The last stop of the orthopedic country has triggered a series of chain reactions!Is the next stop of the collection of consumer medical care?

Last month, the orthopedic spine consumables were released in Circular No. 1. The industry is expected that the results of the winning bid will be announced in Tianjin as soon as in September.

In just about 2 years, artificial joints, trauma, and spine, one after another, orthopedics has almost become the most thorough high -value consumable field.

The national entertainment effect, the power is fierce! Following last year, the artificial joints entered the era of thousands of yuan and the trauma products were "10 % off", and orthopedic manufacturers will again compete on the same stage, and they will still win from a decline!

In addition, today, the National Medical Insurance Bureau issued the "Notice on the Price Governance of Oral Planting Medical Service and Consumption Price (Draft for Soliciting Opinions)". After orthopedic, will dental implants be the target of the next national "surgery"?

Orthopedic harvesting, competition upgrade!

Just as there are no two leaves in the world, there are two kinds of medical consumables that are exactly the same in this world.

Therefore, the National Medical Insurance Bureau said: For consumables, we must adhere to the principle of "one product and one policy". Even if they are orthopedic products, the details of the rules are different.

01

"No dead ends" -style country, the insufficient decline will be "constrained"

In the Document 1 of the spine country released on July 11, according to the type of surgery, surgery site, and approach, etc., 14 sets of spine systems (see the end of the article for details). Compared List separately, more in line with market conditions.

Some people in the industry said that these 14 systems are almost "no dead ends", which means that all spine products will be collected!

Because it is the second national collection of orthopedics, or as a supplement that less than before, some details have been added in this collection.

For example, in terms of services, compared with joint nations, the cost of medical institutions needs to be afforded. In addition to disinfection costs, it is also incorporated into non -dedicated power tool costs. The boundary of the manufacturer's service content is clearer.

In terms of residual amount distribution, the document clearly expires the companies that are high in the election position, and appropriately restrict the enterprises that are reunited in the election. Although the degree of "constraints" has not been determined, it is obviously aimed at manufacturers with insufficient sincere decline. I don't know how much space will be cut off.

02

"Power Player" can enjoy a "resurrection opportunity" once

In the bidding unit, there were only AB groups in the joints of the joint country last year. This time, the spine country has set up three ABC bidding groups based on different situations. It can be briefly understood as:

Group A: Enterprises with large dosage, all varieties, and available in the country;

Group B: Enterprises that are small or cannot be supplied nationwide;

Group C: Lack of major components or companies focusing on single products.

It is reported that in accordance with the above conditions, only "the main components are complete", in the Chinese spine market, about 50%of the enterprises do not meet the standards.

Therefore, the competition of Group A is destined to be a competition between "strength players". Group C is more biased towards the battlefield of SMEs and single products PK.

In addition, for the "superior students" of group A with a high degree of love in medical institutions, the rules also given a special "resurrection opportunity":

Enterprises that are selected in group A are not compared with the highest price of Group B, and they can also be qualified to qualify for the selection.

According to industry news, members of Group A are likely to bid together with group B with the same category. As long as the highest price of the same category in Group B appears, it almost means that Group A can "lie down" to advance.

Of course, according to the rules linked to the volume and price, if you want to get the most, you cannot just count on the "exemption", or you must work hard up and down.

For Group C, which is "not thick enough at home", fate is in the hands of others -the average price of the AB group is the ceiling. If you want to win the bid, you must have a more sincere degradation than the strong.

03

The elimination rate "opens the side", and then send the purchase duration +1 "big gift package"

In this spine country's document, a special sentence is added: In the premise of ensuring fair competition, maintaining competition intensity, and removing high -price space, more enterprises are promoted and the stability of expectations is enhanced.

Promoting more enterprises in the selection means to some extent reduces the elimination rate. It can be clearly seen that the rules intend to expand the number of shortlisted companies.

Jellers, up to 24 shortlists

The spine country can be shortlisted by up to 30 (not higher than the price limit, the price difference can be all won the bid)

▲ Spine country can be shortlisted in the number of companies in the number of shortlisted enterprises

In addition, or for the complexity of the spine collection, compared with the two -year purchase period of joint nations, the spinal cycle is extended to 3 years. (For Anhui, it means that after the spine collection period expires, the result will be postponed.)

The longer procurement cycle, on the one hand, collects and effort, and stimulates the driving force of the enterprise on the other hand, and it will also increase the pressure of the bidding enterprise accordingly.

04

3D printing for the first time, some people win the bid, and some people "stand on the side"

This document specifically explains that 3D printing products can voluntarily participate in this collection, but the grouping situation is not clearly explicit, or it appears as sporadic components.

Just like the prisoner's dilemma, as long as there is a 3D printing product offer to win the bid, other 3D printing products without quotation can only be "standing side by side" in the future.

Domestic market, orthopedic 3D printing leading companies include

Foreign companies: Midunli, Starker, Jiemangmei, Johnson & Johnson, etc.;

Domestic: Aikang Medical, Sanyou Medical, Hunan Huaxiang, etc.

