The dentists of the Regional Dental Chamber in Karviná in the Czech Republic negotiated the prices at which they would buy dentures from dental laboratories. The Czech Office for the Protection of Competition, which dealt with the case, did not proceed with the punishment.
At the end of 2021, Petr Okenica, the chairman of the Karviná Regional Dental Chamber, sent a letter to Karviná dental laboratories in which he warned of a possible significant increase in the price of fully covered restorations. Specifically, in the letter he wrote: “The Board of Directors of the Regional Dental Chamber has decided that as far as removable prosthetics are concerned, price increases for Code I will be accepted in our area only up to half of the value that insurance companies will pay for this product. We leave the C and N codes entirely to your discretion, but for I codes for sensing prosthetics this is a ceiling we are not going to go over and the area will act uniformly on this”.
I codes refer to dentures in the Czech Republic that are fully covered by health insurance. C codes indicate restorations for which the dentist is reimbursed by the health insurance company and N codes indicate restorations that are not reimbursed by the insurance company and are not reimbursed by the dentist.
The full letter is available in Czech here.
The Czech Office for the Protection of Competition dealt with the letter and the sentence in question because it suspected that the conduct described by the Regional Chamber of Dentistry could constitute a prohibited agreement distorting free trade competition. The final decision did not come until November 2023, when the Office stated that “Such a resolution of the association’s board of directors, which aligns the competitive behaviour of its members and limits the level of supplier prices to be accepted by the members, could fulfil the characteristics of a prohibited decision of an association of competitors. It could even fulfil the characteristics of the most serious hard-core price restraint which is presumed to have a negative impact on the market.”.
The dental technicians didn’t complain
Yet the Karviná Regional Dental Chamber got away with only a “warning”. When the Office only wants to “emphatically draw attention to the possible illegality of such an action initiated directly by the dental chamber, even if only at the regional level” and must “appeal to the Czech Dental Chamber and its bodies, or Regional Dental Chambers and their chairmen and all members, to avoid similar actions in the future” and not to initiate administrative proceedings.
The reason why the Office did not initiate administrative proceedings with the Regional Chamber is that “the Office has subsequently monitored the situation in this area and has not recorded any complaints or other documents unifying the practice of your members within publicly available sources or from dental technicians”.
The full Communication of the Office for the Protection of Competition is available in Czech here.
Dental labs to bear costs of social dentistry, say dentists
Okenica also mentions in his letter that because dentists are a regulated craft, dental labs are regulated with dentists in the I codes. He argues that the costs of social dentistry should be equitably shared and passed on to dental laboratories. The question is why only on the dental labs and not on, say, impression manufacturers or even energy suppliers.
Dental laboratories are not bound by the agreements between dentists and health insurance companies. They themselves often do not know which dentist has a contract with a health insurance company and which operates on the basis of direct payments from patients. They also do not know what business and pricing policies their customers practice. And dental laboratories make their price calculations independently of payments from health insurance companies.
The cost of removable prosthetics continues to rise
The costs of dental laboratories continue to rise. In addition to the cost of running the dental laboratory and dental supplies themselves, labor costs are rising significantly in dental laboratories. Dental laboratories that are unable to reflect the cost of a dental technician’s work, which is close to CZK 3,000, in the price of a total removable prosthesis are unlikely to find employees today.
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