Novo Nordisk readies once-a-week insulin shot for Indian market

Mumbai: Danish pharma giant Novo Nordisk is set to launch the world's first once-weekly insulin brand Awiqli (insulin icodec) in India, making the country one of its earliest target markets. Seen as a breakthrough for diabetes patients, Awiqli lessens the need for insulin injections from 365 or one a day to 52 in a year, consolidating Novo Nordisk's global leadership ahead of rivals Eli Lilly and Sanofi.

"We have always aspired to bring breakthrough therapies to Indian patients at the earliest opportunity," Vikrant Shrotriya, MD of the Indian operations, told ET in an interview.

"People perceive insulin as the last resort because they associate it with multiple injections every day," he said. "With once-weekly basal insulin (ultra long-acting), we have an opportunity to change that perception." Basal refers to long-acting insulin that keeps the blood glucose levels within range over a longer timeframe.


Novo Nordisk expects annual treatment costs with Awiqli to be 20-25% lower than existing analogue basal insulin therapies.

"The annual treatment cost varies from patient to patient because insulin dosing depends on individual insulin requirements...However, we have been very conscious about pricing...," said Shrotriya.

Sources told ET that once-weekly insulin icodec is launching at approximately ₹3.5 per unit, virtually at price parity with existing basal insulins such as degludec and glargine. India has approved Awiqli for adults with both Type 1 and 2 diabetes, broader than the current US approval, which is only for use in Type 2 diabetes patients. In global clinical trials, Awiqli showed higher risk of hypoglycaemia (low blood sugar) in Type 1 diabetes patients compared to other insulins.

"While insulin analogues such as glargine, degludec and U300 glargine have focused on smoother pharmacokinetics and lower hypoglycaemia, insulin icodec changes something far more fundamental-the frequency of insulin administration," said leading diabetologist Rajiv Kovil.

Awiqli showed better HbA1c reduction and time in range or the percentage of time glucose levels stay within recommended target range compared to daily basal insulins. More people with Type 2 diabetes reached an HbA1c below 7% without hypoglycaemia.