Diabetes affects roughly 100 million people in India, and approximately one in four Indians carries excess weight
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March data tracked by industry intelligence provider Pharmarack show a five-percentage-point slide in Eli Lilly $LLY's slice of India's GLP-1 weight-loss market, dropping from 61% to 56% as a wave of cheap semaglutide generics arrived following the ingredient's patent expiry. Novo Nordisk's position was unchanged at 25%, CNBC reports.
According to the Pharmarack report, a total of 26 semaglutide products — used to treat both obesity and type 2 diabetes — entered the market within weeks, representing launches by 13 separate Indian generic manufacturers.
The erosion of Lilly's position was unexpected. The patent expiry applied to semaglutide, the active ingredient in Novo Nordisk's GLP-1 drugs, and analysts had anticipated the Danish company would bear the brunt of generic competition. Instead, Lilly's tirzepatide-based brands — which carry a higher price — took the larger hit.
Vishal Manchanda, a pharma sector analyst at Indian brokerage Systematix Group, told CNBC that growing awareness of affordable semaglutide generics, combined with the expanding price gap between semaglutide and tirzepatide, was the primary driver of Lilly's share loss. He predicted that tirzepatide's superior efficacy may ultimately keep it relevant but confine its user base to higher-income patients who can absorb the cost.
In a March 31 news release, Novo Nordisk announced steep reductions to its branded semaglutide pricing — 38% for Ozempic and 48% for Wegovy — narrowing but not closing the gap with generic rivals. Entry-level pricing for Novo's lineup now sits at 5,660 rupees monthly, while premium generics are available at roughly 4,200 rupees.
The commercial stakes in India are substantial. Diabetes affects roughly 100 million people there, and approximately one in four Indians carries excess weight, creating a large addressable patient population for GLP-1 therapies. India's pharmaceutical sector, which provides about a fifth of the world's generic drug supply, gives the country an unusual ability to manufacture these treatments at low cost.
Lilly and Novo Nordisk have been moving in opposite directions globally, with Lilly posting 43% revenue growth in its most recent quarter while Novo guided to declining 2026 sales. The India dynamic adds a new wrinkle: even as Lilly outpaces Novo globally, the generic wave is proving more disruptive to Lilly's higher-priced franchise in price-sensitive emerging markets.
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