Are global drugmakers shifting to Indian distribution alliances instead of building direct chronic care sales teams?

Emcure Pharmaceuticals Limited’s exclusive distribution and promotion agreement with Sanofi India Limited for its oral anti-diabetic brands Amaryl and Cetapin has reignited discussions about a growing strategic shift in India’s pharmaceutical industry. Rather than investing heavily in direct sales force expansion, global drugmakers are increasingly turning to partnerships with domestic pharmaceutical companies to scale their chronic care reach. This model allows multinational firms to maintain brand and manufacturing control while leveraging the local expertise and extensive doctor networks of Indian pharmaceutical players to accelerate market penetration.

The Sanofi India Limited and Emcure Pharmaceuticals Limited partnership reflects a clear strategic pivot for chronic care brands in India. With over 100 million people living with type 2 diabetes and 60 percent reportedly having uncontrolled blood sugar levels, according to the ICMR-INDIAB and LANDMARC studies, the demand for trusted oral anti-diabetic therapies continues to grow. Sanofi India Limited is now betting that Emcure Pharmaceuticals Limited’s entrenched presence in semi-urban and rural markets can unlock significant incremental prescription volumes that its own sales infrastructure could take years to achieve.

Why are multinational drugmakers increasingly favoring distribution partnerships with Indian pharmaceutical companies to expand chronic care access?

Analysts point out that the primary reason for this shift is cost optimization. Building a full-scale chronic care sales force across India can take years and requires significant investment in training, logistics, and physician engagement programs. Domestic pharmaceutical companies like Emcure Pharmaceuticals Limited already have established chronic care networks, making them ideal partners for global brands that need faster market access.

This approach also reduces operational risks. By outsourcing sales and distribution to trusted local partners, multinational firms can focus on their strengths—innovation, pipeline development, and global manufacturing—while ensuring that their products reach doctors and patients through a proven network. Emcure Pharmaceuticals Limited’s deep penetration into tier 2 and tier 3 cities is particularly valuable in diabetes care, where rural and semi-urban prescription penetration remains relatively low.

The trend is not limited to Sanofi India Limited. Abbott has previously adopted a similar strategy, strengthening its chronic care brands in India through co-marketing alliances with mid-sized domestic players to improve rural reach. Novo Nordisk, meanwhile, has used targeted partnerships for its GLP-1 receptor agonists, particularly in awareness-driven campaigns where Indian partners handle field-level education and physician engagement.

What does this trend reveal about the evolving priorities of global pharmaceutical companies in India’s chronic care market?

Industry observers note that global drugmakers are increasingly adopting a “capital-light” model for commercial operations in India. A decade ago, multinational firms such as Sanofi India Limited, Abbott, and Novo Nordisk invested heavily in building dedicated sales teams for diabetes and cardiovascular care. However, as the chronic care market matured and pricing pressures mounted, partnerships have emerged as a faster, more cost-efficient route to growth.

Institutional sentiment suggests that this strategy is also a response to India’s highly fragmented healthcare delivery system. Local pharmaceutical distributors have stronger relationships with doctors in smaller markets, where prescription loyalty is critical for chronic care therapies. By partnering with companies like Emcure Pharmaceuticals Limited, multinational players can bypass many of the regulatory, logistical, and cultural challenges of expanding their own sales teams.

Experts further argue that these alliances are not only cost-saving but also strategically future-proof. Chronic care therapies, such as oral anti-diabetics and cardiovascular drugs, have long treatment cycles and high adherence rates, making them ideal for distribution partnerships where the domestic partner can steadily build prescription volumes over time.

Could distribution partnerships become the dominant model for chronic care expansion in India over the next five years?

Analysts believe this partnership-led approach is likely to dominate chronic care expansion in India, especially for therapies with established efficacy and physician trust. With the chronic care market projected to grow at a double-digit compound annual growth rate through 2030, Indian pharmaceutical companies with strong semi-urban and rural penetration are expected to attract more multinational collaborations.

If the Emcure Pharmaceuticals Limited–Sanofi India Limited partnership meets commercial expectations, similar deals could emerge in other chronic segments such as hypertension and dyslipidemia, where prescription volumes remain heavily concentrated in urban centers. Institutional projections suggest that chronic care alliances may increasingly extend to next-generation therapies, including GLP-1 analogues and SGLT2 inhibitors, as global drugmakers look to scale newer drug classes without committing to full-scale sales force investments.

For domestic players, these alliances offer not just revenue upside but also stronger positioning as preferred partners for multinational brands entering or expanding in India. Emcure Pharmaceuticals Limited’s success could prompt other companies like Lupin and Alkem Laboratories to seek similar partnerships, reinforcing this partnership-driven commercialization model as the new normal in India’s chronic care market.