Main Article Content
Abstract
This study examines how regulatory compliance, product innovation, and service quality contribute to market-driven strategy transformation in the medical device industry and influence customers’ brand loyalty, specifically in the Indonesian medical device industry. Data were collected using self-administered surveys from 120 institutional customers of a medical device manufacturing company in Indonesia as part of a quantitative research design and analyzed using structural equation modeling (SEM). The findings demonstrated that product innovation, service quality, and regulatory compliance all had significant effects on brand image (p < 0.05), with service quality being the most significant predictor (β = 0.503). Brand loyalty was positively and significantly impacted by brand image (β = 0.587; p < 0.001). Product innovation was found to have a significant direct impact on loyalty (β = 0.389; p < 0.001), whereas regulatory compliance had an indirect impact through brand image (p < 0.05) but no direct impact on loyalty (p > 0.05). These Findings imply that medical device sector in Indonesia should prioritize market-driven strategies which integrate service quality excellence and continuous product innovation, while also positioning regulatory compliance as credibility foundation to empower brand image and sustain customer loyalty.
Keywords
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References
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- Cravens, D. W., & Piercy, N. F. (2009). Strategic marketing (9th ed.). McGraw-Hill Education.
- Darawong, C. (2025). Examining the impact of hospital pharmacy service quality on patient loyalty in Thailand: The moderating role of illness condition. International Journal of Quality & Reliability Management. https://doi.org/10.1108/IJQRM-08-2024-0273
- Daulay, R., Hafni, R., Nasution, S. M. A., Jufrizen, & Nasution, M. I. (2024). Determinants affecting trust, satisfaction, and loyalty: A case study of low-cost airlines in Indonesia. Innovative Marketing, 20(1), 101–112. https://doi.org/10.21511/im.20(1).2024.09
- Ewaldo Jader Pereira, P., Marcelo Ardigó, C., & Flóres Limberger, P. (2021). Brand reputation and relationship with customer loyalty in the retail pharmacy sector: A case study. Review of Business Management, 23(3), 557–570. https://doi.org/10.7819/rbgn.v23i3.4120
- Farrag, M. E. (2025). Investigating the effect of perceived healthcare products quality and brand image on brand usage moderated by brand trust. Journal of Advances in Economics and Business Studies, 2(1), 81–104. https://doi.org/10.21608/jaebs.2025.424641
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- Feng, L. (2025). A study on the impact of corporate social responsibility performance on consumer purchase decisions: A case of the pharmaceutical industry. Business Administration and Economic Review.
- Guoha, L., & Dellova, R. (2025). Perceived impact of product innovation on brand loyalty: A study of smartphone consumers in China. Diversitas Journal, 10(special_1). https://doi.org/10.48017/dj.v10ispecial_1.3151
- Haag, K., Achtenhagen, L., & Grimm, J. (2023). Engaging with the category: Exploring family business longevity from a historical perspective. Family Business Review, 36(1), 84–118. https://doi.org/10.1177/08944865231154835
- Hendarwan, D. (2023). Analysis of market-driven strategies to increase capabilities and performance advantages in business. Journal of Economic Empowerment Strategy, 6.
- Ishaq, S., Hoang, T. G., Tanveer, U., Hoang, T.-H., & Truong, H. Q. (2024). Transformative capabilities of MedTech organizations in driving circularity in the healthcare industry: Insights from multiple cases. Journal of Cleaner Production, 446, 141370. https://doi.org/10.1016/j.jclepro.2024.141370
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- Lolemo, S. E., & Pandya, H. B. (2025). Customer e-satisfaction as a mediator between e-service quality, brand image, and e-loyalty: Insights from Ethiopian digital banking technology. Journal of Digital Economy, 4, 1–15. https://doi.org/10.1016/j.jdec.2025.05.005
- Luthfitawati, R., & Sutejo, B. (2025). Examining the influence of brand image and brand trust on customer satisfaction and loyalty: A study on Wardah cosmetics. Golden Ratio of Marketing and Applied Psychology of Business, 6(1), 179–192. https://doi.org/10.52970/grmapb.v6i1.1323
- Mangalindung, G. H., & Hendayana, Y. (2024). The influence of product innovation, brand image, and brand trust on purchasing decisions (study literature). Dinasti International Journal of Management Science, 5(5).
