Growing a tooth is equivalent to buying a BMW, how difficult is it to "grow teeth freely"?

Text/Yu Yuan

"Don't look at the teeth, the toothache; after reading the teeth, it hurts."

Dental implants are known as the third pair of human teeth, patients have better chewing effects, and at the same time have a higher service life, so they are highly anticipated by patients who are willing to implant. According to the "In-depth Report on the Implant Industry", 4 million new dental implants will be added to the mainland in 2020.

But at the same time, because oral consumables are not covered by medical insurance reimbursement, the high price of implants is also daunting. Someone once calculated an account, people's teeth generally have 28 to 32, if you choose to do dental implants, at a price of 12,000 yuan a calculation, then the cost of a tooth is more than 300,000 yuan, you can buy a county house or a BMW.

Recently, the executive meeting of the State Council proposed to gradually expand the coverage of high-value medical consumables collection, and carry out collection and collection of orthopedic consumables, drug balloons, and dental implants that are of concern to the masses at the national and provincial levels. It is worth noting that this is also the first time at the national level that the national collection of implants has been clearly proposed.

So after dental implants are included in the collection, can the people have "freedom to grow teeth"?

"Planting full teeth is equivalent to buying a suite in the county"

Mr. Wang, who lives in Beijing, lost one of his front teeth in a car accident and, out of aesthetics and convenience, went to a public dental hospital in Beijing for treatment. In the two options given by the doctor, movable dentures and implants, he chose dental implants with a longer service life and higher comfort, but the cost was really expensive. "The doctor told me that it would cost about 18,000 to 20,000 yuan to complete the implant, and that I could not take medical insurance reimbursement."

However, this is not the whole cost of Mr. Wang. Because the teeth have been falling out for a long time, Mr. Wang needs to implant bones before planting teeth, and this alone cost nearly 8,000 yuan. And before the dental implant is completed, Mr. Wang has to go to the hospital at least twice a month for review. In the end, it took a year to complete the implant surgery, which cost a total of more than 30,000 yuan.

Dental implants, which are considered to be the best treatment for missing teeth, have been controversial in recent years. On the one hand, with the improvement of national consumption level and the improvement of oral health awareness, the number of implants in China is rising rapidly, from 130,000 in 2011 to 4.06 million in 2020, with a compound growth rate of 140.6%.

But on the other hand, because the current oral consumables are not covered by medical insurance reimbursement, a tooth is often tens of thousands. According to the research report data of Pacific Securities in June 2021, the cost of implant surgery in the domestic market is about 8,000-22,000 yuan.

During the two sessions of the National People's Congress in 2021, some deputies to the National People's Congress said that if a full mouth of teeth is implanted, it is equivalent to buying a suite in the county, and it is recommended that the cost of dental implants be included in the scope of medical insurance reimbursement as much as possible to meet the needs of the masses for oral health.

However, in the view of Zhang Xiao, director of the Institute of Medical Insurance of Southeast University, the functional positioning of medical insurance is "basic insurance", and dental implants have consumption attributes, and are not the only choice for toothless restoration, which does not belong to basic medical needs, so it is difficult to include medical insurance.

In September of that year, the National Medical Insurance Bureau pointed out that according to the regulations, at present, all provinces (autonomous regions and municipalities) are not included in the scope of basic medical insurance payment for glasses, dentures, prosthetics and other appliances. The document once again clarifies the functional positioning of the current basic medical insurance system "to guarantee the basic".

On January 10 this year, the executive meeting of the State Council proposed: normalization and institutionalization of centralized procurement of drugs and high-value medical consumables. Gradually expand the coverage of high-value medical consumables collection, and carry out collection and collection of orthopedic consumables, drug balloons, and dental implants that are of concern to the masses at the national and provincial levels.

It is worth noting that this is the first time that the national level has clearly proposed the national collection of implants. So, how much money can the upcoming collection of high-value consumables for dental implants be cut?

The effect of price reductions remains to be seen

According to reports, the average price of coronary stents dropped from about 13,000 yuan to about 700 yuan after the collection, a decrease of 93%; the average price of artificial joints after collection was reduced by 82%, of which the average price of artificial hip joints fell from 35,000 yuan to about 7,000 yuan, and the average price of artificial knee joints fell from 32,000 yuan to about 5,000 yuan.

However, compared with the previous post-harvest price plunge in cardiac stents and artificial joints, industry insiders have different views on the decline in the price of dental implants.

Zhang Xiao said that the sales market for drugs and high-value consumables promoted at the national or local level was mainly concentrated in public hospitals, and many of them belonged to the scope of medical insurance payment. However, in the field of dentistry, oral consumables are less dependent on public hospitals.

According to the data of the National Health Commission, as of the end of 2019, there were about 885 stomatological hospitals in the country, of which 723 were private specialty hospitals, accounting for 81.69%.

