The nuclear medicine industry is on the edge of an explosion, and Indianapolis is at the epicenter, says one industry leader. Ohio-based Cardinal Health—already with significant investments in central Indiana—recently announced the city’s growing might in nuclear medicine enticed it to spend millions more to make Indianapolis the company’s nerve center for innovation. The major investment helps validate what has been growing here, says Cardinal Health Nuclear & Precision Health Solutions President Tiffany Olson: a powerful hub for radiopharmaceuticals.
“The nuclear medicine and molecular imaging industry is at a tipping point,” says Olson. “Over the next several years, our industry is estimated to triple.”
The radiopharmaceutical contract manufacturer says the 2019 MEDraysintell Nuclear Medicine Report projects the global nuclear medicine industry will grow to $14 billion by 2025, up from $5 billion in 2018. Olson says the area of theranostics in particular is fueling the growth, and that’s the focus of Cardinal’s investment in Indianapolis.
Nuclear medicine is a specialized area of radiology that uses very small amounts of radioactive materials, or radiopharmaceuticals, to examine organ function and structure; the field has previously focused mostly on diagnostics. Theranostics is an even newer and emerging specialty within the field of nuclear medicine and centers on precision medicine. Oncology comprises the majority of Cardinal’s portfolio, but the company also works in neurology, pulmonology and cardiology.
“Very simply put, theranostics is a therapeutic, which means ‘help fix me,’ and a diagnostic, which is ‘tell me what’s wrong,’” says Olson. “[Theranostics] combines those—a diagnostic and a therapeutic—for an individual and goes down to the cellular level, so patients get exactly what they need. It’s an incredibly precise way to treat different diseases.”
Already with a significant footprint in Indianapolis, Cardinal Health is investing millions more to establish its Center for Theranostics Advancement, which is comprised of three facilities. The first is an innovation center where the company works with pharmaceutical innovators to move discoveries through Phase 1 and 2, helping them develop, scale and do appropriate clinical trials. The second facility focuses on the precommercial stage and small manufacturing involved with Phase 3, while a third site powers largescale manufacturing when products earn regulatory approval or require higher levels of production. The growth is expected to create nearly 100 jobs.
While Cardinal has other manufacturing sites throughout the U.S., the company chose Indianapolis to power its innovation, largely due to the city’s logistics infrastructure.
“We need access to an international airport, and Indy has the second largest FedEx hub in the world, so we are able to get our products wherever they need to go quickly, being right here at the Crossroads of America,” says Olson. “In our business, speed and moving products when we’re finished manufacturing them to get into the patient is so important.”
Due to the radioactive materials in nuclear medicines, the drugs have an extremely short shelf life; Olson says Cardinal’s products range from 96 hours to 72 hours or less to get them into patients.
“The half-life is what makes nuclear medicine unique, compared to other types of pharmaceuticals,” says Olson. “In nuclear medicine, our products decay at the rate of their half-life; some are as short as 10 minutes…and we have others that are longer at 11 days.”
Being the Crossroads of America is a key factor building Indianapolis’ might in nuclear medicine. Advanced Accelerator Applications (AAA) is investing $72 million to build a production facility at the Purdue Research Park of Indianapolis, and company leaders cited the Indianapolis International Airport as a key factor in its decision.
Indy’s roster of players in nuclear medicine also includes Telix Pharmaceuticals (US), Inc., and Cardinal already manufactures radiopharmaceutical Xofigo in Indianapolis for Bayer. Sector leaders say educational programs with strengths in nuclear pharmacy at Purdue University and Butler University also support future growth. Indiana’s life sciences initiative BioCrossroads will soon host a virtual Frameworx session focused on Indiana’s emerging radiopharmaceutical industry.
“[This expansion] will absolutely open the door to further investment from Cardinal; the industry is really at that tipping point—we’re just starting up that curve. We expect growth, and as we continue to grow, we’re going to continue to invest here in Indy,” says Olson. “These new therapeutics and diagnostics are going to be able to improve patients’ lives, and that’s what we’re so passionate about within Cardinal and what gets us very excited about the future.”
While Cardinal has other manufacturing sites in the U.S., Olson says the Center for Theranostics Advancement in Indy is the company’s only facility dedicated to the innovation cycle.
In addition to Indy’s strong transportation infrastructure, Olson says other factors led Cardinal to choose the city as its center for innovation.