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From 365 injections a year to 52: a weekly insulin is now licensed in the UK

Qurexa Editorial Team14 October 20267 min read 0 0
From 365 injections a year to 52: a weekly insulin is now licensed in the UK

What happened

On 13 October 2026, the Medicines and Healthcare products Regulatory Agency (MHRA) licensed a new insulin for use in the UK. It is called Onswik. The active ingredient is insulin efsitora alfa, and it is made by Eli Lilly. What makes it different is how often you take it. Onswik is a long-acting basal insulin given by injection once a week. Most long-acting insulins are injected once or twice every day. The MHRA points out what that means in practice. For some people with type 2 diabetes, it could cut the number of insulin injections from up to 365 a year down to 52. The licence is for adults with type 2 diabetes. It was granted through something called the ACCESS Procedure, which is one of the routes the MHRA uses to assess new medicines. Julian Beach, the MHRA's Executive Director of Healthcare Quality and Access, said the decision "follows a rigorous assessment of the available evidence". He added that, "as with all medicines, we will continue to monitor its safety closely through our established surveillance systems". The National Institute for Health and Care Excellence (NICE) had already published final draft guidance recommending Onswik as an option for some adults with type 2 diabetes. That recommendation was waiting on the MHRA licence. Now the licence has been granted, the last gate has opened.

Why this matters

Injecting insulin every day is a job that never stops. It has to be done whether you are at work, on holiday, unwell or simply tired. For a lot of people it becomes routine. For others it is a daily hurdle. NICE was clear about who stands to gain the most. It expects the biggest benefit for people who need help to inject. That includes some frailer people, people with sight loss, people with limited movement in their hands, and people with learning disabilities. For those groups, a weekly injection does not just mean fewer needles. It can mean fewer visits from a carer or a district nurse, and far less disruption to ordinary life. If someone currently needs a carer to call in every single day purely to give an insulin injection, a weekly dose changes the shape of their week. There is a second reason this matters. Missed doses are a real problem in diabetes care. The fewer times you have to remember something, the harder it is to forget. A weekly rhythm is easier to build a habit around than a daily one. None of this makes Onswik right for everyone. It is one more option on a list, not a replacement for what already works.

What the evidence actually says

It is worth being careful here, because the headline number is about convenience, not about better blood sugar control. The MHRA said clinical trial data showed glycaemic control - how well blood glucose is kept in a healthy range - that was comparable to once-daily basal insulin treatments in adults with type 2 diabetes. NICE looked at the same kind of evidence and found the weekly treatment controlled blood glucose as effectively as two commonly used long-acting insulins, insulin degludec and insulin glargine. So the claim is that it works about as well, not that it works better. That is an important distinction, and it is the honest one. The MHRA's announcement did not publish the number of people in the trials or the detailed results. Those sit in the full Summary of Product Characteristics and the Patient Information Leaflet, which the MHRA says will appear on its Products website in due course. If you want to read the detail, that is where it will be. On safety, the MHRA named hypoglycaemia - low blood sugar - as the most commonly reported side effect. That is not a surprise. It is the main risk with insulin generally, and it is why dose changes are made carefully and with monitoring. NICE also added a condition that is easy to miss. It said the least expensive suitable option should be chosen, including basal insulin given once or twice a day, after the advantages and disadvantages have been discussed with the person who has the condition. Cost of the dose, cost of giving it, and local commercial arrangements all come into that decision. In other words, a licence and a NICE recommendation do not automatically mean you will be offered a switch.

Qurexa perspective

A change in dosing rhythm sounds small on paper and is rarely small in practice. We deliver prescriptions and support people with taking their medicines as prescribed, so this is the part we see up close. If a weekly insulin becomes an option for you, two practical things change. The first is your repeat prescription pattern. Quantities, review dates and reminders are usually built around a daily dose, and they may need resetting. The second is your routine at home - which day of the week you inject, where you write it down, and who else in the household knows. We would say the same thing to anyone switching any long-term medicine: the switch is the risky moment, not the months either side of it. That is when doses get doubled up or missed because the old habit and the new one overlap. If you use our delivery service and your insulin changes, tell us when you get your new prescription, so your deliveries match what you are actually taking rather than what you used to take.

Practical advice

If you have type 2 diabetes and this interests you, here is a sensible order to do things in. Do not change anything on your own. Never stop, swap or stretch out an insulin dose because of a news story. Insulin doses are matched to you, and changing them without advice can be dangerous. Wait for your next routine review, unless you have a reason not to. Your GP practice, diabetes nurse or consultant can tell you whether a weekly insulin would suit your situation. Availability will also take time to settle, so there may be nothing to decide yet. Write down your questions first. Useful ones include: would this work as well for me as what I take now? What happens if I inject on the wrong day? How would my blood glucose monitoring change? Would it cost the NHS more or less locally? Be honest about why you are asking. If daily injections are a struggle - because of your eyes, your hands, your memory, your job or your mood - say so plainly. That is exactly the information that makes a clinician think about a weekly option. Know the signs of low blood sugar. Shaking, sweating, feeling hungry, going pale, feeling anxious or confused. Keep fast-acting sugar with you and know what to do. This applies with any insulin, weekly or daily. Report side effects. Anyone can report a suspected side effect to the MHRA through the Yellow Card scheme or app. Those reports are a genuine part of how safety is monitored after a medicine is licensed.

What to know

The MHRA licensed Onswik (insulin efsitora alfa) on 13 October 2026 for adults with type 2 diabetes. It is a long-acting insulin injected once a week instead of once or twice a day, which could reduce injections from up to 365 a year to 52. The evidence says it controls blood glucose about as well as existing once-daily long-acting insulins, not better. The most common side effect reported is low blood sugar. NICE has recommended it as an option, with a reminder to pick the least expensive suitable treatment after a proper conversation with the patient. NICE thinks the clearest gains are for people who need help to inject. Nothing changes for you today. Keep taking your insulin exactly as prescribed, and raise it at your next review if you think a weekly dose would help. Sources: GOV.UK / MHRA, "MHRA authorises Onswik (insulin efsitora alfa) for adults with type 2 diabetes", 13 October 2026, https://www.gov.uk/government/news/mhra-authorises-onswik-insulin-efsitora-alfa-for-adults-with-type-2-diabetes; NICE Newsroom, "NICE recommends weekly insulin jab that could cut injections from 365 a year to just 52", 2026, https://nice-newsroom.prgloo.com/news/embargoed-nice-recommends-weekly-insulin-jab-that-could-cut-injections-from-365-a-year-to-just-52; Nursing in Practice, "NICE recommends weekly insulin jab for type 2 diabetes in final draft guidance", 2026, https://www.nursinginpractice.com/clinical/diabetes-and-endocrinology/nice-recommends-weekly-insulin-jab-for-type-2-diabetes-in-final-draft-guidance/ This article is for general information and does not replace advice from a doctor, pharmacist, diabetes nurse or other qualified healthcare professional. Never change an insulin dose without speaking to your healthcare team.

#diabetes#insulin#MHRA#NICE#medicines#NHS

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