Novo Nordisk and Eli Lilly Bring Weight Loss Contest to India

Danish pharmaceutical giant Novo Nordisk is planning to launch its obesity management injection, Wegovy, in India within the next couple of months—advancing its original 2026 launch target. This move comes just weeks after rival Eli Lilly and Company received approval from the Drug Controller General of India (DCGI) to launch Mounjaro, another class of glucagon-like peptide-1 (GLP-1) receptor agonist. These drugs stimulate insulin release, suppress appetite, improve blood sugar control, and can potentially lead to weight loss.

Interestingly, while Novo Nordisk had clearance to launch Wegovy as an anti-diabetic medication in India for more than a year, the launch is happening right after Eli Lilly’s clearance for Mounjaro and market launch.

"They (Novo Nordisk and Eli Lilly) won't really struggle to get a share since the market is very large," said Vishal Manchanda, senior vice president, institutional research, Systematix Group, adding that adoption would depend on the price point.

Mounjaro, which has been priced at Rs 3,500 for a 2.5 mg vial and Rs 4,375 for a 5 mg vial, makes the monthly cost for weight management range between Rs 14,000 and Rs 17,000, which Manchanda says is "quite high" for a full-year treatment. Nordisk has so far only said that they want to launch Wegovy in the Indian market this year.

“The pricing is influenced by various factors, including the national economy and the country’s pricing and reimbursement systems,” Vikrant Shrotriya, managing director and corporate vice president, Novo Nordisk India, told Business Today in an interview.

Systematix's Manchanda expects Novo Nordisk to price Wegovy at a much lower cost because the patent for Wegovy's active ingredient, semaglutide, is set to expire in 2026, and is expected to bring in a flood of generic versions of the weight management pen.

"Novo would try to build relationships with doctors as much as possible before generics enter to build a market for their brand. My sense is they'll price it at a much more attractive level, much lower than what Lilly has priced," said Manchanda.

Booming Anti-Obesity Market

Obesity rates in India are rising, with the obese/overweight adult population potentially growing from 180mn in 2025 to 450mn in 2050, according to a report by Nuvama Institutional Equities. Obesity rates for women in India increased from 1.2% in 1990 to 9.8% in 2022, and for men from 0.5% to 5.4%. The overall weight management industry in India is about $25bn and is expected to more than double to $56bn in 2033.

"This, coupled with growing awareness and availability of cheaper alternatives 2026 onwards, implies the Indian market can also become a sizeable opportunity for domestic companies organically or via in-licensing deals," the brokerage firm said.

The WHO's definition of overweight is a Body Mass Index (BMI) more than 25 kg/m² and that of obesity is a BMI more than 30 kg/m². For Asian and Indian populations, these thresholds are modified because the risks at lower BMIs are greater, according to Siddhant Bhargava, co-founder and chief executive, InnerGize.

"The guidelines from India assume overweight as those with BMI 23.0–24.9 kg/m² and categorise obesity as those with 25.0 kg/m² or greater. Studies conducted recently suggest that 8.4% of Indian children are obese and an additional 12.4% are overweight. In adults, the prevalence is variable, with greater figures found in the urban population," he said.

GLP-1 receptor agonists like Wegovy and Mounjaro work by helping the body to produce more insulin when needed. They also reduce the amount of glucose, or sugar, produced by the liver, and slow down how quickly food is digested. This helps to lower blood sugar levels and HbA1c (also known as glycated hemoglobin), according to Ashok Kumar Jhingan, senior director, Centre for Diabetes, Thyroid, Obesity and Endocrinology, BLK-MAX Super Speciality Hospital.

"Mounjaro and other GLP-1 receptor agonists are powerful tools for managing obesity. Like other chronic disorders, obesity also generally entails lifelong management," he said.

Taken as weekly injections and combined with lifestyle changes, they can significantly reduce body weight. Clinical trials have shown that regular use of Wegovy can lead to about 15% weight loss, while Mounjaro may help patients lose up to 20% of their body weight.

So far, India has only one GLP-1 receptor agonist, which Novo Nordisk launched in 2022, called Rybelsus, an oral medication. In the last two years, according to a new report by market research firm Pharmarack, Novo Nordisk's medication has a 69% share of India's anti-obesity market. The launch of Mounjaro is expected to further push the growth.

What Pushed an Early Debut

With the launch of Mounjaro and patent expiry looming in March 2026, the company seems to have fast-forwarded its plan.

“The Wegovy patent is set to expire in March 2026, which may lead to the entry of many generic players into the market. We believe this will likely reduce the cost of treatment by 50-70%,” said JM Financial in a report in March.

Experts believe several Indian players are set to debut their generic version of GLP-1 receptor agonists. According to Nuvama’s report, Cipla is also looking to be part of the first wave of generic launches in India. Divi’s Laboratories is believed to be supplying key components like FMOC (solid-phase peptide synthesis) and Bulk Osmotic Capsules (BOCs) for synthetic GLP-1 production. Dr Reddy’s Laboratories is preparing to launch a generic version of Semaglutide across multiple “rest-of-the-world” markets, including Canada, Brazil and India. Lupin and Torrent Pharma are eyeing launches of Liraglutide and Semaglutide, respectively, in select international markets. Aurobindo Pharma has three GLP-1 candidates in development and is scaling up its manufacturing capacity.

“Probably by the end of this year we will see a few approvals coming from Drug Controller General of India (DCGI),” said Manchanda over the launch of generic GLP-1 Drugs in India.

Meanwhile, Sun Pharma is developing a novel GLP-1 molecule, Utreglutide, which is in early clinical stages. Biocon plans to launch Semaglutide and Liraglutide in a few markets, while Natco Pharma has secured a settlement with Novo Nordisk for the entry of Semaglutide in the US through its partner, Viatris. Additionally, companies like Shaily Engineering and OneSource are contributing by manufacturing GLP-1 pens and handling fill-finish operations, that is, the process of filling vials.

“That said, medications are just one part of the equation. A balanced diet and regular physical activity remain the foundation of any effective weight management plan. These lifestyle habits not only support weight loss but also enhance long-term overall health, energy levels, and quality of life,” said Dr Onkar Swami, senior VP, medical services, Alembic Pharmaceuticals Ltd.

Insulin Makers to Take a Hit

The introduction of GLP-1 drugs is also expected to have an immediate negative impact on the growth of insulin sales, analysts say.

“GLP-1 usage could delay the need for insulin in advanced Type 2 diabetes patients. Sanofi and Novo Nordisk (through AIL) are the two largest suppliers of insulin in India, followed by companies like Lupin, Cipla and Wockhardt,” according to JM Financials.

Systematix’s Manchanda says the share of insulin use in the global diabetic market has declined from 20% to 18% in the last two years.

At present, the anti-diabetic market in India is Rs 206bn, with oral treatments constituting 74% of the market, insulin making up about 23% and GLP-1’s forming 2%. India has a diabetes population of approximately 100mn, with another 140mn who are pre-diabetic, according to the Indian Council of Medical Research.

As Novo Nordisk and Eli Lilly debut their blockbuster weight loss injections in the Indian market, analysts believe these drugs will not only boost the country’s anti-obesity industry but may also “cannibalise” the market share of insulin manufacturers and other diabetes medications — to what extent, however, remains to be seen.