This article is from WeChat official account:Snowball (ID: xueqiujinghua), author: snowball, head Figure from: vision China

Heavy news in the pharmaceutical sector: National centralized procurement has extended from pharmaceuticals to the field of medical devices.

This weekend, the country’s first centralized procurement of high-consumption varieties, the policy of centralized procurement of coronary stents is here. As the first national gathering of high-value consumables, the market generally believes that this event must have a deterrent effect and will set the main tone of a big bargain. With the gradual ferment of emotions, many people have expressed their pessimism on the market for medical devices this weekend.

Today, as everyone expected, the medical device sector really led the decline of the two markets, closing down -2.42%, and the big bull stock Kailitai once fell by the limit.

Heart stents, artificial joints, intraocular lenses… These high-value medical consumables have always accounted for a large proportion of the burden of medical expenses due to their large clinical use and high prices. The “national team” has officially launched in this area, will the heart bracket that is about to usher in “soul bargaining” appear “floor price”?

1. The central procurement of coronary stents is coming soon, and related stocks plummeted

According to the National Organization for Centralized Purchasing Documents of Coronary Stents, the state’s centralized procurement of coronary stents in the first year intends to purchase more than 1.07 million pieces of coronary stents, involving 27 products, with an amount exceeding 12.3 billion yuan, occupying heart stents 80% of the market size.

Centralized procurement will be in 202On November 5, 0, (Thursday) will be conducted at 10:00 am, and the information will be declared publicly on site. The bid winning rules are:

1. Product ranking low price priority (the same price depends on sales volume), the top 10 are the first to be shortlisted.

2. The winning company is further selected from the shortlisted products, and the winning company must meet one of the following conditions:

(1) The declared price is lower than the minimum product declared price 1.8;

(2) The declared price is 1.8 times higher than the minimum product declared price but lower than 2850 yuan.

The centralized procurement of coronary stents has been expected for a long time since the Jiangsu provincial-level centralized procurement. After the news of the national centralized procurement broke out, the market generally expected that heart stents would have soul bargaining. Today, relevant stocks plummeted across the board. .

Among them, Great White Horse Lepu Medical, which was 10 times A shares in 7 years, fell sharply and ended up at -8.83%; Kailitai fell sharply, closing down -9.54%.

The Hong Kong stock MicroPort Medical also plummeted. By the end of the market, MicroPort Medical plunged nearly 12%.

Second, the patient will be the winner of this collection

The biggest winners of this centralized procurement are the Medical Insurance Bureau and the patients.

According to the research of Industrial Securities, before the centralized procurement, each patient had PCI (implanting a domestic cobalt-chromium alloy coronary stent), on average The cost is 25,000 yuan.

After centralized procurement, each patient saved an average of 10,000 yuan. The price of the PTCA balloon is reduced by 3,000 yuan, and the coronary stent is saved by 7,000 yuan.(The price of the coronary stent is planned to be less than 2850 yuan/pc).

According to the National Medical Insurance Administration, the annual market size of medical consumables nationwide is 320 billion yuan, of which 150 billion yuan is for high-value consumables.

The total amount of intended purchases in the first year is 1074722(1.07 million), which far exceeds the earlier expected purchase volume of 600,000~800,000 One.

The Medical Insurance Bureau will therefore save 10 billion yuan in expenditure.

3. Why is the coronary stent bargained first?

The ball mate @usefield pointed out sharply: the gun hit the head.

From the perspective of terminal scale, coronary stents are undoubtedly the largest medical device category in the domestic market. According to Huo Yong, director of the Department of Cardiology, Peking University First Hospital, in the 10 years from 2009 to 2019, the number of PCI operations in my country has grown from 230,000 to more than 1 million. Based on the usage of about 1.5 stents per surgical stent, my country will consume 1.5 million heart stents a year, with a total cost of 15 billion yuan. This variety alone accounts for 10% of the total market for high-value medical consumables, which is nothing short of discount. Unbuckled “small bracket, large volume”.

