Aunt Zhang in Jinan has just filled her teeth recently. After repairing her bad teeth, she plans to plant six teeth. Recommended by her friends, she went to a stomatological hospital in Jinan for consultation. According to the hospital, the price of each implant varies from more than 3000 yuan to more than 9000 yuan due to different materials.
She plans to choose the implant with a unit price of about 5000 yuan. “My friend planted it in this hospital seven or eight years ago. I feel that the quality is guaranteed. It doesn’t depend on how much money you spend. If it breaks down in three or five years, it’s too troublesome.”
Compared with Aunt Zhang, Mr. Shen’s dental implants cost more. Five years ago, he planted three teeth in Shanghai and spent more than 60000 yuan before and after.
The current situation of the high price of dental implants may soon usher in a turnaround with the convening of the executive meeting of the State Council on January 10. The executive meeting of the State Council held this time decided to carry out centralized procurement of drugs and high-value medical consumables in a normalized and institutionalized manner, so as to further reduce the medical burden of patients. The meeting pointed out that it is necessary to gradually expand the coverage of centralized collection of high-value medical consumables, and carry out centralized collection of orthopaedic consumables, drug balloons and dental implants concerned by the masses at the national and provincial levels respectively.
in 2020, the market scale will be nearly 30 billion
According to the popular science introduction of West China stomatological hospital, the material of implant teeth is metallic titanium, titanium silver white, with stable chemical properties, high temperature resistance, low temperature resistance, strong acid resistance, strong alkali resistance, high strength and low density. At present, titanium and titanium alloy are the most widely used metals implanted into human body in modern medicine, accounting for more than 80%. After the implant is implanted into the alveolar bone, it will be in an environment with complex physical, chemical, biological, mechanical and other factors, which requires that the implant has no cytotoxicity, tissue irritation, genotoxicity and carcinogenicity, and will not cause immune reaction and allergic reaction. Titanium and titanium alloy are materials that can get along well with the cells, blood and organs in the human body.
The operation process of dental implant is to implant the artificial root into the alveolar bone in the missing tooth area through minimally invasive surgery. After about 1-3 months, after the implant is fully integrated with the alveolar bone, the artificial crown is made on it. It usually takes three months to complete planting, and it may take half a year to a year.
Implant model. Figure source: West China stomatological hospital
Implant teeth are almost the same as natural teeth in function and beauty, so they are called the third set of human teeth. It has the advantages of stable retention, high chewing efficiency, no wear of adjacent teeth, strong aesthetics, comfort and convenience, small trauma, fast healing and so on.
According to the in-depth report on the implant industry released in July 2021, the number of dental implants in China is expected to be 4 million in 2020, and the compound annual growth rate from 2016 to 2020 is 30%. According to the payment of 7400 yuan for patients with single implant at the consumer end, the market scale will be 29.7 billion yuan in 2020.
The report points out that from the two aspects of aging will catalyze the further growth of the market and penetration, the space of China’s dental implant market can exceed 100 billion yuan, and the high-speed growth of dental implant market in the next decade is highly uncertain.
In the first three quarters of 2021, Topchoice Medical Co.Inc(600763) , known as “dental Mao”, the income of dental implant business reached 331 million yuan, a year-on-year increase of 46.49%, accounting for 16.47% of revenue.
Work scene of stomatological hospital
Taking Shandong as an example, the reporter of Dazhong · poster news learned from keen stomatological hospital that in 2021, the total number of dental implants in 23 branches in seven cities of keen stomatology was more than 20000. In terms of outpatient volume and business income, the dental implant business accounted for more than 30% of keen stomatological hospital.
where are dental implants?
The Pacific Securities Co.Ltd(601099) according to the in-depth report of dental implant industry released by securities in June 2021, the cost of dental implant surgery in the Chinese market is about 8000-22000 yuan. As the core material, the cost of implant is the highest, generally up to 3500-12000 yuan, accounting for 50% of the whole operation cost, followed by operation cost + anesthesia cost of 3000-5000 yuan (accounting for 25%), repair material of 1200-2500 yuan (10%), implant abutment of 1500 yuan (10%), and dental crown is divided into porcelain teeth of 300-1000 yuan or all ceramic teeth of 1000-2500 yuan (5%).
The report shows that in China, more than 90% of the implant market is occupied by foreign brands (including European, American and Korean brands), and the market share of domestic brands is less than 10%. Both European and American brands and Korean brands have been listed in the Chinese market for more than ten years. China’s implant system was basically launched around 2015, with a short time to market, technically imitating European brands, and the products are in the imitation stage, but the price is close to that of Korean brands, and there is no advantage in price, resulting in limited market share at present. By the end of 2020, 15 enterprises and institutions in China had been approved for implants, including meijiajing, Allianz and Yiti technology from Taiwan.
\u3000\u3000 “Implants need precision machining. Titanium is cut and processed into implant teeth by precision lathe. After that, surface treatment is a relatively key core technology to improve the bioactivity of implant surface and promote the combination of implant and alveolar bone. Some key points of this technology are developed and mastered by major brands from Switzerland and Sweden.” Qi Qingguo, President of keen stomatological hospital, believes that some domestic implant brands have been very good in terms of production and processing. However, since the implant market has been occupied by foreign brands for many years, foreign brands have been used since the training of doctors. Doctors will have preconceived habits and give priority to foreign brands. At the same time, many patients also have a certain bias that imported brands are more reliable.
