The price of implant centralized procurement is announced! How much money can you save by implanting a tooth after centralized procurement is implemented?

Produced by | Eye Health is Real

Author | Chen Zhenzhen

1. The cost of consumables, medical services, as well as the added costs of circulation, institutional operations, etc., make the price of dental implants "very expensive."

2. Recently, under the guidance of the National Medical Insurance Administration, Sichuan Province led the inter-provincial alliance for oral implant system centralized volume procurement and opened bids, and produced the proposed winning results. It is expected that people will be able to enjoy the "thousand-yuan" dental implants from late March to mid-April this year.

3. Behind the centralized procurement, it is not only about price, but also an important step towards "sunshine medical care".

Recently, the topic of "The era of tens of thousands of yuan for dental implants is about to end" has become a hot search, sparking heated discussions among netizens.

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The reason is that the dental implant centralized procurement, which has always attracted much attention, has made the latest progress: on January 11, the centralized procurement of oral implant systems was opened in Sichuan, and the proposed winning results were produced. The average winning price of the proposed winning products has dropped to more than 900 yuan, an average decrease of 55% compared with the median purchase price of more than 2,000 yuan before the centralized procurement. It is expected to be implemented from late March to mid-April this year.

Why are dental implants so expensive? Does the current price reduction mean the end of the "10,000 yuan era" of dental implants? Will there be new revenue-generating projects after the price reduction?

Interweaving of light and dark lines to create a "luxurious" dental implant

The cost of dental implants is mainly composed of consumables and medical service fees. Consumables include implants (implanted into the alveolar bone to serve as artificial tooth roots), abutments (components used to connect implants and crowns), and crowns. Among them, implants are the core components of dental implants. In addition, during the dental implant process, oral repair membranes, bone powder and other repair materials will also be used depending on the patient's specific situation.

Dental implant structure and surgical procedure

In November 2021, Xiaofang underwent the first phase of dental implant surgery at a public dental hospital in Beijing. The bill she received showed that the dental implant consumables and surgery costs totaled 10,680 yuan, bone powder was about 1,058 yuan, and other fees were several hundred yuan, for a total of about 12,000 yuan.

The total bill for the first-stage dental implant surgery provided by Xiaofang

The author interviewed several patients who have had dental implant experiences. According to their feedback, the high price of dental implant consumables, especially imported dental implant consumables, is a major reason for the overall high charges.

At present, imported dental implant products almost monopolize the Chinese market. According to statistics from Guohai Securities, the market share of European and American, Korean and domestic products is 35%, 58% and 7% respectively. The mainstream products of public hospitals and high-end private hospitals are high-priced and well-reputed European and American products, while Korean and domestic products are mainly in private hospitals. An industry insider revealed to the author that the low localization rate of implant products means that part of the profits in the dental implant market will flow into the hands of foreign companies and dealers to a certain extent, which is a major factor in the high price of implant consumables.

"We do almost all dental implant surgeries with imported brands, 60% of which are European and American brands, which cost tens of thousands of yuan each, and about 30% are Korean brands, which cost about 6,000 to 7,000 yuan each. We basically don't do domestic brands, mainly because there are too few cases." Wang Xiang, a practitioner at a chain of private dental hospitals in Beijing, told the author. Wang Xiang said that the purchase cost of different implant brands varies greatly, with Korean brands costing about 1,000 yuan and European and American brands costing between 4,000 and 6,000 yuan.

Dental implant consumables are indeed expensive, but the real big deal is the added value on the medical service side.

According to Guohai Securities' research data, the dental implant industry chain spans a long period, and the downstream hospital costs account for a large proportion. In fact, the money paid by consumers flows more into dental hospitals (used to pay for doctors' fees, marketing expenses, purchase of medical equipment, dental hospital profits, etc.), and the actual proportion of consumables costs is not high.

