New Delhi: A Bengaluru-based investor was 15 when he was diagnosed with Type 2 diabetes. At the time, he was already 6’2” and weighed close to 90 kg. Over the years, his blood sugar remained high, his weight went up, and the amount of insulin he needed kept increasing.
“By my mid-30s, I weighed around 120 kg and was taking insulin injections every day,” he told ThePrint.
But in May 2025, he finally saw a ray of hope.
Chennai-based diabetologist V. Mohan prescribed a relatively new medication that has emerged as a “wonder drug” in the treatment of diabetes: Mounjaro.
Developed by US pharma giant Eli Lilly, the weekly injection is approved for managing Type 2 diabetes, and for obesity management.
When the Bengaluru investor started taking Mounjaro, he weighed 112 kg. Over the next few months, his weight dropped to 94-95 kg.
“For me, it’s like a replacement for insulin injections but with an added benefit of weight loss,” he told ThePrint.
Eight months after starting Mounjaro, he no longer requires insulin, his weight has stabilised, and follow-up tests showed his fatty liver markers had improved.
But the treatment is expensive, costing around Rs 20,000 per month.
Now 45, the investor from Bengaluru is one of many people looking forward to 20 March, when cheaper generic versions of some anti-obesity drugs are expected to hit the Indian market.
The date marks the expiry of the patent in India for semaglutide, an active ingredient in similar drugs used to treat Type 2 diabetes, support long-term weight management, and lower cardiovascular risks by mimicking the hormone that regulates appetite and insulin.
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist, which mimics a naturally occurring gut hormone known to send signals of fullness to the brain.
Though the Bengaluru-based investor uses Mounjaro, which contains tirzepatide as its active ingredient and whose patent remains in force, he will still benefit from generic versions of anti-obesity and weight loss drugs that contain semaglutide, such as Ozempic and Wegovy, when the patent expires on 20 March.
According to estimates, semaglutide generated roughly $30 billion for Novo Nordisk in 2025, making it one of the Danish pharmaceutical company’s most successful products.
Its patent is now expiring in several major markets, including India, Canada, China, Brazil and Turkey, opening the door for companies to produce generic versions.
“About 25 percent of the population cannot currently afford anti-obesity drugs such as semaglutide and tirzepatide because they remain expensive. Many patients need these therapies, but cannot access them due to cost,” Dr Anoop Misra, chairman of Delhi’s Fortis-C-DOC Centre of Excellence for diabetes, metabolic diseases, and endocrinology, told ThePrint.
“As prices decline, a larger number of people who require treatment will be able to receive it,” he added.
He said that with more companies expected to introduce generic versions, distribution will expand significantly, improving the availability of semaglutide across India.
Rush for launching generics
The expiry of the semaglutide patent is particularly significant for India, which is often described as the diabetes capital of the world.
It will open the door for generic drugs in India, where some 135 million are estimated to be living with the disease.
With the semaglutide patent due to expire, several Indian drugmakers have already secured regulatory approvals or recommendations to produce and market generic versions in India.
They include Sun Pharmaceutical Industries, Zydus Lifesciences, Alkem Laboratories, Dr. Reddy’s Laboratories, Torrent Pharmaceuticals and MSN Laboratories.
A Sun Pharmaceutical Industries spokesperson told ThePrint that the company has received approval from the Drug Controller General of India (DCGI), India’s drug regulator, to manufacture and market generic semaglutide for both chronic weight management and the treatment of Type 2 diabetes.
The brand name for Sun Pharma’s weight management injection will be Noveltreat, and the injection for Type 2 diabetes management will be launched under the brand name Sematrinity.
“The products have been approved by the DCGI following a review of a Phase III clinical trial conducted by Sun Pharma in India,” the spokesperson said.
“The products will be administered via an easy-to-use prefilled pen, designed to support convenient and accurate dosing. Sun Pharma plans to be in the market on day-one of the generic launch, following patent expiry,” the spokesperson added.
