The price of coronary stent cuts by over 90%, the medical insurance bureau said it does not affect the quality
The Medical Insurance Bureau said that it will not affect the quality of the stent; data shows that this centralized procurement is expected to save 10.9 billion yuan; experts: the price reduction is mainly in the agent link
On the morning of November 5th, at the service center of the Science and Technology Business District in Chentang District, Tianjin, many representatives of pharmaceutical companies and media reporters crowded in front of a conference room, listening to the voices coming from inside through the cracks in the door, and people kept sighing, “It’s terrible Up."
What is going on here is the first national collection of coronary stents organized by the National Medical Insurance Administration (Note: Coronary stents are medical devices commonly used in interventional heart surgery, commonly known as "heart stents").
From the submission of quotations by medical device companies to the release of the list of the 10 lowest-priced products, in less than 2 hours, the average price of coronary stents went from about 13,000 yuan to about 700 yuan.
After the price announcement, netizens called it an unprecedented "Double Eleven Great Benefit".
According to data released by the Medical Insurance Bureau, based on the amount of intended purchases, the collective procurement is expected to save 10.9 billion yuan.
Regarding the doubts about whether the price cut will affect the quality of the product, many interviewed experts said that the price cut is mainly at the intermediate agent link, and the cost of the bracket itself is not high. Even if the price is reduced significantly, the manufacturer still has a profit.
The lowest declared price of 469 yuan, the medical insurance bureau said "exceeded expectations"
At around 8 o'clock in the morning on November 5, many business representatives have gathered in the lobby on the 3rd floor of the service center, ready to line up to submit application materials.
26 coronary stent products from 11 companies will jointly compete for 10 places.
According to the previously announced "National Organization for Centralized Purchasing Documents for Coronary Stents" (hereinafter referred to as procurement documents), the rules for winning the bid for the product are very simple, and the product meets the following two conditions to be shortlisted: the declared price ≤ 1.8 times the minimum product declared price ; The declared price>1.8 times the minimum product declared price, but less than 2,850 yuan.
"It's cheaper than anyone else." A representative of an enterprise involved in centralized procurement concluded.
At 9 o'clock, representatives of enterprises participating in the centralized procurement began to enter the venue.
At 10 o'clock, the deadline for submission of application materials, the application information will be announced in the venue.
Representatives of companies who failed to enter the venue listened to the sound from the speakers in the venue through the crack of the door.
Whenever a company's quotation is less than 800 yuan, a small wave of sighs will appear outside the market.
When he heard the quotation of more than 500 yuan in the venue, "it's over, it's over", a business representative shook his head.
On the afternoon of November 5, the state organized a joint procurement platform for medical consumables to release the results of the proposed selection, involving 10 products from 8 companies.
According to the information provided by the National Medical Security Administration, after this centralized procurement, the price of the stent dropped from an average price of about 13,000 yuan to about 700 yuan.
Compared with 2019, the average price of the same product of the same company has been reduced by 93%.
The information obtained on the spot showed that the declared prices of all the products to be selected were lower than 800 yuan, half of which were lower than 700 yuan, and the lowest price was only 469 yuan.
This quotation was also confirmed by invited experts on site.
The product with a price of only 469 yuan is the drug-coated stent system (rapamycin) of Shandong Jiwei Medical Products Co., Ltd.
This product occupies about 9% of the previous intended purchase volume, ranking top 4 among 26 participating products.
At present, the market share of alloy stents is relatively large, including Chinese companies Minimally Invasive Medical, Lepu Medical, Jiwei Medical, and foreign-funded companies Medtronic and Boston Scientific.
These manufacturers all have their products on the list of candidates.
"I thought that half of the products would be below 800 yuan, but I didn't expect them to be below 800 yuan." Jiang Changsong, an associate researcher of the National Academy of Medical Security who has been paying attention to price recruitment for a long time, said bluntly. He had never expected the price to be so low before.
"Frankly speaking, the results of today's centralized procurement exceeded our expectations. Originally, we expected it to be about five or six hundred yuan, but I didn't expect it to be more than 400."
Zhong Dongbo, Director of the Medical Price and Bidding and Purchasing Department of the National Medical Insurance Administration, said this at the post-collection communication meeting.
Central procurement of stents does not mean poor quality because of high demand and low price
On July 31, 2019, the State Council issued the "Reform Plan for Governance of High-Value Medical Consumables", which clearly requires the exploration of classified and centralized procurement of high-value medical consumables in accordance with the principles of quantity procurement, quantity-price linkage, and promotion of market competition.
The important reason why coronary stents have become the "first shot" in the reform of high-value medical consumables is the large demand.
According to statistics from the National Medical Insurance Administration, China's medical consumables market is 320 billion yuan, of which high-value medical consumables 150 billion yuan.
The total cost of coronary stents is about 15 billion yuan, accounting for one-tenth of the total cost of high-value medical consumables in the country.
Huo Yong, director of the Department of Cardiology and Heart Center of Peking University First Hospital, said that in the domestic interventional treatment of coronary stents, the cost of medical consumables including coronary stents accounted for more than 70% of the total treatment costs.
In addition to high market demand, product maturity is also one of the reasons that coronary stents are suitable for centralized procurement.
“Coronary stents are relatively standardized medical consumables. The coronary stents required by hospitals are not very differentiated and are more convenient for centralized procurement.” Li Tianquan, the founder of a medical platform, said in an interview with a reporter from the Beijing News on November 4.
