Study attempts to find out how India made expensive diabetes medicines affordable
India’s low medication prices are tied to its role as a major pharmaceutical exporter, supported by legislation that prevents ‘patent evergreening’ and enables generic drug manufacturing, says a study by diabetologists
A recent study by diabetologists from Chennai explored the reasons behind India's success in making expensive diabetes medications more affordable, with the aim of providing insights for other low- and middle-income countries (LMICs). The study, titled "Making Modern Diabetes Medications Affordable and Accessible: Lessons from India for Other Countries," was led by V. Mohan, chairman of Dr. Mohan’s Diabetes Specialities Centre in Chennai, and published in the journal Diabetes Care.
Approximately 80% of the 589 million adults worldwide living with diabetes reside in LMICs, according to the study. Modern diabetes therapies, including GLP-1 receptor agonists, SGLT2i, and analogue insulins, have proven effective in improving cardiovascular and renal outcomes while reducing hypoglycaemia risk. However, affordability remains a significant challenge as diabetes requires lifelong care and management of complications.
India's ability to maintain low medication prices is largely attributed to its position as a major pharmaceutical exporter. The country has implemented strategic legislative measures, such as preventing "patent evergreening" and allowing generic manufacture, to maintain critical safeguards. Additionally, India has been focusing on strengthening domestic manufacturing capacity. The paper highlighted concerns over global trade policies affecting prices and raw material availability.
Promoting domestic manufacturing of raw materials through a government incentive scheme, which began production for 26 molecules previously imported as of 2025, has been instrumental. Metformin and sulfonylureas continue to be the foundation of type 2 diabetes management in India, both of which are included in the National List of Essential Medicines (NLEM). However, newer drugs like DPP-4 inhibitors, SGLT2i, and GLP-1 receptor agonists are not yet part of the NLEM, and their initial uptake was constrained by pricing.
The competitive entry of multiple domestic manufacturers led to a significant drop in the price of semaglutide, and there has been a surge in sales. Nevertheless, the absolute monthly costs remain high relative to household income in India, and these medications are not covered by insurance, similar to the situation in the United States.
Key factors contributing to affordable drugs in India include quick availability of generic and biosimilar drugs, deliberate regulatory and distribution strategies, such as government's Jan Aushadi Kendras, and market competition.
The study emphasized that building local manufacturing capacity as a strategic public health investment, alongside balancing patent governance to facilitate easier access to newer molecules, predictable and structured price regulation, and good distribution networks at reasonable retail prices, can help improve access to affordable medicines.
These core principles could also be applied to high-income countries grappling with high drug prices. Remaining challenges include urban-rural disparities in distribution and availability, tight regulations potentially hindering drug innovation, differences in quality between generics, and limited formal evaluation of government schemes regarding their long-term impact on clinical outcomes.
Written by urgent.news from The Hindu - Sci-Tech's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