A doctor with more than 20 years of clinical experience in oral implants told the author that dental implants require very high technical skills from doctors. If you want to implant a tooth in your mouth, the doctor first needs to evaluate the oral tissue to ensure that the patient's "oral environment" is suitable for implants. Then the doctor needs to make a precise design for "how to implant" to form a reasonable implant plan. "In fact, the length of time an implant can be used has a lot to do with the level of the doctor. There is a saying in the industry that a dentist with very good implant technology can achieve the effect of a high-end implant even with mid- to low-end implants, just like a brilliant architectural designer who designs a house that people can live in for many years without risk." said the above doctor.

According to China Newsweek, an important reason for the high price of dental implants in public hospitals is an unwritten rule: the fees for the implant system and crowns should generally be controlled at about 30% of the total cost of dental implants, otherwise it will affect the hospital's performance evaluation. This means that if the material cost of a dental implant is 5,000 yuan, the total fee will not be less than 15,000 yuan.

In addition to material costs and labor costs, the costs incurred in the circulation process cannot be ignored. According to China Business News, dental implant-related consumables go through many agents from manufacturers to terminal medical institutions. The price sold by agents to hospitals is even higher than that of clinics. The reason is that entering the hospital requires bidding and managing various relationships, which invisibly increases some costs.

The centralized procurement has been implemented, has the “10,000 yuan era” come to an end?

The country's special governance of dental implant prices is progressing step by step. As early as September 8, 2022, the National Medical Insurance Administration made it clear that the full-process regulation target for dental implant medical service prices in tertiary public hospitals is 4,500 yuan per tooth (referring to the sum of medical service prices such as outpatient examinations, biochemical tests and imaging examinations, implant placement, and crown placement, excluding implants and crowns).

Details on the regulation of dental implant medical service fees

Next, it is the progress of the centralized procurement of implant consumables. The dental implant consumables in the scope of this centralized procurement are based on a complete set of implant systems, including 1 implant, 1 restoration base, and 1 accessory package (including screws, healing bases, transfer rods, replacements and other accessories). According to the implant material, it is divided into two product system categories: the four-level pure titanium implant product system and the titanium alloy implant product system. The highest valid declared price of the four-level pure titanium implant product system and the titanium alloy implant product system is unified at 2,380 yuan/set.

The person in charge of the inter-provincial alliance procurement office said in an interview with the media that this oral implant system centralized procurement alliance was led by the Sichuan Provincial Medical Insurance Bureau and all provinces in the country participated. A total of 55 companies participated, all mainstream companies have participated, of which 39 are expected to be selected, with a selection rate of 71%. The Straumann, Dentsply, and Nobel implant systems, which had higher prices before centralized procurement, dropped from the original median purchase price of 5,000 yuan to about 1,850 yuan, and the Ostotech and Denton implant systems, which have the largest market demand, dropped from the original median purchase price of 1,500 yuan to about 770 yuan.

Now that the price has been negotiated, people will naturally look forward to when they can enjoy the discount. Jiang Changsong, assistant to the director of the price procurement office of the National Medical Security Research Institute of Capital Medical University, said that according to the plan, after completing the price of dental implant medical services and the centralized procurement of implants, the crowns used in the dental implant process will be listed online for bidding in the near future. Sichuan will do it first, and other provinces will follow suit in March. It is expected that the fastest provinces to start centralized procurement of dental implants will be at the end of March, and some provinces will start in April. At the latest, it should be before May, and people will be able to fully enjoy dental implants below 10,000 yuan.

Jiang Changsong also said that currently, in big cities and big hospitals, it may cost 15,000 to 20,000 yuan to implant a tooth, but after the centralized procurement is implemented, it will be in the thousands of yuan level. However, there will be some differences in each place. For example, in big cities such as Beijing and Shanghai, it may cost 7,000 to 8,000 yuan to implant a tooth, while in some relatively less developed places, it may cost 4,000 to 5,000 yuan to implant a tooth.

Centralized procurement of dental implants: "something you can get, some things you can't get"

After the centralized procurement, will the various chaos in the dental implant market, such as irregular charges, inferior products, doctors without dental implant qualifications, and false advertising, be curbed? A doctor from a dental hospital said, "For some standardized private institutions, the price reduction of public hospitals will have a demonstration effect. However, for some medical institutions without any bottom line, it seems to have no effect. After all, the sharp knife of the law is always hanging over their heads, and they still take risks."

