Shanghai adds 76 new medical items including "Da Vinci surgical robot" to medical insurance

Recently, it was reported that Shanghai has included 76 new medical services such as the "Da Vinci surgical robot " into the scope of medical insurance payment, and this year it will continue to expand new projects and new medical equipment (consumables) items that are ready to be included in the scope of medical insurance payment.

As an innovative intelligent medical device, surgical robots can perform delicate surgical operations in human cavities, blood vessels and nerve-dense areas. They have the advantages of accurate positioning, minimal surgical trauma, low risk of infection and rapid postoperative recovery. They can meet patients' needs for high-quality medical services and help better cope with problems such as insufficient medical resources caused by global aging.

However, the use of surgical robots is very expensive. According to a report, the average cost of using a da Vinci robot for each operation is 44,000 yuan, of which the cost of special imported consumables is 25,900 yuan, accounting for the majority, and maintenance costs and amortization costs account for 18,000 yuan.

Including surgical robots in the scope of medical insurance will undoubtedly reduce the burden on patients and accelerate the application of surgical robots. In recent years, Shanghai's medical insurance department has continued to take effective measures to actively promote the development of the biopharmaceutical industry, including surgical robots, including:

1. Continue to expand the scope of medical service items and medical equipment (consumables) covered by medical insurance; optimize the new technology access process. For new technologies that are clinically applied for the first time, after the project is approved for charging, other hospitals only need to complete the filing procedures to charge, and promote the accelerated clinical application of new technologies. 105 new projects have been announced and implemented, and 4,174 new project filings have been completed;

2. Speed ​​up the review of new projects, improve the management mechanism of the trial period of new projects, allow medical institutions to set prices independently during the trial period, and review and determine prices according to procedures three months before the end of the trial period, further speeding up the review of new projects;

3. Improve the dynamic adjustment mechanism of the medical device catalog. For registered and marketed medical devices that can be charged separately and are included in the national or municipal special review procedures for innovative medical devices, companies can directly apply for the municipal charging code or apply for adjustment of the catalog. 50 new catalogs of single-use medical devices that can be charged separately have been announced, and 7,471 new medical device codes have been added.

Surgical robots play a positive role in protecting people's lives, health and safety. The country is also working hard to promote the application of surgical robots. The "14th Five-Year Plan for the Development of the Medical Equipment Industry" proposes that by 2025, the level of advanced medical equipment industry foundation and modernization of the industrial chain will be significantly improved, mainstream medical equipment will be basically effectively supplied, and the performance and quality level of high-end medical equipment products will be significantly improved.

As a high-end medical device, surgical robots started late in my country and have a low penetration rate. Taking laparoscopic surgical robots as an example, data show that the penetration rate of laparoscopic surgical robots-assisted laparoscopic surgery in China was only 0.7% in 2021, while in the United States it was 13.3% during the same period. This also means that domestic surgical robots have great room for development.

A report pointed out that currently my country's high-end medical device field is mainly occupied by imported brands, and the localization rate is low. Therefore, accelerating domestic substitution and achieving independent control are the main themes of the long-term development of my country's medical device industry. It is expected that in the next 5-10 years, domestic equipment products will continue to increase their market share in various segments such as imaging equipment, high-value consumables, endoscopes, and surgical robots.