Overview
- The National Institute for Health and Care Excellence has issued final draft guidance endorsing efsitora alfa (Onswik, Eli Lilly) as a treatment option for adults with type 2 diabetes, subject to Medicines and Healthcare products Regulatory Agency authorisation.
- Phase 3 QWINT trials found once-weekly efsitora provided glycaemic control that was non-inferior to daily basal insulins and showed similar or lower rates of clinically significant hypoglycaemia in some comparisons.
- Regulatory steps remain: the drug must gain MHRA marketing authorisation before it can be used on the NHS and the draft guidance is open to appeal before it is finalised.
- NICE's economic assessment found overall costs are similar to or lower than daily basal insulins, with the biggest savings where weekly dosing reduces visits from carers or healthcare staff; NHS England would be required to commission the treatment within 90 days after final guidance is published following MHRA approval.
- Patient groups and NHS leaders say the weekly option could ease daily burdens for people who need help injecting insulin—such as frail patients, people with poor eyesight or limited dexterity—and stress the need for clear clinical guidance, staff training, and measures to ensure fair access.