With the Spring Festival approaching, the dental implant market has ushered in a small peak.
Ms. Zhang's father is 63 years old this year and has been wearing removable dentures for five or six years. It has always been the wish of the father and daughter to plant a high-quality tooth for her father.
"I checked the information at that time, I remember that the whole mouth implants were based on different materials, 300,000 to 400,000, and they gave up. If hundreds of thousands of (implants) can be collected through the collection of tens of thousands, I think it can be done.", Zhang The lady told Shell Finance reporters.
The "300,000 to 400,000" that Ms. Zhang said was not an exaggeration.
Wang Huan (pseudonym), president of a private dental hospital in Beijing, told reporters that there are many ways to repair teeth, and the price of dental implants is mainly related to the brand. If it is more than 10,000 yuan, this is not to say that it is very good, and there is still money for a very good (dental implant) Mercedes-Benz."
On January 10, the executive meeting of the State Council decided to carry out the centralized and bulk procurement of drugs and high-value medical consumables in a normalized and institutionalized manner to further reduce the medical burden on patients.
It is mentioned that it is necessary to gradually expand the coverage of centralized procurement of high-value medical consumables, and conduct centralized procurement at the national and provincial levels for orthopedic consumables, drug balloons, and dental implants that are of concern to the public.
In the medical device market, the high price of dental implants has been discussed, and the initiative to reduce prices through centralized procurement has also been proposed for a long time.
Shell Finance reporters found that Sichuan, Ningbo and other places have started the centralized procurement of dental implants.
Behind the centralized procurement of dental implants is the further normalization of centralized procurement.
According to the news released by Shanghai Sunshine Pharmaceutical Purchasing Network on January 6, the first-year agreement procurement volume of insulin special centralized procurement has been determined, and the results of the selection of insulin special centralized procurement will be implemented in May 2022.
【High price】
Imported dental implant products almost monopolize the market behind the huge profits
On January 27th, near the Spring Festival, in the Weier Dental Clinic in Beijing, there are also various gifts for year-end customers to thank: refrigerators, electric cars, sweeping robots... There are also dental implants during the Spring Festival in the hall. Event advertisement: "Imported dental implants will get one free, first come, first served."
Like Vail Dental, putting "imported dental implants" in advertisements is actually a common operation in the industry.
People who are not familiar with the dental implant consumer market do not know that my country's dental implant market has been monopolized by imported products for a long time, and domestic implants are rarely used.
At present, the popular dental implant products on the market are mainly from South Korea, the United States, Switzerland and Sweden.
On January 28, the staff of Beijing Stomatological Hospital said that the price of dental implants in the hospital is between 15,000 and 20,000 yuan each, mainly using brands from the United States, Switzerland and Sweden, including implants, crowns and other costs. , there is no medical insurance reimbursement, "A full mouth of planting costs almost a car, more than 200,000 yuan."
Huge Oral Prospectus mentioned that "my country's oral medical device industry has developed relatively late, and the overall development level is still behind developed countries", "Currently, the dental materials in the domestic market, especially the high-end precision dental materials, are at a considerable level. China still relies on imports, among which: implant imports account for 90%; orthodontic products account for 70%; high-end equipment intraoral scanners and CBCT are basically monopolized by foreign companies.”
"There are actually a lot of domestic products, but many people can't accept domestic products. They always feel that domestic implants are not good. There are very few domestic implants used in hospitals." Dental brands represent different price points.
Regardless of the surgeon's technique, implants of the same brand have almost the same effect.
"(A dental implant) costs more than 5,000, 7,000, 8,000, and more expensive ones. Aototai, Haosheng, and Yading belong to the middle and high-end. Straumann is high-end, and the price is 10,980 yuan. One, including the price of implants and crowns, is included. Generally, a regular one is made for a mouthful of teeth. For example, the price of Haosheng in the United States is about 100,000 to 120,000.”
The president of the stomatological hospital told reporters that in the dental implant market, the "one price" charging rule is basically implemented, that is, a tooth is implanted and charged according to a unified pricing method, including all costs such as implants, crowns, and surgery fees. , there will be no other charges. "If you count the crown bill, the implant bill, and the surgery bill, your costs will be much higher.
