Daybreak - India got cheap Ozempic. No one knows how to sell it

Episode Date: September 1, 2026

Ozempic went off-patent in India this year, and everyone from Novo Nordisk to Nestlé has rushed in expecting a billion-dollar market. Instead, growth has already stalled, and the reason isn't price. It's culture. While Hollywood joked about Ozempic on late-night TV and Serena Williams advertised a GLP-1 program for a tele-health platform at the Super Bowl, not a single Indian celebrity has admitted to using it. We trace why the drug ran out of India's easiest customers within months, why its next move — into Tier 2 and Tier 3 cities — might not work either, and what it would actually take to sell a $200-a-month injection in a country that's only now starting to believe that obesity is a disease.Daybreak is produced from the newsroom of The Ken, India’s first subscriber-only business news platform. Subscribe for more exclusive, deeply-reported, and analytical business stories.

Can you think of a single Indian celebrity who has publicly said that they are on a ZemPEC? If Karan Johar's dramatic weight loss just came to mind, well, he has only ever denied the rumors. So, I'm people who are saying, what you're on, Zampi on Jambique, you're on, you're on Jani. You know, I don't know what I'm not saying. And if you can't think of anyone else, don't worry. You are not behind on any gossip. There isn't a single Bollywood celebrity who has openly admitted to being on the blockbuster weight loss drug. And on the other side of the world, it's the complete polar opposite.

For example, here's Jimmy Kimmel hosting the 2023 Oscars. When I look around this room, I can't help but wonder, is Ozempic right for me? Even three years ago, Ozempic was common enough in Hollywood that Kimmel was making. jokes about it on live TV. Since then, more public figures have admitted to being on the medication and have even advertised it or other related products. And you might be surprised to know that Bollywood's almost total radio silence on this new class of diabetes and weight loss drugs is part of the reason why the medication, which was expected to blow up in India, has actually kind of hit a wall. In fact, a couple weeks ago, the India MD of Novo Nordisk, the company that owns Ozympic, said in an interview for the print that weight loss drugs were just scratching the surface in India.

And this is the case, four months into the wave of GLP1 generics that hit the Indian market in March this year. Almost as soon as Novo Nordisk's patent on semi-grutide, a key chemical component in Ozempic expired, more than 50 pharma brands, release their own cheaper variance. The excitement had the numbers to back it up in the start. Analysts predicted that the segment could be worth a billion dollars in India by just 2030. After all, India also currently has the world's second largest diabetes population and the third largest obese population. And to take a bite out of that pie, it wasn't just the drug makers who rushed in.

A whole ecosystem of products and services are popular. up to address the side effects of being on these drugs. This includes FMCT brands like Nestle and Tata Consumer, beauty brands like sugar and lacmea, and even nutrition and fitness tracking platforms like Healthify Me. But the growth everyone has bet on is already showing signs of stalling. For example, a Nomura report predicted 26 sales for the medicine would cross $260 million. But by July, only 20% percent. of the number has been hit, leaving only five months for the producers to make up the other 80. And the reason behind the stall is a cultural mismatch that pharma companies forgot to factor in.

Welcome to Daybreak, a business podcast from the Ken. I'm your host, Trey Treyrake's, and every day of the week, my co-host, Nita Sharma and I will bring you one news story that is worth understanding and worth your time. Today is Wednesday, the 2nd of September. Before we go any further, let me quickly explain to you what GLP medications are and what they do. They basically mimic a hormone that your body already makes. The hormone helps regulate blood sugar, appetite and how full you feel. They were first developed to treat diabetes patients, but it has increasingly become popular

in treating obesity and to trigger weight loss as well, because one of the things it does is reduce appetite and make people feel full for longer. In India, they first became popular with urban affluent folks around 2024. way before any of these medicines were officially even available here. A Fortune report even described a fancy New Delhi clinic for cosmetology and metabolic treatment where celebrities and NRIs were trying to get their hands on the drug through prescriptions and the grey market. Even a reporter here at the Ken had found the drug on the black market around that time, through Facebook groups and eventually a pharmacy in the posh suburb of Juhu in Mumbai.

