The concentration of pharmaceutical and medical technology supplies within relatively few large global corporations is a big problem for healthcare. More precisely, the abuse of monopoly positions to drive higher profits is very costly for hospitals that are already operating on thin margins. Fortunately, the legal system is reacting: In early February, a California federal jury ordered Medtronic to pay nearly $382 million to its competitor Applied Medical for antitrust violations. The jury found that the medical device giant illegally used its monopoly power to crush competition in the advanced bipolar vessel sealing device market. The Medtronic decision is similar to a recent $442 million jury decision against J&J’s Biosense Webster. Both cases hinged on the fact that it is illegal to bundle your products and services with something nobody else can offer.
While bundling arrangements might seem to provide benefits, the practice harms hospitals when they pay higher prices and have less choice. Importantly, bundling is illegal when it’s used to block competitors and claim higher profits.
That’s why recent antitrust verdicts are more than headlines. They are practical signals for hospital leadership and supply chain teams to tighten contracting discipline, especially where discounts, rebates, or “portfolio pricing” are tied to purchasing commitments that limit real choice.
Every major supplier agreement should be reviewed with a specific lens: Identify where access to pricing on one product line is conditioned on volume or exclusivity in another, where competitive products are effectively locked out, and where contract language makes switching costs punitive or operationally unrealistic.
Vendor management should also reflect the new reality: Hospitals are not obligated to accept take-it-or-leave-it bundling structures as “standard practice.” Contract negotiations should be approached with a documented record of communications and a clear expectation that commercial terms will not be used to block competition. When warranted, hospitals should escalate concerns. The goal is not confrontation for its own sake, but the restoration of genuine choice, fair pricing, and a supply market that rewards clinical value instead of leverage.
And there is an upside worth naming plainly. Holding global healthcare behemoths accountable is a first step toward rebalancing a system where the financial gravity has drifted away from the bedside. When monopoly tactics lose their “business as usual” cover, competition has room to breathe, prices have a reason to behave, and hospitals regain dollars that can be reinvested in staffing, access, technology, and safer, more consistent care.
A more sustainable hospital margin is not a corporate victory; it is a patient victory. Accountability is how the system starts paying for health again, instead of paying a premium for power.
In March, Biosense Webster released its first compliance report pursuant to section 5 of the August injunction that prohibited the company from engaging in certain anti-reprocessing activities. The report describes how Biosense Webster informed their employees, their customers, and their prospective customers of the injunction. In September, 2,483 emails were sent to employees, 2,381 FedEx notices were sent to EP labs, and Biosense Webster's 137 territory managers sent a total of 2,459 emails to physicians. Moreover, Biosense Webster's quote system now automatically includes a copy of the injunction with a quote for a CARTO machine. Biosense Webster has adopted a policy of providing clinical support at no additional cost for CARTO 3 procedures, regardless of whether a third-party reprocessed catheter is used. Finally, since the injunction, Biosense Webster has launched two new versions of the CARTO 3 software, one in August and one in January, and neither of these included technology intentionally designed to prevent reprocessing.
It is possible to control and restrict monopolistic behavior in healthcare. Now it is time for hospital contracting to do their part.