The action will radically expand access to treatments previously viewed as a luxury, particularly in middle-income nations, where high demand has bumped up against high prices.

Doctors at clinics in Mumbai report that they are already getting ready to receive an increased number of new patients.

Endocrinologist Nadeem Rais receives more than 50 people in his office weekly who want to receive weight-loss injections.

Currently, he has about 70 to 80 patients under active treatment, he told AFP.

“Now, when generics come in, and the prices go down, that can easily go up to 200.”

His co-worker Sunera Ghai says that demand is high, but most are unlikely to take it simply because it is a luxury good at this stage.

A study published earlier this month found that core patents on semaglutide will expire in 10 countries covering 48 per cent of the global burden of obesity by the end of 2026.

The study said these included Brazil, China, South Africa, Turkey and Canada.

Launching soon

This is the beginning of a new aggressive race by the drug giants of India.

Regulatory filings and compliance documents that AFP has viewed indicate that at least four large companies have already made generic semaglutide injections.

Others, such as Zydus Lifesciences, have declared Day 1 launches, implying that generic counterparts can come out as early as this weekend in India.

The Indian market is about to be overwhelmed with alternatives, according to research company Pharmarack.

“The information we have is that there will be over 50 brands that will be entering the market, and there will be over 40 players who will be entering with these drugs,” Pharmaracks vice president, Sheetal Sapale, said.

This is timely considering the changing health situation in India.

Although the nation continues to contribute a third of the global undernourishment rates established by the World Health Organisation (WHO), increasing incomes and urbanism have put obesity rates through the roof.

According to government data published in March last year, 24 per cent of all women and 23 per cent of all men are overweight or obese in India.

“When an individual begins to earn money, he gets more sedentary here,” says bariatric surgeon Sanjay Borude.

“In first-world nations, the more, the merrier, so they get time to work on their fitness, but the opposite happens in India.”

These upside-down economics have paid off well for large pharma players such as Eli Lilly and Novo Nordisk, who have been making money off the market.

The sales of weight-loss drugs in India have increased tenfold during the last five-year period to reach 153 million, and are expected to reach over half a billion by 2030.

The side effects of taking such drugs include nausea and gastrointestinal problems.

Breaking the price barrier

Last year, Eli Lilly’s Mounjaro was the most valuable drug sold in the country, outselling even generic antibiotics.

Nevertheless, expensive rates – as much as 15,000 to 22,000 rupees, $161-236 a month – restrict access, according to Swati Pradhan, director of a weight-loss clinic in Mumbai.

She hopes patient numbers will increase when generics bring treatment costs near 5,000 rupees (60) a month.

The effect on the world could be more dramatic.

The country of India is already producing over fifty per cent of the generic drugs in Africa, and more affordable semaglutide may prove to be a lifeline to nations where obesity is escalating fast, yet the medicines to treat it are not affordable.

“Alternatively, less expensive semaglutide would greatly increase access to effective treatment, especially in middle-income nations where price has posed a significant obstacle,” Simon Barquera, president of the World Obesity Federation, told AFP.

“However, no drug will turn around the upward trend of obesity in the world. Obesity is a multi-faceted, chronic condition,” he said, and prevention activities and healthier living conditions are significant.

The Indian companies will be one of the major impetuses, and Dr Reddy Laboratories plans to release its semaglutide version in Canada by May 2026.

In the case of patients such as Sukant Mangal, 46, who had lost almost 30 pounds over eight months, expanded access can hardly come quickly enough.

Some of them, he is aware, just dropped treatment halfway when they realised that they would need to spend 20,000 rupees ($214) a month over 7 or 8 months.

“Had it been cheaper, it would have been a lot easier to have.”