Prior to the national centralized procurement of coronary stents, Jiangsu, Shanxi and other places have taken the lead in conducting centralized procurement trials, and the average price of selected products has fallen by more than 50%.
The reason why enterprises are willing to offer such a low price, in the words of Zhang Tiejun, deputy director of Tianjin Medical Insurance Bureau, is "market force."
According to the data provided by the Joint Purchasing Office, the first year's intended purchase of coronary stents in this centralized procurement reached 1.07 million, accounting for 65% of the purchase of coronary stents of various materials in 2019.
Such a high proportion of market share is a "cake" that no pharmaceutical company can ignore.
Zhong Dongbo, Director of the Pharmaceutical Price and Bidding Purchasing Department of the National Medical Insurance Bureau, said in an interview with CCTV that the core of the state’s active centralized procurement is the volume procurement mechanism. The quantity of pharmaceutical procurement is specified in a contract to ensure use, which is equivalent to a direct meeting between supply and demand. , To save all the intermediate sales costs, which is the main reason for the large price reduction.
The price cut is so strong that there are also doubts on the Internet, worrying that the low price will affect the quality of the bracket.
In this regard, Zhong Dongbo explained in response to reporters’ questions that the price cuts are mainly in the intermediate links. Manufacturers are still profitable and there is no incentive to reduce costs to make up for profits.
Hu Dayi, chief physician of the Department of Cardiology, Peking University People’s Hospital, also told the Beijing News reporter: “In fact, the cost of stents is very low. Some stents cost only two to three hundred yuan. The previous high price was due to the presence of many agents. "An industry insider who is unwilling to reveal his identity said that the company’s pricing strategy in this centralized procurement is to add an acceptable profit on the basis of cost, "it (referring to pharmaceutical companies) cannot lose money."
Zhong Dongbo said that the coronary stents selected in this centralized procurement have been used all over the country. After the centralized procurement is selected, the same manufacturers, products, and production lines are still available, and the quality is guaranteed.
"What are we afraid of? We are afraid of picking some cheap but not in line with mainstream products." Zhong Dongbo said frankly, but the procurement results show that the range of key products is very ideal.
“The cooperation between the selected quantity of products and the demand of medical institutions reached 73%.” said Zhang Tiejun, deputy director of the Tianjin Medical Insurance Bureau who participated in the recruitment process. This shows that the quality of the selected stent products has been tested by the market, which also reflects this. This collection fully respects the usage habits of medical institutions and the habits of patients.
For the quality of the selected products, the relevant departments will also strengthen supervision.
Zhang Tiejun said that in the production process of coronary stent companies, they must accept strict supervision and follow relevant quality standards and requirements. "The intensity of supervision will only be stronger than in the past and will not be weakened."
Challenges and opportunities coexist for patients and medical insurance funds benefiting companies
The price of coronary stents is greatly reduced, and the first benefit is the patient.
The materials provided by the Medical Insurance Bureau show that patients across the country are expected to use the selected products after the national centralized procurement price reduction in January 2021.
Zhong Dongbo said that this move is conducive to releasing the needs of patients and making it available to patients who cannot use the stent because of its high cost.
Medical insurance funds will also be saved.
According to previous calculations in Shanxi Province, which was used as a pilot, the cost of purchasing and using coronary stents can be saved by about 200 million yuan a year after centralized collection.
According to data released by the National Medical Insurance Bureau, in this centralized procurement, it is estimated that 10.9 billion yuan will be saved based on the amount of intended purchases.
Zhong Dongbo also mentioned that the centralized procurement of high-value consumables is also beneficial to hospitals and enterprises.
For hospitals, centralized procurement can create a clean environment for doctors.
The benefits to pharmaceutical companies are reflected in the reduction of sales costs and the high-quality development of the industry.
"The original industry ecology was based on rebates and cash sales, which did not reflect the quality of the product itself. Now we must make the ecology completely based on quality, innovation, etc."
However, some pharmaceutical companies are also worried that the sharp price cuts in centralized procurement will have an impact on companies.
A staff member of a medical consumables company told a reporter from the Beijing News that since this purchase has already accounted for more than 60% of the market share, if a company fails to be selected in the centralized procurement of its main products, it will suffer market share losses. Occupy, may face survival dilemma.
At the same time, centralized procurement of coronary stents may also provide new opportunities for some companies.
At the centralized procurement site, many medical device logistics company staff who are looking for new cooperation opportunities said that as the scope of centralized procurement expands, the profits of agents and distributors will be compressed, and logistics companies may be able to replace part of the work of agents. , Directly connect with device manufacturers and medical institutions.
When it comes to the doctor’s session, in some doctors’ eyes, the price reduction of the stent is a good thing for patients, but “doctors can also recommend higher-priced stents that are not in the medical insurance system, and this problem cannot be cured.” Hu Dayi said, “It’s still basically We must standardize medical behavior and guard the doctor’s conscience."
Huo Yong also said that in the next medical system reform, not only the high-value medical consumables or drug price system must be straightened out, but also the value of intermediate services in the medical system, such as the value of doctors' labor or technology.
"Reducing the price of consumables or medicines more reflects the value of knowledge and the labor value of medical staff."
Beijing News reporter Han Qinke Ma Yanjun