Health system readiness for radioligand therapy

HPP developed an international framework to assess health system readiness for radioligand therapy, an innovative cancer treatment.

Health System Readiness for Radioligand Therapy


Radioligand therapy is a highly targeted cancer treatment that delivers radiation directly to cancer cells, with minimal effect on the surrounding healthy cells. With an expanding array of applications, a tool was needed to enable assessment of the extent to which health systems around the world are ready for the delivery of this cancer treatment.

Radioligand therapy allows for a high degree of precision in the delivery of cancer care. It can be adapted to different types of cancer located anywhere in the body and is delivered to cancerous cells directly, leaving healthy cells largely unaffected. It is currently approved for use in certain types of neuroendocrine neoplasms and lymphoma, and is being trialled in metastatic castration-resistant prostate cancer and several other cancers. With new applications of radioligand therapy on the horizon, now is the time to plan for its wider use in the future.

The Radioligand Therapy Readiness Assessment Framework can be adapted to any country or health service context. It divides the health system into five domains: governance, regulation and reimbursement, identified need, service provision and health information, with each broken down further into subdomains. The framework enables a detailed analysis of a health system and helps to identify areas for change by clinicians, researchers, patient advocates and policymakers.

The framework is underpinned by research on cancer care planning and preparedness. It draws on tools developed by the Economist Intelligence Unit, World Health Organization and International Atomic Energy Agency, and European Society for Radiology, among others, as well as expert consensus.

Project resources

Radioligand Therapy Readiness Assessment Framework

Radioligand Therapy Readiness Assessment Framework

Download framework from the radioligand therapy website
Radioligand Therapy Readiness Assessment Framework

Radioligand Therapy Readiness Assessment Framework: user guide

Download user guide from the radioligand therapy website
Health system readiness for radioligand therapy

UK framework, policy action blueprint and situation analysis report

Download from the radioligand therapy website
Health system readiness for radioligand therapy

Fostering system readiness in cancer care: policy brief

Download policy brief
Health system readiness for radioligand therapy in the US

US framework, policy action blueprint and situation analysis report

Download from the radioligand therapy website

What we’ve achieved

HPP worked with an International Expert Advisory Group to develop the Radioligand Therapy Readiness Assessment Framework, which is the first tool of its kind. As this highly targeted and safe cancer treatment is being sought out by patients and clinicians alike, barriers to its implementation must be addressed to enable equitable access.

The framework has been made available in the public domain under a Creative Commons licence, to enable stakeholders anywhere in the world to apply it to their own national context. It is accompanied by a user guide, explaining each step of the assessment in turn and containing methodology used to create the framework.

The framework was launched on 9 June 2021 at an ancillary event to the American Society of Clinical Oncology Conference.

HPP has also worked with experts to apply the framework to the UK and US health systems. The adapted framework for the UK was launched at a webinar on 9 September 2021, along with a situation analysis and policy blueprint based on the findings from the UK assessment. The adapted framework for the US and its associated materials were launched at a webinar on 3 November 2021.

In 2022, we launched the Radioligand Therapy Readiness Hub, which collects examples highlighting different ways of improving the integration of radioligand therapy into cancer care, and boosting readiness for the approach in the future. This was followed in 2023 by the launch of the Radiopharmaceuticals Patient Advocacy Toolkit, an online resource for patient advocates to learn more about the use of radiopharmaceutical diagnostics and treatments, and how to advocate for equitable access to them.

This is part of a longer-term project on radioligand therapy that HPP has led since 2019.

Key partners and stakeholders

The development of the international framework was supported by an International Expert Advisory Group:

  • Dr Erik Briers, Patient Advocate, Europa Uomo; Patient Representative and member of Guidelines Committee on the treatment of prostate cancer, European Association of Urology, Belgium
  • Dr John Buscombe, Locum Consultant Physician in Nuclear Medicine, Barts Health, UK
  • Professor Martin Dreyling, Senior Physician, LMU Klinikum, Germany
  • Dr Boris Hadaschik, Head of Department and Full Professor, Department of Urology, Essen University Hospital, Germany
  • Professor Ken Herrmann, Chair, Department of Nuclear Medicine, Essen University Hospital, Germany
  • Nikie Jervis, Senior Patient Support, Information Nurse Specialist and Education Lead, Neuroendocrine Cancer UK
  • Dr Jolanta Kunikowska, Associate Professor and Nuclear Medicine and Internal Medicine Physician, Nuclear Medicine Department, Medical University of Warsaw; President, European Association of Nuclear Medicine, Poland
  • Josh Mailman, President, Northern California CarciNET Community, US
  • Professor Nicolas Mottet, Professor of Urology, University Jean Monnet, France
  • Professor Hein Van Poppel, Adjunct Secretary General for Education, European Association of Urology; Professor of Urology, Catholic University of Leuven, Belgium
  • Professor Jens Siveke, Director, Bridge Institute of Experimental Tumor Therapy, German Cancer Consortium, Germany
  • Lorna Warwick, Chief Executive Officer, Lymphoma Coalition, Canada

Project funding

This project is supported with funding by Advanced Accelerator Applications, a Novartis Company, with additional support from Nordic Nanovector.