Profit protection by actors and risks for medicine quality
| Actors | Profit protection | Risks for medicine quality |
| Manufacturers or distributors | Cut production costs: Use cheaper active pharmaceutical ingredients | Substandard products at point of manufacture |
| Cut production costs: Use cheaper packaging materials | Downgraded packaging, prone to degradation | |
| Cut production costs: Unregistered contract manufacturing to smaller factories without valid Good Manufacturing Certificate | Substandard products at point of manufacture | |
| Cut distribution costs: Limit supply to remote areas | Localised shortage, creating market opportunity for falsification | |
| Cut distribution costs: Reduce investment in temperature-monitored storage for injections | Downgraded storage, prone to product degradation | |
| Withdraw from market (including non-participation in public procurement) | Shortage, creating market opportunity for falsification | |
| Healthcare providers | Prescribe premium and uncovered medicines | Irrational unmet demand of certain products or brands, creating market opportunity for falsification |
| Select cheapest possible products especially during JKN medicines stockouts | Downgraded packaging, prone to degradation | |
| Limit medicine dispensed to patients | Push patients to unregulated supply chain, more vulnerable to poor-quality products especially falsified ones |
JKN, Jaminan Kesehatan Nasional.