DES second VBP renewal prices rise, MNC participation rebounds

Overview

This report focuses on the results of the second nationwide renewal of VBP for coronary drug-eluting stents (DES). Goldman Sachs points out that prices continued to trend upward in this round, MNC submitted-volume share rebounded significantly, and underlying demand remained strong, indicating that the VBP mechanism is shifting from pure price suppression toward greater emphasis on price stability, supply assurance, and industry economics. The report also places the DES renewal within the broader context of expanding VBP coverage in China's medical device sector, arguing that consumables coverage is still advancing and capital equipment could become the next area of policy extension.

Core views

The core views include three points: first, the DES VBP renewal price range rose to Rmb839-949, above the 2022 renewal level, supporting the view that VBP is a one-off price reset rather than a continuing margin headwind; second, MNC share in this round's submitted volume rose to about 41%, a clear rebound from about 32% in the first renewal, with innovation capability, product portfolio, and hospital coverage becoming key to gaining incremental share; third, submitted demand, PCI procedure volume, and the number of participating hospitals all indicate that the demand base remains strong, and improved accessibility after VBP may continue to support patient and physician preference for high-quality brands.

Analysis framework

The report uses a combination of policy event tracking, volume-price mechanism breakdown, and competitive landscape comparison: it first compares this round's price range and price cap with the 2022 DES renewal, then analyzes the impact of the 90%/75%/60% tiered volume allocation on company bidding behavior, and finally assesses industry supply-demand and competitive trends using submitted demand, PCI procedure volume, hospital participation, and changes in MNC share.

Methodology notes

• Policy and industry analysisVBP renewal pricing framework

  Assess the marginal impact of VBP on industry margins and pricing expectations through the renewal price range, effective price cap, and comparison with historical renewal prices.

  The DES renewal price in this round was Rmb839-949, above the Rmb730-848 in the 2022 renewal, indicating that the policy mechanism is not a continuous one-way push to lower prices.

• Volume-price mechanism analysisTiered volume allocation mechanism

  Use guaranteed-volume allocation ratios to constrain company bidding behavior and create a clearer linkage between price and sales volume.

  The report notes that this round used a 90%/75%/60% tiered allocation mechanism, reducing the risk of irrational low-price bidding by companies fearing the loss of all allocated volume.

• Competitive landscape analysisMNC participation and share tracking

  Evaluate the degree of recovery of multinational brands in the post-VBP competitive landscape through changes in MNC submitted-volume share.

  Submitted-volume share from MNCs such as Boston Scientific, Medtronic, and Abbott rose from about 32% in the first renewal to about 41%, indicating that innovation, product breadth, and local hospital coverage remain competitive strengths.

• Demand validationPCI demand and hospital coverage indicators

  Use submitted demand, PCI procedure volume, and the number of participating hospitals to verify whether real end-market demand continues to grow after VBP.

  Submitted demand was about 2.73 million units, 2025 PCI procedure volume was 2.21 million cases versus 1.29 million in 2022, and the number of participating hospitals rose from 2,408 to 4,468.

Asset mapping & comparison

Structured mapping from thesis to named assets (strengths, weaknesses, peers, risks).

• MNC DES manufacturers (Boston Scientific, Medtronic, Abbott)

  Direct beneficiaries of the rebound in participation in this DES VBP round

  Strengths

  MNC submitted-volume share rose to about 41%, with innovation capability, portfolio breadth, hospital coverage, and local participation supporting share recovery.

  Weaknesses

  They still need to balance price, guaranteed volume, and margins under the VBP pricing framework, while domestic competition continues to exist.

  Comparison

  Compared with about 32% MNC share in the first renewal, this round's roughly 41% shows a rebound in multinational brand competitiveness.

  Risks

  If subsequent VBP rules tighten again, domestic substitution accelerates, or hospital preferences change, the pace of share recovery may slow.

• Chinese domestic DES and medical consumables companies

  Benefiting from demand expansion but facing more rational price competition

  Strengths

  Growth in PCI procedure volume, broader hospital participation, and improved accessibility after VBP create a larger end-demand pool.

  Weaknesses

  The rebound in MNC share may reduce incremental room for domestic companies in some high-end product lines.

