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When it comes to orthodontic correction, the first thing that comes to mind is the word
"profiteering".
In the second half of 2022, dental implant collection and orthodontic collection will be closely implemented! Dental implant collection has just landed, and orthodontics, known as another nugget track in the oral field, has also begun to officially face the storm
of centralized procurement.
Recent developments all indicate that the wind of collective procurement has crossed the fence of "medical insurance coverage" and begun to blow into the category of dental consumables
.
On October 19, Shaanxi Public Resources Trading Center-Centralized Procurement Platform for Pharmaceuticals and Equipment issued the latest "Announcement on the Centralized Procurement of Orthodontic Brackets of Inter-provincial Alliance (District, Corps)"
.
According to the announcement, the procurement work will be jointly carried out
by 15 provinces (autonomous regions and production and construction corps) including Shaanxi, Shanxi, Inner Mongolia, Liaoning, Heilongjiang, Anhui, Henan, Guangxi, Hainan, Guizhou, Tibet, Gansu, Qinghai, Ningxia and Xinjiang.
A month ahead, on September 22, the Sichuan Provincial Medical Insurance Bureau issued the "Announcement on Centralized Procurement of Oral Implant System Inter-provincial Alliance (No.
1)", which opened the door
to centralized procurement in the oral field.
For patients, collective procurement means price reduction, which is undoubtedly good, and for the industry, the continuous decline in the share price of Angelalign, the "first stock of domestic orthodontics" on the head is also a portrayal
of the other side of the orthodontic industry.
With the public cheering, the stock market downturn, and the story of dental "profiteering" beginning to end? 01.
Comparison of oral two-standard centralized procurement Procurement rules are very different Comparing the collective procurement announcement, it can be basically determined that the coverage mode of medical institutions in the two collective procurement alliances is similar
.
The scope covers public medical institutions (including military hospitals) that carry out orthodontics in the Union provinces (autonomous regions and corps); Voluntary participation
will be taken for medical insurance designated social medical institutions.
Different from the previous Sichuan Alliance centralized procurement aimed at the current hot dental implant consumables, this alliance centralized procurement aimed at the procurement of orthodontic consumables, including brackets, invisible braces without brackets, and buccal tubes
.
The announcement also attached a specific national medical insurance consumables code table
.
The procurement demand of each product is calculated by adding up the procurement requirements of each product submitted by each medical institution participating in this procurement (the reported procurement volume shall not be less than 70% of the actual consumption of the previous year).
Judging from the published centralized procurement documents, the collective procurement will also be carried out in groups, divided into ordinary metal brackets (two groups A and B), ordinary ceramic brackets (two groups A and B), self-locking metal brackets (two groups A and B), self-locking ceramic brackets (two groups A and B), bracketless appliances (two groups A and B), buccal tube (bargaining).
The grouping rules will be sorted according to the procurement demand of medical institutions in the inter-provincial alliance from most to least, and the enterprises covered by the top 70% (inclusive) of the cumulative procurement demand of each product category will be the bidding units of group A, and the rest will be the bidding units
of group B.
If the number of valid reporting enterprises entering the Group A bidding unit is less than 5, it will be supplemented in descending order according to the procurement demand of medical institutions of the inter-provincial alliance from most to least, until the number of valid declaration enterprises of Group A bidding unit reaches 5; If there are less than 5 declared enterprises in the same product category, all of them will enter Group
A.
In terms of enterprise qualifications, the announcement shows that medical device registrants (agents) who have obtained the legal qualifications of brackets and other products can participate
in terms of quality standards, production capacity, supply stability, corporate credit, etc.
Overseas medical device registrants (recordators) shall designate domestic enterprise legal persons in China to assist them in performing corresponding legal obligations
.
The procurement of this alliance is carried out
according to the three steps of "first round of bidding, expert negotiation, and determination of selected enterprises and products".
