The medical sector, which has been falling endlessly, finally raised its eyebrows and breathed a sigh of relief.
On September 9, the medical-related sector rose across the board, with dental and ophthalmic stocks leading the gains. Among the dental stocks, Mapu Medical rose nearly 17%, and Tongce Medical, Yuexin Health, Rongyu Group and so on rose and fell; Among the ophthalmic stocks, the light orthoptic ophthalmology rose and stopped, and the Aier ophthalmology and Opcom vision rose by more than 6%.
The trigger for the sharp rise in the sector was the Notice of the National Medical Security Bureau on The National Medical Security Bureau on the Special Governance of Oral Implant Medical Service Charges and Consumables Prices on September 8, which drew a target line for medical service costs that accounted for more than half of the overall cost of implants: 4500 yuan, and the price reduction did not exceed 50%, which was relatively mild.
After the policy was released, Lu Jianming, chairman of Tongce Medical, posted a screenshot on Weibo overnight, saying that "the boots have finally landed!" Very good! Backing! Endeavor! Win-win! ”
The Financial News Agency noted that after experiencing a series of "soul bargaining", from the landing of the dental implant collection policy to the collection and collection of orthopedic spine consumables at the end of this month, many analysts believe that the policy marginal improvement signal is strong, so can medical stocks be reversed?
Dental implant collection: medical service fees are limited to 4500 yuan
The story of dental implant collection has been repeated for more than a year, and the market value of "Tooth Mao" Tongce Medical has been squeezed out by hundreds of billions.
On the evening of September 8, the National Medical Insurance Bureau issued the "Notice on Carrying out Special Governance of Oral Implant Medical Service Charges and Consumables Prices", marking the official landing of the regulation of the cost of implant dental medical services that has attracted much attention.
The biggest change from the previous draft for comments is that oral implants will be collected, crowns will be auctioned and hung, and dental implant medical services will be regulated by price, which makes it clear that the whole process of price regulation target for medical services in tertiary public hospitals is 4500 yuan per tooth.
In this regard, the National Medical Insurance Bureau interprets that the cost of oral implants is roughly divided into three parts: implants, crowns and medical services. The prices of the two parts of the implant and the crown need to be generated through centralized procurement and bidding, so the Notice has no specific quantitative targets artificially set. At present, public medical institutions purchase high-end brand implants 4000 yuan -6000 yuan per set, other implants 2000 yuan - 3500 yuan per set, there is an inflated price space in the circulation process, and the price will drop to varying degrees after centralized procurement. Most of the crowns purchased by public medical institutions from third-party processing plants are more than 1,000 yuan, and the price of self-made crowns is higher, and there will be a certain degree of decline after bidding on the net.
According to the preliminary results of the recent nationwide registration survey, the average cost of medical services is more than 6,000 yuan, and the cost of some provinces and cities is more than 9,000 yuan, which has become one of the important reasons for the cost of dental implants.
Further, there are many reasons for the high cost of medical services, including unreasonable project settings and excessive decomposition, as well as overpricing and indiscriminate charging. Judging from the previous solicitation of opinions, most opinions believe that the whole process of costs should be guided back to a reasonable range when standardizing charges, and some opinions believe that the value of technical labor services, technical level, degree of risk and scarcity of resources should be considered. Based on the opinions of the masses, medical institutions, professionals and other parties, the price regulation target of the dental implant medical service part of the tertiary public hospital was finally determined to be 4500 yuan. For areas or medical institutions that meet specific conditions, the Notice also clarifies the conditions that allow appropriate relaxation.
The biggest highlight of the policy is that the regulatory objectives consider regional differences, not a one-size-fits-all single standard. For example, considering that areas and cities with the highest level of economic development do have higher cost factors such as resources and manpower, according to the feedback of the solicitation of opinions, the Notice clearly states that this part of the region can be floated by no more than 20%, and the specific situation is determined and published by the provincial medical security department as a city.
According to the policy, there are three types of relaxation scenarios, of which "non-directional" applies to all public medical institutions in the jurisdiction and private medical institutions that actively promise to accept the whole process of price regulation, and "directional" only applies to specific medical institutions that meet the situation.
If the conditions are met at the same time, the relaxation ratio can reach up to 40%, and the maximum price of a single implant medical service can reach 6300 yuan: 4500 × (120% + 110% + 110%) = 6300 yuan.
What is the impact on "tooth grass"?
