• Zimbabwe’s Competition and Tariff Commission has launched a formal probe into Cimas over allegations it is excluding an independent pharmacy (Harvey Brown) from its direct-payment system, potentially restricting competition
• The investigation centres on claims that Cimas is steering members toward its own clinics and pharmacies, raising concerns about abuse of dominance in a vertically integrated healthcare mode
• The case carries wider implications for patient choice and market fairness in a healthcare system where only 10% of Zimbabweans have medical aid, making access and affordability highly sensitive

Harare — Zimbabwe’s Competition and Tariffs Commission has opened a formal investigation into Cimas Medical Aid Society, one of the country’s largest medical aid providers, following allegations that it is deliberately blocking an independent pharmacy from its direct-payment system and steering members toward its own in-house facilities.

The probe, announced through an official government notice published under Section 28 of the Competition Act [Chapter 14:28], focuses on Belnash Investments, which trades as Harvey Brown Pharmacy in Milton Park, Harare.

‘’It is alleged that Cimas Medical Aid Society declined to register Belnash Investment trading as Harvey Brown Pharmacy as a alleged conduct is said to have not withstanding the registration of other similarly placed service providers on the same system,’’ CTC said in a press statement.

According to the notice, Cimas declined to register the pharmacy on its direct-payment platform even though other similarly situated providers were approved.

As a result, Cimas members visiting Harvey Brown Pharmacy are reportedly forced to pay cash upfront for medicines and services.

The Commission further alleges that Cimas, which operates its own pharmacies and clinics in close proximity to Harvey Brown, is indirectly directing its members to its in-house outlets. This pattern, if proven, raises serious questions about whether a medical aid society that also provides healthcare services is using its dominant position to limit competition in an already strained sector.

The investigation comes against the backdrop of Zimbabwe’s deeply challenged healthcare system. Public hospitals and clinics continue to battle chronic shortages of medicines, broken equipment and severe staff shortages, problems worsened by years of economic instability and the emigration of thousands of health professionals.

For the minority who can afford private care, medical aid is often the only lifeline. Coverage remains extremely limited. According to surveys and reports by Association of Healthcare Funders of Zimbabwe, only around 10% of the population  roughly 1.7 million out of Zimbabwe’s approximately 17.4 million people  hold medical aid membership.

The vast majority of Zimbabweans must pay cash for every doctor visit, prescription or hospital stay. Cimas Medical Aid Society, originally the Commercial and Industrial Medical Aid Society and now operating under the Cimas Health Group umbrella, has grown into a major integrated player.

It runs 14 primary-care clinics across the country, including seven in Harare and others in cities such as Mutare, Kwekwe, Gweru, Bulawayo, Masvingo and Victoria Falls. The group also maintains its own pharmacies, notably the well-known Cimas Fife Avenue Pharmacy in central Harare, and has expanded into diagnostic services such as radiology through its Medlabs arm, as well as dental care.

The direct-payment system is crucial for members, a swipe of the medical aid card allows seamless reimbursement without the need for large cash outlays in a 80% dollarized economy where incomes remain under pressure.

The Commission’s preliminary assessment highlights the potential harm. Through  refusing to register Harvey Brown Pharmacy, Cimas may be restricting its members’ ability to choose providers based on location, price or quality, effectively channelling them toward Cimas-owned or preferred outlets.

Independent pharmacies that remain outside the network face clear disadvantages, they lose out on the steady flow of insured patients, making it harder to grow or even survive in a market where medical aid members represent the most reliable source of revenue.

The practice, the notice states, could therefore create artificial barriers to entry and expansion for Harvey Brown and any other providers in the same situation.

This is not the first time Cimas has attracted regulatory scrutiny for similar conduct. In December 2022, the Commission investigated the society after it deregistered Family Medical Clinic in Masvingo from its direct-payment system, prompting concerns about limited patient choice and foreclosure of rival clinics.

Earlier cases, dating back to 2011–2013, involved allegations that Cimas was refusing to reimburse claims at independent dialysis centres while directing members to facilities in which it held stakes. In one instance the Commission ordered Cimas to stop the restrictive practices and reimburse affected members.

These repeated episodes suggest a pattern in which vertical integration, the combination of insurance and service provision under one roof  may be tipping from efficiency gains into exclusionary behaviour.

In a country where healthcare is already a luxury for most families, the stakes are high. Middle-income households juggling school fees, rising food prices and fuel costs can ill afford sudden cash demands at the pharmacy counter.

Delayed treatment or skipped medication becomes a real risk. From a broader competition standpoint, the case mirrors international debates about vertically integrated healthcare markets. While insurers that own providers can sometimes deliver better coordination and cost control, the danger arises when that control translates into captive markets that squeeze out independent players and reduce consumer options.

The Commission has emphasised that the launch of an investigation does not imply any finding of wrongdoing. The process is designed to gather evidence and determine whether the alleged conduct directly or indirectly restricts competition in violation of the Act.

If the Commission finds merit in the complaints, it may issue remedial orders requiring Cimas to register Harvey Brown Pharmacy and similar providers on equal terms, or negotiate undertakings to restore fair access.

A favourable decision for independent providers would reinforce the principle that medical aid cards should open doors to any qualified pharmacy, not just those owned or favoured by the insurer. Conversely, if the non-registration is shown to have legitimate business reasons, the probe will close without action.

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