India is launching cheap, weight-loss drugs and Novo Nordisk is betting on its brands to stay on top

The first wave of generic versions of Novo Nordisk's GLP-1 weight-loss drugs launched in India over the weekend, with at least five domestic drugmakers undercutting the original price by up to 80%. It comes as the Danish drugmaker's patent expired on Friday, with the company fighting to maintain its lead in the lucrative market.
India is a critical market, with around 100 million people living with diabetes and nearly a quarter classified as obese. The country is also known as "the world's pharmacy" with its well-developed generic drugs industry supplying around 20% of global off‑patent medicines.
Sun Pharmaceutical, one of the top generics manufacturers in the world, on Saturday launched a generic semaglutide for as low as 750 rupees ($8) for a weekly injection, or about 3,400 rupees per month. That compares with Novo's retail price of between 8,800 and 10,000 rupees in India, depending on the dosage.
Meanwhile, export-focused Dr. Reddy's Laboratories has so far launched semaglutide for treating diabetes at around 4,200 rupees per month and plans to expand to Canada, Turkey and Brazil this year.
The company's goal is to democratize access to GLP-1 drugs worldwide, said Deepak Sapra, CEO of Pharmaceutical Services and API at Dr. Reddy's, at a virtual launch event on Saturday. It's targeting annual sales of 12 million semaglutide pens in the first year of launch across all markets, including India.
"This is something that Indian generic players have been preparing for a very long time," Salil Kallianpur, an independent pharma consultant based in India, told CNBC.
More than 50 brands are expected to launch generic versions of semaglutide in the coming months. That's a small number by Indian standards, because of the relative complexity of making such drugs with their more stringent quality controls, Kallianpur said.
A price war
Even as semaglutide remains protected from generic competition in the U.S. – its largest market by far– until 2032, patent expirations in India, Canada, Brazil, and China this year are likely to have a sizable impact on its revenue. In February, Novo warned that sales could decline by 5% to 13% in 2026.
Novo is already facing declining market share amid fierce competition from Eli Lilly and other drugmakers. U.S. President Donald Trump has also pushed for lower drug prices, and a November deal with the administration slashed GLP-1 prices in the country. It is unclear whether higher sales volumes will offset the lower prices.
In December last year, Novo reduced the price of Wegovy by 37% from its launch price in India, before its patent expired, Reuters reported.
Analysts told CNBC that Novo needs to cut prices in India to defend its market share. Vishal Manchanda, a pharma sector analyst at Systematix Group, said that Novo could retain a large share of the market if it maintains a 15%–20% premium over generic versions.
Generic entries will affect Novo's sales in India, but it's not yet clear whether the Danish drugmaker will lose its leading position, said Sydbank analyst Søren Løntoft Hansen.
Novo has historically maintained a leading market share despite losing patent protection. The company has been a leading producer of insulin since its inception a century ago, and it has continued to dominate the market while still selling at a premium to generic rivals. Generic manufacturers have struggled to scale up production to challenge Novo's dominance, Hansen said.
Novo is confident in its ability to retain users in India. "Our size, technology, and complete care ecosystem justify the price we are getting after a 37% reduction," Vikrant Shrotriya, managing director of Novo Nordisk India, told CNBC's "Inside India" on Friday.
Even though Novo launched popular obesity drug Wegovy and diabetes treatment drug Ozempic in India after Lilly launched its rival Mounjaro and Zepbound, it "converted a mistake into an opportunity," as it came in at a much lower price and is now launching second brands, Kallianpur said.
Wegovy is being launched as Poviztra through a partnership with Emcure Pharma, while Ozempic is being marketed as Extensior in collaboration with Abbott India. These partners bring deep ties to pharmacies and physicians across the country, improving the drugmaker's reach.
It's a classic strategy for protecting a premium brand against cheaper generics, Kallianpur said, adding that Novo is banking heavily on its reputation. "The brand is essentially the moat."
The growing Indian market
While Sun Pharma and Dr. Reddy's launched semaglutide at about 50% below Novo's original prices, smaller domestic-focused manufacturers such as Natco Pharma and Alkem Laboratories are offering steeper discounts of nearly 80%.
Natco Pharma's vial formulation is priced at 1,250 rupees per month, making it one of the most affordable options on the market, while Alkem Laboratories has introduced the lowest-priced prefilled semaglutide injections starting at 1,800 rupees per month.
Through a combination of affordable pricing and "extensive distribution across smaller cities in India, Alkem aims to "make this product accessible to more patients who need it," the company's CEO Vikas Gupta told CNBC in an email.
Sales of GLP‑1 drugs in the country have risen rapidly, with the moving annual turnover in February rising 178% from a year earlier to 14.46 billion rupees, according to data from Indian market intelligence firm Pharmarack.
Despite the rising popularity of these GLP-1 drugs in India, the price remains a key deterrent. Rajiv Kovil, a diabetes specialist, said nearly 50% of his patients could benefit from GLP-1 drugs, but only 5% are currently using them.
There is no official indication from Novo or Eli Lilly on a fresh round of price cuts, acknowledged the Mumbai-based diabetologist, but said that "Novo will bite the bullet eventually."
Meanwhile, he plans to wait for more evidence on the effectiveness and availability of the new generics before switching his patients from Novo's and Lilly's GLP-1 drugs.
Challenges for Indian generics
GLP-1 drugs such as semaglutide are peptide-based medicines that require specialized technology for production and distribution, including a cold chain for storage, making them more complex to manufacture. This is unlike most drugs manufactured in India, such as painkillers and antibiotics.
"You have to pay really good attention to quality control, because these molecules are way more complex than aspirin, for example," Knud Jensen, a chemistry professor at the University of Copenhagen and President of the European Peptide Society, told CNBC.
"Quality control for these large molecules is more difficult than for small molecules," he said. "The molecule that is given to patients has to be perfect, and it cannot have any side products or contaminants."
Kallianpur, however, said that many underestimate the progress of Indian drug manufacturers over the past 10 years.
"They've understood that compliance is today not a cost, but it can be converted into a very valuable moat," he said. "That is a big mindset shift that is happening in India."
Experts, however, still largely agree that despite progress, quality control in India is still catching up with Europe or the U.S.
There is also concern among some industry watchers that generic semaglutide could become available in markets where the drug is still patent-protected. "If India is starting to manufacture GLP-1s at a large scale, that will not all stay in India, whatever companies try, countries try to prevent it from coming in," Ben van der Schaaf, Partner at Arthur D. Little, told CNBC. "It's big business."
Jyske Bank analyst Henrik Hallengreen Laustsen says that if the laws are followed and semaglutide is sold only in countries where the patent has expired, Novo would be able to maintain its market dominance.