Belgium is taking steps to prepare its health systems for the rapid expansion of radiopharmaceuticals, launching a national hospital capacity mapping project and a new Radioligand Therapy (RLT) Coordination Hub.

The move comes as pharmaceutical investment in RLT surges, with global companies ramping up efforts to develop new cancer treatments.

The initiatives stem from Belgium’s National Action Plan for Radioligand Therapy (RLT4BE), introduced in June 2024, aimed at strengthening infrastructure, improving patient access, and maintaining the country’s role in radiopharmaceutical research.

“Having a clear overview of treatment and clinical study capacity in Belgian nuclear medicine centres improves patient access and ensures that we remain an attractive location for industry-led clinical trials. The current mapping strengthens Belgium’s competitiveness in RLT,” said Prof. Dr. Nadia Withofs, nuclear medicine specialist at CHU Liège.

Foundations sector growth

At the initiative’s core is the RLT Coordination Hub, designed to streamline collaboration, guide investment, and enhance Belgium’s infrastructure for nuclear medicine.

The mapping exercise provides a comprehensive overview of hospital capacity and clinical research sites specialising in RLT, helping to anticipate future needs as demand rises.

“By establishing a coordination hub, we are building a central ‘cockpit’: a concrete tool to foster collaboration, streamline investments, and develop a robust infrastructure. This will allow us to anticipate the growing demand for RLT,” added Prof. Dr Sarah Baatout, Deputy Director of ‘Nuclear Medical Applications’ at SCK CEN (the Belgian Nuclear Research Centre).

Belgium has long been a key player in nuclear medicine, producing 20-25% of the world’s medical radioisotopes, with peaks of up to 65% during high-demand periods. In 2021 alone, over 10 million patients worldwide were treated with isotopes produced in Belgium.

Reinforcing Belgium’s RLT status

As part of efforts to strengthen Belgium’s role in radiopharmaceuticals, Flanders Investment & Trade (FIT) facilitated a high-level visit to Novartis’ headquarters in Basel. Minister-President of Flanders Matthias Diependaele, alongside Belgian RLT experts, met with Novartis representatives to discuss ways to reinforce Belgium’s position as an RLT hub in Europe and beyond.

The visit underscored Belgium’s role in the global RLT value chain, with Novartis conducting seven of its 33 global RLT studies in Belgium. As pharmaceutical companies invest heavily in radiopharmaceuticals, the need for coordinated infrastructure, regulatory alignment, and long-term investment is becoming increasingly urgent.

Pharma investment in RLT accelerates

The radiopharmaceutical sector is witnessing an investment boom, with pharmaceutical giants acquiring radioligand therapy companies and expanding research into new treatment areas. The global radiopharmaceutical market is projected to triple by 2031, reaching $26.5 billion.

Belgium is already seeing the impact of this growth. The country was the first in Europe to approve reimbursement for Novartis’ Pluvicto, the first targeted radioligand therapy for progressive PSMA-positive metastatic castration-resistant prostate cancer, in April 2024.

“Our pipeline includes a growing number of RLT indications, with several in advanced development,” Gina Volkaert, spokesperson of Novartis Belgium, told Euractiv. “With two radioligand therapies available to patients worldwide, we are actively expanding our portfolio.”

Long-term vision

Belgium’s new government coalition agreement has officially recognised the potential and complexity of radioligand therapies, reinforcing the country’s commitment to RLT.

“The inclusion of RLT in Belgium’s new government coalition agreement acknowledges both the potential and complexity of these therapies,” Volkaert told Euractiv.

She emphasised the need for a long-term vision to ensure sustainable growth in the sector, saying “A long-term vision is necessary to ensure Belgium remains prepared for future advancements by financing and coordinating necessary infrastructure and to support the entire RLT value chain, from basic R&D to production, clinical trials, and patient access to new innovations. A strong ecosystem will benefit not only patients but also the economy and society.”

EU infrastructure and policy gaps

Disparities in RLT infrastructure and reimbursement policies across Europe remain a challenge. While the United States has moved quickly to integrate radiopharmaceuticals into oncology, European adoption has been slower due to fragmented national policies and inconsistent reimbursement frameworks.

To remain competitive, experts highlight the need for greater European regulatory alignment and sustained investment in nuclear medicine infrastructure.

“With the action plan and RLT4BE, Belgium is not only laying the groundwork for preparing its own healthcare system for these new therapies but also contributing to a broader European cross-border collaboration framework for radiopharmaceuticals development,” said Ingrid Maes, Managing Director at Inovigate, the independent consultancy supporting the action plan.

What’s next?

The next phase of Belgium’s RLT strategy will focus on implementing key recommendations from the capacity mapping and coordination hub.

A progress update is expected in September, with policymakers and industry leaders continuing discussions on how to scale up infrastructure, expand clinical research, and ensure long-term patient access.

With pharmaceutical investment in radioligand therapy growing rapidly, Belgium’s latest initiatives mark an important step in aligning policy, research, and healthcare capacity with the evolving demands of precision cancer treatment.

[Edited by Vasiliki Angouridi, Brian Maguire]