How hard is it to regain a good tooth? Unlock the secret of the high price of dental implants

"Three teeth have been missing for several years, will it be cheaper after the national collection?" Recently, the news that dental implant consumables have been included in local collections has brought the hope of regaining a good tooth to many patients who are "afraid to look forward".

In recent years, the social demand for dental implants has become larger and larger, but the price of tens of thousands of yuan has brought invisible pressure to patients, and it is for this reason that the folk have been circulating the saying that "a mouthful of teeth is equal to a BMW". Beijing Business Daily reporter found through market research that the single price of different brands of implant teeth ranges from thousands of yuan to tens of thousands of yuan, in addition to consumables costs, medical costs, etc., the current wide range of "recovery deduction" phenomenon has also promoted the inflated price, which further breeds certain excessive medical problems.

According to Chen Jinfu, deputy director of the National Medical Security Bureau, in the first half of this year, he strived to launch a reform of the alliance of local collection. In the view of industry insiders, the alliance reform of local dental implant collection will not only suppress the inflated price, but also effectively regulate the market order and correct market failure.

Expensive in consumables or expensive in technology

Ms. Yi's three teeth have been missing for three or four years. "I know that it is not good to have teeth missing for too long, but it is too expensive," she said, "a better implant in Beijing costs about 20,000 yuan, if there is a condition, it must be planted after the tooth extraction, but taking so much money at once is too expensive for ordinary families, I can only wait for the conditions to be better before getting it." ”

As the best way to repair missing teeth at present, dental implants are relatively high-end consumer items in dental treatment. Beijing Business Daily reporter learned from a dental clinic in Shanghai that the price of domestic brand implants is about 10,000 yuan per piece, and the import of high-end ones is almost 20,000 yuan. "You are still very young, it is recommended to plant better, the implant life will be longer, the imported implant production process and bone combination will be much better." The other party introduced.

At present, most cities and regions have not included implants in medical insurance reimbursement, if calculated at a single 10,000 yuan, then a full mouth of 28 teeth need to cost nearly 300,000 yuan.

However, the price of implants also varies from brand to brand. Dr. Qin, who works in the stomatology department of a public hospital in Beijing, told the Beijing Business Daily reporter, "According to the domestic and imported different materials, patients basically cost thousands to more than 10,000, if you choose South Korea's Dengteng, count one 4,000 yuan, three cost about 12,000." ”

There have also been some lower-priced products on the market in recent years. A dental consumables dealer introduced to the Beijing Business Daily reporter when selling products, "We are the brand of the agent Israel, 60 pieces to send a small tool box, implant outpatient price of 1040-1300 yuan, implant + personalized abutment + crown a set of program out of 2000 yuan / set." ”

Although the price of small brands is low, Dr. Qin told the Beijing Business Daily reporter that large brands have the time to be launched and clinical experience to support, and the price will be higher. The choice of large brands in materials will be more secure, and the production background and historical background are all considerations.

What percentage of consumables account for patients' spending? Pacific Securities research report shows that in the cost composition of dental implant surgery, the cost of consumables such as core material implants, abutments, crowns, and prosthetic materials accounts for 75%. Hao Fei (pseudonym), a specialist manager of the Dental Department, told the Beijing Business Daily reporter that one of the conventional allocations in the industry is that of the 75% consumables fee, 16% are prosthetic materials, 59% are implant systems, and implants account for 40% in the system, abutments 7%, and artificial crowns 12%. In terms of toolbox, Beijing Business Daily reporter learned from some dealers that the general price of dental implant tool boxes is 800-900 yuan a set.

However, some insiders pointed out that the doctor's technology and operation is the main reason why dental implants are expensive. Li Jiangdong, president of Youpeng Dental, told the Beijing Business Daily reporter that in general, among the patients' dental costs, the proportion of doctors' fees is definitely higher than the cost of materials, and the proportion of higher is not fixed. He said, "This is the result of socio-economic development and market balance, one is because doctors have been trained after years of study, and the other is that doctors' operations are very important in treatment." In particular, the oral cavity belongs to surgery, and various operations are closely related to people's life and health, and the value of life and health is getting higher and higher. ”

Li Jiangdong also said that the overall price of private hospitals is more market-oriented than that of public hospitals, and many advertisements for low-price competition have been launched. For example, in public hospitals, South Korean implants may cost about 10,000 per implant, and European and American implants may get 15,000-20,000 yuan per implant. In private hospitals, Korean implants are cheap as long as less than 4,000 yuan, and Europe and the United States may be between 10,000-15,000 yuan per piece.

Red envelope temptation and excessive medical treatment

In addition to the relatively high cost of consumables and medical services, the high "rebates" in the industry make the price of dental implants more watery.

In the interview with the Reporter of Beijing Business Daily, the industry insiders intentionally or unintentionally revealed some clues. Internal personnel of oral consumables manufacturers told the Beijing Business Daily reporter, "Our sales are mainly volume. The basic difference between the consumables materials at the same price is not big, it depends on which manufacturer gives more red envelopes, and the material manufacturers will give the doctor a rebate. He also said, "How much is the cost of medical treatment, and the price is your teeth." Doctors don't make money from the clinic, they rely on kickbacks. ”

Under the inducement, it is inevitable that there will be excessive medical treatment. Netizen Xiaotian said that she saw several doctors in different dentistry in several hospitals, some said to pull, some said to stay, and finally did surgery in the pulp dentistry department to preserve her teeth. Some netizens said, "See a few more doctors, some doctors will only let people pull out, this is not right." ”

Li Jiangdong pointed out, "In fact, some teeth do not need to be planted, the first principle of oral treatment is retention, not necessarily to extract teeth, repair and repair, try to save their teeth is better." In fact, you should try a variety of repair methods that are suitable for the patient and the condition. ”

Controversy over the excessive price of dental implants, (identity?) Chen Jinfu revealed on February 11 that the mainland has been deployed since the beginning of last year, and Sichuan has organized an inter-provincial alliance to study the procedures for collecting implants and dental implants, and now the program is basically mature, and the opinions of clinical, enterprises and localities have been extensively listened to, and they are preparing to strive to launch a local collection alliance reform in the first half of this year.

