"A mouthful of teeth is equal to a BMW" used to be a metaphor for "growing teeth is expensive", and it may become history in the future.
On January 10, the executive meeting of the State Council proposed the decision to normalize and institutionalize the centralized procurement of medicines and high-value medical consumables in bulk to further reduce the medical burden on patients.
Dental implants, which have been criticized as "can't afford to plant", are clearly going to be collected at the national and provincial levels.
One stone stirred up a thousand waves. For the dental implant market, which has been occupied by imported brands for a long time, can centralized procurement bring opportunities for domestic brands to nugget the 100 billion market?
How much will the price of dental implant collection be reduced?
"When will I start the centralized collection of dental implants, and how much can I reduce?" Ms. Shao, who is over 40 years old, was very excited to hear the news of the centralized collection of dental implants. She needed dental implants because of missing teeth, but the result of the inquiry in the public hospital was 1.5 10,000 yuan a piece, which also means that it will cost her nearly three months of salary to plant two teeth.
Compared with orthodontics, which is close to medical aesthetics, dental implants have stronger medical attributes and have been criticized for being expensive.
At the beginning of 2021, Li Xiaoli, a representative of the National People's Congress, submitted a proposal to the two sessions based on her personal dental implant experience: the average cost of a dental implant treatment in a hospital below the county level ranges from 6,000 to 20,000 yuan. Buying a suite in the county”, it is recommended that the cost of dental implant treatment and services be included in the overall reimbursement of medical insurance.
The National Medical Insurance Bureau stated in its reply in September 2021 that according to the current national centralized procurement plan, only medicines and consumables covered by medical insurance are eligible to be included in the centralized procurement.
At present, in all provinces, autonomous regions and municipalities, glasses, dentures, artificial eyes and other appliances are not included in the scope of basic medical insurance payment.
However, each locality can formulate the province's medical insurance consumables and diagnosis and treatment catalogs according to the operation of the medical insurance fund in the region, and guide the localities to include the implants in the scope of the platform.
On January 10, 2022, the executive meeting of the State Council proposed the decision to normalize and institutionalize the centralized procurement of medicines and high-value medical consumables in bulk to further reduce the medical burden on patients.
It clearly mentioned that "the coverage of centralized procurement of high-value medical consumables will be gradually expanded, and the centralized procurement of orthopedic consumables, drug balloons, and dental implants that are of concern to the public will be carried out at the national and provincial levels."
Dental implants will be included in centralized procurement, how much will the price be reduced?
Some market analysts believe that with reference to the data of national centralized procurement of high-value medical consumables in recent years, the price of cardiac stents will drop from 13,000 yuan to 700 yuan in 2020, a drop of more than 90%. In 2021, the artificial joint will also drop by more than 80% after centralized procurement. After the teeth are included in the centralized procurement, the price reduction is expected to reach about 70%-80%.
However, some people in the industry believe that even if dental implants are included in centralized procurement, the price reduction experienced by patients may not be as good as expected.
It is reported that the materials of dental implants mainly include implants, abutments, and crowns, as well as bone meal, periosteum and other repair consumables that some patients need to use.
Ou Yao, Chairman of the Supervisory Board of Guangdong Stomatological Association and Chairman of Guangdong Private Dental Association, introduced that after decades of development, dental implants, whether imported or domestic, are basically homogenized, and the prices of dental implant consumables are relatively transparent. The difference mainly lies in the brand, supporting and after-sales service.
The biggest cost of dental implants is actually the labor cost.
"The labor cost accounts for about 2/3 of the overall medical expenses for dental implants." Ou Yao pointed out that this also means that if the purchase price of the material itself is 3,000 yuan, then the overall treatment cost will be about 9,000 yuan.
"A patient needs to have a team of doctors, nurses, assistants and other teams to serve 3-5 times. It takes 10-15 years for a skilled implant doctor to mature. This cost is already high."
Ou Yao pointed out in particular that some private dental clinics currently use the price of dental implants as marketing advertisements to attract customers with gimmicks such as "free dental implants" and "subsidies". not cheap.
Domestic dental implants usher in the benefits?
According to the data of the "2020 China Oral Medical Industry Report", the number of dental implants in my country in 2020 will be about 4.06 million, which is one of the fastest growing dental implant markets in the world. The scale of my country's dental implant market is nearly 160 billion yuan.
According to China's population base and aging development level, it is conservatively estimated that China's dental implant market has a growth potential of more than 10 times.
At present, the domestic dental implant market is dominated by imported brands.
The research report of Guohai Securities shows that the positioning of domestic implants is similar to that of Korean brands, but it started late, and the current market share is expected to be 7%.
