Closing proceedings that ran over 10 years, in June 2026, the CCI passed its final order dismissing allegations of abuse of dominance and anti-competitive agreements against Max Super Specialty Hospital, Delhi (‘Max Hospital’).

The case originated from a complaint about disposable syringe price markups, allegedly caused by an anticompetitive agreement between Becton Dickinson and Max Hospital. The CCI’s investigation wing, the Director General (‘DG’), found no evidence of an exclusive supply agreement after a two year investigation. But it did find excessive pricing of syringes by hospitals in an ‘aftermarket’ for locked-in patients.

On reviewing the DG’s recommendations, the CCI directed a supplementary investigation to examine all aftermarket abuse concerns in the hospital market in Delhi. The supplementary investigation spanned another three years and focused on healthcare products and services provided to ‘in-patients’ (patients admitted to stay in the hospital) by 12 super specialty hospitals across Delhi. Five aspects of the hospital market were investigated: room rent, medical tests, medical devices, consumables, and medicines.

The CCI’s final Order has two significant implications. First, on the issue of defining aftermarkets, and second, on the test to establish a case of excessive pricing under Section 4 of the Competition Act.

The DG had recommended that the relevant markets be defined as the provision of healthcare services by each of the hospitals only to their respective in-patients. The CCI, however, disagreed with this and held that elective patients can reasonably assess the total cost of healthcare upfront and easily switch hospitals without incurring substantial costs. So, although an in-house ‘lock-in’ may exist once a patient is admitted, defining a separate aftermarket was not warranted. The CCI, therefore, ultimately delineated a unified product market (‘provision of healthcare services by super specialty hospitals’).

On the issue of excessive pricing, the DG had concluded that each of the hospitals investigated contravened the Competition Act because, compared to independent service providers (e.g., standalone diagnostic services, government-run hospitals, etc.), they charged higher prices. The CCI disagreed with these findings. It emphasised the United Brands test and held that to establish a case of excessive pricing, prices must be both excessive in relation to the costs and unfair either in and of themselves or compared to those charged by competitors. None of the five aspects examined by the DG met both these conditions, leading to the investigation being closed.