There is a invisible incentive filter though- nobody will create a startup that is not worth buying for a large company - or whos product would cannibalize somebody elses product in the oligopoly.

I am not sure that's true (is it?) but more so, don't see how that follows from Pharma's alleged focus on acquisition. Can you give me an example where in a different world something good would happen that isn't happening now and why? I am not trying to be difficult just genuine don't see it yet.

You're right. More and more pharmaceutical manufacturing is contracted out to CDMOs. So one day big pharma might only do marketing.