The "price revolution" of domestic coronary stents is a milestone in China's medical reform. National enterprises represented by Lepu, MicroPort, and Jiwei have achieved a qualitative leap in domestic substitution through 20 years of technological breakthroughs. With centralized procurement, the price that used to be "ten thousand yuan" under the import monopoly has been slashed to a civilian price of 700 yuan, directly benefiting over 3.7 million patients. The cost of a single surgery has drastically decreased from 30,000 to 40,000 yuan to 13,000 yuan, and after insurance reimbursement, patients only need to pay about 6,000 to 7,000 yuan out of pocket, significantly reducing the financial burden on patients.

But behind the victory lies the 'tree effect' of the industry chain. Although the body of the base unit has achieved a high domestic content rate of 95%, the downstream accessories such as the drive shaft, drive tube, and capsule are still trapped in the "low domestic content" problem, like a car that stalled in a gearbox of domestic factories. In high-end fields, companies like Daewoo and Hyundai control more than 80% of the market share, and doctors and surgeons in hospitals still rely on "invisible dependence" on foreign companies.

To tackle core technologies, domestic companies are breaking through on two fronts: On one hand, they achieve overtaking by means of product technological innovation; on the other hand, they accelerate the layout of the entire industrial chain, comprehensively upgrading from material processes to intelligent production. This攻坚not only concerns corporate profits but also determines whether China can truly achieve self-reliance and control in the field of high-end medical manufacturing. As the legend of stent prices becomes a thing of the past, comprehensive breakthroughs in supporting systems will be an even more challenging test in the next decade.

Heart valve

Import monopoly 90% market share

But domestic black tech has emerged.

The technological evolution of heart valves is divided into two main types: mechanical valves and bioprosthetic valves. The Starr-Edwards ball-cage mechanical valve, introduced in 1960, ushered in the era of valve replacement, but required patients to undergo lifelong anticoagulation therapy. The emergence of bovine pericardial bioprosthetic valves in 2002, with their 15-year lifespan and lower risk of thrombosis, became the mainstream choice. A truly disruptive breakthrough came with transcatheter intervention technology - in 2002, France performed the first transcatheter aortic valve replacement (TAVR), giving hope to high-risk patients who were unable to undergo open-chest surgery.

The path of domestic catch-up is distinctive: the VitaFlow valve (self-expanding bovine pericardial bioprosthesis) independently developed by Shanghai MicroPort features a "skirt design for leak prevention." In clinical studies conducted in 2021, it demonstrated non-inferior performance compared to imported products. However, the core materials remain under the control of foreign entities; the polymer material selected by Edwards Lifesciences after 20 years of research still represents a technological barrier that China finds hard to overcome.

Domestic cardiovascular medical devices may still be using high-performance bioplastic valves, even though imported valves are used in 90% of the market, but domestic valves are now priced at 2/3 of the imported ones.

Neurointervention

China mines for gold in the "capillaries."

still being swept by the wind

Comparing to the "rich first, then the rest" of coronary stents, neural interventions more resemble "the last one drinking soup." International giants like Medtronic and Stryker, leveraging their financial strength (research capabilities + clinical education), have dominated for a long time, with core products like flow-directionality meshlike stents and thrombectomy catheters becoming de facto imported "exclusive skin." However, domestic players are not idle either; Willis Cover Mesh stents from the micro-medical field were globally first-to-launch, and Heart Radiance's thrombectomy stents reached a 5% market share within a year, with the pace of replacement accelerating.

The piston ring is priced at 13,000 yuan from a 4,000-yuan brand, and then reduced to 3,000 yuan by foreign investment. The domestic brand is then sold at 100% of the original price to the people, and the performance of this is described as a "price war", with the quote being "we are actually fighting a price war".

In the markets for sheaths, middle tubes, balloons, and other products such as Transbridge, Pumed森 (普微森), Cyano (赛诺), and Xinrui (心玮), domestic brands have nearly caught up with imported ones, with 11 out of 17 registration certificates coming from domestic products, and even high-end products like blood flow direction devices are starting to outperform imports.

The quick-fix innovations of domestic cardiovascular product lines, whether through horizontal expansion (production line layout) or in-depth development (overall sales, profit margin), often involve "me too" or "me better" strategies. Consequently, these domestic medical device companies inevitably suffer from the same ailment as the up-and-coming heroes in martial arts novels: their techniques are fierce, but their inner strength still needs cultivation.

Although alternative slogans are shouted loudly, many players who obtain certifications through OEM methods still abound.加之在 the background of centralized procurement, homogenized competition has gradually被淘汰. Upstream in the industrial chain, hidden champions such as Swiss EMS Group, Zeus, and Nordson continue to firmly control the supply of catheter materials. This scene is like a young cultivator who has just learned to fly with a sword looking up and seeing a group of Yuan Ying elders passing by overhead.

innovation

But a price war is not the cure.

International giants are accustomed to simmering "old fire soup" with money and time, while domestic innovation resembles "pre-packaged fast food." The gap here cannot be bridged by simply sprinkling a bit more "financing seasoning." The SAPIEN 3 valve from Edwards Lifesciences has anti-calcification technology that comes from twenty years of consistent material selection; Boston Scientific's rotational catheter boasts a machining precision of 0.1 millimeters, backed by a hundred thousand hours of machine tool debugging experience.

The current situation in the industry is that there is a market demand for laboratory equipment and sales environment, while the upstream materials and equipment are still blocked. Without breaking through the whole chain of lab equipment to the operating room, what is a domestic substitute is to take the air-conditioned hall.

Compared to domestic alternatives in other industries, the medical device sector benefits from a 300 million-strong essential demand and strong policy support. If they focus on core materials, cutting-edge technologies like biodegradable stents, and avoid price wars, they could potentially evolve from "domestic substitutes" to "global solution providers." The challenge lies in when the upstream market for medical devices will produce a "Contemporary Amperex Technology Co. Limited (CATL)" equivalent.

Innovation is the source of sustained profits for enterprises, but innovation is also a gamble. If one blindly pursues innovation without revolutionary iterations in upstream materials, relying solely on financing and the stories of large domestic markets, one might secure a ticket to the future, but when they will be thrown off the ship is uncertain. Domestic substitution cannot just stop at quantity; it must achieve a true full industrial chain replacement. Returning to that familiar saying, the time left for Chinese medical device companies may not be too much.