Wu Ming, a professor at the School of Public Health of Peking University, said in an interview with the Beijing Business Daily reporter that the collection of pharmaceutical consumables is not only to reduce the price and control medical costs, but also to point directly to the sale of gold, or "rebates". The main purpose of the collection is to squeeze out the "water" in the price and purify the ecological environment in the field of medicine from the institutional mechanism.

"Rebates disrupt the order of the two markets of medicine (including the production and circulation of pharmaceutical consumables) and medical services. In the past pharmaceutical market, rebates have become the survival rules of the industry, and the competition is not price and quality, but rebates, which has led to serious market failures and is one of the main reasons for the irregular behavior of medical services. Collection and procurement is the government's correction of market failures, the standardization of market order, the promotion of effective competition under the premise of ensuring quality, and the control of excessive use of pharmaceutical consumables. Wu Ming said.

In fact, in January 2021, the General Office of the State Council issued the "Opinions on Promoting the Normalization and Institutionalization of centralized drug procurement", which pointed out that it is necessary to clarify the purchase volume, exchange the price with the amount, ensure the use, smooth the procurement, use, settlement and other links, and effectively control the drug rebate. On November 12 last year, the National Health Commission and other three departments issued the "Nine Guidelines for the Honest Practice of Medical Institution Staff", which also stipulates that it is strictly forbidden to accept rebates given by medical product production and operation enterprises or distributors of medical products such as drugs, medical equipment, medical devices, medical and health materials, etc. in any name and form.

After the consumables collection lands, the phenomenon of "kickbacks" will be further cracked down. Wu Ming said, "After the collection of consumables prices fell sharply, there is no room for gold sales." More importantly, the collection and mining rules of 'purchasing with quantity, exchanging price with volume' ensure the sales volume of collection products, so that enterprises have stable expectations, enterprises no longer need to sell with gold, and return to competitive quality and price. ”

How to squeeze out the price reduction space

As early as January 10 this year, the executive meeting of the State Council clearly included dental implants in the scope of high-value medical consumables collection. As soon as the news came out, many patients with missing teeth said that they still wanted to wait and wait until the policy landed before planting.

It is worth mentioning that this is also the first time that medical insurance has included self-funded consumables in the collection. Zhao Heng, founder of the medical strategy consulting company LatitudeHealth, explained to the Beijing Business Daily reporter that the main reason is that China's toothless population is large and the market demand is clear, but the price of consumables is too high, which leads to the demand cannot be met. He believes that the cost of dental implants does have an inflated part, with reference to other collection price reduction space, the price reduction after collection is about 50%.

So far, the mainland has carried out six batches of drug procurement, with a total of 234 kinds of drugs purchased. Chen Jinfu introduced that the average reduction in the centralized procurement of the first six batches of drugs was 53%, the average reduction in cardiac stents was 93%, and the average price of artificial hip joints and knee joints was reduced by 82%, which effectively squeezed the inflated space. The drug price monitoring data carried out by the Medical Insurance Bureau shows that in 2019 and 2021, the overall price level of drugs will continue to decline, reaching an average of about 7% per year.

However, in Hao Fei's view, after some domestic dental implants are included in the collection price reduction, other brands may reduce prices a little because of market competition. The price of big brands may still be strong for a period of time and then change, and the masses will choose to collect or high-end products according to their economic ability.

Zhao Heng explained that the collection and mining of dental consumables is mainly based on the provincial alliance, Zhao Heng explained that the collection and mining alliance means that a province takes the lead in uniting several provinces to promote together, although the collection and mining of the provincial alliance only affects the participating provinces in the short term, but the state has follow-up requirements for other provinces from this year, so it will eventually land in the country.

"The collection is promoted in accordance with the working mechanism of 'national organization, alliance procurement, and platform operation', and the provincial alliance is one of the main bodies of the collection." Some are in the country, some are in the provincial alliance, and some will be explored in the provincial alliance first, and if a better way and method is explored, the state can organize the collection. Wu Ming explained. As for how long it will take to cover the whole country, she believes that it is difficult to say the specific time at present, depending on the effect of local exploration and whether there are other provincial alliances to follow up.

So, what kind of impact will the collection and procurement bring to the enterprise and industrial structure? Wu Ming said, "Gathering and mining is an innovative exploration in the mainland, and the rules for collecting and mining are constantly improving. The recent results of insulin and bone and joint belt volume procurement reflect the effectiveness of this exploration, the rules are more perfect, and the comprehensive consideration of quality, price, adaptation to clinical needs and other factors has formed a substantial decline in price, but also reduced the crowding out effect of pharmaceutical consumables with high market share, and avoided the substantial adjustment of the clinical demand pattern. At the same time, she believes that at present, pharmaceutical production enterprises and circulation enterprises are merging and restructuring, and there will also be a number of outs, the market concentration is gradually increasing, and the enterprises are gradually scaled, and the cost will be reduced.

Zhao Heng believes that "for enterprises, the main thing is how to calculate the cost-benefit ratio, if the volume exchange can increase revenue, even if the profit is lowered, it is beneficial to itself, but if the cost is higher, it may be more appropriate to focus on the private market that does not participate in the collection." ”

Beijing Business Daily reporter Yang Yuehan Lu Yinling