7千万円の値引き！！！

2023-03-14 22:23:27 | 知らんでもええこと

医療機器には、膿盆や攝子（ピンセット）の様に一世紀も前からほとんど形を変えていないものもあれば、凄まじいスピードで進化していくものもあります。

薬では、解熱剤なんて30年前とほとんど変わっていませんが、抗がん剤や糖尿病薬では、10年ごとに別世界に突入しているのではないかと思えるほどの変化がこれまでにもありました。

MRI、ＣＴ、超音波診断装置（エコー）などの画像診断機器の進歩も素晴らしいものがあります。私が医師になった30数年前、MRIは出来たばかりでその解像度は酷いものでした。その当時、動くものは撮れなかったＣＴですが、今では拍動する心臓を取り巻く血管の動脈硬化迄分かるようになりました。超音波診断装置（エコー）も、整形外科に必須のものになるなんて当時想像も出来ませんでした。

そんな長足の進歩を遂げている超音波診断装置（エコー）に関するお話です。

医院のエコー機が時代遅れになって来たので、買い替えることにしました。

それで見積もりを取ったのですが、それがこれです。

重要な部分を拡大します

ふざけているの？って言いたくなりませんか？

ロールスロイスのファントムextendedをプリウスPHEVの値段で売るのって事ですよね！！

または、駅から徒歩2分　新築のタワマン　ファミリータイプ３ＬＤＫを、40年落ちのワンルームマンション価格にもいかない値で売るのか？と言う事です。おかしいですよね！！！

7千2百7十5万円引き！！！！！

おいおい

大体、この定価がおかしいですよね。

一体どういった意図で付けられているのでしょうか？

この見積もりに、定価76,800,000と書いてあるから、定価と言いましたが、医療機器の定価って分からないことが多いです。

ネットで調べても定価が分かるのは安価な品物ばかりで、高価なものは、定価が明かされていないことが殆どです。MRI、CT、エコーなどの高額医療機器、ネット上にカタログは出ていますが、価格は表示されていません。（数十万円程度のものは出ていますが・・・・

なかなか表に出てこない　このとんでもない「定価」。「定価」が付けられている以上、そこに何らかの意味はあるのでしょう。では、なんでこんなにとんでもない価格が付けられているのか？

ひょっとすると、公的なところに定価に近い価格で売り込んで、その利益の多くを賄賂としてどこかに流し込んでいるのか？なんていうブラックな想像までしてしまいますよね！！

医療機器の「定価」と「取引価格」の異様なまでの差を解説していただける方おられましたら、すみませんが説明していただけないでしょうか。なにとぞよろしくお願いいたします。私には超不思議でしかないです！！

最新の画像［もっと見る］

17 コメント

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Unknown (kikokikonoriko19888888): 2023-03-15 10:04:23; 不可解ですよね、、
、誰が儲けているのでしょうね？

研究者は、、、研究バカだから、、、皆貧乏ですよね。; 返信する

Unknown (marurobo36): 2023-03-15 10:06:59; 目を疑ってしまうような値引き額ですね。
定価設定どうなっているんでしょうか？？
医療機器ってそんな感じなんでしょうか？？; 返信する

Unknown (camper): 2023-03-15 11:05:49; 花鳥風月さん、マルさん、コメントありがとうございます。
本当にこのぶっ飛んだ価格設定の真意や如何に！！ですよね！！

一般常識に欠けた開業医が多いと言っても、流石に「値引額でロールスロイス買えまっせ！！」「うひょーっつほな買うわ！」とはならないと思うのですがねぇ・・・

100万以上の医療機器、定価の半額以下で買うのが常識？なのかもしれませんが、定価の9割以上の値引きって・・・・定価の意味が分からないですね。; 返信する

Unknown (uparin): 2023-03-15 13:51:50; そうですよね。不思議な定価ですよね。
定価は公立病院向けの値段なのかなぁと思っていましたが、公立病院が定価に近い値段で買わされているとしたら、それも問題ですよね。; 返信する

Unknown (camper): 2023-03-15 15:00:29; uparinさん、謎ですよねぇ！！
何処か、定価に近い価格で買っているとしたら・・・と、思ってしまいますが・・・・たとえ半額で買ったとしても実売価格の8倍以上って一体何なの・・・ですよねぇ。どこかでそんな金額で取引しているところがあるのですかねぇ。皆無であれば、こんな定価つけないでしょうし・・・・・ホント、不思議です！！; 返信する

Unknown (Kyuchan): 2023-03-15 23:37:38; I feel your pain. I was both buyer and purchaser of capital equipment . Yes, giving a large discount makes it easier for the buyer to push that purchase through versus his peers at larger institutions (universities , hospitals ). But the main reason for these high list prices (which are not even publicly disclosed is plain financial) . The list price reflects the salaries (scientists engineers, marketing and sales folks etc ), material, development time spent plus some profit for a very low number of equipment sold . These prices are simply extremely high. Of course the companies who produce and or sell that equipment know that . The hope is to offer a large discount and hopefully sell a higher number of equipment in course of the next years which makes the sale profitable (note that once research and development are done and very low production costs remain the profit increases ).
Please don’t forget the main purpose of the sale of capital equipment . It is the maintenance contracts which enable the seller to recoup a big part of any initial loss and add some profit . Hope that helps; 返信する

Unknown (camper): 2023-03-16 13:17:42; Kuchan, thank you for your comment.
The high list price is the initial setting to recoup the enormous development costs, etc., and it is my understanding that the actual sales price will go down because there are some who will sell a lot and earn from maintenance costs. Is it okay?
I think I understand a little. thank you very much.

