CSN Murthy, Founder and CEO of SatyaRx Pharma Innovations, speaks about how India cannot remain only a buyer market and how it can bridge the gap between science, capital, and indigenous discovery.
Published Nov 13, 2025 | 7:00 PM ⚊ Updated Nov 13, 2025 | 7:00 PM
CSN Murthy, Founder and CEO of SatyaRx Pharma Innovations.
Synopsis: There was a time when if you were a tech company and you didn’t have an office in Bengaluru, then you were not really a tech company. The VCs would not even give you money. Pharma has become like that, too. If you look at big pharma, big funds, VC funds in the US, private equity funds in the US—they all have offices and full-fledged staff sitting in China doing things. They’re following new cohorts of assets that they got from China. China will definitely, going forward, be very important in everybody’s plans.
India today stands on the brink of its biggest chronic health wave – obesity. Nearly 300 million Indians are now within the risk spectrum, marking a surge that didn’t exist two decades ago.
At the same time, a new class of powerful drugs — GLP-1 analogues — is redefining how obesity is treated. For the first time, medicine offers a disease-modifying solution rather than just a symptom fix.
But while India is rapidly adapting to this global shift, the challenge ahead is clear: Will we stay in the buyer market, or can we build our own innovation pipeline to make these treatments affordable and accessible for millions?
In this exclusive conversation with South First, CSN Murthy — an IIT-Madras graduate with post-graduation from IIM-Bangalore — Founder and CEO of SatyaRx Pharma Innovations, one of the few Indian biotech leaders who has taken drug discovery from idea to lab to global partnerships, speaks about how India cannot remain merely a buyer and how it can bridge the gap between science, capital, and indigenous discovery.
Q: You have built companies across drug discovery, clinical development and even venture financing. Can you briefly walk us through this journey?
A: I’ve been in the healthcare space for over three decades. The early part of my career was with large pharma companies in India — first with Gland Pharma, then with Dr Reddy’s. About 20 years ago, I moved into drug discovery, leading Dr Reddy’s discovery arm, Aurigene, based in Bengaluru and Hyderabad. In many ways, Aurigene was a pioneering biotech, taking several compounds from discovery into the clinic, both in India and globally.
Around six years ago, I left Aurigene to start on my own. Even before my pharma years, I’d worked in investment banking and venture finance — I began my career at ICICI Ventures, helping several pharma companies in the Hyderabad region raise capital, well before the days of big venture funding and IPOs.
I’ve spent a fair amount of time across business, science, and company-building, but the most exciting part has always been working with science — watching ideas move from the lab to animal models, and finally seeing them translate into the clinic in humans.
Q: Do you believe obesity in India is now a durable, long-term market like diabetes, or is this an early-stage market shaped by the novelty of GLP-1s?
A: I think two things have happened. First, obesity, as an epidemic, has clearly been on the rise, driven by changing lifestyles and rapid urbanisation. If you compare my generation to what I see with my children and the generations after, we’re moving towards an economy where obesity has become an inevitable consequence of how that scenario has evolved.
For pharma, the holy grail has always been figuring out how to treat obesity — something science hadn’t achieved for decades. That changed dramatically in 2023 with the advent of GLP-1s and their first approval for obesity treatment. For the first time, we could address obesity with a class of drugs long familiar to the industry in diabetes, now used at higher doses.
When people began seeing the effects on weight loss, it was an “aha” moment — real proof that obesity could be treated pharmacologically. Since then, the field has evolved rapidly with dual-action drugs like the GLP-1/GIP analogues such as Mounjaro, which are proving even more effective.
Once it became clear that obesity is treatable, interest in the space rose sharply. We now have not just a recognised public-health problem but a solution that works and is reasonably safe — far safer than earlier approaches. This is a field that’s here to stay and grow, not just for cosmetic reasons, but because of the comorbidities that accompany obesity — diabetes being the foremost. With increasing evidence that this class of drugs can address multiple metabolic disorders, it’s fair to say this is not a passing wave but the beginning of a durable, long-term market.
