A big fat fight has just broken out in India

Economic Times

11 hours ago

With the launch of Wegovy by Novo Nordisk in India, the country's obesity drugs sector is all set to witness intense competition. The drug's arrival sets the stage for a high-stakes battle against Eli Lilly's Mounjaro, which debuted earlier in March 2025 and quickly captured market interest. With obesity and Type 2 diabetes rising at alarming rates across India, these powerful weight-loss drugs are ushering in a new era of competition and long-term market disruption.Eli Lilly's Mounjaro, based on the molecule tirzepatide, entered the Indian market several months ahead of Wegovy. Its early presence helped it gain momentum rapidly, with over 81,000 units sold within weeks of launch and revenues approaching Rs 24 crore, according to data from prescription audit firm PharmaTrac. Its dual-action mechanism, targeting both GIP and GLP-1 receptors, has proven superior in global clinical trials, showing weight loss effects of up to 23%. Novo Nordisk's Wegovy, which contains semaglutide, comes with a slightly lower average weight-loss efficacy but boasts a strong global track record, particularly with its well-documented cardiovascular benefits. Wegovy, a once-a-week injection, will be in pharmacies by the end of the month, Novo said, as the drug looked poised to erode some of Lilly's market share. Mounjaro's sales jumped 60% between April and May, industry experts told Reuters.
Novo Nordisk's ambition to race ahead of Mounjaro will be supported by robust clinical data on its benefits in heart patients, in addition to weight loss. Novo Nordisk has demonstrated the cardiovascular benefits of Wegovy in Indian patients, according to regulatory filings seen by ET. The company is taking the drug 'beyond obesity,' by illustrating clear benefits of cardiovascular risk reduction, according to Novo Nordisk India Managing Director Vikrant Shrotriya. 'We call it the 20-20 strategy — 20% weight loss and 20% cardiovascular risk reduction.'To close the launch gap, Novo Nordisk has adopted an aggressive pricing and accessibility strategy. Wegovy is available in 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg doses. The first three will be priced at Rs 4,336, the company said, with the monthly cost being Rs 17,345, in similar range to Lilly's Mounjaro. Wegovy's 1.7 mg dose will be priced at Rs 24,280, and 2.4 mg at Rs 26,015. Its rival Mounjaro, a once-weekly injection, is priced at Rs 3,500 for a 2.5 mg vial and Rs 4,375 for a 5 mg vial, its lowest doses, the company said in March. Its highest dose is 15 mg. Novo's ambition is bold. It expects Wegovy to generate Rs 8,600 crore (roughly $1 billion) in sales in India within five to seven years. But in this rapidly evolving marketplace, strategy alone may not be enough.
The core driver of market differentiation will lie in efficacy and patient experience. While Mounjaro is better placed in terms of absolute weight loss, both drugs deliver transformational outcomes for people with obesity or metabolic disorders. Semaglutide, meanwhile, benefits from longer-standing clinical trust. It has been prescribed globally for both diabetes and obesity under brands Ozempic and Wegovy, and is increasingly supported by cardiovascular outcome data. Physicians in India may favour semaglutide for its broader evidence base. In practice, many patients may switch between the two based on cost, availability, efficacy response and physician guidance, making brand loyalty fluid and competitive positioning crucial.For Eli Lilly, the immediate goal is to consolidate its first-mover advantage. It will focus on scaling supply, enhancing prescriber engagement and cementing Mounjaro's reputation as a gold-standard therapy. Novo Nordisk, on the other hand, will look to rapidly close the gap by leveraging pricing strategy and its global brand equity, before its patent expires next year.Cost is a critical factor point in the Indian market. Both Wegovy and Mounjaro currently sit in a price range that makes them accessible mainly to upper-income groups or those with compelling medical need. Annual therapy can cost lakhs of rupees per patient, depending on dose and duration, a figure far beyond the average Indian household healthcare budget. "Novo Nordisk is strategising the timely introduction of Wegovy in India. However, unless these firms bring down the cost of these designer medicines, they will not be popular among masses. They will be restricted to a very few patients," Nishith Chandra, director, Interventional Cardiology, Fortis Escorts Heart Institute in Delhi, told ET recently.
However, a tectonic shift is looming. The patent for semaglutide expires in India in 2026, unlocking the door for local pharmaceutical giants such as Dr. Reddy's, Sun Pharma, Cipla, Lupin and Biocon to manufacture and launch generic versions. These versions could drive prices down substantially. Indian drugmakers are now racing to develop cheaper versions of these weight-loss drugs to grab a share of the vast Indian market.
Reuters reported in December last year that cheaper copies of patented drugs of both the companies are winning approval from some regulators overseas, posing a threat to the pharma giants' prices and market share. Since Novo's blockbuster Ozempic diabetes treatment was approved in the US in 2017, regulators have greenlighted 22 medicines containing its main ingredient in Bangladesh, Laos, Russia and Paraguay as well as seven copies of Lilly's rival drugs in Bangladesh, according to a Reuters review. Last month, Novo Nordisk sued Dr Reddy's Laboratories and OneSource in the Delhi High Court over allegations of patent infringement. The generic versions will transform the current high-cost niche market into a volume-driven market, enabling middle-class and even lower-income segments to access life-changing obesity treatments. Mounjaro, which enjoys patent protection beyond 2026, will remain in the premium bracket, potentially defending its position through strong branding.India's anti-obesity drug market has grown more than fourfold in the last five years fuelled by rising instances of lifestyle diseases along with greater affordability and willingness among a section of the population to pay for weight-loss treatment, showed data from industry tracker and market researcher PharmaTrac. The anti-obesity drug market soared to Rs 576 crore as of March 2025 from Rs 133 crore in March 2021. With obesity and Type 2 diabetes rates skyrocketing, India is at a tipping point. According to the International Diabetes Federation, the number of Indian adults with diabetes is expected to surge from 74.2 million in 2021 to over 124 million by 2045. Against this backdrop, demand for weight-loss drugs is surging. Mounjaro's launch had triggered a wave of public interest, with doctors receiving a lot of queries from curious patients. .Over the next few years, India's weight-loss drug market is likely to evolve in three phases. Through 2025 and mid-2026, the competition between Wegovy and Mounjaro will dominate, with branded drugs holding center stage. By late 2026, the entry of generic semaglutide will disrupt the market, expanding access but also challenging branded revenue models. Finally, from 2027 onward, the market will likely bifurcate. Premium treatments like Mounjaro will serve patients with critical needs who would want an established brand, while low-cost generics will democratise obesity treatment across income segments.
(With agency inputs)