Novo Nordisk eyes oral Wegovy as semaglutide generics loom

Oral anti-obesity formulations will be the next growth lever in Danish drugmaker Novo Nordisk's India strategy, following the 2025 launches of its blockbuster diabetes and obesity brands Ozempic and Wegovy.

“Oral semaglutide has already been launched in the US. It would be our intention to bring those molecules to India on priority, subject to regulatory approvals,” Vikrant Shrotriya, Managing Director, Novo Nordisk India, told Business Today.

Novo Nordisk already markets Rybelsus, the oral version of semaglutide for Type 2 diabetes, in India. However, its obesity portfolio in the country currently remains injectable. With generics set to enter the injectable segment, the company indicated that the next competitive frontier could move towards oral therapies.

Meanwhile, Rybelsus has received expanded approval in India to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes who are at high cardiovascular risk.

A franchise at stake

Semaglutide has been a key growth driver for Novo Nordisk globally. Ozempic and Wegovy together generated more than $30 billion in global sales in 2024, making GLP-1 therapies the backbone of the company’s recent revenue expansion.

India remains an emerging market for obesity pharmacotherapy, but the rising prevalence of diabetes and obesity presents long-term growth potential. According to the Indian Council of Medical Research, India is home to more than 100 million people living with diabetes, while the National Family Health Survey shows nearly one in four  Indian adults is overweight or obese.

Industry estimates place India’s diabetes drug market at around $1.7 billion (approximately ₹14,000 crore), with GLP-1 therapies forming one of the fastest-growing segments. However, pharmacological treatment for obesity remains underpenetrated, suggesting room for expansion if access improves.

Not chasing a price war

With patent expiry approaching, domestic manufacturers are preparing to launch generic injectable semaglutide. Analysts expect meaningful price erosion once competition intensifies in India’s largely out-of-pocket market.

Sheetal Sapale, Vice President – Commercial at Pharmarack, said generic entry typically leads to sharp pricing adjustments.

“Usually prices come down to one-third to one-fifth of the innovator product. Monthly volumes increase three to five times for the first five to six months and then stabilise,” she said.

Novo Nordisk, however, is not positioning itself for a discount-led battle. “Price is one element. But stakeholders should also look at legacy, product quality and the difference we bring in terms of education and obesity advocacy,” Shrotriya said.

The Indian market remains price-sensitive, but Novo believes brand equity and long-term presence in metabolic care offer resilience. “We are not in a game of chasing the price with generics. We have not done that in insulin, and we will not do that with semaglutide. We will remain competitive, but we will chase our own standards,” he said.

The company has maintained leadership in insulin despite not always being the lowest-priced option and appears intent on following a similar approach in obesity.

Building beyond the molecule

Shrotriya described obesity treatment in India as being at an early stage. “Obesity is just at the start of its journey. There is a long runway ahead not only for our molecule, but for the advocacy and ecosystem we are building around it,” he said.

Novo Nordisk is investing across manufacturing, cold chain infrastructure, distribution reach, doctor education and awareness initiatives. Obesity, he noted, requires more than medication alone. Lifestyle interventions often fail for many patients, while bariatric surgery remains invasive and costly. GLP-1 therapies address what he described as a significant treatment gap between those two extremes.

Beyond semaglutide, Novo Nordisk’s obesity pipeline includes next-generation candidates such as CagriSema and amycretin. Oral formulations are expected to play a larger role in future therapy cycles.

Securing supply

Global demand for GLP-1 therapies has created supply challenges in several markets over the past two years. Novo Nordisk acknowledged initial supply constraints during early launch phases in India but said capacity has since been strengthened. “We are prepared for strong demand growth. We cannot predict exact demand levels, but we are ready,” Shrotriya said.

The drug is a complex biologic rather than a small molecule, requiring advanced manufacturing capabilities and regulatory approvals across markets, he said. The company has invested significantly in API and fill-finish facilities to support global supply.

Meanwhile, domestic drugmakers including Dr Reddy’s Laboratories and Sun Pharma have indicated plans to introduce generic semaglutide following patent expiry, setting the stage for intensified competition in India’s metabolic therapy market.