Certainly not GLP-1 drugs, who are now set to go mainstream. As the patent expires, the Indian markets will be flush with low-cost options. But, experts warn, indiscriminate jab-hopping may cost you more than you think
Demi Moore; Elon Musk; Aishwarya Mohanraj is the only influencer who has come on record about using Mounjaro. Pic/Youtube@Aishwarya Mohanraj; James Corden; Serena Williams: These celebrities have been known to use semaglutide drugs for weight loss. Pics/Getty Images
To say that you’re on Ozempic had become a bit of a flex, as was the “Ozempic face” — markers of the fact that one could shell out Rs 24,000 a month to access the weight loss drug once only available abroad. But with Novo Nordisk’s patent on semaglutide — the active ingredient in Ozempic or Mounjaro-like drugs — expiring in India on March 20, dozens of generic versions are now set to flood the market at a fraction of the cost.
While making a life-saving drug like semaglutide more affordable feels like a win for equitable healthcare, it has also raised questions over the manufacturing quality of the drug and another equally important aspect — storage.
Pic/iStock
There is no doubt that the drug is life-saving for those whose bodies are being ravaged by obesity and diabetes, but we also have to consider the potential for misuse. According to a Lancet study published in August 2025, India has the second-largest population of overweight and obese adults in the world (18 crore), surpassed only by China (40 crore).
The bigger concern, though, is the temptation the drug poses to those who see it as a shortcut to feed their obsession with being skinny, or as a way to tackle their body dysmorphia.
Self-administration is huge concern in the medical community. Representational pic/Getty Images
It’s a classic “too much of a good thing” scenario. Doctors now fear that there aren’t enough barriers to prevent abuse of the drug without medical supervision. In a statement on March 24, the Ministry of Health and Family Welfare announced that the drug can only be prescribed by an endocrinologist, an internal medicine specialist, and for some indications by cardiologists. In the same statement, the ministry, too, warned of misuse. It stated, “With the recent introduction of multiple generic variants of GLP-1-based weight loss drugs [such as semaglutide] in the Indian market, concerns have emerged regarding their on-demand availability through retail pharmacies, online platforms, wholesalers, and wellness clinics. These drugs, when used without proper medical supervision, may lead to serious adverse effects and related health risks.”
While a prescription is mandatory, there are concerns of loose oversight on the retail end of the chain, which has been known to allow antibiotic and painkiller abuse in India. Which basically translates to people having complete control over — or lack of it — on when and how much of the drugs to self-administer.
Rs 1200
Average monthly cost of the generic versions of the drug
18crore
No. of obese people in India *Lancet, 2025
The need of doctor intervention
Patient A, 57, Diabetic, Male
“I was recommended to take a five-injection course of Mounjaro when I was hospitalised for spine surgery last year [to drop blood sugar levels to make post-op recovery smoother]. I’m diabetic, but since my blood sugar readings were good, the physician did not recommend a stronger dose.
I was discharged and started the injections on a weekly basis. My average blood sugar reading had reduced from 6.8 to 6.1, which was quite remarkable.
However, I endured aftereffects such as extreme weakness and constipation. Now, this need not be attributed to Mounjaro. It could have been the medication given to me post-surgery.
Amid my spine issue, I was also suffering from a urinary tract infection. When it got worse, I visited a urologist who is a family friend of a close friend. When I asked for his opinion on Mounjaro, he swung his head side to side [indicating ‘No’].
I stopped at four injections. At the back of my mind, I feel that maybe I should give it a shot — pun not intended — again.”
Two red flags: No data collection, no monitoring
“Right now, everyone is talking about Mounjaro or Wegovy [another semaglutide injectable that delivers a higher dosage than Ozempic],” says Dr Sanjay Borude, Dr Sanjay Borude, Senior Consultant Bariatric Surgeon, S L Raheja Hospital.
After the patent expiry, doctors like Borude are seeing an influx of drugs that they can prescribe. “There are 19-20 companies that have jumped into the fray. To the extent that the cost of semaglutide-based drugs, which used to cost R17,000 to 24,000 per month, has now dropped to merely R1200 per month,”
he adds.
