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Let’s not conflate US pharma with their healthcare more generally.

The US is dominant in pharmaceutical and biotech, and FDA is generally excellent as a regulator, despite (IMO) sometimes being too conservative and resistant to any ideas not gestated within the agency. There are weird quirks (like the wide and wacky dosages of melatonin available over the counter, in this example) but most countries have such quirks.

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Irrelevant due to a scoping problem. If you’re peddling a dietary supplement there is virtually no regulation at all.

As long as you don’t say anything in the marketing material, you’re good.

The only science in supplements is the marketing.

As I understand it, the FDA doesn't regulate melatonin as it's not sold as a medication, but as a supplement.

FDA does regulate supplements, but using a different legal framework which is far, far more hands-off than for pharmaceuticals.

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