  Comparison

  After earlier VBP rounds, the market had seen a domestic substitution trend; this round shows that MNC brands remain attractive at comparable price points.

  Risks

  Changes in price caps, guaranteed-volume allocation, and brand preferences may lead to fluctuations in share and margins.

• China medical device capital equipment

  Potential area for policy spillover

  Strengths

  The report believes the likelihood of VBP expanding from consumables to capital equipment is rising, and a clearer policy path helps the market price this in earlier.

  Weaknesses

  Capital equipment has higher unit prices and more complex procurement cycles and product differentiation, making the policy rollout pace and impact magnitude uncertain.

  Comparison

  Consumables VBP is already more mature, while capital equipment remains in the expansion and pilot observation stage.

  Risks

  If VBP expands to capital equipment and price declines exceed expectations, related companies' ASPs and margins may come under pressure.

• PCI procedures and the cardiovascular intervention value chain

  Supported by underlying demand

  Strengths

  PCI procedure volume reached 2.21 million in 2025, above 1.29 million in 2022, and the number of participating hospitals also increased substantially.

  Weaknesses

  Demand growth still depends on hospital coverage, patient accessibility, and physician adoption.

  Comparison

  Compared with 2022, both submitted demand and hospital participation have increased significantly.

  Risks

  If procedure volume growth slows or medical insurance cost controls tighten further, consumables sales growth could fall short of expectations.

Key data

• DES VBP second renewal price rangeRmb839-949Higher than the Rmb730-848 in the 2022 renewal.
• Effective price capRmb949Higher than the previous price cap of Rmb848.
• Tiered volume allocation90%/75%/60%Used to reinforce price-volume linkage and support more rational bidding behavior.
• MNC submitted-volume shareAbout 41%Higher than about 32% in the first renewal, showing a rebound in MNC participation.
• Submitted demand约2.73mn unitsEquivalent to about 14% CAGR since the 2022 renewal.
• PCI procedure volume2.21mn in 2025 vs. 1.29mn in 2022The report cites F&S as the data source, reflecting growth in underlying procedural demand.
• Number of participating hospitals4,468 vs. 2,408The number of participating hospitals increased significantly from the prior period, showing broader coverage and deeper PCI penetration.
• 2022 renewal price change5-76% increaseThere were already price increases in the 2022 renewal, helping ease margin pressure.
• VBP coverage outlooklikely full coverage by YE26The report says consumables VBP may approach full coverage by the end of 2026 and may extend to capital equipment.

Impact & implications

For the medical device industry, the DES renewal results send a signal of marginal policy stabilization: the upward shift in the price range and a clearer volume-price mechanism help ease concerns about continual price cuts, while the rebound in MNC share suggests that innovative products and broad hospital coverage can still win volume under the VBP framework. For investment judgment, this means the market may need to shift from simply worrying about VBP-driven price cuts to evaluating differences among companies in product portfolio, innovation capability, local channels, cost control, and guaranteed-volume acquisition.

Risks

• If the DES renewal or subsequent category rules under VBP tighten again, they may once again push down price caps and company margins.
• The rebound in MNC share may trigger more intense competition, putting pressure on domestic companies' share and pricing power.
• If PCI procedure volume, submitted demand, or hospital participation growth comes in below expectations, guaranteed-volume fulfillment and industry revenue growth may be affected.
• There is uncertainty around the pace and magnitude of price cuts if VBP expands from consumables to capital equipment.
• If policy guidance, regional alliance implementation, or the national renewal mechanism changes, the sustainability of this round's results may be weakened.

What to watch

• New announcements from national or regional medical insurance authorities on the coverage scope of consumables VBP.
• Whether consumables VBP approaches full coverage by the end of 2026 as the report expects.
• Pilots and formal rules for capital equipment VBP, especially price caps, volume allocation, and hospital participation requirements.
• Localization, innovative products, and hospital coverage progress of MNCs such as Boston Scientific, Medtronic, and Abbott in the China market.
• Ongoing changes in PCI procedure volume, DES submitted demand, and the number of participating hospitals.
• The ability of domestic companies to maintain share after VBP through product upgrades, cost control, and channel coverage.