Swati Pradhan sees about 12 obese patients every day in her small clinic in south Mumbai. They expect that number to at least double from this month as the Indian drugmaker prepares to launch a generic version of Novo Nordisk’s blockbuster weight loss drug at half the price.
The Danish drugmaker’s key patent on semaglutide, the active ingredient in Ozempic and Vegovy that is reshaping the global weight loss industry, is expiring in India on March 20. According to their statements and post-earnings calls, at least five Indian drugmakers—Mankind Pharma Ltd., Ajanta Pharma Ltd., Sun Pharmaceutical Industries Ltd., Dr. Reddy’s Laboratories Ltd. and Lupine Ltd.—are preparing to sell generic versions of the drug immediately after expiry.
This has prompted hospitals, tele-health firms and clinics across India to expand obesity-focused services in anticipation of a surge in demand. Generic versions are expected to be at least 50% cheaper—costing around ₹The people familiar with the matter spoke on condition of anonymity because the pricing information is competitive, compared to Novo Nordisk’s therapy at Rs 5,000 for a weekly dose.
India is the first major country after Canada where Novo is losing the patent on semaglutide and will see an invasion of generic versions. With a high burden of diseases and a pharmaceutical industry famous for generic drugs, India is poised to test how low the prices of these anti-obesity drugs can be.
Metabolic disorders such as thyroid disease, diabetes and fatty liver have increased rapidly among India’s population of over 1.4 billion, largely due to increasingly sedentary urban lifestyles. On the other hand, a high-calorie diet rich in oils and fats has contributed to weight gain in the country, which has the world’s third-largest overweight population after the US and China.
India’s drug regulator this week banned advertising and promotional activity related to weight loss programs, in an effort to curb aggressive business practices that have led to a surge in demand. This prohibition also extends to disease-awareness campaigns, social media endorsements and corporate marketing initiatives.
Pradhan, an endocrinologist who runs LiveLight Clinic, charges between ₹21,000 more ₹₹26,000 per month for a program that includes services ranging from dietary counseling and blood tests to side effect management and weekly check-ins.
The program ensures weight loss of up to 5 kg per month, which is sometimes not possible if patients take injections without professional help, Pradhan said. People who drop out of the program in the early stages, she said, “start to notice side effects or their weight loss slows down, and end up having to contact the clinic.”
India’s potential GLP‑1 market size is likely to grow nearly fivefold ₹More than Rs 1,000 crore last year ₹Rs 5,000 by 2030, CareAge Ratings said in a March 10 note. Ozempic prices could fall 40% to 50% after the patent expires and then fall some more next year as more drugmakers enter the field.
Obesity Clinic
Hospital chains Apollo Health & Lifestyle Ltd and Fortis Healthcare Ltd are either starting or expanding obesity management clinics staffed by physicians, dieticians, fitness trainers and psychologists. Novo has already partnered with Apollo Clinics to set up a dedicated obesity centre.
Krishnan Akhileshwaran, chief financial officer of Apollo Hospitals Enterprise Ltd., told Bloomberg News that the hospital chain continues to evaluate the weight management space given the huge opportunity here.
Diagnostic chains like Tata 1MG Technologies Pvt. Ltd. Ltd. is offering discounted weight check-up packages. Pharmacies including PharmEasy offer home delivery of these medicines after e-consultation, although market researcher Pharmarack says online channels remain a small part of total sales.
Sipun Mishra of Bengaluru had to opt out ₹Rs 65,000 in May last year for a three-month consultancy with app-based wellness platform HealthifyMe Wellness Pvt Ltd. Ltd. The package they purchased included a wide range of services, from monthly consultations with an endocrinologist to fitness and diet coaches, as well as around-the-clock access to weight loss vials and monthly prescription injections.
The 32-year-old, who has lost almost 42 kilograms (92.6 pounds) after 40 weeks of weekly injections, said the structured support provided at the start of the program was “vital”.
“In the beginning, a lot of the habit changes” like measuring weight daily, taking supplements, and accountability to the network are encouraging, Mishra said. “I took this program because I was afraid I was going to stop traveling,” he said.
Dr Reddy’s, one of India’s largest drugmakers, is in discussions with hospitals and health care providers to launch patient assistance programs along with its generic launch, its Branded Markets Chief Executive Officer MV Ramana said after an earnings briefing in January.
Cipla-Lilly agreement
Cipla Ltd., which sells Eli Lilly & Co.’s tirazepateide drug as Eurpik in India, is working with clinics in smaller towns. Lilly’s drug is still under patent protection.
Achin Gupta, chief executive officer-designate of Cipla, said healthcare professionals are “very curious about how to prescribe, how to manage” the category, which could help drugmakers like Cipla work with them.
Consultants see significant revenue potential for providers who combine drugs with diagnosis and follow-up care. Hospitals offering obesity programs in major cities could earn this much annual revenue ₹Compared to about Rs 11 crore per facility ₹6 crore from the drugs-only model, Kaustav Ganguly, managing director of healthcare and life sciences at Alvarez & Marsal, told Bloomberg News.
Ganguly said the market expansion driven by patients starting generic therapy will directly benefit health care institutions.
Startups are also establishing themselves. New Delhi-based Enlighten Now Healthcare Pvt Ltd, which operates weight management platform Elevate Now, is adding corporate partnerships, tying up with big gym chains and exploring collaborations with drugmakers including Dr Reddy’s, founder Suryansh Kumar said.
The online company, which has about 30,000 registered patients, plans to open eight clinics this year.
The adoption of obesity medications has followed different paths globally. In the US, telehealth platforms launched by Eli Lilly and Novo have gained popularity, while being fueled by price cuts and government programs. In China, online channels such as JD Health have been central to sales strategies.
In India’s largely self-funded health care system, patients bear most of the costs themselves and are a key constituency for hospitals and clinics providing long-term supervision packages. And every stakeholder is taking advantage of this opportunity.
Cipla’s Gupta said, “India as a market is very deep and what we are finding is that there are takers for treatments in different parts of the country.”
