Indian Human Insulin Market: Up for Grabs!

The global anti-diabetes therapy market is undergoing a massive transformation, with the advent of GLP-1 ‘wonder drugs’ fundamentally reshaping the treatment landscape. Against this backdrop, it is particularly interesting to examine developments in the domestic Indian market – often referred to as the ‘diabetes capital of the world’. India has the second-largest diabetic population globally, with ~11% of adults living with diabetes (~90mn people). This is projected to rise to ~13% by 2050, reaching an estimated 157 million patients. In addition, ~39 million adults are pre-diabetic, and various studies suggest that 35–45% of diabetics remain undiagnosed, significantly increasing the risk of severe long-term health complications.

In our previous note, we highlighted how GLP-1 therapies are transforming diabetes and obesity care, and how global innovators have already introduced their weight-loss formulations in India. (Update: GLP-1 sales in India reached ~₹180 crore in Oct’25, annualizing at ~₹2,200 crore — already ~10% of the total anti-diabetic market!)

As both GLP-1 giants — Novo Nordisk and Eli Lilly — increasingly prioritise their GLP-1 portfolios in India, a sweet opportunity is quietly opening up for domestic players.

Innovators Are Vacating the Human Insulin Pen Market

• Novo Nordisk announced earlier this fiscal year that it will discontinue the pen devices and cartridges of Mixtard (India’s largest human insulin brand, marketed via Abbott). This move is widely seen as part of its strategy to redirect manufacturing capacity toward GLP-1 products.

• Eli Lilly, which had earlier out-licensed its human insulin brand Huminsulin to Lupin, fully transferred the brand to Lupin in December 2024 for a consideration of ₹464cr.

These developments effectively vacate a significant portion of the human insulin pen market, creating one of the most attractive near-term opportunities for Indian insulin manufacturers/marketers.

As we stand today, India’s domestic branded-generic insulin market is valued at ~₹ 4800 crore, contributing ~22% of the anti-diabetes segment, and has evolved from basic human insulin to more stable analogue insulins, premixes, and device-based delivery for better control and convenience.

Domestic Insulin Market is dominated by MNCs: While the Indian Pharma market is largely dominated by domestic players (~85% share of Domestic formulations market), the Insulin market in India has always been dominated by multinational players. MNC players hold ~70% market share of insulins in India, while Indian players only hold ~30% share. Indian companies have had limited success so far in building an Insulin brand in India, at best they have been distributing innovator’s product. If we exclude the in-licensed brands by Indian companies from MNC players, domestic players have only been able to capture ~20% market share of Insulins in India.

Abbott (distributor for Novo Nordisk’s Insulins) and Sanofi have historically dominated the Indian insulin market, leveraging their US technological superiority and developing strong market reputation, and aggressive marketing strategies that established deep ties with doctors. Abbott which distributes Novo’s insulins in India has more than half of India’s Insulin market, while Sanofi holds ~17% market share.

India’s Insulin Market Breakdown: The Insulin Market in India valued at ~₹4800cr has Human Insulin as the largest selling Insulin in India. While newer gen insulins like Aspart, Glargine, Lispro have been gaining share, Human Insulin (a short-acting insulin, which starts working within 30 minutes after injection) still remains the largest selling Insulin in India.

Overview of Insulin Types and their Pharmacological Profiles:

Insulin manufacturing is a complex, capital-intensive process, and Indian companies have historically held limited market share due to two major bottlenecks:

1. Fermentation capacity is limited and slow to scale

   • Human insulin is produced using recombinant DNA (rDNA) fermentation in bioreactors.

   • India has very few large-scale fermentation facilities dedicated specifically to insulin — primarily Biocon and Wockhardt.

   • Lead times to add meaningful fermentation capacity are long: ~18–30 months to set up upstream + downstream capacity and validate it.

2. Cartridge & pen-fill infrastructure is a major constraint:

3. With Novo discontinuing Mixtard pens and cartridges, the primary bottleneck for domestic substitution is the shortage of high-speed fill–finish lines.

4. The key gaps are:

   1. Sterile, high-throughput cartridge-filling lines

   2. Automated vision inspection and sealing lines

5. Setting up this infrastructure requires 12–18 months and an investment of ₹150–300 crore, depending on automation levels.