I'll be linking it in the show notes. you'd like to give it a read. Now, these rich Indians from posh areas in the country were possibly the easiest demographic for the medicine to reach once it was officially available in the Indian market. But unfortunately for pharma companies, the numbers show that they ran out of this group quite soon. Market research firm Farmer Act reported last month that the monthly sales for GLP1 drugs rose only by about 2% in June. That's down from a 58.4.4.com. percent growth in April. Sheetal Sapale, the VP of Commercial at Pharma Act, explained in a report to Bloomberg that

the dip was because all eligible patients have been onboarded onto this drug and fewer newer patients are starting this therapy. And there are three reasons why this has happened so quickly. Firstly, the cultural resonance. Now, this was a drug that had pretty much gone viral in the West. Of course, it resonated first with the English-speaking West. wealthy Indians who actually have the time and context to keep up with Hollywood gossip and the money to afford the drug both legally and otherwise. For them, it became a kind of class or wealth

marker. Secondly, general access. You see, prescriptions for these drugs require endocrinologists, cardiologists and internal medicine specialists. These kinds of specialists are more concentrated in urban metro areas. My colleague Sidesha Ray reported earlier this year that these consultations can cost as high as $1,700 to $1,800 for a single session. Plus, starting the medication also requires patients to be in regular contact with a health professional. In fact, academic studies show that 70% of Indians have no access to specialist care at all and that 80% of India's specialists are concentrated in urban areas. Thirdly, GLP1 is not a magic fix. The medication remains effective only.

if it's actually paired with lifestyle choices like diet and exercise. They also come with a slew of side effects like nausea, irregular bowel movements, muscle loss, dehydration and much more, which all require constant care and monitoring. And of course, not all of India's millions of diabetes and obesity patients are really part of the demographic that could afford to keep up with both the medication and the lifestyle. Which is why companies like Novo Nodis and Eli Lili, the owner of another, the popular GLP1 drug called Mojaro have started moving into Tier 2 and Tier 3 India. More on this in the next segment.

India has a population of 100 million diabetes patients and 180 million obesity patients. And the latest National Family Health Survey released this year shows that obesity is spreading significantly all across the entire urban spectrum. Nearly 43% of all urban women and more than 36% of urban men between the ages of 15 to 49 are now overweight or obese. The percentage of obese women has in fact almost doubled over the last 20 years. In the survey from 2005 to 6, the number used to be 23.5%. So it makes sense why Novo Nodisk and Eli Lilly have partnered with local players like MQR Pharmaceuticals and Sipla to sell beyond just the metrocities.

But this demographic can relate even less to what they're trying to sell, and there's two reasons why. First, most GLP1 drug users in India have been diabetes patients because cosmetic weight loss as a category is yet to really emerge here. In fact, a report from Care Edge ratings, a credit rating agency, estimated that nearly 60 to 70% of demand would be driven by type 2 diabetes treatment. Part of the reason why is mainly because of how doctors themselves are prescribing it. Dr. Azim Maldar, a consultant endocrinologist and diabetes specialist from Hinduja Hospital in Mumbai,

said in a Forbes report that endocrinologists and healthcare providers are also increasingly prescribing them as these medications help in diabetes control, treating heart failure, reducing the progression of kidney disease, managing and reversing fatty liver, and multiple other metabolic and mechanical problems. In the same report, he also cautioned potential users to think of it as a long-term metabolic therapy and not a short-term cosmetic solution. Second, like I mentioned earlier, many don't have the cultural context to the medicines and the glamour around it. The U.S., for example, has brand ambassadors like Serena Williams promoting telehealth platform Roe and their GLP1 specific program on Super Bowl. I'm on row, 34 pounds down on GLP ones.

Healthier on row. Supporting on row. She speaks about losing around 35 pounds or 15 KG and how she's moving and feeling better because of the support she's gotten on the platform. Imagine this is one of the best tennis players in the world advertising a weight loss medication to millions of people. India's regulations on the other hand don't even allow pharma companies to advertise their products, which is why Eli Lilly went for an obesity awareness campaign instead. The ads showed Bollywood stars like Bomanirani and Supriya Pathak informing their obese friends that obesity is a chronic disease and not a personal failure.

Some of them even aired during the India versus Pakistan T20 match when it would get major eyeballs and what I saw at least one level, LinkedIn Post referred to as the Super Bowl of the East. Now, the ads didn't advertise Eli Lilly's products or Monjaro itself, but it did encourage people to get a doctor consultation and made its branding impossible to miss. Still, that did not stop India's regulators from flagging Eli Lilly's campaign in writing twice. Reuters reported that the regulator has specifically scrutinized the timing of the ads because it lined up with Monjarro's launch in India.

The regulator treated this coincidence as the kind of evidence that the ads were in fact indirect promotion. Eli Lilly pushed back against the scrutiny but still took the ads of air, though you can still find them online if you look them up. But let's say the awareness campaign had worked. It still wouldn't really solve the affordability problem. You see, one reason is because insurance doesn't cover GLP1 medication, especially for patients with obesity.

That's pretty much the case for almost every country though, except France and the US, but there is only in some states. In both those countries, though, insurance does cover GLP1 medication for type 2 diabetes. Now, in India, it's not really covered for that either. It can be, based on specific plans and on a case-by-case basis, though those cases are rare, and in general, insurers are right now kind of skeptical because of how the way. rate loss aspect is what has gone viral with these meds. Besides, the UNIT economics don't really match either.

