Storm brewing for 136-year-old company in South Africa
The Competition Commission has formally referred a prosecution case against Adcock Ingram Critical Care (AICC) to the Competition Tribunal.
AICC is accused of abusing its market dominance and engaging in excessive pricing, violating Section 8(1)(a) of the Competition Act.
AICC’s activities in critical care encompass a range of services, including the manufacture and distribution of intravenous fluids and renal dialysis systems.
Renal dialysis serves essential functions similar to those of healthy kidneys when a patient faces kidney deterioration or failure.
Peritoneal dialysis can be conducted at home, whereas continuous renal replacement therapy is primarily performed in intensive care units.
The case specifically addresses the hardware and consumables required for peritoneal dialysis (home treatments) and continuous renal replacement therapy (primarily used in hospital ICUs) for kidney failure.
“The complaint referral concerns the products required to provide these treatments, rather than the treatment itself,” said the Competition Commission of South Africa’s spokesperson, Siyabulela Makunga.
The commission investigated the matter following a complaint filed with it and found that AICC is dominant in the South African market for renal replacement therapy products.
The alleged overcharging and profiteering occurred over a five-year period from July 2019 to June 2024, encompassing the pandemic era.
The commission found that AICC’s prices significantly exceeded its actual economic and operating costs.
“Economic costs include operating costs and costs of capital. This is a prima facie indication of an abuse of dominance in terms of section 8(1)(a) of the Act,” said Makunga.
With chronic kidney disease affecting 6% to 17% of South Africans, this condition artificially inflates healthcare costs, placing a heavy financial burden on vulnerable patients, private medical schemes, and the government.
“The pricing of essential healthcare products has important implications for healthcare costs, access to
treatment, and the efficient functioning of healthcare markets,” said 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 care.”
The commission is seeking a declaration of guilt from the Tribunal and an administrative fine of up to 10% of AICC’s annual turnover.
Adcock Ingram’s financials
Adcock Ingram reported group turnover of R9.8 billion for its 2025 financial year. This means that the maximum possible administrative penalty could reach R980 million.
The company’s most recent annual financial statements provide some context, although they do not specify revenue from the particular renal products mentioned in the commission’s referral.
The hospital division of Adcock Ingram is identified as the supplier of critical care products, including intravenous solutions, blood collection products, and renal dialysis systems.
For the year ended June 30, 2025, this division reported revenue of R2.19 billion, up from R2.05 billion in the previous year.
However, trading profit in the hospital division declined to R125.3 million from R128.4 million.
Additionally, the division reported revenue of R558.1 million from the South African government, down from R570.2 million in the prior year.
Adcock Ingram was delisted from the Johannesburg Stock Exchange (JSE) in November 2025, with India’s Natco Pharma acquiring around 35% shares of the 136-year-old company.
South African giant Bidvest owns the remaining shares of Adcock Ingram, which is around 65% of the company.
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