According to the Frost & Sullivan Report, the size of the mainland oral medical service market reached 119.9 billion in 2020, with a compound growth rate of 10% between 2015 and 2020; It is expected that the industry growth rate is expected to reach 20% in 2021-2025, which means that the market size will be nearly 300 billion yuan by then.
In the domestic oral medical service market of more than 100 billion, the current penetration rate of dental implants is particularly low, about 29 pills per 10,000 people, only higher than india.
Low penetration rate corresponds to high growth rate. According to the Rare Dental Prospectus, the compound growth rate of the number of implants dental between 2011 and 2020 was as high as 46.3%, which was much higher than the overall growth rate of the oral industry. In 2020, the mainland dental implants are about 4 million (the corresponding penetration rate is about 28 per 10,000 people), according to the terminal survey to take the median, assuming that the single implant terminal charge is 10,000 yuan, the implant terminal service scale is about 40 billion, accounting for about 1/3 of the oral industry.
Benefiting from the continuous improvement of industry penetration, the performance of Tongce Medical, a leading stock in the industry, has maintained years of growth.
From the 2021 annual report, Tongce Medical has 60 operating oral medical institutions, the company as a professional stomatological hospital for oral medical services, does not produce implants and other medical devices and consumables, the upstream undertakes oral medical equipment and consumables suppliers, the downstream mainly faces patients. In 2021, the revenue generated by the company's medical services was 2.632 billion yuan, accounting for 94.67%. At the same time, the company's comprehensive gross profit margin and net profit margin were 46% and 28.27%, respectively, maintaining a stable improvement.
However, in the first half of this year, Tongce Medical's revenue increased slightly, and its net profit fell by 15.73% to 296 million yuan, which was another negative performance growth after the first half of 2020. The company believes that the main reason is that due to the impact of the epidemic, many of its hospitals have been closed for dozens of days, in addition, the dandelion branch is in the preparatory or cultivation period and a large number of talent reserves have pulled down the overall profit.
From the data point of view, in the first half of this year, among the listed dental companies, in addition to the double increase in revenue and net profit of Keen Dental, tongce medical, Rongyu Group, and Blue Sky Dental did not increase profits as a whole, Huamei Dental and Huaya Dental fell into a situation of double decline in revenue and net profit, and Rongyu Group and Huaya Dental recorded losses, reflecting that the days of the oral medical service industry did not seem to be good.
It is worth noting that after the decline in the performance of Tongce Medical, market confidence fell to the freezing point, and the stock price continued to hit a new low in the year, in addition to the company's so-called new crown impact reasons, the greater hidden worry is that there was a sharp bargaining price in the previous dental implant collection in Ningbo and Bengbu.
In April 2022, the Ningbo Medical Insurance Bureau issued the "Five Questions and Five Answers" of the "Dental Implant Medical Insurance Limit Payment Policy", which was the first to launch the medical insurance price limit payment policy for dental implants nationwide, limiting the whole process of "agreed brand" dental implants to domestic brands 3000 yuan / piece, imported brands 3500 yuan / piece, of which the price of consumables is 1000 yuan / piece for domestic production and 1500 yuan / piece for imports.
Anhui Bengbu City learned from the experience of Ningbo, the implant dental into the centralized procurement, after centralized negotiation negotiations, the cost of dental implant materials (including crowns, implants) the average reduction of 84.17%, the highest reduction of 89.5%; the Municipal Medical Insurance Bureau actively guided the pilot medical institutions on the basis of voluntary consultation, the implementation of dental implant project price limit charges, that is, tertiary hospitals are not higher than 2200 yuan / piece; The second-level hospital is not higher than 2000 yuan / pill; First-level and below hospitals (including oral clinics) are not higher than 1800 yuan / pill. In terms of the charges for planting medical service projects, from the average price of about 10,000 yuan / piece, it has dropped to less than 2200 yuan / piece, with a maximum reduction of more than 82%.
In other words, the limit price of Ningbo implant dental medical service is 2000 yuan, and the limit price of Bengbu is 2200 yuan. The final landing policy of the National Medical Insurance Bureau is a limit price of 4500 yuan, which is significantly higher than that. Because of this, Tongce Medical opened with a word up and down.
On September 9, Tongce Medical clearly responded to the outside world that the policy was good for the company, and the service fee price was better than the previous market expectations, and the previous market expectations were generally two or three thousand yuan. Subsequent dental implants will also introduce consumables (price regulation), but this has no impact on the company, and consumables have nothing to do with the company.
