India is a weird market. With obesity rates shooting up, I’d have bet on the sales of generic GLP-1s exploding once their patents expired. They now cost about Rs 1,000–2,500 a month, and there’s growing evidence pointing to benefits well beyond weight loss, including cardiovascular, metabolic, and liver health.

Yet, generic drugmakers are quietly cutting their sales targets by 25–30%. At Rs 1,000–2,500 a month, it’s cheaper than a gym membership. The real problem seems to be retention. GLP-1s are injectables, and you have to keep taking them. If you stop, you gain back the lost weight. It seems like asking someone to stay on a weekly injection indefinitely is a much harder sell.

A few other friction points:

For a variety of reasons, Indians haven’t taken to GLP-1s with the same enthusiasm as Western populations. Could it be because Indian physicians are conservative when it comes to prescribing newer drugs?

Self-injecting is a pain for most people, and that friction and inertia might be stopping them from starting in the first place.

Given that there are now GLP-1 pills, I’m wondering if the adoption curve will change.

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