Opinion: Semaglutide Is Going Off-Patent in India. But Will People Who Need It Be Able to Get It?

Why It Matters

Affordable semaglutide could dramatically improve cardiovascular prevention in India, yet BMI‑based restrictions threaten to limit those public‑health benefits.

Key Takeaways

• Patent expires March 24, 2026 in India
• Generic semaglutide could cut prices up to 90%
• 20% cardiovascular risk reduction proven for GLP‑1 drugs
• Access may be limited by BMI‑based eligibility
• One billion Indians could face treatment barriers

Pulse Analysis

The imminent expiry of semaglutide’s Indian patent marks a pivotal moment for the country’s pharmaceutical landscape. As the active ingredient behind Ozempic and Wegovy, semaglutide belongs to the GLP‑1 class that has reshaped diabetes care and, more recently, cardiovascular risk management. Generic manufacturers are poised to enter the market, potentially driving retail prices down by as much as ninety percent. This price compression could make a drug that reduces heart‑attack and stroke risk by one‑fifth accessible to a far broader segment of the population, aligning with India’s broader goals of expanding affordable chronic‑disease therapies.

Despite the price promise, Indian health authorities are linking reimbursement to body‑mass‑index (BMI) cut‑offs, effectively restricting coverage to patients classified as overweight or obese. Critics argue that BMI, a metric derived from Western cohorts, fails to capture the nuanced risk profiles of South Asian individuals, who often experience metabolic disease at lower body weights. By anchoring access to an arguably inappropriate measure, policymakers risk sidelining a substantial pool of patients—particularly older adults with normal BMI but elevated cardiovascular risk—who could benefit most from semaglutide’s protective effects.

The Indian case underscores a broader tension between drug affordability and eligibility criteria worldwide. While patent cliffs can unleash cost‑saving opportunities, the ultimate impact hinges on regulatory frameworks that determine who receives treatment. Countries grappling with rising non‑communicable disease burdens may need to rethink BMI‑centric policies in favor of risk‑based algorithms that reflect local epidemiology. If India adjusts its approach, it could set a precedent for more inclusive access models, encouraging other emerging markets to balance cost containment with equitable health outcomes.