Status: formally approved on 16 September 2026; reimbursement, launch and hospital adoption were not confirmed as of 30 October 2026.
Approved scope
Onswik (insulin efsitora alfa) is a once-weekly basal insulin for type 2 diabetes requiring insulin therapy. It is not indicated for type 1 diabetes.
Evidence
QWINT-2 randomized 928 adults and met non-inferiority versus once-daily insulin degludec for HbA1c change at 52 weeks. Non-inferiority does not mean overall superiority.
Safety and access
Hypoglycaemia remains important. A weekly formulation is not a simple sevenfold conversion of a daily dose. Initiation and switching require medical supervision. Approval alone does not establish reimbursement, launch or international-patient access.