The global fight between Eli Lilly and Novo Nordisk for dominance in the red-hot weight-loss drug market is shifting to India, one of the fastest-growing pharmaceutical frontiers.
As rising obesity and diabetes rates collide with expanding middle-class incomes, the country is becoming a pivotal battleground for the two drugmakers.
On Thursday, Eli Lilly announced that India’s drug regulator has approved its full range of Mounjaro KwikPen pre-filled injectors, a once-weekly treatment for diabetes and obesity.
The company had already introduced Mounjaro to the Indian market in March, but only in limited vial strengths. This was followed by Novo’s launch of Wegovy in India just days ago.
The latest approval enables Lilly to sell six dosage variants, from 2.5 mg to 15 mg, in pen format — a move aimed at boosting convenience and personalisation.
“With this approval, all six dosage options for Mounjaro will soon be available in India, supporting a more personalized approach to treatment,” Eli Lilly India president Winselow Tucker said.
Novo Nordisk launches Wegovy ahead of generics production
The announcement comes just two days after Novo Nordisk launched Wegovy, its competing GLP-1 receptor agonist, in India with multiple dose strengths and an easy-to-use injector pen.
The Danish firm is betting on early adoption in the Indian market ahead of a critical turning point: the patent for Wegovy’s active ingredient, semaglutide, is set to expire in India in 2026.
Until then, both companies will try to capture market share in a highly price-sensitive country.
Wegovy’s window to dominate with brand exclusivity is short — once the patent lapses, Indian pharma majors like Sun Pharma, Dr. Reddy’s, Cipla, Lupin, and Biocon are expected to flood the market with cheaper generics.
India’s obesity epidemic creates a vast opportunity
The stakes are high. India is home to the third-largest obese population globally, and the numbers are rising sharply.
According to The Lancet, lifestyle-related conditions like obesity and diabetes have surged over the last decade.
The International Diabetes Federation projects that the number of Indian adults with diabetes will jump from 74.2 million in 2021 to 124 million by 2045.
Data from PharmaTrac shows India’s anti-obesity drug market has grown more than fourfold in five years, reaching ₹576 crore by March 2025 from ₹133 crore in 2021.
Mounjaro’s launch in March sparked intense interest among patients and doctors alike, with clinicians reporting a sharp rise in weight-loss drug inquiries.
Cost remains a major barrier to access
Despite the buzz, price remains a major hurdle.
Both Mounjaro and Wegovy are priced well beyond the average Indian healthcare budget.
Annual therapy costs can run into several lakhs per patient, making these drugs accessible only to the affluent or medically critical cases.
“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 The Economic Times recently.
Each Mounjaro KwikPen includes four fixed doses of 0.6 ml, though Lilly has not disclosed pricing details.
Three-phase evolution of India’s weight-loss drug market
Over the next few years, India’s weight-loss drug market is expected to evolve in three distinct phases.
The first, the branded phase, will stretch from 2025 through mid-2026, during which time Eli Lilly’s Mounjaro and Novo Nordisk’s Wegovy are likely to dominate the market.
These treatments will primarily cater to affluent or high-risk patients, as few alternatives will be available and prices will remain steep.
The second phase, beginning in late 2026, will bring disruption with the launch of generic versions of semaglutide.
As Novo Nordisk’s patent expires, Indian pharmaceutical firms are poised to flood the market with cheaper alternatives.
This influx is expected to dramatically expand access while driving down prices, intensifying competition, and eroding Wegovy’s pricing power.
Finally, from 2027 onwards, the market will likely enter a dual-track phase, where it bifurcates into two segments.
Branded drugs such as Mounjaro will continue to serve patients with critical medical needs or the financial means to pay a premium for established treatments, while generics become the go-to option for broader sections of the population, democratizing access to obesity care across income groups.
Why Lilly looks safer as a long-term investment, as Novo races against time
The biggest risk for Novo Nordisk lies in the 2026 patent expiry of semaglutide in India.
Once off-patent, generics could undercut prices by as much as 90%, dramatically reducing Wegovy’s revenue.
In contrast, Lilly’s tirzepatide, the active compound in Mounjaro, enjoys patent protection until 2036, giving Lilly a longer runway for growth and pricing control.
This disparity could reshape the market. Novo Nordisk must aggressively grow Wegovy’s adoption in the next 18 months to build brand loyalty before lower-cost alternatives arrive.
Against these factors, analysts see differing investment implications:
According to AInvest, Novo Nordisk (NVO) is a compelling short-term buy as it pushes for early market share, but faces sharp revenue pressure post-2026.
On the other hand, Eli Lilly (LLY) is a stronger long-term growth story, with robust patent protection, superior efficacy data, and expanding global demand.
Coming to Indian generics, Biocon, Viatris, and Cipla are positioned to benefit from the expected semaglutide flood after 2026.
“Invest in Lilly for steady growth, but keep an eye on Novo’s performance in India—it could still deliver surprises before generics strike,” AInvest said.
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