New Delhi: Despite Mounjaro being priced lower in the Indian market compared to developed countries, viable and affordable anti-obesity medicines for Indian patients may still be about a year away—until semaglutide’s patent in the country expires.
Within days of the launch of Mounjaro—a global blockbuster for treating obesity since its debut a few years ago in the US and several other developed countries—endocrinologists across India have been inundated with queries from patients eager to adopt the weekly injectable.
However, the high cost of the drug—which contains tirzepatide, an active pharmaceutical ingredient developed by US pharma giant Eli Lilly and Company—estimated at nearly Rs 2 lakh annually per patient, means only a limited segment of people can afford it.
The company has introduced the drug in two strengths—2.5 mg vials priced at Rs 3,500 and 5 mg vials at Rs 4,375. The starting dose of 2.5 mg of the weekly injectable will cost Rs 14,000 per month, while the higher strength will cost Rs 17,500 per patient per month.
While the development has caused a stir in the Indian drug market, many clinicians have pointed out that the injectable, though a powerful tool against obesity in those struggling with the morbid condition, may still remain out of reach for many.
They note that it will only be after the arrival of generic versions of semaglutide—a drug similar to tirzepatide and another global hit for obesity—that anti-obesity medication will become a viable option for the majority of Indians.
“Mounjaro coming to India definitely makes it accessible to to those who can afford it but I think once semaglutide goes off patent next year and its generic versions hit the market will the anti-obesity drugs really take off in the country,” Mumbai-based diabetologist Dr Rajeev Kovil told ThePrint.
A number of Indian generic drug manufacturers—including Dr Reddy’s Laboratories, Cipla, Natco Pharma and Alkem, among others—are working on generic versions of semaglutide, which is marketed in the US under the brand names Ozempic and Wegovy, industry sources said. The patent for semaglutide is set to expire in India in March 2026.
Market sources also noted that India’s anti-obesity drug market is undergoing rapid growth, with projected revenue of $2.6 billion by 2030, driven primarily by increasing prevalence of obesity and diabetes and the launch of medicines like Mounjaro.
This massive demand for anti-obesity treatments—which were previously dominated by older drugs such as liraglutide and dulaglutide—has emerged against the backdrop of a country grappling with a growing burden of diabetes and obesity.
Government estimates suggest that around 101 million Indians are affected by diabetes, while obesity—a chronic, relapsing disease—is a major risk factor and is linked to more than 200 health complications, including hypertension, dyslipidaemia, coronary heart disease, and obstructive sleep apnoea.
As of 2023, adult obesity prevalence in India stood at around 6.5 percent, affecting nearly 100 million people.
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High-cost concerns
Semaglutide, developed by Danish drugmaker Novo Nordisk, is available in India in the form of oral pills under the brand name Rybelsus. Both semaglutide and tirzepatide work by binding to receptors of various gut hormones.
These receptors regulate the secretion of pancreatic hormones and gut functions. Malfunctioning of these receptors exacerbates type 2 diabetes and obesity.
These drugs—also known as incretin mimetics because they mimic the incretin hormone released in the gut in response to food intake—promote a sense of fullness for longer durations and help reduce appetite.
While semaglutide targets a receptor called glucagon-like peptide-1 (GLP-1), tirzepatide acts on both GLP-1 and gastric inhibitory polypeptide (GIP), and is, therefore, referred to as a dual receptor agonist.
In the US, the drug is marketed under two brand names—Mounjaro for diabetes and Zepbound for managing obesity. In India, however, Mounjaro in the dosage strengths of 2.5 mg and 5 mg has been indicated for both obesity and diabetes.
As the drug entered the Indian market last week, many clinicians expressed concern that, depending on the amount of weight a patient needs to lose, dosage may need to be increased every 30 days, and after achieving their goal weight, patients may require long-term maintenance doses.
“So, if a patient, for instance, needs to lose 20 kgs, they might need to titrate the weekly dose to 15 mg. Now, the company has said nothing about doses beyond 5 mg,” an obesity researcher with the All India Institute of Medical Sciences (AIIMS) told ThePrint.
However, assuming that each higher dose is priced more than the previous one and subsequent dosages are 7.5 mg, 10 mg, 12.5 mg, and 15 mg, then the 15 mg strength—which may end up being the long-term maintenance dose for many—could cost over Rs 30,000 per month, the researcher underlined.
Kovil, too, agreed that part of this concern may be true.
ThePrint has reached Eli Lilly and Company via email with a query regarding this concern. This report will be updated if and when a response is received.
Dr V. Mohan, a Chennai-based diabetologist and chairman of the Madras Diabetes Research Foundation (MDRF), on the other hand, argued that owing to their smaller body sizes—and side effects associated with this class of drugs—most Indian users may opt to stick to lower dosages of Mounjaro.
“I do not see majority of Mounjaro users titrating the dosage upwards and those who can afford about Rs 17,000 per month cost of the drug should not have a problem in shelling out a few thousands more if the drug works for them,” he told ThePrint.
Race for India-made drugs
Wegovy and Ozempic, along with Mounjaro, have been global runaway successes and have propelled Novo Nordisk—a relatively lesser-known Danish drugmaker—into becoming the most valuable corporation in Europe within a couple of years of semaglutide’s launch.
Global estimates suggest the company’s market value—about $570 billion—is now greater than the annual gross domestic product of Denmark, its home country.
The list price of the drug in the US is approximately $936 (around Rs 81,000) to $1,349 (about Rs 1.15 lakh) per month.
Though Novo Nordisk’s global leadership team has not provided a definitive timeline for the launch of injectable semaglutide in India, they have indicated that despite the product approaching patent expiry next year, they are looking to bring it to the Indian market in the coming months.
Meanwhile, several Indian pharmaceutical companies—including Sun Pharma, Biocon, Dr Reddy’s, Cipla, Zydus, Shilpa Medicare, Natco, and Aurobindo Pharma—are already developing generic versions, which are expected to bring down the treatment cost significantly.
Additionally, Sun Pharma, the country’s top drugmaker by sales, is also developing a GLP-1 category drug named utreglutide. In June last year, it released study results showing significant weight loss, glucose-metabolic benefits, and lipid-lowering efficacy for the product under trial.
With semaglutide expected to go off patent, the availability of affordable generic versions could greatly improve access to diabetes and obesity treatment in India, according to physicians.
“Currently, the high cost of branded semaglutide limits its use, but generics could reduce prices by 50 percent or more, making long-term treatment feasible for a larger population. This shift may lead to better blood sugar control, sustainable weight loss, and reduced complications associated with diabetes and obesity,” Dr R.R. Dutta, head of internal medicine at Paras Health, Gurugram, told ThePrint.
“Additionally, lower costs could encourage insurance coverage, further easing the financial burden on patients. However, ensuring regulatory approval, quality standards, and physician awareness will be key to maximising its benefits. Overall, this development has the potential to revolutionise diabetes and obesity care in India, improving health outcomes for millions,” Dutta said.
(Edited by Radifah Kabir)
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