By Rishika Sadam

HYDERABAD (Reuters) -Eli Lilly ( LLY ) launched its blockbuster diabetes and weight-loss drug Mounjaro in India on Thursday, beating rival Novo Nordisk for a much-awaited entry into the world's most populous country grappling with increasing rates of obesity and diabetes.

U.S.-based Lilly and Danish Novo Nordisk have seen skyrocketing global demand for their innovative weight-loss drugs, with investor interest also boosting the drugmakers' valuations.

Mounjaro, a once-weekly injection approved by India's drug regulator, is priced at 4,375 rupees ($50.67) for a 5 mg vial and 3,500 rupees ($40.54) for a 2.5 mg vial, its lowest doses, the company told Reuters exclusively. Its highest dose is 15 mg.

A patient in India may have to spend about $200 a month when taking a weekly dose of 5 mg, subject to doctor's prescription.

Mounjaro carries a list price of $1,086.37 for each monthly fill in the U.S., but the amount patients pay largely depends on their insurance plan. Lilly also offers 5 mg, 7.5 mg and 10 mg vials of Zepbound, with prices around $499 for a month's supply if customers pay directly in cash without any third-party entities.

Chemically known as tirzepatide, Mounjaro is currently sold in the UK and Europe under the same brand name for both diabetes and weight loss. It is sold as Zepbound for obesity in the U.S.

Lilly, however, said that the pricing in different geographies cannot be compared given significant variation in healthcare systems, economies and reimbursement policies in each country.

"(Mounjaro) launch is ahead of Novo Nordisk and the first mover advantage should help ... but pricing seems high (for the Indian market). At the highest dose, a patient will have to spend close to 700,000 rupees (around $8,100) per annum," Vishal Manchanda, analyst at Systematix Institutional Equities said.

Novo's weight-loss drug, Wegovy, can cost non-insured U.S. patients more than $1,000 a month.

Novo's India team has been pushing the global leadership to launch Wegovy as early as 2025 in the country as opposed to the company's target of a 2026 launch.

The drugmaker told Reuters that Wegovy has already been approved in India, but said it did not have a confirmed date for the medicine's launch there.

The company's shares were down 0.6% at 1145 GMT, underperforming the broader European market. Shares of U.S.-based Lilly rose as much as 2.07% to $854.39 on Thursday.

Novo's stock has fallen over 12% so far this year, while Lilly's has jumped 8%.

Novo is not the only competition Lilly will have to confront in India. Local drugmakers such as Sun Pharma, Cipla, Dr. Reddy's and Lupin have been racing to make generic versions of these drugs to grab a share of the global market estimated to be worth $150 billion in the next decade.

The active ingredient in Wegovy is semaglutide, which is likely to go off-patent in 2026 in India.

"The dual burden of obesity and type 2 diabetes is rapidly emerging as a major public health challenge in India," said President and General Manager Winselow Tucker at Lilly India.

Obesity and diabetes rates in India, a country of more than 1.4 billion people, have been steadily climbing. The number of adults with diabetes is set to increase to over 124 million by 2045 from 74.2 million in 2021, according to International Diabetes Federation.

Meanwhile, a government survey conducted between 2019 and 2021 showed that 24% of women and nearly 23% of men between the ages of 15 and 49 were either overweight or obese, up from 20.6% of women and 19% of men in 2015-2016.

Wegovy and Novo's diabetes drug, Ozempic - which has the same main ingredient - and Mounjaro, belong to a class of therapies known as GLP-1 receptor agonists that help control blood sugar and slow digestion, making people feel fuller for longer.

($1 = 86.3425 Indian rupees)