From 365 Pricks To 52 A Year: Novo Nordisk Brings Once-A-Week Insulin At Rs 2,600 Per Pen | India News
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Awiqli will be priced at Rs 2,611 for a disposable FlexTouch pen containing 700 units, which works out to roughly Rs 3.70 per unit.
The company on Thursday launched Awiqli – derived from the word “a weekly” – in India, and the drug is likely to be available at pharmacies starting Friday, 10 July. (AI generated image)
For a person living with diabetes, the day often begins with a needle – needing at least 365 shots of insulin in a year. Danish drugmaker Novo Nordisk has found a way to cut that number down to just 52 with the launch of the world’s first “once-weekly basal insulin”.
The company on Thursday launched Awiqli – derived from the word “a weekly” – in India, and the drug is likely to be available at pharmacies starting Friday, 10 July.
Vikrant Shrotriya, managing director of Novo Nordisk India, told News18 in an exclusive interview that, “The launch of Awiqli is a watershed moment for the company,” he said. “Instead of 365 injections a year, to start with foreign insulin initiation, somebody just has to take 52 injections.”
The company has launched Awiqli at Rs 2611 for 700 units, claiming that the pricing is 25 to 35 per cent cheaper on average than modern second-generation insulin.
With over 100 million diabetics and another 130 million pre-diabetics, India is one of the largest markets for the Danish drugmaker. “It is in the top 10 — I don’t shy away from saying that,” Shrotriya said of India’s importance to Novo Nordisk globally, pointing to the company’s manufacturing and R&D presence in Bengaluru, its foundation office at IIT Delhi, and its regional holding office in Mumbai’s Bandra-Kurla Complex as evidence of long-term commitment beyond the commercial business.
How Is Once-A-Week Insulin Important For India?
Shrotriya believes that this insulin solves the problem of human reluctance and hesitation in accepting insulin. Despite a century of insulin therapy and multiple generations of increasingly refined molecules, India still struggles to get patients onto insulin when they need it — and to keep them there. “Many of the treatments, availability of so many of the treatments, we still do not have ideal HbA1c control of the glucose,” he said. “Primarily, one of the reasons is that people deny early insulin. By the time they take insulin, it’s 8 or 9 years late. It has been studied that 93 per cent of patients would not like to take insulin injections, and in fact, even the physicians have the same hesitancy.”
That delay is not a small thing, Shrotriya warns. By the time many patients finally begin insulin therapy, he said, close to half of the beta cells that would have secreted the hormone naturally are already lost — a quiet, irreversible cost of procrastination that both patients and doctors are complicit in.
The numbers back him up. Data from the National Family Health Survey-6 (2023-24) shows that 20.9 per cent of Indian men aged 15 and above now have high blood sugar or are on medication for it, up from 15.6 per cent just a few years earlier in NFHS-5 (2019-21). Among women, the figure has climbed to 17.8 per cent from 13.5 per cent over the same period. India is already home to over 101 million people living with diabetes, and another 136 million sit just one step behind them with prediabetes — a population large enough to reshape the country’s public health priorities for a generation.
What Actually Happens Inside The Body
The science behind Awiqli traces back to a discovery from the 1950s, when scientists, including Frederick Sanger, who first sequenced insulin’s amino acid structure, opened the door to modifying the hormone itself rather than just its delivery. Novo Nordisk has altered three amino acid positions on the insulin chain and attached a fatty acid to one end — changes that extend the drug’s effective half-life to more than 190 hours, according to Shrotriya. That modified molecule binds reversibly to albumin, a protein in the blood, and releases slowly over days rather than hours, which is what allows a single injection to cover an entire week.
“Time in range, that means insulin coverage, is very good. HbA1c control is very good,” Shrotriya said, adding that the risk of hypoglycaemia — the low-blood-sugar episodes patients fear most — remains “as good or as bad” as with existing insulins, despite the far longer coverage window.
The claims rest on the ONWARDS clinical programme, six phase 3a trials that together studied more than 4,000 patients globally, including participants in India. Novo Nordisk says all six trials met their primary endpoints, and that Awiqli demonstrated superior HbA1c reduction and improved time in range compared with once-daily glargine U100, without any added safety trade-off.
