IMPLEMENTAÇÃO DO PET NO BRASIL:IMPLEMENTAÇÃO DO PET NO BRASIL:NECESSIDADES E DESAFIOSNECESSIDADES E DESAFIOS

CLAUDIO MENEGHETTI INCOR-FMUSP

IMPLEMENTATION OF PETs IN BRAZIL:NEEDS AND CHALLENGES

JUNHO- 2005

PET SYMPOSIUM

SETTING UP A PET IMAGING CENTER

WFNMB & ALASBIMN

THE ECONOMICS BEHIND

CLAUDIO MENEGHETTI- BRAZIL

IAEA

DIRECTORY OF CYCLOTRONS USED FORRADIONUCLIDE PRODUCTION IN MEMBER STATES

206 ENTRIES FOR CYCLOTRONS OPERATING IN 34 MEMBER STATES

USA 90EUROPE 54JAPAN 38LATIN AMERICA 8*

INCOR-FMUSP -1998

COINCIDENCE HIBRIDSCINTILATION CAMERA

CNEN/IPEN ROLE

BRAZILIAN HISTORICAL

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 IN BRAZIL

PET DEDICADOINCOR- 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 - 4 PET INCOR/HSL/HCOR/EISNTEIN

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 PET SCINTIGRAPHY $2,000LATIN AMERICA PET SCINTIGRAPHY $1,000

USA INTEREST RATE LOWLATIN AMERICA INTEREST RATE HIGH

BRAZIL NATIONAL 19,75%/YRBRAZIL INTERNATIONAL 8,5%/YRBRAZIL TRANSPORT, INSURANCE AND TAXES 30%

PET IMAGING CENTER IN LATIN AMERICA

PRICE OF SCINTIGRAPHY 1998 R$1800 2003 R$3000 2005 R$3000

1 DOLAR = 1 REAL 19981 DOLAR = 2,5 REAL 2005

YOU BUY THE MACHINE IN AMERICAM DOLLARS AND HAVE TO PAY THE SAME PRICE WITH REAL, 250% HIGHERWITH THE CHEAPER SCINTIGRAPHY.

PET SCINTIGRAPHY IN BRAZIL

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 TESTNEED TO BE NEAR $1000 AND THIS PRICE IS VERY EXPENSIVETO BRAZIL.

SO, YOU HAVE $600 OR $700 TO PAY DIRECT AND INDIRECTCOSTS, INCLUDING THE NATIONAL TAXES AND MACHINE. IFYOU 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 IS VERY IMPORTANT AND SHOWED TO BEPROFIT TO THE PATIENTS AND TO THE MEDICAL DECISIONS.

PET SCINTIGRAPHY IMPROVE THE PATIENT TREATMENT AND THERESULTS 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 COUNTRIESAND THEY DONT HAVE DIFFERENT TREATMENT TO DIFFERENT KINDOF ECONOMY.

PET SCINTIGRAPHY

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 ?

DO WE HAVE OTHER KIND OF PROBLEM?

THE PET OF INCOR, A PUBLIC HOSPITAL, WAS A DONATION FROM THE MINISTRY OF HEALTH SINCE2003.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.

WHAT ARE OUR NEEDS AND CHALLENGES?

PAULISTA SOLUTION

IPEN + FMUSP + SC&T-SP

DEDICATED CYCLOTRON – SAO PAULOIPEN? FMUSP?

DEDICATED CYCLOTRON – CENTRE STATE ( JAU? )

2 PET MOBILE INVOLVED WITH HEALTH SECRETARY SP

PET-CT MOBILE

ESTADO DE SP

RESOLVE?

PET-CT MOBILE

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