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The second shot of centralized procurement of consumables is about to fire! Will the average drop of

Issuing time:2021-09-06 09:57

The "Second Knife" of high-value medical consumables from China is being swiped towards orthopedic artificial joints.

As the National Organization for High-Value Medical Consumables Joint Procurement Office issued the "National Organization for Centralized Procurement Documents for Artificial Joints (GH-HD2021-1)" (referred to as "Procurement Documents") on August 23, countries with high-value consumables for artificial joints The centralized procurement will officially kick off in Tianjin on September 14.

  Different from the centralized procurement of medicines, high-value medical consumables have more complex products, and there are greater differences between different consumables, which makes the national organization’s high-value medical consumables procurement rules show the general characteristics of "one product, one policy".

  How to design the plan for the centralized procurement of artificial joints? What are the key points that enterprises need to pay special attention to? How to determine the bidding strategy? Previously, domestically produced products had a market share of less than 30%. Can domestically produced substitutes be successfully realized through centralized procurement?

   In order to better promote the centralized procurement of artificial joints, on August 26, the State Organization of the Joint Procurement Office of High-Value Medical Consumables held a training meeting for participating companies to interpret and answer the procurement documents on-site.

  01 One product, one strategy, more gentle rules

Regardless of whether it is medicines or high-value consumables, although the significance of the national organization of centralized procurement is to effectively reduce product prices, "centralized procurement does not pursue low quotations without a bottom line. We hope that companies will reduce prices rationally, and do not seek lower-cost quotations in pursuit of selection. "The relevant person in charge of the Joint Procurement Office of High-Value Medical Consumables of the National Organization made it clear.

   Judging from the procurement documents, the artificial joint procurement products are finalized as the primary replacement artificial total hip joint (hereinafter referred to as the hip joint) and the primary replacement artificial total knee joint (hereinafter referred to as the knee joint). Among them, the hip joint is divided into three product system categories: ceramic-ceramic hip joint product system, ceramic-polyethylene hip joint product system, and alloy-polyethylene hip joint product system. The highest effective declaration price is 19,000. Yuan, 18,000 yuan, 16,000 yuan, the highest effective declaration price of the knee joint is 19,000 yuan.

  The procurement cycle for the quantity is 2 years, and it will be calculated from the actual implementation date of the selected results in each region of the alliance. Among them, the total number of intended purchases of hip joint product systems in the first year was 305,542 (126,797 ceramic-ceramic hip joint product systems, 142,757 ceramic-polyethylene hip joint product systems, and 35,988 alloy-polyethylene hip joint product systems. ), the total number of intended purchases of knee joint product systems in the first year was 231976.

  According to the statistics of E-pharmaceutical managers, there are 49 companies participating in the centralized procurement of artificial joints (including hip and knee joints) with a total of more than 140 products. There are many multinational companies and local leaders. It is worth noting that the rules for the centralized procurement of artificial joints stipulate that under the same product system category, two groups A and B will be formed according to the procurement requirements of medical institutions, the supply capacity of the enterprise, and the material of the product, each of which is a bidding unit. .

   Group A and Group B can be simply understood as a large group and a small group of product intentional purchases. Judging from the current grouping situation, multinational companies and some domestic leading companies generally exist in Group A, and more domestic equipment companies are in Group B. Large group winning bids will show the characteristics of relatively high prices and small declines, while the group's "fighting" will be more intense, and the winning bid prices will be lower and the decline will be larger. Regarding this grouping rule, the industry generally believes that it is the embodiment of the relatively "moderate" policy for centralized procurement of consumables: listing products with greater industry demand as a large group can further ensure the purchase willingness of medical institutions and the quality of clinical diagnosis and treatment.

   From the point of view of the proposed selection rules, the first proposed selection rule is the core rule, while the second and third rules play more of a "resurrection role."

  The first selection rule stipulates that within the same group (within the same bidding unit), the shortlisted companies are determined according to the order of the company's bid comparison price from low to high. The product system bidding price of the shortlisted enterprises shall not be higher than the highest effective declared price. If the product system of the shortlisted company meets one of the two conditions, it will be eligible to be selected, including: bid comparison price ≤ 1.5 times the bid comparison price of the lowest product system of the same bid unit; bid comparison price> the lowest product system bid comparison price of the same bid unit 1.5 times, but the bid comparison price is less than 50% of the highest effective declaration price of the product system category.

   "Incoming and exiting" has long become a microcosm of centralized procurement. From this point of view, if a company wants to be eligible for the proposed selection, the bid price must be reduced by at least 50% on the basis of the highest effective declared price.

   It is true that obtaining the qualification for the proposed selection is only the "first step". The final share of the product's intended purchase volume depends on the order of the selection. According to the "Procurement Documents", the selected companies in the same bidding unit are ranked in the order of the selected ones. The product ranked first (the lowest bid price) can get 100% of the intended purchase volume, and the second and third products will get 90% and 85% respectively. % Of the intended purchase volume, and so on.

  02 After coronary stent, why is it an orthopedic joint?

In November last year, the national organization of centralized procurement of coronary stents produced the results of the selection. The 10 selected varieties dropped by more than 90% on average. It is estimated that 10.9 billion yuan of medical insurance funds will be saved. The horn of high-value medical consumables.

