Antimicrobial sales growth set to temper in 2026 over govt's AMR push

Stricter rules to curb antimicrobial resistance may limit antibiotic sales growth in 2026, as India tightens OTC use and pushes prescription-led, responsible consumption

Sales of antimicrobials such as antibiotics are expected to see constrained growth this year due to possible regulatory restrictions on their use, as part of the Central government’s plan to reduce antimicrobial resistance (AMR).

 

AMR is a condition where microorganisms such as bacteria, viruses, fungi and parasites evolve to resist the medicines designed to kill them, making infections harder or impossible to treat.

 

“Restrictions on antimicrobial overuse, combined with seasonality, may constrain category growth, as there is a good amount of focus on using the right antibiotics at the right dose for the right duration in the right patient,” Sheetal Sapale, vice president (commercial) at market research firm Pharmarack, said.

 

Anti-infectives form the third largest therapy segment in the Indian Pharma Market (IPM), with the supergroup seeing sales worth ₹27,534 crore in calendar year (CY) 2025, a 5.2 per cent value growth from ₹26,167 crore in CY 2024.

 

Of this, antibacterials make up 86 per cent of overall sales at ₹23,806 crore, followed by antifungals and antivirals, which contributed 7 per cent and 4 per cent to the segment, respectively.

 

“The segment is expected to see a tempered growth of 4 to 5 per cent on a realistic level in 2026,” Sapale added.

 

According to the World Health Organisation (WHO), around 10 million deaths are projected to occur globally by 2050 due to AMR, with India’s share at around 2 million.

 

With AMR a major public health threat, the Centre has periodically been taking steps to counter its rising prevalence in the country.

 

The Union Health Ministry on Friday introduced a draft amendment to the Drug Rules mandating all antimicrobials and their preparations to bear a blue vertical chip across their packaging labels.

 

Officials in the know told Business Standard that the Central Drugs Standard Control Organisation (CDSCO) may also roll out an overhauled policy for sale and strict monitoring of antibiotics.

 

This comes after a high-level subcommittee of the CDSCO’s Drugs Consultative Committee (DCC) submitted a report in November last year, outlining at least a dozen urgent recommendations for the National Action Plan on AMR.

 

The Directorate General of Health Services (DGHS) had also asked pharmacies not to dispense any antibiotics without a doctor’s prescription, at a time when drugs such as azithromycin and amoxicillin were commonly dispensed over the counter (OTC).

 

Commenting on the effects of such moves, Rishi Agrawal, chief executive officer and co-founder at compliance firm TeamLease Regtech, said stricter enforcement on OTC antibiotic sales may trim volumes at the margins in the short term, especially for products that relied on informal access rather than prescription-led demand.

 

However, he added that the policy is correcting misuse and not medical need. “Legitimate, prescription-based demand will continue, and over time, the market will shift towards evidence-based prescribing and responsible consumption,” Agrawal said.

 

Nirali Shah, analyst at Ashika Group, added that while a clampdown on OTC antibiotic sales will not collapse the anti-infectives market, it will expose where growth has been fragile.

 

“Segments driven by self-medication and loose retail practices will see pressure, while prescription-led and hospital-focused products hold up better. This is less about demand destruction and more about demand re-routing,” she added.

 

The new framework, based on a report submitted by a top panel of experts to the DCC, may also call for the development of new antibiotics, stamping prescriptions to check re-use, and developing state-specific software models to track antimicrobial sales in real time.

 

At the same time, pharmaceutical companies such as Mankind Pharma and Orchid are actively strengthening their own AMR-led initiatives.

 

This includes aligning antibiotic portfolios with national treatment guidelines, improving manufacturing quality standards, and working closely with healthcare professionals to promote rational prescribing and patient awareness.

 

Calling the government’s steps positive and timely to address AMR, Sheetal Arora, promoter and chief executive officer at Mankind Pharma, said antibiotic demand in India is largely driven by genuine clinical need, and doctor-prescription-led usage would bring sustainable growth for the category over time.

 

Sapale added that there has been a shift towards targeted therapy and diagnostics, which has also created greater scrutiny of irrational antimicrobial combinations.

 

“Hospital anti-infectives have been showing stronger growth than trade anti-infectives, indicating that rampant usage of antimicrobials is being curbed,” she added.