Technetium-99 process mapping: an end-to-end SCOR and BPMN modelling

The supply chain of Molybdenum-99 (Mo-99) or more precisely, its daughter product, Technetium-99 (Tc-99m), is widely acknowledged as complex by both practitioners and researchers. This product is used to diagnose some of the deadliest diseases and loses its active substance over time. Furthermore, its supply chain (SC) is highly regulated because by nature it is a pharmaceutical and a radioactive product at the same time. The complexity of the SC is also due to the fact that said SC was not initially designed for the Tc-99m. In parallel, different production technologies are being investigated, which adds more to the diversity of the Tc-99m SC landscape which consequently can vary tremendously. In this context, this study aims at implementing a model that would clearly distinguish the roles and activities of the major stakeholders in the most prevalent Tc-99m SC: a reactor-based SC, from the production of the raw materials to the patient examination. Furthermore, this perspective will ultimately lead to the optimization of the SC and to reach that goal, the establishment of an end-to-end supply chain mapping as comprehensive as possible is the first step toward to be achieved. The originality of this study lies in the detailed modeling of the activities of the key actors of the Tc-99m chain based on the Supply Chain Operations Reference (SCOR) reference and the Business Process Modelling Notation (BPMN) standard. A presentation of other production routes using different technologies completes this study to give a perspective as broad as possible of the different Tc-99m SC design.