HYDERABAD, India: With generic rivals waiting in the wings, Eli Lilly and Novo Nordisk are intensifying efforts to lock in market share in India's rapidly expanding obesity drug market, turning pricing, promotion, and partnerships into key competitive weapons.

The two global drugmakers are racing to strengthen their positions before lower-cost copies begin arriving as early as March next year. Novo has leaned heavily on price cuts and faster launches, while Lilly has benefited from earlier access to its drug. Both have stepped up doctor outreach, obesity-awareness campaigns, clinic tie-ups, patient incentives, and local distribution deals, according to doctors, analysts, medical representatives, patients, and distributors.

Lilly has even enlisted Bollywood actors for social media campaigns aimed at increasing awareness of obesity.

India, expected to have the world's second-largest overweight or obese population by 2050 in absolute numbers, is emerging as a critical battleground. Analysts estimate the global obesity drug market could reach US$150 billion annually by the end of the decade.

While the United States remains the largest market, early sales data show strong uptake in India, despite most patients paying out of pocket.

"We believe that this market can be more than $1 billion within two years," said Shrikant Akolkar, vice president at Nuvama Institutional Equities.

Pharmarack estimates the Indian obesity drug market is currently worth 6.28 billion rupees ($70.23 million), a fivefold increase since 2021.

Lilly's Mounjaro, approved in India for diabetes and weight loss, became the top-selling therapy by value in October. Sales doubled within months of its March launch, overtaking Novo's Wegovy, which entered the market in June.

"We realized just after a couple of months that for accessibility, we had to take a price cut," said Vikrant Shrotriya, Novo Nordisk's managing director in India, referring to Wegovy's November price reduction. He spoke earlier this month at the launch of Ozempic in India.

Ozempic, approved by U.S. regulators in 2017 for Type 2 diabetes, became a global bestseller and is widely used off-label for weight loss.

More than 20 Indian drugmakers — including Dr Reddy's, Cipla, Sun Pharma, Zydus, and Lupin — plan to launch cheaper versions of semaglutide once Novo's patent expires in March 2026. Analysts expect generics to be about 60 percent cheaper, intensifying pressure on Novo in India's price-sensitive market.

Shrotriya downplayed patent concerns, saying Novo would focus on quality, trust, and affordability rather than competition.

Mounjaro has gained rapid traction. A 2.5 mg monthly pack costs about Rs. 13,125 ($146.79), rising to Rs. 25,781 ($288.33) for the highest dose.

Novo responded by cutting Wegovy prices by up to 37 percent in November and launching Ozempic at Rs. 8,800 ($98.42) per month for the lowest dose.

While Wegovy is catching up, Mounjaro's early entry and claims of greater weight loss give it an edge, five doctors told Reuters.

"Mounjaro clearly has a first-strike advantage and continues to have strong demand, but price-sensitive patients are reassessing alternatives," said Dr. Anoop Misra of Fortis C-DOC Hospital.

Lilly faces no immediate need to cut prices, said analyst Vishal Manchanda, citing more extended patent protection for tirzepatide. Lilly said demand has been "highly encouraging."

Both companies are pushing into smaller towns as demand spreads beyond urban elites.

Lilly has partnered with Cipla to launch a second tirzepatide brand, Yurpeak, and teamed up with Apollo Hospitals. It is also investing more than $1 billion to expand contract manufacturing in India.

Novo has partnered with Emcure Pharmaceuticals, launched a second brand, Poviztra, and teamed with Healthify and Apollo Hospitals to broaden reach and awareness.

With prescription advertising banned in India, both companies are relying on education campaigns to frame obesity as a disease, a strategy that could determine who prevails as generics loom.