The results of the spinal national procurement have been announced for nearly three years. Based on the procurement schedule for joint connections and considering the recent large event held in Tianjin, several volume-based consumable projects have postponed their related work progress. It is expected that in the fourth quarter, around the National Day, multiple projects such as hemostatic materials 3+N alliance, the sixth round of national procurement, and spinal national procurement will fully commence.
We provide several speculations regarding the arrangements for spinal procurement compared to joint procurement, to remind manufacturers and distributors.
1. Will there be any changes in the prices of existing volume-based products?
Most systems have an overall profit margin per surgery higher than the trauma alliance in 28 provinces. However, the price caps for vertebroplasty (PVP), kyphoplasty (PKP) systems, and spinal endoscopic radiofrequency knife tips are set too low, leading to various tricks during execution. Previously unused bone powder is now paired with bone cement, and previously free sterilization burrs are now charged as disposable items in some regions. This feels counterproductive and somewhat deviates from the purpose of volume-based procurement. Will there be a price correction to ensure the normal application and reasonable profit of these consumables?
2. Will any omitted products be included in the volume-based procurement?
1) For example, the standalone cervical fusion device, where the volume-based fusion device does not include the associated screws. Some hospitals can charge according to the provincial platform price for screws, and distributors are willing to supply, while other hospitals only allow charging for the fusion device, making it difficult to meet the contractual volume. Should the procurement include screws as volume-based items to ensure consistent execution standards across different hospitals? The standalone lumbar fusion surgery is complex, and the low price has made the application and promotion of this type of surgery more niche.
2) Should titanium mesh and artificial vertebrae be included in the volume-based procurement list? Although their usage is not high, they belong to the spinal category. Currently, the listed prices for these products from various manufacturers are not cheap, with some being much higher than the volume-based winning bid price for a set of plates and fusion devices.
3. Will some loopholes in the selection rules of certain systems be fixed?
1) For the vertebroplasty angle push rod, the bid price for the set is one price, but in practice, 6-8 are used, turning this system’s volume-based procurement into a joke. Is this a loophole in the rules or “some other reason”?
2) For multiple sets within the same system, if screws and fusion devices are expensive, will the price cap for a certain product in the system be adjusted? Is it necessary to have multiple combinations? If manufacturers can simplify various combinations into one pricing system, will this reduce production pressure and eliminate the need for clinical distributors to struggle with supply?
4. Will 3D printing-related products be included?
In the last round of national procurement, 3D printed fusion devices participated voluntarily. In 2022, there were not many certified companies, but now there are dozens. Different companies have different ideas; those with a large presence in hospitals want to maintain the status quo and profits, while newcomers find it difficult to enter hospitals with such products. Therefore, they can only “flip the table” for a gamble. The only way is to include 3D printed titanium alloy fusion devices in the volume-based procurement, with two strategies:
1. Referencing the bidding for PEEK fusion devices, with a maximum cap of 3500,
2. Creating a separate directory, ideally with a price higher than 3500, depending on whether manufacturers or the industry can unite and communicate with the national procurement office through associations.
Once a company wins the national procurement bid for a 3D printed fusion device, the existing high-priced 3D fusion device brands in public hospitals may collapse immediately. With one low-priced volume-based product and one high-priced listed product, it is likely that clinicians will only dare to use the volume-based product.
Will 3D printed tantalum metal and PEEK material fusion devices tell a new story? Will there be price limits on products with similar functions? The high listed prices prevent most public hospitals from using them, and only large hospitals in Beijing, Shanghai, etc., which are not short on funds, dare to use them. Ultimately, it will be the early certified manufacturers that benefit, while those certified later will miss out.
The spinal national procurement, like the joint volume-based procurement, will see competition at the same price level once certain loopholes are closed. Ultimately, the competition will still depend on brand depth, coverage, supply chain strength, etc. Truly innovative products that can solve clinical problems, have unique features, and meet local medical insurance requirements at reasonable prices will usher in a “spring”!
Special Attention:
[Attention all national consumable manufacturers, Nanjing, Jiangsu has adjusted the online listing policy and price negotiation]
[Attention all national consumable manufacturers, do you need this kind of service cooperation? Save and contact us]
[Attention all manufacturers: How to report your consumables to Nanjing Medical Insurance? How much to report? Look here]
[Save: This article explains how to connect Jiangsu’s promised price listed consumables with Nanjing Medical Insurance]
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