Google翻訳使えますね！！; 返信する

Unknown (Kyuchan): 2023-03-16 17:53:55; Dear Camper , yes or almost ! Mostly the company understands the initial list price will never be achieved , so they start with some discount from beginning on , betting on many future sales .; 返信する

Unknown (camper): 2023-03-16 23:07:12; Thank you for your comment Kyuchan！！
What I find strange is that the difference between the list price and the actual selling price of medical equipment is too large. In other industries, the difference between the decline and the selling price is not as large as 50%, but in the medical industry it can exceed 90%. That makes me wonder.; 返信する

Unknown (Kyuchan): 2023-03-16 23:21:12; Haha! The reason is we are dealing here with capital equipment , which is used in clinical settings or applied / basic research institutes . It’s a small market . Don’t forget how eager Olympus was to sell its microscope division . Confocal microscopes are pricing between 300K USD and a few million . The market is simply not as big . Clinical equipment has the additional burden it needs to be approved by FDA (or at least must be pass requirements for medical use ) . Just think of orphan drugs . It’s a similar situation . High R&D costs, small market (rare diseases ). It’s just a different market than cars or cameras . IN ADDITION the medical market is full of middlemen and murky dealers . For example many Leica dealers are not really Leica Microsystems . They buy at thr list price from the company (minus a hefty discount ) and sell it a little higher. To make it short , high R&D costs smash into a tiny market with high competition .; 返信する

Unknown (Kyuchan): 2023-03-16 23:32:01; 90 percent is excessively high . Here I must speculate and reiterate high R&D cost , small market and middle men. I personally never have seen a discount more than 50% (basic research capital equipment such as laser scanning microscopes , US market or Singapore ) . I know Europe is similar . Are you buying from dealers or the company directly (dealers can carry the company name but often are just dealers )? Maybe I have to look at the screenshots you provided in the blog . The company will provide the dealer with a list price , a hypothetical price based on an unrealistic small demand maybe .; 返信する

Unknown (Kyuchan): 2023-03-17 00:00:21; Dear Camper (I’m using your avatar name , apologies !)

Hm…. I assume you are purchasing an ultrasound vessel imaging system . Indeed they cost “only” 40’000 USD from a dealer , but they are refurbished (used) . I have no idea what those systems cost new , but I know that cheap standard light microscopes with way less technology sell for 40’000 USD (new) , and new advanced laser scanning systems sell for not less then 300’000 USD (mostly 750’000 to 1 or 2 Mio USD). And that is basic research equipment which doesn’t have to be approved for medical use

To make it short , I am also surprised at the huge list price or discount . I naively would have expected 400’000 list price and 200’000 (USD) quote price for a new system . This is just an off the cuff estimate !

Please see references below . Please note that quote is for a refurbished system , not a new one

https://www.ultrasoundsupply.com/products/ultrasound-machines/canon-ultrasound/canon-aplio-i800/

Citation from that link

“A refurbished Canon Aplio ultrasound can cost between $30,000 and $45,000 on average, depending on the model year, condition, nature of past use, and what transducers come with the system. Scroll below for a detailed overview of the Aplio i800,”; 返信する

Unknown (Kyuchan): 2023-03-17 00:17:04; https://www.infinitymedicalstore.com/product/canon-aplio-i800-ultrasound-machine-new/

This one is even cheaper and they list the transducers and components .

Well, a lot of time has passed since my dark days in technical equipment :) , I was a basic researcher turned core facility director at a molecular biological institute and know only about confocal microscopes back from those days . I was postdoc under the guidance of T Honjo at Kyoto University medical school before that , now I’m retired . I just don’t know enough about medical equipment , I just conjecture from my basic life science research experience and core facility management and my several years stints at microscope and imaging companies before returning to academia.

Either the list price is an error and has one digit less, or it is just excessively high . But at least your price quote seems reasonable , assuming it is a used and refurbished system . (If it’s new even better !) . Again, I have never met discounts larger than 50%. But that was basic research .; 返信する

Unknown (Kyuchan): 2023-03-17 00:57:30; The price for a new advanced flow ultrasound system is 75’000 USD , it can go up to 200’000 USD (very roughly 9’314’002 to 26’618’335JPY ) . It really depends on the transducers and specifications . So I assume the list price in your quote is a typo - an error. The list price will have one digit less . It should be 7’500’000 JPY roughly; 返信する

Unknown (camper): 2023-03-17 18:35:17; Thank you very much, Kyu-chan, for your many interesting stories. (Especially the story about the sale of Olympus's microscope division was interesting.) It seems that the list price of the ultrasound diagnostic equipment I'm about to buy is not a mistake. In Japan, it is not uncommon to see such a difference between the list price and the actual selling price in the sale of medical equipment.
I plan to buy canon aplioflex at a lower price than the estimate after trimming off unnecessary parts. I will report back when I buy it! Thank you dear Kyu-chan!; 返信する

Unknown (Kyuchan): 2023-03-27 01:13:53; Thank you for your kind words ! Well, in the end it remains a mystery ! I enjoy reading your blog , very enlightening !; 返信する

Unknown (camper): 2023-03-27 18:21:07; Kyuchan, thank you for your kind words! I am motivated to continue writing this blog.let's do it！！; 返信する

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