Reporters Yan Guowen and Cao Xueping reported in Beijing
On February 21, Beijing municipality issued a notice to take the lead in integrating 16 assisted reproductive technology services into medical insurance. The new policy will be implemented from 26 March.
Affected by this news, on February 21, the stock prices of many listed companies with assisted reproduction business or related to the concept of assisted reproduction, such as Jinxin Reproduction, Kangzhi Pharmaceutical, and Beikang Medical, rose sharply or rose, reflecting the optimism of the industry and the capital market on the policy.
On February 24, Ling Ge, president of CITIC Xiangya Reproductive and Genetics Specialist Hospital, said in an interview with China Business Daily, "Our mood when we heard this news was not enough to summarize with the word 'excitement', and it is 'the people's will' to include assisted reproductive technology service projects in medical insurance." ”
Ringo said: "This policy is a thousand calls, and it is a great thing for patients or people who need assisted reproductive technology services. Assisted reproductive technology has been developing in China for more than 30 years, and social acceptance is constantly improving. There are also more and more medical institutions that can provide assisted reproductive technology services in the country, with nearly 1 million assisted reproductive cycles implemented nationwide every year. Assisted reproduction involves different types of technologies, more of which is IVF technology, which is also a relatively high cost. The inclusion of 16 assisted reproductive technology service projects in medical insurance is good news for the majority of infertility patients or groups of people, and it is believed that Beijing's new policy will bring demonstration effects to other provinces across the country. ”
Beijing set a precedent in the country
On February 21, the Beijing Municipal Medical Insurance Bureau, the Beijing Municipal Health Commission, and the Beijing Municipal Bureau of Human Resources and Social Security jointly issued the Notice on Regulating and Adjusting the Price Items of Some Medical Services, which regulates the price items of 63 medical services and clarifies the reimbursement policy for basic medical insurance.
Among them, the most concerned by the outside world is the inclusion of 16 assisted reproductive technology projects involving a wide range of people and necessary for diagnosis and treatment, such as intrauterine artificial insemination, embryo transfer, and sperm optimal treatment, into the scope of medical insurance Class A reimbursement. Among the 16 services, the lowest price is the comprehensive assessment of ovulation induction therapy, the price is 180 yuan / time; the highest price is the embryo single gene disease diagnosis, the price is 5050 yuan / embryo.
At present, there are 15 designated medical institutions with basic medical insurance qualifications in Beijing. Among them, 14 are public medical institutions, including Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University, the Third Hospital of Peking University, etc.; only 1 is a private medical institution, Beijing Jiayuan Hospital.
According to the National Health Commission, infertility is a fertility disorder state caused by a variety of factors, women of childbearing age have a normal sexual life without contraception for at least 12 months and are not pregnant is called infertility, and in men it is called infertility. The incidence of infertility in mainland China ranges from 7% to 10%.
The incidence of infertility varies from country to country, ethnic group and region, and its treatment methods are diverse, and most patients can achieve successful pregnancies through lifestyle changes, psychological treatment, drug treatment, surgical treatment, etc., and less than 20% of patients need to receive assisted reproductive technology treatment.
It is understood that assisted reproductive technology can be divided into artificial insemination (AI), egg/gamete transfer technology, in vitro fertilization - embryo transfer (IVF-ET) and its derivative technology (commonly known as "IVF").
In recent years, the number of approved assisted reproductive medical institutions in the mainland has been increasing. According to data disclosed by the Department of Maternal and Child Health of the National Health Commission on May 27, 2021, as of December 31, 2020, there were 536 medical institutions approved to carry out human assisted reproductive technology nationwide, and a total of 27 medical institutions approved to set up human sperm banks nationwide. Among them, there are 18 assisted reproductive medical institutions and 2 medical institutions with human sperm banks in Beijing.
This time, Beijing took the lead in the country to include assisted reproductive technology service projects in the scope of medical insurance payment, which was unexpected by industry insiders. Because in the past one or two years, many departments have said that they do not support the inclusion of assisted reproductive technology service projects in medical insurance.
In August 2021, the National Health Commission pointed out in response to the proposal of cppcc members that at present, due to the mainland's economic development level and medical insurance financing capacity, the mainland's basic medical insurance can only be based on "guaranteeing the basics" and does not have the conditions to expand the scope of payment to the treatment of infertility costs.
In addition, the reporter noted that many ordinary netizens also appealed to relevant departments through platforms such as the People's Network leadership message board to incorporate assisted reproductive service projects into medical insurance.
In April 2020, the Guangzhou Municipal Medical Insurance Bureau said in response to the relevant suggestions of netizens that "various infertility (pregnancy) diseases, sexual dysfunction diagnosis and treatment projects" belong to the basic medical insurance fund does not pay the cost of the diagnosis and treatment projects, the provincial medical insurance directory is uniformly implemented throughout the province, and the municipal department has no adjustment authority.