Among them, Aikang Medical is more well -known. In December 2017, it was listed as the "domestic orthopedic 3D printing first share" in Hong Kong. It was applied to bone joints and spine replacement implants, or it will participate in the competition of this key category. In addition, it is recently reported that Shandong Weigao Orthopedics will cooperate with Hunan Huaxiang to promote the spine 3D printing fusion product and the front PK Aikang Medical similar products.

05

It is expected to be "completed" as soon as September.

Simply review the process form of the lower spine country, it has been prepared for more than half a year:

December last year: "Opening an account" in an enterprise, receiving a digital certificate;

April this year: Medical institutions fill in historical procurement data;

May: Release the draft for solicitation;

July 11: Issuing Document No. 1 of the Spine State Call, enterprise declaration, and hospital reporting.

Next, the Liancai Office will introduce Document No. 2 of the spine country according to the needs of the hospital to publicize the highest price limit and corporate group information. The benchmarking joint country will be issued, and the No. 3 document may also be issued to ask the enterprise to "report the cost and price".

Considering major domestic meetings in the second half of this year, the industry news said that the bidding time of the spine country will be moved forward as soon as possible. As soon as the results of the secondary election will be released as soon as in September, this year will be launched in Q1 large -scale next year.

In other words, it is less than half a year left for manufacturers and dealers.

06

From the pilot of Anhui, will Midunli still "lie down"?

Although the orthopedic high -value consumable market exceeds 10 billion, it is the leading company. According to the corporate prospectus, in 2019, the overall market of Chinese orthopedic implantation of medical devices,

The first four foreign companies Johnson & Johnson, Midunli, Jiemimi, and Stick accounted for nearly 40%.

In July 2021, Anhui spine collection was regarded as the "outpost" of the spine country. From the participation of enterprises, it can be known to the spine country's competition.

Among the multinational enterprises, the "Four Great Kings" of the spine shows each other:

Stick has performed positive in multiple groups of products, and has won the highest decline in many times;

After Jiemai's quotation followed Johnson & Johnson, the two bidding products were completely the same.

After the spine king, Midunli sold Libel, or for adjusting the domestic strategy consideration, multiple products in Anhui Ji Cai were accompanied, and even a "lying flat" quotation of 1%decreased was not interested in participation. However, its domestic brand Kanghui performed well, with 4 groups of products selected.

As the pilot work of the spine country, multinational enterprises have performed the poles, and many domestic "barefoot" enterprises, such as Dabo Medical, Beijing Liber, and Weigao Orthopedics, seize opportunities and borrow breakouts.

Anhui spine collection has a maximum decrease of more than 80%, and the price price is likely to become a reference for the limited price of Guotai. Therefore, the upcoming decline of Guotai can be imagined!

The success or failure is collected, and the reshuffle of the head orthopedic enterprise accelerates

In the past three years, domestic orthopedic manufacturers can be described as "house leaks prefer night rain", which is not only severely frustrated by the epidemic, but also faces a series of combinations. From the perspective of the data of 7 orthopedic listed companies, there are two trends.

On the one hand, in 2019, before the epidemic, the seven companies were "like breaking bamboo", all of which increased at high speeds of double digits; but after the epidemic, the growth rate gradually decreased in 2020, and even two companies had negative values. Growth has risen, but it is not the same as before the epidemic.

On the other hand, each enterprise focuses differently, and the influence is different. Compared with the 2019 revenue ranking, Aikang Medical Ranking declined in 2021, from fourth place to sixth place; Chunli rose from fifth.

▲ Main orthopedic listed enterprises in China have revenue data in the past 3 years

"Awkward" winner Aikang Medical: The dealer "run away", and the revenue profit declines doubles.

Judging from the performance in 2021, Aikang Medical

Revenue of 763 million yuan, year-on-year-26.5%;

The net profit was 92.62 million yuan, a year-on-year-70.5%.

It is like a transcript that has been "abandoned" by victory, but in fact, Aikang Medical is actually a domestic winner of joint country.

In the session of joint country collection, Aikang Medical took off the "Most Love Product NO.1" crown in medical institutions, and its three types of products all entered the TOP 5 intentional procurement list and all won the bid. The total amount is close to 1 billion yuan.

In the business of Aikang Medical, the proportion of orthopedic joint implants is very high. Some data show that 80%of its income comes from hip and knee joints, accounting for 55.1%and 24.9%, respectively.

As the one of the few business income and net profit "double drop" of the first echelon of orthopedic high -value consumables, Aikang Medical complained in the financial report:

The main reason for the decline in income is that the price of artificial joints has caused the price of the product to fall. Dealers (that is, the customers of Aikang Medical) reduced the purchase of joint implants, and Aikang Medical made more than 100 million yuan for artificial joint products for more than 100 million yuan Differential price subsidy.

It is worth noting that at the end of 2021, the joints of the joints have not yet landed, and their performance has been hit. These are the painful pains of the bidding enterprise.