"
Wang Huan, the director of another dental hospital, told Shell Finance reporter that the price difference between consumers’ psychological price and what brand they choose will be more obvious. Now, this is not to say that it is particularly good, especially good (dental implants) a Mercedes-Benz still has money”, “Just like BMW has one series and seven series, the configuration of dental implants is different, and it is combined with bones. The degree of implantation is different. The technology of dental implants is becoming more and more mature, especially the implantation of single teeth can be done in many places, but the implantation of full mouth teeth is also best done by experts.”
According to the report on the dental implant industry released by Guohai Securities in July 2021, Odentate predicts that my country's domestic implantation market in 2019 will be as follows: South Korea's Odentate has the highest market share of 33%, the second is Denteng 25%, and the market share is 25%. The third is the Swiss brand Straumann with 22%, the fourth is the American Danaher with 10%, and the fifth is Dentsply Sirona with 8%.
On a group buying platform, a reporter from Shell Finance searched for "Swiss dental implants" and found that the prices after the event were all above 10,000 yuan per piece, and prices of 16,800 yuan and 18,800 yuan were very common.
【Link】
Thousands of yuan are purchased into China, and consumers spend tens of thousands of yuan to plant. Where is the price in the middle?
How is the high price of dental implants formed?
Shell Finance reporters found that in the implant market, due to the large proportion of domestically imported implants, the cost of sales in the cost of consumables far exceeds the cost of raw materials.
A reporter from Shell Finance searched on a group buying platform. The price of "Astra dental implants" after the event in a dental clinic in Beijing was priced at 18,000 yuan per piece, including the cost of implants, abutments, crowns, oral examinations, and scheme design. and other expenses.
The dental clinic staff told reporters that each person can only enjoy this price twice. If it is a third implant, the fee is 25,000 yuan.
What is the cost of imported implants that cost 18,000 to 25,000 yuan to consumers?
Let's look at the production side first.
Dentsply is a world-renowned supplier of dental materials and equipment. Astra®TX and Astra®EV-S implant series are products of Dentsply.
According to Dentsply's 2020 financial report, the company's gross profit from sales accounted for 49.6% of net sales, compared with 53.7% in 2019.
In the Chinese market, Dentsply has many cooperative distributors, and Jiahong Dental is one of them.
According to the prospectus disclosed by Jiahong Dental in June 2021, Jiahong Dental is mainly engaged in the research and development, production and sales of fixed dentures, removable dentures and orthodontic products, as well as the operation and sales of prosthodontic medical device products.
In 2018, Jiahong Dental established a cooperative relationship with Dentsply, a world-renowned manufacturer of implant products. Dentsply authorized Jiahong Dental to sell Astra®TX and Astra®EV-S implant series in public hospitals and private markets in some cities in Guangdong Province Products (except for national dental chain institutions).
According to the prospectus of Jiahong Dental, the average price of implants purchased by the company in 2020 is 1469.3 yuan/piece.
The prices of the abutments, other accessories and tools included in the implant accessories are 651.38 yuan/piece, 212.8 yuan/piece, and 6.57 yuan/piece respectively.
During the agency process of Jiahong Oral, Dentsply will also make corresponding rebates according to the sales volume, and the rebate amount in 2020 will reach 4.3198 million yuan.
After purchasing the above implant products, Jiahong Dental will sell them directly without any processing.
In 2020, Jiahong Dental will sell planting products to Shenzhen People's Hospital, Southern Medical University Stomatological Hospital (Guangdong Stomatological Hospital), and Sun Yat-Sen University Affiliated Stomatological Hospital. Yuan/piece.
In 2019 and 2020, the gross profit margins of Jiahong Oral's sales of implant products were 32.59% and 30.77%, respectively.
Distributors take 30% of the gross profit margin and then sell them to the dental hospital, and the final price of dental implants will increase again according to the diagnosis and treatment services.
"The cost of dental implants accounts for a very small part of the entire cost. For example, it costs 5,000 yuan to implant a tooth, and the cost of materials does not account for a high proportion of it. After you want to get dental implants, how many people will you have to serve this? things," the president of a dental hospital in Beijing told Shell Finance reporters.
