The proportion of domestic dialysis gradually rises |

According to the medical network on May 11th, the number of hemodialysis patients in China has increased year by year. In 2016, hemodialysis patients have reached 447,000. If the actual annual dialysis cost is 75,000 yuan, the current market size of hemodialysis in China will be approximately 33.5 billion yuan. According to CNRDS data, the number of domestic hemodialysis centers in 2016 was 4,089 and the number of peritoneal dialysis centers was 1,100. According to experts' predictions, after the gradual increase in the proportion of dialysis, China should need about 10,000 hemodialysis centers.

With the liberalization of the national policy, independent hemodialysis centers have a vast market space, and now more and more social capital is flowing into this segment. As a whole, there are many opportunities but great challenges.

The National Health and Family Planning Commission released at the end of 2016 the National Health and Family Planning Commission's Notice on Issuing the Basic Standards and Management Practices for the Hemodialysis Centers (Trial), which states that the Independent Hemodialysis Center 'has carried out hemodialysis services'.

Compared with the “Independent Hemodialysis Center Management Practice” published in 2014, the standards introduced at the end of 2016 have actually lowered the threshold for access to the Hemodialysis Center. In the past, it was necessary to require a second-level or higher hospital with a Department of Nephrology to establish a dialysis center. , And later independent hemodialysis centers only need to sign more than two-mile general hospitals within the range of 10 kilometers, and the green channel signed with the top-three hospitals to ensure the referral can be established.

The document also pointed out that the development direction of independent hemodialysis centers is 'through the chain, the scale of group development, the establishment of standardized, standardized management and service model'; for security reasons, the document requires independent hemodialysis centers and secondary hospitals Establishing a collaborative relationship with tertiary hospitals. The question is whether public hospitals are willing to give hemodialysis centers to people. It is a challenge for social forces.

On February 28, 2017, the National Health and Family Planning Commission issued “About Modifications <医疗机构管理条例实施细则>(Decision No. 12 of the National Health and Family Planning Commission) to identify five categories of medical institutions, including the hemodialysis center, and to include them in the social investment field.

Due to the high cost of hemodialysis treatment, whether or not reimbursement of medical insurance can affect patient's willingness to treat is a major factor. According to projections, the number of ESRD patients in China is currently about 2 million. About 300,000 patients receive hemodialysis every year. The average dialysis treatment is The rate is less than 20%, lower than the global average of 37%. It is far lower than the dialysis treatment rate of 90% in Europe and the United States. The development space is clearly visible.

Dialysis treatment is more expensive. According to the 2012 “Green Paper on Health Development in China”, each hemodialysis patient has a dialysis cost of about 500 yuan per year. He needs to receive about 156 dialysis treatments every year. The annual total cost of dialysis treatment exceeds 75,000 yuan. yuan.

In the statistics of CNRDS, the number of hemodialysis patients in China has increased year by year. In 2016, hemodialysis patients have reached 447,000. If the actual annual dialysis cost is 75,000 yuan, the current market size of hemodialysis in China is about 33.5 billion.

According to CNRDS data, the number of domestic hemodialysis centers in 2016 was 4,089 and the number of peritoneal dialysis centers was 1,100. According to experts' predictions, after the gradual increase in the proportion of dialysis, China should need about 10,000 hemodialysis centers.

With the further expansion of medical insurance for major diseases in China, since 2013, the reimbursement rate for hemodialysis treatment has been no less than 90%, which will further release energy for the development of the hemodialysis market. Therefore, although the independent hemodialysis centers of chain operations can rely on large-scale development Reduce costs and reduce costs, but whether or not you can join the Medicare and Medicare reimbursement ratio will still be related to patient selection.

The cost of independent hemodialysis centers is mainly composed of five parts: dialysis machines, dialysis consumables, dialysis drug , Artificial services, construction costs. In fact, the operation of independent hemodialysis centers has low profits and challenges, but the threshold is high and the stability is strong.

Key areas:

National distribution of hemodialysis patients, data source CNRDS

Before the national policy was released at the end of 2016, the only domestic independent hemodialysis centers were Shenyang Sansheng Pharmaceutical Co., Ltd. (hereinafter referred to as Sansheng Pharmaceutical), Bethune Fund Management Committee, and Weigao Group Co., Ltd. (hereinafter referred to as Weigao Group). Several license plates are still in the exploratory stage. More social forces from home and abroad have chosen to enter the area of ​​hemodialysis services through the hospital co-construction model.

Around the year of 2009, Shenyang Sansheng Company (domestic EPO manufacturer) established the 'Home of Three Kidney Friends' in Jinzhou and other places in Liaoning Province, and set up to establish a 'chain-based hemodialysis center'. In December 2010, Shandong approved Weigao The company, Bethune Fund Management Committee pilot. In the case of unknown policies at the time, the three private enterprises started trials of the third party hemodialysis centers by means of affiliation.

