Big pharma pivoting to more lucrative obesity segment, Indian drugmakers eye insulin market

The Print

3 days ago

Insulin is a hormone that helps move glucose (sugar) from the bloodstream into cells to stop it from building up in the bloodstream. Patients with type 1 diabetes or advanced type 2 diabetes need to administer insulin, typically multiple times a day, in order to keep their blood sugar in a healthy range.
Now, with a number of Indian drugmakers foraying into the insulin market in the country once dominated by multinational drugmakers—Big Pharma, its cost is expected to dip further.
New Delhi: Insulin, a lifeline for nearly all patients with type 1 diabetes and nearly 10 percent of those with type 2 diabetes, is available in India at an average cost of Rs 133 per vial—among the cheapest in the world.
With the country seeing a near explosion of diabetes, the size of India's insulin market stood at an estimated Rs 4,404 crore in April this year, according to Pharmatrac, a market research company that tracks the Indian drug market.
Its April report, the latest, which ThePrint has seen, said, 'Indian players are making a steady entry in the Insulins market that was once dominated by MNCs'.
Four Indian companies have launched various insulin brands in India over the last two years in the segment where multinationals such as Novo Nordisk, Eli Lilly and Company and Sanofi have ruled the roost, according to Pharmatrac statistics.
It added that with innovator companies like Eli Lilly and Novo Nordisk increasingly focusing on the anti-obesity segment (Mounjaro, Ozempic and Wegovy), it opens 'doors of opportunity for the Indian players' to expand their footprint.
According to data from the Pharmatrac report, of over 90 insulin brands available in the Indian market, 14 have a collective market share of more than 80 percent.
Of these, 11 are owned by either Novo Nordisk, which has a tie-up with Abbott for marketing them in India, or Sanofi, while one brand, Huminsulin by US-based pharma giant Eli Lilly, was sold to Indian drugmaker Lupin last year.
The two best-selling insulin brands in the country include Mixtard and Ryzodeg, both by Danish drugmaker Novo Nordisk. Mixtard alone has a market of over Rs 800 crore in India.
The only Indian company, which has two brands among the top-selling 14 insulin brands, is Ahmedabad-based Eris Lifesciences.
Indian companies that have entered the segment since 2023 include USV, Anthem Biopharma, Cadila and Mankind. Additionally, Cipla, following a strategic tie-up with Eli Lilly, launched its insulin drug, Lyumjev, in India in October 2023.
Pharmatrac statistics also showed that Indian companies, which include Eris Lifesciences, Cipla and Mankind, apart from Lupin, sold insulin worth Rs 1,088 crore between April 2024 and April 2025—24.7 percent of the total insulin market.
However, as of now, a large number of diabetics in need of insulin still cannot access or afford the new generation versions that are more convenient to use, and most new brands being launched in India have yet to address this issue.
Also Read: Fat-busting drug Mounjaro launched in India. Here's how much it will cost
Further price crashes expected
In 2023, the Indian Council of Medical Research (ICMR) and Madras Diabetes Research Foundation estimated that nearly 101 million people in India had diabetes. It is suggested that while the majority with the condition have type 2 diabetes, the number of those with type 1 is also estimated to be around 9 lakh, and this includes a large number of those under 18 years of age.
Type 1 diabetes, say experts, is characterised by complete loss of the insulin-producing beta cells due to an autoimmune disease or idiopathic (unknown) reasons.
Type 2 diabetes, also called diabetes mellitus, on the other hand, is mainly triggered by insulin resistance or the body's inability to respond to insulin, often combined with relatively reduced insulin secretion and is linked with lifestyle issues such as poor dietary habits and lack of physical activity.
Nearly 10 percent of patients with type 2 diabetes, mainly those in the advanced or severe stage of the condition, require insulin, but for all patients with type 1 diabetes, insulin is mandatory, mostly 3-4 times a day
Type 1 diabetes is growing at a rate of 6.7 percent annually in India, compared to 4.4 percent for type 2 diabetes, the latest Pharmatrac report noted.
Diabetologist and researcher Dr V. Mohan underlined that the exact reason why the number of people with type 1 diabetes is growing may not be properly understood, but it could also be due to better awareness about the condition and quicker diagnosis.
'Earlier, many with type 1 diabetes used to die within years of disease onset as they did not get insulin on time, but now they are living longer, and those with type 2 diabetes, after living with the condition for years, typically need insulin,' he said.
This is why, the clinician-researcher said, the insulin segment is growing rapidly in the country. Adding, 'More competition is always good because that will help to keep up the quality of the product and also bring down the price of the insulin.'
Industry insiders said the trend of Indian firms entering the segment was mainly prompted by expiration of patents on key insulin analogues and rapid global adoption of GLP-1 analogues like semaglutide and tirzepatide, used for diabetes and obesity management
'With diabetes now recognised as a national health priority, domestic companies are investing in biosimilar innovation, scaling production capabilities, and forming strategic collaborations to secure insulin supply for the domestic market,' said Saransh Chaudhary, president (global critical care) of research-driven pharma company Venus Remedies.
Innovative therapy, devices for diabetics
Till the 70s the insulin used by those in need was derived from animals like pigs and cows, while the 80s saw the advent of human insulin, a type of synthetic insulin made in a laboratory that mimics the insulin our body makes.
Over the last 15-20 years, insulin analogues, which are more convenient and quicker to act, have been in use in developed countries. This type of medicine is made in the same way as human insulin but is genetically altered to change the way it acts in the body.
More expensive than human insulin, insulin analogues have a different chemical structure and are designed to act more rapidly, within 5-10 minutes of administration and for a longer time of up to 40 hours, ensuring ease in diabetes care.
These often come in specifically designed devices such as pre-filled pens that are simply administered through a click, instead of most human insulins in vials that have to be administered as an injection.
However, as these formulations are not part of the National List of Essential Medicines (NLEM) and are costlier—typically costing Rs 10,000-15,000 per month—most Indian diabetics in need of insulin therapy cannot afford them. As of now, only some basic formulations of insulin are on the NLEM, whose upper price ceilings are fixed by the government.
Once protected by patent, as some of them are now off-patent, their biosimilar versions—just like generics in case of small molecule drugs—have now hit the Indian market, and it could change the affordability issue, underlined Dr Manisha Arora, director, internal Medicine at the CK Birla Hospital. 'The entry of multiple pharmaceutical companies into this space reflects the segment's growth potential and the opportunity to enhance treatment outcomes through competitive pricing and technological advancements,' she said.
Increased competition could spur further innovation, improve patient-centric delivery systems, and contribute to a more sustainable and equitable diabetes care ecosystem, Arora added.
(Edited by Sanya Mathur)
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