According to the public transfer statement of Huato Dental, the company's gross profit margins for prosthodontics, dental diagnosis and treatment, dental implants, and orthodontics in 2017 were 50.07%, 44.85%, 59.62%, 60.10%, and 49.66%, respectively.
In the overall cost structure of Huato Dental in this year, the largest proportion is labor compensation, followed by rent and depreciation, and the third is material cost.
In 2017 and 2018, the material cost of Huato Dental was 8.06 million yuan and 13.79 million yuan respectively, accounting for 22.89% and 25.16% of the total cost, respectively.
Huge Dental clearly stated in the prospectus that "there are many segments in the oral medical market, among which implantation and orthodontics are typical high-value projects."
As a large-scale oral medical group in China, Tongce Medical's main business consists of pediatric medical services, orthodontic medical services, and implant medical services.
In 2020, the gross profit margin of Tongce Medical's medical services reached 45.78%.
Another dental implant company, Dr. Dental, which accounts for over 40% of its revenue, achieved gross profit margins of 53.3% and 62.1% for dental implant services and orthodontic services, respectively, in the first half of 2020.
Guohai Securities believes that the dental implant industry chain spans a large span, and the downstream hospital costs account for a large proportion. "Traditionally, 25% of the costs paid for dental implants are medical fees, 75% are consumables, and 16% are repair materials. 59% is the dental implant system", "more money paid by consumers flows into the dental hospital, which is used to pay the doctor's fee, marketing expenses, purchase of medical equipment, and the profit of the dental hospital, etc."
【collection】
Ningbo and Sichuan are the first to attack. How much room is there to reduce the price of dental implants after centralized procurement?
The executive meeting of the State Council on January 10, 2022 will continue to release the signal to expand centralized procurement.
The meeting pointed out, "In recent years, the reform of centralized procurement of medicines and high-value medical consumables has continued to advance, and the market-oriented mechanism has effectively suppressed the inflated prices of medicines. As of the end of last year, a total of 260 billion yuan in medical insurance and patient expenditures have been saved."
In fact, in 2021, the deputies to the National People's Congress proposed to the National Medical Insurance Bureau to "regulate the cost of dental implant materials and include their treatment and service costs into medical insurance".
At that time, the National Medical Insurance Bureau replied, "It will standardize the price items of oral medical services, and integrate the items that are divided too much and too finely." Water out. Promote the construction and implementation of the credit evaluation system for pharmaceutical prices and recruitment, and include medical commercial bribery cases such as rebates involving implants into the scope of credit evaluation, and take restrictive measures.”
In fact, Ningbo and Sichuan in my country have already started the payment of dental implant medical insurance and the price reduction of centralized procurement.
According to the official website of Ningbo Medical Insurance Bureau, in August 2021, Ningbo City held a symposium with 5 suppliers of imported dental implants. The negotiation plan, most of the suppliers present agreed."
Then in November 2021, Sichuan Province issued a document to carry out the information declaration of oral implants, prosthetic abutments, implant prosthetic accessories and other products.
Such a determination to collect and purchase has made consumers have more expectations for centralized purchases.
Ms. Zhang told the Shell Finance reporter that she was already planning to inoculate her father with dental implants in the future. "If I can really get tens of thousands, I will decide to do it for him."
So, how much can centralized procurement reduce the price of dental implants?
On January 18, a staff member of Sichuan Stomatological Hospital told reporters that the hospital has not yet received the latest policy notice on the centralized procurement of dental implants, and the price reduction of dental implant centralized procurement has not yet landed in Sichuan. "We are also waiting for news from Ningbo."
The reporter then learned about the centralized procurement of dental implants in Ningbo and found that some areas in the local area have implemented dental implant medical insurance reimbursement.
According to the work progress disclosed by the Xiangshan County People's Government of Ningbo City on January 11, 2022, the medical insurance dental implant project initiated by designated medical institutions and fully supported by the medical insurance department will be piloted in the whole Ningbo city, and there are 23 designated medical institutions in Xiangshan County. Actively sign up to participate.
"Medical institutions participating in medical insurance dental implants implement overall package charges for the brand dental implants in the catalog, that is, according to the level of medical institutions, they are classified into three grades: second-level and below, third-B, and third-class, and domestic brands are 3,000 yuan, 3,200 yuan, and 3,400 yuan. Imported brands are 3,500 yuan, 3,700 yuan, and 3,900 yuan. The contracted medical institutions charge uniformly according to the above standards.”