Q: India has around 300 million obese people, which is just four or five crores less than the entire US population. Why hasn’t this massive domestic market created enough commercial incentive for Indian companies to develop their own drug classes? What’s missing in the innovation ecosystem that exists in the US or Europe?
A: I think, actually, the comfort of knowing that you can make generic semaglutide and still make money from it is one big problem. It’s a problem because there’s no need to innovate as long as you can wait for Ozempic to become generic, which is happening in March, and then you just wait for another six years, and Mounjaro becomes generic. When you actually see these solutions—which have traditionally been how pharma has operated—I can clearly see why there is no immediate visible effort in the domestic ecosystem. It’s probably inertia that has just come to stay.
But I would also argue that, unlike several other therapies in immunology or in cancer or cardiovascular, there is a very different incentive structure at play, which actually should propel more companies to start thinking about innovating directly for the Indian market. I don’t see that happening in a very big way yet. There is one drug in phase two in the US right now, but at least in public information, there isn’t a whole lot of research that you actually see happening in India.
Also Read: Newer definitions of obesity: Key takeaways for Indian population
Q: Mounjaro became India’s top-selling drug within months of its launch, proving that Indian patients will pay for effective obesity treatment. Yet Indian pharma companies are largely waiting for patent expiries. What structural, regulatory or cultural barriers are blocking original obesity research?
A: Generally, the challenge for us as an economy has been that there is a significant amount of pricing control on pharma. Some of it is justifiable because you do not want people at the bottom of the pyramid to be left out. But alternative ways of paying for pharma products, which will allow for research to take place, have not evolved.
If you look at what’s happening in countries like China, for example, there was a time not too long ago—I would say 10 years—there’s not a whole lot of difference between India and that country. There were a bunch of CROs coming up in India, likewise in China. But in the last 10 years, things have dramatically changed in China, where you now see something like 30% of all licensing revenues in 2024 went to Chinese pharma companies. All of these are Western biotechs and large pharmas that have licensed products from China.
When we start realising that, it’s actually going to fundamentally change pharma economics globally. What China is doing will change pharma economics quite conclusively.
Coming back to your question, the availability of risk capital and more than that, the propensity for people to take risks—especially when there’s sufficient comfort from making revenues and churning out profitabilities from the generic sector—has probably been a moat that many companies have found too hard to cross. It’s not like Indian companies have not innovated. There have been companies like Lupin, or Glenmark, that have shown the ability to generate significant licensing revenues. Wockhardt has an antibiotic that is out in global markets. But these are still very tiny pieces—very few examples that we see in an ocean that is so big in terms of what’s happening globally.
Q: Global pharma companies have made GLP-1 drugs more affordable in India than in Western markets, but they’re still out of reach for most Indians. Can indigenous innovation actually solve this affordability issue, or will locally developed drugs still end up being expensive because of high R&D costs?
A: Lilly has definitely priced their drug much cheaper than what they have done elsewhere in the world, but it has limitations. It is not in the business of solving India’s problems. I don’t think that’s its primary objective, and hence you can’t blame them. But I think it has done a commendable job in trying to get access down. In fact, now that Cipla is a partner of Lilly, you should expect that the distribution and the reach of this drug would enormously improve.
From the Indian perspective, if you’re trying to come up with a different mechanism that somebody has not yet done a lot of work on—in other words, if you start with new target discovery and then try and take it all the way through the clinic—failure rates are obviously going to be high, and it would be fairly expensive.
But then you go back and look at the Chinese model. They have not figured out that GLP-1 drugs give rise to weight loss—somebody else did it. They’re not the ones who figured out GLP-1 and GIP dual agonists will do better than GLP-1 alone. But if you look at the pipeline globally, there are more Chinese GLP-1/GIP dual agonists than you see in the US, and some of those in the US also come from China.
If you simplify this, you don’t need to invent the first class of drugs. As long as it is de-risked and you actually do better, then your discovery risk and your biology risk will substantially come down. What would happen is you would actually take advantage of the fact that doing clinical development in India is far cheaper than elsewhere in the world. The “far faster” part is something we still have to solve for—that’s in the regulator’s hands—but that it is far cheaper is undeniable.
