Insight Focus
Semaglutide comes off patent in India in January 2026. From then on, generic drug companies can start to sell biosimilar products. This could increase the availability of weight loss drugs and bring down costs, which could have a major impact on Indian sugar consumption.
Cost is a Major Barrier to GLP-1 Drug Uptake
Semaglutide has revolutionised obesity and diabetes treatment. Better known by its brand names Ozmepic and Wegovy, its sales growth at one point made Novo Nordisk the most valuable company in Europe.
However, semaglutide starts to come off patent in several countries in early 2026, including India, which is both the world’s largest sugar consumer and also home to approximately 135 million pre-diabetic adults. This is significant because it opens the possibility of generic drug manufacturers making biosimilar semaglutide. Greater availability could then lead to lower costs.
The largest markets for GLP-1 weight loss drugs like Ozempic and Zepbound today are the world’s richest countries. The US alone accounts for well over half of global GLP-1 sales, given that North America represents about 77% of worldwide GLP-1 revenues and the US makes up the lion’s share of that market.
As with any new drug, affordability is a major barrier to uptake. The median income in India is around INR 27,300/month, or USD 320. The list price of Wegovy (Ozempic for weight loss, not diabetes) is INR 16,400 per month. At 60% of income, semaglutide is unaffordable for most Indians.
By contrast, the median American worker earns USD 5,020 a month and while Wegovy’s list price is USD 1,349 per month (27% of income), recent price cuts mean the drug can be accessed for as little as USD 350 per month (7% of income).
Make in India
India is home to some of the world’s largest generic drug manufacturing companies. Already, some of these companies have announced they are preparing generic semaglutide for when the patent expires.
For example, Dr Reddy’s Laboratories is seeking to launch biosimilar semaglutide not just in India, but across 87 different countries as patents expire. Indian company Biocon has already agreed a semaglutide licensing and supply deal in Brazil with Biomm SA.
If generic semaglutide increases availability, this should lower costs. We have seen estimates that semaglutide may only cost around USD 10 to make a monthly dose. For other drugs, the arrival of generics has typically led to prices falling by 60-70%. This level of price decrease suggests semaglutide could ultimately retail for INR 5,000. This remains expensive at 18% of median income but also puts GLP-1 drugs within reach of India’s middle class.
India’s Role in Global Sugar Consumption
This is significant because India is the world’s largest sugar-consuming country in absolute terms, at around 29 million tonnes a year. This equates to just a little less than 20kg per person per year, close to the global average but a little below levels seen in countries like the UK (25-30kg per person per year).
However, these average figures are likely to hide significant disparities in consumption between affluent urban middle classes for whom packaged food is easy to find and purchase, and the rural population in non-sugar producing states. Even modest uptake of GLP-1 drugs among India’s middle class could lead to unexpected changes with implications for the world’s sugar markets.
For some kind of comparison, we can look at the US, by far the world’s largest semaglutide market. We estimate at least 5% of the adult population are using GLP-1 drugs in America at any given time. Since the growth of using semaglutide for weight loss started in the early 2020s, the USDA has noted falling deliveries of sugar for human consumption since GLP-1 drugs became mainstream. For the first time since 2010, the American obesity rate has started to fall. At CZ, we have also tapered our forecast for American sugar consumption because of the drugs.
Source: Gallup
A similar scenario could have far-reaching effects on Indian sugar consumption. Just a 1% absolute decline in sugar consumption would result in around 280k tonnes more sugar being available each year. Indian mills already typically make excess sugar. In the 2010s, this excess was exported to the world market with subsidy support from the government. This was a major factor in the prolonged bear market in sugar in this time.
In recent years, the Indian government has recognised that sugar subsidised exports are not sustainable and has worked closely with the Brazilian authorities to develop a domestic ethanol program using cane as a feedstock. At first this successfully reduced the local sugar surplus, but today most ethanol is made from grains and the Indian sugar market looks oversupplied once more. Sugar exports are not viable at today’s prices. Lower consumption growth could make this trend worse and put heavy pressure on the local milling sector.
When considering soft drinks, usually the largest sugar-containing category, India’s consumption is climbing from a low base, while the UK has shed a huge amount of per capita sugar and the US has flattened, as it’s HFCS-heavy. The small increase in India almost certainly comes from its growing urban middle class, the part of the population with the greatest access to packaged food.
Some analysts assume that as India urbanises and incomes rise, per capita consumption must climb too. But the data tells a different story.
Over the last decade, India’s population has grown by almost 10% and it’s GDP has grown by roughly 55%. Yet, growth of per capita sugar consumption has been relatively flat (2.85% in the same period). This suggests that rising living standards do not necessarily translate into proportionally larger sugar consumption, and if GLP-1s can gain as much traction in India as they have in the US – we could see growth slowing in even more.
