A review from Chennai sets out how India has made modern diabetes medicines cheaper. After patent expiry, generic competition, price regulation and government support were followed by price reductions of about 60–90% for SGLT2 inhibitors and GLP-1 receptor agonists. Insulin glargine biosimilars are also much cheaper than elsewhere.

Cross-national comparisons put Indian generic prices 15- to 65-fold below US list prices for selected agents. Schemes such as Ayushman Bharat have widened access for poorer patients.

The authors are frank about the limits: rural access remains patchy, and with many manufacturers there may be differences in quality and pharmacokinetics even between branded generics. It is a policy analysis, not a trial, but it matters directly to how Indian clinicians prescribe.

Cost is now less of a reason to withhold an SGLT2 inhibitor in people with type 2 diabetes and cardiovascular or kidney disease in India.
Ask patients what they actually pay; generic prices vary widely between brands and pharmacies.
If glycaemic control changes after a brand switch, consider whether the product changed before escalating therapy.
Check eligibility for Ayushman Bharat or state schemes for patients who cannot afford therapy.

Why it matters

It removes a common default excuse for under-prescribing cardio-renal protective drugs in Indian practice.

The statistics, in plain English

The 60–90% figure is a range of price falls across different drugs after patent expiry, not a single average; the 15- to 65-fold gap is against US list prices, which few US patients actually pay.