So we will have speed, we will have low cost, and if we can de-risk by using biology that has already been proven to be safe and effective, it is possible to fast-follow and do better in the same space, which is really what a lot of Chinese companies are doing. That’s the model we should replicate.
Also Read: Why the Lancet Commission is calling for a shift beyond BMI to diagnose obesity
Q: There’s a perception that global pharmaceutical companies are selling these drugs in India partly to collect safety data from the Indian patient population. How do you respond?
A: I think we should first stop worrying about public service. Nobody is in the business of doing public service. Governments have to provide public services, not companies. Companies pay taxes. Governments use those taxes to do whatever they want.
Number two, Lilly has not simply flown down its drug to Delhi and Mumbai and started selling it through quacks. It has a DCGI licence, which is far better qualified than anybody else, and has seen every bit of data that they wanted from Lilly before approving the drug to be sold. So we must trust that DCGI has done its job. DCGI is definitely not trying to be in cahoots with the multinationals. I think that would be the last thing.
This argument (collecting patient data) is flawed, and we should never indulge in it. Looking at things with suspicion is important. But when the world is benefiting from these drugs, we’re not the first country where they’ve been sold. Actually, GLP-1s have been in trials for 20 to 25 years now. Semaglutide is the most recent version. There have been other GLP-1s that we have also been using in India.
This class of drugs has been used by millions of patients, including in India. If you look at the number of trial sites that Lilly and Novo have had both for semaglutide and tirzepatide, you’d be amazed—something like 400 different sites have been used by these companies for trials in India before global approval.
I would like to look at it from that perspective and argue always in favour of innovation. No risk, all return, is a bad argument. We are no more precious as human beings than somebody in the Philippines or America or Brazil. I think we’re all the same.
Q: Genetic factors make Indians particularly vulnerable to obesity and metabolic syndrome. Can this distinctiveness be India’s competitive advantage in designing treatments optimised for Indian metabolism, which global drugs may not address?
A: I think we are very far away from being able to do that, because that probably goes back into more fundamental biology than is right for us. There will be differences in how our genotype might respond to GLP-1 agonism as compared to somebody from a different race. For now, it would be just to understand and compile such data. Being able to tweak these specifically for Indian biology, we’re still very far away from that.
We are essentially using the same biology that has been developed by Lilly or by Novo to see what it could do differently in India. I think that’s the best that we can do right now, rather than saying we will develop something very specific to India’s population, because that needs fundamentally more depth in biology than we have.
Let’s first figure out how to do these things before we start—I mean, we can’t get drugs for malaria — for heaven’s sake — for our population. We can’t get drugs for TB for our population, and then tweaking an obesity drug for the Indian genotype—the task is ahead of its time. We should first figure out how to make this affordable, where you control the IP, where you actually control the supply chain. You’re not looking at the largest big pharma companies in Denmark or the US to actually bail you out.
Q: Is SatyaRx doing something around obesity drug development?
A: We’re actually doing two things: One is on the scientific level: there are challenges with the GLP-1s, one of which is loss of lean muscle mass. There have been some very interesting targets that people have already started working on—companies like Regeneron and a few others, including a lot of biotechs—that are trying to demonstrate that it is possible to have weight loss without necessarily losing as much lean muscle as GLP-1s would do. So we’re actually working on a particular drug class in the same space that we are hoping to be able to get to the clinic fairly soon. This is basic discovery work. We have not invented these targets. We have not discovered these targets. It’s somebody else who has done that, and we’re trying to say: Can we be the first ones in India to actually do this? At some point, it can be combined, maybe with GLP-1s, and then we can do better than a GLP-1 alone.
The second thing we’re also doing is trying to do some really interesting partnerships where we can bring some of these drugs to India—not from Lilly, obviously, because it would do it on its own—but other companies are developing equally good, if not better drugs, where we can bring India licence or India rights to these drugs and then rapidly develop them for the Indian population.
Both of these are at a fairly advanced stage right now, and we hope that some of what we’re doing will allow us to really pave the path for being a very serious player in markets like India. Obviously, India is the most important because we’re here, but also because it’s probably the largest market outside the US, EU and China that has the potential to become a very significant market in its own right. We hope to have an important role to play, starting with obesity.
