Powerful weight-loss & diabetes drug Mounjaro arrives in India, but high cost still a hurdle

United States’ pharmaceutical giant Eli Lilly has launched its weight-loss and diabetes drug, Mounjaro, in India. Known chemically as tirzepatide, the once-weekly injectable medication arrives amid soaring global demand and rising concern over obesity-related complications in the country. However, the price point may still make it out of reach for most Indian patients. 

With this launch, Eli Lilly beat rival Novo Nordisk to the Indian market, securing a significant first-mover advantage in one of the world’s largest populations grappling with dual health crises — obesity and type 2 diabetes, according to news agency Reuters. Novo Nordisk sells a similar medicine called semaglutide under the brand names Ozempic and Rybelsus for diabetes and under Wegovy for weight loss.

According to the National Family Health Survey (NFHS)-5 (2019-21), about a quarter of Indian women and men are overweight or obese. As of March 5, 2025, a total of 25.27 million individuals in India are receiving treatment for diabetes.

Mounjaro is priced at Rs 3,500 for a 2.5 mg vial and Rs 4,375 for a 5 mg vial, translating to Rs 17,500 per month for a patient on a 5 mg weekly dose — raising affordability questions in India’s cost-sensitive healthcare market. The prescription-only weekly injectable drug is designed primarily for people with type 2 diabetes or those with obesity and related health issues like hypertension or heart disease.

“It’s not for cosmetic weight loss or shedding a few kilos casually — it’s a potent, medically supervised treatment requiring careful consideration of its purpose and risks,” Dr Anoop Misra, chairman of Fortis C-DOC for Diabetes and Allied Sciences told the newspaper Indian Express.

Tirzepatide mimics two gut hormones — GLP-1 and GIP — to regulate insulin, suppress glucose production in the liver and reduce appetite by slowing digestion. On the other hand, semaglutide activates just one hormone, the GLP-1.

Ozempic’s use for weight loss, while not its intended purpose, grew in popularity in the US due to media coverage, celebrity endorsements and social media trends. 

Tirzepatide could have marginally superior efficacy — one clinical trial, which was sponsored by the pharma giant Eli Lilly, found some patients lost more than 20 per cent of their body weight. Another separate, much larger-scale cohort study of 41,000 people investigated differences in weight loss between patients receiving tirzepatide compared with semaglutide and found that people with overweight or obesity lost more weight with tirzepatide.

However, Dr Misra cautioned that while weight loss outcomes are impressive, side effects and cost remain major barriers, according to the Indian Express report. “Two of them [Misra’s patients] discontinued after a few months due to the high cost. One of these patients also experienced severe vomitting and couldn’t tolerate the drug, leading to early discontinuation,” he said. 

Moreover, a 2023 randomised clinical trial showed that patients who stop taking the drug after six months may regain up to 14 per cent of their lost weight. 

The US Food and Drug Administration (FDA) approved Mounjaro based on extensive trials involving over 7,700 patients with type 2 diabetes across 24 countries, including India. The trials confirmed the drug’s ability to lower HbA1c — a key marker of blood sugar — and produce significant weight loss. 

Despite its promising clinical profile, Mounjaro is not for everyone. According to the US FDA, it is contraindicated in people with type 1 diabetes, severe kidney or liver disease, a history of thyroid cancer, or gastrointestinal conditions. Pregnant women or those planning to conceive are also advised against its use due to insufficient safety data, the Indian Express report said.

Still, for patients with chronic metabolic issues, the benefits could be transformative. Beyond blood sugar control and weight reduction, tirzepatide has shown potential to lower cardiovascular risks, slow kidney disease progression and improve liver health. 

Industry experts say Eli Lilly’s early arrival may help it capture a significant share of the Indian market, though pricing may prove a sticking point. “At the highest dose, a patient will have to spend close to Rs 7 lakh per annum,” Vishal Manchanda, analyst at Systematix Institutional Equities told Reuters.

However, with semaglutide set to go off-patent in India by March 2026, local competitors are expected to launch their own versions, including generics priced 90-95 per cent lower than Mounjaro.