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Non medical insurance covers centralized purchase, directly referring to orthodontics! The story of dental "profiteering" will end!

release time:2022-10-22|reading:

 In the second half of 2022. the centralized procurement of dental implants and orthodontics will be closely implemented! The centralized collection of dental implants has just landed, which is known as the orthodontics of another gold digging track in the oral field, and also officially faces the storm of centralized collection. Recent developments all indicate that the wind of centralized purchasing has crossed the fence of "medical insurance coverage" and started to blow towards dental consumables.

  On October 19. Shaanxi Public Resources Trading Center - Centralized Procurement Platform for Pharmaceuticals and Appliances released the latest Notice on Centralized Procurement of Orthodontic Brackets in the Inter provincial Alliance (District, Corps). The announcement shows that 15 provinces (autonomous regions, production and construction corps) including Shaanxi, Shanxi, Inner Mongolia, Liaoning, Heilongjiang, Anhui, Henan, Guangxi, Hainan, Guizhou, Tibet, Gansu, Qinghai, Ningxia and Xinjiang will jointly carry out the procurement in volume.

  A month earlier, on September 22. Sichuan Medical Insurance Bureau released the Announcement on Centralized Procurement of Oral Implant System by Inter provincial Alliance (No. 1), opening the door to intensive procurement in the oral field.

  For patients, centralized purchase means price reduction, which is undoubtedly a good thing. For the industry, the continuous decline of the share price of the angel of the times who heads the "first domestic orthodontic stock" is also a reflection of the other side of the orthodontic industry. With the public cheering and the stock market downturn, does the story of dental "windfall profits" begin to end?

  01. The rules of centralized procurement in oral cavity are different from those of bidding procurement

  By comparing the centralized purchase announcement, it can be basically determined that the medical organization coverage modes of the two centralized purchase alliances are similar. The scope covers the public medical institutions (including military hospitals) in the Union Province (District, Corps) that carry out orthodontics for oral teeth; The designated social medical institutions for medical insurance will participate voluntarily.

  Unlike the previous Sichuan Union's centralized procurement aimed at the current hot dental implant consumables, this alliance's centralized procurement aimed at the procurement of orthodontic consumables, including brackets, non bracket invisible braces and buccal tubes. The announcement also attached the specific national medical insurance consumables code table. The purchase demand of each product is calculated by adding up the purchase demand of each product submitted by each medical institution participating in the purchase with quantity (the amount reported for purchase shall not be less than 70% of the actual consumption of the previous year).

  According to the published centralized purchase documents, the centralized purchase will also be carried out in groups, including ordinary metal brackets (groups A and B), ordinary ceramic brackets (groups A and B), self-locking metal brackets (groups A and B), self-locking ceramic brackets (groups A and B), bracket free appliances (groups A and B), and buccal tubes (negotiated price).

  The grouping rules will be sorted according to the purchase demand of the inter provincial alliance medical institutions from the largest to the smallest. The enterprises covered by the first 70% (including) of the cumulative purchase demand of each product category are selected as group A bidding units, and the rest are group B bidding units. If the number of effective declaration enterprises in Group A bidding units is less than 5. they shall be supplemented from more to less according to the procurement demand of provincial alliance medical institutions until the number of effective declaration enterprises in Group A bidding units reaches 5; If there are less than 5 enterprises applying for the same product category, all of them will enter Group A.

  In terms of enterprise qualification, the announcement shows that medical device registrants (agents) who have obtained the legal qualification of bracket and other products and meet the requirements of purchasing in quantity in terms of quality standards, production capacity, supply stability, enterprise credit, etc. can participate. Overseas medical device registrants (filers) shall designate domestic enterprise legal persons to assist them in performing corresponding legal obligations.

  The volume purchase of the Alliance is conducted in three steps: "the first round of bidding, expert negotiation, and determination of the selected enterprises and products". In addition, enterprises are required to submit the price reduction of each group of products on site during the first round of bidding. An enterprise in the same group is allowed to declare only one price reduction, and the declared reduction shall not be lower than the lowest effective reduction, otherwise it will be deemed as invalid quotation.

