Published Sep 24, 2026 | 3:33 PM ⚊ Updated Sep 24, 2026 | 3:33 PM
GLP-1 receptor agonists such as semaglutide mimic a hormone that regulates blood sugar and reduces appetite.
Synopsis: A new Diabetes Care study from Madras Diabetes Research Foundation finds that India has cut prices of several modern diabetes medicines by 60 percent-90 percent after patent expiry. Semaglutide prices fell sharply after March 2026, while sales jumped nearly sevenfold, highlighting the impact of generic competition, regulation and domestic manufacturing.
Nearly 40 Indian pharmaceutical companies have entered the semaglutide market after the drug’s patent expired in March 2026, with monthly sales jumping almost sevenfold within two months, according to a new review published in Diabetes Care, the journal of the American Diabetes Association.
Semaglutide is an anti-diabetic medication used for the treatment of type 2 diabetes, and an anti-obesity medication used for weight management.
The review, led by Dr V Mohan and researchers from the Madras Diabetes Research Foundation (MDRF), examines how India has brought down the cost of newer diabetes medicines through a combination of patent policies, generic competition, price regulation and domestic pharmaceutical manufacturing.
The paper found that prices of several SGLT2 inhibitors and GLP-1 receptor agonists fell by approximately 60 percent-90 percent after patent expiry, while insulin biosimilars have also become substantially cheaper in India. The researchers found that Indian generic prices for selected medicines were 15 to 65 times lower than US list prices.
“This is a matter of great pride for India. We have shown that modern diabetes medicines, which were once considered unaffordable for large sections of society, can become much more accessible through the right combination of government policy, pharmaceutical manufacturing and competition,” said Dr V Mohan, Chairman of MDRF and one of the authors.
“The Indian Government deserves considerable appreciation for the policies and regulatory framework that have helped build one of the strongest pharmaceutical industries in the world. This has not only made India a major supplier of medicines globally but has also helped bring down the cost of treatment for Indians.”
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Semaglutide’s patent expired in India on 21 March 2026, paving the way for generic competition. Before patent expiry, the originator semaglutide was priced at approximately ₹11,000-₹16,409 per month in India.
Prices subsequently fell to around ₹2,000-₹3,500 per month, depending on the manufacturer.
The market response was equally dramatic.
In February 2026, before patent expiry, around 25,000 units of semaglutide were sold. By April, monthly sales had risen to 170,000 units, roughly a six- to sevenfold increase within two months.
The researchers say the episode illustrates how rapidly competition can change access to newer medicines once patent protection ends.
The review found similar reductions in several other modern diabetes medicines.
For sitagliptin, linagliptin, empagliflozin and dapagliflozin, retail prices fell by approximately 60 percent-90 percent after generic versions entered the Indian market, with competition between multiple manufacturers playing a major role.
The paper also highlights insulin glargine. For a patient using 30 units a day, the originator product costs about ₹2,500 per month, compared with ₹700-₹1,000 for biosimilar versions in India.
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The researchers argue that India’s price advantage is not simply a result of producing medicines at low cost.
India supplies around 20 percent of generic medicines globally by volume, with large-scale manufacturing allowing companies to serve both domestic and international markets.
The country’s patent framework also plays a role. The authors point to Section 3(d) of the Indian Patent Act, which limits patents on new forms of known substances unless significant therapeutic enhancement is demonstrated. This can allow generic competition to begin earlier after the primary patent expires.
The paper gives empagliflozin as another example. Monthly sales increased from 55 lakh units before patent expiry to 78 lakh units after generics entered the market, a 42 percent increase.
The researchers also highlight government initiatives such as Jan Aushadhi and Ayushman Bharat in improving access for poorer and vulnerable populations.
Through Jan Aushadhi Kendras, generic medicines are typically sold at 50 percent-90 percent lower prices than branded generic alternatives, while the Drug Price Control Order allows the government to impose ceiling prices on medicines included in the National List of Essential Medicines.
However, the authors caution that lower prices alone do not guarantee access.
Modern GLP-1 medicines remain concentrated among urban and higher-income populations, while outpatient medicines for chronic conditions such as diabetes are generally not comprehensively covered under public health insurance.
The review points to continuing urban-rural disparities, limited uptake of newer GLP-1 and SGLT2 medicines, dependence on imported pharmaceutical ingredients and the need for continued monitoring of the quality and safety of generic medicines.
The authors also stress that multiple manufacturers can create challenges around quality consistency and pharmacovigilance, even as competition helps lower prices.
“India has demonstrated that affordability is possible when government policy, regulation, manufacturing capacity and competition work together. Our experience can offer hope to lakhs of people with diabetes around the world,” Dr Mohan said.
(Edited by Dese Gowda)
