Abstract:
Purpose: India's semaglutide patent expired in March 2026, prompting entry of over 40 domestic generic manufacturers and a reduction in monthly treatment costs from ?10,000–16,000 to under ?2,000. Despite widespread clinical adoption, no independent post-marketing data exist for any Indian generic semaglutide formulation. This study reports the first real-world effectiveness and tolerability evidence for Indian generic semaglutide delivered through a nationally deployed physician-supervised telehealth programme.
Patients and Methods: We conducted a retrospective observational study using electronic medical records from the WeightWise programme (Tata 1mg Healthcare Solutions Pvt. Ltd., New Delhi), between March and May 2026. Fifty adults with obesity (BMI ≥27 kg/m²) initiating Indian generic semaglutide were identified; one was excluded because semaglutide had been prescribed for glycaemic management in type 2 diabetes with BMI below the obesity threshold(BMI 23.67 kg/m²). The final analytic cohort comprised 49 patients. The primary outcome was percentage body weight change from baseline to last recorded follow-up. Secondary outcomes included proportions achieving ≥5% and ≥3% weight loss, weight-loss rate (kg/week), gastrointestinal adverse-event profile with severity grading, and treatment discontinuation rate.
Results: The cohort had a mean age of 38.5 ± 9.3 years; 57% were male. Mean baseline BMI was 34.6 ± 5.2 kg/m² and mean baseline weight was 96.6 ± 18.0 kg. Mean treatment duration was 3.9 ± 1.7 weeks. Mean body weight decreased by 2.94% ± 2.16% from baseline (95% CI: −3.54% to −2.34%; p<0.001), corresponding to an absolute weight reduction of 2.79 ± 2.22 kg (95% CI: −3.42 to −2.15 kg; p<0.001). Mean weight-loss rate was 0.78 ± 0.78 kg/week. Forty-seven of 49 patients (96%) achieved measurable weight loss. Fifty-three percent achieved ≥3% weight loss and 14% achieved the clinically significant ≥5% benchmark. A dose-duration response was observed, with patients treated for ≥6 weeks achieving 4.50% mean weight loss compared with 2.12% among those treated for ≤3 weeks. Gastrointestinal adverse events occurred in 27% of patients, most commonly dyspepsia (12%); 77% of affected patients reported only mild symptoms. Two patients (4%) discontinued treatment. Four Indian generic formulations were represented: SEMANEXT (51%), SEMAGLYN (39%), SEMBOLIC (8%), and SEMATRINITY (2%).
Conclusion: Indian generic semaglutide produced statistically significant and clinically meaningful weight reduction in 96% of patients over a mean treatment duration of 3.9 weeks, with a favourable tolerability profile and low discontinuation rate. These findings constitute the first independent post-marketing evidence for Indian generic semaglutide and support the viability of physician-supervised national telehealth as a scalable GLP-1 delivery model. Larger prospective studies with longer follow-up and formal formulation comparisons are warranted.
