Swapnadip Roy, 33, and Vicky Ramancha, 37, Indian citizens and Dubai residents, were indicted in the Middle District of Florida over an alleged scheme to smuggle and sell counterfeit Ozempic to U.S. distributors at discounted prices. Roy pleaded not guilty Tuesday after being extradited from Italy, while Ramancha remains at large. Prosecutors say the products came from China and included counterfeit packaging, inserts, labels and needles intended to resemble Novo Nordisk's authorized medicine. The alleged scheme ran from July 2023 through April 2024, including the delivery of about 11,000 counterfeit units to an Ohio warehouse in March 2024. The Justice Department said the activity continued after the FDA seized some counterfeit Ozempic in December 2023 and issued a public warning. Each defendant faces up to 71 years in prison if convicted.