The Competition and Markets Authority (CMA) is clearing UnitedHealth’s £1.2 billion purchase of UK electronic patient record systems and software supplier EMIS — including the electronic patient record system used by most NHS GPs.
“The NHS increasingly relies on digital technology and data analytics to support the delivery of high quality healthcare, so it is important to ensure that, as the main customer of these services, the NHS continues to have access to the options and innovations that new and developing technology can bring,” said chair of the independent inquiry group carrying out the investigation, Kirstin Baker.
“Following a thorough investigation, careful consideration of a broad range of evidence and consultation with a variety of stakeholders, we are satisfied that this deal will not reduce competition or mean that the NHS and its patients lose out.”
Last month we covered expectations this would happen. The deal, announced in 2022, had been referred for an in-depth Phase 2 CMA investigation by an independent inquiry group in March 2023.
A Phase 2 review means the inquiry group considers whether it is more likely than not that a deal will substantially lessen competition, so it’s judged against a higher threshold than a Phase 1 exercise. It had identified competition concerns that it felt warranted further investigation during an initial Phase 1 review. Following a thorough investigation, the CMA has confirmed that the transaction “does not raise competition concerns when considered against the higher legal standard that applies in Phase 2 investigations, clearing the deal to proceed”.
EMIS supplies data management systems to the NHS, while Optum, part of UnitedHealth, currently supplies software used by GPs when prescribing medicines, as well as data analytics and advisory services that the NHS uses to help improve overall healthcare and health service provision.
Although the merging businesses do not supply competing services, the CMA was initially concerned that the deal would allow Optum to limit its competitors’ access to the data held within EMIS’s patient record system or to degrade the digital connections to this system, which rivals rely on to provide integrated software.
The investigation confirmed that EMIS, as the lead supplier to NHS GPs across the UK, holds a particularly strong market position in the supply of electronic patient record systems but after considering the potential impact of the merger in two markets in which Optum could limit its competitors’ access to the data held within EMIS, the Authority has found that the deal does not raise competition concerns.
In the supply of data analytics and advisory services for population health management, the CMA found that the merged business would not, in practice, be able to use the data that EMIS holds to harm the competitiveness of rivals, primarily because the NHS could use its oversight role to prevent the merged business from pursuing this kind of strategy.
In the supply of medicines optimisation software, the CMA found that a strategy that involved restricting access to EMIS’s electronic patient record system would not be commercially beneficial to the merged business, with any possible gains being limited and capable of being reduced through intervention by the NHS. More information can be found on the CMA’s Optum/ Emis case page.
CMA says it gathered and assessed a wide range of evidence, including thousands of internal business documents from EMIS and Optum, as well as evidence from requests for information and calls with competitors as well as customers across the NHS and from NHS England — including following its consultation with stakeholders following the provisional findings.
