Cheaper weight-loss drugs may come with diet plans, follow-ups

As semaglutide’s patent expires today, the entry of generics is set to nearly halve treatment costs, opening up injectable anti-obesity treatment. But pharma firms, trying to stand out in a crowded room, are looking beyond simple price cuts, eyeing an entire weight-loss ecosystem. This could include counselling and clinic partnerships.If you are looking to start your weight-loss journey via a ‘magic shot’, you are in luck. Your doctor’s prescription may soon come with more than just an injection. You may also get additional support, including diet plans, derma consults, regular follow-ups and access to specialised obesity clinics.This ‘broad-base’ shift is expected from Friday (March 20), the day Danish firm Novo Nordisk’s patent on semaglutide — the key ingredient in ‘blockbuster’ weight-loss drugs, better known through the brand names Ozempic and Wegovy — expires. This is expected to open up the market to affordable, generic versions, bringing the treatment of injectable diabetes and weight loss within reach of the middleand upper-middle classes.With prices expected to fall sharply in the coming weeks, domestic drugmakers are positioning these therapies for a bigger patient base and, for the first time, building structured care models around them.The therapy cost offered by the innovators ranges between Rs 11,000 and Rs 16,400 a month. Now, with the entry of generic alternatives, analysts and experts expect the price of the jabs to roughly halve: to around Rs 3,500 to Rs 4,000 a month for the starting dose priced at Rs 8,800.Standing Out In A CrowdRarely has a therapy generated as much buzz in India’s pharma market as the anti-obesity segment, driven by Ozempic and Wegovy.With over 50 brands entering the anti-obesity and diabetes market soon — many carrying the ‘sema’ suffix — standing out could be a challenge in what is set to become a highly competitive space.The answer, for most new entrants, is to go beyond price competition — and build an integrated ecosystem around treatment, combining medical supervision, nutrition programmes, wellness services and clinic partnerships, signalling a shift from standalone prescriptions to a “managedcare” model.This marks a significant departure from the trend seen with previous blockbuster patent expiries in India, where the story ended at just price-tag cuts.“The real differentiator will be the ability to turn a widely available molecule into a trusted treatment experience for doctors and patients,” says Hari Natarajan, founder of Pronto Consult, a market research firm. “For decades, diabetes and obesity have been managed in fragments, and semaglutide represents a shift towards integrated outcomes — where glycaemic control, weight management, and cardiovascular risk reduction are addressed together.”Access And DeliveryThis ‘integrated approach’ to treatment takes on added urgency, given the sheer scale of requirement.With over 100 million people suffering from diabetes and around 135 million with obesity in India, improving early diagnosis, screening and access to evidencebased care is critical, say experts.Even innovator companies are recalibrating their India strategy around access. US firm Eli Lilly, which markets the top-selling tirzepatide injection Mounjaro for weight management and type 2 diabetes, is collaborating with govts, healthcare providers and medical associations to enhance clinical capabilities and support early diagnosis, according to Winselow Tucker, the president and general manager of Eli Lilly India.Some of these partnerships include those with Apollo Clinic, Apollo HealthCo (Apollo 24|7), and the Association of Physicians of India.A layer of supervision also becomes important for patients, who may need education around appropriate usage, monitoring protocols and long-term treatment goals.Unlike a pill, semaglutide is injected subcutaneously — administered under the skin — similar to insulin. And even the seemingly simple task of using the pen device correctly requires proper patient-training.Industry insiders say that many of the ‘treatment ecosystem’ services could be offered at the shots’ points of sale, or through digital platforms, along with clear guidance on usage and potential side-effects, supported by tele-counselling.Building An EcosystemSeveral specialised obesity and metabolic clinics — with doctorsupervised weight management — have started opening up in cities like Delhi and Mumbai.Globally, too, semaglutidebased programmes are built around integrated care models that combine drug therapy with nutrition counselling, lifestyle coaching and long-term patientsupport systems.“In the near term, deeper partnerships between pharmaceutical companies, consumer health players, and digital platforms are expected to play a role in improving access beyond major urban centres,” says Bhanu Prakash Kalmath S J, healthcare industry leader, Grant Thornton Bharat.The therapy needs to be monitored and tracked with regular follow-ups to assess response, manage side effects, make dose adjustments and mitigate the impact of rapid weight loss on overall nutritional balance, particularly protein, say industry experts.“Obesity treatment is not just about the medicine. It is about building a complete ecosystem around the patient. Through partnerships with healthcare providers, we are enabling a holistic, 360-degree care model that integrates physician support with diet and nutrition counselling, including capacity-building initiatives like obesity clinics,” says Novo Nordisk India MD Vikrant Shrotriya. “These patient-centric initiatives are helping improve adherence and retention to therapy, which are important in ensuring better health outcomes.”Novo Nordisk has tied up An ICMR survey (2008-2020) found % of over-20 people suffering from with health tech companies — such as TATA 1MG and HealthifyMe — to offer health, nutrition and lifestyle-coaching.Similarly, Zydus LifeSciences is launching an indigenously developed reusable single-pen device that accommodates multiple dose strengths from one unit, aimed at improving convenience and adherence. The company is also working on a broader support package that includes nutrition counselling and dermatology services.Several other domestic majors are expected to announce similar partnerships over the next few weeks.Market ExpansionBeyond metros, companies with strong field force and distribution networks in metabolic therapies — including Sun Pharma, Abbott and Torrent — are targeting tier-2 cities and smaller towns, where improved access and affordability could unlock the next wave of patients.Firms that have not developed indigenous versions have struck distribution partnerships with generic manufacturers or innovators to gain a foothold in the high-growth, about Rs 1,500-crore market, according to a report brought out in Feb by Pharmatrac, a pharmaceutical market research company.But wider access also brings wider responsibility.Doctors caution that while these therapies are effective, they can cause side effects such as nausea, vomiting and gastrointestinal discomfort and, in some cases, more serious complications like pancreatitis or gallbladder issues.This underscores the risks of misuse or unsupervised use, even as access expands.“Lower-priced generic options could expand access for many patients,” says Dr Anoop Misra, chairman of Delhi-based Fortis C-DOC. “However, quality and reliability remain critical. In metros, nearly 15-20% of eligible patients have not started therapy mainly due to high costs; in smaller towns, this could be as high as 50%.”Prescribers — doctors and other health professionals — may need a clear understanding of dosing protocols, contraindications and long-term management, even as patients need to be coached on correct usage, lifestyle alignment and adherence.As the market opens up, the real measure of success will not be how many brands enter, but how effectively companies create value beyond the vial — turning a widely available therapy into a trusted treatment experience.