Table 5.

Indicative components to flag potentially falsified medicines.

Indicates	Indicator	Level at which indicator applies	Rationale
Market opportunity: limited affordability	Product is on patent but not listed in current national formulary	Brand	On-patent products usually have premium prices. When they are not listed in current national formularies, they are usually not covered in the national insurance scheme, indicating limited affordability for patients. Patients or health care providers may seek these products at cut prices outside of the regulated supply chain.
Market opportunity: desirability	Molecule is used recreationally or off-label	Molecule	Some narcotics and psychotropic medicines are used recreationally or otherwise abused, including use for purposes for which they are not licensed. Additionally, access to some medicines is tightly restricted for political reasons, such as their potential use as abortifacients. Since the sale of these products is regulated, users without prescriptions commonly seek them outside of the regulated supply chain or from vendors who do not observe due diligence.
Profitability	Ratio of (price × retail channel sales volume) to market median, for the same dosage form	Brand	Falsifiers want to sell products for which there is a lucrative market, for which a large number of patients are prepared to pay a high price. For any given medicine for which there is a choice of brands, those brands with a combination of a relatively high retail price and a relatively large sales volume will be attractive targets.
Low risk of detection	Number of listings for product on 2 largest internet marketplaces	Brand	General internet marketplaces provide an unregulated but commonly used space for trading medicines without official licenses. The vast number of online transactions creates difficulty for regulatory monitoring, and anonymity limits the possibility of repercussions. More listings of products on the largest general online marketplaces also indicate high demand.