High prices are the primary barrier keeping these drugs away from the people who need them most
In September 2025, the World Health Organization added Semaglutide and Tirzepatide to its Model List of Essential Medicines — a quiet bureaucratic act with the potential to redirect the course of a slow-moving public health crisis. India, where the overweight and obese population has grown fourfold in a single generation to 235 million people, stands at a crossroads: the global machinery for making these drugs affordable has been set in motion, but whether that machinery will be engaged remains a matter of political will and institutional follow-through. The listing does not guarantee access, but it opens a door that was previously closed to the many and open only to the few.
- Weight-loss drugs that could help hundreds of millions remain priced beyond reach for most Indians, with monthly costs running as high as Rs 27,000 — a figure that places them firmly in the category of privilege, not medicine.
- India's obesity burden has exploded from 53 million to 235 million in just three decades, and without intervention, projections warn of more than 520 million affected — a crisis quietly compounding into diabetes wards and cardiac units across the country.
- The WHO's essential medicines designation is a deliberate lever: it signals generic manufacturers, pressures procurement systems, and reframes these drugs from lifestyle luxuries into public health necessities.
- Generic competition and primary care integration could follow — but India's regulatory and procurement systems must actively choose to act, and the timeline for that choice remains uncertain.
In September 2025, the World Health Organization added Semaglutide and Tirzepatide — sold in India as Wegovy and Mounjaro — to its Model List of Essential Medicines. The list functions as a global reference for public procurement, insurance coverage, and reimbursement decisions across more than 150 countries. When a drug earns that designation, the conditions for generic manufacturing and price negotiation typically follow.
For now, the drugs are expensive. Wegovy costs between Rs 17,000 and Rs 26,000 per month; Mounjaro between Rs 14,000 and Rs 27,000. For the vast majority of Indians, these are not medicines — they are luxuries. The WHO's core argument is simple: price is the wall, and the essential medicines list is a tool for dismantling it.
The scale of India's obesity crisis gives that argument urgency. In 1990, roughly 53 million Indians were overweight or obese. By 2021, that figure had risen to 235 million. Researchers publishing in The Lancet warn that without intervention, India could surpass 520 million — second only to China globally. Behind those numbers are lives increasingly shaped by diabetes, heart disease, and preventable early death.
The WHO's listing is designed to trigger three things at once: a signal to generic manufacturers that demand is real and regulatory ground is clear; a directive to national health systems to prioritize these drugs for those who need them most; and downward pressure on prices through the volume that public procurement makes possible.
What follows now depends on India. Generic versions could arrive within months or years. Primary care programs could begin reaching underserved communities where obesity is rising fastest. Or the listing could remain a symbolic milestone — meaningful on paper, inert in practice. The mechanism exists. Whether India chooses to use it is the question that remains.
The World Health Organization has made a decision that could reshape how millions of Indians access weight-loss medications. In September 2025, the organization added Semaglutide and Tirzepatide—drugs sold domestically as Wegovy and Mounjaro—to its Model List of Essential Medicines. The move matters because this list serves as a reference point for public procurement, insurance coverage, and reimbursement decisions across more than 150 countries, including India. When a drug lands on it, the machinery of generic manufacturing and price negotiation typically follows.
Right now, these medications are expensive. Wegovy runs between Rs 17,000 and Rs 26,000 per month depending on dosage. Mounjaro ranges from Rs 14,000 to Rs 27,000 monthly, with vials costing less than the pre-filled Kwikpen devices. For most Indians, these are luxury prices—out of reach for anyone without substantial disposable income or private insurance. The WHO's reasoning is straightforward: high prices are the primary barrier keeping these drugs away from the people who need them most.
India's obesity crisis has accelerated dramatically over the past three decades. In 1990, roughly 53 million Indians were overweight or obese. By 2021, that number had climbed to 235 million—more than a fourfold increase in a single generation. Without intervention, researchers publishing in The Lancet have warned, India could see more than 520 million overweight or obese people, making it second only to China globally in absolute numbers. These are not abstract statistics. They represent a population increasingly vulnerable to diabetes, heart disease, and early death from preventable causes.
The WHO's inclusion of these drugs on the essential medicines list is designed to unlock three mechanisms simultaneously. First, it signals to generic manufacturers that there is legitimate demand and regulatory clarity for producing cheaper versions. Second, it encourages countries to prioritize these medications in their public health systems, directing them toward people who would benefit most rather than those who can simply afford them. Third, it creates pressure on pricing through the sheer volume of potential procurement that becomes possible when a drug is recognized as essential rather than optional.
What happens next depends on how India's own regulatory and procurement systems respond. The WHO has made the case; now the work of implementation begins. Generic versions could emerge within months or years. Public health programs could begin offering these drugs in primary care settings, particularly in underserved areas where obesity rates are climbing fastest. Or the drugs could remain expensive and scarce, their inclusion on the essential list a symbolic victory with limited practical impact. The machinery exists to make these medications affordable and widely available. Whether India chooses to use it remains an open question.
Notable Quotes
Prioritising those who would benefit most, encouraging generic competition to drive down prices and making these treatments available in primary care, especially in underserved areas, are key to expanding access and improving health outcomes— World Health Organization
The Hearth Conversation Another angle on the story
Why does the WHO's list actually matter? Isn't it just a recommendation?
It's more than that. When a drug lands on the essential medicines list, it becomes a reference point for how 150 countries structure their entire procurement and insurance systems. In India specifically, it signals to generic manufacturers that there's a legitimate market, and it gives public health officials cover to prioritize these drugs in government programs.
So prices will just drop automatically?
Not automatically, but the conditions shift. Generic competition becomes viable. Right now, at Rs 17,000 to Rs 26,000 a month, these drugs are only for people with real money. Once generics enter, that changes. But it requires India's own regulators and health systems to actually move.
What's the scale of the problem we're talking about?
Two hundred thirty-five million Indians are already overweight or obese. That's roughly one in six people in the country. And it's accelerating—the number has more than quadrupled since 1990. Without intervention, it could exceed 520 million within a generation.
That seems like it should be urgent.
It is urgent. But urgency and action aren't the same thing. The WHO has done its part. Now it depends on whether India's health system treats this as a priority worth funding and distributing through public channels.
Who benefits most from this decision?
In theory, people in underserved areas—rural communities, lower-income urban populations—where obesity is rising fastest but access to any treatment is nearly zero. In practice, it depends on whether India's government actually makes these drugs available in primary care settings rather than leaving them as private-market luxuries.