GLP-1 drugs set to transform India’s metabolic healthcare

For decades, diabetes treatment in India largely revolved around oral medicines and insulin. Now, a new class of medicines known as GLP-1 receptor agonists is beginning to redefine the management of diabetes and a broader spectrum of metabolic disorders—from obesity and fatty liver disease to cardiovascular risk. The transformation began with the expiry of the primary compound patent for Novo Nordisk’s semaglutide, marketed globally as Ozempic and Wegovy.

The patent expired on March 20, 2026, opening the door for domestic pharmaceutical companies to launch generic versions. Since then, the market has rapidly evolved into one of India’s fastest-growing branded generic opportunities. More than 20 pharmaceutical companies have introduced generic injectable semaglutide, sharply reducing treatment costs and significantly expanding patient access. While the generic market is currently driven primarily by type 2 diabetes, prescriptions for obesity are rising rapidly.

“My primary bet is on metabolic health, particularly solutions centred on insulin resistance,” says Amit Bakshi, Chairman and Managing Director of Eris Lifesciences , now the country’s second-largest player in the generic semaglutide market. “Diabetes is only one part of the equation. The larger challenge lies in the associated cardiovascular disease, obesity, fatty liver disease and several other metabolic conditions.”

A huge market to tap

The generic semaglutide market is currently estimated at around ₹30 crore per month, translating into an annualised run rate of about ₹360 crore. This represents only the generic segment and excludes Novo Nordisk’s innovator brands.

According to PharmaTrac data, the overall semaglutide market in India was valued at about ₹589 crore (annualised sales) as of May 2026. The broader GLP-1 market—including semaglutide, tirzepatide, and other GLP-1 therapies—stood at around ₹1,906 crore annually. Semaglutide accounts for about 31% of this market while tirzepatide, Eli Lilly’s once-weekly diabetes and obesity therapy marketed as Mounjaro, contributes more than ₹1,200 crore.

Leading players in the generic semaglutide market include Torrent Pharmaceuticals, which captured about 38% market share soon after launch, and Eris Lifesciences, with an estimated 22% share by volume and 13-14% by value during the first quarter after launch. Dr. Reddy’s Laboratories , Sun Pharmaceutical Industries , Zydus Lifesciences , Glenmark , Alkem , and Natco are among the other major participants.

Semaglutide sales increased from roughly 25,000 units in February 2026 to about 170,000 units in April 2026, driven largely by the availability of lower-priced generics. However, monthly growth has begun to moderate after the initial post-patent surge, suggesting that the market is transitioning from launch-driven expansion to a more sustainable, prescription-led growth phase.

Many industry observers expect the Indian GLP-1 market—not just semaglutide—to exceed $1 billion (₹8,500-9,000 crore) over the next few years as both diabetes and obesity indications gain wider acceptance.

New opportunities

Bakshi believes insulin resistance lies at the centre of India’s growing metabolic disease burden. In men, it contributes to hypertension and cardiovascular complications, while in women it is closely associated with polycystic ovary syndrome (PCOS). Excess visceral fat—even among people who may not appear conventionally obese—increases the risk of diabetes, fatty liver disease and cardiovascular disorders.

That is where GLP-1 therapies are beginning to reshape clinical practice.

“Globally, GLP-1 therapies have already begun transforming how we approach diabetes,” Bakshi says. “We now have evidence across diabetes, cardiovascular disease, obesity and fatty liver conditions such as MASH and NASH. Over time, we may also see stronger evidence in areas such as PCOS.”

According to him, the significance of GLP-1 therapies lies in their ability to influence multiple disease pathways simultaneously rather than merely lowering blood glucose.

“These therapies are already disease-modifying and will evolve into something even more significant,” he says.

Yet Bakshi cautions against the hype surrounding these medicines.

“Social media narratives have created considerable noise. These are not magic drugs or instant cures. They are powerful therapies that must be understood and used within the right clinical framework.”

Krishna Kumar, Executive Director and Chief Operating Officer of Eris Lifesciences, says injectable semaglutide accounts for nearly 90% of the current generic semaglutide market by value.

“The patient base continues to expand month after month, but today’s market is only the tip of the iceberg,” Kumar says. The availability of generic products at substantially lower prices than innovator brands is expected to improve affordability and broaden patient access.

“The top four or five companies account for more than half the market and the rest have only a marginal presence,” he says, attributing this concentration to the complexity of manufacturing injectable GLP-1 therapies.

Evolution of metabolic medicines

Launching a GLP-1 product is only the first step. Sustained profitability requires sophisticated manufacturing capabilities, cold-chain logistics and backward integration. Eris has already backwards-integrated synthetic semaglutide manufacturing at its injectables facility, while recombinant semaglutide is being developed at its biotechnology facility in Bhopal. Cartridge manufacturing is also being brought in-house. Without such manufacturing integration, Kumar believes scaling the business economically becomes difficult.

Another misconception is that GLP-1 therapies will eventually replace insulin.

“There is no evidence anywhere in the world that GLP-1 adoption has suppressed insulin demand,” Kumar says. “Scientifically, GLP-1 is not an insulin substitute. The body still needs to produce insulin for GLP-1 therapy to work.”

Instead, both therapies are expected to grow together as diabetes diagnosis improves and treatment becomes more comprehensive.

Current prescribing patterns also remain relatively narrow. Under existing Indian approvals, injectable semaglutide is prescribed largely by endocrinologists and internal medicine specialists, limiting the eligible prescriber base to around 30,000-35,000 doctors nationwide. Consequently, nearly three-fourths of current prescriptions continue to be for diabetes rather than obesity.

The addressable market is expected to expand as clinical evidence grows and regulatory approvals widen. Existing international evidence already supports GLP-1 use across obesity, cardiovascular disease and fatty liver disease, while future approvals could potentially extend to conditions such as PCOS, opening the market to gastroenterologists, gynaecologists and other specialists.

Bakshi believes the evolution of metabolic medicine has only just begun.

“As India becomes more affluent, healthcare spending will increase significantly. Metabolic disorders will become one of the country’s biggest healthcare challenges. Our strategy is to build solutions around metabolic health rather than around individual diseases.”