As $2 bn legal storm brews, can India be Novo Nordisk’s safe haven?

While expanding its footprint in India for its diabetes and weight-loss drugs, Danish pharmaceutical giant Novo Nordisk could face potential legal liabilities of nearly $2 billion in the US, with more than 1,800 lawsuits consolidated in federal court in Pennsylvania and new claims emerging weekly, according to several US-based law firms.

Ozempic, Wegovy, and the Safety Debate

Plaintiffs allege the company failed to provide adequate warnings about severe side effects linked to its blockbuster GLP-1 drugs, including Ozempic, Wegovy, and Rybelsus. Reported complications range from stomach paralysis (gastroparesis) and intestinal blockages to persistent vomiting, gallbladder inflammation, vision loss, and pancreatitis. The first suit was filed in August 2023, and consolidated proceedings began in February 2024. Evidence cited in court filings includes a 2023 JAMA Internal Medicine study linking GLP-1 drugs to gastroparesis, ophthalmologists’ reports of vision loss, and thousands of gastrointestinal and eye-related complaints logged in the FDA’s adverse event database.

The litigation is currently in the discovery phase, with bellwether trials scheduled for early 2026. These trials, testing representative cases, could shape the course of any potential settlement.

Legal experts say that if plaintiffs prevail in early trials, Novo Nordisk may face pressure to negotiate a global settlement. Meanwhile, new claims continue to emerge, ranging from hair loss to kidney injury and emotional distress, further widening the scope of litigation.

For FY25, Novo Nordisk reported revenue of $38.7 billion, with GLP-1-based therapies forming the largest share. The US remains its biggest market, driving demand for both diabetes and obesity treatments. While these drugs have transformed the weight-loss market and powered record growth, analysts caution that the scale of litigation highlights rising scrutiny and poses a significant risk to the company’s long-term outlook.

Industry observers warn that one of the largest pharmaceutical litigations in history is now unfolding, with financial stakes potentially running into tens of billions of dollars. “The money at stake may be enormous,” said pharmaceutical analyst Salil Kallianpur. “The eventual payout will depend on the number of valid claims, the strength of scientific evidence, and any internal documents that emerge in discovery. Early trial verdicts will also be decisive.”

India’s Appetite for Wegovy Grows

In India, unlike the US and Europe, Novo Nordisk’s obesity drug Wegovy and diabetes drug Ozempic are not yet under major legal scrutiny, though experts have raised concerns over indiscriminate use of weight-loss injectables. Medical associations have flagged risks such as gastrointestinal issues, malnutrition from unsupervised use, and the growing trend of online or offshore purchases by consumers.

In June, Novo Nordisk launched the anti-obesity prescription-only drug Wegovy (semaglutide 2.4 mg) in India, introducing the once-weekly injectable treatment at a starting price of Rs 4,336.25 per dose. While semaglutide is also the active ingredient in Ozempic, Novo Nordisk’s popular diabetes drug, Ozempic itself is not yet approved or available in India. The two drugs differ in approved indications and dosage.

As per PharmaTrac, since its launch in India in June 2025, Wegovy has seen rising demand, with cumulative sales of Rs 7.20 crore recorded in its first month, July. This positions it among the top new introductions in the anti-diabetic segment, contributing to the 6.3% growth driven by new products in the category. “Early uptake indicates that the market is responding positively, and Wegovy is beginning to establish itself in India’s obesity and weight-management treatment segment,” said Sheetal Sapale, Vice President at Pharmarack, a pharmaceutical market research company.

Supreme Court advocate Jaikush Hoon highlighted safety concerns over GLP-1 drugs, including Ozempic (semaglutide), Mounjaro (tirzepatide), and Victoza (liraglutide). “It has been observed that doctors are prescribing these drugs alongside Ozempic. These medicines, which have been associated with serious potential adverse consequences in the United States and globally, ought to be subject to strict regulation and limited exceptions in India as well,” Hoon said. He warned that reports of such drugs being available over the counter without prescriptions were a “matter of grave concern,” contravening the Drugs and Cosmetics Act, 1940, and posing significant public health risks in the absence of medical supervision.

A response from Novo Nordisk was awaited until the time of publication.