Export controls on gadolinium have lifted global prices and squeezed gadolinium oxide supply for gadolinium-based contrast agents (GBCAs) used in magnetic resonance imaging (MRI).
Atlantic gadolinium prices have risen sharply since the start of 2026, driven by extremely tight supply and strong demand from end markets including defence and medicine. Argus assessed 99.99-99.999pc gadolinium oxide prices at $2,500-3,000/kg cif Europe on 8 October, up by 708pc from $250-430/kg on 1 January.
Gadolinium stocks in the west have fallen sharply since export controls on gadolinium and six other heavy rare earths were introduced on 4 April 2025.
Some gadolinium has continued to flow to the west for non-military purposes under export licences. Export licences have been granted to many medical companies for a variety of controlled materials.
But even licensed gadolinium exports have fallen in recent months, Argus has heard, which has pressured medical companies seeking secure GBCA supplies.
The supply squeeze has placed the four main western GBCA producers — Bayer, Guerbet, Bracco and GE HealthCare — in an unprecedented position.
Gadolinium crucial for diagnostic medicine
GBCAs have been essential to diagnostic imaging since the first agent was approved in 1988. During an MRI, a patient is injected with a GBCA to provide contrast that makes small abnormalities visible. Contrast-enhanced MRIs are essential for cancer treatment, vascular imaging and cardiac MRIs.
Contrast is not necessary for some diagnostic MRIs, but there is no widely available alternative for certain conditions such as brain cancer. More than 60mn doses of gadolinium contrast agents were administered worldwide in 2024, and more than 900mn have been delivered globally since 1988.
Historically, the medical industry has been able to obtain rare earths material with comparative ease, even immediately after the introduction of export controls last year. But the tightening squeeze on exports is now starting to impact pharmaceutical groups.
"Our company is actively monitoring the situation and implementing mitigation measures to minimise the impact on customers as much as possible," a Bayer representative told Argus.
Bayer said supplies of Gadavist (gadobutrol), the company's main contrast offering, remain unaffected. When asked whether Bayer expects to meet demand for Gadavist over the next 12 months if current feedstock supply conditions persist, the representative declined to comment further.
A second GBCA producer confirmed that it is exploring alternative sources of gadolinium outside China.
Pharmaceutical companies enter western spot market
With Chinese supply no longer sufficient to meet demand, several major GBCA producers have entered the western spot market for gadolinium oxide, multiple sellers told Argus. But gadolinium oxide supply outside China is insufficient to meet pharmaceutical demand.
The ex-China gadolinium spot market is relatively illiquid because of tight supply. Many traders see only upside after the dramatic price surge since April 2025 and are unwilling to release material at current prices.
The medical industry must compete with deep-pocketed defence buyers for the limited amount of gadolinium currently available in the west. Gadolinium is also used in military and nuclear applications.
"The shortage is not medical-specific. Larger trading companies are asking for it, and we see a shortage all around," a trader told Argus.
Medical companies have long been aware of gadolinium supply vulnerabilities and are pursuing alternatives. GE HealthCare, for example, is in the clinical trial phase of research into a manganese-based alternative to GBCAs.
GE HealthCare identified supply security as one of the benefits of a manganese contrast agent. "As a rare-earth element, gadolinium supply is largely dependent on mining and processing infrastructure in China. Manganese, however, is abundantly available from multiple countries, including South Africa, Australia and Gabon, reducing the risk of supply challenges impacting patient care," the company said in an April statement announcing the start of the clinical trial.
Advances that reduce the amount of gadolinium needed per dose are already offering some potential relief. On 15 June, the US Food and Drug Administration (FDA) approved Bayer's Ambelvist (gadoquatrane), a contrast agent that Bayer described as the lowest-dose macrocyclic GBCA in the US.
In the near term, there is no indication that export controls on gadolinium will be loosened. But the western spot market cannot supply enough gadolinium to meet medical demand. If gadolinium exports to the western medical sector do not rise, GBCA costs may skyrocket and patients may face a shortage of a critical, life-saving diagnostic tool.
