Global pharma eyes India's obesity mkt, but weight-loss drugs face hurdles

India, grappling with a growing obesity epidemic, has caught the attention of pharmaceutical companies selling weight-loss drugs. Between 2025 and 2026, the country is set to witness the launch of major obesity drugs.

 

These drugs belong to a class known as glucagon-like peptide receptor agonists (GLP-1RAs), which mimic a natural hormone that helps regulate blood sugar and appetite. It gives the brain receptors the sense of fullness, and also slows the emptying of the stomach, thereby helping a person lose weight.

 

Leading global pharma companies, including US-based Eli Lilly and Denmark’s Novo Nordisk, are gearing up to introduce their drugs in India.

 

Eli Lilly has announced plans to laun­ch tirzepatide (branded as Mounjaro) in India in 2025, pending regulatory approvals. Novo Nordisk, on the other hand, has not provided a confirmed launch date but said that it is working towards making its semaglutide injection (2.4 mg) available in India “as soon as possible”.

 

Novo Nordisk India has indicated that it is open to distribution partnerships. “Novo Nordisk India has historically distributed its portfolio medicines through partners. We will continue to follow that model,” a company spokesperson said.

 

Eli Lilly has also emphasised its commitment to the Indian market. “India is a strategic market for Lilly, and we are deeply committed to bringing innovati­ons to the country to address unmet medical needs,” an Eli Lilly spokesperson said. However, the company declined to comment on potential marketing collaborations at this stage.

 

Business in loss

 

India is witnessing a growing demand for weight-loss drugs.

 

An OTT series recently reflected this trend when a celebrity referred to the off-label use of ‘Ozempic’ (semaglutide), a Novo Nordisk drug originally developed for diabetes management.

 

Novo Nordisk’s oral semaglutide tablet, Rybelsus, launched in India in January 2022, has already captured nearly 65 per cent of the anti-obesity drugs market, which includes other weight-loss medications such as dulaglutide, orlistat, and liraglutide.

The market for anti-obesity drugs in India has seen exponential growth, swell­ing from Rs 137 crore in November 2020 to Rs 535 crore in November 2024, according to market research firm Pharmatrac.

 

“The launch of semaglutide in 2022 has been a game changer,” said Sheetal Sapale, vice-president, commercial, Pharmarack. “The market has nearly quadrupled in value over the past five years.” She said this surge may not be solely due to an increase in obesity cases; it also signals a greater willingness to seek medical solutions.

 

The demand for anti-obesity therapy brands such as Wegovy and Ozempic, too, has increased in India, Sapale added.

 

The question of safety

 

However, despite their effectiveness, these drugs are not without risks.

 

A senior Mumbai-based endocrinolo­gist who teaches in  a leading government medical college and wished to remain anonymous, highlighted the growing patient demand for semaglutide prescriptions.  

 

In injectable form, the drug has to be taken once a week, which makes it convenient, he said, adding that seldom have doctors like him seen such demand from patients for prescription. Some individuals are even importing the drugs through unofficial channels due to their popularity, he said.

 

The doctor, however, cautioned: “These drugs come with side effects such as nausea, vomiting, abdominal pain, and constipation. Many patients struggle to continue the course due to these issues.”

 

Abhishek Katakwar, a bariatric and metabolic surgeon based in Hyderabad, emphasised that while these medications have proven benefits, they are not suita­ble for everyone. “These are not a one-size-fits-all therapy. The drugs must be taken continuously — once stopped, the weight-loss benefits are lost,” he said. “Additionally, the long-term side effects remain unknown. The cost is also prohibitive, ranging from Rs 40,000-50,000 per month.”

 

Despite the high cost, demand persists, particularly among younger patients at risk of chronic cardio-diabetic conditions. Sapale explained, “The mode of action of these drugs requires prolonged use for sustained results, making it imperative for patients to continue the medication for an extended duration.”

 

 Expanding problem

 

India has witnessed a dramatic rise in obesity over the past decade. Weight-loss surgeries have increased 100-fold — from around 200 in 2004 to 20,000 in 2019, according to the Obesity Surgery Society of India. Approximately 80 million Indians are classified as obese, with 30 million adults experiencing obesity-related complications, including excessive body fat and abdominal fat accumulation.

 

One in four Indians is overweight, shows the National Family Health Survey (NFHS) 2022. Obesity among women has risen from 21 per cent to 24 per cent, while among men, it has increased from 19 per cent  to 23 per cent.

 

Obesity is linked to serious non-comm­u­nicable diseases such as hyper­tension, diabetes, and liver disease. NFHS data reveals that 21 per cent of women and 25 per cent of men above 15 years have hypertension, while 12 per cent of women and 14 per cent of men in the same age group have high blood glucose levels.

 

Katakwar pointed out that India ranks among the top 10 nations struggling with obesity. “Obesity is just one aspect of malnutrition, with underweight conditi­o­ns representing the opposite end of the spectrum. Both extremes can lead to seve­re health complications, affecting vital organs like the heart and liver,” he said.

 

Make in India?

 

The pricing of GLP-1 drugs remains prohibitive. While pharmaceutical giants have not disclosed their pricing strategies, Eli Lilly said that the price of tirzepatide in India would reflect its efficacy and the overall value it brings in managing diabetes and obesity.

 

Globally, demand for these drugs is outpacing supply. In 2024, Mounjaro’s sales surged to $11.54 billion, more than doubling from the previous year. The diabetes and obesity market, driven by GLP-1 drugs, is projected to reach $100 billion within the next decade.

 

Could global pharmaceutical firms outsource production to Indian manufacturers to meet growing demand?

 

At present, this seems unlikely. Siddharth Mittal, MD & CEO of Biocon, explained, “We are also a competitor in a way for them. None would share their intellectual property and processes.” The manufacturing process for these drugs is highly complex, and most innovators prefer in-house production, he added.

 

Piramal Pharma, which operates overseas manufacturing facilities and serves a large global clientele, said it has capabilities for peptide production.

 

“We do have peptide manufacturing capabilities and are actively working on GLP-1. However, at this stage, there is nothing significant to report,” said Nandini Piramal, chairperson of Piramal Pharma, in an interview with Business Standard. “We currently produce vials for injectables rather than pre-filled syringes, though we may explore that option in the second phase of our expansion.” She added that several ongoing projects in both the US and India, including at the company’s Pithampur (Madhya Pradesh) facility, are expected to come online from the next financial year.

 

Other Indian pharmaceutical companies are also actively exploring opportunities in the GLP-1 space. Glenmark has already launched a generic version of liraglutide, while Cipla and Dr Reddy’s Laboratories are working on off-patent GLP-1 alternatives. Sun Pharma is also developing a novel molecule in this category, and is currently in Phase 2 trials.

 

The battle against obesity is on.