   The discussion about who will be the next high-value medical consumables to be acquired by the country has never stopped. The industry generally believes that the field of orthopedic implants will become the second for two main reasons.

  On the one hand, the market size of orthopedic implants is second only to vascular intervention, and is the second largest market for high-value medical consumables.

   According to the "Blue Book of China Medical Devices 2020", the domestic orthopedic implant market in 2019 reached 30.4 billion yuan. If the field of orthopedics implantation is further subdivided, it can be divided into trauma type, spine type, joint type and others. In terms of market share, the market share of spine, trauma, and joints is basically the same.

However, from the perspective of localization, due to the high technical content in the field of orthopedic joint implanted medical devices, the import substitution rate of joint products is the lowest. Domestically produced products are less than 30%, only 27%, and most of the domestic market share is controlled by Johnson & Johnson, International brands such as Medtronic and Stryker are occupied. In 2019, the top seven domestic orthopedic joints market share were Zimmer (15.53%), Johnson & Johnson (13.55%), Akcome Medical (9.21%), Chunli Medical (8.96%), and Link Orthopedics (6.92%). , Shi Lehui (5.36%), Weigao Orthopedics (3.53%).

   With the advent of centralized procurement of artificial joints, whether domestic brands can expand their market share through centralized procurement and ultimately achieve domestic substitution has attracted attention.

   Orthopedic artificial joints became the second high-value consumables centralized procurement product. Another reason comes from the deepening of the aging degree, so that the use of artificial joints will continue to increase in the future.

In June of this year, a paper entitled "The Future of Joint Surgery" published in the Chinese Journal of Orthopaedics showed that the number of artificial hip and knee replacement operations in my country in 2019 has exceeded 900,000 cases, an increase of nearly 20%. The rapid increase year by year, this growth rate is mainly due to the continuous deepening of my country's population aging.

According to the seventh national census data, as of the end of 2020, there were 264 million people over 60 years old in my country, accounting for 18.7%, indicating that China is about to enter a moderately aging society. Orthopedic medical equipment is an important need to ensure the health of the elderly population. one. Data shows that most of the users of artificial total hips and knee joints are elderly patients over 60 years old. With the acceleration of the aging process, the demand for orthopedic medical devices in the elderly population will increase year by year, and artificial joints will have more in the future. Big potential market.

   Obviously, it is imperative to start the national collection of orthopedic artificial joints as soon as possible.

  03 The local area first, the country learns from it

   After the centralized procurement of medicines has become normal, the development of the centralized procurement of high-value consumables at the national level has been the focus of the market in recent years. With the gradual maturity of the centralized procurement system for high-value medical consumables in various pilot areas, the policy for centralized procurement of consumables has gradually become clear.

In June this year, eight ministries and commissions including the National Medical Insurance Administration issued the "Guiding Opinions on the Centralized Procurement and Use of High-Value Medical Consumables by National Organizations" (hereinafter referred to as the "Guiding Opinions"). Six aspects, including measures, put forward relevant opinions for the national organization of the centralized procurement and use of high-value medical consumables. Experts said that the issuance of this document indicates that volume procurement has become the mainstream recruitment model for medical consumables, and the volume procurement of high-value medical consumables has entered a new stage of comprehensive advancement.

The "Guiding Opinions" clarified that the overall idea of centralized procurement of high-value medical consumables is "national organization, alliance procurement, platform operation". The state formulates basic policies and requirements, organizes various regions to form alliances, and uses public medical institutions as the main body of implementation. Carry out the centralized procurement of high-value medical consumables organized by the state.

   In terms of procurement varieties, we will focus on some high-value medical consumables that are large in clinical use, high in procurement amount, more mature in clinical use, more competitive in the market, and high in homogeneity. For example, cardiovascular, orthopedics, ophthalmology and other fields have the characteristics of high procurement amount, mature clinical use, and sufficient market competition. They may be included in the procurement scope in the future.

   In fact, a number of provinces in China have launched centralized procurement of orthopedic implant products. Among them, orthopedic joints have been piloted in Anhui, Jiangsu, Zhejiang, Fujian and other places.

   In 2019, Anhui and Jiangsu took the lead in opening the centralized procurement of consumables. In 2019, the average drop of hip joints in Jiangsu Province was 47%, the average drop of initial replacement artificial knee joint collection was 67.3%, and the largest drop was 81.9%; in August 2020, in the collection of orthopedics in Anhui Province, the average drop of 240 joint products was 81.97. %; In February of this year, Shandong Province announced the "Notice on Announcement of the Selection Results of Shandong Province's High-value Medical Consumables Concentrated Quantity Procurement in 2020", which showed that the average reduction rate of artificial hip joint replacement for the first time in the 7-cities Alliance of Shandong Province was 86.26%...

   Judging from the pilot situation in various places, the industry generally believes that the price reduction of the artificial joint centralized procurement organized by the state may not be less than 80%.

   How much reduction will be achieved by the national procurement of orthopedic artificial joints? We will wait and see who will win the battle between domestic and imported products.

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