In fact, a single dose of the brand that Eli Lilly and Sipla are partnered to distribute and promote called Your Peak, specifically in tier 2 and tier 3, is quite steep for the average middle class income bracket. The ICE 360 surveys splits India's middle class into two tiers. The bigger and more price-sensitive half of that class earns about five. 5 to 15 lakh rupees per annum. The lowest starting dose of your peak costs about 12,000 rupees a month. The most expensive one costs about 24,000 rupees.

That means a single month on the starting dose could eat into anywhere between 10 to 29% of what a household in this range makes each month. But the thing is, the doses don't stay stable all the time. patients are usually asked to increase the dosage for about five months until they're at the highest and the most expensive dose. At that point, the monthly cost could take up about 20 to 60 percent of entire incomes, and that's just for one prescription. Plus, as the NFHS survey notes, women are more likely to be obese than men, and they are the same people who have less spending power beyond the affluent urban areas,

especially if they're from traditional households. Swati Pradhan, a doctor from Mumbai, told Bloomberg that she has patients who come to her with a specific amount of money saved up and asked for quicker treatments. Now, companies seem to be betting on the brand name trust and credibility to beat out generic competition. But the thing is, Indians are famously price-sensitive.

And for the brand trust and credibility to work, they need to understand what exactly the... they're paying for. And what worked in the US for these drugs is not working here. Since about 2023, OZMPIC and other weight loss drugs have been incredibly visible in the US. Remember Kimmel's Oscars' joke? And while Indian celebs have been entirely silent about using the medicine or denying it vigorously, public figures like Oprah and even Elon Musk have talked and joked about taking it extensively. Actors and celebs like Kelly Clarkson and an evening, Schumer have casually talked about being on Ozenpic or other drugs on late-night shows.

And even dramatic, visible weight loss on red carpets have always come with speculations. The result is a drug so normalized that a study from PWC shows that as of May 26th, one in five US households has at least one GLP1 user and that adoption has been flat across income levels, which means affluent and poorer people are purchasing these medications alike. Now, this kind of access is mainly possible because the US government actually capped brand name GLP1 drugs at $2.45 a month under a federal program and even launched a Medicare pilot with drugs priced at about $50 a month. In fact, like I mentioned earlier, Medicare covers GLP1 drugs for type 2 diabetes in general, and in some states, the state-specific programs even cover the meds

for obesity. All of this is probably why Ozmpic alone made roughly $12 billion in the US in 2025. India's entire GLP1 market, by the way, made about $220 to $2.30 million in the year to May 26. Basically, OZempic's U.S. market alone earns India's entire annual GLP1 market in about a week. And a lot of that growth has actually been a combination of the virality of the product, government negotiated pricing, and a more robust insurance coverage than what we have in India. But none of that is really possible here. Now that generics have flooded the market and the average cost for GLP1 has come down, the Indian government is not really going to come in and cap prices for the more expensive brands.

On top of that, there is also the advertisement complication we see. spoke about. So the only possible solution is for companies to spur community awareness and build trust through channels that have already built health-related trust, like AHA or accredited social health activist workers. Now, they're basically trained female community health activists who conduct door-to-door health visits, community events to raise awareness about health concerns, and even serve as clinical care providers at very basic levels. A lot of this care is concentrated on women as well, which is an added plus for an obesity-related campaign. They could also try routing awareness through physicians or established groups like the Indian Council of Medical

Research. Considering obesity rates are going up steadily is a national health concern and is also increasingly being understood as a chronic disease, it's actually important for these kind of groups to start campaigns of their own with or without partnerships with pharma companies. Plus, considering doctors do prescribe GLP1 drugs for comorbidities, it would be useful to make clear that their advantages go beyond just being a weight loss solution and could help with issues like cardiovascular problems, obesity-related joint aches, PCOS and more. But like we saw earlier, awareness only solves part of the issue. Affordability is still a problem and there's all the side effects as well.

So, demystifying the side effects, addressing them more openly and discussing ways to care for oneself at that stage could be of help. Plus, it would be important to negotiate with insurers and make sure that insurance is a norm for JLP1 prescriptions, whether it's for diabetes or obesity. Basically, a combination of all of this is necessary. And if JLP1 drug makers can't solve the marketing and insurance problem in India first, that the U.S. answered years ago, both the drugs and the ecosystem around it will soon have nowhere to go. Daybreak is produced from the newsroom of the Ken, India's first subscriber-focused business news platform. What you're listening to is just a small sample of our subscriber-only offerings. A full subscription offers daily long-form feature stories, newsletters and a whole bunch of premium podcasts.

To subscribe, head to the Ken.com and click on the red subscribe button on the top of the Ken website. Today's episode was hosted and produced by my colleague Rachel Vargis and edited by Rajiv Sien.