  In the expert negotiation link, it was also mentioned that if the declared price is higher than the lowest selection price of other provincial (including league) and municipal centralized procurement in quantity, all declared products of the group of the declaring enterprise will be eliminated directly; The review experts can negotiate the price of the enterprise and vote for the final price based on the comprehensive clinical needs, usage, product functions, product quality and other factors; The declared price of the product that is not approved by the experts will be eliminated.

  As for the products that are not selected, the document also points out that they belong to the scope of this centralized procurement with volume, and the products that are not declared by the enterprise and that have been declared but not selected are regarded as non selected products. Non selected products shall be purchased online according to relevant policies and regulations of each alliance region, and relevant price management policies of each alliance region shall be implemented. If the product is selected, the period of centralized purchase will be 2 years from the execution date.

  Relatively speaking, there are more varieties intensively purchased in Sichuan. The dental implant belt purchased in Sichuan consists of an implant product system consisting of one implant, one restoration abutment and one accessory package. According to the implant material, it can be divided into four levels of pure titanium implant product system and titanium alloy implant product system. However, the requirements for enterprise qualification are consistent with this Shaanxi Alliance Centralized Purchase.

  However, the period of centralized purchase in Sichuan is 3 years, and the bidding rules are different. Due to the different characteristics of the consumables for dental implants, the sum of the unit prices of implants (including covering screws), repair abutments, and accessory kits (healing abutments, transfer rods, and implant substitutes) accumulated by the product system as the main part of the quotation is used as the declared price for competitive price comparison. All declared product systems shall participate in the quotation, and the same part of the product system of the same medical device registrant in the same bidding unit, regardless of material, specification and model, can only have one quoted price.

  In the same bidding unit, the declared price of the product system of the same medical device registrant shall not be higher than the low value of the effective purchase price of all product systems of the medical device registrant purchased by the national three-level public medical institutions and large private chain medical institutions in 2021 (hereinafter referred to as the "effective purchase price"). In the same bidding unit, if all product systems of the medical device registrant do not have the purchase price of the national three-level public medical institutions and large private chain medical institutions in 2021. then it cannot be higher than the lowest value of the effective purchase price of all medical device registrants in this bidding unit in 2021.

  02. Centralized purchase beyond the "fence" covered by medical insurance stirs up the oral market

  Following the centralized collection of implant teeth, the centralized collection of orthodontics followed. The similarity with the former is that both belong to consumer medical care, and the medical insurance coverage is basically not realized.

  Recently, the State Health Insurance Bureau issued the Reply to the No. 6184 Recommendation of the Fifth Session of the 13th National People's Congress, stating that the current medical insurance system in China is based on "basic care", and implant teeth belong to a higher level of medical needs, so it is not considered to include implant teeth in the scope of medical insurance payment for the time being. He also said that in the future, eligible medical consumables and medical services will be included in the payment scope of medical insurance to better meet the medical needs of patients.

  This time, the 15 provinces' centralized purchasing alliance continues to extend its hand to the dental orthodontic consumables that are not included in the medical insurance category, sending an important signal that the "purchase with quantity" has developed to a new stage, that is, whether a category is included in the centralized purchasing depends on whether the purchase amount is large, whether the total treatment cost is too high, and whether the patient's treatment burden is heavy; It is no longer limited to the coverage of medical insurance, and the degree of difficulty is no longer a problem.

  It is worth noting that in this collection, the "bracket free invisible braces" are the latest technology developed with the development of modern science and technology in the orthodontic specialty, and also the most expensive invisible orthodontics in the orthodontic market. Compared with traditional orthodontics, invisible orthodontics has the advantages of high aesthetics, hygiene, comfort, saving time and frequency of visits, and predicting the effect of correction in advance; But at the same time, it has been criticized by many consumers because of its high price.

