Swati Pradhan sees approximately 12 obese patients per day at her modest clinic in southern Mumbai. She anticipates this figure to at least double starting this month, as Indian drugmakers prepare to introduce off-patent versions of Novo Nordisk A/S's blockbuster weight-loss medication at half the price.
The Danish pharmaceutical company's primary patent on semaglutide, the active ingredient in Ozempic and Wegovy, which transformed the worldwide weight-loss business, expires in India on March 20. According to announcements and earnings calls, at least five Indian drugmakers - Mankind Pharma Ltd., Ajanta Pharma Ltd., Sun Pharmaceutical Industries Ltd., and Od Lupin Ltd - are preparing to market cheaper copies of the medicine soon after its expiration.

This has spurred hospitals, telemedicine companies, and clinics across India to expand obesity-focused services in anticipation of increased demand. The generic versions are projected to be at least 50% less expensive than Novo's medication, priced at roughly 5,000 rupees ($54) for a weekly dose, according to individuals familiar with the situation who spoke on the condition of anonymity because pricing information is competitive.
After Canada, India is the first big country where Novo's patent on semaglutide is expiring, and generic versions will flood the market. With a big illness burden and a well-established pharmaceutical industry infamous for counterfeit medications, India is poised to be a test case for how far anti-obesity drug prices can fall.

Metabolic illnesses such as thyroid disease, diabetes, and fatty liver have increased among India's 1.4 billion people, owing largely to more sedentary urban lifestyles. On the other hand, high-calorie meals heavy in oil and fat have contributed to increased weight gain in the country, which has the world's third-largest overweight population, trailing only the United States and China.
India's medicines authority banned advertising and promotional activity for weight-loss programs this week, in an effort to discourage aggressive commercial practices as demand rises. The prohibition also applies to disease awareness efforts, social media endorsements, and business marketing operations.

Pradhan, an endocrinologist who owns LiveLight Clinic, costs between 21,000 and 26,000 rupees per month for a program that includes everything from food advice and blood testing to side-effect management and weekly check-ins.
According to Pradhan, the regimen ensures weight loss of up to five kilograms per month, which is not always attainable when patients take injections without professional supervision. Those who drop out of the program at the beginning "start seeing side effects or their weight loss slows down, and end up contacting the clinic," she said.
According to CareEdge Ratings, India's potential GLP-1 market size will nearly fivefold, from 10 billion rupees last year to up to 50 billion rupees by 2030.

Obesity clinics
Apollo Health & Lifestyle Ltd. and Fortis Healthcare Ltd. are establishing or developing obesity control clinics staffed by doctors, dietitians, fitness trainers, and psychologists. Novo has already worked with Apollo Clinics to establish specialist obesity centers.
Apollo Hospitals Enterprise Ltd.'s chief financial officer, Krishnan Akhileswaran, told Bloomberg News that the hospital chain is still evaluating the weight management market due to the significant possibilities.
Diagnostic chains like Tata 1MG Technologies Pvt. Ltd. are offering inexpensive weight check-up packages. Pharmacies such as PharmEasy provide home delivery of these pharmaceuticals following e-consultations, but market researcher Pharmarack reports that online channels continue to account for a modest share of total sales.

A counselor (in green shirt) interacts with a patient at Rajiv Kovil's diabetes and obesity clinic in Mumbai.
Cipun Mishra of Bengaluru paid 65,000 rupees in May for a three-month consulting contract with HealthifyMe Wellness Pvt. Ltd., an app-based wellness platform. The package he purchased included a monthly meeting with an endocrinologist, round-the-clock access to exercise and diet experts, weight-loss vials, and a monthly guided injection, he stated.
The 32-year-old, who has reduced approximately 42 kilos (92.6 pounds) after 40 weeks of weekly injections, described the structured support provided at the outset of the course as "critical."

Mishra stated that "in the beginning, a lot of habitual changes" occur, such as daily weight measurement and supplementation, and that accountability to a network is encouraging. "I took up this programme because I feared I was going to discontinue my journey," stated the actor.
Dr Reddy's, one of India's top drugmakers, is in talks with hospitals and healthcare providers about launching patient support programs alongside its generic launch, said M. V. Ramana, Chief Executive Officer for Branded Markets, at an earnings announcement in January.

Mishra stated that "in the beginning, a lot of habitual changes" occur, such as daily weight measurement and supplementation, and that accountability to a network is encouraging. "I took up this programme because I feared I was going to discontinue my journey," stated the actor.

Dr Reddy's, one of India's top drugmakers, is in talks with hospitals and healthcare providers about launching patient support programs alongside its generic launch, said M. V. Ramana, Chief Executive Officer for Branded Markets, at an earnings announcement in January.
Cipla-Lilly Pact
Cipla Ltd., which sells Eli Lilly & Co.'s tirzepatide medication as Yurpeak in India, is collaborating with clinics in smaller communities. Lilly's medication is still patent protected.

According to Achin Gupta, Cipla's Chief Executive Officer Designate, health professionals are "very keen on how to prescribe, how to manage" the category, for which drugmakers like Cipla may collaborate.
Consultants believe there is tremendous income opportunity for providers who bundle medications with diagnostics and follow-up care. According to Kaustav Ganguli, managing director for health care and life sciences at Alvarez & Marsal, hospitals in major cities that offer obesity programs could generate up to 110 million rupees in annual revenue per facility, compared to about 60 million rupees from a drugs-only model.
Ganguli stated that market increase caused by patients starting generic therapy would directly benefit health care facilities.Start-ups are also positioning themselves. Enlighten Now Healthcare Pvt. Ltd. is situated in New Delhi and runs a weight management platform. Elevate Now is expanding its business ties, partnering with huge gym chains, and looking into collaborations with drugmakers such as Dr Reddy's, according to creator Suryansh Kumar.
The internet company, which has over 30,000 registered customers, plans to build eight clinics this year.
Obesity medications have been adopted in a variety of ways worldwide. In the United States, telehealth systems established by Eli Lilly and Novo have gained popularity, while price decreases and government programs have increased adoption. In China, online channels like JD Health have played an important role in sales strategy.In India's primarily self-funded health-care system, patients cover the majority of the costs and are an important constituency for hospitals and clinics offering long-term supervision packages. Every stakeholder is mapping out the opportunity.India as a market is very large, and we are discovering that medicines are popular in many sections of the nation," said Cipla's Gupta.