Overview
- NICE issued final draft guidance this week recommending efsitora alfa (Onswik, Eli Lilly) as a once-weekly insulin option for adults with type 2 diabetes, but the recommendation is conditional on MHRA marketing authorisation.
- Phase 3 QWINT trials found weekly efsitora alfa achieved blood-glucose control that was non-inferior to daily long-acting insulins and showed similar or lower rates of clinically significant hypoglycaemia.
- Switching eligible patients from daily basal insulin to the once-weekly pen could cut annual injections from 365 to 52, which may reduce caregiver visits and ease treatment for people with frailty, sight loss, limited hand movement, or learning disabilities.
- NICE judged overall costs for efsitora alfa to be similar to or lower than current basal insulins and said NHS England would have to fund the drug within 90 days of final guidance if the MHRA grants a licence, noting the draft guidance is open to appeal and finalisation is expected in early September.
- Rollout will depend on MHRA approval, local decisions across the devolved nations, clinician training, and further data on groups underrepresented in trials so clinicians can identify which patients will benefit most.