  Compared with conventional orthodontics, the cost of consumables for invisible orthodontics has doubled on average, or even higher. According to the 2018 China Orthodontic Market Consumption Blue Book, the market prices of orthodontic metal bracket, ceramic bracket, metal/ceramic self-locking bracket, invisible correction and lingual invisible correction are 20000 yuan, 22000 yuan, 23000-33000 yuan, 35000-45000 yuan, and 55000-80000 yuan respectively.

  Faced with potential huge profits, it is bound to attract a large number of enterprises. At present, in addition to the angel of the times, a large number of domestic invisible orthodontic brands are emerging in the market. Shanghai Zhengya, Tianjin Zhengli Technology, Beijing Meizao, Shenzhen Baishimei

  According to the research of Zhongtai Securities, as of January 2021. there are 125 valid registration certificates of invisible orthodontic products in China, which are held by 104 companies. In other words, more than 100 enterprises have obtained the registration certificate of invisible orthodontic products.

  In addition, in the primary market, invisible orthodontic enterprises are also favored by the capital, and frequently cast weight, and there is no lack of big money:

  In August 2022. Shanghai Plyson Electromechanical Technology Co., Ltd. announced that it had completed a round C financing of 200 million yuan, and would launch a full set of solutions for the invisible orthodontic braces, covering the whole industry chain solution from 3D printing and orthodontic membrane materials to automatic film pressing and cutting in the invisible orthodontics, and create a full set of processing and manufacturing process system for the invisible orthodontics.

  In July, Xi'an Aishile Medical Technology Co., Ltd. received a financing of 5 million dollars led by overseas capital. Zhang Liye, its co-founder, said: The company will use this round of financing for product development, platform improvement, brand building, etc.

  In March, Zhengya Dental completed round D financing of 500 million yuan. This round of financing will accelerate Zhengya's industrial layout in the field of invisible orthodontics, promote the continuous R&D and innovation of invisible orthodontics 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 market of invisible orthodontics, Yinshimei and Zeitgeist have the highest market share, and they have built a high competitive barrier in the field of invisible orthodontics by virtue of their first mover advantage and scale effect.

  In the face of the crazy influx of the market, Yinshimei, the industry leader, took the lead in starting the price war for some reason. Since this year, Yinshimei, which has always been high in price, has started to reduce its price and promote in order to seize market share; In April, Yinshimei lowered its product price again. In order to maintain market share, domestic brands led by the Angel of the Times also began to reduce prices.

  When the blue ocean becomes the red ocean, homogeneous competition will naturally promote the upgrading of the industry. According to market analysis, in the early days of blue oceans, it is true that some of the largest enterprises ate all the dividends. However, with more and more enterprises pouring in, it is inevitable for the industry to passively upgrade products and reduce prices. Perhaps the invisible orthodontic collar market once made people jealous, but today there is no strong force to support its continued development under the prosperous appearance.

  The experts in the industry said that the purpose of centralized purchase of both drugs and equipment is to squeeze out the water of inflated prices, reduce procurement costs, and effectively solve the problem of "difficult and expensive medical treatment". This successive release of centralized procurement of two oral categories proves that the policy of centralized procurement has already been further explored in deep-water areas. When easy to conquer areas are fully covered, it is inevitable to attack difficult areas.

  Centralized procurement in the field of oral consumables is by no means the last bone to be chewed. What is the result of centralized procurement in this field? How far will centralized purchase go in the future? These are the focus of our concern, as well as the focus of China's medical system reform in the future.


Shandong Zhushi Pharmaceutical Group Co., Ltd., founded in 2003, has more than 5000 registered employees. After years of development, it has developed into a diversified industrial cluster integrating medical devices, polymers, cosmetics, health food, daily necessities and biological reagent production, enterprise management consulting and training, real estate economy, pharmaceutical transportation, pharmaceutical printing, etc.


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