As India’s US$70 million obesity drug market bulges, so does price war

Global pharmaceutical giants Eli Lilly and Novo Nordisk are scrambling to cement their lead in India’s booming obesity drug market before cheaper generic versions hit shelves in March next year.\nNovo’s strategy emphasises price cuts and accelerated launches, while Lilly’s products benefited from hitting the market early. Both companies focused on aggressive outreach to doctors, heavier advertising about obesity, tie-ups with clinics, patient incentives and distribution deals with local drug makers, according to doctors, analysts, medical representatives, patients and distributors.\nLilly has even teamed up in India with well-known Bollywood actors in a social media ad campaign about obesity.\nIndia, projected to have the world’s second-largest overweight or obese population by 2050 in absolute numbers, is becoming a major battleground for obesity drugs. Analysts expect the global market for such drugs to hit US$150 billion a year by the end of this decade.\nAlthough the US remains the largest market for obesity drugs, early sales figures in India show rapid uptake, even though most patients in the world’s most populous nation pay for the medication out-of-pocket.\n“We believe that this market can be more than US$1 billion within two years,” said Shrikant Akolkar, vice-president at research firm Nuvama Institutional Equities.\nData analytics firm Pharmarack said in July that the market was estimated to be worth 6.28 billion rupees (US$70.23 million) at present, growing fivefold since 2021.\nUS drug maker Lilly’s Mounjaro, approved for diabetes and weight loss in India, became the top-selling therapy by value in October, with sales doubling within months of its March launch, outpacing Danish drug maker Novo’s Wegovy, which entered the Indian market in June.\n“We realised just after a couple of months that for accessibility, we had to take a price cut,” said Vikrant Shrotriya, Novo Nordisk’s managing director in India, referring to Wegovy’s price cut in November. Shrotriya spoke earlier this month while launching Novo Nordisk’s blockbuster diabetes drug, Ozempic, in the country.\n\nOzempic, a once-weekly injection approved by the US drug regulator in 2017 for type 2 diabetes, became a global bestseller and is widely used off-label for weight loss due to its appetite-suppressing effects.\nMore than 20 Indian drug makers, including Dr Reddy’s, Cipla, Sun Pharma, Zydus and Lupin, plan to launch cheaper versions of Novo’s weight-loss drug in India once its patent on semaglutide, the active ingredient in Wegovy and Ozempic, expires in March 2026.\nAnalysts expect generic drugs to cost about 60 per cent less, intensifying the fight – particularly for Novo – for dominance in India’s price-sensitive market.\nShrotriya played down concerns over looming patent expiries, saying that Novo will focus on quality, trust and affordability rather than on patents or competition in India.\nLilly’s Mounjaro has quickly gained traction in India. A 2.5mg Mounjaro KwikPen costs about 13,125 rupees (US$146.79) for a month’s usage, with the highest 15mg dose going up to 25,781 rupees (US$288.33).\nIn response, Novo cut the price of Wegovy in India by up to 37 per cent in November, pricing its lowest dose of 0.25mg at 10,850 rupees (US$121.34) for a one-month pack. It launched Ozempic last week for a monthly price of 8,800 rupees (US$98.42) for 0.25mg.\nWhile Wegovy is catching up, Mounjaro’s early launch helped it penetrate the market, and the latter drug’s claim of offering greater weight loss makes it a popular choice among patients, according to five doctors.\n“Mounjaro clearly has first-strike advantage and continues to have strong demand, but price-sensitive patients are reassessing alternatives,” said Dr Anoop Misra, an endocrinologist and executive chairman of Fortis C-DOC Hospital.\n\n\nMounjaro also differentiates itself by targeting people with severe obesity, said Vishal Manchanda, analyst at Systematix Institutional Equities. He added that Lilly faces no immediate pressure to cut prices, given its strong position.\nEven if Lilly lowers prices later, Mounjaro would still cost about 30 per cent more than other branded weight-loss drugs, he said.\nLilly declined to comment on its Indian pricing strategy. It said, however, that early response to Mounjaro in India has been “highly encouraging”.\nOzempic, Wegovy and Mounjaro belong to a class of drugs called GLP-1 agonists, which mimic a hormone that slows digestion and helps people feel full longer.\nNovo has sued Dr Reddy’s and Sun Pharma in a local court to enforce semaglutide patents and attempted to block generics until March 2026.\nLonger patent protection for Mounjaro’s active ingredient, tirzepatide, which extends at least until the middle of the next decade, also gives Lilly an advantage, analysts said.\nThe battle has expanded beyond pricing and patents.\n\nDemand for weight-loss treatments in India is spreading beyond urban elites as interest grows among middle-class families, office workers, women nearing menopause and people with obesity-related complications in smaller towns.\nLilly has partnered with India’s third-largest drug maker by revenue, Cipla, to launch a second tirzepatide brand, Yurpeak, targeting smaller towns, and teamed up with Apollo Hospitals to raise awareness of obesity and diabetes. It is also investing more than US$1 billion to expand contract manufacturing in India.\nCipla said it would help market Lilly’s weight-loss medication in deeper markets in India.\nMeanwhile, Novo has tied up with Emcure Pharmaceuticals and launched a second semaglutide brand, Poviztra, to widen distribution beyond India’s major cities. It has teamed with start-up Healthify to offer patients health coaching and with Apollo to raise awareness of obesity.\nIn India, where prescription drug ads are prohibited, Novo launched a “WeGoWithYou” obesity awareness campaign that connects people to doctors to learn more about the disease and its management. Lilly has a similar initiative known as “WeKnowNow” that talks about obesity management.\nBoth drug makers are pushing to frame obesity as a disease, utilising newspaper ads, billboards, airport displays and pamphlets at wellness clinics.\nNeither company disclosed its spending on marketing in India.\n