Chain industry expert Wen Zhihong also said that from the perspective of the industrial chain, the dental industry belongs to the vertical consumer medical treatment with a very high degree of marketization and depth. Although the collection and mining solves the problem of procurement cost of materials, due to the principle of independent pricing adopted by private medical institutions, even if the cost can be reduced, it does not mean that the overall price will inevitably decrease.

On the other hand, the current mainland implant consumables market is dominated by imported products. Zhang Xiao pointed out that the small number of domestic products and the low rate of nationalization mean that the bargaining power is controlled by overseas enterprises, and even if the purchase is carried out, domestic enterprises lack sufficient products for import substitution.

According to the Pacific Securities Research Report, in China, more than 90% of the implant market is occupied by foreign brands, and the market share of domestic brands is less than 10%.

Ai Media Consulting data shows that implants can be divided into high-end, mid-range, low-end three gears. At present, the global high-end dental implant market is mostly international brands, such as Swiss Straumann, German BEGO, Israel MISI and so on. There are also 13 domestic implant brands in China that have been approved for listing, but most of the listed products are positioned in the low-end market, such as Beijing Leiden BLB, Shandong Weigao WEGO, Jiangsu Chuangying TRANSIM, etc. At present, China's domestic dental implant brands have begun to gain certain recognition, but the development is mainly concentrated in the low-end market, and the follow-up should be further developed to the high-end market.

In addition, for consumer medical industries such as oral and medical aesthetics, the cost of non-consumables is also huge.

Wang Handi, founder of Beijing Youyi Stomatological Hospital, said that the cost of dental implants is mainly composed of three parts: the doctor's technology, implant materials, and the cost of medical institution operation.

Previously, it was also reported that the dental clinic had invested a huge amount of money in the early stage, and the price of a dental chair was as high as hundreds of thousands of yuan. It can be seen that in fact, a considerable part of the money paid by consumers is used to pay for doctors' fees, marketing costs, purchase of medical equipment, store rent, and profitability of dental hospitals.

Wang Handi said that from the perspective of the cost of consumables, the short-term price reduction effect of dental implant collection is still worth looking forward to, and in the long run, it is a good thing, whether it is to take care of the people, or for the development of oral technology, it has a role in promoting.

Solving the problem of expensive teeth also requires a multi-pronged approach

This time dental implants are included in the collection catalogue of special social attention, fundamentally because they look down on dentistry and cannot afford to plant teeth, which has become a common feeling of the public. So, in addition to collecting, how to solve the problem of expensive teeth?

In the view of Xu Zebin, president of Liangmei Dental Group, cultivating oral health care awareness and doing a good job in disease prevention is also an important way to solve the problem of expensive teeth. "Mainland stomatology focuses on post-event management, while foreign countries focus more on pre-event prevention. Because it is difficult to heal on its own, most dental diseases actually develop from small problems. Many patients do not go to the hospital because toothache is not a disease, and it is too expensive to see their teeth, thus missing the best time for treatment. Problems can not be avoided when they are solved, and it is often difficult to remedy. At this time, the disease is more serious, the complexity of treatment is higher, and the cost is naturally higher. ”

Xu Zebin further said that oral hygiene management also directly affects the digestive system of the whole body, the so-called disease from the mouth, there are data show that 56% of major diseases are related to oral health problems. "Therefore, in my opinion, the biggest significance of this policy is to further improve the public's attention to oral health."

Wen Zhihong said that the high cost of dental diagnosis and treatment in mainland China is also related to the scarcity of dentists. According to the "2019 China Dental Industry Trend Report", there is a huge gap in the number of dentists in the mainland, and the coverage rate of dentists is much lower than that of other countries. Compared with the number of dentists per million population, China has less than 100 per million population, while developed countries such as Europe and the United States have 500-1000 per million population. "Therefore, increasing the supply of medical care will also help solve the problem of expensive teething."

From the perspective of business operation, private hospitals can improve operational efficiency, reduce operating costs and expenses by rationally organizing operating personnel and optimizing the efficiency of equipment use, and can also solve the problem of expensive teeth to a certain extent. Wen Zhihong explained that at present, private dental medical institutions still have a lot of room for improvement in many details such as appointment numbering and assistant functions.

Recently, in the face of the news of implant collection, Tongce Medical, known as the "first share of the mouth", said that the collection of implants affects the cost of oral services, and the company actively responds to industry policies and common prosperity actions to launch low-cost implant business.

In Wen Zhihong's view, it is of great significance to clarify the collection of implants from the national level. In the future, with the landing of the collection policy, the price of dental implants is bound to be more transparent, when the market will begin to differentiate, some medical institutions will take the route of affordable popularization, with the price as the main advantage, and the other part will go to the middle and high-end, attracting people with quality and service.