Poor quality and drug shortages appear to be behind China’s recent decision to end price caps on some low-cost drugs. The Wall Street Journal reports that the change will affect 280 medications made by Western drug companies and will have an impact on items including antibiotics, painkillers and vitamins.

The WSJ notes that China has put significant pressure on prices in an effort to keep health costs down, which encouraged manufacturers to either stop making drugs because of the lack of profit (which is what happened with thyroid medication Tapazole), or swap in cheaper ingredients, such as industrial gelatin—a carcinogen—instead of pharma-grade gelatin to save money.