(Yicai) Oct. 14 -- The outcome of China's surgical robot market race will be determined by an ecosystem of technology, clinical education, and services rather than by price, according to Jason Liu, the chief executive officer of Intuitive Fosun, the Chinese joint venture of US' Intuitive Surgical and Shanghai Fosun Pharmaceutical Group that makes and sells da Vinci surgical robots in the country.

" A future built on low-price competition alone is unsustainable," Jason Liu said in a recent interview with Yicai. "What we truly hope to build is the best ecosystem, a platform that grows together with surgeons, and a diagnosis and treatment solution that patients deeply trust."

Established in 2017, Intuitive Fosun will show the da Vinci 5, da Vinci SP, Ion, and the domestically manufactured da Vinci Xi at the ninth China International Import Expo in Shanghai next month, with the da Vinci SP is expected to win approval soon.

This year marks the 20th anniversary of the da Vinci surgical robot's entry into China. They have served more than one million domestic patients, with the local combined installed base of da Vinci and Ion systems exceeding 510 units.

The Chinese surgical robot market is drawing a growing number of domestic players. Public hospitals in China bid for 90 laparoscopic surgical robots last year, of which 59 went to da Vinci and 16 to Shenzhen Edge Medical, according to data released by MedRobot. In addition, 27 units were awarded in the first half of this year, with domestic brands taking 17 and da Vinci the rest, while the average price per unit fell to CNY13.3 million from CNY17.7 million (USD2 million from USD2.6 million) year over year. 

The entry of so many players proves that Intuitive Fosun's two decades of investment in pioneering this field was worthwhile, Liu pointed out. But "serious medical care" is about patient value, and "whether it is the price of the system or the price of instrument, it will be only one component of the broader surgical value chain," he stressed.

"It's less about robot versus robot. It is much more about the total ecosystem needed to build a successful robotics program in a hospital. It’s really ecosystem versus ecosystem." Gary Guthart, executive chair of the board of directors of Intuitive, told Yicai. "We see, and I expect to continue seeing, innovation from Chinese, Japanese and European players. They will try new things. “

"Some of these new things will be very good. We will also innovate and remain agile," Guthart stressed.

Intuitive Fosun has 33 training centers across China, and has trained more than 22,000 healthcare professionals, according to the company. Shanghai is also the only manufacturing base for da Vinci systems outside the United States.

Unmet Needs

China performed about 143,200 robot-assisted laparoscopic surgeries in 2024, or 0.7 percent of the total, compared with around 1.8 million in the US, or 22 percent of the total, according to a report by Ping An Securities' pharmaceutical team, citing data from the prospectus of Edge Medical.

This reflects huge unmet demand for precise, minimally invasive surgery, Liu noted, adding that this is Intuitive Fosun's belief in the market’s potential and that wider adoption of surgical robots also depends on factors such as hospital procurement and medical payment.

The influencing factors for wider adoption fall into two areas, Liu said. The first is equipment allocation management, where surgical robots are Class B large medical equipment and require an allocation permit, he noted, adding that gradually relaxing, or eventually removing, that requirement at the appropriate time would be an important step for the industry's development.

The second is medical service pricing and reimbursement, he said. In January, the National Healthcare Security Administration issued the Guidelines for Establishing Price Items for Surgical and Therapeutic Auxiliary Operation Medical Services, with Gansu province beginning to implement the policy in August, while Beijing, Guangzhou, Shanghai, and Jiangsu and Zhejiang provinces are expected to follow this quarter, he added. Looking ahead, Liu said a more comprehensive payment system, including a greater role for commercial health insurance alongside public reimbursement, will be critical to expanding patient access and supporting broader adoption of robotic-assisted surgery.

Da Vinci Robots' Stage 4.0

The two decades since the da Vinci surgical robot entered China can be divided into four stages: entry into China; establishing Intuitive Fosun; building a local factory and obtaining domestic registration; and the current stage focusing on "deep localization and digitalization," using local supply chains to cut costs and improve efficiency, Liu stressed. 

In 2022, construction began on Intuitive Fosun's headquarters and industrialization base in Shanghai Free Trade Zone's Zhangjiang Science City, covering about 2.08 hectares and including a medical robot manufacturing and research and development center. The facility went live in June 2024, with a total investment of about CNY700 million, becoming the firm's largest integrated R&D, production, and training base in the Asia-Pacific region.

Intuitive Fosun also works with Chinese healthcare artificial intelligence companies Infervision and SurgSmart to explore using AI in medical robots.

Infervision and SurgSmart are examples of Chinese-led innovation that could also be used overseas, Guthart pointed out. "We also think that investments in local companies will help bring Chinese innovations in the future through Intuitive to other parts of the world.

"We have local partnerships in digitalization, expanding partnerships in supply chain localization, and co-creation of ideas," he noted. “It is about both participating in the healthcare market and harnessing the great resources here to benefit patients around the world.”

Editor: Martin Kadiev