In addition, enterprises are required to submit the price reduction of each group of products on the spot during the first round of bidding, and only one enterprise in the same group is allowed to declare one price reduction, and the enterprise shall declare a reduction rate that is not lower than the minimum effective reduction, otherwise it will be regarded as an invalid offer
。 In the expert negotiation link, it is also mentioned that if the declared price is higher than the lowest winning price of other provincial (including alliance) and municipal centralized procurement in the country, all declared products of the reporting enterprise in this group will be directly eliminated; Review experts comprehensively consider clinical needs and usage, product functions, product quality and other factors, and experts can negotiate the price of the enterprise and vote on the final price; If the declared price of a product is not recognized by expert vote, the product is eliminated
.
For the unselected products, the document also pointed out that it belongs to the scope of this centralized procurement, and the products that have not been declared by the enterprise and the declared but not selected products are regarded as non-selected products
.
Non-selected products shall be purchased on the network in accordance with the relevant policies of each alliance region, and the relevant price management policies
of each alliance region shall be implemented.
If the product is selected, the collective procurement cycle will be calculated for 2 years
from the implementation date.
Relatively speaking, Sichuan has more varieties of centralized procurement, Sichuan's oral implant procurement products with implants, prosthetic abutments, accessories package each to form an implant product system, according to the implant material, divided into four levels of pure titanium implant product system and titanium alloy implant product system a total of two product system categories
.
However, the qualification requirements for enterprises are consistent
with the Shaanxi Alliance centralized procurement.
However, the cycle of Sichuan collective procurement is 3 years, and the bidding rules are also different
.
Due to the different characteristics of consumables of oral implants, the product system is the main body to accumulate the unit price of the implant (including covering screws), the unit price of the restoration abutment, and the unit price of the accessory package (the unit price of the healing abutment, the unit price of the transfer rod, and the unit price of the implant replacement) as the declared price for bidding comparison
.
All declared product systems shall participate in the quotation, and the same part of the same medical device registrant's product system in the same bidding unit, regardless of material and specification model, is allowed to have only one declared price
.
In the same bidding unit, the declared price of the same medical device registrant's product system cannot be higher than the lower value of the effective purchase price of all product systems of the medical device registrant purchased by tertiary public medical institutions and large private chain medical institutions in 2021 (hereinafter referred to as the "effective procurement low price").
In the same bidding unit, if all product systems of medical device registrants do not have the purchase price of national tertiary public medical institutions and large private chain medical institutions in 2021, they cannot be higher than the minimum value
of the effective procurement low price of all medical device registrants in this bidding unit in 2021.
02.
Crossing the "fence" not covered by medical insurance, centralized procurement stirs up the oral market Following the centralized procurement of dental implants, orthodontic centralized procurement followed
.
Similar to the former, both are consumer medical care and basically do not achieve medical insurance coverage
.
A few days ago, the National Medical Insurance Bureau issued the "Reply to Recommendation No.
6184 of the Fifth Session of the 13th National People's Congress", saying that the current medical insurance system in China is based on "basic protection", dental implants belong to a higher level of medical needs, and dental implants are not considered into the scope
of medical insurance payment for the time being.
It also said that in the future, eligible medical consumables and medical service items will be included in the scope of medical insurance payment to better meet the medical needs of
patients.
The collective procurement alliance of 15 provinces continues to extend its hand to orthodontic consumables products that are not included in the scope of medical insurance, sending an important signal that "volume procurement" has developed to a new stage, that is, whether a category is included in collective procurement depends on whether the purchase amount is large, whether the total cost of treatment is too high, and whether the patient's treatment burden is heavy; It is no longer limited to health insurance coverage, and the degree of difficulty is no longer an issue
.
It is worth noting that in this collection, "bracketless invisible braces" is the latest technology produced by the development of modern science and technology in orthodontic specialties, and it is also the most expensive invisible orthodontics in the current orthodontic
market.