On January 10 this year, some netizens suggested to the leaders of relevant ministries and commissions through the people's network leadership message board that the assisted reproductive medical treatment project should be included in the scope of universal medical insurance. It said, "Some infertile people turn to ordinary gynecological infertility outpatient TCM treatment for 1 to 2 years without effect, and then turn to artificial assisted reproductive technology." Because the current artificial assisted reproductive medical projects are often more than 10,000 yuan and are not included in the scope of medical insurance, many families who want to have children are prohibitive. At present, the base of women of childbearing age is limited, there are many late marriages and late children, and the inclusion of artificial assisted reproductive technology in the scope of medical insurance will greatly shorten the preparation time for women of childbearing age, so that women of childbearing age who want to have children will be born early, have two or three more children, and increase the birth rate of newborns. ”
The inclusion of assisted reproductive services in Beijing into medical insurance was also unexpected by Ringo.
"Limited by the current level of technology, many families can not succeed in doing IVF once, there are many families who have not succeeded for the first time, the economic conditions are unbearable, there is no money, and some need to work for another year to be able to make up the next money." This is not uncommon. Some of them have too much financial and psychological burden and divorce. This is a good policy and signal for people in need of assisted reproductive technology services. Ringo said.
Ringo believes that Beijing's new policy on assisted reproduction may have an exemplary role for other provinces and cities across the country in the future. On December 30, 2020, the National Medical Insurance Bureau issued the Interim Measures for the Designated Management of Medical Security in Medical Institutions (Order No. 2 of the National Medical Security Bureau). Article 12 of the document stipulates that non-basic medical services such as medical cosmetology, assisted reproduction, life care, and dental implants as the main scope of practice will not be accepted for medical insurance fixed-point applications. Only economic development and sufficient financial resources can make medical insurance cover more types of diseases. This time, Beijing took the lead in the country to include 16 assisted reproductive service projects in the scope of medical insurance payment, which will have a certain demonstration effect on other provinces, especially for some provinces with high economic development levels. ”
The technology is mature
It is understood that the upstream of the assisted reproduction industry is a supplier of related drugs, instruments, testing reagents and equipment, and the downstream is the assisted reproductive medical service institutions and patients.
Ringo introduced, "At present, there are also some restrictive influencing factors for the development of the assisted reproductive technology market, such as the localization of the main consumables, culture fluids and laboratory equipment used in assisted reproductive technology services. In the event of international unfavorable factors, it may also have a greater impact on the assisted reproduction market and industry. For example, when the epidemic was severe last year and the year before, many centers encountered some difficulties in importing culture solutions from abroad. ”
"In general, assisted reproductive technologies are relatively mature. After years of standardized development, the number of medical institutions that can carry out assisted reproductive technology services in each province is now relatively sufficient. Although there is still a certain gap in the technology of different centers, this can be improved through further training, learning, training, collaboration, etc. In general, the accessibility of assisted reproductive technologies in mainland China is already relatively high. Ringo said.
According to Gao He's "Assisted Reproduction Industry Research Report", at present, the penetration rate of assisted reproduction in mainland China is low, and the scale of China's assisted reproduction market has increased from 14 billion yuan to 25.2 billion yuan from 2014 to 2018. It is estimated that the scale of China's assisted reproduction market will reach 40.6 billion yuan in 2023.
At present, domestic assisted reproductive medical institutions are dominated by public hospitals, and public hospitals account for 90% of the existing licensed assisted reproductive service institutions in the industry. Non-public assisted reproductive medical institutions mainly include CITIC Xiangya Reproductive and Genetics Specialist Hospital, Jinxin Reproductive Medical Group and Avive Medical Group.
According to the market share calculated by the egg retrieval cycle, the total market share of the top 10 assisted reproductive hospitals in 2018 was 26%, and the top 20 were 36%, and the competition pattern was highly dispersed. Among them, CITIC Xiangya Reproductive and Genetics Specialist Hospital occupies 5.8% of the market share, ranking first in the market.
According to Jinxin Reproductive Financial Report, in the first half of 2021, the number of Jinxin Reproductive IVF treatment cycles was 13164, compared with 9643 in the first half of 2020.
According to the data disclosed by CITIC Xiangya Reproductive and Genetics Hospital, the total number of hospital visits in 2021 was 328,500, an increase of 40.92% over 2020. There were 32,500 first-time visits, an increase of 10.44% over 2020. The number of transplant cycles in 2021 was 42,307, an increase of 3% over 2020. So far, Professor Lu Guangxiu's team has helped infertile couples to produce more than 190,000 healthy babies. Data such as the average pregnancy rate of ivy infants in hospitals have been leading the country and even the world for many years.
In addition, the hospital received 93,000 visits through the Internet in 2021, an increase of 40.87% over 2020.
In order to make up for the inability of medical insurance to cover and reduce the medical burden on patients, some commercial insurance companies and medical institutions have successively launched new insurance products for infertility.
According to the Red Network, on May 28, 2021, CITIC Xiangya Reproductive and Genetics Specialist Hospital joined hands with Chinese Insurance and Medical Weidu Technology to launch a series of packages of "Fertility Ivy Insurance".
Ringo told reporters that this is the first insurance variety for infertility launched by CITIC Xiangya Reproductive and Genetics Specialist Hospital. Starting in June 2021, many patients are paying attention to this product, especially those who have failed multiple embryo transfers. From June last year to now, 376 couples have applied for insurance, and more than 200 couples have actually participated in the insurance. Other hospitals also offer different types of insurance. The combination of commercial insurance and assisted reproduction is of great help to reduce the psychological burden and economic pressure of patients.