The National Institute for Health and Care Excellence (NICE) has recommended a weekly insulin injection for people with type 2 diabetes, potentially reducing annual injections from 365 to 52—an 86% reduction. The treatment, insulin efsitora alfa (also known as Onswik and manufactured by Eli Lilly), is designed to stabilize blood sugar levels as effectively as daily injections but requires only one dose per week.
Health officials confirmed that the Medicines and Healthcare Products Regulatory Agency (MHRA) must still approve the treatment before it can be made available on the National Health Service (NHS). NICE’s final draft guidance, published on Thursday, assesses the drug as cost-effective, but NHS England has not yet announced plans for a nationwide rollout.
Who benefits most?
The shift to a weekly injection is expected to particularly assist individuals who require assistance with daily injections, including frailer patients, those with sight loss, limited hand mobility, or learning disabilities. The change could also improve adherence for people who struggle with daily treatment regimens.
Clinical and patient group responses
Diabetes UK welcomed the development, stating that the new option could improve quality of life for those with additional care needs. Douglas Twenefore, Head of Clinical at Diabetes UK, emphasized the importance of clear guidance and fair access if the treatment is adopted by the NHS. Meanwhile, Helen Knight, Director of Medicines Evaluation at NICE, highlighted the potential for greater flexibility in diabetes management, particularly for those relying on carers or healthcare professionals for injections.
Next steps
The MHRA’s decision remains pending, and officials have indicated they are awaiting regulatory approval to determine whether the treatment can be integrated into NHS diabetes care. If approved, the weekly jab could become a game-changing alternative for the 4.7 million people in the UK living with diabetes, 90% of whom have type 2.
Background on type 2 diabetes
Type 2 diabetes occurs when the body either does not produce enough insulin or the insulin it produces does not function properly, leading to elevated blood sugar levels. Approximately one in four people with type 2 diabetes currently relies on insulin injections, which are typically administered daily or multiple times per day. The new weekly injection aims to address challenges such as treatment adherence, physical limitations, and caregiver support, while maintaining the same clinical effectiveness as existing options.