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You'd expect that by now someone's tried to break this monopoly with legitimate product TLDR: It's due to regulations

Amneal Pharmaceuticals of New York that to be listable in the Orange Book, a patents claims must recite the active pharmaceutical ingredient of the approved drug

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Finally, all units are sold

The anti-wrinkle efficacy of argireline, a synthetic hexapeptide, in Chinese subjects: a randomized, placebo-controlled study

The concentration of the resulting solution is determined by the diluent volume added