India's Drug Pricing Secret: A Model for the World?

A study led by V. Mohan in Chennai highlights India's achievements in making advanced diabetes medications accessible and affordable for its population. This research offers valuable insights for other low- and middle-income countries facing similar challenges.

The study found that India's ability to maintain lower prices for new diabetes drugs is significantly linked to its robust pharmaceutical export sector and its legislative history, which actively prevents patent evergreening and supports generic drug manufacturing.

Furthermore, India has prioritized enhancing its domestic production capabilities. As of 2025, government incentives have initiated the local production of 26 previously imported molecules, addressing concerns about global trade policies and raw material availability.

While essential medicines like metformin are on the National List of Essential Medicines (NLEM), newer therapies are not yet included, initially limiting their uptake due to pricing. However, increased competition from domestic manufacturers, such as for semaglutide, has led to price reductions, though high absolute costs and lack of insurance coverage remain issues.

Key strategies contributing to affordability include the quick availability of generic and biosimilar drugs, government initiatives like Jan Aushadi Kendras, and effective market competition. The paper proposes that building local manufacturing, balancing patent governance, implementing price regulation, and ensuring good distribution networks can improve access globally.

Challenges persist, including disparities in distribution, potential impacts of regulations on innovation, quality control of generics, and the need for formal evaluation of government schemes for long-term clinical impact.