Semaglutide patent expiry: India’s next big public health inflection point

Expiry of the main patent in India on semaglutide, the active ingredient in Novo Nordisk’s ‘weight-loss’ drugs Ozempic and Wegovy, represents more than a commercial event. It marks a possible structural inflection point for public health and Indian pharma.

Economic Survey 2025-26 recognises that non-communicable diseases now dominate India’s disease burden and are closely linked to long-term economic productivity. Obesity-related costs, estimated at nearly 1% of GDP in 2019, are projected to rise significantly in the coming decades if corrective action is not taken.

This is no longer a metropolitan concern but visible in tier-2 and -3 towns, and even increasingly in rural India. Changing diets, rising consumption of ultraprocessed foods and sedentary lifestyles are reshaping the country’s metabolic health profile.


Globally, GLP-1 therapies have transformed management of type-2 diabetes and obesity by regulating blood sugar and reducing appetite. In India, early market signals reflect strong underlying demand. Sales of semaglutide have risen sharply over the past few years, demonstrating that patients are willing to seek better metabolic solutions when they are available.

Yet, access remains limited by affordability. Advanced metabolic therapies are largely out-of-pocket expenses. For a vast segment of patients, particularly outside major urban centres, price remains the primary barrier.

Entry of multiple Indian manufacturers following today’s patent expiry has the potential to change this equation meaningfully. Estimates suggest generic semaglutide could be introduced at prices 70-90% lower than current innovator pricing.

Affordability is not merely a commercial lever but a gateway to access. Wider access, when combined with responsible medical supervision, can help bend the long-term curve of obesity and diabetes in India. India’s semaglutide market alone is projected to approach $2 bn by 2030. This is not a niche opportunity.

It represents one of the most significant therapy expansions in recent years. India’s enduring strength has been its ability to scale quality medicines across geographies. In the context of GLP-1 therapies, three factors will determine impact:u Affordability Lower prices will bring treatment within reach of patients who were previously excluded.

Affordability

Lower prices will bring treatment within reach of patients who were previously excluded.

Accessibility

These therapies shouldn’t remain confined to large urban hospitals. India’s pharma distribution network, one of the deepest globally, can carry innovation into smaller towns and districts.

Availability

Supported by multiple credible manufacturers and resilient supply chains, availability will create confidence among physicians and ensure continuity of care.

International experience shows that GLP-1 adoption often brings new patients into the formal healthcare system. Many individuals seeking weight management are first-time or infrequent healthcare users. In India, this effect could be even more pronounced.

Obesity frequently coexists with undiagnosed hypertension, lipid disorders and early-stage diabetes. When patients enter the healthcare ecosystem under medical guidance, comorbidities are often identified earlier. This enables timely intervention and long-term risk reduction.

An often under-recognised dimension of obesity care is its impact on women’s reproductive health. Obesity and associated metabolic disorders
such as polycystic ovary syndrome (PCOS) are among the leading contributors to infertility in India, affecting ovulation, hormonal balance and pregnancy outcomes.

By improving insulin sensitivity, reducing excess weight and restoring metabolic stability, GLP-1 therapies have demonstrated the potential to help re-establish ovulatory cycles, and improve fertility outcomes in appropriately selected patients under medical supervision.

As access expands, these therapies may offer new hope to millions of women struggling not only with metabolic disease but also with its deeply personal consequences. In doing so, their impact extends beyond chronic disease management to enabling healthier families and strengthening long-term population health.

GLP-1 therapies are not cosmetic interventions. They are prescription medicines that require clinical oversight. Used appropriately, under a doctor’s supervision, they can reduce complications that impose heavy economic and social costs on families. The broader impact will extend beyond the molecule itself. Increased doctor consultations, diagnostics, nutritionalcounselling and metabolic monitoring will become integral parts of the care pathway.

Diabetes prevalence in India remains among the highest globally. Once established in adolescence, obesity often tracks into adulthood, increasing risk of cardiovascular disease and other chronic conditions.

Medication alone is not the solution. Public awareness, better nutrition, physical activity and preventive screening remain foundational. GLP-1 therapies should be viewed within this broader preventive framework. They complement lifestyle interventions, not substitutes for behavioural change.

For Indian pharma, this moment carries both opportunity and responsibility. Quality standards must remain uncompromising. Doctor education must be evidence-based. Patient communication must be ethical and measured.

India has long been recognised as a global supplier of affordable generics. The next phase of leadership will require mastery of complex manufacturing, advanced delivery systems and specialty therapies. The patent has expired. For Indian healthcare, real opportunity is only beginning.

(The writer is CEO, Mankind Pharma)