The Department of Energy's isotope program lacks a systematic process for forecasting demand and timely plans for supply risks, even though it is the only domestic supplier for many materials used in medicine, research and industry, federal auditors reported.
From fiscal 2020 through 2025, the Office of Isotope Research and Development and Production produced, sold and distributed 265 isotopes. It made more than 7,700 shipments, most for medical purposes, according to the Government Accountability Office.
The program monitors markets through interactions with industry, customers and production sites, but GAO found those contacts were tracked manually and needs were assessed case by case rather than through a consistent forecasting mechanism.
That gap can matter when a production line takes time to prepare. One university production-site representative told auditors that clearer market analysis could have prompted earlier preparation for an isotope facing an imminent supply failure.
DOE data show the number of isotopes experiencing market disruptions fell from 40 in 2023 to 25 in 2025. GAO said the United States still relied on countries classified as sensitive for a majority of the remaining isotopes.
A supply risk is not proof that a shortage will occur. Production capacity, inventories, private suppliers and foreign sources can change, and GAO reviewed a nongeneralizable sample of recipients alongside program data and documents.
The stakes cross several sectors. Isotopes support diagnostic imaging and cancer treatment, manufacturing, national security, quantum science and basic research; substitutes may not exist for a particular application.
GAO issued four recommendations, including systematic demand assessment, creation of a statutorily required advisory committee, time-bound mitigation plans and clearer risk communication to customers. DOE's Office of Science agreed.
The recommendations remain open until auditors verify action. The practical test is whether DOE can detect a tightening market early enough to expand production or reduce dependence before customers face an interruption.