Despite India's large-scale generic production of GLP-1 class drugs, with prices as low as $14 per month, and India being the world's second-largest country for diabetes patients, sales performance has been far below expectations. Nomura Holdings last year predicted that sales of related drugs in India would reach $261 million by 2026. However, according to Pharmarack Technologies data, as of July this year, actual sales were only about 20% of that forecast. Reasons for the lukewarm market include India's complex cultural perceptions of obesity, the stigma associated with injectable medications, women patients' lack of autonomy over healthcare spending, the spread of misinformation, and India's strict regulations on pharmaceutical advertising.