India's Weight-Loss Drug Boom Exposes Regulatory Gaps as Semaglutide Patent Expires

An investigation found that prescription-only weight-loss drugs Mounjaro and Wegovy are being sold in India without proper medical oversight, despite regulatory requirements mandating specialist prescriptions. The findings come as semaglutide — the active ingredient in Wegovy and in Ozempic, a diabetes drug widely used off-label for weight loss — is set to go off-patent in India next month.

India is approaching an obesity crisis affecting 25.4 crore people classified as obese, alongside 10.1 crore people living with abnormal blood sugar levels. The arrival of Mounjaro and Wegovy in the country last year triggered surging demand, with Mounjaro, launched in India in March 2025, already becoming the country's top-selling drug.

Mounting evidence suggests that the boom is being fuelled, at least in part, by self-prescription. In a country where even prescription-only medicines are frequently dispensed without scrutiny, the appetite for quick weight-loss solutions appears to be outpacing regulatory oversight.

Prices are expected to drop by as much as 70 percent as domestic manufacturers roll out generic versions of semaglutide. Meanwhile, a pill version of Wegovy has already been launched in the United States, and its entry into the Indian market appears imminent.

An investigation found that even before the anticipated price crash, accessing these high-profile obesity drugs is alarmingly simple. Under Indian drug regulations, no medicine — not even paracetamol — is formally approved for over-the-counter sale. In practice, however, enforcement often tells a different story.

It is common knowledge that customers can walk into a neighbourhood pharmacy and purchase prescription medicines without presenting a doctor's note. The rise of online pharmacy platforms has made the process even more frictionless, placing potent medications just a few clicks away.

The investigation was able to purchase Mounjaro — manufactured by Eli Lilly and containing tirzepatide — from neighbourhood chemists and through an online weight-loss platform without difficulty. Both Mounjaro and its rival Wegovy were procured through two major e-pharmacies, Tata 1mg and Apollo Pharmacy, without undergoing a doctor's consultation or the pre-treatment tests that experts strongly recommend before initiating such therapies.

Indian approval conditions are explicit: Mounjaro and Novo Nordisk's Wegovy are to be dispensed only on the prescription of an endocrinologist or an internal medicine specialist. Both drugs are administered as weekly injections and require medical supervision. Yet the investigation found that they are being sold with few questions asked.

Five pharmacies were approached asking for Mounjaro or Wegovy; four agreed to supply Mounjaro within hours of placing an order and none requested a prescription, suggesting Mounjaro had a better supply chain in reaching the pharmacies. One even offered a 10 percent discount, a practice that appears increasingly common as pharmacies advertise such drugs and compete for customers.

The drug was easily purchased without a doctor's prescription from two pharmacies, after placing the order a few hours before over telephonic calls.

An Ahmedabad-based online platform, Aktive, which advertises a "unique combination of medication and personalised support" on social media platforms, was also tested. By intentionally entering incorrect details and falsely indicating obesity, the drug was immediately offered after payment. A brief call from a customer service representative followed but no consultation with a doctor—specialist or otherwise—took place, though an online prescription by a doctor whose qualification indicated he was a general surgeon followed. The package arrived within hours.

The drugs were also procured from Tata1mg and Apollo Pharmacy following quick calls from people who identified themselves as doctors and dispensed quick prescriptions for exactly the drugs that had already been ordered. All this within hours of placing the order.

The financial barrier is hardly insignificant. A month's starter dose of Mounjaro costs around Rs 13,125, while Wegovy is priced at approximately Rs 10,850. For medicines that are not classified as essential, these are substantial sums.

What is most troubling, however, is not the scale of demand. It is the ease with which such powerful drugs can be obtained. Without stronger oversight, the country risks a surge of patients grappling with the long-term side effects of these powerful therapies.