In order to cope with the birth rate (8.52‰) falling below 1% for the first time in 2020, the state promulgated the "three-child policy" and its supporting measures in July 20021year to promote population growth and optimize population structure. It also explicitly mentioned the rational distribution of human assisted reproductive technology service system to improve the level of prenatal and postnatal care. All provinces, cities and regions in China actively responded to the above policies, including the inclusion of three-child birth expenses in medical insurance, the general extension of maternity leave, the addition of parental leave, the issuance of maternity subsidies, and the development of an inclusive parenting system. And almost all of them are included in the key plan for 2022.
In addition, in August, 20021,the national medical insurance bureau brought a series of drugs for assisted reproduction into the scope of medical insurance payment, which opened the door to assisted reproduction.
The infertility rate in China continues to rise, and the average childbearing age continues to rise. Assisted reproduction, as the last guarantee for families who want to have children but can't, has always attracted much attention and high hopes.
The introduction of the above-mentioned series of policies has pushed assisted reproduction into the spotlight again and again, and the industry's heat continues to rise.
In order to clarify the impact of this series of policies on the upstream and downstream of assisted reproduction and the industrial chain, eggshell research institute investigated 1 scientific research institutes, 8 innovative enterprises and 2 investment institutions, and interviewed 8 experts, founders and investors to make this report.
Main conclusions
With stronger and more comprehensive support, the three-child policy will once again expand the assisted reproductive market. Compared with the "comprehensive two-child policy" of 20 16, the "three-child policy" has great support and a wide range, which is hard to see in history. We estimate that the policy dividend will build an assisted reproductive market of nearly 800 billion.
With the support of technology and payment related policies, the downstream assisted reproductive institutions give priority to dividends. With the support of the policy, the number of assisted reproductive institutions that implement the third generation of IVF is accelerating, the domestic medical devices for assisted reproductive are constantly improving and comprehensive, the payment threshold for assisted reproductive is gradually decreasing, and the education level in the market is gradually improving. Downstream assisted reproductive institutions will usher in more cycles and eventually achieve higher success rate and live birth rate.
With the support of policies, the Commercial Insurance Association will introduce more valuable insurance to feed back the healthy development of the whole assisted reproductive market. Driven by policies and markets, the status of commercial insurance has been improved year by year. With the improvement of the education level of the assisted reproductive market, commercial insurance will introduce more valuable types of assisted reproductive insurance, thus gradually showing the regulatory role of the market, eventually feeding back the entire assisted reproductive market and promoting the market to accelerate its benign development.
Driven by demand and policies,
Assisted reproduction has entered a period of rapid rise.
The potential demand of 1. 1 exceeds150,000, creating a blue ocean market of 800 billion.
The demand for assisted reproduction in China is as high as 654.38+0566 million. Statistics from the National Bureau of Statistics show that the infertility rate in China is increasing year by year. At present, it has reached 12- 18%. According to the information released by the State Administration of Pharmaceutical Products official website at the end of 2020, the infertility rate in China will increase to 18.2% in 2023. The United States has a high success rate of assisted reproduction and a high market penetration rate. According to Frost Sullivan's data, in 20 18 years, the American assisted reproductive penetration rate reached 30.2%. If China reaches this rate, it means that the potential demand for assisted reproduction is close to15.66 million.
Calculation of the potential market demand of artworks
Data sources: National Bureau of Statistics, Arterial Orange Database and Eggshell Research Institute.
The potential market size of artworks exceeds 799.5 billion yuan. ART mainly includes artificial insemination (AI) and in vitro fertilization (IVF). According to the data published in Reproductive Biology and Endocrinology, the ratio of domestic doctors choosing AI and IVF is about 7: 19.
According to the above data, the potential market size of Chinese artworks is 799.5 billion yuan. In addition, some pregnant women have two or more needs for ART services due to the birth of a second or third child, and each ART service may require three or more cycles of treatment due to old age and other reasons. The overall market size will exceed 799.5 billion yuan.
Estimation of the potential market size of artworks
Data sources: National Bureau of Statistics, Arterial Orange Database and Eggshell Research Institute.
1.2 ART expenses are included in medical insurance, which supports the "three children" in many ways and reduces the fertility rate.
The three-child policy is more supportive: extending maternity leave and increasing parental leave. On July 20th, 20021,the Decision of Central the State Council on Optimizing the Birth Policy and Promoting the Long-term Balanced Development of the Population was promulgated, which implemented the policy that a couple can have three children and supporting measures.
All provinces and cities responded positively. By the end of 2022.65438 10, according to incomplete statistics, 27 provinces have updated their population and family planning regulations, generally extending maternity leave by 30-60 days, extending male nursing leave (paternity leave) to 15-30 days, and increasing parents with children under 3-6 years old by 5-30 days every year.
Revision of maternity leave, nursing leave and parental leave in various provinces and cities
Data source: official website, provincial and municipal people's congresses, produced by eggshell research institute.
