Inhaler sales hit new high in January as India struggles to breathe

The impact of air pollution on life expectancy is noteworthy, with an average Indian citizen losing 5.3 years due to air pollution.

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26 Aug, 2025 12:21

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Indian respiratory therapy sales registered an upswing in January, propelled by an extended winter, escalating lung complications due to high pollution, and the impact of the Covid-19 pandemic.

Cipla’s inhaler Foracort, used to treat asthma and chronic obstructive pulmonary disease, was the third-bestselling therapy in the country in the three months ended January, according to market research firm Pharmarack.

Drug sales are usually dominated by therapies for chronic conditions such as cardiac and anti-diabetes treatments. However, a product from the acute segment, a respiratory inhaler, is among the leaders of the pack now.

Sales of Foracort, which usually is among the top 10 brands, spiked with the onset of winter. Foracort sales came in at Rs 60 crore, with a unit growth rate of 11.3 percent in January, according to Pharmarack.

Pharmaceutical product sales are cyclical. In the rainy season from June to October, consumption of cough and cold medication rises, while sales of dermatological products are higher in the summer.

Respiratory drug sales climbed to Rs 1,604 crore (as a moving annual total) in January.

Covid impact

Additionally, the respiratory drug segment, including treatments for asthma, chronic obstructive pulmonary disease (COPD), bronchitis, cystic fibrosis, and virus-induced respiratory syndromes, has grown substantially since the onset of the Covid-19 pandemic in 2020. Successive waves of Covid-19, coupled with severe winter pollution, have significantly boosted the consumption of respiratory products in India.

“In general, the respiratory and anti-infectives segments pick up in monsoon and winters,” said Sheetal Sapala, VP of Pharmarack.

She said low temperatures and humidity increase sales for asthma and therapies for breathing difficulties. This season also is marked by a rise in viral infections due to temperature variations.

The impact of air pollution on life expectancy is noteworthy, with an average Indian citizen losing 5.3 years due to air pollution. In New Delhi, the loss is even more severe, with individuals losing up to 11.9 years of their life, as per the Air Quality Life Index by the Energy Policy Institute at the University of Chicago (August 2023).

Cold waves persisting across north Indian states since December have exacerbated the situation.

Doctors noted that though India has a stigma against inhalers, doctors advise using them instead of taking tablets or syrups as they are more effective.

“Inhalers are preferred over oral and systemic agents as they have localised action, rapid onset of action and less side-effects,” according to Paritosh Baghel, senior consultant-internal medicine at SL Raheja Hospital Mahim.

Global surge

Globally, there has been an uptick in respiratory virus infections in the US and Europe and a new Covid wave in China. Respiratory syncytial virus (RSV) had surged in the US even before the winter months, leading AstraZeneca and Sanofi to acknowledge that demand had outpaced supply in October 2023.

“While the respiratory virus season is likely past its peak, it is definitely not over,” the US Centers for Disease Control and Prevention said in an update on its website on February 20.

Indian drug manufacturer Cipla said last month it had completed filings for generic Symbicort (inhaler for COPD) and one other generic inhalation asset.

Lupin said respiratory products accounted for 40 percent of its US revenue, its top product being the generic Spiriva HandiHaler.

“We definitely feel on Spiriva that we're in a very strong position. We feel pretty good about the potential of being alone in the market over the next couple of years,” Vinita Gupta, CEO of Lupin, told investors. The company is looking at organic and inorganic growth to build its respiratory portfolio, she said.

Beyond inhalers, nasal sprays and treatments for allergic rhinitis like Glenmark’s Ryaltris are gaining traction. Glenmark Pharmaceuticals highlighted the success of its respiratory portfolio in Europe and leveraged its developmental capabilities to build a robust portfolio for the US market, as outlined in its Q3 investor presentation.