There have long been rumors about the inclusion of dental implants in the centralized procurement market.
In August 2021, Ningbo City, Zhejiang Province issued the "Plan for Further Clarification of Medical Insurance Accounts for Payment of Dental Implant Projects" (draft for comments), which mentioned that the overall medical insurance payment standard for dental implant projects was planned to be adjusted, which led to concerns that dental implants will enter the collection. Picking discussion.
On November 17, 2021, the Sichuan Provincial Pharmacy Bidding and Purchasing Service Center issued the "Notice on Carrying out the Information Collection of Some High-value Oral Medical Consumables".
Since then, Zhejiang, Ningxia and other places have also issued similar notices to carry out the filling and reporting of historical procurement data of dental consumables.
“纳入集采对国产种植牙品牌来说肯定是利好。”欧尧认为，目前公立医院种植牙仍以进口品牌为主，国产种植牙集采后如果能在公立医院率先推开使用，将有利于种植牙材料加速国产化。
欧尧指出，目前国产种植牙行业地位尴尬，前有成熟的欧美系进口高端品牌基本垄断市场，后有韩系低端进口品牌低价争抢生存空间。“目前国产种植牙品牌至少有十几个，但一直难以打破市场格局。”
珠海乔丹科技股份有限公司董事长乔栒柏则认为，已经占据市场绝大份额的进口品牌参与集采的意愿或许不大，韩系种植体和国产品牌更有希望通过集采实现开拓市场。但纯粹模仿国外技术的国产品牌并不具备市场竞争力，国产种植体要实现“弯道超车”，必须在技术上实现创新，才能在市场上争得一席之地。
1952年，瑞典的Branemark教授发现了纯钛材料的骨整合现象，并将其用于制作种植牙根，成为现代口腔种植学的奠基人。发展至今，种植牙的技术已经相当成熟。乔栒柏指出，占据行业95%市场的进口种植体，在国际上应用多年，最早也是为欧洲人口腔而设。国产品牌如果在加工精度、操作技能、生产技术等方面没有创新，即便参与集采，也很难赢得市场。
口腔医疗市场面临挑战
以往的集中带量采购，主要市场在公立医院，医保成为带量的指挥棒，但对于竞争充分的口腔医疗市场，集采后是否纳入医保，谁来实现带量，医生的技术和服务价值如何体现，都成为口腔医疗行业必须面对的挑战。
口腔医疗市场竞争充分，无论是机构数量还是服务总量，民营均远高于公立医疗机构。欧尧介绍，以广东为例，注册口腔医生2.1万，其中有1.6万—1.7万在民营口腔医疗机构。全省民营口腔医疗机构有八九千家，占总数的70—80%，其中深圳的民营口腔医疗更是占比高达80—90%。
Lin Jianping, vice president of Dasuihua Oral Medical Group, believes that 80% of high-value medical materials in oral medical care rely on imports, which is a very unhealthy phenomenon.
The implementation of centralized procurement of dental implants is a weather vane for the rise of domestic products, and it is also a watershed for the localization of imported brands.
For patients, it is expected to receive affordable and high-quality medical services, but at the same time, how to better reflect the medical value and realize the public medical and private medical services to meet the needs of different oral consumer groups at different levels is a medical institution after the implementation of dental implant centralized procurement. challenges to be faced.
"For private dental medical institutions, it may not have much impact in the short term, but in the long run, medical added value and services must be improved, otherwise the income of medical talents and the income of medical institutions will be greatly affected."
"If public hospitals are allowed to carry the capacity, it means that the workload of doctors will be greatly increased, and it may also bring challenges to the quality of medical services." Qiao Lubai, who is also a dentist, pointed out.
Lin Jianping also pointed out that the average price of dental implants in private oral medical care has been lower than that of public medical institutions in recent years, so the first stage of centralized procurement may be implemented in public hospitals, which may further promote the self-employment of public medical dental doctors or move to private hospitals. Medical institutions.
"Even if dental implants after centralized procurement are included in medical insurance, the reimbursement ratio should not be too large, otherwise medical insurance will be unbearable as a whole," Lin Jianping also pointed out that the healthy development of the oral medical industry requires the mature promotion of oral commercial insurance, and cannot rely solely on medical insurance. support.
It is reported that the National Medical Insurance Bureau also mentioned in its previous reply to the suggestion of the deputies to the National People's Congress that commercial insurance companies are encouraged to strengthen cooperation with dental consumables manufacturers and medical institutions to research and formulate dental specialty insurance projects that meet market demand.