Over the past decade, pharmaceutical companies have quietly reshaped their growth strategy by aggressively expanding portfolios of chronic medicines used to treat long-term conditions such as diabetes, hypertension, cardiovascular diseases, and cancer. According to PharmaTrac data, the diabetes and cardiac segments grew 18.8% and 16.1% respectively in the first half of 2026, surpassing the 11.3% growth of the broader Indian pharma market. Unlike acute medicines prescribed for short durations, chronic therapies generate recurring demand, stronger prescription stickiness, and greater earnings visibility. While the country's largest drugmakers already have strong presence in these therapies, a new group of companies is building scale through focused portfolios and targeted acquisitions. The sector's evolution is being driven by technological breakthroughs in biotechnology and the pervasive integration of AI into drug discovery, diagnostics, and care delivery, with AI expected to influence over 30% of the projected $30 trillion global healthcare market by 2030.
Mankind Pharma built its domestic business on high-volume acute therapies but is rapidly repositioning towards specialty and chronic therapies through acquisitions. The company's ₹13,700 crore acquisition of Bharat Serums and Vaccines (BSV) strengthened presence in fertility, critical care, and women's health, while acquiring Roche's Rivotril brand expanded its neurology portfolio. Chronic therapies now represent 40% of the domestic formulation business, up from 32% in 2020, with gross margins improving to 71.6% in March 2026 quarter. The strategy resulted in 17% revenue growth in FY26 to ₹14,278 crore, though net profit fell 3.4% due to higher depreciation and finance costs from the BSV acquisition.
Alkem Laboratories built its domestic franchise on anti-infectives but is steadily reshaping towards cardiology, diabetes, respiratory and specialty therapies through organic expansion. The company launched semaglutide with an 11% unit market share and consistently expanded its chronic field force. Chronic therapies now contribute 22% of Alkem's branded generics business, increasing by roughly one percentage point annually. In FY26, the company reported 13.5% revenue growth to ₹14,712 crore with chronic portfolio growing 16.1%, while EBITDA margins improved to 20.4%. ROCE has improved to 21% in FY26 from 14% three years ago, suggesting investments are translating into higher capital efficiency.
Torrent Pharmaceuticals already has a chronic care franchise contributing 75% of its India business, with the company's ₹25,700 crore acquisition of JB Pharma reflecting strategy to consolidate leadership. The JB Pharma acquisition strengthened presence in hypertension and gastroenterology, while Torrent launched semaglutide with first-year sales estimated at ₹200-250 crore. In FY26, revenue grew 21% to ₹13,980 crore with operating margin improving to 32.6%. However, the acquisition increased borrowings from ₹3,202 crore to ₹15,026 crore, resulting in net debt to EBITDA of 2.3x and compressing ROCE from 27% to 15%.
Zydus Lifesciences is pursuing a broader strategy beyond chronic expansion, investing in biosimilars, MedTech and specialty medicines to move up the pharmaceutical value chain. Chronic therapies now account for 46.3% of India branded formulations business, up 620 basis points over three years. In FY26, the company reported 17% revenue growth to ₹27,148 crore with operating margins expanding to record 31.2%. However, acquisitions including Amplitude Surgical pushed borrowings from ₹3,213 crore to ₹12,496 crore, with operating cash flow falling sharply to ₹2,117 crore from ₹6,777 crore, compressing ROCE to 21% from 24%.
