Approaching the Spring Festival, the dental implant market ushered in a wave of small peaks. Ms. Zhang's father, 63 years old, has been wearing a movable denture for five or six years, and it has always been the wish of both father and daughter to plant a mouthful of high-quality good teeth for her father.
"At that time, the information checked, I remembered that the whole mouth planting depending on the material, 300,000 to 400,000, it was retreated. If hundreds of thousands of (dental implants) can come down through the collection of tens of thousands, I think it can be done," Ms. Zhang told Shell Financial Reporter.
Ms. Zhang's statement of "300,000 to 400,000" is not an exaggeration. Wang Huan (pseudonym), president of a private stomatological 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, "The whole mouth (dental implants) are generally more than ten or two hundred thousand, which is not to say that it is particularly good, especially good (dental implants) A Mercedes-Benz money is still there." ”
On January 10, the executive meeting of the State Council decided to carry out centralized procurement of drugs and high-value medical consumables on a regular and institutionalized basis to further reduce the medical burden of patients. It is mentioned that it is necessary to gradually expand the coverage of high-value medical consumables collection, and carry out collection and collection of orthopedic consumables, drug balloons, dental implants, etc. that are of concern to the masses at the national and provincial levels.
In the medical device market, the high price of dental implants has been discussed, and the initiative of reducing prices through collective procurement has also been proposed for a long time. Shell financial reporter found that Sichuan, Ningbo and other places have previously opened the collection of dental implants.
Behind the collection of dental implants is the status quo of further normalization of collection. According to the news released by Shanghai Sunshine Pharmaceutical Procurement Network on January 6, the amount of agreed procurement for the first year of insulin special collection has been determined, and the results of the special collection of insulin will be implemented in May 2022.
【High price】
Behind the huge profits, imported dental implant products almost monopolize the market
On January 27, near the Spring Festival, the Weier Dental Clinic in Beijing also placed all kinds of gifts that customers thanked at the end of the year: refrigerators, electric vehicles, sweeping robots... There is also an advertisement for the event during the Spring Festival of Dental Implants in the hall: "Imported implant seeds are given one free, first come, first served." ”
Like Welle Dental, putting "imported dental implants" in advertising is actually a common operation in the industry. People who are not familiar with the consumer market for dental implants do not know that the mainland dental implant market has long been monopolized by imported products, and it is almost impossible to use domestic implants. At present, the popular dental implant products on the market are mainly in 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 15,000-20,000 yuan a piece, mainly using brands from the United States, Switzerland and Sweden, including implants, crowns and all other costs, there is no medical insurance reimbursement, "full mouth implants almost cost a car, more than 200,000." ”
The Huge Dental Prospectus mentions that "the development of the mainland oral medical device industry is relatively late, and the overall development level is still lagging behind that of developed countries", "At present, the oral materials in the domestic market, especially high-end precision dental materials, still rely on imports to a considerable extent, of which: implant import products account for 90%; orthodontic products import products account for 70%; high-end equipment intraoral scanners and CBCT are basically monopolized by foreign enterprises." ”
"There are actually many domestic products, but many people can't accept domestic products, always feel that domestic products are not good, hospitals use very few domestic implants", the president of a chain of dental hospitals in Beijing told Shell Financial Reporter, different implant brands, representing different price points. Without taking into account the surgeon's technique, the same brand of implants, the effect is almost the same.
