IMPLEMENTAÇÃO DO PET NO BRASIL: NECESSIDADES E DESAFIOS CLAUDIO MENEGHETTI INCOR-FMUSP IMPLEMENTATION OF PETs IN BRAZIL: NEEDS AND CHALLENGES JUNHO- 2005

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  • IMPLEMENTAO DO PET NO BRASIL:NECESSIDADES E DESAFIOSCLAUDIO MENEGHETTI INCOR-FMUSPIMPLEMENTATION OF PETs IN BRAZIL:NEEDS AND CHALLENGESJUNHO- 2005

  • PET SYMPOSIUM SETTING UP A PET IMAGING CENTER

    WFNMB & ALASBIMNTHE ECONOMICS BEHINDCLAUDIO MENEGHETTI- BRAZIL

  • IAEA DIRECTORY OF CYCLOTRONS USED FORRADIONUCLIDE PRODUCTION IN MEMBER STATES206 ENTRIES FOR CYCLOTRONS OPERATING IN 34 MEMBER STATESUSA 90EUROPE 54JAPAN 38LATIN AMERICA 8*

  • INCOR-FMUSP -1998

    COINCIDENCE HIBRIDSCINTILATION CAMERA

    CNEN/IPEN ROLEBRAZILIAN 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 - 2005RIO DE JANEIRO - CYCLOTRON 11 MEV

    SAO PAULO - CYCLOTRON 30 MEV MULTIPLE USERIO DE JANEIRO - 2 PET BARRA / SAMARITANO

    SAO PAULO - 4 PET INCOR/HSL/HCOR/EISNTEINPLACE WITH A IMMEDIATE POTENCIAL INSTALLATION

    RECIFE BELO HORIZONTE PORTO ALEGRE

  • PET IMAGING CENTER IN LATIN AMERICA

    CYCLOTRONS IN LATIN AMERICAARGENTINA 2 CYCLOTRONS

    BRAZIL 4 CYCLOTRONS*

    CHILE 1 CYCLOTRON

    MEXICO 1 CYCLOTRON

    VENEZUELA 1 CYCLOTRON

  • LATIN AMERICA PERSPECTIVESLIMITATIONSDevice / inhabitants

    Distribution

    Imported Devices/cost

    Reimbursement

  • LATIN AMERICA PERSPECTIVESBRAZIL LIMITATIONS170.000.000 INHABITANTS

    8 CAMERA BASED PET

    6 DEDICATED PET

    2 PRODUTIVE CYCLOTRON

    2 CITIES SO 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 AMERICAUNDERSTANDING 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 AMERICAPET 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 SPRESOLVE?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 PETLETS DO A MARCH TO BRASILIA, TO MC&T AND TO CNENCLAUDIO MENEGHETTI-INCOR-FMUSP