP + SC&T-SP
DEDICATED CYCLOTRON – SAO PAULO
IPEN? FMUSP?
DEDICATED CYCLOTRON – CENTRE STATE ( JAU? )
2 PET MOBILE INVOLVED WITH HEALTH SECRETARY SP
PET-CT MOBILE
PET-CT MOBILE
RESOLVE?
ESTADO DE SP
PET MOBILE
WHAT ARE OUR NEEDS AND CHALLENGES?
WE ARE NOT A POOR CONTINENT. WE HAVE
A BAD MONEY DISTRIBUTION.
AS WE HAVE ECONOMIC PROBLEM
DISTRIBUTION AND WE CAN NOT STOP
THE SCIENCE EVOLUTION, WE NEED
A POLITICAL SOLUTION. WE KNOW
WHAT WE HAVE TO DO.
WHAT ARE OUR NEEDS AND CHALLENGES?
WE ARE THE “WITHOUT CYCLOTRON AND PET”
LETS DO A MARCH TO BRASILIA,
TO MC&T AND TO CNEN
CLAUDIO MENEGHETTI-INCOR-FMUSP