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Obesity is a chronic disease. That recognition has changed treatment, policy and investment around the world. This change is driven by GLP-1 medicines that deliver clinically meaningful results in weight management, diabetes control and cardiovascular risk reduction. Demand is rising and patents are expiring. The next chapter of the story is about protecting patient trust.
Why GLP-1 Revolution is Transforming Care
Obesity affects more than 1 billion people worldwide. The scale of the disease burden has forced health systems to make obesity a medical priority. GLP-1 therapies remain at the heart of this response because their clinical benefits extend beyond weight loss and management of type 2 diabetes to reduction in cardiovascular risk. Now physicians have a single therapeutic class that targets multiple interrelated conditions.
Governments and health systems have noticed. Medicaid prescriptions for FDA-approved GLP-1 obesity drugs increased 546% from 2019 to 2024, a pace that demonstrates how rapidly this class has become mainstream. Market analysts anticipate the global GLP-1 market to cross US$ 190 billion by 2035. These figures attract manufacturers, investors and regulators and prepare the ground for rapid structural change across the market.
The next stage: Innovation meets competition
IQVIA views 2026 as a key year, as patents on semaglutide start to expire in markets such as India. Generic and follow-on manufacturers get to enter the market when patents expire. Broader competition in manufacturing will lower the price and make it affordable for populations that are currently priced out.
Brazil has already demonstrated what this transition looks like in practice, with five new injectable semaglutide products approved after the patent expired. That approval shows just how fast markets can expand when exclusivity barriers are removed. India stands at a similar crossroads, with a real opportunity to become a trusted center of innovation in manufacturing and formulation. The country's existing pharmaceutical infrastructure is well-placed to scale up production while meeting the quality benchmarks that patients and regulators demand.
When Trust Is Broken
More access is both a risk and an opportunity. Counterfeit and falsified GLP-1 products have been detected in several markets, with the US FDA issuing warnings to consumers and health care providers regarding fraudulent compounded GLP-1 medicines and counterfeit formulations. Pharmacovigilance studies have identified safety problems directly related to counterfeit semaglutide, demonstrating how quickly a therapeutic breakthrough can become a public health liability when quality assurance breaks down.
The problem is compounded by an unregulated online marketplace where patients are exposed to products of unverifiable source and composition. Poor quality copycat formulations further expose patients, especially in markets where the enforcement infrastructure is unable to keep pace with demand. Misleading marketing and hyperbolic claims distort patient expectations. Social media hype is increasingly supplanting evidence-based medical advice. Accurate dosing and clinical supervision are core to this therapeutic class, making self-medication and inappropriate prescribing additional risks.
Safeguarding Trust: A Collective Obligation
In the GLP-1 era, safeguarding trust requires collective action from all supply chain players. Regulators need to enforce higher quality standards, active surveillance and strong pharmacovigilance systems that can identify counterfeit or substandard products before they get to patients. Pharma companies need to commit to ethical marketing, transparent claims and continued investment in research that expands the evidence base.
Healthcare professionals are obliged to provide evidence based prescribing and patient education and to base their treatment decisions on clinical judgment. Digital pharmacies and health care platforms need to establish secure, authenticated supply chains to help close the gaps that counterfeiters are exploiting. There's also the weight of the media coverage, which provides public awareness along with the communication based on scientific evidence.
The Opportunity for India
India's base of pharmaceutical manufacturing gives it a real leg up as the GLP-1 market opens up to competition. The country has decades of experience in producing high-volume, quality-assured medicines for both domestic and export markets. That foundation provides a direct path to be a global leader in affordable, high-quality GLP-1 therapies based on rigorous manufacturing standards.
Whether India takes full advantage of this opportunity depends on maintaining world-class quality with affordability. Success there would enhance India's image as a reliable provider of sophisticated treatments, adding a track record developed in other therapy areas to one of the fastest-growing segments of the global pharmaceutical market.
The GLP-1 era is a new chapter in the management of chronic disease and has the potential to change the health outcomes of more than a billion people living with obesity. This revolution was started by innovation. Maintaining patient trust is about safeguarding it throughout the supply chain. As access improves through increased competition, the responsibility going forward is clear: all patients deserve scientifically proven, quality, integrity and robustly regulated therapies.
(By Dr. Sabine Kapasi, Global Health Strategist and a UN Advisor)
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