Pricing: The Part That Decides India’s Story
Innovation is one thing, but getting a price-sensitive market like India to adopt it is another altogether, and Shrotriya was candid that the company has learned this lesson over four decades of operating in the country. Awiqli will be priced at Rs 2,611 for a disposable FlexTouch pen containing 700 units — which works out to roughly Rs 3.70 per unit.
“You will be surprised, and it’s a moment of joy, that it is actually cheaper by 25 per cent on average from the modern second-generation insulins,” Shrotriya said, later revising the figure upward in conversation to as much as 35 per cent against some comparators. “We want early insulin initiation, and we personally believe it changes life for many patients when it is given.”
The strategy echoes what the company did with semaglutide branded as Ozempic, he said: lower the price, and adoption follows. “We learned from semaglutide that we reduce the price, and the accessibility increases,” he said. “It’s a very classic example.”
Who Should Actually Make The Switch?
Shrotriya was careful not to position Awiqli as a blanket replacement for every patient on insulin today. The decision, he said, rests squarely with treating physicians. “They must be having their close physician and diabetologist who can prescribe,” he said. “If their glucose is not controlled, and in diabetes, normally periodically, patients go to the doctor — if the doctor prescribes, then they can take the benefit of this medication.”
Benefits And Side Effects: Experts
According to Dr Anoop Misra, executive chairman of Fortis C-DOC Hospital for Diabetes and Allied Sciences, “once-weekly basal insulin is a significant advance in diabetes care.”
“It can reduce the burden of daily injections and improve treatment adherence in appropriately selected adults with type 2 diabetes who require basal insulin. Careful patient selection, education, and dose titration are essential to ensure safe and effective glycaemic control.”
Similarly, Dr Ambrish Mithal, group chairman, endocrinology & diabetology at Max hospitals believe that the launch of Awiqli is a significant advancement in the country’s arsenal against diabetes. “Basal insulin does not take care of meal-related spikes. Insulins such as glargine mimic basal insulin secretion and are classically given once every 24 hours. Delivering a large dose once every seven days is a very significant advancement. The advantages are convenience and better adherence, as people are more likely to stick to treatment and follow-up. It also becomes easier to convince patients to start insulin therapy.”
The downside, he explained, is that we cannot micro-adjust doses as we can with daily basal insulin. “If a patient develops hypoglycaemia, it may last longer because you cannot stop the insulin once it has been administered. It will require significant training for doctors and diabetes educators. Initially, there may be some challenges.”
Another challenge is a missed dose, Mithal said. “Managing a missed weekly dose is more complicated, and it cannot be corrected quickly.”
Overall, experts believe it is a good advancement and a welcome one. It is largely meant for people with type 2 diabetes whose blood sugar is not controlled with oral diabetes medications. Many patients are reluctant to start insulin, but a once-a-week injection may make it much easier for doctors to convince them.
Beyond Insulin: What Else Is Coming?
Shrotriya shared a glimpse into Novo Nordisk’s broader India pipeline, which extends well past diabetes. The company has filed for approval of an oral GLP-1 formulation, Wegovy pill, in India, though he cautioned its launch remains some way off. Also in development are cagrilintide-semaglutide for weight management, a treatment positioned for both obesity and cardiovascular risk, a once-weekly growth hormone therapy for growth hormone deficiency, and an upcoming treatment for sickle cell disease.
On semaglutide losing patent protection in India in March this year, Shrotriya rejected any suggestion that the company is seeing a “dry” revenue trend despite generic competition entering the market. “I think we are sequentially, month by month, growing,” he said, crediting the company’s fully in-house supply chain — from the active ingredient to the needle itself — for sustaining physician and patient trust even as generics multiply. He pointed out that even a year after launch, less than 1 per cent of India’s eligible population has received semaglutide-based treatment, against a backdrop of 250 million people classified as overweight, 350 million with central obesity, 100 million living with diabetes, and 130 million with impaired glucose tolerance.
About the Author
Himani Chandna, Senior Associate Editor at CNN-News18, tracks healthcare, pharma and medical research, bringing clarity to complex science and policy.
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