Novo Nordisk launches Awiqli, a once-weekly basal insulin

Novo Nordisk has launched Awiqli (insulin icodec-abae), the first once-weekly basal insulin approved to improve glycemic control in adults living with type 2 diabetes. Awiqli will be available at 70,000 pharmacies in the United States and is expected to be covered by insurance for most eligible patients with Type 2 diabetes.

Awiqli is available as a prefilled FlexTouch pen. It will have a list price of $99 per package, a company spokesperson told Managed Healthcare Executive. For those with commercial insurance or considering a self-pay option through NovoCare.com, Awiqli will be available for $35 a month for patients with Medicare or commercial insurance or $55 a month for those who are uninsured.

Terms of the savings card programs say that patients whose insurance includes accumulator or maximizer programs are not eligible. Insurance company accumulator programs do not count the copays made through these programs toward deductibles. Maximizer programs adjust out-of-pocket sharing amounts based on the availability of manufacturer savings offers.

“Research supports weekly injectable diabetes medications can be associated with improved patient adherence. Having a weekly basal insulin option such as insulin icodec-abae may reshape insulin management in adults with Type 2 diabetes, giving them a routine that feels more manageable as they work toward their blood sugar goals,” Principal Investigator Julio Rosenstock, M.D., a clinical professor of medicine at the University of Texas Southwestern Medical Center, said in a news release in March 2026 when Awiqli was approved by the FDA.

About 40 million Americans have diabetes, and about 90% to 95% have Type 2 diabetes, according to the CDC. In Type 2 diabetes, cells don’t respond normally to insulin. This can lead to heart disease, vision loss and kidney disease. Risk factors for diabetes include being over the age of 45 and being overweight. African American, Hispanic or Latino, American Indian, or Alaska Native person. Some Pacific Islander people are at a higher risk.

The approval was based on results from the ONWARDS Type 2 diabetes phase 3a program, which included three randomized, open-label, active-controlled trials and one randomized, double-blind active-controlled trial. These trials included a total of about 2,680 adults with uncontrolled type 2 diabetes in patients previously treated with insulin and who were insulin-naïve.

The trials showed that Awiqli was non-inferior to active controls in the mean change in HbA1c. Active controls included once-daily insulin degludec, as well as insulin glargine plus an oral antidiabetic drug.

Common adverse events include hypoglycemia, serious allergic reactions, reactions at the injection site, skin thickening or pits at the injection site, itching, rash, swelling of the hands and feet, and weight gain.

Related: Novo Nordisk resubmits BLA for once-weekly insulin for Type 2 diabetes

Originally, Novo Nordisk had submitted an application for Awiqli for use in patients with Type 1 and Type 2 diabetes. But a meeting of the FDA’s Endocrinologic and Metabolic Drugs Advisory Committee meeting determined that the data available were not sufficient to conclude a positive benefit-risk in patients with Type 1 diabetes.