Another pharma company, Zydus Lifesciences, has also announced the launch of its semaglutide injection in India on the day the patent expires. The company plans to market the drug under three brand names—SEMAGLYN, MASHEMA, and ALTERME in a 15 mg/3 ml injectable formulation.
Zydus has also developed a reusable adjustable injection pen, which allows patients to change dose strengths using the same device instead of buying multiple pens during treatment, a move the company says could reduce the overall cost and make long-term therapy more accessible.
Hyderabad-based Dr. Reddy’s Laboratories is also expected to launch its generic semaglutide injection under the brand name “Obeda”.
The product is likely to be launched as an injectable pen, similar to existing GLP-1 treatments, and could be priced up to 60 percent lower than the branded products currently available, news agency Reuters reported last month.
Similarly, Alkem Laboratories is also preparing to enter the semaglutide market after receiving approval from the Subject Expert Committee (SEC) under India’s drug regulator, the Central Drugs Standard Control Organisation (CDSCO), to manufacture and market a synthetic semaglutide injection for the treatment of Type 2 diabetes and obesity management.
ThePrint has reached out to Dr. Reddy’s Laboratories and Alkem Laboratories for comment. This report will be updated as and when they respond. Zydus Lifesciences refused to respond to ThePrint’s queries.
In India, to sell a generic version of a drug already approved globally, companies must prove that their generic version works the same way as the original.
This is done by submitting bioequivalence (BE) and bioavailability (BA) studies to the CDSCO, which is responsible for approving new drugs, overseeing clinical trials, and ensuring the safety, efficacy, and quality of medicines in the country.
Between 2025 and early 2026, the Subject Expert Committee on Endocrinology under the CDSCO reviewed applications from several Indian companies seeking to manufacture and market semaglutide.
SEC reports show that firms, including Cipla and Macleods Pharmaceuticals, progressed after their BE studies were accepted. Following this, DGCI granted final approvals in early 2026 to multiple companies, clearing the way for several Indian versions of semaglutide to enter the market.
India’s weight management market was valued at $27.4 billion in 2025, and is projected to grow to $56.79 billion by 2034, according to estimates by the IMARC Group, a market research and consulting firm.
Globally, the anti-obesity drugs market is also set to expand rapidly. Research estimates by Goldman Sachs, an American multinational investment bank, say that the global anti-obesity drug market could grow to over $100 billion in the next decade.
‘Unprecedented success’
Anti-obesity drugs had historically delivered limited results until the arrival of GLP-1 receptor agonists such as Ozempic and Wegovy, which have transformed obesity treatment.
Chennai diabetologist Mohan said that from the 1980s onward, medicines such as sibutramine, phentermine, and orlistat typically resulted in only two to three kg of weight loss. Many were later withdrawn due to adverse effects on the heart, lungs, or brain.
This track record, he said, led to widespread scepticism about the long-term safety and sustainability of obesity pharmacotherapy, particularly in India, where some of these drugs were briefly available before being discontinued.
A shift began about 15 years ago with the introduction of GLP-1 receptor agonists.
“Early molecules like liraglutide, exenatide, and lixisenatide demonstrated modest weight loss while also providing glycemic control, marking a significant improvement over earlier medications,” Mohan said.
According to him, semaglutide represents a major advance in metabolic treatment.
Unlike older drugs, it can lead to 10-15 kg of weight loss alongside significant anti-diabetic benefits. Both injectable formulations—Ozempic for diabetes and Wegovy for obesity—as well as the oral version Rybelsus, are available.
“The success of semaglutide is unprecedented in pharmaceutical history,” Mohan said.
He added that even newer drugs are now showing stronger results.
For example, tirzepatide, which works on two hormone pathways (GLP-1 and glucose-dependent insulinotropic polypeptide or GIP) that control blood sugar and appetite, has shown that patients can lose 15-20 kg, levels of weight loss usually achievable only through bariatric surgery.
Upcoming molecules, such as the triple-agonist retatrutide, which act on three hormone pathways (GLP-1, GIP, and glucagon), promise a 25-30 percent weight loss, signalling an unprecedented shift in obesity management.