- Masud, A. Al, Ahmed, S., Kaisar, M. T., Hossain, B., Shimu, M., & Islam, M. F. (2024). Unveiling brand loyalty in emerging markets: Analyzing smartphone user preferences—Robustness of structural equation modeling and simultaneous equation modeling. Journal of Open Innovation: Technology, Market, and Complexity, 10(3), 100353. https://doi.org/10.1016/j.joitmc.2024.100353
- Mauliano, I. R., & Arimbawa, P. A. P. (2025). The effects of product differentiation and brand image on customer loyalty. Jurnal Kewirausahaan dan Inovasi, 4(1), 23–34. https://doi.org/10.21776/jki.2025.04.1.03
- MohammadEbrahimzadeh, S., Khajeheian, D., Arbatani, T. R., Labafi, S., & Sepasgozar, S. (2025). Sustainable knowledge-based enterprise products using AI-powered social media for enhancing brand equity: A scientometric review. Sustainability, 17(18). https://doi.org/10.3390/su17188427
- Muthoni Mwabu, A., & Munyoki, J. (2021). A critical review of literature on product differentiation strategy and brand loyalty. Proceedings of the 3rd International Conference. http://ir.mksu.ac.ke/handle/123456780/8093
- Nagarajan, D. V. (2024). Zoomers and healthcare choices: A study of mental processes of consumer decision-making in the digital age. Journal of Consumer Behaviour, 23(6), 2952–2974. https://doi.org/10.1002/cb.2382
- Oliver, R. L. (1999). Whence consumer loyalty? Journal of Marketing, 63(Special Issue), 33–44. https://doi.org/10.2307/1252099
- Orazgaliyeva, E., Abuzhalitova, A., Sokhatskaya, N., Smykova, M., & Kazybayeva, A. (2024). Trust as a critical driver of customer loyalty in the pharmaceutical market: A study of Kazakhstan. Regional Science Policy & Practice, 16(9), 100021. https://doi.org/10.1016/j.rspp.2024.100021
- Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12–40.
- Prasetyo, Y. T., Belmonte, Z. J. A., Esberto, E. M., Cahigas, M. M. L., Nadlifatin, R., & Gumasing, M. J. J. (2025). Cognitive perceptions and behavioral loyalty in telecommunication services: Integrating SERVQUAL and CSI in the Philippine context. Acta Psychologica, 259, Article 105298. https://doi.org/10.1016/j.actpsy.2025.105298
- Rahmi, N. A., & Ridhaningsi, F. (2025). Service quality and innovation as drivers of customer loyalty. Golden Ratio of Marketing and Applied Psychology of Business, 6(1), 202–216. https://doi.org/10.52970/grmapb.v6i1.1327
- Roberts, P. W. (1999). Product innovation, product-market competition and persistent profitability in the U.S. pharmaceutical industry. Strategic Management Journal, 20(7), 655–670. https://doi.org/10.1002/(SICI)1097-0266(199907)20:7<655::AID-SMJ44>3.0.CO;2-P
- Sah, A. K., Hong, Y. M., & Huang, K. C. (2025). Enhancing brand value through circular economy service quality: The mediating roles of customer satisfaction, brand image, and customer loyalty. Sustainability, 17(3). https://doi.org/10.3390/su17031332
- Ščiukauskė, I., Romeika, G., & Šarkiūnaitė, I. (2024). The consumers’ perceptions of employer and service brand equity’s: The exploratory and confirmatory factor analysis. Journal of Business Economics and Management, 25(1), 85–103. https://doi.org/10.3846/jbem.2024.20716
- Semuel, H., Siagian, H., & Octavia, S. (2017). The effect of leadership and innovation on differentiation strategy and company performance. Procedia - Social and Behavioral Sciences, 237, 1152–1159. https://doi.org/10.1016/j.sbspro.2017.02.171
- Sudirjo, F., Dewi, L. K. C., Elizabeth, Mustafa, F., & Santosa, S. (2023). Analysis of the influence of consumer behavior, product attributes, and brand image on purchasing decisions of pharmaceutical industry product consumers. JEMSI (Jurnal Ekonomi, Manajemen, dan Akuntansi), 9(6), 2432–2437. https://doi.org/10.35870/jemsi.v9i6.1648
- Tabiat, A. (2022). The impact of digital marketing on sales performance: The case of Lebanese pharmaceutical companies. European Journal of Business and Management Research, 7(4), 349–355. https://doi.org/10.24018/ejbmr.2022.7.4.1600
- Tahir, A. H., Adnan, M., & Saeed, Z. (2024). The impact of brand image on customer satisfaction and brand loyalty: A systematic literature review. Heliyon, 10(16), e36254. https://doi.org/10.1016/j.heliyon.2024.e36254