The dialysis service was included in the major disease medical insurance from 2012. At present, the proportion of reimbursement in various regions is approximately 70%-85%. Prior to this policy, private capital was not allowed to be set up separately. Therefore, private/foreign-funded dialysis centers are developing slowly, with more than 4000 dialysis centers across the country, 90% In public hospitals.

On February 28, 2017, the National Health and Family Planning Commission issued “About Modifications <医疗机构管理条例实施细则>(Decision No. 12 of the National Health and Family Planning Commission) to identify five categories of medical institutions, including the hemodialysis center, and to include them in the social investment field.

Currently, the hemodialysis industry is mainly distributed in Guangdong, Shandong, Fujian and other places; active multinational companies mainly include Fresenius, Baxter, DaVita, Japan's Nikkiso, Toray, Nipro, etc.. Domestic independent hemodialysis centers. There are mainly Bethune, Weigao, and several investment houses of CITIC. Fresenius used the whole industry chain coverage model to acquire hospitals and establish dialysis service points based on its advantages in the equipment side. Weigao's approach is similar to the establishment of kidney disease hospitals and blood. The combination of dialysis centers; CITIC relies on acquiring hospitals and investing in independent hemodialysis centers.

Now let's take a closer look at the situation of the capital's layout in China.

Sansang Pharmaceutical is the earliest company to enter the independent hemodialysis center. There are currently more than 10 independent hemodialysis centers.

On November 23rd, 2009, China's first grassroots chain hemodialysis center, 'Sansheng Renyou's House', was put into use in Jinzhou City, Liaoning Province. Check the news and see pictures of the year.

Source: 'Three Health Kid's Home' Blog

Since 2011, Weigao Group has undertaken the task of piloting an independent hemodialysis center in Shandong Province. It is understood that the company has more than 10 independent hemodialysis centers. In 2017, Shandong Weigao invested 10 million yuan to set up Fengzewei in Quanzhou. High hemodialysis center, set up 30 hemodialysis units, set up medical treatment subjects including internal medicine (nephrology) and medical laboratory.

Sansang Pharmaceuticals and Weigao Group are in the same industry chain upstream. The main business is medical instruments , Consumables and pharmaceuticals. The Independent Hemodialysis Center is currently only a small branch of its business line.

Currently, Dakang Medical has the largest number of independent hemodialysis centers in China. As of December 2016, Dakang Medical has established and operated independent hemodialysis in 14 provinces and cities including Jiangxi, Shandong, Hebei, Shanxi, and Guangdong with the help of domestic investment. Center more than 100 homes.

Each of Dacom's hemodialysis service centers has an investment limit of 3 to 4 million RMB. For fund requirements, Dakang is not worried. Because the cash flow of its own project is good, there are several investment institutions behind it. The support. In addition to cornerstone capital, CDH investment, open-source investment, and an investment company with a background of state-owned enterprises, Chongshan Capital has become a shareholder of Dakang Medical.

According to Dakang Medical's public data, the usage rate of its hemodialysis centers exceeds 80%, and the number of patients and benefits are growing rapidly. It is understood that Dakang Medical is currently inviting partners across the country to jointly open blood. Through the center.

December 15, 2017, China medicine Announcement: Guangdong General Motors, a holding company of China Pharmaceutical, and Guangzhou Yide Medical Investment Management Co., Ltd. signed the “Equity Cooperation Agreement on a Newly Established Company”. The two parties intend to co-fund the establishment of Guangdong Universal Hemodialysis Center Co., Ltd. The new company has a registered capital of 10 million. Yuan, among which, Guangdong GM contributed RMB 5.1 million in currency, which accounted for 51% of the equity of the new company; Yide Medical contributed RMB 4.9 million in currency, which accounted for 49% of the equity of the new company.

5, Weili Medical invested 15 million yuan to set up two hemodialysis centers

On October 11, 2017, Weili Medical announced that its controlling company, Sunstar Guangdong Wes Tai Hemodialysis Co., Ltd. invested RMB 5 million with its own funds, and established a wholly-owned subsidiary, Guangzhou Wes Tai Fuhua Hemodialysis Center Co., Ltd. It is used to establish hemodialysis centers and conduct hemodialysis business. At the same time, its controlling company Sunwest Guizhou Weishitai Hospital Investment Management Co., Ltd. has invested 10 million yuan on its own funds and established a wholly-owned subsidiary Zunyi Weststar Hemodialysis Center Co., Ltd. for the establishment of Hemodialysis Center and Hemodialysis Service. Announcement shows that the two Hemodialysis Centers have completed industrial and commercial registration procedures, and have obtained business licenses issued by relevant departments of Guangzhou City and Zunyi City.