For medical devices with a particularly large number of subdivided tracks, 15 billion single products are already the largest variety of medical devices. The first centralized procurement has a strong demonstration effect, a lot of savings in medical insurance, and the market has become a mature product after years of competition.

Many well-known domestic cardiovascular experts said that after 20 years of development, the domestic stent industry is the first and only high-end medical device in the domestic market that is dominated by domestic companies. Due to the large amount of clinical use and sufficient competition, the conditions for “full bidding” are ripe, so it is more appropriate for cardiac stents to become the first nationally collected variety.

Four. Collective quotations, a complex game

Before the centralized procurement of coronary stents at the provincial level in Jiangsu, the price of Lepu’s cobalt-based stents was reduced from 8000+ by 65% ​​to 2,850 yuan, which became the lowest price in Jiangsu centralized procurement. Therefore, the implicit meaning of the national centralized procurement is that no matter what product, if you are willing to drop to the previous lowest price in Jiangsu centralized procurement, you can try your best to win the bid.

However, the real situation is not necessarily that simple. The ball friend @阿基米德Biotech said: The purchaser of this centralized procurement will build a tragic prisoner’s dilemma, which is reflected in the following aspects:< /p>

1. Taking the lowest price of 2850 yuan for centralized procurement in Jiangsu Province as the ceiling, higher than 2850 yuan is very dangerous, and lower than 2850 yuan is promising.

2. Don’t do grouping, and all rush into one place to kill each other.

3, 8 companies have only one registration certificate, which means that there is only one chance, and they may be dying and adopt a radical price strategy with bottom-line thinking.

4. A few foreigners, Poco, Abbott, and Medtronic may be surprised. After all, their thinking is different. The collection of generic drugs, Sanofi’s raid on Xinlitai, and Bayer’s second killing of Huadong Medicine may still be fresh in my memory.

If a manufacturer offers 1580 yuan(this is very likely to happen), all quotations higher than 2580 yuan will be sold out.

The purchaser must have touched the cost price beforehand. With 2,850 yuan as the anchor, the final bid price should be higher than the ex-factory price, but the 20 billion coronary stent market is estimated to shrink by at least half.

And Qiuyou@斛芸贞谈医论股 is even more pessimistic: the winning bid price will intensively appear between 800 yuan and 1,000 yuan. Coronary stent (cobalt-based alloy) collection documents should be read carefully. There are 27 products in total, and 10 products are shortlisted first.There are 12 companies participating in the competition. In other words:

(1) If the three minimally invasive medical stents win the bid at the lowest price, the finalists will be able to squeeze into 7 more companies. 12 into 8.

(2) If Minimally Invasive Medical, Abbott, and Boston Scientific each have the lowest price of the three stents, they will only be able to squeeze into one finalist, 12 into 4.

(3) If minimally invasive medical stents win the bid at the lowest price, the finalists will be able to squeeze into 8 companies. 12 into 9.

The first step is to make a quotation. The 10 lowest prices are selected from low to high. (The same company is shortlisted for ≥ 4 products, and the products beyond are also shortlisted. Other companies will be added later), ranking from 11th (or 12) to 27th, directly eliminated; the second step Only added the 11th place shortlisted; the third step is to see if the top 10 is below 2850 yuan.

“So, please be pessimistic. In order to preserve the stock market, the bid prices of the national coronary stents will be intensively between 800 yuan and 1,000 yuan, rather than the highest price.” @斛芸贞谈医论 The stock said.

5. What is the impact of centralized procurement on domestic companies?

Qiuyou@usefield said: Central procurement of coronary stents has a significant impact on domestic manufacturers’ related businesses., But the impact on their respective stock investment logic is different .

Minimally Invasive Medical: Chuang , For minimally invasive, it is also the main variety, all in the range of centralized procurement, soCan the Firebird and Firehawk win the bid for , at what price? , have a great impact on minimally invasive coronary artery business. But for minimally invasive medical stocks , coronary Stents are only part of the platform’s various medical device business,Investors focus more on orthopedics. char unicode=”3001″>,Pacemaker, Interventional valve,Robots and other businesses .

