South Africa’s Competition Commission has referred pharmaceutical manufacturer Adcock Ingram’s hospital division to the Competition Tribunal for prosecution over alleged excessive pricing of kidney dialysis products. The referral, announced on 3 June 2026, targets Adcock Ingram Critical Care (AICC) and covers pricing for peritoneal dialysis and continuous renal replacement therapy (CRRT) products between July 2019 and June 2024.
The commission is seeking an order declaring that AICC contravened section 8(1)(a) of the Competition Act, which prohibits a dominant firm from charging an excessive price “to the detriment of consumers or customers”. It is also seeking an administrative penalty of up to 10% of the company’s annual turnover.
Dialysis Product Excessive Pricing Case Heads To Tribunal
The commission said it opened an investigation after receiving a complaint, but did not name the complainant. It alleges AICC is dominant in the market for renal replacement therapy products in South Africa.
According to the regulator, AICC’s prices “significantly exceeded the economic costs attributable to those products”. It added that economic costs include operating costs and costs of capital. The commission describes this as a prima facie indication of abuse of dominance.
The commission also stressed that the referral relates to the products required to provide dialysis therapies, not the clinical treatment itself.
Dialysis Product Excessive Pricing Risks For Providers And Schemes
Dialysis products sit at the centre of life-sustaining care. Peritoneal dialysis can be performed at home, while CRRT is mainly delivered in intensive care units. AICC’s critical care activities include the manufacture and distribution of intravenous fluids and renal dialysis systems, which are used as inputs in these settings.
For funders and providers, the case falls within a high-cost area of care with limited room for delay. The commission estimates that 6% to 17% of South Africans are living with chronic kidney disease, and it expects demand to rise due to high rates of diabetes, hypertension, and HIV.
Commissioner Doris Tshepe said pricing of essential healthcare products has direct implications for healthcare costs, access to treatment, and the efficient functioning of healthcare markets.
What The Referral Means For Business And Governance
AICC forms part of Adcock Ingram, which is jointly owned by Bidvest Group and India’s Natco Pharma. Adcock Ingram delisted from the JSE last year. For the year ended 30 June 2025, AICC contributed R2.18bn to Adcock Ingram’s total revenue of R9.76bn.
For healthcare executives, the matter is a reminder that pricing strategy is also a governance and compliance issue. Manufacturers will need robust cost models and documentation. Providers and medical schemes may review contracting, utilisation, and procurement controls in renal care pathways.
The Tribunal process will now test the commission’s allegations. The referral itself is not a finding of guilt, but it raises the stakes for how essential renal inputs are priced, justified, and monitored across the health system.
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