Q: Are you looking at partnerships with China, given how fast they scale-up?
A: There was a time when if you were a tech company and you didn’t have an office in Bengaluru, then you were not really a tech company. The VCs would not even give you money. Pharma has become like that, too. If you look at big pharma, big funds, VC funds in the US, private equity funds—they all have full-fledged offices and staff sitting in China. They’re following new cohorts of assets that they got from China. China will definitely, going forward, be very important in everybody’s plans.
We are talking to people in China, but that’s not the only place we’re working right now. There are other geographies as well. We’re looking at opportunities in China as well as elsewhere in the world, including the US, to help bring such innovation and then customise it to our needs.
Q: When we go to the Delhi High Court website, there are at least 20 to 30 cases related to GLP-1 licences, mostly about IP. These are companies based out of India, particularly Hyderabad, fighting with global pharma. There’s also an argument that CDSCO approved these monotherapy drugs relatively quickly, enabling rapid market access, but Indian approval cycles are slow for domestic innovation. How do we create a regulatory framework that encourages faster pathways for homegrown obesity drugs without compromising safety?
First, Lilly—as I mentioned—has done extensive trials in India. It was not that it just got data from Europe or the US and asked the Indian regulator for approval. In fact, it generated an extensive amount of data in India through trials. This is easily visible on our CDSCO website as well. You can actually go and look up every single centre in India that has recruited patients.
It was on the back of this that Lilly sought the approval, and I’m so glad that it got it, because we deserve to get drugs as and when they get approved globally. There are so many areas where there are amazing drugs that are being approved and are not available in India. We’re very fortunate that this has not been the case with GLP-1. So we should be thankful to CDSCO and these companies for making this available to us.
The second part is that there is definitely a certain amount of concern the industry has—in India as well as elsewhere—about the timelines CDSCO takes to provide approvals for trials. There is obviously room for improvement, and there has been tremendous progress over the years, but we’re still not at par with the US. If we compare with China, we’re way behind, which also reflects in how many more drugs are in trials in China than elsewhere in the world today.
There is significant room for speeding up. It’s a combination of two things. One is the caution that traditionally we have exercised as a country. We exercise significant caution because of fears that we are somehow the “lab for the world” to generate data from. Looking at it from the industry standpoint, I would like to believe that it’s absolutely not true. We are, on the other hand, beneficiaries of thousands of inventions that have been made elsewhere in the world.
Look at cancer, look at Keytruda. It sells $30 billion a year now. It’s such a miracle drug. I don’t think we would have had Keytruda because it was developed entirely outside India, and now we have the benefit of it—so many patients take it in India. That’s just one example, but there are hundreds.
So there’s been some amount of caution, which has led to delays. The second is the depth of experience that regulators in other countries have—something we lack. If you look at the FDA, their expertise in every conceivable mechanism is just phenomenal. People are going in and out of the FDA from industry and academia. There’s tremendous learning the organisation has. We obviously cannot become like that overnight, but there is a long way to go before that level of expertise comes.
As more expertise comes in, there will be less worry about the risk that exists today, and some of the worries are probably unfounded.
Q: What kind of structural ecosystem is actually needed for India to move from being a buyer to an inventor? Is it capital maturity? Regulation? Talent? Scientific risk appetite?
A: If you look at government efforts, recently, there has been an announcement of a ₹1 lakh crore R&D fund. That’s obviously a good thing. We’ll have to see how that balances out. But if I look at some of the earlier funds that the government has used for innovation, they probably have not been the greatest use of those funds, because when the government decides to fund R&D, it says: I will give you funds provided you do malaria research.
It’s very hard for private companies to do malaria research unless the government, in turn, is willing to pay the right price for the drug when it comes out. So on one hand, you have price control, and on the other hand, the government is trying to tell you what to invent. I think the government should not try to direct research in India.
China does it, and they do a phenomenal job. But we are not China. China has the most meritocratic system in the world at the local government level—enormously powerful local governments. They have incentives to foster innovation. They have land banks that they use to drive industry into their provinces. They’re built very differently.
