Global Radiopharmaceutical Surge: BMS and Novartis Make Billion-Dollar Bets

Recently, RayzeBio, a subsidiary of BMS, spent $1.35 billion to introduce the prostate cancer nuclear medicine OncoACP3, while Novartis simultaneously launched the Phase III clinical trial of SSTR2-targeted drug Lutathera for the treatment of advanced gastroenteropancreatic neuroendocrine tumors in China. The heavy investments and key advancements from these two giants mark the entry of the global nuclear medicine industry into a new stage of accelerated development—**the global nuclear medicine wave has arrived**.

The Global Wave of Nuclear Medicine

The global medical industry is witnessing an explosive growth in therapeutic nuclear medicine, which is reshaping the treatment paradigm for major diseases such as cancer with its unique advantages of precise targeting and integrated diagnosis and treatment.

According to Precedence Research, the global radiopharmaceuticals market size reached USD 6.74 billion in 2024 and is accelerating its expansion at a compound annual growth rate (CAGR) of 8.2%, expected to exceed USD 14.44 billion by 2034. This growth is primarily driven by technological breakthroughs and commercialization of Radiopharmaceutical Drug Conjugates (RDC). The structure of RDC is similar to Antibody-Drug Conjugates (ADC), but their mechanism of action is entirely different. RDC utilizes targeting ligands to guide radionuclides (such as Lutetium-177 and Actinium-225) to precisely locate lesions, achieving "precise internal radiotherapy," rather than the cytotoxic killing seen with ADC.

Radiopharmaceuticals Market Size 2024-2034/

Image Source: Precedence Research

Among them, Novartis' two RDC drugs, Pluvicto and Lutathera, have become industry benchmarks. In 2024, Pluvicto, a PSMA-targeted prostate cancer therapy, achieved sales of $1.392 billion, a year-on-year increase of 42%, becoming the first "blockbuster" drug in the nuclear medicine field.

To consolidate Pluvicto's position, Novartis is expanding its indications. In March 2025, Pluvicto was approved for a new indication for the treatment of earlier-stage prostate cancer. According to Novartis' forecast at the 2025 JPM Conference, its peak sales are expected to exceed $5 billion. Meanwhile, Lutathera, another drug targeting SSTR for neuroendocrine tumors, generated $724 million in revenue in 2024, representing a 20% year-over-year increase. Together, the two drugs contributed $2.116 billion, validating the commercial potential of therapeutic radiopharmaceuticals.

In addition, the growth momentum of diagnostic nuclear medicines is also promising. In 2024, the combined sales of two PSMA-PET imaging agents, Plarify and Illuccix, reached $1.6 billion, increasing by 33% year-on-year. The reform of the U.S. medical insurance payment will further drive the market expansion of diagnostic nuclear medicines. According to Lantheus' prediction, the scale of PSMA PET diagnosis is expected to exceed $2.5 billion in 2025, and its market size is expected to surpass $3.5 billion by 2030.

2025

Forecast for the U.S. PSMA PET Diagnostic Market in 2030 / Image Source:

Lantheus

MNCs Rush to Enter the Market

With the commercial success of Novartis' Pluvicto and Lutathera, the nuclear medicine sector has become a new focal point in MNCs' strategic layouts. From 2024 to early 2025, giants such as Eli Lilly, BMS, and AstraZeneca have accelerated their deployments through high-premium acquisitions and strategic collaborations.

Lilly Becomes the Most Active Investor, Acquiring Point Biopharma for $1.4 Billion in October 2023 to Obtain Its PSMA-Targeted Therapy PNT2002; In 2024, It Established Collaborations with Aktis Oncology and Radionetics Oncology; In February 2025, It Expanded Cooperation with AdvanCell, Integrating the Latter's Leading Pb-212 Production Technology to Jointly Develop Targeted Alpha Radionuclide Therapies.

BMS Acquires RayzeBio for $4.1 Billion, Setting a Record High in the Nuclear Medicine Field, with the Core Asset Being the 225Ac-Targeted Drug RYZ101, Aiming to Challenge Novartis' Lutathera. On June 10, 2025, RayzeBio, a Wholly-Owned Subsidiary of BMS, Further Introduced OncoACP3, a Clinical-Stage Prostate Cancer Treatment and Diagnostic Drug, with a Potential Total Deal Value of $1.35 Billion, Demonstrating Its Ambition.

