Having made waves the world over, revolutionary anti-obesity drugs Wegovy and Ozempic (manufactured by Danish drugmaker Novo Nordisk), and Eli Lilly’s tirzepatide are set to enter the Indian market this year. “We anticipate a positive response from the Indian market,” Eli Lilly (India) told FE, as the company gets ready to bring its anti-obesity drug tirzepatide, or Mounjaro, to India this year. The company also said it will price its drug competitively for the Indian market.
Competitor Novo Nordisk had initially planned to bring its Wegovy to India in 2026, but reports say they will likely pre-pone their arrival to coincide with Eli Lilly, not wanting to miss out on the huge opportunity the Indian market brings. The company declined to comment when asked by FE on a possible launch date in India.
These drugs have made bank in the West so far, which is what makes their entry exciting here as well. In 2023, Novo Nordisk’s share price increased by over four times from what it had been just five years ago — and it not only became Europe’s most valuable company but also had a market capitalisation that was higher than its native country Denmark’s GDP. In 2022, over 65% of all drug prescriptions in the US were for Ozempic alone.
In fact, in the second quarter of this financial year, Eli Lilly’s Zepbound made $1.24 billion and Mounjaro made $3.09 billion, far exceeding expectations.
Interestingly, celebrities like Elon Musk, Oprah Winfrey and Amy Schumer, among others, have also endorsed drugs like Ozempic after using them for weight loss. In India, too, the weight loss transition of celebrities like Karan Johar, Kusha Kapila, Tanmay Bhat, etc, have been linked to Ozempic, though they have denied taking these medicines.
“As per the India Economic Survey 2024, obesity is a serious concern among India’s adult population, with the adult obesity rate having more than tripled. It is critical that people with obesity are able to access comprehensive care that can prevent and treat the disease,” the Eli Lilly spokesperson told FE.
Sensing the shake-up this will bring to the Indian pharma sector, domestic pharma companies are also in a race to come up with alternatives or prototype versions of these drugs that are more economical, more accessible, or have exclusivity benefits.
Sun Pharma is working on an anti-obesity drug utreglutide. Cipla is coming up with a generic and affordable version of Wegovy, and is eyeing a deal with Eli Lilly to market its drug in the country. Dr Reddy’s Laboratories is also coming up with a generic version of Wegovy. Biocon, on the other hand, is working on GLP-1 therapies, and has got an approval for liraglutide. Similar to Cipla, Natco Pharma is also developing a generic version of Ozempic.
The interest in these drugs is justified. In 2022, the World Health Organization (WHO) had stated that one in eight people in the world lived with obesity—and that obesity was responsible for 44% of all diabetes cases, 23% of ischemic heart diseases, and 7-41% of all cancer cases. A 2024 Lancet study focused on India found that at least 44 million women and 26 million men who were over 20 years old, were clinically obese.
While there’s no specific data on how many people with obesity need surgical intervention or medication in India, Dr Anoop Misra, executive chairman and director, diabetes and endocrinology, Fortis C-Doc Hospital for Diabetes and Allied Sciences, told FE that most patients with obesity are prescribed medication, adding, “More and more patients are coming with queries regarding anti-obesity medications now that they have become aware of it.”
The scale of the problem is such that after all the acclaim that these drugs received, people were travelling to foreign countries to access them, resorting to grey markets, and even getting these imported from Europe, in a phenomenon dubbed ‘Ozempic tourism’.
Because of this huge scale, Eli Lilly said their “pricing strategy in India will reflect the medicine’s efficacy and the significant value it brings in reducing the overall health and economic burden of type 2 diabetes and obesity”. The company’s spokesperson added that however, “we have not yet finalised the pricing of tirzepatide”.
In the US, without insurance, Wegovy can cost around $1,350, Ozempic can cost around $968, and Zepbound (or tirzepatide) can cost around $1,060 for a month’s supply.
But would insurance companies in India cover these medications? Pankaj Nawani, CEO of CarePal Secure, a medical insurance provider, said, “Traditionally, health insurance policies in India exclude obesity treatments, considering them lifestyle-related rather than medically necessary. This stance may evolve as obesity gains recognition as a chronic condition linked to severe comorbidities, which already qualify for coverage.”
Nawani goes on to add that insurance coverage will depend on other factors as well — regulatory clearance from the Central Drugs Standard Control Organisation, doctors prescribing these drugs for managing obesity-related complications rather than for weight loss alone, competitive pricing, etc. “A shift in public health narratives toward preventive care may encourage insurers to reconsider their stance, particularly if these drugs demonstrate cost savings by mitigating long-term healthcare expenditures,” Nawani told FE.
The biggest benefit of these drugs would, of course, be to the patients. Dr Ambrish Mithal, chairman and head of endocrinology and diabetes at Max Healthcare, Delhi, explained, “The existing anti-obesity drug choice in India is poor. Patients would take orlistat, sibutramine, etc, which weren’t very effective or potent and had a lot of side effects. But the way these drugs work, especially the GLP-1 pathway, is exciting.”
Interestingly, a lot of people would qualify as candidates for these drugs too. Since Eli Lilly and Novo Nordisk are both essentially making anti-diabetic drugs that also have strong weight loss properties, the first candidates would be patients with type 2 diabetes.
Dr Mithal added that people with severe obesity and out of control weight problems that are causing comorbidities like sleep apnea and osteoarthritis, would be prescribed these drugs too. “But patients who have a medical history of pancreatitis and thyroid cancer in the family will not be prescribed any of these drugs,” Dr Mithal went on to say.