"The cost of [a dental implant] is more than 5,000, 7,000, 8,000, and more expensive." Aoyatai, Haosheng and Yading belong to the middle and high-end. Strausmann is high-end, the price is 10980 yuan a piece, including the price of implants and crowns are inside. Full of teeth is generally a routine, such as the United States Haosheng down to 100,000 to 120,000 or so. ”
The president of the dental hospital told reporters that in the dental implant market, basically the implementation of the "one price" charging rule, that is, the implantation of a tooth, charged according to the unified pricing method, the cost includes implants, crowns, surgical fees and other costs, there will be no other charges, "if according to the "crown alone, implant alone, surgical fee alone, your cost will be much higher." ”
Wang Huan, president of another stomatological hospital, told Shell Financial Reporter that the psychological price of consumers and what kind of brand to choose is different, the price gap will be more obvious, "the whole mouth is generally more than ten, two hundred thousand or more, this is not to say that it is particularly good, especially good (dental implants) A Mercedes-Benz money is still there", "Just like BMW has a series, seven series, the configuration of dental implants is not the same, and the degree of bone combination is not the same." 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 the best for experts to do. ”
According to the report on the implant dental industry released by Guohai Securities in July 2021, Aoyatai expects that the pattern of the domestic planting market in mainland China in 2019 is: south Korea's Aoyatai market share is the highest at 33%, the second is Dengteng 25%, the third market share is Swiss brand Strausmann 22%, the fourth is Danaher 10% in the United States, and the fifth is 8% for Duns Bessinoord.
On a group buying platform, Shell financial reporters searched for "Swiss Dental Implants" and found that the prices after the event were more than 10,000 yuan / piece, and prices such as 16,800 yuan and 18,800 yuan were very common.
【Link】
Thousands of yuan of procurement into the country, consumers spend tens of thousands of yuan to plant, where is the middle expensive? 】
How did the high price of dental implants come about? Shell financial reporter found that in the implant market, due to the relatively large proportion of domestic imported implants, the cost of consumables, the cost of sales far exceeds the cost of raw materials.
Shell financial reporter retrieved on a group purchase platform, "Astra Dental Implant" in Beijing after the activity, priced at 18,000 yuan / piece, including implants, abutments, crown costs, oral examination, program design and other costs. The dental clinic staff told reporters that each person can only enjoy such a price twice, if it is a third implant tooth, the fee is 25,000 yuan.
What is the cost of an imported implant that costs 18,000 yuan to 25,000 yuan in the hands of consumers?
Let's start with the production side. Dunspar is a world-renowned supplier of dental materials and equipment, and the AstraTX and AstraEV-S implant series are all Products of Dunspar. According to Dunspar's 2020 financial report, the company's gross profit from sales accounted for 49.6% of net sales, compared to 53.7% in 2019.
In the Chinese market, Dunsberg 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, active dentures and orthodontic products, and is also engaged in the business of operating and selling prosthodontic medical device products.
In 2018, Jiahong Dental established a cooperative relationship with The World's Leading Implant Product Manufacturer Dunspar, and Dunsbro authorized Jiahong Dental to sell AstraTX and AstraEV-S implant products in public hospitals and private markets in some cities in Guangdong Province (except for the national dental chain institutions).
Jiahong Dental Prospectus disclosed that the average price of implants purchased by the company in 2020 was 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. In the process of representing Jiahong Dental, Dunsberg will also make corresponding rebates according to sales, and the rebate amount in 2020 will reach 4.3198 million yuan.
Jiahong Dental Prospectus, Implant and Accessories Procurement Data.
After Jiahong Dental purchases the above implant products, it will not do any processing and will directly sell to the outside world. In 2020, Jiahong Dental sold implant products to Shenzhen People's Hospital, Stomatological Hospital of Southern Medical University (Guangdong Provincial Stomatological Hospital), and The Affiliated Stomatological Hospital of Sun Yat-sen University, with sales unit prices of 1098.12 yuan / piece, 1022.34 yuan / piece, and 1139.81 yuan / piece, respectively.
In 2019 and 2020, the gross profit margin of Jiahong Dental sales of implant products was 32.59% and 30.77%, respectively.
Distributors receive a gross profit margin of 30% and then sell it 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 overall cost. For example, planting a tooth costs 5,000 yuan, the cost of the material is not high in it, you want to implant teeth down, how many people want to serve this thing," the president of a Beijing stomatological hospital told Shell Financial Reporter.
According to the public transfer prospectus of Huaya Stomatology, the gross profit margins of the company in 2017 for prosthodontics, oral diagnosis and treatment, oral implantation and orthodontics were 50.07%, 44.85%, 59.62%, 60.10% and 49.66%, respectively.