- Tarmidi, D., & Wijaya, K. P. (2023). The impact of perceived value and product innovation toward brand loyalty on video premium application services. Jurnal Ekonomi, 12(1). http://ejournal.seaninstitute.or.id/index.php/Ekonomi
- Utomo, S. B., Setiadi, B., Astuti, E. D., Wahyuningratna, R. N., Hendra, & Nusyirwan. (2025). The role of e-service quality and brand image on purchase intention of smartphone products. International Journal of Engineering, Science and Information Technology, 5(1), 290–296. https://doi.org/10.52088/ijesty.v5i1.714
- Wu, J. C., Tsai, P. H., Tang, J. W., & Chen, C. J. (2024). Do store and brand attachments influence customer loyalty? Evidence from migrant workers in Taiwan. SAGE Open, 14(1). https://doi.org/10.1177/21582440241234794
- Xu, J., Xu, X., Sun, K. S., Wu, D., Lam, T. P., & Zhou, X. (2022). Changes in residents’ hygiene awareness and behaviors in public toilets before and during the COVID-19 pandemic in Hangzhou, China: A two-round cross-sectional study. BMC Public Health, 22(1), 1690. https://doi.org/10.1186/s12889-022-14114-8
- Ye, C., & Zhang, J. (2025). How does customer concentration affect firm innovation in the Chinese pharmaceutical industry? Journal of the Knowledge Economy. https://doi.org/10.1007/s13132-025-02771-0
References
Almasarweh, M. S., Harb, A., Alnawaiseh, M. B., & Almajali, T. A. (2024). Beyond service excellence: Exploring brand image as the bridge between service quality and customer loyalty in nature tourist camps. Geojournal of Tourism and Geosites, 53(2), 725–735. https://doi.org/10.30892/gtg.53236-1248
Arote, K. S., Salade, D. A., & Patil, N. V. (2023). A brief review on regulatory affairs: Ensuring compliance, safety, and market access. International Journal in Pharmaceutical Sciences, 1, 22–30. https://doi.org/10.5281/zenodo.8397986
Cardoso, A., Gabriel, M., Figueiredo, J., Oliveira, I., Rêgo, R., Silva, R., Oliveira, M., & Meirinhos, G. (2022). Trust and loyalty in building the brand relationship with the customer: Empirical analysis in a retail chain in Northern Brazil. Journal of Open Innovation: Technology, Market, and Complexity, 8(3), 109. https://doi.org/10.3390/joitmc8030109
Chen, H., Akparep, J., Sulemana, I., & Osei, A. (2024). Advancing green innovations in pharmaceutical firms towards societal development: Nurturing customers’ health and building loyalty. Environment, Development and Sustainability. https://doi.org/10.1007/s10668-024-05690-3
Cravens, D. W., & Piercy, N. F. (2009). Strategic marketing (9th ed.). McGraw-Hill Education.
Darawong, C. (2025). Examining the impact of hospital pharmacy service quality on patient loyalty in Thailand: The moderating role of illness condition. International Journal of Quality & Reliability Management. https://doi.org/10.1108/IJQRM-08-2024-0273
Daulay, R., Hafni, R., Nasution, S. M. A., Jufrizen, & Nasution, M. I. (2024). Determinants affecting trust, satisfaction, and loyalty: A case study of low-cost airlines in Indonesia. Innovative Marketing, 20(1), 101–112. https://doi.org/10.21511/im.20(1).2024.09
Ewaldo Jader Pereira, P., Marcelo Ardigó, C., & Flóres Limberger, P. (2021). Brand reputation and relationship with customer loyalty in the retail pharmacy sector: A case study. Review of Business Management, 23(3), 557–570. https://doi.org/10.7819/rbgn.v23i3.4120
Farrag, M. E. (2025). Investigating the effect of perceived healthcare products quality and brand image on brand usage moderated by brand trust. Journal of Advances in Economics and Business Studies, 2(1), 81–104. https://doi.org/10.21608/jaebs.2025.424641
Febriyani, Y., Sapta Putra, S., & Digdowiseiso, K. (2023). The influence of brand image, product innovation, and brand trust on the competitiveness of Wardah cosmetic products among students of the National University of Jakarta. Economic Journal, 12. http://ejournal.seaninstitute.or.id/index.php/Ekonomi
Feng, L. (2025). A study on the impact of corporate social responsibility performance on consumer purchase decisions: A case of the pharmaceutical industry. Business Administration and Economic Review.
