American drugmaker Eli Lilly and Company launched its weight-loss injectable drug Mounjaro in India on Thursday, becoming the first multinational pharma firm to bring a treatment already widely used in Western markets to India, where obesity and associated type-2 diabetes poses a major health burden.
Launched as a once-weekly injection, the drug is priced at ₹4,375 rupees for a 5 mg vial and ₹3,500 rupees for a 2.5 mg vial, its lowest dose, the company said separately.
The drug, which earlier received authorisation from India’s Central Drugs Standard Control Organisation (CDSCO) on June 16, 2024 for import and sales, has demonstrated significant weight-reduction effects in clinical trials. Adults participating in controlled studies lost an average of 21.8 kilogrammes at the highest dose and 15.4 kilogrammes at the lowest dose over 72 weeks when combined with diet and exercise, according to company data.
Mounjaro, known chemically as tirzepatide, has already gained popularity in the US, UK and European markets. Since the CDSCO authorisation, Indian patients had been importing the drug for personal use prior to the India launch, which helps bring the cost. A monthly course of four 2.5mg shots in India, based on the above pricing, comes to about ₹14,000, while in a country such as the UK, it costs ₹23,000 to ₹25,000 when converted to Indian currency.
India faces significant public health challenges related to metabolic disorders. According to various estimates cited by the company, India has approximately 101 million people living with diabetes, with nearly half of adult patients receiving inadequate treatment resulting in suboptimal glycaemic control. Additionally, adult obesity prevalence in India stood at around 6.5% as of 2023, affecting nearly 100 million people.
Obesity is linked to over 200 health complications, including hypertension, dyslipidaemia, coronary heart disease, and obstructive sleep apnoea, and is a major risk factor for diabetes.
“The dual burden of obesity and type 2 diabetes is rapidly emerging as a major public health challenge in India. Lilly is committed to collaborating with the government and industry to promote awareness and improve the prevention and management of these diseases,” said Winselow Tucker, president and general manager of Lilly India.
However, experts emphasise caution regarding the use of such medications. Dr Nikhil Tandon, head of endocrinology at All India Institute of Medical Sciences (AIIMS) in Delhi, warned against unsupervised use of emerging anti-obesity drugs.
“At the moment they are our best bet but these must be taken under strict medical supervision,” Dr Tandon said. “There are clear recommendations for who they work and for who they don’t, especially when talking about weight-loss in non-diabetics. The percentage of people who can tolerate maximum dose is not 100%.”
The drug represents a significant advance in obesity pharmacology by simultaneously targeting two critical hormone pathways in the body.
It activates what is known as glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. These receptors are expressed in key brain regions that regulate appetite. When activated, they create a dual effect that suppresses hunger, reduces food intake, decreases fat mass through appetite regulation, and alters how the body utilises lipids.
According to Eli Lilly’s statement, Mounjaro is indicated as a supplement to reduced-calorie diets and increased physical activity for chronic weight management in adults with specific body mass index (BMI) thresholds.
These include individuals with a BMI of 30 kg/m² or greater (classified as obesity) or 27 kg/m² or greater (classified as overweight) who have at least one weight-related health condition. The drug is also approved for glycaemic control in adults with type 2 diabetes mellitus alongside diet and exercise.
The efficacy of Mounjaro was established through two global clinical programmes: the SURMOUNT-1 trials for chronic weight management and the SURPASS trials for type 2 diabetes.
In the SURMOUNT-1 study, which involved 2,539 adults with obesity or excess weight and weight-related medical problems (excluding diabetes), participants taking Mounjaro alongside diet and exercise experienced substantial weight loss compared to those on placebo at 72 weeks.
At the highest dose of 15 mg, participants lost an average of 21.8 kilogrammes, while at the lowest dose of 5 mg, the average loss was 15.4 kilogrammes. The placebo group lost an average of 3.2 kilogrammes.
“Additionally, one in three patients taking Mounjaro at the highest dose lost over 26.3 kilogrammes (25% of body weight), compared to 1.5% on placebo, according to data not controlled for type 1 error,” the company stated.
For diabetes management, the phase 3 SURPASS programme evaluated Mounjaro’s efficacy at various doses, both alone and in combination with commonly prescribed diabetes medications over 40 weeks. Participants achieved average A1C reductions (an indicator of long-term blood sugar levels) between 1.8% and 2.1% for the 5 mg dose and between 1.7% and 2.4% for both the 10 mg and 15 mg doses.