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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