For the newly added relaxation of the conditions, the staff of the Tonce Medical Securities Department said that Tonce Medical should meet conditions one and three, and condition two is more difficult; This standard is for public hospitals and the company uses it only as a reference; As stated by the National Medical Insurance Bureau in its policy interpretation, it hopes to play the role of price "anchor" through public hospitals.
The Yang Song team of Tianfeng Pharmaceutical believes that the price of a single implant service in tertiary public hospitals is 4500 yuan, and the proportion of appropriate relaxation is as high as 40%, and the overall pricing is better than expected. Considering that the implant cost = service fee is 4500 + implant + crown, the price of implant consumables is calculated separately, and the overall price is expected to be above 6000, and the overall price is significantly better than the price of implant dental packaging in Ningbo, Bengbu and other places. Price regulation is mainly for public medical institutions, private medical institutions still set their own prices in accordance with regulations, guide private medical institutions to formulate reasonable prices, and at the same time let the value of technical labor services be reasonably reflected.
Zheshang Securities pointed out that the policy clearly stipulates that the price of a single implant dental medical service is capped at 4500 yuan, which can be relaxed to 6300 yuan if specific conditions are met. The dental implant collection policy clearly proposes to separate the price of medical services from the price of consumables, emphasize the value of medical services, and bring strong policy confidence to the medical service industry as a whole.
Marginal relaxation of the collection policy
In addition to dental implants, other medical fields have also been introduced recently, and many analysts believe that the policies will be more moderate.
On September 7, the Joint Procurement Office of High-value Medical Consumables of the National Organization issued the "National Organization orthopedic Spine Consumables Centralized Procurement Document", which clearly stated that the declaration materials would be submitted by the enterprise on September 27 and the bid would be opened on the spot.
Orient Securities believes that from the previous results of high-value consumables collection, the average price of coronary stent collection varieties in 2020 will be reduced by more than 90%, and the average reduction of orthopedic artificial joint collection products in 2021 will be more than 80%. Therefore, the price reduction of orthopedic spine consumables collection is inevitable, but the price reduction may be more moderate. Previously, Anhui Province has carried out two procurements of orthopedic spine consumables, and the overall average decline is 53.4% and 54.6%, respectively.
On September 6, two growth hormone products of Changchun High-tech appeared in the "Fujian Provincial Drug Centralized Procurement Document (Draft for Comment)". Considering the previous market rumors that Changchun high-tech growth hormone products were included in the collection, the company's stock price once fell to a halt, and many investors are worried that the collection news "real hammer" may cause another heavy blow to the company's stock price.
But the slight decline in the stock price reflects that investors are really worried about the collection of water injection dosage forms rather than powder injection forms. In the view of third-party institutions, the short-term price system of growth hormone water injections will remain stable. According to Changchun High-tech previously revealed at the investor exchange meeting, in the revenue composition of the company's growth hormone products, powder needles, water needles and long-acting water injections accounted for about 10%, 70% and 18% respectively.
In addition, the recent "Reply of the National Medical Security Bureau to Recommendation No. 4955 of the Fifth Session of the Thirteenth National People's Congress" said that the centralized procurement of the amount of medical consumables with large clinical use, mature clinical use, higher procurement amount and sufficient market competition into the scope of collection, because the clinical use of innovative medical devices is not yet mature, the amount of use is temporarily difficult to estimate, it is still difficult to implement the method of taking volume, leaving a certain market in addition to centralized volume procurement to provide space for innovative products to open up the market. The "Reply of the National Medical Security Bureau to Recommendation No. 6102 of the Fifth Session of the 13th National People's Congress" said that innovative drugs have not been included in the scope of collection varieties due to unstable clinical use and insufficient competition.
Debon Securities believes that the previous exemption of innovative drugs, innovative medical devices and innovative medical service projects from DRGs in Beijing Medical Insurance has triggered a positive response in the market, and the positive response of the National Medical Insurance Bureau is a more positive signal of the allocation of medicines, or triggers a breakthrough in the emotional inflection point. Pharmaceuticals have been fully adjusted and the valuation is at the bottom, the current fund is seriously under-allocated, optimistic about the second half of 22 and 23 years of pharmaceutical structural market.
This article originated from the Financial News Agency