Islamabad: Locally manufactured versions of GLP-1 and dual GLP-1/GIP medicines used for weight loss and diabetes are proving effective in routine clinical practice in Pakistan and are expanding access to treatment for millions who could not afford imported brands such as Ozempic, Wegovy and Mounjaro, senior endocrinologists and diabetologists said on Thursday.
However, they warned that Pakistan still lacks head to head comparative trials and long-term local safety data, urging the Drug Regulatory Authority of Pakistan (DRAP) to ensure close regulatory oversight as the use of these medicines expands.
With an estimated 35 million people living with diabetes in Pakistan, and some studies suggesting that up to 50 percent of adults in rural areas may be diabetic, doctors say the arrival of lower-cost semaglutide and tirzepatide by local pharmaceutical companies has begun to change the treatment landscape for both diabetes and obesity.
Physicians report that patients who were previously priced out of these therapies are now starting treatment and achieving meaningful weight loss alongside improved blood sugar control.
Several Pakistani manufacturers, including Getz Pharma, Ferozsons Laboratories, Macter and Hoechst Pakistan, formerly Sanofi, have introduced injectable versions of semaglutide and tirzepatide in recent months, while industry sources say more companies are preparing to enter the market.
Some of these firms are also developing oral semaglutide, while others plan to introduce oral tirzepatide in the near future, which clinicians say could further widen access and improve treatment adherence.
Prof Tasneem Ahsan, a senior endocrinologist and former executive director of Jinnah Postgraduate Medical Centre, said GLP-1 receptor agonists have become a key part of modern diabetes care because their benefits extend beyond sugar control.
She said these drugs are also useful in metabolic associated fatty liver disease and obesity and offer organ protective effects, including reducing the risk of diabetic kidney disease, acute cardiovascular events and heart failure, with or without diabetes.
“Most of our patients with diabetes and obesity are likely to benefit from this treatment. We were limited in using it for the vast majority of our patients due to financial constraints,” she said. “With the arrival of locally formulated GLP-1 drugs, many more patients can now be treated.”
Prof Tasneem Ahsan said some locally available products are produced through biological processes and are therefore biosimilars, while others are manufactured through chemical processes. Based on her clinical use of both originator brands and local formulations, she said the local versions appear effective.
However, she warned that no proper head to head trials have been conducted in Pakistan and that companies largely rely on safety data generated for innovator products. She also flagged concerns about immunogenicity, noting that these are protein molecules and local immunogenicity studies have not been conducted.
Prof A H Amir, another senior endocrinologist, said clinicians are seeing weight reduction and improved glycaemic control with locally manufactured GLP-1 and GIP based medicines, but comparative studies with originator brands have not been carried out and long-term local safety data remain limited.
He said the main advantage at present is cost effectiveness, which is critical in a country where most healthcare spending is out of pocket. He added that regulators should require local data before granting approvals for biosimilar products.
Prof Abdul Basit, a leading diabetologist, said certainty about whether local formulations match originator brands in safety and effectiveness would only come after properly designed head to head comparative studies.
Patients say affordability has been decisive. A man in his early twenties who weighed 118 kilograms said he started tirzepatide under medical supervision and lost around 25 kilograms over six months. “I could not afford the imported injection. The local one made treatment possible,” he said.
Another patient, a 38-year-old man from Rawalpindi who weighed 147 kilograms, reported losing about 30 kilograms over eight months. Doctors say such outcomes are becoming increasingly common as more patients gain access to these therapies.
Specialists stress that these medicines are not a short-term fix. Endocrinologists advise that GLP-1 and GIP based therapies should be continued under close medical supervision, alongside dietary and lifestyle changes, and should not be stopped abruptly, as weight often rebounds quickly after discontinuation.
They also warn against unsupervised use, noting that nausea and gastrointestinal side effects are common during dose escalation and that careful monitoring is needed in patients with certain underlying conditions.
Public health experts say the growing availability of locally produced semaglutide and tirzepatide marks a significant shift in Pakistan’s response to two of its fastest growing health challenges. While prevention through healthier diets and physical activity remains essential, clinicians say affordable access to modern therapies could help slow the tide of diabetes-related complications and obesity-linked heart disease.
At the same time, they stress that stronger regulatory oversight and locally generated evidence are needed to ensure quality, safety and sustained benefit as these medicines become more widely used.
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