Parneet Sachdev
Until recently, Indians had to spend hours at the gym or with trainers to shed those extra pounds. Foregoing the luscious food fare at parties was a torture one would have to bear just for the somewhat elusive waistline. Suddenly, there is hope.A significant shift occurred in March 2025 when Mounjaro, a weight-loss drug from Eli Lilly, Indianapolis, Indiana, United States became legally available in India. Eli Lilly is one of the largest global pharmaceutical corporations, with a focus on innovation in areas such as diabetes, oncology, immunology, and neuroscience. Founded in 1876, Eli Lilly has grown into a major player in both branded and specialty medicines.
By June, Wegovy, a similar medication from Novo Nordisk, followed suit.
WHY INDIA NEEDS TO BE THINNER
India, despite having an average body mass index (BMI) lower than that of many Western countries, is home to one of the largest populations of obese individuals globally, alongside the United States and China. In Delhi, for instance, 25% adults suffer from Type 2 diabetes, a condition closely linked to obesity. This paradox underscores the rising health challenges in the country.
Between 2021 and 2024, the sale of weight-loss drugs in India grew five-fold, reaching $72 million in annual sales. Investment bank Jefferies predicts that this market could expand to $1 billion in the coming years. While this represents a modest share of the global $24 billion market today, industry insiders view India as a prime growth engine in a sector projected to reach $150 billion annually by 2035.
What makes the Indian market particularly attractive is its unique socioeconomic structure. In contrast to the U.S., where obesity disproportionately affects lower-income communities, obesity in India correlates more strongly with wealth. The most prosperous southern states and urban centers report higher obesity rates, with the condition disproportionately affecting the educated, affluent, and urban populations. These are precisely the segments with the purchasing power to access premium drugs.
Beyond price, medical suitability is another factor. South Asians are genetically predisposed to conditions such as non-alcoholic fatty liver disease, a comorbidity frequently associated with obesity. Novo Nordisk’s clinical trials have suggested that semaglutide could reduce fatty liver prevalence by 37%, offering a therapy uniquely aligned with the region’s health profile.
INDIAN GENERICS MARKET
India’s generics market is one of the largest and most influential in the world. It supplies around 20% of the global demand for generic medicines and nearly 50% of the generic drugs consumed in the United States. The country’s pharmaceutical exports exceed $24 billion annually, with a strong presence in over 200 countries, including key emerging markets such as Brazil, Turkey, and South Africa. Indian companies like Cipla, Dr. Reddy’s Laboratories, Sun Pharma, Lupin, and Biocon are global leaders in producing cost-effective, high-quality medications.
For India’s pharmaceutical industry, the timing is opportune. Generic drug manufacturers such as Biocon are already offering affordable alternatives to older weight-loss injectables like liraglutide. Meanwhile, Sun Pharma, India’s largest drugmaker, plans to launch its own next-generation formulation within five years.
The real breakthrough is expected next year when the patent for semaglutide, the active ingredient in Wegovy and Ozempic, expires in India. At that point, pharmaceutical giants like Cipla and Lupin are expected to flood the market with generic versions, racing to capture market share. However, to truly succeed, Indian companies must tailor these drugs to local needs rather than merely reproducing Western formulations.
Cost is the first major hurdle. Even with price reductions, a year’s supply of Mounjaro or Wegovy in India can cost up to $2,400, roughly equivalent to the nation’s per capita GDP. Experts predict that generics could cut prices by up to 95%, bringing monthly costs down to levels accessible to a much broader segment of the population. Such affordability could redefine the treatment landscape.
INDIAN GENERICS VS. WESTERN PHARMACEUTICALS
A comprehensive study published in MedRxiv in April 2025 analyzed the cost differences in pharmaceutical manufacturing between India and the United States. The findings revealed that for products destined for the U.S. market, the cost of land acquisition was approximately $1.2 million in the U.S., compared to $681,000 in India—a difference of about 43%. Additionally, the overall cost of manufacturing a typical pharmaceutical product in India is estimated to be 30–40% lower than in the U.S., driven by factors such as cheaper raw materials, streamlined regulatory processes, and efficient supply chains.
Western pharmaceutical companies face higher operational costs. For instance, in the U.S., the average salary for a pharmaceutical professional is around $55,000 per annum, with top-level managers earning up to $120,000. In Europe, particularly in countries like Switzerland and Germany, salaries are even higher, with pharmacists earning between $83,600 and $127,000 annually. These elevated labor costs contribute significantly to the higher overall production expenses in Western pharmaceutical industries (Pharmacist Migration). In India, the average monthly salary for a pharmacist is approximately ₹33,179 (around $400), aligning closely with the national average income.
Indian pharmaceutical manufacturers benefit from a well-established infrastructure and a deep pool of skilled labor, contributing to high production efficiency. The Indian government’s support through initiatives like the Pharmaceuticals Export Promotion Council (Pharmexcil) and favorable policies has further bolstered the industry’s growth. Indian companies are adept at navigating both domestic and international regulatory requirements, earning numerous approvals from the U.S. FDA and other global authorities. This regulatory expertise, combined with cost-effective manufacturing, positions Indian generics as attractive alternatives in the global market.
In contrast, Western pharmaceutical companies often face more stringent regulatory environments and higher compliance costs. While these regulations ensure high standards, they also contribute to increased production expenses. Additionally, the reliance on imported raw materials and active pharmaceutical ingredients (APIs) adds to the cost burden for Western manufacturers.
This underscores why Indian pharmaceutical companies can produce the same molecules at significantly lower prices than their Western counterparts.
WHICH INDIAN COMPANY WILL RULE
Logistics also present challenges. Both Mounjaro and Wegovy are injectable treatments that require cold-chain storage—a complex requirement in a tropical country with inconsistent infrastructure. Enter Mankind Pharma, which is conducting trials for India’s first oral weight-loss drug, expected to compete with injectables by the end of 2025. Eli Lilly and Novo Nordisk are preparing to enter this space next year as well, but whoever perfects an effective and stable oral formulation could dominate not just urban markets but also rural ones.
The implications extend beyond India’s borders. The country already supplies nearly 20% of the world’s generic drugs and 50% of the generic medications consumed in the United States. As obesity rates rise across low- and middle-income nations—from Africa to Latin America and Southeast Asia—Indian generics stand to become critical players in global healthcare.
Dr. Reddy’s Laboratories, for example, plans to launch its generic version of Wegovy in 87 countries once patents expire next year, focusing on emerging markets such as Brazil and Turkey. The forecasted boom is substantial: rising diabetes rates in these regions are fueling demand for cost-effective, long-term treatments.
That said, geopolitical uncertainties loom. While American tariffs on Indian generics currently stand at zero, this could change in the coming years. David Ricks, CEO of Eli Lilly, has warned that former U.S. President Donald Trump’s proposed tariffs—potentially as high as 200% on pharmaceuticals—could complicate exports.
Yet for now, Indian pharmaceutical companies find themselves at the cusp of a health revolution. If global markets remain accessible, Indian generics could play a transformative role—not only by making weight-loss therapies affordable but by reshaping the fight against obesity itself. In a world where affluence and lifestyle diseases are colliding, India’s pharma sector is poised to make the world slimmer, one affordable dose at a time.
(Views expressed are the author’s own).
Parneet Sachdev, IRS is the Chairman of Real Estate Regulatory Authority and a leading author.