The diabetes and obesity medication Mounjaro, produced by US pharmaceutical company Eli Lilly, has now surpassed Merck’s cancer treatment Keytruda to become the leading-selling drug globally. This significant shift represents a notable change in the pharmaceutical landscape, particularly highlighting the advancing field of obesity and metabolic therapies.

Keytruda, which contains pembrolizumab as its active ingredient, is an immunotherapy treatment used for nearly 22 types of cancer. The drug had been the highest grossing globally since 2023, shortly after it overtook AbbVie’s Humira. However, recent sales data indicates that Mounjaro’s revenue has now exceeded that of Keytruda for the first quarter of 2026, with earnings of $8.7 billion compared to Keytruda’s $7.9 billion.

The rise of Mounjaro is particularly evident in India, where it became the highest-selling medicine by value in April 2026, maintaining a leading position since its launch in March 2025. According to Pharmarack data, Mounjaro’s sales in the Indian market reached nearly Rs 1,009 crore over the past year, signifying a strong demand for diabetes and obesity treatments among the population.

Mounjaro contains tirzepatide, a molecule designed to activate both GLP-1 and GIP receptors, making it effective for diabetes management and weight loss. Analysts suggest that Eli Lilly’s tirzepatide franchise could result in one of the most lucrative drug portfolios in the pharmaceutical sector’s history, catering to the increasing global focus on GLP-1 and dual-action metabolic therapies.

Despite facing competitive pressure from alternatives such as semaglutide-based medications, Mounjaro has held onto its market dominance in India. The entry of several generic semaglutide products followed the expiration of their patents, yet Mounjaro remains preferred by many healthcare professionals and patients alike for its novel approach to treating obesity and diabetes.

Lilly’s Future Plans in India

India has emerged as a significant market for Eli Lilly’s therapies, prompting the company to consider strengthening its manufacturing and supply channels in the region. Viewing India as a high-growth consumer base, Lilly plans to utilise the country as a potential hub for exports, further expanding its footprint in the global market.

Although the introduction of lower-cost generics has somewhat impacted Mounjaro’s market position, it has consistently retained its leadership in sales value. The ongoing demand for advanced therapies reflects a willingness among Indian patients to invest in higher-quality chronic treatments that offer substantial health benefits.

The robust performance of the tirzepatide portfolio, including Mounjaro and the obesity drug Zepbound, has positioned it as a key growth driver for Lilly. In 2025, the combined sales reached approximately $36.5 billion, far exceeding Keytruda’s annual earnings of $31.6 billion. This substantial performance has allowed Eli Lilly to revise its annual revenue and profit forecasts upwards, driven by strong demand for both Mounjaro and Zepbound.

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