A college student in Delhi walks into a pharmacy and buys a strip of painkillers. A construction worker picks up a cough syrup, one he has been using regularly—not to treat a cold, but to help him sleep. A young professional adds vitamins and antacids to her online shopping cart, preferring speed over medical consultation.

These everyday transactions are fuelling India’s Over the Counter (OTC) drug market, in 2023 valued at INR 532.39 billion and projected to reach INR 1,547.08 billion by 2029, growing at 19.1% CAGR. While OTC drugs offer convenience, their unchecked growth raises a critical question—how long this industry can remain unregulated?

The Rise of Self-Medication

For millions of Indians, a doctor’s visit is a last resort. With consultation fees from ₹300 to ₹1,500, plus prescription costs, self-medication is often the easier choice. Over 52% of Indians now self-prescribe, relying on Google, online forums, and pharmacist recommendations.

The pandemic only strengthened this behaviour, making people more comfortable diagnosing and treating minor ailments themselves. As healthcare becomes more consumer-driven, e-pharmacies and retail pharmacies are now the first stop for medical needs.

E-Pharmacies and the Digital Shift

The traditional pharmacy model is rapidly evolving, with platforms like Tata 1mg, PharmEasy, Netmeds, and Apollo revolutionizing medicine sales. Tata 1mg dominates digital sales with 47.8 million monthly visits, leading to a market where 73% of OTC drug purchases still happen in retail stores. With growing trust and faster delivery, e-pharmacies are expanding, offering discounts and easy access. 

OTC Drug Misuse and Addiction

The lack of oversight means consumers can buy painkillers, sedatives, and codeine-based cough syrups in large quantities. These drugs, often intended for short-term use, are being misused for recreational purposes or leading to dependency.

Without a tracking system, there is no limit to how much a person can buy from different pharmacies, allowing addiction to grow unchecked. Antibiotics are freely available over the counter, leading to rampant misuse. Improper self-medication is creating drug-resistant bacteria, making common infections harder to treat.

The World Health Organization has flagged India as a high-risk country for antibiotic resistance, warning that misuse could render basic treatments ineffective, leading to a public health disaster.

Lack of Regulatory Oversight

Unlike the United States and Europe, where OTC drugs are tightly monitored, India’s regulatory framework is weak.

• In the US, ID verification is needed for certain painkillers and sedatives.
• In Europe, antibiotics are strictly prescription-only to control resistance.
• In India, anyone can buy sleeping pills, antibiotics, or painkillers freely.

This lack of restrictions is not just a loophole—it’s a liability. Without stronger policies, the OTC market risks collapsing under its own success.

The Race to Control India’s Digital Pharmacy Boom

The fight for dominance is no longer about who sells the most medicine—it’s about who owns the future of healthcare retail.

With Tata 1mg leading, and Apollo, Netmeds, and PharmEasy aggressively expanding, competition is fierce. Yet, despite their rapid growth, the industry remains largely unregulated.

Key concerns remain:

• Will the government introduce stricter policies for online OTC drug sales?
• Will e-pharmacies be required to verify prescriptions for certain drugs?
• Or will the industry continue expanding unchecked until it reaches a crisis point?

For now, the race is wide open, and whoever wins will define the next phase of India’s healthcare revolution.

The Government’s Struggle to Regulate

Recognizing the risks, the Indian government is slowly making moves to regulate the sector. The Production Linked Incentive (PLI) Scheme aims to boost domestic drug manufacturing with an approved incentive of INR 6,940 crores, while the Bulk Drug Parks initiative focuses on reducing import dependency by developing three major drug parks with an allocation of INR 3,000 crores to establish it.

However, these measures do not address the core issue—OTC drug regulation. Without clear guidelines on which drugs should require prescriptions and how sales should be monitored, the market will continue operating in a legal grey area.

Opportunity or Crisis?

India’s OTC market sits at a crucial crossroads. It is both a healthcare success story and a growing public health concern.

With proper regulations, India could build a model OTC market balancing access and safety but if unchecked growth continues, the consequences could be irreversible—from drug addiction to antibiotic-resistant infections.

The next few years will determine the future of India’s healthcare landscape. The only question is: will action be taken before it’s too late?