Restricting competition in online advertising: Insights from the SCA’s decisions against digital healthcare providers
On 3 April 2025, the Swedish Competition Authority (the “SCA”) fined three digital healthcare providers—MinDoktor, Doktor.se, and Doktor24—for entering into anticompetitive agreements with Kry, another provider of online healthcare services. These bilateral agreements, which related to advertising strategies on Google Ads, were found to restrict competition in the digital healthcare sector and limit consumers’ freedom of choice. The fines against MinDoktor, Doktor.se and Doktor24 amounted to approximately SEK 26 million (approx. EUR 2.6 million). Kry, however, was granted immunity from fines after filing a leniency application to the SCA. In this blogpost, we analyse the SCA’s decisions and its implications.
Background
In 2020, the digital primary care provider Kry entered into separate bilateral agreements with three of its competitors: MinDoktor, Doktor.se, and Doktor24. Under these agreements, the companies agreed not to bid on each other’s brand names in Google Search ads. Google Ads, Google’s advertising platform, allows companies to display their ads at the top of a Google Search results page. Advertisers bid on specific keywords, and when users search for those words, Google runs an auction to determine which ads are shown.
The four digital healthcare companies had initially made independent decisions to bid on each other’s brand names. However, in 2020, Kry sent separate emails to the other three companies suggesting that they should refrain from bidding on each other’s brand names on Google Search. Each company agreed to the proposal. As a result, when consumers searched for one company, the paid advertisements of competing companies would not appear in the search results.
The conduct came to light after Kry alerted the SCA through its leniency program, which offers companies immunity or reduced fines in exchange for self-reporting anticompetitive behaviour. Due to Kry’s cooperation, the company was granted full immunity from fines.
The SCA’s decisions
Following Kry’s leniency application, the SCA initiated an investigation on the suspicion that the agreements could potentially restrict competition in violation of Chapter 2, Section 1 of the Swedish Competition Act, and Article 101(1) of the Treaty on the Functioning of the European Union.
The investigation conducted by the SCA revealed that online advertising, especially on platforms like Google Ads, has become a crucial avenue for businesses to compete and that many customers use a specific healthcare provider’s brand name when searching for services, making it vital for companies to appear at the top of Google Search results. According to the SCA, this visibility strongly influences customer choice and is consequently a key parameter of competition between the digital healthcare providers. The SCA found that the agreements had the object of restricting competition by effectively reducing exposure to alternative options in the market.
Implications of the decisions
The practice at issue clearly seems to have caught the attention of the SCA, which is now investigating similar practices in the pharmacy sector. However, as the SCA based its assessment on the specific characteristics of the digital healthcare market, it cannot be assumed that such advertising arrangements will be prohibited across all sectors.
The SCA’s decisions underline the critical role that online advertising (such as Google Ads) plays in ensuring competition and consumer choice in today’s economy, particularly in emerging sectors such as digital healthcare. The European Commission has also considered, in the Guess case, that restrictions on online advertising can undermine competition and harm consumer choice. The Guess case concerned vertical agreements between a brand (Guess) and its authorized retailers, where the retailers were prohibited from bidding on Guess’s brand name in Google Ads. The SCA’s case is thus somewhat novel as it concerns horizontal restrictions in the realm of online advertising. It is evident that businesses must remain vigilant and flexible to ensure compliance with competition rules as the digital marketplace continues to evolve.