Author: Guo Jinhui
According to the established timetable, all parts of my country have successively formulated and introduced new price policies for oral implants since September, and dental implants are about to usher in the era of centralized procurement and price reduction.
The centralized procurement of dental implants is one of the tasks of the National Medical Insurance Bureau in the second half of this year.
At the recent meeting on the centralized procurement of medicines organized by the state and the joint procurement meeting of drugs and consumables, Chen Jinfu, deputy director of the National Medical Insurance Bureau, will "accelerate the special treatment of charges for dental implant medical services and centralized procurement of dental implant consumables" and "actively promote the national organization The centralized procurement of orthopaedic spinal consumables and "promoting the unified continuation of the centralized procurement agreement for coronary stents in a timely and stable manner" are listed as the key points of the centralized procurement of medicines organized by the state.
Liao Zangyi, an associate professor at the School of Politics and Public Administration of China University of Political Science and Law, told Yicai that compared with the centralized procurement of medicines, the technical threshold for dental implants is still relatively high. In addition, the reform of "separation of technology and consumption" requires further highlighting the value of medical technology services. It makes it difficult to simply replicate the "quantity-for-price" model of medicines for the centralized collection of dental implants.
In the process of landing, how to attract the participation of private dental hospitals, which account for 80% of the market, is also a focus that deserves attention.
The private dental institutions interviewed by Yicai believe that the introduction of the national unified deployment and guidance policy has put forward higher requirements for the operating efficiency of dental service institutions.
Where is the difficulty in collecting dental implants?
Recently, the National Medical Insurance Bureau announced the "Notice on Carrying out Special Treatment of Oral Implantation Medical Service Charges and Consumables Prices" (hereinafter referred to as the "Notice"), which proposed to strengthen policy guidance on the price of oral medical services in public medical institutions and the price of oral implantation in private medical institutions. Supervision and guidance.
The National Medical Insurance Bureau believes that with the improvement of living standards and the deepening of the aging population, the demand for dental implants in my country has shown a continuous double-digit growth. one.
The main purpose of this reform is to reduce the high cost of dental implants, so that ordinary people who need dental implants have more opportunities to enjoy "affordable medical care".
Dental implants, as one of the restoration methods for missing teeth, can obtain restoration effects similar to natural teeth in function, structure and aesthetics, and are called "the third set of human teeth".
According to the "Fourth China Oral Health Epidemiological Survey Report", the proportion of patients with unrepaired missing teeth in the 35-44-year-old, 55-64-year-old, and 65-74-year-old groups were 18.6%, 38.9%, and 47.7%, respectively. The proportion of implanted dentures was only 0.2%, 0.1% and 0.3%.
Although the compound growth rate of my country's dental implant market from 2011 to 2020 is 48% and the market growth rate is 30%, the penetration rate of dental implants in my country is still far lower than that of Japan, South Korea, Europe and the United States, and the penetration rate is less than 0.1%.
High prices and insufficient affordability are the reasons for the low penetration rate of dental implants in my country.
Liao Zangyi believes that the current medical services such as implant placement and dental crown placement are purely self-funded projects, and the medical insurance fund does not pay. The dental implant-related services adopt an independent pricing method, which is regulated by the market, and lacks effective supervision and management by the medical insurance department. constraint.
Although there are more and more institutions in the dental implant market, patients usually choose familiar dental management institutions for a long time, so there are not many choices in this service, and it is still a state of insufficient competition.
And similar to other medical consumables models, dental implant-related consumables also adopt a high-priced and high-rebate model, which is prone to inflated prices and failure of market mechanisms.
The timetable for the centralized procurement of dental implants requires that from September to December, the project establishment guidelines for dental implant medical services will be successively issued, the bidding announcement for the centralized procurement of implants with quantity will be issued, and the bidding of dental implant crowns will be implemented. Publish the project and price policy of dental implant medical services.
Yicai learned from the local medical insurance bureau that the centralized procurement of dental implants has not yet been carried out at the prefecture and city level.
Dental implant collection is considered to be the "most difficult collection" in the industry.
Liao Zangyi believes that the technical threshold for dental implants is still relatively high, and the patient's experience of the quality of medical services is very obvious. The treatment of the same dental implant may have different effects in the hands of doctors of different levels. This is also not simple. Reasons for replicating the centralized drug collection model.
In addition, the biggest difference between dental implants and medicines is that the cost of materials and surgery are calculated separately. The national document also clarifies the implementation of "separation of technology and consumption", and the price of consumables will drop. Services such as restoration, implant repair and removal are allowed to reflect differences in the price of medical services, further highlighting the value of medical technical services, which is one of the reasons why it is difficult to promote the “quantity-for-price” of dental implant centralized procurement.
The "Notice" proposes that the price control target for the medical service part of a single conventional dental implant in a tertiary public hospital is set at 4,500 yuan, and regions or medical institutions that meet certain conditions are allowed to relax appropriately, and the rate of relaxation does not exceed 20%.
Xu Yucai, a medical management expert, told Yicai that one of the difficulties in the centralized procurement of dental implants is that dental implants are not included in the medical insurance, and the medical insurance control is not strong, which can only play a guiding role. , profit margins may be squeezed, and private dental institutions will develop better.
How to achieve "price reduction without quality reduction"
The "Notice" requires that various medical institutions at all levels be widely mobilized to participate.
In principle, the number of medical institutions (including private individuals) participating in this centralized procurement in each coordinating area should account for more than 40% of the medical institutions providing dental implant services, or the proportion of the total demand reported by the region to the total actual use in the previous year. more than 50%.
It also stipulates that a differentiated price policy should be implemented for public medical institutions that carry out dental implant services but refuse to report the volume or the reporting rate is less than 80% of the actual use in the previous year.
According to Liao Zangyi, the relevant data shows that by the end of 2019, among the 885 dental specialty hospitals in the country, 723 were private dental specialty hospitals, accounting for 81.69%.
The "Notice" also proposes to strengthen the supervision and guidance of oral implant prices in private medical institutions, but the policy of private medical institutions to implement market-adjusted prices remains unchanged, allowing independent adjustment of prices according to changes in cost supply and demand.
How to "cut prices without reducing quality" after centralized procurement is also a hot spot of public concern.
Liao Zangyi said that taking into account the effect of teeth "pulling one hair and moving the whole body", the siphon effect of large hospitals blessed by famous doctors may be more obvious.
In order to ensure that the price is not lowered, the supervision of medical institutions must be increased. Through patient satisfaction surveys, medical cost accounting, and excessive medical behavior supervision, medical institutions cannot take the opportunity to transfer revenue models and truly reduce the burden on patients. .
Chen Honghua, a member of the management committee of Taikang Insurance Group and CEO of Taikang Bybo Dental, said in an interview with the media that this policy has taken into account the people's demand for cheap and high-quality dental implants, and the economic level of different regions varies. , put forward the charging method of separation of technology and consumption, and unified and standardized the whole process of dental implant billing, which has a great role in promoting and guiding the standardized development of the dental industry.
Chen Honghua told Yicai that the policy presents both opportunities and challenges for dental institutions that run medical services in the society.
On the one hand, market competition requires all dental medical institutions to continuously reduce costs and improve efficiency; The introduction of commercial insurance and other payment methods will help promote the healthy development of the dental industry.