“The training cost and scarcity of planting doctors are also factors driving up the planting cost. Planting is a typical post graduation education.” Qi Qingguo said that it will take at least three to five years for graduates majoring in stomatology to grow into a more mature implant doctor, so as to grasp the indications and judge the prognosis, “Dental implant is not so simple. The main group of dental implant is the elderly aged 60 or 70. The alveolar bone conditions of many people are not as good as those of young people. Either the height is not enough or the width is not enough, which requires a variety of clinical techniques to complete the implant operation.”
multiple deployment implant system centralized belt procurement
In 2021, Li Xiaoli, deputy to the National People’s Congress and part-time vice chairman of Feidong County Federation of trade unions, submitted the proposal on standardizing the cost of dental implant materials and including their treatment and service costs into medical insurance, which attracted attention from all walks of life.
Because of her experience in a dental clinic, she found that the price of dental implants was very high. Her local research found that the quality of various dental implant materials is uneven, the price is generally high, and medical institutions charge different fees for dental implants of the same material. An oral treatment hospital below the county level receives about 30 patients every day, and the average treatment cost of one implant varies from 6000 to 20000 yuan. If you plant full teeth, it is equivalent to buying a suite in the county. Implant teeth were not included in the overall reimbursement scope of medical insurance.
In August 2021, the National Medical Security Bureau replied to the proposal on regulating the cost of dental implant materials and including their treatment and service costs into medical insurance, saying that at present, the national level adopts the exclusion method to pay and manage consumables, and stipulates the items that are not paid and partially paid by basic medical insurance.
According to regulations, at present, glasses, dentures, artificial eyes and other instruments in all provinces (regions and cities) are not included in the payment scope of basic medical insurance.
Industry insiders told dazhong.com · poster news reporter that implant teeth belong to consumer medical treatment, do not belong to basic medical needs, and are replaceable, such as movable dentures, but its disadvantages are strong sense of foreign bodies and poor chewing efficiency; There are fixed dentures, but its disadvantage is that it needs to wear the healthy teeth next to it, which also causes a heavy burden on the healthy teeth.
The State Medical Security Bureau replied to the proposal on regulating the cost of dental implant materials and including their treatment and service costs into medical insurance
The good news is that in the second half of 2021, the deployment of centralized volume procurement of implant system came out in Sichuan, Ningxia, Shanxi and other places. On November 26, 2021, November 29, 2021 and December 3, 2021, Sichuan, Ningxia and Shanxi successively issued notices on filling in the historical procurement data of oral medical consumables. The notice shows that according to the work arrangement of centralized procurement of oral implant system of inter provincial alliance led by Sichuan Medical Security Bureau, the filling in of historical procurement data of oral medical consumables is carried out.
Notice on filling in historical purchase data of oral medical consumables issued by Shanxi
The notice of the above-mentioned provinces pointed out that it is necessary to fully realize the importance of volume reporting for overall volume procurement and data collection.
The executive meeting of the State Council held on January 10 was a further clarification of the centralized collection of dental implants at the national level.
How much did fall?
Qi Qingguo believes that the centralized purchase will lower the purchase price of implants. “The government will make statistics on the brands and dosage of implants used in all public hospitals. After the statistics, it will talk to the manufacturer. The quantity of centralized purchase is very large, such as hundreds of thousands of implants. For the manufacturer, the quantity must be exchanged for the price.”
Various brands of implants in keen stomatological hospital
“In this way, professional implant agents will face challenges. Manufacturers find agents to do market promotion. As soon as the government collects, the agents may have nothing to do.” Qi Qingguo said.
Qi Qingguo introduced that the implant purchase mechanism of public and private stomatological hospitals is different. For public hospitals, whether it is centralized purchase or the current bidding, the implant belongs to the consumables fee in the price approved by the price bureau, and the price increase is not allowed. The patient’s consumption of implant is the purchase price. However, in terms of dental implant, besides the cost of implant, there are operation expenses, crowns, disinfection, CT and other expenses, which may maintain the status quo. Therefore, the cost of planting a tooth may not decrease very much.
Private dental hospitals negotiate their own prices. Qi Qingguo believes that under the condition of full competition in the market, private dental hospitals have pressed down the price of implants. “For example, for Korean brand implants, the private dental market has actually decreased a lot compared with previous years.”
“Centralized purchase talks about the price. We go to talk with the manufacturer. Of course, we will also ask to implement the reduced price. This is market behavior.” Qi Qingguo said.
It is worth noting that the 2020 China Health Statistics Yearbook shows that in 2019, there were 885 stomatological hospitals in China, including 723 private hospitals, accounting for 81.69%, and 162 public hospitals, accounting for 18.3%. The conventional volume purchase takes the consumption of public hospitals as the price reduction chip, but the comparison of the above data to a certain extent means that oral consumables are less dependent on public hospitals. If the purchase volume does not go up, it will weaken the bargaining power.
Yang Li, a senior researcher at Guangzhou Zhongcheng medical equipment research institute, said in an interview that private dental hospitals occupy the vast majority of the service market, and the reporting volume of public hospitals alone is not accurate enough. The latter idea should be that enterprises become the main body of reporting volume, because they have the actual sales data of dental implant products.
In addition, Qi Qingguo said that he believed that the centralized purchase would consider the shortlist of domestic consumables. Domestic enterprises would certainly improve their market share if they got on the vehicle of centralized purchase, but the key is to learn to swim in the tide of the market, so as to occupy more markets.
