Eli Lilly and Novo Nordisk Compete for Dominance in India's Obesity Medication Market

HYDERABAD, India, Dec 24 (Reuters) - Global pharmaceutical leaders Eli Lilly and Novo Nordisk are racing to establish a stronghold in India's rapidly expanding obesity medication sector ahead of the anticipated arrival of more affordable generic options next March. Novo is focusing on cutting prices and expediting product launches, while Lilly has gained an edge by entering the market earlier. Both companies are prioritizing outreach to healthcare professionals, enhancing their advertising efforts on obesity, forming partnerships with clinics, providing incentives for patients, and securing distribution agreements with local pharmaceutical firms, as confirmed by interviews with doctors, analysts, and industry representatives. Lilly has even collaborated with prominent Bollywood actors to promote obesity awareness in a social media advertising campaign. With India projected to have the world's second-largest population of overweight or obese individuals by 2050, the market for obesity drugs is becoming increasingly critical. Analysts estimate the global market for these medications could reach $150 billion annually by the end of this decade. While the U.S. remains the leading market, preliminary sales data from India indicates a swift uptake despite the fact that most patients bear the cost themselves. "We believe this market could exceed $1 billion within two years," stated Shrikant Akolkar, vice president at Nuvama Institutional Equities. In July, data analytics firm Pharmarack valued the current market at approximately 6.28 billion rupees ($70.23 million), marking a fivefold increase since 2021. Lilly's Mounjaro, which has received approval for both diabetes management and weight loss, emerged as the top-selling drug by revenue in October, boasting sales that doubled within months of its March rollout, surpassing Novo's Wegovy, which launched in India in June. "Realizing the need for better accessibility, we had to adjust pricing within a couple of months," said Vikrant Shrotriya, managing director of Novo Nordisk in India, referencing the November price reduction for Wegovy. Speaking earlier this month during the introduction of Novo's diabetes drug Ozempic in the country, Shrotriya noted Ozempic, which is administered weekly and approved by the U.S. FDA in 2017 for Type 2 diabetes, has become a global bestseller and is frequently used off-label for weight loss due to its appetite-suppressing properties. Over 20 Indian pharmaceutical manufacturers, including Dr. Reddy's, Cipla, Sun Pharma, Zydus, and Lupin, plan to introduce cost-effective alternatives to Novo's weight-loss treatment once the patent for semaglutide, the active ingredient in Wegovy and Ozempic, lapses in March 2026. Analysts predict that generic medications will be approximately 60% cheaper, intensifying competition in India’s price-sensitive market, especially for Novo. Shrotriya expressed confidence that Novo will emphasize quality, trust, and affordability rather than focusing solely on patents or competition. LILLY'S GAIN IS NOVO'S PAIN Lilly's Mounjaro is rapidly capturing market share in India. A 2.5 mg Mounjaro KwikPen is priced at around 13,125 rupees ($146.79) for a month’s supply, with the highest 15 mg dose costing up to 25,781 rupees ($288.33). In response, Novo has reduced the price of Wegovy in India by as much as 37%, setting the cost of its lowest dose at 10,850 rupees ($121.34) for a month's supply. Ozempic, launched just last week, is offered at 8,800 rupees ($98.42) for the 0.25 mg dose. While Wegovy is making strides, Mounjaro's early entry into the market has allowed it to establish a significant presence, with patients drawn to its touted effectiveness for weight loss, according to insights from five doctors who spoke with Reuters. "Mounjaro clearly benefits from a first-mover advantage and continues to see robust demand, although price-sensitive patients are exploring alternatives," stated Dr. Anoop Misra, an endocrinologist and executive chairman of Fortis C-DOC Hospital. Mounjaro distinguishes itself by catering to individuals with severe obesity, noted Vishal Manchanda, an analyst at Systematix Institutional Equities. He added that Lilly is not under immediate pressure to lower prices, given its strong market position. Even if Lilly were to adjust its pricing, Mounjaro would still be around 30% more expensive than other branded weight-loss medications, he emphasized. While Lilly did not provide details on its pricing strategy in India, it noted that the initial response to Mounjaro has been "highly encouraging." Ozempic, Wegovy, and Mounjaro are part of the GLP-1 agonist drug class, which mimics a hormone that slows digestion and promotes feelings of satiety. Novo has taken legal action against Dr. Reddy's and Sun Pharma in an attempt to uphold semaglutide patents and prevent generics from launching until March 2026. Analysts suggest that Mounjaro's active ingredient, tirzepatide, is protected by patents for a longer duration, extending at least into the middle of the next decade, giving Lilly a competitive advantage. PARTNERING FOR REACH The competition has expanded beyond pricing and patent issues. Demand for weight-loss treatments in India is expanding from urban centers to include middle-class families, office workers, women approaching menopause, and individuals with obesity-related health issues in smaller towns. Lilly has collaborated with Cipla, India's third-largest pharmaceutical company by revenue, to launch a second brand of tirzepatide, Yurpeak, aimed at smaller towns. Additionally, Lilly is partnering with Apollo Hospitals to enhance awareness of obesity and diabetes while investing over $1 billion to expand contract manufacturing in India. Cipla will assist in marketing Lilly's weight-loss medication in less accessible areas of India. On the other hand, Novo has partnered with Emcure Pharmaceuticals to introduce a new semaglutide brand, Poviztra, to expand its market presence beyond metropolitan areas. Novo is also collaborating with startup Healthify to provide patients with health coaching and working with Apollo to promote obesity awareness. In India, where advertising for prescription medications is banned, Novo launched an obesity awareness campaign titled "WeGoWithYou" to connect individuals with doctors for guidance on the disease and its management. Lilly has a similar initiative called "WeKnowNow" focused on obesity management. Both companies are striving to promote the understanding of obesity as a disease through various advertising channels, including newspapers, billboards, airport displays, and informational materials at wellness clinics. Neither company disclosed their marketing expenditures in India. ($1 = 89.4160 Indian rupees) (Reporting by Rishika Sadam in Hyderabad, India; Editing by Dhanya Skariachan and Matthew Lewis)