Insulin Capacity Build-out: Commentary from Indian Listed Players:

The opportunity that’s opening up: As highlighted in Eris’s latest investor deck, the Human Insulin market in India is valued at ~₹1750cr annually, of which ~₹750cr is the RHI cartridge segment. Innovator Novo Nordisk – through Abbott - commands ~65% share of this cartridge market with Mixtard. With the innovator exiting this segment, a ~₹500cr+ opportunity is opening up for domestic companies to build scale and establish themselves as credible, long term insulin brands in India.

In the section that follows, we highlight how Eris Life sciences is positioned to tap the potential opportunity (Disclosure: Eris is a Portfolio company)

Strong Positioning in Antidiabetic Segment: Eris today has one of the strongest franchises in diabetes care among Indian companies, with ~32% of revenue coming from antidiabetic therapies (~23% oral; ~9% injectable). The company ranks #6 in the IPM diabetes therapy group, holding ~5% share, and derives ~80% of revenues from specialty and super-specialty prescriptions – an important advantage for building an insulin and GLP-1 franchise.

Strategic moves that set up Eris for the Next Decade: Eris historically had a dominant position in oral antidiabetics, but the injectable antidiabetic market (~30% of the category by value) remained a gap in its portfolio. This changed in April 2024, when Eris acquired Biocon’s India branded formulations business for ₹1,242 crore, gaining immediate entry into the insulin space.

This acquisition accelerated multiple strategic advantages:

• Expanded branded insulin portfolio (RHI, Glargine, Aspart readiness)

• A running manufacturing base via the Chemman Labs acquisition (now the Bhopal facility)

• Early access to vial and cartridge fill-finish capabilities

• Deeper engagement with Biocon across insulin analogues and pipeline assets

Additionally, with the MJ Biopharm tie-up for recombinant insulin APIs and the company’s own investments at Bhopal, Eris is progressing toward backward integration, an important differentiator as domestic companies prepare to take share in a market long dominated by MNC innovators. At the Bhopal facility, the vial line is already commercial, and the cartridge line is expected to go live shortly, positioning Eris among the few domestic companies with both interchangeable products and integrated manufacturing.

Market Share Gains already Visible: The impact of Novo’s withdrawal is already reflected in market data. Abbott’s Human Insulin share has fallen from 27% in Q3FY25 to just ~13% by October ’25. While some of this volume has shifted to innovator vials, Eris and Lupin have each gained ~400 bps of share, with Eris now at ~14% share—a sharp and early acceleration ahead of full cartridge capacity coming online.

Why Eris Is Well-Placed to Win the Insulin Opportunity:

• Integrated portfolio + manufacturing capability: Once cartridge production is fully commissioned, Eris will be among the few players offering interchangeable RHI products with domestic backward integration, enabling cost competitiveness and assured supply.

• Strong inpatient (institutional) opportunity: The RHI vial business allows for rapid scalability because vials dominate inpatient usage, where switching is easier and driven by formulary and procurement economics.

• Access to insulin analogues & global optionality: Eris has already added Insulin Aspart to its strategic collaboration with Biocon, enabling distribution in select RoW markets. Notably, this is the first and only interchangeable biosimilar approved by the USFDA for its reference product—a strong validation of the underlying platform.

• A robust future-facing pipeline: Eris’s latest investor deck showcases a rich pipeline across insulin analogues (Aspart, Aspart Mix, Degludec, combinations) and GLP-1s (Semaglutide synthetic & recombinant), positioning the company for sustained leadership as the antidiabetic market transitions toward injectables and incretin-based therapies.

Conclusion

Novo Nordisk’s withdrawal from the Mixtard cartridge segment marks a rare strategic opening in the injectable antidiabetic space—historically dominated by innovators. Domestic companies with capabilities in insulins are likely to be better positioned for GLP-1 adoption, given their established presence in super-specialist prescriptions and closer clinician engagement.

Backed by timely acquisitions, strategic collaborations, and early investments in manufacturing, Eris now stands out as one of the few Indian companies capable of emerging as a scaled, credible insulin player. The company’s dual engine—Insulin + GLP-1—gives it a platform to potentially become the “Novo Nordisk of India” over the coming decade.