This paper discusses radioisotope pharmaceutical licensing and provides background information on the manufacturing process, supply chain, and how royalties are developed, using the radioisotope Molybdenum- 99, which decays into technetium-99m, as an example. Technetium-99m is the world's leading isotope for medical imaging. Radioisotope pharmaceutical licensing involves "stacked" royalties, with royalties going to the isotope manufacturer, isotope separation, monoclonal antibody licensee, and final sale to end users at the hospital level on the supply chain, with the majority of the costs being charged by the hospital. This paper provides a literature review on licensing fees for the production of other isotopes and our experience with an otherwise rare isotope, copper-67, which holds promise as a Non-Hodgkin Lymphoma therapy. While Tc-99m is a diagnostic isotope and Cu-67 is a therapeutic, the business models for both are based on government subsidized isotope production. Currently, many isotopes are produced using research-scale nuclear reactors; however, this manufacturing method entails a large capital cost. In addition, these research reactors are aging and have maintenance issues. New approaches to radioisotope production using particle accelerators, which are less capital intensive, appear to provide a more efficient and economical method of isotope production.