World’s First Once-a-Week Insulin Launches in India
On July 9, 2026, Novo Nordisk India launched Awiqli (insulin icodec), the world’s first once-weekly basal insulin, reducing injections from 365 to 52 per year. It is approved in India for adults with Type 1 and Type 2 diabetes who require basal insulin, to be taken on the same day every week.
Why Weekly Dosing Matters
Diabetes is a condition where the body either does not produce enough insulin or cannot use it effectively, causing blood sugar levels to rise. Uncontrolled diabetes can damage eyes, kidneys, nerves, heart, and blood vessels. Many people with Type 2 diabetes initially manage it with lifestyle changes and oral medicines, but as it progresses, many require insulin because the pancreas can no longer produce enough.
Basal insulin is long-acting, providing a steady background level of insulin throughout the day and night to control blood sugar between meals and during sleep. Until now, basal insulin required one injection every day. Awiqli contains insulin icodec, an ultra-long-acting insulin designed to remain active for an entire week, allowing patients to replace seven daily injections with one weekly dose.
Overcoming Psychological Barriers to Insulin Therapy
In India, many patients delay insulin therapy by an average of 7-9 years due to fear of daily injections, anticipated pain, and treatment complexity. Vikrant Shrotriya, Managing Director of Novo Nordisk India, said: “Insulin has been available for more than 100 years, but the majority of patients who need it still don’t take it. Worldwide, around 25-30% of people with Type 2 diabetes eventually require insulin. In India, only about 6-7% are on insulin. Insulin therapy has always been seen as an inconvenience. Hopefully, when it becomes once a week instead of every day, it breaks a significant barrier.”
Dr. S.K. Wangnoo, Senior Consultant Endocrinologist at Indraprastha Apollo Hospital in New Delhi, noted: “Whenever I tell patients they need insulin, many say, ‘Doctor, don’t give me insulin.’ They believe insulin is the last stage of diabetes, that it is painful and has to be taken every day. Many patients continue taking several oral medicines despite poor blood sugar control because they are reluctant. My rule is that if two or three medicines are not able to control blood sugar, it is time to start insulin. But many patients delay it for eight to ten years.”
Clinical Evidence Supporting Awiqli
Awiqli’s approval is based on the global ONWARDS clinical program, which enrolled more than 4,000 adults with Type 1 and Type 2 diabetes, including participants from India. All six Phase III trials met their primary endpoints. In the ONWARDS-1 trial, Awiqli achieved greater reductions in HbA1c (glycated hemoglobin) than once-daily insulin glargine U100, with patients spending more time within the target glucose range and experiencing fewer episodes of low blood sugar.
Pricing and Accessibility
Awiqli will be available in two FlexTouch pen variants, priced close to existing daily basal insulin therapies. A 700-unit (1 ml) pen costs Rs 2,611, which comes down to Rs 3.73 per unit, making it roughly 30-40% less expensive than current daily insulin options. Patients just beginning insulin therapy typically require around 10 units per day, or about 70 units per week, making the weekly insulin cost approximately Rs 261. The 2,100-unit (3 ml) pen costs Rs 7,833.
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