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NEW DELHI: Our battle with toxic air across cities is showing up sharply in medical bills. Sales of respiratory medicines, including anti-allergics and anti-asthma therapies, surged past Rs 1,950 crore in Dec 2025, the highest monthly level ever, signalling a troubling escalation in pollution-linked illnesses.

The Dec sales were 10% higher than the corresponding month in 2024, and over 18% more compared with 2023, figures culled from market research firm Pharmarack showed, indicating a consistent increase each year. For the Oct-Dec quarter, the period when pollution typically peaks, sales rose in tandem, by 14% year-on-year over 2024, and by 8% over 2023. During the quarter, respiratory therapy sales crossed Rs 5,620 crore, a rise of 17% over the previous quarter.

A majority under this therapy - nearly Rs 3,500 crore - was contributed by anti-asthma and COPD (chronic obstructive pulmonary disease) medication.

Further, Foracort, the medication used for asthma and respiratory issues, is among the top selling drugs during the winter months, mirroring the trend. In Dec, it was the second largest selling drug with sales of Rs 90 crore, following weight-loss therapy, Mounjaro.

Overall, the domestic pharma market is estimated at Rs 2.4 lakh crore annually. Exposure to air pollution can aggravate asthma and respiratory infections, and can even lead to serious issues like chronic obstructive pulmonary disease, medical experts say. "With rise in suspended particles in the air, allergic rhinitis and bronchitis patients increase by about 60% in the daily outpatient (department). Use of masks and air purifiers does help to a great extent especially in susceptible individuals.

As far as treatment is considered, use of steroid inhalers as well as anti-allergics forms the backbone," Amitabh Malik, head of department - ENT, Paras Health in Gurgaon, told TOI.

Other widely-used therapies during these months include Augmentin (marketed by GSK Pharma) and Paracetamol (pain and fever management). A GSK Pharma India executive said, "The Oct to Feb period typically coincides with a seasonal rise in upper respiratory infections.

This leads to increased demand for related medications during these months. Poor air quality is purported to be a contributing factor, particularly in the rise of allergic rhinitis and respiratory symptoms like cough and cold." Significantly, the trend is visible across zones - with north and south similar in sales, the data noted. "Multiple regions recorded a double-digit month-on-month growth, indicating that winter triggered ailments are no longer a seasonal fluctuation but air pollution in winter months makes it an escalating public health trigger," Pharmarack noted in its Nov update.