Global supply strains and patent clock push Novo Nordisk into tight corner in India’s obesity drug race

Danish pharmaceutical giant Novo Nordisk, which triggered a global rush for weight-loss drugs with its GLP-1-based therapies, is now grappling with the fallout of having underestimated the very demand it helped stimulate.

The global shortage of its GLP-1-based drugs—Ozempic and Wegovy—has dampened investor confidence and opened doors for rivals like Eli Lilly in high-growth markets, including India. These GLP-1 inhibitors, a class of drugs used to manage type 2 diabetes and obesity, mimic the natural GLP-1 hormone to regulate blood sugar and suppress appetite.

In 2023, Novo Nordisk briefly became Europe’s most valuable company on the back of surging demand. But supply chain constraints, insurance bottlenecks in the US, and a staggered global rollout have since slowed its momentum. Its share price has fallen over 15% since March, wiping out over $100 billion in market value.

Meanwhile, Eli Lilly has gained traction. Its twin offerings, Mounjaro and Zepbound—both based on tirzepatide—have demonstrated greater efficacy in clinical trials. Zepbound, for example, has delivered over 15% weight loss in more than half of participants within a year, outperforming Wegovy in head-to-head trials.

“The Icarus Paradox suggests that a company’s greatest strengths can become its weaknesses if overextended. Novo Nordisk’s initial success with Ozempic and Wegovy may have led to overconfidence, causing it to overlook emerging competition and market shifts. This strategic inertia prevented timely innovation and adaptation, allowing Eli Lilly to surpass Novo Nordisk in the obesity drug market,” said Salil Kallianpur, a pharmaceutical analyst.

In India, semaglutide—the active ingredient in Ozempic—has been approved for type 2 diabetes, and its off-label use for weight loss is reportedly growing. However, Wegovy, the obesity-specific version, has yet to launch. In contrast, Mounjaro (tirzepatide) is already approved for diabetes and obesity in India.

“Obesity is a chronic disease that requires comprehensive management, and Lilly is committed to supporting people with obesity and raising the standard of care in India,” said Winselow Tucker, President and General Manager, Eli Lilly and Company (India).

He pointed to the SURMOUNT-5 phase 3b clinical trial, published in The New England Journal of Medicine, where tirzepatide delivered average weight loss of 20.2%, compared to 13.7% for semaglutide.

India, home to over 100 million people with diabetes and a fast-rising burden of obesity, offers a compelling case for long-term pharmacological interventions.

“As urban lifestyles become more sedentary and dietary patterns shift, we’re seeing obesity and diabetes rise in tandem. Effective pharmacological interventions can play an important role—but access, availability, and affordability will be vital,” said Dr Anoop Misra, Chairman, Fortis C-DOC Hospital for Diabetes and Allied Sciences.

While Wegovy is not yet approved for use in obesity treatment in India, Novo Nordisk has advanced its launch timeline from 2026 to the end of 2025. 

“We are introducing Wegovy (injectable semaglutide 2.4 mg), which offers the full therapeutic strengths of semaglutide for comprehensive management of overweight and obesity, this year,” said Vikrant Shrotriya, Corporate Vice President and Managing Director, Novo Nordisk India.

Eli Lilly’s Mounjaro became available in India in March 2025, priced between ₹14,000 and ₹17,500 per month, and is sold in 2.5 mg and 5 mg doses. Its dual-action mechanism—targeting both GLP-1 and GIP receptors—offers added therapeutic potential for both diabetes and obesity.

Globally, Novo Nordisk reported revenue of DKK 290.4 billion (USD 42.1 billion) in 2024—a 25% rise over the previous year. Net profit grew to DKK 100.9 billion (USD 14.5 billion), while Q1 2025 alone saw revenue of DKK 78.09 billion (USD 11.3 billion) and net profit of DKK 29.03 billion (USD 4.2 billion). Wegovy’s annual sales doubled to DKK 58.2 billion (USD 8 billion), while Saxenda brought in DKK 8.6 billion (USD 1.2 billion).

Still, supply challenges persist, particularly in the US, where compounded drug alternatives are being used. Novo has accordingly revised its 2025 sales growth forecast to 13–21%. The US accounted for 57% of the company’s Q1 2025 revenue—making markets like India critical to sustaining global growth.

The Indian obesity treatment market—currently valued between ₹3,000 and ₹3,500 crore—is projected to grow eightfold to ₹25,000 crore by 2030, according to IMARC. Both Novo Nordisk and Eli Lilly are now working to deepen their footprint before Indian drugmakers enter the fray with generics. Novo is particularly wary of the 2026 patent expiry of semaglutide, after which local players are expected to enter en masse.  

“We recognise that competition is growing, which is ultimately a positive shift for healthcare, enabling greater awareness and improved care solutions. Patent expiry is a natural phase in the lifecycle of pharmaceutical products,” Shrotriya asserted. 

Indian pharmaceutical majors such as Sun Pharma, Cipla, Dr. Reddy’s, and Lupin are already developing their own versions of weight-loss drugs like Wegovy to tap into the global obesity drug market, which is projected to reach ₹8.3 lakh crore ($100 billion) annually by decade’s end.

Sun Pharma, for instance, is actively pursuing GLP-1 therapies. “Our GLP-1 R agonist has completed Phase-1 clinical trials. Early clinical data demonstrated marked weight loss in single and multiple ascending dose studies. The drug was well tolerated, and we expect Phase 2 to start during H1CY25. We are dedicated to advancing this innovative therapy and our focus will be on completing the studies in an accelerated timeframe to bring meaningful benefits to patients worldwide,” said Dilip Shanghvi, Managing Director, Sun Pharmaceutical Industries. The company is also developing a generic version of semaglutide for the Indian market, currently under clinical evaluation.

Biocon, too, is eyeing this space. “We have a strong pipeline of GLP-1s. There’s interest in semaglutide, the Ozempic generic, which is expected to go off-patent by the end of 2026. That opens up significant opportunities in emerging markets and Canada,” said Kiran Mazumdar-Shaw, Executive Chairperson of Biocon Limited. Biocon, which already markets liraglutide, was among the first to gain approval in a regulated market. “We aim to be among the key players in the Ozempic segment as well,” she added.