‘As more patients are prescribed these drugs, intolerance due to gastrointestinal and other side effects will become more visible, leading to higher discontinuation rates.’
IMAGE: A pharmacist displays a box of Mounjaro, a tirzepatide injection drug used for treating type 2 diabetes made by Lilly at Rock Canyon Pharmacy in Provo, Utah, USA. Photograph: George Frey/Reuters
India’s fast-growing glucagon-like peptide-1 (GLP-1) drug market is likely to witness a sharp rise in volumes but slower value growth as cheaper generics are set to enter the country after semaglutide goes off patent in March 2026, industry executives and doctors said.
While broader access could expand the patient base, experts also warn of higher therapy discontinuation rates. This comes as more users experience side effects or fail to sustain long-term treatment.
Two global drugmakers — Novo Nordisk and Eli Lilly — are currently vying for a larger share of India’s ₹1,109 crore anti-obesity market.
“The GLP-1 category is among the fastest to reach ₹1,000 crore market size within months of launch, largely because of its high pricing,” said Sheetal Sapale, vice-president (commercial) at Pharmarack.
Once the semaglutide patent expires in March next year, Sapale added that prices could drop by as much as 80 per cent, significantly slowing value growth.
While price erosion would drive higher consumption, Sapale said the segment would also face new challenges.
“Volume growth will pick up, but competition will intensify,” she said.
Companies such as Dr Reddy’s Laboratories, Cipla, Mankind Pharma and Sun Pharma are already preparing to enter India’s ₹427 crore semaglutide market.
“There are more than 14 anti-obesity drugs currently in the pipeline,” Sapale said. She added that the initial surge in demand may taper off within months, giving way to more stable consumption patterns.
Doctors caution that wider prescription use could also translate into higher dropouts.
“As more patients are prescribed these drugs, intolerance due to gastrointestinal and other side effects will become more visible, leading to higher discontinuation rates,” said a Delhi-based endocrinologist.
Common side effects of GLP-1 therapies include nausea, vomiting, diarrhoea and constipation. Doctors also report increasing complaints of hair loss among some patients.
Originally introduced as a diabetes treatment, semaglutide made its India debut with Novo Nordisk’s oral drug Rybelsus in January 2022. The drug gained traction quickly, with moving annual turnover (MAT) rising from ₹71 crore in November 2022 to ₹377 crore by November 2025.
Commercialisation of semaglutide for weight loss picked up this year, with three injectable launches in quick succession — Mounjaro in March, Wegovy in June and Ozempic in November.
As a result, India’s anti-obesity market expanded sharply, reaching an estimated MAT of ₹1,109 crore in November 2025 from ₹242 crore in November 2022. This is a compound annual growth rate (CAGR) of 61.4 per cent.
India’s large disease burden has made it an attractive market for weight-loss therapies. According to World Health Organization estimates for 2023-2024, the country has around 101 million people living with diabetes and another 136 million with pre-diabetes.
Studies suggest India also has 254 million people with generalised obesity and 351 million with abdominal obesity.
Doctors note, however, that Ozempic and Mounjaro are currently approved in India only for type-2 diabetes, and prescriptions are restricted to diabetic patients.
Eli Lilly’s Mounjaro (tirzepatide), launched in March, has already clocked ₹496 crore in sales within seven months, benefiting from a first-mover advantage. The drug emerged as the highest-selling product in India in October and November 2025.
Novo Nordisk launched Wegovy in June for obesity management, but uptake has been relatively slower, with revenues of about ₹50 crore till November. In response, Novo announced a 30 to 35 per cent price cut across all dosage forms.
“The price reduction led to a 70 per cent jump in Wegovy consumption within just 15 days, increasing its market share from 9 per cent in October to 14 per cent in November,” said an industry executive.
With the launch of Ozempic, Novo has now completed its semaglutide portfolio in India, offering treatments across indications.
Doctors say patient interest continues to rise. “We’re seeing increased inquiries, both from new patients and those already on weight-management therapies,” said a Mumbai-based bariatric surgeon.
“Some patients — previously prescribed drugs like fenofibrate — are now being evaluated for Mounjaro as an alternative or add-on.”
Under standard obesity management guidelines, patients must have a body mass index (BMI) above 27 along with at least one comorbidity, such as type-2 diabetes, hypertension or high cholesterol.
However, doctors are also reporting inquiries from individuals who do not meet the criteria. “We are strictly discouraging use for cosmetic weight loss or in patients who fall below the clinical threshold,” the surgeon added.
