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Document/ "Competition" forgives American Hospital and Hygeia, they have a dominant position, but "they behaved well after making offers"!

2026-04-28 11:33:03Aktualitet SHKRUAR NGA REDAKSIA VOX
Document/ "Competition" forgives American Hospital and Hygeia, they

The Competition Authority has decided to close the preliminary investigation into two of the largest actors in the private hospital market in the country, American Hospital , otherwise known as the American Hospital, and International Hospital or as it is better known, Hygeia Hospital, but the way this process has been handled raises more questions than answers.

The decision to open the preliminary investigation was made in April 2025.

While the decision to close the procedure, which was consulted by ekofin.al, was taken in July 2025, but was only recently made public on the official website of the Competition Authority, seriously questioning the transparency and accountability of this authority towards the public and the market.

The Competition Commission clearly recognizes that these two companies have a dominant role in the private hospital services market in Albania.

According to the analysis, they own a significant share of the market and, most importantly, offer advanced and exclusive services that are not even found in the public sector.

These are specialized interventions such as mechanical thrombectomy, kidney transplants or advanced diagnostic technologies such as PET-CT, which according to the Competition Commission constitute "essential services" within the meaning of the competition law.

So, we have a clear conclusion: the market is concentrated, services are differentiated, and entry barriers are high, whether due to technological costs, lack of qualified staff, or sectoral regulation.

Under such conditions, any competition manual would suggest increased attention to the risk of abuse of dominant position.

However, in a twist that makes the entire analysis contradictory, the Competition Authority concludes that, despite this dominant position, there is no evidence of abusive behavior.

The main argument is that prices for services covered by the Mandatory Health Insurance Fund are transparent and equal for patients, while the companies themselves have also applied flexible pricing policies and discounts for certain categories of patients.

Competition even goes further with the following formulation.

Document/ "Competition" forgives American Hospital and Hygeia, they

This logic raises several fundamental problems. First, the fact that prices are regulated or partially financed by the state does not automatically exclude the possibility of abuse in other market segments, especially in private services or those not covered by public schemes.

Secondly, the Competition Authority itself admits that in many cases there are no real alternatives in the domestic market and patients are forced to turn to these structures, which further strengthens their dominant position.

Even more problematic is the fact that a portion of these services are financed by public funds through contracts with FSDKSH, creating a situation where a private operator benefits from public resources, while real competition remains limited.

The document itself acknowledges that this mechanism provides a stable flow of patients and significant income to the dominant operator.

Although the Competition Commission has taken care to hide the figures in the report, it is clear that the two private hospitals are not only in dominant positions, offering exclusive services, but also benefiting from considerable income, a good portion from the state budget, in addition to citizens' money.

On the other hand, the Authority justifies the lack of competition by the fact that the market is "regional", as patients can choose to be treated in other countries such as Turkey or countries in the region.

This argument is highly controversial, bordering on the ridiculous, as moving abroad for health treatment is not a realistic alternative for most patients, due to costs and other practical barriers.

The Competition Authority's decision is to close the investigation and establish a one-year monitoring period for the behavior of these companies.

But this solution seems more like a "hands-off solution", more of an administrative compromise than a strong response to a market that the institution itself describes as concentrated and with high entry barriers.

This whole situation is aggravated by the fact that the decision has been kept out of public attention for months.

The delayed publication of such an important document not only damages trust in the institution, in which head Denar Biba was recently re-elected for a second term, but also creates doubts about the way sensitive issues affecting critical sectors such as healthcare are handled.

Practically, we have a paradox: the Competition Authority acknowledges the existence of a dominant position and exclusive services, but at the same time downplays the risk, relying on procedural and social arguments. For an institution whose mission is to protect competition and consumers, this approach seems more like an avoidance of responsibility than an in-depth analysis of the market./ ekofin


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