[blackdog]

Perhaps combines compounds made elsewhere, as very, very, few medicines are manufactured in America. Blending and packaging perhaps. Even that is mostly sub-contracted out to packaging specialty companies.

Ireland, India, China, Malaysia, Vietnam, mostly. I'm not sure why Ireland? But they do.

America is mostly research and pilot manufacturing facilities. Once the drug is cleared and commonly marketed it is made elsewhere.

[aposiopetic]

Ireland has favorable tax policies.