Guoha, L., & Dellova, R. (2025). Perceived impact of product innovation on brand loyalty: A study of smartphone consumers in China. Diversitas Journal, 10(special_1). https://doi.org/10.48017/dj.v10ispecial_1.3151
Haag, K., Achtenhagen, L., & Grimm, J. (2023). Engaging with the category: Exploring family business longevity from a historical perspective. Family Business Review, 36(1), 84–118. https://doi.org/10.1177/08944865231154835
Hendarwan, D. (2023). Analysis of market-driven strategies to increase capabilities and performance advantages in business. Journal of Economic Empowerment Strategy, 6.
Ishaq, S., Hoang, T. G., Tanveer, U., Hoang, T.-H., & Truong, H. Q. (2024). Transformative capabilities of MedTech organizations in driving circularity in the healthcare industry: Insights from multiple cases. Journal of Cleaner Production, 446, 141370. https://doi.org/10.1016/j.jclepro.2024.141370
Jakovljevic, M., Wu, W., Merrick, J., Cerda, A., Varjacic, M., & Sugahara, T. (2021). Asian innovation in pharmaceutical and medical device industry – Beyond tomorrow. Journal of Medical Economics, 24(sup1), 42–50. https://doi.org/10.1080/13696998.2021.2013675
Khalifa, S. A. M., Swilam, M. M., El-Wahed, A. A. A., Du, M., El-Seedi, H. H. R., Kai, G., Masry, S. H. D., Abdel-Daim, M. M., Zou, X., Halabi, M. F., Alsharif, S. M., & El-Seedi, H. R. (2021). Beyond the pandemic: COVID-19 pandemic changed the face of life. International Journal of Environmental Research and Public Health, 18(11), 5645. https://doi.org/10.3390/ijerph18115645
Kristanti, I. G. A. M. I., Senastri, N. M. J., & Arjaya, I. M. (2024). Effectiveness of disposable medical device procurement in increasing the acceleration of the use of domestic products in RSUD Bali Mandara. Journal of Court and Justice, 3(1), 30–47. https://doi.org/10.56943/jcj.v3i1.485
Lolemo, S. E., & Pandya, H. B. (2025). Customer e-satisfaction as a mediator between e-service quality, brand image, and e-loyalty: Insights from Ethiopian digital banking technology. Journal of Digital Economy, 4, 1–15. https://doi.org/10.1016/j.jdec.2025.05.005
Luthfitawati, R., & Sutejo, B. (2025). Examining the influence of brand image and brand trust on customer satisfaction and loyalty: A study on Wardah cosmetics. Golden Ratio of Marketing and Applied Psychology of Business, 6(1), 179–192. https://doi.org/10.52970/grmapb.v6i1.1323
Mangalindung, G. H., & Hendayana, Y. (2024). The influence of product innovation, brand image, and brand trust on purchasing decisions (study literature). Dinasti International Journal of Management Science, 5(5).
Masud, A. Al, Ahmed, S., Kaisar, M. T., Hossain, B., Shimu, M., & Islam, M. F. (2024). Unveiling brand loyalty in emerging markets: Analyzing smartphone user preferences—Robustness of structural equation modeling and simultaneous equation modeling. Journal of Open Innovation: Technology, Market, and Complexity, 10(3), 100353. https://doi.org/10.1016/j.joitmc.2024.100353
Mauliano, I. R., & Arimbawa, P. A. P. (2025). The effects of product differentiation and brand image on customer loyalty. Jurnal Kewirausahaan dan Inovasi, 4(1), 23–34. https://doi.org/10.21776/jki.2025.04.1.03
MohammadEbrahimzadeh, S., Khajeheian, D., Arbatani, T. R., Labafi, S., & Sepasgozar, S. (2025). Sustainable knowledge-based enterprise products using AI-powered social media for enhancing brand equity: A scientometric review. Sustainability, 17(18). https://doi.org/10.3390/su17188427
Muthoni Mwabu, A., & Munyoki, J. (2021). A critical review of literature on product differentiation strategy and brand loyalty. Proceedings of the 3rd International Conference. http://ir.mksu.ac.ke/handle/123456780/8093
Nagarajan, D. V. (2024). Zoomers and healthcare choices: A study of mental processes of consumer decision-making in the digital age. Journal of Consumer Behaviour, 23(6), 2952–2974. https://doi.org/10.1002/cb.2382
Oliver, R. L. (1999). Whence consumer loyalty? Journal of Marketing, 63(Special Issue), 33–44. https://doi.org/10.2307/1252099
Orazgaliyeva, E., Abuzhalitova, A., Sokhatskaya, N., Smykova, M., & Kazybayeva, A. (2024). Trust as a critical driver of customer loyalty in the pharmaceutical market: A study of Kazakhstan. Regional Science Policy & Practice, 16(9), 100021. https://doi.org/10.1016/j.rspp.2024.100021
Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12–40.
