India may soon become a slimmer country — this is claimed by the BBC.
The patent for semaglutide expires on Friday, allowing for the release of cheap generics from Indian pharmaceutical companies. This will create conditions for intense competitive pressure on prices, which could lead to a reduction of more than half and ensure wider access to these medications.
The investment bank Jefferies calls this event a "magic pill moment" for India, forecasting that the semaglutide market could reach $1 billion in the country with the right pricing policy and active implementation.
About 50 generics of semaglutide are expected to enter the market in the coming months, which is typical for India's competitive pharmaceutical industry. For example, after the patent for sitagliptin expired in 2022, around 30 analogs appeared within just a month, and within a year their number increased to nearly 100.
The Indian pharmaceutical industry, valued at $60 billion, is expected to double by 2030. Most of it is based on the production of generics, which creates prerequisites for fierce competition in the semaglutide market. What was previously available only to wealthy patients may soon become widespread.
Originally developed for the treatment of diabetes, these medications have become revolutionary weight loss agents, providing results that are hard to compare with other methods. Semaglutide belongs to the class of GLP-1 receptor agonists, mimicking hormones that control appetite and blood sugar levels.
These medications promote insulin release and slow gastric emptying, allowing people to feel full faster and stay full longer. Their popularity as weight loss agents is growing worldwide.
Several Indian pharmaceutical companies are already preparing to launch generics. According to Shital Sapale, vice president of Pharmarack, major companies such as Cipla, Sun Pharma, Dr. Reddy’s Laboratories, Biocon, Natco, Zydus, and Mankind Pharma are working on creating generics, and many others are expected to follow suit. This will lead to significant price reductions.
Current treatment costs remain high: the drug Ozempic costs between 8,800 and 11,000 rupees ($95-119), while Wegovy can cost between 10,000 and 16,000 rupees ($108-173). With the emergence of generics, prices could drop to 3,000–5,000 rupees ($36-54) per month.
Price reductions could change the market.
The Indian anti-obesity sector, including injectable and oral medications, is already showing rapid growth: from $16 million in 2021 to nearly $100 million. Demand for medications increased after the launch of Rybelsus, the first oral version of semaglutide, in 2022.
These changes also reflect a broader trend in healthcare.
In India, more than 77 million people suffer from type 2 diabetes, making it one of the largest populations with excess weight in the world. Urbanization, high-carbohydrate diets, and sedentary lifestyles contribute to the development of these diseases.
For doctors, more accessible GLP-1 inhibitors could become an effective tool in treating diabetes and obesity.
Weight loss medications are becoming relevant not only for endocrinologists. Cardiologists use them to prepare patients for angioplasty, orthopedists — to reduce joint stress before surgeries, and pulmonologists — to treat obstructive sleep apnea.
Bariatric surgeon Muffazal Lakdawala from Mumbai notes that these medications could significantly expand treatment options for many people in India suffering from diabetes and obesity.
He emphasizes that access to these medications has been limited: injectable forms of GLP-1 have been expensive and hard to obtain, while the oral Rybelsus was the only available option.
“It’s wonderful that they will become cheaper, and more Indian patients with diabetes and obesity will be able to access them,” he says.
However, he warns: “The quality of the produced drugs must be strictly controlled.”
This caution reflects the overall reality of the Indian pharmaceutical industry, which is a global leader in the production of generics.
India ranks first in the world in the production of generics, producing about 60,000 items in more than 60 therapeutic categories and supplying 20% of the global market.
Its reputation as the "pharmacy of the world" is largely based on its ability to turn expensive medications into affordable goods.
A striking example of this is the reduction in prices for antiretroviral drugs for HIV two decades ago, which significantly increased access to treatment in Africa and other developing countries.
Today, India supplies medicines to more than 200 countries, meeting over half of the demand for generics in Africa, about 40% of the generics used in the U.S., and roughly a quarter in the UK.
“The export potential of Indian weight loss generics is enormous,” claims Namit Joshi, chairman of the Indian Pharmaceutical Export Promotion Council. “The U.S. market alone could reach $10 billion in the coming years due to the growing demand for obesity medications.”
This would be an important addition to India's pharmaceutical trade, where the export of generics amounts to $30.46 billion, and the U.S. is already the largest market.
However, optimism among doctors is tempered by concerns.
GLP-1 inhibitors have powerful effects but also come with risks. Side effects can include nausea, vomiting, and digestive disorders; rare complications may include gallstones and pancreatitis. Rapid weight loss without adequate protein intake or physical activity can also lead to muscle mass loss.
Doctors note that many patients misunderstand how these medications work. Some expect significant weight loss within a few weeks, influenced by social media and advertising.
Rahul Baxi, a diabetologist from Mumbai, emphasizes that success depends not only on the medication but also on “the proper selection of patients.”
Doctors consider not only body mass index (BMI) but also comorbidities such as diabetes and high cholesterol. Lifestyle is also important: if a patient continues to follow an unhealthy diet, medication alone may not be sufficient.
Patients often seek a quick fix. “People come asking to lose 10 kg in three months,” says Baxi.
Too rapid weight loss can lead to undesirable consequences. It can cause fat loss in the face, neck, and arms, making patients look weak and emaciated.
“Gradual weight loss, slow dose increases, and an emphasis on protein intake, physical activity, and strength training are the keys to improving health,” adds Baxi.
Another issue is that weight loss often returns once medication is stopped. Appetite can surge as the body begins to resist fat loss.
“If you stop taking the medication, appetite returns with incredible force,” says Baxi.
There are also concerns about misuse related to price reductions.
Doctors report that some patients obtain high doses of medications from trainers at gyms, beauticians, or dietitians who are not qualified to do so. Online pharmacies sometimes dispense medications after superficial consultations. Beauty salons are already offering packages for rapid weight loss before weddings or events.
This behavior may spread with the increased availability of cheap generics.
“Wider access to cheap medications means a higher likelihood of misuse,” notes pulmonologist Bhaumik Kamdar from Mumbai. “Availability requires greater responsibility and strict regulation. I have cautious optimism about these medications.”
This warning resonates with Lakdawala's concerns about manufacturing standards.
“These are very useful medications,” he says. “We don’t want side effects from poor-quality drugs to tarnish the reputation of the molecule itself.”
The government is also trying to temper the hype. In a warning last week, the Indian regulator cautioned pharmaceutical companies against directly advertising prescription weight loss medications, such as GLP-1, to consumers.
Advertising that promises impressive results or downplays the need for diet and physical activity may be deemed misleading, officials stated, emphasizing that such medications should only be used under medical supervision.
Thus, for regulators and doctors, the coming months may serve as a test of India's ability to find a balance between accessibility and control.
Baxi urges patients to improve their lifestyle and nutrition before prescribing weight loss medications.
Even then, a high-protein diet designed by a dietitian is recommended first. Studies show that medications may be needed for a long time. However, many patients come seeking a “quick fix” after watching videos on Instagram, which adds extra pressure on doctors.
Nevertheless, the benefits could be significant. Medications that previously cost tens of thousands of rupees a month could become accessible to millions of people, possibly even beyond India.
“I am already prescribing to many patients: come to me after March 20, when prices will drop,” says Baxi.
The record "Indian Generics for Weight Loss: A New Hope in the Fight Against Obesity" first appeared on K-News.