Main MNC

Summary of Nuclear Medicine Layout / Image Source: Ping An Securities Research Report

AstraZeneca Shifts from Experimentation to Full Commitment: In 2020, after partnering with Fusion Pharmaceuticals, AstraZeneca directly acquired the company for $2.4 billion in March 2024, gaining access to its FastClear linker technology platform and four radiopharmaceutical candidates under development, including the PSMA-targeted 225Ac therapy FPI-2265. In the same year, AstraZeneca also invested in the CDMO firm Nucleus RadioPharma to strengthen its industrial chain.

While consolidating its first-mover advantage, Novartis acquired Mariana Oncology, previously invested in by Eli Lilly, for $1.75 billion in May 2024, strengthening its radioligand therapy (RLT) pipeline and accelerating the advancement of next-generation drugs such as 225Ac PSMA617.

In recent years, Bayer has continued to expand its presence in the field of nuclear medicine. In 2021, Bayer acquired Noria Therapeutics and PSMA Therapeutics, broadening its pipeline of nuclear medicine products based on Ac-225. In May 2023, Bayer entered into a strategic collaboration with Bicycle Therapeutics to develop RDCs. By the end of 2024, Bayer’s pipeline included seven RDC projects in preclinical research and two RDC projects in early clinical development.

The commercialization journey in China has already begun.

In recent years, the nuclear medicine industry in China has also achieved substantial breakthroughs, transitioning from the research and development phase to the commercial value realization period.

From 2020 to early 2025, five new radiopharmaceuticals were approved in China, among which Grand Pharmaceutical's Yttrium [90Y] Microsphere Injection stood out the most, generating nearly HKD 500 million in revenue in 2024, representing a year-on-year increase of 140%. Subsequently, with the introduction and implementation of commercial insurance in 2025, Yttrium [90Y] Microsphere Injection is expected to see significant growth.

Moreover, 2025 will be a critical milestone for the commercialization of nuclear medicines in China. Among them, Andike's Sodium Fluoride [18F] was approved for marketing by the NMPA at the end of May. Meanwhile, Novartis' prostate cancer treatment drug Gallium [68Ga] Gozetotide and its companion diagnostic drug Lutetium [177Lu] Texiveptide received priority review from the CDE in November 2024 and are expected to gain dual approval in 2025. Notably, on June 10, 2025, Novartis also initiated a Phase III clinical study in China for its SSTR2-targeted radiopharmaceutical Lutathera in patients with advanced Grade 1 and Grade 2 Gastroenteropancreatic Neuroendocrine Tumors (GEP-NET).

At the same time, the R&D and pipeline layout of companies in China have also entered the harvest period. Grand Pharmaceutical's nuclear medicine anti-cancer diagnosis and treatment segment has already accumulated 12 innovative products, with 3 RDC products currently in Phase III clinical trials. Among these, the prostate cancer diagnostic drug TLX591-CDx is planned to submit a marketing application in 2025. Grand Pharmaceutical has also proposed the "self-developed nuclear medicine going global" strategy, aiming to submit one product application to the FDA annually starting from 2025, with the first product completing clinical trials and submitting an FDA marketing application between 2028 and 2029.

Grand Pharmaceutical Interventional Treatment and RDC Pipeline/

Source of the image: Grand Pharmaceutical 2024 Annual Report

Dongcheng Pharmaceutical Focuses on the Commercialization of Diagnostic Radiopharmaceuticals; Its Product Sodium Fluoride [18F] Was Approved for Marketing by the End of May 2025. Products Such as Technetium [99mTc]-GSA Are Expected to Submit New Drug Applications Within the Year; Among Therapeutic Radiopharmaceuticals, Its FAP-Targeted Drug 177Lu-LNC1004 Has Received FDA Fast Track Designation, Leading Globally in Progress.

Conclusion

As companies in and outside of China accelerate their strategic layout and commercial breakthroughs, nuclear medicine is set to引爆 the next hundred-billion-dollar blue ocean market. Precise "nuclear explosion," the future is already here!

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