But the government trying to directly intervene and decide what innovation should happen is not the smartest idea. A lot of private-sector involvement and voluntary help is available. Every time I talk to scientists elsewhere in the world—especially Indian-origin scientists—they genuinely say: “If there’s an opportunity for us to contribute, we’d love to do that. We’d even want to move back if we knew we could actually do something like this in India.”
From a regulatory perspective, it is worthwhile to take their help: Ask them to walk us through how IND approvals happen at the FDA, and replicate systems. It’s possible to use our diaspora to drive things positively, and that’s one attitude the government can definitely adopt.
The second thing is that the private sector does not work like the government. If the government says, “I’m giving you a grant; for every equipment you want to buy, give me three quotes and justify your choice,” that’s simply not how private labs function. They choose based on specific technical needs. It’s very hard to explain that. So, trying to drive private-sector innovation with government-style processes is not ideal.
Q: If these funds can be administered by people who come from the right background or are volunteering, that is the way government intervention can help. Government is definitely required to foster this, but the larger ecosystem question is: who will pay for innovation?
A: Today, if we innovate in India—except in areas like obesity—you innovate only with the hope that somebody in the West will buy your invention, because nobody in India will pay for it. You can’t make money trying to sell a new cancer drug in India. It just won’t work. So a lot of things will have to change, essentially from the ground up.
Q: There are concerns about GLP-1 side effects: rebound weight gain after stopping treatment, skin issues, and eye impacts. If we were to design indigenous obesity therapies specifically for the Indian population, what would be the top priorities? Where would we start—biology, dosing, endpoints?
A: I want to say one thing. GLP-1s are not cosmetic drugs. They’re not for people to casually lose weight before a date or something like that. Almost all drugs—every drug, actually—has a benefit and a risk, and in a physician’s opinion, if the risks are tolerable and the benefits outweigh them, that’s when they will actually prescribe it.
GLP-1 drugs, like all drugs, have to be taken under supervision and under care, even starting from the way they’re administered. There’s a run-in period. If somebody starts at the top dose of 2.4 mg, it’s very likely that in two weeks or three weeks, they’ll drop out because they cannot handle the side effects. They’ll have to actually start at much lower doses and then slowly ramp up to the highest dose.
Why are these drugs being prescribed? One is obviously overweight, as defined by BMI, or slightly lower BMIs, but there’s a comorbidity such as diabetes—these are the people who will most immediately benefit from these drugs. But going even beyond that, something called MACE—major probability of having a major cardiovascular event such as a heart attack or a stroke—there are now clinical studies showing statistically significant reduction in heart disease by using some of these drugs.
There are significant benefits in NASH, which is liver disease, or even if it has not gone so far as NASH, if there’s liver fibrosis, these patients are benefiting. Kidney disease patients are benefiting. So it’s actually aimed at some of these conditions that the usage is really spreading.
There are, of course, downsides. Some of the downsides you’ve mentioned are important, but not so high that they should stop somebody who is going to benefit from the drug. On balance, they have significantly more benefits than the risk of side effects. Typically, many patients who have experienced side effects are advised by the doctors to discontinue and to use something else.
Now, if you’re looking at whether we can make it better in India, if we make it better in India, we should sell it to the whole world. Why just India? Just like Lilly is selling an obesity drug here, let’s make something better than Lilly and sell it to the US. I think we should not be obsessed with India. The whole world is a market for Lilly; India is just a market. For us, the US should be a market.
We should stop worrying about doing something for India. We must actually start worrying about innovating in India for the world. If we actually can get out of those side effects and then sell it, I would first sell it—along with India—in the US, because there’s so much more money in it.
But that said, it’s not trivial. That’s the thrust of the entire pharma R&D effort, and we should actually join in and see if there are ways in which we can be the ones who can come out with these breakthroughs.
Q: Where do you see the growth of GLP-1s going? Are there any downfalls for this sector from the industry’s point of view, or is it just going to grow bigger in the coming years?
