DIALYSIS DISPUTE : Adcock Ingram unit referred to Competition Tribunal over alleged excessive pricing of dialysis products

The Competition Commission has referred Adcock Ingram Critical Care to the Competition Tribunal for alleged excessive pricing of dialysis products used in the treatment of kidney failure, raising fresh questions about the cost of essential healthcare products in South Africa.

The Competition Commission said the complaint relates to peritoneal dialysis and continuous renal replacement therapy products supplied by Adcock Ingram Critical Care. The alleged conduct took place between July 2019 and June 2024.

The products in question are used in renal replacement therapy, which steps in when a patient’s kidneys are no longer able to do their job. Peritoneal dialysis can be done at home, while continuous renal replacement therapy is mainly used in intensive care units.

The commission stressed that the complaint concerns the products required to provide these treatments, rather than the dialysis treatment itself.

Adcock Ingram Critical Care’s activities include the manufacture and distribution of intravenous fluids and renal dialysis systems. The commission said it found that the company was dominant in the market for renal replacement therapy products in SA.

It also found that Adcock Ingram Critical Care’s prices for peritoneal dialysis and continuous renal replacement therapy products during the period under investigation were excessive, as they “significantly exceeded” the economic costs attributable to those products.

Economic costs include operating costs and costs of capital. The commission said this was a prima facie indication of an abuse of dominance under the Competition Act.

The case cuts into one of the most sensitive corners of the healthcare system. The commission said an estimated 6% to 17% of South Africans are living with chronic kidney disease, with that number likely to rise because of high rates of diabetes, hypertension and HIV.

Expensive renal replacement therapies can restrict access to treatment and add pressure on the government, renal facilities, medical schemes and patients.

The commission said the alleged excessive pricing contributed to the increase or escalation in the costs of making dialysis treatment available to patients.

“The pricing of essential healthcare products has important implications for healthcare costs, access to treatment, and the efficient functioning of healthcare markets,” said Competition Commissioner Doris Tshepe.

“The commission’s intervention in this matter reflects its commitment to ensuring that firms do not use market power to charge excessive prices for products that are critical to patient car