The promise and perils of weight loss drugs
Doctors have warned of the risk of overuse and misuse, cautioning that patients will see such medications as an easy, quick fix, without tougher lifestyle changes
Novo Nordisk’s much-awaited launch of Wegovy on June 24 provides patients in India with one more choice when it comes to weight management solutions. But while Wegovy scores on ease of administration, it remains too pricey for most Indian patients.
There has been some attempt to make Wegovy more price competitive while addressing patient pain points. After all, Novo Nordisk had a few months to observe how the market responded to the launch of Eli Lilly’s Mounjaro.
Since its launch this March, Mounjaro has mopped up sales of INR 520 million as of May 2025. As per a company statement, Wegovy comes with an Indiaspecific price, with the first three dosing strengths (0.25 mg, 0.5 mg, 1 mg,) priced at Rs 17345 for four weekly doses, the 1.7 mg dose at Rs 24,280 per month, and the 2.4 mg dose at Rs 26,015 per month. This is apparently to support dosage adjustment in the initial three weeks without additional financial impact.
Novo Nordisk’s strategy to offer Wegovy in an easyto-use pen device across five dosing strengths makes it a self-administered medication, a huge advantage over medication that needs a doctor’s visit and possible needle-phobia incidents.
Eli Lilly’s Mounjaro starts with the 2.5 mg single dose vial available at Rs 3,500 and the 5 mg singledose vial at Rs 4,375, taking the monthly cost to between Rs 14,000 to Rs 17,500.
However, the two drugs are not directly comparable in terms of dosage levels. The dosage levels for Mounjaro start at a much higher range, of 2.5mg going up to 15mg, which is significantly higher than the typical dosage for Wegovy which starts at 0.25mg.
Of course, both medications have slightly different indications so it’s not an -apples to apples comparison. While Wegovy claims to be the first and only weight management medication indicated for both chronic weight management and risk reduction in major cardiovascular events like stroke, heart attack and cardiovascular disease-related death in overweight adults, Mounjaro claims to increase insulin secretion in response to food intake and improve glucose control and weight loss.
Eli Lilly claims that Mounjaro (tirzepatide) showed superior weight loss over Wegovy (semaglutide), citing results from the complete SURMOUNT-5 results published in The New England Journal of Medicine. For the primary endpoint, participants treated with tirzepatide achieved an average weight reduction of 20.2 per cent (an average of 22.8 kg) compared to 13.7 per cent (an average of 15.0 kg) with semaglutide at 72 weeks using treatment-regimen estimand, a 47 per cent greater relative weight loss.
Wegovy’s principal ingredient semaglutide is set to go off patent in India in March 2026, opening the door to generic semaglutide. Once generic versions hit the market, analysts are predicting up to a 50 per cent crash in prices. Novo Nordisk intends to protect its turf, as observed in the case filed against OneSource Specialty Pharma and Dr Reddy’s Laboratories. The latter’s patent challenge to one of semaglutide’s patents set to expire in March 2026 is being closely watched. The case could set a precedent, with more contenders preparing their legal strategies and ready to launch as soon as the patents expire.
But what’s more promising than injectable weight loss drugs are oral tablets in the clinical research pipeline. These oral formulations also hold the promise of being more affordable than injectables, though the latter prove to be more efficient in terms of weight loss.
As pharma companies battle it out for a slice of India’s weight management pie, companies will have to choose their strategies: collaborate to increase volumes or remain a premium player, focusing on the top of the pyramid.
While this battle will be an interesting chase, it has serious implications for the millions of Indians who struggle with weight loss and diabetes. Doctors have warned of the risk of overuse and misuse, cautioning that patients will see such medications as an easy quick fix, without tougher lifestyle changes. Eye surgeons are already citing the European Medicines Agency’s safety committee warning that up to 1 in 10,000
Patients using semaglutide, the active component of Wegovy, Ozempic, and Rybelsus, for at least a year may develop non-arteritic anterior ischemic optic neuropathy (NAION). Patient awareness and counselling will be as important as writing a prescription or administering these weight loss shots.
Viveka Roychowdury, Editor