Orthopedics "king" is not guaranteed, and Dabo Medical Orthopedics is about to overtake

Judging from the 2021 revenue TOP 3,

First place, Weigao Orthopedic is known for its spine products, with revenue of 2.154 billion yuan;

In the second place, the income of trauma products is better, followed by, and the income is close to 2 billion yuan;

Third, the main product of Chunli Medical is joint prosthesis with income of 1.108 billion yuan, which is a large gap compared with the previous two.

After careful observation, in the past three years, the gap between TOP 2 Weigao Orthopedics and Dabo Medical has decreased year by year, and the latter's growth rate is extremely considerable.

In fact, from this year's Q1, Dabo's medical revenue is 431 million, and Weigao Orthopedics is 340 million. In the first half of this year, it may be about to overtake.

It can be described as a collection, and the defeat is also a collection.

Last year, the Twelve Provincial Alliance Collection of Orthopedic Innovation Category. According to the selection share, Dabo Medical became the biggest winner in the audience, accounting for 17.6%; the Weigao Orthopedic Department, which surpassed the first market share (accounting for 10.7%of the proportion).

In addition, from the perspective of "post -force", although Weigao Orthopedic has been in the industry's leader, it has lost its appearance in various key indicators. For example, R & D expenses, from 2018 to 2020, the total investment in Weigao R & D is 200 million yuan, Dabo Medical is 290 million yuan, and the three types of device registration certificates are very close.

▲ From Weigao Orthopedics Prospectus instructions

After orthopedic, the country's "surgery" to consumer medical care?

Today, the three major categories of orthopedics are settled, joints and spine have been determined by the country, and the trauma spreads by local alliances. So, who returned to the desktop, after orthopedic, who will the next consumables be used?

In fact, as early as November 24, 2020, the Medical Insurance Bureau issued the prelude to the second batch of consumables of consumables in the "Notice on the Corruption of the second batch of centralized procurement data of high -value medical consumables and the monitoring of price monitoring". 6 major categories, namely:

Nowadays, orthopedic products are "smoothly promoted". According to the order, the following is the "playing time" of the defibriller, blocking device, and anastomat.

However, the plan cannot keep up with changes.

In 2021, Ningbo released the signal of dental implants for the first time, which stirred thousands of waves, and the discussion on dental implants costs on the hustle and bustle of dental implants, and even rose to the scope of discussion at the State Council meeting.

In January of this year, the executive meeting of the State Council decided to normalize and institutionalize the concentrated volume of drugs and high -value medical consumables, which directly named dental implants.

Dental implants are called "the most difficult collection in history". After several operations, it is to promote weakness. The original plan has been delayed.

In November last year, the Sichuan Alliance launched a report on dental implants and no progress.

In April of this year, the Sichuan Alliance once again organized a report on dental implants and no progress.

As a direct institution of the State Council, the State Medical Insurance Administration has to do it in the face of the tasks issued by the directly -affiliated units.

▲ On August 18th, the State Medical Insurance Bureau issued the "Notice on the Development of Oral Planting Medical Services and Special Governance of Consumption Price (Draft for Soliciting Opinions)" to release the pressure of collecting collection,

Check the original text

The reason why it is said is because there are two major difficulties in dental implants:

First, it belongs to non -medical reimbursement products. Private hospitals occupy the market in the market. They collect "teachers out of the door" and the price is not strong;

The second is that the highest cost is not the consumables, but the medical service fee.

Although it is difficult, it is not 100%inevitable.

At present, this "hard bone" should be eaten. According to the opinion draft, it should be investigated, endorsed, and programs by the National Medical Insurance Bureau. The Sichuan Medical Insurance Bureau led the inter -provincial alliance to implement it, and emphasized that all provinces should participate. Maybe a new model of decentralized national collection may be formed?

Regardless of the model, an important direction of dental implants has been released -the people's livelihood may become one of the decisive factors to choose a national collection variety, even if it is a consumer medical product within non -medical insurance.

After trying to deduct, after the dental implants, will the price management of products such as Ophthalmology OK mirrors also be released in accordance with the voice of the masses?

Having said that, many people could not understand the varieties of medical insurance. In fact, the official website of the National Medical Insurance Bureau will find that the fifth item is to organize the formulation of policies such as drugs, medical consumables, and medical service project charges. The scope of which is not explained as "within the medical insurance directory". It is not impossible for medical insurance.

If you still can't understand it, it is better to default to the "medical product and service price management and guarantee bureau".

▲ The official website of the State Medical Insurance Bureau

But this is not necessarily a good thing for the industry.

A common example is that US medical expenses account for nearly 17%of GDP (about 7%of China). This kind of payment space and incentive for enterprises must be related to the world's leading innovative vitality.

Development requires space and requires trial and error. A simple truth -under economic pressure, the children of the poor will dare not pursue what they want, thereby forming a hand -to -foot personality; while the children of rich people dare to take risks and attempts, be good at risk management, and naturally naturally There are more possibilities to realize ideas.

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