Insulin Glargine(Boehringer Ingelheim)

For patients living with Type 2 diabetes in the United Kingdom, a more convenient treatment option may be on the horizon after the country's drug price watchdog recommended Eli Lilly’s once-weekly insulin injectable, Onswik, for coverage on the National Health Service. The National Institute for Health and Care Excellence (NICE) serves as the U.K.’s drug cost assessor, determining whether a new drug’s price-to-benefit ratio merits coverage via the publicly funded NHS. The agency's seal of approval for Onswik means hundreds of thousands of patients with type 2 diabetes could eventually switch to a weekly injection and reduce their annual injections by 85%, should Lilly's long-acting option score approval in the country. The Onswik option could be particularly valuable to patients who need assistance with their insulin injection because of factors like sight loss, frailty, limited hand movement or difficulty following the necessary steps, according to final draft guidance from NICE issued early Thursday U.K. time. Switching to weekly injections also could reduce those patients' dependence on caregivers and healthcare workers and offer more flexibility in their day-to-day lives, the drug value appraiser added. A Lilly spokesperson told Fierce that the pharma is now "awaiting a decision from the MHRA on marketing authorization." “This recommendation is an important step towards giving people with type 2 diabetes greater flexibility in how their condition is managed,” Douglas Twenefour, head of clinical at Diabetes UK, said in a press release. Younger patients with type 2 diabetes may also benefit from Onswik if the weekly schedule helps them balance treatment with their working life. NICE based its recommendation on data from Lilly’s late-stage QWINT-1, QWINT-3, and QWINT-4 clinical trials. The results showed non-inferior A1C reduction with Onswik compared to daily insulin in patients taking insulin for the first time, patients who previously took daily insulin and patients who previously used daily insulin and mealtime insulin. Overall, Onswik controlled blood glucose as well as two commonly used daily insulins, insulin degludec and insulin glargine, and maintained a similar safety profile. “This recommendation is the result of rigorous, evidence-based decision making, striking a balance between the benefits to patients and the best use of limited NHS funding,” Helen Knight, director of medicines evaluation at NICE, said in a statement. The endorsement comes at a time when several pharmas, including Lilly , have been critical of the agency’s cost-effectiveness evaluations and their influence on the prices paid for new medicines in the U.K. Last year, Merck and AstraZeneca pressed pause on expansion plans in the U.K., citing an inhospitable environment for drugmakers. And Bristol Myers Squibb threatened to withhold a drug from the NHS if the agency wouldn’t match its U.S. price. By the end of 2025, corporations had pulled 2 billion pounds ($2.7 billion) in planned investments in the country. The tension was partially resolved by a U.S.-U.K. pharma trade deal struck in December and finalized this spring. Under the deal, the U.K. is subject to 0% tariffs on pharmaceutical exports to the U.S. until 2029. In exchange, the NHS must raise spending on new medicines by roughly 25% and NICE must increase its price ceiling, paving the way for a higher cost-effectiveness threshold. Onswick earned a favorable recommendation for type 2 diabetes treatment from the European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) earlier this summer, but the drug is still awaiting final sign-off from the European Commission. Lilly could also see an FDA decision on its long-acting insulin by the end of the year.

iStock, Golden Sikorka Newly approved weight loss pill Foundayo reduced blood sugar more than Novo Nordisk’s semaglutide and other comparators in multiple Phase 3 type 2 diabetes trials. Eli Lilly will seek approval in this indication. Eli Lilly’s oral GLP-1 drug orforglipron—approved as Foundayo for chronic weight management—elicited better blood sugar control than competing diabetes drugs, including Novo Nordisk’s blockbuster therapy semaglutide. That’s according to data from three Phase 3 studies in the broad ACHIEVE clinical program, focusing on patients who had achieved inadequate glycemic control on metformin and other prior treatments. ACHIEVE-3 compared Foundayo head-to-head against Novo’s oral semaglutide, marketed as Wegovy for weight loss. Meanwhile, ACHIEVE-2 used AstraZeneca’s Farxiga as the control and ACHIEVE-5 used placebo plus insulin glargine. Lilly presented findings from all three trials Monday at the 2026 American Diabetes Association conference. Foundayo’s achievements across the ACHIEVE program “further solidify” the drug’s positioning in type 2 diabetes (T2D), BMO Capital Markets told investors in a Monday note, adding that the asset has shown a “consistently competitive profile” in the indication. At the 52-week follow-up in ACHIEVE-3, a 9-mg dose of Foundayo led to a 1.9% reduction in HbA1c, an indicator of blood sugar levels over the past two to three months. Comparators on 7-mg semaglutide, meanwhile, saw a 1.1% decrease in HbA1c. Foundayo maintained this advantage at higher doses: 17.2 mg of Lilly’s drug drove HbA1c down 2.2%, versus 1.4% with 14 mg of Novo’s drug. In ACHIEVE-3, 17.2 mg Foundayo elicited 73.6% greater weight loss than 14 mg oral semaglutide. ACHIEVE-2 and ACHIEVE-5 similarly delivered victories for Foundayo. The GLP-1 cut HbA1c by an average of 1.7% at 40 weeks in ACHIEVE-2, versus 0.8% in controls on Farxiga. The sugar-lowering effect of Foundayo reached up to 2.1% on average at 40 weeks in the latter trial, whereas placebo plus insulin glargine elicited a 0.8% HbA1c drop. “Orforglipron demonstrated clear benefits in HbA1c reduction and weightloss as an add-on to metformin or insulin glargine when compared to dapagliflozin, semaglutide or placebo,” the analysts wrote. “The consistency of these data across treatment combinations and comparator arms continues to position orforglipron well in the broader landscape of oral T2D therapeutics.” New data in hand, Lilly is preparing another regulatory run for Foundayo, with a type 2 diabetes submission planned for the second quarter of this year, according to a company announcement on Monday. “We continue to see an opportunity for orforglipron to compete as a once daily oral treatment with room for multiple winners in T2D,” BMO wrote in its note. Foundayo won approval in April , marking the next chapter in its heated weight-loss rivalry with Novo, which earned the FDA greenlight for oral Wegovy in late December 2025. With its thorough victory in the injectables phase of the competition, Lilly is an early favorite in the oral face-off. But Novo has come out swinging with a four-month headstart, better efficacy numbers—16.6% weight loss at 72 weeks for oral Wegovy, versus Foundayo’s 11.2%—and a massively successful launch . There have been no direct head-to-head comparisons of the two drugs in weight loss. Obesity ADA: Novo boasts deep pipeline, ‘breadth of assets’ after analysts award Lilly weight loss gold Novo Nordisk and Eli Lilly presented data extolling the benefits of their relative weight loss therapies in obesity-linked indications, while analysts at BMO Capital Markets were “encouraged” by the strategy communicated by Novo management. June 8, 2026 · 5 min read · Heather McKenzie Read more Obesity Deep dive: The oral obesity wars BioSpace examines how the FDA approval of Eli Lilly’s oral obesity drug Foundayo has ignited a key race with Novo Nordisk. May 18, 2026 · 3 min read · Heather McKenzie Read more