While generally well-tolerated, GLP-1 receptor agonists have known side effects.
“Common side effects of these drugs include nausea, vomiting, and diarrhoea in about 50 percent of patients, which can often be reduced by increasing the dose only gradually,” Mohan said.
“In rare cases, serious events such as blindness—occurring in one in 7,000 to 10,000 patients—or gastric and intestinal paralysis, seen in a few per thousand patients, can occur. These drugs are effective only while taken continuously; if they are stopped, patients typically regain weight and lose glycemic control,” he added.
A University of Oxford study published in The British Medical Journal in January 2026 found that weight regain after stopping weight-loss drugs occurred faster than after lifestyle-based programmes.
Participants in the analysis regained weight within about 1.7 years of discontinuation, with cardiometabolic gains reversing within roughly 1.4 years.
Concerns over pharmacovigilance
In India, concerns over the approval of GLP-1 receptor agonists reached the Delhi High Court last year. Fitness entrepreneur Jitender Chouksey filed a public interest litigation (PIL) questioning the approval of GLP-1 receptor agonists for obesity without large India-specific clinical trials.
“These drugs were originally developed and internationally approved for the treatment of Type 2 Diabetes Mellitus, with their primary therapeutic role being the regulation of glycemic levels,” the plea said.
“However, over the past few years, they have been repurposed and approved often through accelerated pathways for obesity treatment and chronic weight management, based largely on short-term efficacy trials,” it added.
In July 2025, a Delhi High Court bench comprising Chief Justice D.K. Upadhyaya and Justice Tushar Rao Gedela directed the CDSCO to review the safety and licensing of widely used GLP-1 drugs and take a decision within three months.
Media reports at the time indicated that the CDSCO was likely to constitute an expert panel to examine concerns around the unregulated use of weight-loss medications.
ThePrint has reached out to the CDSCO seeking clarification on whether the safety and licensing review has been completed, whether the expert panel was formed, and if it has submitted its findings. This report will be updated if and when a response is received.
With generics set to expand access after patent expiry, Chouksey said pharmacovigilance systems must be strengthened.
“If millions more people start taking these drugs, where is the monitoring framework?” he asked, adding that this raises concerns about adverse event reporting and accountability.
Chetali Rao, a Senior Scientific & Legal Researcher with Third World Network, a non-profit organisation, said that while the drugs are promising and could become more affordable with many players entering the market, there are significant risks, particularly around pharmacovigilance.
“With hundreds of manufacturers and millions of potential new patients, monitoring for side effects such as gastroparesis and pancreatitis is crucial,” added Rao, who has previously worked with Novo Nordisk.
“India’s pharmacovigilance system continues to face significant challenges, and off-label use for weight loss could raise legitimate concerns about off-label misuse and safety monitoring,” she told The Print.
“Prescription enforcement is therefore important, especially since standard guidelines recommend these medicines for adults with a BMI of 30 or above, or a BMI of 27 or above with at least one weight-related comorbidity such as Type 2 diabetes, hypertension, dyslipidemia, or obstructive sleep apnea,” she added.
Pharmaceutical companies that ThePrint spoke to maintain that approvals have followed existing law, including requirements for BE studies and post-marketing surveillance.
Safety concerns are also being examined internationally
In the United States, lawsuits are currently ongoing against Novo Nordisk and Eli Lilly over GLP-1 drugs such as Ozempic and Mounjaro. Allegations include inadequate warnings about risks, including chronic stomach disorder, gastroparesis and intestinal blockage.
Lawsuits are also mounting in the US against manufacturers of popular GLP-1 weight-loss and diabetes drugs, alleging that the drugs caused a rare but serious eye condition known as non-arteritic anterior ischemic optic neuropathy (NAION), leading to permanent vision loss or blindness.
They have defended their weight-loss and diabetes drugs, arguing that the medicines are safe when used as indicated.
(Edited by Sugita Katyal)
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