Prasetyo, Y. T., Belmonte, Z. J. A., Esberto, E. M., Cahigas, M. M. L., Nadlifatin, R., & Gumasing, M. J. J. (2025). Cognitive perceptions and behavioral loyalty in telecommunication services: Integrating SERVQUAL and CSI in the Philippine context. Acta Psychologica, 259, Article 105298. https://doi.org/10.1016/j.actpsy.2025.105298
Rahmi, N. A., & Ridhaningsi, F. (2025). Service quality and innovation as drivers of customer loyalty. Golden Ratio of Marketing and Applied Psychology of Business, 6(1), 202–216. https://doi.org/10.52970/grmapb.v6i1.1327
Roberts, P. W. (1999). Product innovation, product-market competition and persistent profitability in the U.S. pharmaceutical industry. Strategic Management Journal, 20(7), 655–670. https://doi.org/10.1002/(SICI)1097-0266(199907)20:7<655::AID-SMJ44>3.0.CO;2-P
Sah, A. K., Hong, Y. M., & Huang, K. C. (2025). Enhancing brand value through circular economy service quality: The mediating roles of customer satisfaction, brand image, and customer loyalty. Sustainability, 17(3). https://doi.org/10.3390/su17031332
Ščiukauskė, I., Romeika, G., & Šarkiūnaitė, I. (2024). The consumers’ perceptions of employer and service brand equity’s: The exploratory and confirmatory factor analysis. Journal of Business Economics and Management, 25(1), 85–103. https://doi.org/10.3846/jbem.2024.20716
Semuel, H., Siagian, H., & Octavia, S. (2017). The effect of leadership and innovation on differentiation strategy and company performance. Procedia - Social and Behavioral Sciences, 237, 1152–1159. https://doi.org/10.1016/j.sbspro.2017.02.171
Sudirjo, F., Dewi, L. K. C., Elizabeth, Mustafa, F., & Santosa, S. (2023). Analysis of the influence of consumer behavior, product attributes, and brand image on purchasing decisions of pharmaceutical industry product consumers. JEMSI (Jurnal Ekonomi, Manajemen, dan Akuntansi), 9(6), 2432–2437. https://doi.org/10.35870/jemsi.v9i6.1648
Tabiat, A. (2022). The impact of digital marketing on sales performance: The case of Lebanese pharmaceutical companies. European Journal of Business and Management Research, 7(4), 349–355. https://doi.org/10.24018/ejbmr.2022.7.4.1600
Tahir, A. H., Adnan, M., & Saeed, Z. (2024). The impact of brand image on customer satisfaction and brand loyalty: A systematic literature review. Heliyon, 10(16), e36254. https://doi.org/10.1016/j.heliyon.2024.e36254
Tarmidi, D., & Wijaya, K. P. (2023). The impact of perceived value and product innovation toward brand loyalty on video premium application services. Jurnal Ekonomi, 12(1). http://ejournal.seaninstitute.or.id/index.php/Ekonomi
Utomo, S. B., Setiadi, B., Astuti, E. D., Wahyuningratna, R. N., Hendra, & Nusyirwan. (2025). The role of e-service quality and brand image on purchase intention of smartphone products. International Journal of Engineering, Science and Information Technology, 5(1), 290–296. https://doi.org/10.52088/ijesty.v5i1.714
Wu, J. C., Tsai, P. H., Tang, J. W., & Chen, C. J. (2024). Do store and brand attachments influence customer loyalty? Evidence from migrant workers in Taiwan. SAGE Open, 14(1). https://doi.org/10.1177/21582440241234794
Xu, J., Xu, X., Sun, K. S., Wu, D., Lam, T. P., & Zhou, X. (2022). Changes in residents’ hygiene awareness and behaviors in public toilets before and during the COVID-19 pandemic in Hangzhou, China: A two-round cross-sectional study. BMC Public Health, 22(1), 1690. https://doi.org/10.1186/s12889-022-14114-8
Ye, C., & Zhang, J. (2025). How does customer concentration affect firm innovation in the Chinese pharmaceutical industry? Journal of the Knowledge Economy. https://doi.org/10.1007/s13132-025-02771-0