Key investment points
Event: Recently, Shanghai Medical Insurance Bureau issued the notice on the trial payment based on performance for some medical consumables, proposing to pay based on performance for the consumables of heart valve (folding) and cardiac ultrasound catheter, and include the medical institutions with the number of cases ≥ 30 into the scope of assessment. The pilot period is 2 years. The pilot assessment will be officially implemented from June 15, 2022. We will interpret and analyze the relevant contents.
TAVR consumables are included in the payment scope of medical insurance at the proportion of 80%, and related products are expected to accelerate the volume. Transcatheter aortic valve replacement (TAVR) is a cutting-edge therapy for the treatment of aortic stenosis, regurgitation and other diseases. The high cost of operation (terminal payment or 300000 yuan, of which the cost of consumables is about 200000, data source: medical equipment consultation) leads to a relatively limited audience and low overall penetration rate in China in the short term; In January 2022, Shanghai Medical Insurance Bureau once issued a document to include TAVR charging items into the scope of medical insurance. The charging standard is 5200 yuan, and the patient pays 10%, but it does not involve the consumables themselves. This notice clearly proposes to settle according to the average payment level of medical insurance fund (80%), and does not adjust the price of consumables, which will help release the surgical needs of more patients with valve diseases, reduce the burden of medical expenses, and expand the audience of TAVR surgery. We believe that the coverage of TAVR surgery may expand rapidly, and the volume of products is expected to accelerate.
The surgical treatment effect is included in the assessment scope, and the head brand with sufficient clinical data and superior product performance may benefit first. This notice proposes two assessment indicators for TAVR surgery. The immediate success rate after surgery or the incidence of serious perioperative complications. The consumables used by designated medical institutions in the previous year are assessed in February every year. Institutions that meet the requirements of the indicators can be reimbursed in full, and hospitals that fail to meet the requirements will reduce the total reimbursement by about 5%. We believe that this assessment requirement may guide hospitals to pay more attention to the safety and effectiveness of TAVR surgical treatment, the importance of delivery system and valve recyclability is becoming more and more prominent, and brands with sufficient clinical data and excellent production capacity and performance may further benefit.
Medical institutions with operation volume ≥ 30 are the first to be included in the scope of payment, which is expected to stimulate the operation enthusiasm of more medical institutions. This notice points out that medical institutions with less than 30 cases will not be included in the assessment, and it is not clear whether they will be included in the reimbursement scope. If TAVR consumables of corresponding medical institutions are not included in the medical insurance payment, relevant hospitals may have greater motivation to speed up TAVR surgery to meet the reimbursement requirements; If the corresponding organization is also included in the reimbursement system, it will also help the terminal volume of relevant products.
Investment suggestion: we believe that relevant domestic TAVR brands are expected to accelerate the breakthrough of terminal implantation with the help of this round of medical insurance policies. We suggest paying attention to China's top enterprises such as Qiming medical, Xintong medical and Peijia medical, as well as some enterprises with strong R & D ability and fast research progress, such as Lepu Medical Technology (Beijing) Co.Ltd(300003) , Beijing Balance Medical Technology Co.Ltd(688198) , etc.
Risk warning events: new product R & D risk, market competition risk, and the risk that the public information used in the research report may be delayed or not updated in time.