Compared with traditional orthodontics, invisible orthodontics has the advantages of high aesthetics, hygiene, high comfort, saving consultation time and follow-up frequency, and predicting the correction effect in advance.
But at the same time, it has also been criticized by many consumers for its high price
.
Compared to conventional orthodontics, the cost of consumables for invisible orthodontics has doubled on average, or even higher
.
According to the "2018 China Orthodontic Market Consumer Blue Book", the market prices of orthodontic metal bracket correction, ceramic bracket correction, metal/ceramic self-ligating bracket, invisible correction and lingual invisible correction are between 20,000 yuan, 22,000 yuan, 23,000 yuan to 33,000 yuan, 35,000 yuan to 45,000 yuan, and 55,000 to 80,000 yuan
, respectively.
In the face of potential huge profits, it will inevitably attract a large number of enterprises to enter.
At present, in addition to Angelalign, a large number of domestic invisible orthodontic brands have emerged in the market
.
Shanghai Zhengya, Tianjin Zhengli Technology, Beijing Meimang, Shenzhen Best Mime.
.
.
According to Zhongtai Securities' research, as of January 2021, there are 125 valid invisible orthodontic product registration certificates in China, held by 104 companies
.
In other words, there are more than
100 companies that have obtained registration certificates for invisible orthodontic products alone.
In addition, in the primary market, invisible orthodontic companies are also optimistic about capital, frequently investing weights, and there is no lack of big money: In August 2022, Shanghai Priscon Electromechanical Technology Co.
, Ltd.
announced the completion of a 200 million yuan C round of financing, which will take 3D printing equipment as the core and launch a complete set of solutions for invisible orthodontic braces, covering the whole industry chain solution from 3D printing and orthodontic diaphragm materials to automated film pressing and cutting in invisible orthodontics, creating a complete processing and manufacturing process system
for invisible orthodontics.
In July, Xi'an Aishile Medical Technology Co.
, Ltd.
received a $5 million financing led by overseas capital
。 Its co-founder Zhang Liye said that the company will use this round of financing to develop products, improve the platform, brand building and so on
.
In March, Zhengya Dental completed a Series D financing
of RMB 500 million.
This round of financing will accelerate Zhengya's industrial layout in the field of invisible orthodontics, promote the continuous research and development and innovation of invisible orthodontic technology, strengthen brand building and team development, and promote the further expansion
of its core products in domestic and foreign markets.
At present, in the domestic invisible orthodontic market, Invisalign and Angelalign have the highest proportion of the market, and the two have created high competitive barriers
in the field of invisible orthodontics by virtue of their first-mover advantage and scale effect.
In the face of the crazy influx of markets, industry leader Invisalign did not know what considerations to start a price war
.
Since the beginning of this year, Invisalign has always been highly priced, and has begun to reduce prices in order to grab market share; In April, Invisalign lowered the price
of its products again.
In order to maintain market share, domestic brands led by Angelalign also began to reduce prices
.
When the blue ocean becomes the red ocean, homogeneous competition will naturally promote the upgrading
of the industry.
Market analysis believes that in the early blue ocean, of course, there were several large enterprises that ate all the dividends
.
However, with the influx of more and more enterprises, it is inevitable that the industry will passively upgrade products and reduce prices
.
Perhaps the invisible orthodontic market used to be eye-catching, but today there is no strong force
behind its prosperous exterior.
Industry experts said that whether it is drugs or equipment, the purpose of collective procurement is one - to squeeze out the inflated price of water, reduce procurement costs, and effectively solve the problem of
"difficult and expensive medical treatment".
The two oral category collective procurement released this time prove that the centralized procurement policy has already been
explored further in the deep water area.
When the easy areas are fully covered, it is inevitable to attack the difficult areas
.
Centralized procurement in the field of oral consumables is by no means the last difficult bone to chew, what is the result of collective procurement in this field? To what extent will collective procurement be in the future? These are the focus of our concern, and they are also the focus
of China's medical system reform in the future.
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