In the overall cost composition of Huaya Dental this year, the largest proportion is labor compensation, followed by rent and depreciation, and the third is the cost of materials. In 2017 and 2018, the material costs of Huaya Dental were 8.06 million yuan and 13.79 million yuan, accounting for 22.89% and 25.16% of the total cost, respectively.
Huge Dental clearly stated in the prospectus, "There are many segments of the oral medical market, among which implants and orthodontics are typical high-value projects. ”
As a large-scale dental medical group in China, the main business composition of Tongce Medical is mainly pediatric medical services, orthodontic medical services, and implant medical services. In 2020, the gross profit margin of tongce medical services reached 45.78%.
Another dental implant is a company that accounts for more than 40% of the revenue, and the gross profit margin of oral implant services and orthodontic services in the first half of 2020 reached 53.3% and 62.1%, respectively.
Dr. Dentist's prospectus shows that the penetration rate of China's oral service market is still at a low level.
Guohai Securities believes that the dental implant industry chain spans a large span, and the downstream hospital end costs account for a relatively large proportion, "the traditional view is that 25% of the costs paid for dental implants are diagnosis and treatment fees, 75% are consumables, of which 16% are prosthetic materials, 59% are implant systems", "The money paid by consumers is more flowed into the stomatological hospital, which is used to pay for doctors' fees, marketing costs, purchase of medical equipment, and profitability of stomatological hospitals."
【Collection】
Ningbo and Sichuan took the lead in attacking, how much room is there for price reduction after dental implants after harvesting?
The executive meeting of the State Council on January 10, 2022 continued to release the signal of expanding collection and procurement. The meeting pointed out that "in recent years, the reform of centralized procurement of drugs and high-value medical consumables has been continuously promoted, and the market-oriented mechanism has effectively squeezed the inflated price of medicines, and by the end of last year, the cumulative savings of medical insurance and patient expenditure were 260 billion yuan." ”
In fact, in 2021, some people's congress deputies proposed to the National Medical Insurance Bureau to "standardize the cost of implant materials and incorporate the cost of treatment and services into medical insurance".
At that time, the National Medical Insurance Bureau replied, "The price items of oral medical services will be standardized, and the projects that are split too much and too fine will be integrated", "guide the local government to include implants in the scope of the platform hanging network, and promote the price of various brands of implants to be transparent and squeeze out water." Promote the establishment and implementation of a credit appraisal system for pharmaceutical prices and procurement, including cases of pharmaceutical commercial bribery involving kickbacks for implants into the scope of credit appraisals, and employing binding measures. ”
In fact, the mainland has already opened Ningbo and Sichuan to open the implant dental medical insurance payment, collection and price reduction and other work.
According to the official website of the Ningbo Medical Insurance Bureau, in August 2021, Ningbo interviewed five imported dental implant suppliers to hold a symposium, "to play the leverage of medical insurance, so that dental implants can return to a reasonable price range." Most of the suppliers present agreed with the price negotiation plan proposed by the Health Insurance Board. ”
Then, in November 2021, Sichuan Province issued a document to carry out information declaration work for oral implants, repair abutments, implant repair accessories and other products.
Such a determination to collect and collect allows consumers to have more expectations for the collection. Ms. Zhang told Shell Financial Reporter that she was already planning to inoculate her father with dental implants in the future, "If it can really be tens of thousands, I will decide to do it for him." ”
So, how much can the collection reduce the price of dental implants?
On January 18, a staff member of Sichuan Stomatological Hospital told reporters that at present, the hospital has not received the latest policy notice for implant collection, and the price reduction of implant dental collection has not yet landed in Sichuan, "We are also waiting for the news of Ningbo."
The reporter then learned about the collection of implant teeth in Ningbo and found that some areas in the local area have already implemented dental implant medical insurance reimbursement.
According to the progress of the work disclosed by the People's Government of Xiangshan County, Ningbo City on January 11, 2022, the medical insurance implant project initiated by the initiative of the designated medical institutions and fully supported by the medical insurance department was piloted in ningbo City, and 23 designated medical institutions in Xiangshan County took the initiative to sign up to participate.