In 2016, the wholly-owned subsidiary of Changshan Pharmaceuticals, Jiukang Medical Investment Management Hebei Co., Ltd., used its own capital of 5 million yuan to fund the establishment of the Xinhua Changshan Pharmaceutical Hemodialysis Center in Shijiazhuang. On June 22, 2017, Changshan Pharmaceuticals released According to the announcement, it signed the Agreement on Establishing a Hemodialysis Center in Chenzhou City with the Xinzhou Huaxin Traditional Chinese Medicine Hospital. It is planned to establish a hemodialysis center in Ganzhou to jointly provide medical services.

According to the cooperation agreement, the duration of cooperation between Changshan Pharmaceutical and Chenzhou Huaxin Traditional Chinese Medicine Hospital is 10 years, and the total investment for the proposed preliminary hemodialysis center is set at 7.5 million yuan. Later-stage development can gradually increase dialysis equipment and expand investment scale. In terms of the situation, Changshan Pharmaceutical is expected to invest approximately RMB 4.5 million in the form of imported dialysis equipment, consumables, water treatment equipment, and technical management, and it will account for 60% of all shares; the site of the Dialysis Center provided by the Yanzhou Huaxin Traditional Chinese Medicine Hospital. The investment in the form of decoration, purchase of office supplies, formalities, etc., is expected to be approximately 3 million yuan, accounting for 40% of all shares.

In terms of cooperation and division of labor, Changshan Pharmaceuticals intends to invest 20 imported hemodialysis machines, as well as professional technical guidance for dialysis, personnel training, maintenance of equipment, comprehensive management and management of nephrology specialist outpatients and hemodialysis centers. The TCM Hospital will participate in the management and management of the hemodialysis center, be responsible for the business premises facilities, provide office supplies, carry out renovations according to the company's professional and technical requirements, and be responsible for outreach coordination.

On July 4, 2015, Xinhua Medical Group and Shanxi Longcheng Hospital (Shanxi Provincial Charity Hospital) formally signed a cooperation agreement. The two parties will invest and build and host at least 30 independent blood dialysis centers within Shanxi Province. It is estimated that they will invest in hemodialysis machines. More than 1,200.

Actively introduced by the Shanxi Provincial Health and Family Planning Commission, Xinhua Medical Group will invest social capital in the medical service field in Shanxi Province and intends to cooperate with Shanxi Longcheng Hospital, a non-profit social medical institution, to invest in and construct and host at least 30 within the province. An independent hemodialysis center is expected to invest more than 1200 hemodialysis machines. At the same time, it is necessary to build no less than 3 secondary nephrology hospitals. This project can solve at least 6,000 patients with chronic kidney disease near dialysis and follow-up treatment.

With the release of policies and the improvement of medical payment capabilities, International enterprise Is seizing the domestic market.

On August 8, 2017, the Fujian Provincial Health and Family Planning Commission sent a letter announcing the agreement to set up the 'Fereco Fresenius Hemodialysis Center'. The center was established by Fresenius Medical Hong Kong Co., Ltd. with a total investment of 20 million yuan. A total of 32 were established. Hemodialysis unit. Also learned from the Department of Commerce of Fujian Province, Fresenius has two projects under construction in Quanzhou.

In April 2017, a Fresenius-owned affiliate completed the Kunming Wuhua Healthcare hospital The equity acquisition, which owns 70% of the hospital's equity, takes the first steps for Fresenius to invest in Yunnan. On August 20, 2017, Fresenius Medical Investment (China) Co., Ltd. signed a contract with the Yunnan provincial government. Yunnan Meteorological Cooperation Memorandum for Hexide Hemodia Services '. In the next 3-5 years, Fessen Medical plans to establish two kidney hospitals and 20-25 dialysis centers in Yunnan.

By the end of 2016, Fresenius had deployed 3,624 dialysis clinics in 45 countries around the world.

DaVita has cooperated and established with Chinese hospitals. It has 3 dialysis centers, such as the Dialysis Center established in cooperation with Shanghai Yangpu Antu Hospital and Shandong Sakai Kidney Hospital.

From the perspective of the capital's layout in the Hemodialysis Center, companies in the upper reaches of the hemodialysis industry chain have established a number of independent hemodialysis centers, but only a small branch of their business lines. Some listed companies have also made some attempts in the past two to three years. However, the progress has been slow and there has been no scale effect.

The hemodialysis industry is the second-ranked medical subdivided service market in developed countries, but it is now at a very early stage in the Chinese market. Since then, independent hemodialysis centers have developed slowly. In addition to qualification issues, there are also doctors. Shortage of resources. Hematology Centers have strict management requirements in the fields, doctors, nurses, etc. These cultivations require a longer period.

Most private hemodialysis centers in China used the model of cooperation with hospitals to not only solve patient resources, but also increase brand recognition. However, in the future, if we want to continue to grow, achieve communityization and grass-roots development, an independent hemodialysis center will Will appear in large numbers.

The market space looks large, but at present, independent hemodialysis centers have not found a suitable business model, and it is not easy to profit.