So , There has also been 20 years of growth in coronary stent business in general , but value , Under the reassessment, the market value has increased significantly . Back to the coronary stent business level , Firebird leaves the factory The price is almost the same as this time limit price ,The ex-factory price of Firehawk in the fast-growing period is 5000+,Do you want to lower the price to less than 3000< h-char unicode="ff0c">, may be a dilemma for minimally invasive surgery ,The price reduction won the bid , It is true that the ex-factory price level will be cut One cut , If the price reduction is not strong enough,< /h-inner> may follow up with the import brand PK that is also unwilling to reduce prices the remaining 20% ​​of the market share . See how minimally invasive can use 4 cards , What kind of card face.

Generally speaking ,< /h-inner>Even after this round of centralized procurement price reduction , coronary stent For Wicresoft, the business is still a cash cow business, It still contributes hundreds of millions of profits every year to cultivate other businesses, h-char unicode=”ff0c”>, is only when evaluating the overall business of minimally invasive medical treatment,The embedded value of the heart stent is indeed going to decrease,After all, the national centralized procurement price reduction game ,< /h-inner> Kill the logic again. But I also believe that , Miniport’s subsequent incubation business It is also in the late stage of research and development or in the early stage of market launch , In the future, minimally invasive medical care will still be the leading enterprise in the domestic medical device field .

Lepu Medical:Lepu’s main stainless steel bracket is not within the scope of this collection,Only cobalt-based stents that account for less than 30% of sales are involved in centralized procurement, and Jiangsu Central Purchasing has already appeared 2850 price ,So if this round of national centralized procurement wins the bid at the Jiangsu price , is expected .

But the main stainless steel bracket is not in the scope of centralized procurement, has both benefits and hidden worries, benefits The follow-up price strategy of stainless steel can be mastered and more flexible., The product belongs to “ low-end goods“< h-inner>, even if common sense considers , several It is difficult for manufacturers of stainless steel products to sell more than the price of cobalt-chromium alloys after the collection. Take the price reduction , stainless steel bracket takes advantage of the prevailing situation, will not appear for a long time . The other thing is whether the country will check for deficiencies in the follow-up and come to a round of collection of stainless steel brackets,There is also uncertainty.

Blue Sail Medical: This year’s Blue Sail has completely become an epidemic glove Share,The short-term Jiwei support is positive and negative,< /h-char>may not be the main logic of Lanfan.National Collection,Jiwei stainless steel products are not within the scope of centralized procurement,< /h-inner>Participating in centralized procurement accounts for about 10% of the total centralized procurement,and domestic Lepu, foreign-owned Poco< h-inner>,Medtronic,Abbott are in the same Magnitude.For these manufacturers , Keeping the share counts as expected , Share growth is considered a victory , Losing bids depends on the competitive situation of the self-financed market of abandonment and insuring price.

Xin Li Thai: The acquired Huanchen also has a product involved Centralized procurement , Intentional centralized procurement 2Wangen, is the barefoot role of this round of gathering , But if you want to win the bid, it is estimated that the price will be greatly reduced., h-char>See if the company wants to exchange price for quantity. At the same time , Xinlitai’s own investment logic is still medicine Main , equipment as auxiliary ,< /h-inner> Regardless of whether the stent collection is good or bad , the main battlefield or generic drugs The pharmaceutical business transformed into innovative drugs.

After this round of national centralized procurement,, it can be imagined that the terminal sales of coronary stents will change from 15 billion 3-5 billion, is considered as a benefit for the common people and savings for the medical insurance bureau. also indicates that the medical device industry , The industry is in line with , has evolved into the normalization of centralized procurement of mature equipment products< h-inner>.

So,The way out for the enterprise is still innovation, is like the current pharmaceutical innovation field is in full swing , the future of device innovation is still The new direction of enterprise development and stock investment.

This article is from WeChat official account:Snowball (ID: xueqiujinghua), author: snowball