Impact, Access, and Scale: The Potential of India’s Pharma Market

Roshel Jayasundera, Partner, Dubai

Joshua Siow, Partner, Singapore

Bhavna Desai, Director, Boston

All with Simon-Kucher & Partners’ life sciences division

India presents a compelling case for global pharmaceutical manufacturers seeking to launch innovative therapies. Despite economic disparity and limited public reimbursement, India offers the scale, speed, and cost-efficiency global pharma needs to stay competitive. Large population, low manufacturing costs, evolving healthcare infrastructure, and streamlined regulatory processes make it a top commercial growth market, giving companies a leading advantage in underserved populations.

Expanding access to a large and diverse market

Home to ~18% of the world’s population (>1.4 billion),¹ India is a highly diverse country with varying healthcare needs. Urban areas offer advanced private care comparable to upper-middle-income markets, while rural regions face challenges typical of low-income settings. This variation demands targeted access strategies to address differences in infrastructure, affordability, and coverage. Pharmaceutical companies can leverage this diversity to implement innovative solutions that deliver impact across the market.

High unmet medical need for innovative therapies

India’s rising burden of non-communicable diseases, such as cancer, cardiovascular diseases, and diabetes, highlights a significant unmet need for innovative treatments. With 77 million adults living with type 2 diabetes² and 1.46 million cancer cases,³ the demand for targeted therapies is clear. For instance, Novo Nordisk is expediting the launch of its weight-loss drug Wegovy, recognizing the untapped potential of India’s large and growing market.⁴

Multi-stakeholder investment transforming the infrastructure

India’s healthcare system is undergoing a transformation driven by domestic and global investments:

Domestic public sector. The National Health Mission drives India’s progress toward UN sustainable development goals,⁵ with measurable improvements in maternal health, communicable disease control, and infrastructure. Continued government investment is focused on advancing universal health coverage and reducing health inequities.

Domestic private sector. Indian hospital groups and health tech companies are expanding services into underserved areas, strengthening specialized care and digital health. These efforts complement public initiatives and improve access for both insured and out-of-pocket (OOP) paying populations.

International investment. Global private equity firms, such as Blackstone and Singapore’s state-owned investment firm Temasek, are investing $5 billion to $6 billion annually,⁶ upgrading infrastructure and diagnostics while closing funding gaps in the public sector.

India’s changing regulatory landscape

Recent regulatory reforms in India have increased flexibility and eased trial requirements for innovative drugs already approved in key global markets. In August 2024, the Central Drugs Standard Control Organization issued a new order waiving the requirement for local clinical trials for select drug classes approved in the US, the UK, the EU, Switzerland, Japan, and Australia.⁷ While the order does not specify how long a drug must be on the market or whether the waiver applies only to Phase III or also Phase IV clinical trials, recent approvals, such as Eli Lilly’s Mounjaro and Johnson & Johnson’s Darzalex, demonstrate India’s growing openness to advanced therapies.

Flexible pricing supported by cost-effective manufacturing/distribution

India’s cost-efficient manufacturing capabilities present a significant advantage for pharma companies. By leveraging local contract research and development manufacturing organizations, companies can reduce production costs while maintaining high-quality standards, allowing further pricing flexibility without compromising profitability.

Patient access opportunities in a multi-payer environment

With more than 60% of India’s population uninsured, OOP payments dominate healthcare financing, accounting for reportedly more than 49% of health expenditure.⁸ This affordability burden is particularly pronounced for India’s growing middle class, many of whom fall outside traditional safety nets but still face barriers to accessing high-cost therapies.

To address this, government-backed initiatives such as Ayushman Bharat PM-JAY provide up to INR 5 lakh per family per year to cover ~500 million people.⁹ Other schemes such as ESIC, AFMS, and IRHS cover ~150 million lives. Manufacturers have successfully used these programs to secure reimbursement for high-cost therapies, including Darzalex (J&J), Kyprolis (Amgen), Lucentis (Novartis), and Actemra (Roche).

While public schemes reduce financial strain for part of the population, patient assistance programs are essential for bridging affordability gaps for the uninsured. By customizing patient assistance programs (PAPs) based on income levels and insurance enrollment, companies can provide tailored support to diverse patient segments. This dual approach—public reimbursement and income-based PAPs—enables scalable market entry, making high-value therapies available to both insured and uninsured populations.

Looking ahead

For global pharma companies seeking growth and health equity, India offers a rare convergence of scale, diversity, and innovation potential. With a rapidly transforming healthcare ecosystem, increasing private investment, and government support, India is becoming a cornerstone of forward-looking pharmaceutical strategies. The Vision Pharma 2047¹⁰ initiative aims to position India as a global leader in innovative drug development, biosimilars, and advanced therapies, with the sector projected to reach $450 billion by 2047.¹¹ By prioritizing India, companies can capture long-term growth opportunities while contributing to global health progress.

Roshel Jayasundera, Partner, Dubai; Joshua Siow, Partner, Singapore; Bhavna Desai, Director, Boston; All with Simon-Kucher & Partners’ life sciences division

Darshana Banka contributed to this article

References

1. The World Bank in India. World Bank Group. https://www.worldbank.org/en/country/india

2. Diabetes in India. World Health Organization. https://www.who.int/india/diabetes

3. Sathishkumar, K.; Chaturvedi, M.; Das, P.; Stephen, S.; Mathur, P. Cancer Incidence Estimates for 2022 & Projection for 2025: Result from National Cancer Registry Program, India; Indian J Med Res. 2023. 156 (4-5), 598–607. https://pmc.ncbi.nlm.nih.gov/articles/PMC10231735/

4. Sadam, R. Novo Preparing for Early Launch of Weight-Loss Drug Wegovy in India. Reuters. April 7, 2025. https://www.reuters.com/business/healthcare-pharmaceuticals/novo-preparing-early-launch-weight-loss-drug-wegovy-india-2025-04-07/

5. Gera, R.; Narwal, R.; Jain, M.; Taneja, G.; Gupta, S. Sustainable Development Goals: Leveraging the Global Agenda for Driving Health Policy Reforms and Achieving Universal Health Coverage in India. Indian J Community Med. 2018. 43 (4), 255–259. https://pmc.ncbi.nlm.nih.gov/articles/PMC6319280/

6. Madhur, M.; Kulkarni, R. Private Equity Growth Must Not Undermine Patient Care in Indian Healthcare. HFS. December 17, 2024. https://www.hfsresearch.com/research/private-equity-growth-must-not-undermine-patient-care-in-indian-healthcare/

7. Subject: Specifying Names of Countries Under the Rule 101 of New Drugs and Clinical Trial Rules, 2019 Related to New Drug Approval - Regarding. Drugs Controller General (India). August 7, 2024. https://cdsco.gov.in/opencms/resources/UploadCDSCOWeb/2018/UploadPublic_NoticesFiles/Orde101%20NDCT.pdf

8. Out-of-Pocket Expenditure (% of Current Health Expenditure) - India. World Bank Group. April 4, 2025. https://data.worldbank.org/indicator/SH.XPD.OOPC.CH.ZS?locations=IN

9. About Pradhan Mantri Jan Arogya Yojana (PM-JAY). National Health Authority. https://nha.gov.in/PM-JAY

10. Indian Pharma Vision 2047. PIB. https://pointias.com/2022/05/03/indian-pharma-vision-2047/

11. Kashyap, K. The Rise Of India’s Pharmaceutical Industry to a Forecasted $450 Billion. Forbes. November 16, 2024. https://www.forbes.com/sites/krnkashyap/2024/11/16/the-rise-of-indias-pharmaceutical-industry-to-a-forecasted-450-billion/