The above-mentioned dentist also said that centralized procurement will make implant consumables more open and transparent, and change the situation where implant manufacturers offer different bids to local areas, private and public hospitals, and public hospitals at all levels.

For ordinary people, while they are looking forward to the price reduction of dental implant consumables, more people will inevitably have such concerns: Will the quality of dental implant consumables deteriorate after the centralized procurement? Will the consumables be complete?

It is reported that the selected companies include some well-known international companies as well as domestic companies such as Weihai Weigao and Changzhou Baiconte. The selected products are rich and can effectively meet clinical needs.

"Even if some high-end brands are not included in the centralized procurement catalog, ordinary people who want to have good teeth still have options. Centralized procurement is not a rigid policy for everyone. Its essence is to provide a safety net, which can give more people more choices," said Liu Chen, an industry insider.

Dental implants rely on the skills of dentists. Behind the centralized procurement and price limits on medical service fees, how to reflect the value of their technology is an issue that needs to be considered. So, after the centralized procurement of dental implants, will there be revenue-generating projects that "press down one problem and another will pop up"?

Liu Chen said, "Before dental implants, if the patient's alveolar bone volume is insufficient, bone powder and periosteum may be needed. Bone powder is generally filled in the alveolar socket and the area of ​​missing teeth to increase the height and thickness of the alveolar bone, providing a good implant environment for the implant. The periosteum is a layer of membrane covering the bone powder after it is placed to prevent the loss of bone powder. However, oral repair membranes, bone powder and other repair materials are not yet included in the centralized procurement. Patients do not know whether or not to implant bone powder and how much to implant, which may become a manipulation space for some doctors. Standard doctors will try to simplify the operation process. If bone powder can be implanted without implanting, they will try not to implant it, so that patients can spend less money and suffer less."

Only with good teeth can you be healthy and enjoy your food. We hope that the centralized procurement of dental implants can benefit more people who are in real need.

(The interviewee in this article is a pseudonym)

References:

[1] The Medical Insurance Bureau officially announced that the centralized procurement plan for dental implants is “mature”. Experts: The high price is also due to “service fees”

https://baijiahao.baidu.com/s?id=1724738869458172794&wfr=spider&for=pc

[2] Policy interpretation of the “Notice of the National Healthcare Security Administration on launching a special campaign to regulate the charges for oral implant medical services and the prices of consumables”

http://www.gov.cn/zhengce/2022-09/10/content_5709291.htm

[3] “Several Circumstances Permitting Relaxation of Overall Regulation Targets for Medical Service Prices”

http://www.gov.cn/zhengce/zhengceku/2022-09/08/5709065/files/a0d1c44685a14f1ea3803e83fa8c5525.pdf

[4] Dental implant centralized procurement will be launched soon. The scope and relevant procedures will be released

https://baijiahao.baidu.com/s?id=1744672612510959031&wfr=spider&for=pc

[5] Why are dental implants, “the third set of teeth for humans”, so expensive and what are the problems with them?

https://baijiahao.baidu.com/s?id=1744820885935482274&wfr=spider&for=pc

[6] It costs thousands to tens of thousands to implant a tooth. Why is the “oral business” so lucrative?

https://rmh.pdnews.cn/Pc/ArtInfoApi/article?id=26010982

[7] Huge profits from dental implants: 80% of them are from private hospitals. Will the centralized procurement method of “bargaining by volume” fail?

https://www.cn-healthcare.com/articlewm/20220716/content-1401539.html

[8] How did dental implants become a cash cow? Will prices drop drastically? Reporter’s investigation

https://export.shobserver.com/baijiahao/html/522855.html

[9] The results of the proposed centralized procurement are announced. Is the "10,000 yuan era" of dental implants completely over? Expert interpretation

https://baijiahao.baidu.com/s?id=1754770589835954844&wfr=spider&for=pc

[10] The inter-provincial alliance for oral implant procurement produced the proposed winning results

http://www.gov.cn/xinwen/2023-01/11/content_5736322.htm