Big isotope bills are starting to pile up at medical clinics.
Doctors opened their mail last week and found bills up to $30,000 higher than usual from suppliers that have come to collect after hiking their prices in the spring.
The higher costs came around the same time Atomic Energy of Canada Ltd. shut down its aging reactor at Chalk River, Ont., due to a leak, sparking a worldwide medical isotope shortage.
Those extra costs are just now appearing on bills.
Surcharges have added $5,000 to $30,000 to clinics' monthly isotope invoices, said Christopher O'Brien, head of the Ontario Association of Nuclear Medicine.
"The bills are beginning to come in," he said.
He said some hospitals don't know if they'll be able to pay on time. Budgets were already set before Chalk River went down in May, sparking the current isotope shortage.
The added costs along the isotope supply chain have forced hospitals to go into debt or cut from other departments to pay for the procedures.
Clinics are already coping with higher expenses. Besides paying two to three times more for isotopes, they are also staying open evenings and weekends to do patient scans before the radioactive substances decay.
The isotopes have a short shelf life and cannot be stockpiled.
Hospitals are going cap in hand to Ottawa and the provinces, Dr. O'Brien said. "We're hoping to hear from either the provincial governments or the federal government that there will be funding to cover these increased costs through a bridging fund."
Health Canada says it has no plans to cover the extra costs.
"The government of Canada does not regulate the price of medical isotopes, which is determined by private companies contracted to the provinces," spokeswoman Christelle Legault said in an e-mail.
"The regulation of prices for medical isotopes falls under the responsibility of the provinces and territories."
The Ontario government has not decided on additional funding to cover isotope costs. Spokesman Dave Jensen said the province will look at the added costs and speak to suppliers before deciding anything.
Ontario Health Minister David Caplan has requested compensation from the federal government for extra costs incurred by hospitals because of the isotope shortage.
British Columbia has also raised the issue with Ottawa. However, B.C. health department spokesman Ryan Jab for the province's health department said the impact on hospital budgets has so far been "minimal."
"Right now, we don't have any plans to offset the supply increases," Ryan Jabs said.
Nova Scotia says it doesn't have enough information yet to make funding decisions.
Quebec also plans to seek compensation from Ottawa. Health Minister Yves Bolduc estimates the cost overrun could be around $10-million.
Health departments in other provinces weren't immediately available to comment.
Doctors have scrambled to make do with an erratic supply of isotopes since AECL powered down Chalk River after finding a leak of radioactive water.
The Chalk River reactor, shut down due to a leak, used to produced a third of the world's supply of the isotopes, which are used to diagnose cancer and heart ailments. AECL estimates the reactor won't be running until the end of the year.
So it has fallen to four other foreign reactors built a half-century ago to fill in.
A new Australian reactor is still a "few months" away from shipping isotopes to Canada and elsewhere, a spokeswoman said.
"The contribution to the global shortage will not be great until we can make major changes to the way we operate our production facility," said Sharon Kelly, a spokeswoman for the Australian Nuclear Science and Technology Organisation, which operates the reactor.
Meanwhile, the Conservative government has created a $6-million fund to find substitutes for radioactive isotopes. A panel of experts has also been convened to review proposals for new sources of medical isotopes in Canada. Its report is due at the end of November.