Wen | Zhang Shuxia, a reporter from the "Finance and Economics National Weekly."]
"I planted 4 teeth, used imported consumables, and spent more than 60,000 yuan on various costs." Ms. Xiao told the Reporter of Finance national weekly.
With the improvement of people's living standards and the development of oral medicine, like Ms. Xiao, there are more and more people who solve the "lack of teeth" problem through dental implants. At the same time, "do not look at the teeth, toothache; after reading the teeth, heartache", "a mouth of a BMW", "planting teeth is equal to buying a suite in the county" and other sayings are widely circulated, and the high cost of dental implants has indeed turned away many people with needs.
Promoting the price reduction of high-value medical consumables is one of the important measures to help alleviate the problem of "expensive medical treatment" for the people. The good news is that as high-value consumables such as cardiac stents and artificial joints have been successively included in the national collection and procurement, the price has been significantly reduced, and now the expensive dental implant collection has also been officially put on the agenda, and the cost is expected to drop significantly.
At the State Council Policy Briefing on Deepening the Reform of Centralized Procurement of Drugs and High-value Medical Consumables held on February 11, Chen Jinfu, deputy director of the National Medical Security Bureau, revealed that in the first half of this year, for dental implants, the state led and strived to launch a local collection alliance reform.
So, through the collection, how much can the cost of dental implants be reduced? For the oral healthcare industry, what impact will the collection initiative have?
Where is dental implant expensive?
The first question to be clear is, how expensive is dental implants? Is the price of changing teeth really equivalent to a BMW car or a suite in the county?
Dental implants are also known as artificial dental implants, not real teeth, but through medical methods, pure titanium with high bone compatibility with the human body is precision designed and processed, manufactured into a cylinder or other shape similar to the tooth root, implanted in the alveolar bone of the damaged missing tooth area in a surgical manner, after 1-3 months, the artificial tooth root and the alveolar bone are compacted, and then the crown is installed.
▲A complete dental implant Figure / Overview of Oral Implants in China
"The price of a single implant dental implant ranges from 3,000 yuan to tens of thousands of yuan." A person from a private stomatological hospital told the reporter of "Finance and Economics National Weekly" that it is necessary to understand the bone quality and bone mass in the missing area of the patient according to the comprehensive and systematic oral examination, so as to determine whether it is suitable for dental implant surgery and what kind of implant dental program is more appropriate.
According to an attending doctor in the Department of Stomatology of Shanghai Dongfang Hospital, the price of public hospitals and private clinic studios is slightly different, the price of implant teeth in public hospitals is generally 8000-25000 yuan / piece, its Chinese and Korean implant systems are generally 8000-10000 yuan / piece, the United States and Germany systems are 12000-15000 yuan / piece, and the Swiss and Swedish systems are 18000-25000 yuan / piece.
That is to say, if you choose a single tooth ten thousand yuan implantation program, a bite of teeth down is indeed expensive, "equivalent to a BMW car, a suite in the county" is not exaggerated.
From the perspective of hospital surgery charges alone, the cost of dental implants remains high, mainly because of consumables such as implants and crowns.
The above-mentioned private stomatological hospital said that the pre-implant examination and surgery are free, the hospital mainly charges the cost of consumables, conventional implants include implants, abutments and crowns, and special circumstances will involve bone replenishment, bone grafting, bone meal periosteum, lifting and other projects, which require additional fees.
For example, the fee list provided by Ms. Xiao shows that the total price of three consumables, implants, abutments and crowns, accounts for 94% of the total cost of implant surgery.
▲The dental implant bill provided by Ms. Xiao
However, this is only a cost component on the surface.
"The cost of dental implants actually covers items such as the value of doctors' technical services and the operating costs of hospitals." Zhan Zhaokun, attending physician of The Department of Dental Surgery of Ruining, told the "Finance and Economics National Weekly" reporter that patients choosing implant services is not equivalent to directly buying consumables, how these consumables can be implanted safely and stably, requiring fine individualized program design and surgical treatment, which is a great test of the doctor's technical level.
He introduced that it takes at least seven or eight years to train a dentist, and many doctors continue to participate in refresher training and learning in order to improve the level and ability of professional fields, and the time and capital investment are relatively high.
In addition, the investment in the pre-operation site, equipment and equipment of dental medical institutions is also the upfront cost of carrying out dental implant business.
"Considered comprehensively, the actual proportion of consumables such as implants, abutments, and crowns accounts for about 40% of the total cost of implants." Zhan Zhaokun said.
According to the research minutes released by Tongce Medical, in its planting business, the proportion of consumables for planting orthodontics is even lower, accounting for only about 25%.
Guohai Securities Research Report shows that from the perspective of consumer payment, implants are expected to account for 10.4%, repair materials account for 9.6%, and crowns account for 3.5%. The research report also disclosed the purchase price of some implants in stomatological hospitals: the cost of European and American brand implants is 1600-3000 yuan, South Korea is 500-800 yuan, and domestic production is 400-450 yuan.
How much room is there for collection and mining price reduction?
Dental implants are expensive, but there are not a few people in need.
The number of missing teeth has a strong correlation with age, normal people have 32 permanent teeth after changing teeth, of which 28 grow after teeth change, and 4 wisdom teeth grow or not grow in adulthood. According to the fourth national oral health epidemiological survey released by the former National Health and Family Planning Commission in 2017, in the middle-aged and young people aged 35-44, the tooth loss rate is about 36.4%, and the average amount of teeth is 29 per person; among the 65-74-year-old people, 86% have tooth loss, the proportion of total teethless is 4.5%, and the average tooth volume is 22.
