How can the price of artificial joints be reduced by over 80%?

  Recently, the National Medical Insurance Bureau organized a centralized procurement of artificial joints and produced the results of the proposed selection.

The average price of hip joints dropped from 35,000 yuan to about 7,000 yuan, and the average price of knee joints dropped from 32,000 yuan to about 5,000 yuan, with an average price reduction of 82%.

The centralized procurement of artificial joints is another heavy blow by the state to tackle the falsely high prices and chaotic circulation of high-value medical consumables after the centralized procurement of coronary stents.

The price reduction of artificial joints will greatly reduce the burden on patients and improve their quality of life.

Why can Central Procurement have such a substantial price cut?

When can ordinary people use the artificial joint after the price reduction?

The reporter interviewed experts on related issues.

Why the drop is big

  It is understood that artificial joint replacement is one of the effective methods to treat femoral head necrosis, joint damage, osteoarthritis and other diseases caused by trauma, sports injury, degeneration and aging.

With the advent of an aging society, a large number of patients with femoral head necrosis, osteoarthritis, and rheumatoid arthritis need to be replaced with artificial joints.

At present, the number of artificial joint replacements in my country is increasing at an average annual rate of 20%.

  Before the local centralized procurement, the average price of artificial hip joints and artificial knee joints was around 30,000 yuan, and the price of some products even exceeded 90,000 yuan.

However, due to the large number of circulation links, intermediaries increase prices at various levels, leading to falsely high prices for artificial joints.

In addition, the technical classification and combination of orthopedic consumables are complex, and the costs of disinfection and power tools are included in the product price, which is difficult to directly compete. It has long been a difficult point in centralized procurement.

  In accordance with the principle of "one product, one policy", this collection fully considers the clinical usage habits and characteristics of artificial joints, and quotes artificial hip joints and artificial knee joints in a system-based unit. For example, artificial hip joints consist of femoral stems and femoral heads. , Lining, acetabular cup, screw, artificial knee joint by femoral condyle, tibial spacer, tibial plateau, patella prosthesis.

"Using the system as a unit for quotation can prevent individual products from winning the bid for one accessory while the other accessory does not. This can avoid the situation of "pressing the gourd and lifting the scoop" and reducing the overall cost of patients." National Medical Security Administration medical prices and Ding Yilei, Director of the Department of Bidding and Procurement, introduced.

  In addition, under the same product system category, the participating companies are divided into two bidding groups, Group A and Group B.

Group A is a product with a large historical purchase volume, accounting for 85% of the intended purchase volume. There are no more than 10 Group A companies in each group. According to the selection rules, most Group A companies can be selected smoothly.

This means that companies with sufficient supply capacity and a large original market share enjoy certain advantages in this centralized procurement quotation.

The remaining companies are automatically assigned to Group B. Group B has a higher elimination rate, but it also generates many lower quotations.

At the same time, according to the characteristics of orthopedic products, the materials and whether they include accompanying services are distinguished, and the remaining amount beyond the agreed amount is more respect for the autonomy of medical institutions.

  "The results of this selection are basically in line with expectations." Ding Yilei said that through a comparative analysis of the relevant costs in the previous period, this centralized procurement has not only reduced the falsely high price of artificial joints, but also gave the company a certain amount of profit and development space, which can be said to be achieved. A balance in many aspects.

"The products selected in this collection are all commonly used clinical products, many of which are the leading products of manufacturers. my country's artificial joint replacement surgery is relatively mature. After the collection of artificial joints, the burden on patients will be greatly reduced." China-Japan Friendship Hospital Bone Introduction by Wang Weiguo, director of the joint department.

Is the quality guaranteed

  The scope of the purchase of products this time covers the initial replacement of artificial hip joints and the initial replacement of artificial knee joints. In the first year, the intended purchase amount was 540,000 sets, which accounted for 90% of the total demand of medical institutions nationwide.

Calculated on the basis of the purchase price in 2020, the purchase amount of artificial hip and knee joints in public medical institutions is about 20 billion yuan, accounting for more than 10% of the high-value medical consumables market, and it is expected to save 16 billion yuan.

  In the face of the huge market, the public is very concerned. Is the quality of the artificial joints collected by the central government guaranteed?

"The quality of artificial joint products that can enter the centralized procurement process has been tested and clinically tested by relevant departments. This is also a prerequisite for products to enter the market. Moreover, these products that enter the centralized procurement process are all requirements reported by medical institutions, indicating that they have been Clinical understanding and current use." According to Ying Yazhen, vice president of the National Academy of Medical Security, what has been reduced by the centralized procurement is the false high space. .

  "Previously, there was no quantity in procurement. Although we won the bid, there were still barriers to entry into the hospital, which led to the alienation of procurement and service behavior. The centralized procurement and service behavior of the national organization clarified the huge amount of national consumption, and the successful bid can be sold, so that the company has expectations. The entire process of centralized procurement follows fair and open bidding procurement, which in fact achieves sufficient market competition, helps to improve the industry's ecology, and forces the industry to standardize development.” explained Wu Ming, assistant director of Peking University's medical department.

  Different from coronary stents, this centralized procurement includes 4 categories of ceramic-ceramic hip joint products, ceramic-polyethylene hip joint products, alloy-polyethylene hip joint products, and knee joint products. A total of 5804 medical institutions reported Based on the demand brand of artificial hip and knee joints and the demand in the next year, the centralized procurement "national team" collects the information based on the information reported by medical institutions, and respects the usage habits of clinicians to the utmost extent.

When can I use it

  According to industry insiders, in this centralized procurement of artificial joints, domestic and foreign companies have all proposed products, and the selection rate of companies reached 92%. Among them, there are both commonly used companies in medical institutions and emerging companies.

"From the results of the selection, the matching degree between the selected products and the needs of medical institutions exceeds 80%." Ding Yilei said that quite a number of selected products can be seamlessly connected to medical institutions without any switching, ensuring the continuation of clinical use. sex.

It is understood that it is expected that from March to April 2022, patients will be able to use the artificial joint collection products after the price has been reduced.

  “In order to ensure the supply of enterprises, we conduct research on the production capacity and product flow of enterprises in advance.” Gao Xue, leader of the centralized procurement group of the joint procurement of high-value medical consumables organized by the state, introduced. The company’s delivery status, the operating company’s inventory status, and the use of medical institutions are supervised to ensure product quality and supply.

In addition, the National Medical Insurance Administration is formulating relevant safeguard measures for the implementation of subsequent purchases, including a policy to retain surpluses, and use a part of the medical insurance funds saved in centralized procurement to incentivize medical institutions.

  "The purpose of centralized procurement is to promote the return of medical consumables to a reasonable price range, and at the same time straighten out the price of medical services." Wang Weiguo said that after the implementation of centralized procurement, the labor value of doctors needs to be reflected in the reform. Take joint replacement as an example, at least Two anesthesiologists, three to four surgeons, one instrument nurse, and one traveling nurse are needed. The labor value of these personnel should be reasonably reflected.

"Doctors look forward to having a sunny and decent income, and gaining people's respect through knowledge and technology. The price reduction of centralized procurement will not only reduce the burden on the people, but also win room for reforms in the price of medical services. Various reform measures will boost these goals. accomplish."

  Reporter Wu Jiajia