please note that I am not OP.
How about 'generic' drugs? are they the best 'manufactured' they can be?
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Generally?
No. But will meet regulatory minimums insofar as active ingredients, purity, etc.
They don’t have a monopoly like the OP described, however. If they did? Yikes…
Notably, that kind of economy is roughly how the USSR ran, and no one praised it when it died.