DIP/DRG收费标准

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眼科耗材行业近况更新
2025-06-04 15:25
Summary of the Conference Call Records Industry Overview: Ophthalmic Consumables Key Points on Cataract Surgery Market - **Cataract Surgery Volume Recovery**: In the first five months of 2025, cataract surgeries showed signs of recovery, with some hospitals experiencing a growth of 20%-25% and a slight increase in unit prices compared to 2024. The overall performance for the first half of 2025 is expected to be strong, with stable outpatient volumes and average transaction prices anticipated for the year [1][3] - **Seasonal Trends**: Cataract surgeries have two peak periods annually: from the sixth day after the Spring Festival to the end of the lunar March, and from September to late November. The low seasons occur around the Dragon Boat Festival and from late November onwards [4] - **DIP/DRG Pricing Standards**: The current DIP (Diagnosis-Related Group) and DRG pricing standards differ significantly from previous project reimbursement systems, allowing for more flexibility based on hospital levels. For instance, reimbursement for intraocular lenses in tertiary hospitals can reach 1,800 yuan, with total reimbursements up to 5,000 yuan [5][6] Market Dynamics of Intraocular Lenses - **Market Distribution**: The intraocular lens market is characterized by a normal distribution, with low-end products accounting for 20%-25%, high-end products for about 20%, and the remainder consisting of bifocal and other types. Cost control policies may lead to an increase in low-end products, while the choice of trifocal lenses will depend on pricing compliance with DIP standards [6][8] - **Low Penetration Rate**: China's cataract surgery penetration rate is lower than that of Europe and the US, attributed to limited insurance coverage, inadequate third-party payment systems, and a lack of public awareness regarding eye health. The average age for surgery is nine years later than the average onset age of the disease, indicating significant room for growth [7][9] Market Size and Future Projections - **Surgery Volume Growth**: The number of cataract surgeries in China has been gradually increasing, with projections of 430 million surgeries in 2023 and an expected 470-475 million in 2024. The target for 2025 is set at 490 million surgeries [2][10] - **Market Demand for Contact Lenses**: The demand for orthokeratology lenses is expected to grow by approximately 10% in 2025, with a total shipment of around 150 million lenses in the first five months of the year [16] Competitive Landscape - **Coexistence of Products**: Orthokeratology lenses and defocus glasses are expected to coexist in the market, catering to different consumer needs. While orthokeratology lenses are the most effective tool for myopia control, defocus glasses are gaining market share due to safety concerns among parents [19][20] Regulatory and Policy Implications - **Government Initiatives**: The government has established initiatives to improve cataract surgery penetration rates, but challenges remain due to limited insurance coverage and public awareness. It is anticipated that with increasing demand from the elderly population and ongoing policy support, penetration rates may gradually improve [9][18] Inventory and Pricing Dynamics - **Inventory Levels**: The inventory ratio for intraocular lenses is approximately 1:8, meaning for every 100 surgeries, 800 lenses are kept in stock. In contrast, orthokeratology lenses are ordered on a per-need basis, with no significant inventory maintained [22] - **Price and Margin Differences**: The pricing and profit margins for intraocular lenses and orthokeratology lenses in overseas markets are generally higher than in China, although domestic production costs are lower due to reduced R&D and intellectual property costs [23][24]