A: It would probably sound dramatic, but it is really not an overstatement to say, the world before GLP-1 drugs and the world after. It’s a watershed moment. This class of drugs is going to be humongous. Depending on how you look at it and who you believe, it’s definitely going to be $100 billion-plus, maybe up to a $300 billion market overall, especially as better and better drugs come and side effects are more and more manageable. This class of drugs is just going to explode.
Are there unforeseen risks? They are in every space. But if you look at the specific class of ingredients to which GLP-1 belongs, there is sufficient experience with the human condition to know that, on the whole, this has been tremendously beneficial. It’s not like we’re ignoring some really bad side effects just to lose weight. It is definitely not that. If anything, we are finding better and better uses and other indications as well, such as liver disease, kidney disease, heart disease and so forth.
The scope of the market is only going to increase and make it more and more important as a class, to the extent that it’s definitely recognised as a watershed moment in the pharma industry’s history. Just like PD-1 in immuno-oncology was thought of as a watershed in oncology in 2014–2015 when the first drugs came out, this is very similar—in fact, much more impactful if you look at the number of human beings it affects. This population is humongous, and it’s really growing globally.
Q: What would your message be to Indian biotech founders and investors? Where should they place their big obesity innovation bets?
A: It is worthwhile for us to look at what is emerging in this space, what is already proven, and then try and figure out if we can get an innovative drug to India, even if it is in the same class. GLP-1 is probably a little too late unless we get an oral GLP-1. Lilly has Orforglipron, which is an oral GLP-1 that looks extremely good. Pfizer actually had two compounds, both of which failed in the same class. There are lessons we learned from them.
If there is an oral GLP-1 that can be made for India, that’s a humongous opportunity to look at. Orforglipron is not approved. It may be any time now—maybe in the next quarter or so, maybe no more than two or three quarters at the most, depending on how the FDA looks at it. You probably have a 10- to 12-year patent life ahead. That’s the amount of time we have to come up with something as good as Orforglipron and then sell it in India and in a bunch of other countries, maybe even in the US.
I think even looking at what’s emerging, even if we don’t have to discover new biology, there are opportunities for us to develop drugs, looking at India as a base case, but globally as what should be possible.
The early pioneers in China, in the last 15 or so years, definitely in the last 10 years, made drugs for China first. And then when they started getting successful, when the regulatory act got better, they’re now innovating for the world. So, many US companies are buying from China.
In other words, if we can create market opportunities in India—for which the government has to play a role—the moment that a drug is important, they quickly jump on it and say, “I put a price control because it is super important,” then nobody will innovate. They must not put a price control. They must actually put a subsidy that they will give to customers. Give it to whoever you want, but you subsidise them as the government. Don’t put the burden of making the cost low on the inventor.
I think there should be smart interventions that the government can make, which will actually make it feasible for commercial success to happen in India. And obesity is probably a great place to start, because obesity is just one manifestation of the metabolic disorder, and the population is huge.
We don’t have to sell it at the price of Lilly—even if we go below that price, we can still make it very viable. Imagine out of 300 million people, a million people buy at, say, ₹5,000 a month. You’re already talking about a ₹6,000 crore market. The highest-selling drug as a single brand right now sells ₹85 crore a month, which is ₹1,000 crore for the whole year.
Q: Do you have any message for our audience?
It’s been so much fun talking to both of you, and thank you for your time. I would like to say something very positive first about the class itself. I think we have Lilly and companies like Novo Nordisk to thank for showing that there is a way forward in a very difficult space that is being talked about more now, since there are solutions evident that can solve it.
I think we must find ways of using this as an opportunity—using this as a hook—to start innovating in India, not just for us but for global markets. If this can catalyse it in some form, and the little bit we’re trying to do can also propel us in that direction, I am extremely positive that innovation-based pharma will become a driver for everybody in India and for the economy as a whole.
It’s something that’s waiting to happen. Hopefully, obesity and opportunities in that space will create the environment to be able to do that. The first CAR-T in India that got approved came out of IIT. India is a place where there’s an exception to everything. There’s always somebody who can surprise the world very soon. I really hope so, and I think we shouldn’t wait for things to change. If we want to do something, we have to figure out a way of doing it. Everything else is an excuse.
(Edited by Majnu Babu).