"The medical institutions participating in the medical insurance implant implement the overall package charge for the brand implants in the catalog, that is, according to the level of medical institutions, there are three grades of second and lower, three B and three A, domestic brands 3000 yuan, 3200 yuan, 3400 yuan, imported brands 3500 yuan, 3700 yuan, 3900 yuan. Contracted medical institutions shall charge uniformly according to the above standards. ”
In Cixi City, Ningbo, the "affordable implant" policy has also been promoted. On December 31, 2021, the Cixi City Government released the government affairs dynamics, saying that Cixi City took the lead in promoting the smooth landing of the affordable "dental implant" project, so that the average price of "dental implant" was reduced from about 8500 yuan / piece to about 3500 yuan / piece, a price reduction of 60%.
"Up to now, 5 private medical institutions in our city have implemented affordable implant projects, and the first batch of 330 implants has been purchased, which can reduce the expenditure of patients by 1.65 million yuan, which is currently the first in Ningbo."
【Price supplement by volume】
160 billion dental implant market, what is the future?
The normalization of collection and procurement will also have a great impact on the dental implant industry, jiahong dental once said in the prospectus, in the long run, the field of medical consumables will fully implement the policy of purchasing with quantity, and realize the integration of recruitment and procurement, and the price of volume.
Jiahong Dental said that as far as the distribution business of implant products is concerned, if the future oral consumables field refers to the requirements of the medical consumables procurement documents such as cardiovascular interventional, ophthalmic intraocular lenses, and orthopedic artificial joints that have been introduced, the declaration subject with volume procurement should be Dunsberg or its national general agent (if any), and the company's business of selling implant products to public hospitals will be affected to a certain extent, resulting in a decline in operating performance.
Such worries come from the price reduction of previous collections. At the National Medical Security Work Conference on January 14, it was announced that the average price of artificial hip and knee collection products was reduced by 82%, which is expected to benefit nearly 11 million patients and reduce the burden by nearly 30 billion yuan per year.
The data shows that at present, the national pharmaceutical equipment collection has been carried out to the 6th round, that is, the special collection of insulin. In 2021, the average price of 42 special collection varieties of insulin was reduced by 48%, the maximum reduction of insulin in the collection target reached 74%, and the minimum price of premixed human insulin was reduced to 17.89 yuan / stick.
The first five batches of national collection of drugs and coronary stents saved nearly 170 billion yuan in drug costs throughout the year.
Shell financial reporter noted 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 collection of drugs at the national level", "Before the end of this year, the total number of national and provincial drugs collected in each province will reach more than 350." ”
For the domestic dental implant track, behind the collection is a huge dental implant market.
According to the guohai securities research report, the number of implants per 10,000 people in the mainland in 2020 is 28, compared with 632 per 10,000 people in South Korea, which is a gap of 21 times. According to the penetration rate of 200 per 10,000 people in developed countries, the price is calculated at the current 50%, the mainland dental implant market space can reach 106 billion yuan, and the rapid growth of the implant dental track in the next decade is highly certain.
Caixin Securities also said, "Overall, the treatment rate of oral diseases in the mainland is generally low, and if implants and other related oral consumables are included in the collection, it is expected to promote the treatment rate of caries, orthodontic penetration and implant penetration."
It is worth mentioning that shell financial reporters found that domestic oral implant products in the mainland are constantly enriching. On January 30, the reporter searched the mainland's domestic medical device product records and found that there were 22 records of related "implants", including Beijing Daqing Sig Technology Co., Ltd., Hebei Xinhua Dental Technology Co., Ltd. and other enterprises applying for registration.
In addition, domestic enterprises have also made new progress in implant research and development. According to the statistics of Shell Financial Reporter, the research projects of Dabo Medical, Maipu Medical, Kangtuo Medical, Chujiang New Materials and other enterprises include implant research and development.
In the 2020 announcement, Dabo Medical introduced that the company has raised 365 million yuan of funds for the construction of oral implant production projects. In the research and development of stomatology, Maxcope Medicine includes the "PEEK-HA Dental Implant" project.
Beijing News shell financial reporter Li Yunqi Editor Xu Chao Proofreader Guo Li