CADE convicts hospital union for anticompetitive practices

On 6 August, the Administrative Council for Economic Defense (CADE) convicted the Union of Hospitals and Health Establishments of the Brazilian State of Mato Grosso do Sul (SINDHESUL) for concerted practices. Overall, the fines totalled more than BRL 350 thousand. 

The investigation was initiated after notification of the Federal Prosecution Services of the Brazilian State of São Paulo (MPF/SP). The information referred to a civil enquiry into the news that the hospitals used listed overestimated prices, especially the BRASÍNDICE pharmaceutical guide (Guia Farmacêutico Brasíndice) and the SIMPRO hospital pricing table (Tabela Simpro), as reference for the refund of medication and hospital materials. 

Regarding the case launched at CADE, it was found that the SINDHESUL published a contract template in their website, with recommendations of prices for medication and hospital materials, based on the publications aforementioned (Guia Farmacêutico Brasínice and Tabela Simpro). 

According to Commissioner Diogo Thomson, rapporteur of the case, SINDHESUL is able to influence the conduct of its members, and the guidance available in its website was published by choice and with criteria; thus, he considered the promotion of concerted practices. 

The rapporteur also confronted the defence argument presented. It was stated that the union aimed at neutralising the influence of health insurance providers on hospitals, a claim based on the idea of “countervailing power”. However, Mr Thomson understood that the defence did not present clear, material, and solid evidence to unequivocally prove the existence of relevant power asymmetry to justify the argument.

Finally, CADE fined SIDHESUL in BRL 353,158.00, besides additional penalties, such as taking down any mentions to the antitrust practices from its social media, communication channels, and physical establishments, and prohibiting any guidance or communication that encourages or imposes the adoption of listed prices of materials or medication in hospitals.

Access Case no. 08700.001180/2015-56.