The three-child policy configuration is more supportive: maternity expenses are included in medical insurance. The provincial and municipal medical insurance bureaus have also issued policies to include the maternity expenses of three children in medical insurance and enjoy maternity allowance. Among them, Guangxi Province has decided that flexible employees who have participated in the basic medical insurance for employees can also enjoy the maternity medical expenses in their overall planning areas without paying maternity insurance premiums.
The distribution of the three-child policy is more supportive: reducing the "three-child cost" in many ways. Beijing, Guizhou, Jilin and other provinces and cities have issued the Implementation Plan on Optimizing the Birth Policy to Promote the Long-term Balanced Development of the Population, which has reduced the birth cost, parenting cost and education cost in many ways. For example, the number of nursery beds per thousand people in the community is required; Increase the accessibility of educational resources and medical resources; Specific policies such as tax relief for children under 3 years old and reduction of loan interest rate.
The characteristics of people who have three children are highly consistent with those who accept ART. Most pregnant women who have three children are older, so the success rate of natural delivery decreases and the risk increases. Art is the key to solve this problem. In addition, its economic strength is generally good, and the cost pressure is also small.
It can be seen that the people who have three children are highly consistent with those who choose art in terms of age and economic strength. With the gradual implementation and improvement of the three-child policy and the introduction of a series of supporting measures, the potential of two-child families to have three children will be further released. This also means that the art market will further expand under the promotion of the three-child policy.
Reasonable loosening of technology and payment,
Multidimensional control of combination boxing policy
2. 1 Implementing PGT is no longer the "privilege" of tertiary hospitals.
The growth rate of art institutions has slowed down. On June 9, 2007, 10, "the State Council's Decision on the Fourth Batch of Cancellation and Adjustment of Administrative Examination and Approval Items" delegated the authority of "medical institutions going to CAGR to carry out human assisted reproductive technology licensing" to the health administrative departments of provinces, autonomous regions and municipalities directly under the Central Government, which greatly promoted the growth of the number of ART institutions in China. After adjustment, by the end of 20 12, the compound annual growth rate of the number of medical institutions carrying out ART (.
The growth of medical institutions implementing antiretroviral therapy
Data source: arterial orange database, produced by eggshell research institute.
The Guiding Principles for the Allocation Planning of Human Assisted Reproductive Technology (version 20 15) (hereinafter referred to as the Guiding Principles (version 20 15)) stipulates that the number of institutions to be established shall not exceed 20% of the total number of institutions each year. The latest Guiding Principles for the Application Planning of Human Assisted Reproductive Technology (version 202 1 5) (hereinafter referred to as the Guiding Principles)
Accelerate the development of PGT mechanism. The Guiding Principles (202 1 Edition) gives guidance on the number of PGT institutions for the first time: "The proportion shall not exceed 30%". Judging from the current situation of 14.6%, there is still a lot of room for growth.
In addition, the guideline (version 20 15) stipulates that newly-built PGT should be deployed in "three-level general hospitals, three-level maternal and child care hospitals and three-level maternity hospitals with prenatal diagnosis qualifications", while the guideline (version 202 1 5) cancels the requirement of "three-level" and relaxes it to "medical institutions with prenatal diagnosis qualifications". This makes secondary hospitals join the ranks of institutions that can carry out PGT, which will undoubtedly promote the growth of the number of institutions.
2.2 ART drugs are included in medical insurance, reducing the cost by more than 30%.
ART cost 1/3 or more when assisted reproductive drugs are included in medical insurance. On August 23rd, 20021,the State Medical Insurance Bureau issued the Reply of the State Medical Insurance Bureau to the Proposal No.5581of the Fourth Session of the 13th National People's Congress, which clearly pointed out that eligible fertility support drugs such as bromocriptine, triptorelin and clomiphene citrate were included in the payment scope.
So far, the health insurance covering the whole cycle of ART includes down-regulating drugs, ovulation-promoting drugs, ovulation-promoting drugs and luteal support drugs.
Coverage of medical insurance for assisted reproductive medicine
Data sources: National Medical Insurance Bureau, Arterial Orange Database, Eggshell Research Institute System.
Incorporating drugs such as ovulation induction into medical insurance means that the economic burden of couples receiving ART will be reduced by more than 1/3, so that more infertile couples can afford ART treatment and get their own babies.
2.3 70% of the instruments are free in clinic, and many products break the import monopoly.
Large-scale clinical trials are free, which speeds up the authentication of ART medical devices. 20 19, 19 In February, the State Administration of Pharmaceutical Products issued the Notice on Publishing the List of Newly Added and Revised Medical Devices Exempted from Clinical Trials (hereinafter referred to as the Notice of Exemption from Clinical Trials), which included all passive Class II medical devices in ART medical devices in the list of exempted from clinical trials. In addition, except ART laser system and some culture solutions, most Class III medical devices have also entered the catalogue.