Indias patent reforms represent a shift in Indias policy from one of enormous opposition to revising patent laws according to the WTO, to one of compliance with many aspects of TRIPs (Trade Related Intellectual Property Rights) Agreement. Industry and civil society had a strong interest in blocking reforms on IPRs (Intellectual Property Rights), and initially played an important role in preventing reforms of Indias patent law. India has recently changed its patent regime, led by important industry groups who revised their positions, and new NGOs that promoted reform. The preferences of actors and their changing interests are important factors in the reform process. Perceived benefits from the new regime partly explain the rise of a pro-reform constituency among industry and NGOs. Yet preference formation is complex and depends on interpretation of strategies by various actors. The Indian pharmaceutical case reflects the imperatives both to forge ahead on patent reform, while protecting the generic market and restricting IPRs. NGOs that emerged to support patent reform also played a role in directing policy towards protecting traditional knowledge. The interests of actors do not always follow predictable paths, and are not fixed. Evaluating the preferences of actors rather than assuming them provides insights into the way policy processes are shaped.