The vast majority of brand-name prescription drugs sold in US pharmacies are made overseas and imported by their marketers. Starting about 20 years ago, to bypass the high markups on these drugs, many Americans—particularly those older than 65 years—began importing their prescription drugs at much lower cost over the internet and from Canada and other countries.
PharmacyChecker found that most of the brand-name drugs and APIs in this report are made in other high-income countries with similarly strict standards as those in the United States. Of the 100 brand-name drugs, 32 were finished in the United States, while 67 were finished in countries in the European Union, Canada, Japan, Singapore, Switzerland, and the United Kingdom. Only one brand-name drug, the anticonvulsant Neurontin (gabapentin), was made in India.
https://www.cidrap.umn.edu/report-details-where-top-100-brand-name-rx-drugs-are-made
I can tell you that the Trelegy packet has Distributed by: GlaxoSmithKline Australia Pty Ltd. Also has a Lot number and expiration date. Ingredients listed are the same as what you would get here in the US. I can only assume it is the exact medication a person would purchase in the US.