Most of Dr Borude’s patients, though, have erred on the side of caution, “Patients are doubting the quality; they are asking, ‘How can it be so cheap?’ People are being cautious for now,” he says.
Sanjay Borude
A problem he flags is data collection of patients on the drug — so far, that was done by the doctor administering the treatment. “If the chemist sells the drug directly to a customer, then we will not have the data unless the patient comes back for follow-up. Things like, how many patients have continued the treatment for three months or more? How many just stopped it because of the cost or side effects? If the doctors don’t monitor people on this medication, we will be clueless, and then pharmaceutical companies can pretty much claim any kind of success rate,” he adds.
When we ask if patients have reacted badly to the drug, he responds: “Yes, many times, things like, indigestion, bloating and nausea, while a few are unhappy with the resutls and others about the high cost.”
He also points out that many do not reveal they are on drugs from doctors when undergoing surgery. “If a patient doesn’t disclose it to their anaesthesiologist, there are critical complications that have happened. Patients have vomited after being administered anaesthesia, delaying the operation, and some have even lost their lives,” he adds.
The concern is that getting presription for the drugs won’t be difficult anymore. Representational pic/iStock
‘Couldn’t take it’
Patient B, 46, Borderline diabetic, Female
Neha Singh (name changed), a resident of Mumbai, says she went off Mounjaro after three weeks because of the continuous and vicious cycle of diarrhoea, vomiting, and constipation. “It was crazy, I was puking, having diarrhoea or I would be constipated,” says Singh who started the drug in January on a prescription from her aesthetician.
“I was seeing so many of my friends, including my aesthetician, who were on the drug and benefiting from it. To be honest, I got a little FOMO [fear of missing out],” she adds.
Singh has been trying to lose weight for the last five years with no success. “I tried Mounjaro, but could only take it for three weeks. By the fourth week, I told my aesthetician about my bad reaction, and she said, ‘It doesn’t suit everyone, so let’s take you off it’. I now feel I should have gone to an endocrinologist before taking it,” she says.
“Many of my friends who are on it via an endocrinologist told me I went about it the wrong way so I actually get the fear people have right now,” she adds. “It took all of February to restore my gut health. I might go to a proper doctor in a few months,” she says finally.
It’s not for influencers to recommend
Dr Muffazal Lakdawala, Director in General & Minimal Access Surgery, Sir HN Reliance Foundation Hospital
Many doctors like Dr Muffazal Lakdawala are not handing out any prescriptions for the new drugs yet. “It’s too early to say as to which drug to prescribe and which not to,” he says.
“I just hope that the quality of all the generic drugs is very strictly regulated by the government so that we have no issue as to which drug is safe to prescribe. Some of these drugs have to be maintained at a very clear profile in terms of the cold chain,” he adds.
Dr Muffazal Lakdawala
“These are life-saving drugs,” he asserts, “This is probably the best chain of drugs we have had in 50 years to treat persistent diseases like obesity and type 2 diabetes.”
“But the big problem is the widespread social media messaging on the benefits of this drug. Most social media influencers are giving their take on it despite not being doctors. We need to bring in regulations like other countries [such as China], where you cannot give your opinion on a drug or even say something like ‘it worked for me’ unless you have the qualification to do so,” he adds.
Even before the patent expiry, doctors like him would get calls and messages from people who had started the drug without supervision. “We have also had people who will say, “We are getting this drug. We just want to know what dose to take.” Without me knowing the patient’s history, I have no way to know if they actually need it. So I refuse and apologise to them,” he adds.
How can self-administration of the drug harm? “A patient might go straight to the 7.5 mg dose rather than start with 2.5 mg and ramp it up over four weeks. That is why it’s vital that a medical practitioner oversees the prescription of these drugs,” he says. “Without that, you won’t know the signs of complications, like pancreatitis. Or the early blindness that accompanied some cases of Ozempic usage.”
If someone can afford to buy GLP-1 drugs, they can afford to consult a doctor on usage too. “People must understand that by trying to save a little bit of money they’re actually doing themselves much more harm,” he hopes.
Subscribe today by clicking the link and stay updated with the latest news!" Click here!
