Supply Chain Execution in Radiopharma: The Industry’s Next Critical Challenge

In an interview with BioPharm International®, Andrea Zobel, senior manager of dangerous goods at Cencora World Courier, and Marco Hogenboom, senior director of specialty logistics, discussed the operational realities emerging as radiopharmaceutical therapies advance toward broader commercialization. The conversation explored the increasing complexity of global supply chains supporting radiopharmaceuticals, including regulatory harmonization challenges, highly time-sensitive delivery requirements, and the growing role of AI-enabled orchestration systems.

The executives emphasized that while scientific innovation continues to drive radiopharmaceutical development, long-term commercial success will increasingly depend on scalable execution, supply chain coordination, and operational reliability. Radiopharmaceuticals are attracting growing industry attention due to their ability to deliver targeted radiation directly to cancer cells while minimizing systemic exposure.

BioPharm: When advanced therapies are discussed, the focus is often on scientific innovation. From your perspective, what operational realities are emerging as radiopharmaceuticals move toward broader commercialization?

Zobel: I really want to highlight the science behind this because we’ve had so many improvements in cancer therapy over the last few decades. We understand much more now about cancer cells, about targets, about the proteins involved, and about how therapies can bind specifically to those cells.

We know a lot about cancer cells, which proteins, which targets we have on cancer cells. Now we link to these biopharmaceuticals ... a radioactive molecule and kill in the body the cancer cell by short-distance acting, but very powerful radiation.

What’s happening now is that all this increasing knowledge about cancer biology is coming together with advanced isotope manufacturing capabilities. That combination has really opened the door to a huge pipeline of radiopharmaceutical therapies.

The challenge is that these therapies are no longer targeting only very small patient populations. Companies are now developing radiopharmaceuticals for common cancers such as prostate, lung, and breast cancer, where there may be thousands—or even millions—of patients.

Hogenboom: From the logistics side, we see enormous opportunity, but also enormous complexity. The growth is happening very quickly, especially as therapies move closer to commercial scale. The final delivery step is critical because failing on that side is basically failing towards a patient. That’s why specialty logistics becomes so important. These therapies require what we often call “white glove” handling because everything must be controlled and coordinated extremely carefully.

What logistical challenges are companies underestimating as they attempt to scale radiopharmaceutical therapies globally?

Hogenboom: I think one of the biggest challenges companies underestimate is the regulatory complexity. Even within Europe, requirements can differ significantly between neighboring countries.

In some countries, transport personnel only need specific dangerous goods training, while other countries have much more extensive licensing requirements. Some regions even have differences at the state level.

Companies often underestimate how difficult global implementation can become. They may understand pharmaceutical regulations very well, but radiopharmaceuticals require companies to navigate both pharmaceutical regulations and radioactive materials regulations at the same time.

Zobel: We have to combine two regulatory worlds.

On the pharmaceutical side, there is much more harmonization globally through GMP and GDP standards. But radioactive materials regulations are interpreted differently country by country.

In Europe, we lack a European harmonization. We have so many harmonizations, but not in this space. There is also still a lot of misunderstanding around radioactive materials. People often immediately think about nuclear waste or nuclear weapons, but this is very different. These therapies are highly targeted and designed specifically to act over short distances within the body.

How do short half-lives change supply chain planning for radiopharmaceuticals?

Zobel: Time is really one of the biggest operational challenges. The isotopes have to remain active long enough to allow global distribution, but short enough to provide effective treatment within the patient.

In many cases, companies only have a very small delivery window. We may only have a few days to get the therapy from isotope production to manufacturing, packaging, customs clearance, shipment, and finally to the patient.

That means every step must be orchestrated very carefully.

Hogenboom: Proper onboarding is essential. You cannot just decide one week before shipment that you are ready to distribute globally.

Every customer requires detailed planning around packaging, manufacturing sites, country regulations, shipping lanes, and temperature control requirements. The logistics process becomes an integral part of the therapy itself. If the shipment fails, the therapy fails.

Where can AI and predictive logistics systems improve radiopharmaceutical operations?

Zobel: I think AI can help tremendously, especially with predictive shipment management. We already have large amounts of operational data related to transit times, temperature control, import/export procedures, and lane mapping.

For these extremely time-sensitive therapies, AI could help optimize routing and improve prediction capabilities so shipments arrive within the usable activity window.

Once that calibration window passes, the product effectively becomes waste because there is no longer enough radioactivity remaining for therapeutic effect.

Hogenboom: AI absolutely has potential from an operational perspective, particularly around predictive management, but there will always be a strong human element involved. There’s a patient at the end of the line. Being unable to clear a shipment or deliver a shipment has consequences for the patient.

That emotional and operational coordination piece is still critical because disruptions can happen unexpectedly. Teams still need to make real-time decisions around rerouting, customs issues, weather disruptions, or other operational problems.

Could orchestration systems eventually reduce radiopharmaceutical waste?

Zobel: I think this is actually one of the biggest opportunities moving forward. As shipment volumes increase, we will need much stronger orchestration systems overseeing the entire treatment journey.

Ideally, you would have a system that connects hospital scheduling, isotope manufacturing, radiopharmaceutical production, and courier operations all together in real time.

Then, if something goes wrong, such as a shipment delay or cancellation, there may be opportunities to reroute a dose to another nearby hospital where a patient is waiting for the same treatment.

Because these therapies are not necessarily patient-specific, smarter coordination systems could help reduce waste significantly.

Looking ahead, where will the next competitive advantage in advanced therapies come from?

Zobel: I think it’s really about scale and execution now. Scientific innovation remains extremely important, but operational execution is becoming equally important as these therapies move toward broader commercialization. It’s really about handling and making it normal.

Hogenboom: I completely agree. Adoption by supply chain teams, operational teams, and healthcare systems will determine how quickly these therapies can scale commercially. It will become the new norm basically to fight cancer.

We are already seeing significant momentum clinically and commercially, and I think that growth will accelerate quickly over the next several years.