Semaglutide generics likely to widen access but raise dropout risks

Experts add that while the introduction of branded generics will trigger an acceleration in volumes for GLP-1 agonists, the value growth may moderate due to price erosion

With more than 50 semaglutide-based branded generics set to enter India this month, experts warn that an expansion of prescribing beyond specialists to consulting physicians could require stricter patient profiling to prevent therapy dropouts.

 

“With branded generics, the prescribing specialities for anti-obesity drugs such as glucagon-like peptide (GLP-1) agonists will expand from speciality and super-speciality doctors, such as endocrinologists, to consulting physicians (CPs) and general practitioners (GPs),” a Delhi-based endocrinologist said.

 

This, he added, would require stringent patient profiling and close monitoring of therapy adherence and lifestyle changes as the prescriber base expands significantly.

 

GLP-1 agonists are a class of medicines that help regulate blood sugar, increase fullness (satiety) and slow stomach emptying, leading to weight loss and improved glucose control in patients with type 2 diabetes and obesity.

 

Over the past year, new launches in the injectable GLP-1 agonist segment, including tirzepatide and semaglutide, drove a 177 per cent rise in sales in this category on a moving annual turnover (MAT) basis to ₹1,446 crore in February 2026, compared with ₹571 crore in February 2025. 

Tirzepatide drugs, such as Eli Lilly’s Mounjaro, topped the revenue charts, recording ₹882 crore in sales within 11 months of their March 2025 launch. Semaglutide drugs, meanwhile, posted overall sales of ₹445 crore over the past 12 months.

 

Developed by Danish drugmaker Novo Nordisk, semaglutide is currently available in India as Ozempic, Wegovy and Rybelsus. However, with the molecule expected to lose patent protection by mid-March 2026, several Indian companies have begun aggressive promotion.

 

“Before the launch of an innovator molecule, multinational corporations (MNCs) typically spend more than half a year on scientific education of speciality and super-speciality doctors about the disease, patient profiling and education,” said Sheetal Sapale, vice-president (commercial) at Pharmarack. 

However, she added that this level of engagement is often lost when CPs and GPs begin prescribing following the launch of branded generics. “This can lead to a potentially higher rate of dropouts if patient profiling and monitoring are not done adequately,” she said.

 

Experts say that while the introduction of branded generics is likely to accelerate volumes for GLP-1 agonists, value growth may moderate because of price erosion. “Branded generics typically come at one-third to one-fifth the price of innovators and can increase monthly sales two-three times in the initial three-four months. Although many players enter the segment, it is usually the top three or four companies that capture most of the opportunity created by the patent expiry,” Sapale said.

She added that while prices decline, the pool of eligible patients remains broadly unchanged.

 

In November last year, Novo Nordisk initiated a 37 per cent price cut for Wegovy, its injectable semaglutide drug. As a result, Wegovy injections, available in five dose strengths ranging from 0.25 mg to 2.4 mg, saw their monthly prices fall to between ₹10,850 and ₹16,400, from the earlier range of ₹17,345 to ₹26,050.

 

Similarly, Novo introduced Ozempic in the Indian market at a relatively affordable price of ₹8,800 per month (₹2,200 per week) for the entry dose of 0.25 mg. The 0.5 mg dose costs ₹10,170 per month (₹2,542.5 per week), while the 1 mg dose costs ₹11,175 per month (₹2,793.75 per week).

“Patients already onboarded on innovator drugs are unlikely to switch, as they generally belong to the affording class,” Sapale said.

 

She added that speciality and super-speciality doctors may continue to prefer innovator brands because of the robust clinical evidence supporting their efficacy and safety profiles.