In a dental clinic, doctors are filling patients' teeth. Photo by Xinhua News Agency reporter Wang Fei
China Merchants Securities Research Report estimates that from the perspective of the penetration rate of dental implants in the toothless group, in the city, the penetration rate of dental implants in middle-aged people with missing teeth is 20%; in rural areas, the penetration rate of dental implants in middle-aged people with missing teeth is 5%, and the penetration rate of dental implants in elderly toothless groups is only 0.1%.
One of the main reasons for the low penetration rate is the high cost of dental implants, and at present, dental implant projects are not yet included in the mainland medical insurance reimbursement, requiring patients to pay their own expenses.
There is no doubt that the inclusion of dental implants in the collection is a heart-warming move that meets the expectations of the people.
The executive meeting of the State Council held on January 10 this year clearly proposed that the coverage of high-value medical consumables will be gradually expanded, and the collection and collection of orthopedic consumables, drug balloons, and implants that are of concern to the masses will be carried out at the national and provincial levels.
Chen Jinfu revealed that the collection of dental implants has been deployed since the beginning of last year, and the inter-provincial alliance has been organized by Sichuan to study the procedures for the collection of dental implants, and now the program is basically mature, and the opinions of clinical, enterprises and localities have been widely listened to, and we are ready to strive to launch the alliance reform of local collection of dental implants in the first half of this year.
So, through the collection, how much can the price of dental implants be reduced?
Judging from the procurement of cardiac stents and artificial joint belts organized at the national level in recent years, the average decline rate of winning products has reached 93% and 82% respectively. According to this, some experts in the pharmaceutical industry predict that with the future collection and landing, the price reduction of implant dental consumables is expected to reach 60% to 90%, and the price reduction of different materials and different brand products is different.
However, it should be noted that in the past, the sales of collected drugs and consumables were mainly public hospitals, and the amount of collection and reporting was guaranteed, and the willingness of enterprises to reduce prices was relatively high. Half of the market for dental implants is in private institutions, so the participation of private institutions in the collection and the amount of quotation also have an impact on the final price reduction.
In addition, the price reduction of collection and production is only the cost of consumables. As mentioned above, the cost of consumables is only a part of the cost of implants, including the value of medical services for specialists, hospital operating costs, etc. Therefore, from the perspective of the overall cost, after the collection, the price reduction of dental implant costs is lower than that of consumables.
That is to say, if the total cost of single tooth implantation is 10,000 yuan, of which the cost of consumables is calculated by 40%, that is, 4000 yuan, if the collection of consumables is reduced by 70%, then the total cost of implantation is reduced to 7200 yuan, a decrease of 28%.
It is clear that the price reduction of consumables, which account for the majority of the cost of dental implants, will obviously help reduce the medical expenses of patients and reduce the burden of medical treatment.
The import-based market pattern is expected to break
For the majority of patients, the collection will really bring the dividend of reducing medical costs, and for the dental implant industry, the collection may affect the existing market pattern, and opportunities and challenges coexist for related enterprises.
"Implant consumables need to be kept in the mouth for a long time, many people feel that this is a surgery, there is no need to do it again, more willing to spend more money to choose products with clinical data support, stability and durability, the quality and performance of imported implants are more trusted." Zhan Zhaokun said.
It is understood that at present, in the oral implant system used by dental medical institutions in the mainland, imported products account for the mainstream. Among them, high-end products are occupied by Imported Products from Europe and the United States, represented by European and American brands such as Switzerland, Germany, and the United States. Korean brands mainly take the cost-effective route, and the price is relatively low. The price of domestic implants and Korean brands is similar, but it started late and its market share is still relatively small.
Guohai Securities Research Report shows that taking the core consumable implants in dental implants as an example, European and American manufacturers are the originators of implants, and have advantages in surface treatment technology, implant materials, and product design, and are favored by public hospitals and high-end markets; the consumer price of Korean implant brands is about 1/3 of the European system, with a wide audience advantage, the market share has increased to 58% in recent years; the positioning of domestic implants is close to that of Koreans, but the start is late to be suppressed by Korean prices, and the market share is expected to be at 7%.
Some insiders said that in the past few years, domestic brands could hardly enter public hospitals in economically developed areas, mainly gathering in private hospitals or clinics, focusing on the low-end consumer market.
Zhan Zhaokun introduced that from the perspective of clinical success rate, European and American products do have certain advantages, but for patients with relatively good oral basic conditions, doctors are also willing to recommend them to try domestic implants with higher cost performance. Moreover, the effect of dental implants does not depend entirely on consumables, and the design of implantation schemes and the skills of doctors are also crucial.
For domestic implants, expanding the number of users and supplementing clinical data is still the only way to promote. Participating in the collection is undoubtedly a great opportunity.
Many industry insiders believe that the collection will accelerate the replacement of domestic implant dental consumables, which is expected to break the market pattern dominated by imports.
"Imported planting consumables from foreign to domestic medical institutions, most of them need to go through layers of agents, and the circulation cost is high. And domestic products from manufacturers to hospitals, the intermediate process is much less. Zhan Zhaokun said that with the inclusion of implant dental consumables in the collection, it is conducive to domestic implant dental related enterprises to further open up sales channels.
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