In Cixi City, Ningbo, the policy of "affordable dental implants" has also been promoted.
On December 31, 2021, Cixi City Government released government affairs updates, saying that Cixi City took the lead in promoting the smooth implementation of affordable "dental implants" projects, reducing the average price of "implanted teeth" from about 8,500 yuan per piece to about 3,500 yuan per piece, and the price was reduced. 60%.
"Up to now, 5 private medical institutions in our city have implemented affordable dental implant projects, and the first batch of 330 implants have been purchased, which can reduce the cost of 1.65 million yuan for patients. It is currently the first in Ningbo."
【Compensation price based on quantity】
160 billion dental implant market, what is the future?
The normalization of centralized procurement will also have a great impact on the dental implant industry. Jiahong Dental once stated in the prospectus that in the long run, the field of medical consumables will fully implement the procurement policy with volume to achieve the integration of recruitment and procurement, volume and price. hook up.
Jiahong Mouth said that in terms of the distribution business of implant products, if the future oral consumables field refers to the requirements of the procurement documents for medical consumables such as cardiovascular interventional, ophthalmic intraocular lenses, and orthopaedic artificial joints that have been issued, the procurement will be carried out with volume. The applicant should be Dentsply or its national general agent (if any), and the company's sales of plant products to public hospitals will be affected to a certain extent, resulting in a decline in operating performance.
Such concerns are due to the price reduction efforts of previous centralized procurement.
It was announced at the National Medical Security Work Conference on January 14 that the average price of artificial hip and knee joint procurement products was reduced by 82%, which is expected to benefit nearly 11 million patients and reduce the burden by nearly 30 billion yuan each year.
The data shows that at present, the national-level centralized procurement of medicinal equipment has reached the sixth round, that is, the special centralized procurement of insulin.
In 2021, the average price of 42 special insulin products for centralized procurement will be reduced by 48%, the highest price of insulin that has won the bid will be reduced by 74%, and the lowest price of pre-mixed human insulin will be reduced to 17.89 yuan/piece.
The first five batches of national centralized procurement of drugs and coronary stents saved nearly 170 billion yuan in drug costs throughout the year.
The Shell Finance reporter noticed that at the executive meeting of the State Council on January 10, it was also required to "focus on chronic diseases and common diseases, and continue to promote the centralized drug procurement at the national level", "before the end of this year, the national and provincial centralized drug procurement will be carried out at the national and provincial levels. Each province has a total of more than 350."
For the domestic dental implant track, behind the centralized procurement is a huge dental implant market.
According to a research report by Guohai Securities, the number of dental implants per 10,000 people in my country will be 28 in 2020, compared with 632 per 10,000 people in South Korea, a 21-fold gap.
According to the penetration rate of 200 per 10,000 people in developed countries, and the price is calculated at the current 50%, the market space for dental implants in my country can reach 106 billion yuan, and the rapid growth of the dental implant track in the next ten years is highly certain.
Caixin Securities also said, "Overall, the treatment rate of oral diseases in my country is relatively low. If implants and other related oral consumables are included in the centralized procurement, it is expected to promote the treatment rate of dental caries, the penetration rate of orthodontics, and the penetration rate of implants." .
It is worth mentioning that the reporter of Shell Finance found that my country's domestic oral implant products are constantly enriched.
On January 30, the reporter searched the domestic medical device product records and found that there were 22 records of related "implants", including Beijing Daqing Xige Technology Co., Ltd., Hebei Xinhua Dental Technology Co., Ltd. and other companies that applied for registration.
In addition, domestic enterprises have also made new progress in implant research and development.
According to the statistics of Shell Finance reporter, the research projects of Dabo Medical, Maipu Medical, Kangtuo Medical, Chujiang New Materials and other companies all include implant research and development.
In the 2020 announcement, Dabo Medical introduced that the company has raised funds of 365 million yuan for the construction of oral implant production projects.
Maipu Medical's research and development in the department of stomatology includes the "PEEK-HA dental implant" project.
Beijing News Shell Finance reporter Li Yunqi