First weekly insulin injection coming to Canada in 2 weeks, manufacturer says

Nicole Ireland, The Canadian Press

Posted on Monday, June 17, 2024 7:06AM EDT

Last updated Monday, June 17, 2024 7:06AM EDT

TORONTO – More people with diabetes in Canada will soon be able to take insulin once a week instead of every day, drugmaker Novo Nordisk announced Monday.

Insulin icodec, which will be marketed under the brand name Awiqli, is the world’s first once-weekly basal insulin injection and will be available nationwide starting June 30, the company told The Canadian Press ahead of the launch.

Canada is the first country to receive the product, which was approved by Health Canada in March for the treatment of adults with Type 1 and Type 2 diabetes.

“I think it’s a very big deal,” said Dr. Harpreet Bajaj, head of the Diabetes Canada clinical guidelines committee.

“(It’s big) for reducing the burden on these people who need insulin injections,” said Bajaj, an endocrinologist at LMC, a specialty diabetes and endocrinology clinic located in southern Ontario and Calgary.

He said some of his patients have participated in Awiqli’s clinical trials and have been asking when it will be available because they have had to return to daily injections since the study ended.

Although weekly insulin is approved by Health Canada for the treatment of Type 1 and Type 2 diabetes, endocrinologists say it will be more beneficial for Type 2 patients.

This is mainly because patients with Type 1 diabetes still have to give themselves rapid-acting insulin injections during meals every day because their bodies do not make insulin on their own. , Bajaj said.

People with Type 2 diabetes make insulin, but not enough or their body doesn’t use it properly. Basal insulin shots bring their hormone levels into balance during fasting, and other medications can control “glucose spikes that come with meals,” Bajaj said.

A series of randomized clinical trials for Awiqli — which involved many countries, including Canada and the US — were mostly conducted in Type 2 patients. Only one trial involved patients with Type 1 diabetes and found a greater risk of low blood sugar when those patients take a weekly insulin regimen.

The US Food and Drug Administration has not yet approved Awiqli. Its advisory committee on endocrinology and metabolic drugs concluded in May that more information is needed on the use of weekly insulin in patients with Type 1 diabetes.

Dr. Alexander Abitbol, ​​who is also an endocrinologist at LMC, said that the main advantage of the new product is that many patients who need insulin can only take it once a week – to help protect them against stressful problems if the disease. it is not properly treated.

“The result for patients is that fewer will remain with high blood sugar for longer,” said Abitbol.

“High sugar over a long period of time contributes to eye disease, kidney disease, stroke, heart disease and all the other problems we hear about with diabetes.”

Awiqli works as a time-release insulin over the course of a week, Abitbol said.

He said that insulin proteins are absorbed when injected and bind to another protein in the blood called albumin. In the weekly form, they bind more tightly and the insulin proteins gradually decrease.

Abitbol, ​​who was a researcher in a clinical trial involving Type 1 diabetes patients, said he would often prescribe Awiqli for Type 2 patients.

“I think that while weekly insulin is a great tool for nurses, we’re going to have to use it properly,” he said.

“It won’t be for every patient with diabetes, but for those who are, it will be a better option for them than basal insulin every day.”

Awiqli may still be the best option for some Type 1 diabetes patients, Abitbol said, because it’s the most effective way for them to get the treatment they need.

“Type 1 patient (patient) who refuses to take their insulin and stays in the hospital. Type 1 who may have a developmental or mental disorder and their family helps them (taking insulin) but he won’t be able to help her every day, but I can help them once a week,” he said.

Dr. Ehud Ur, an endocrinologist in Vancouver who was not involved in the clinical trials, says the new weekly insulin is “another tool in the toolbox” for treating diabetes – but many patients can’ can’t get it because of the cost.

“It can be a good option because it gives you one needle a week instead of a needle every day,” Ur said in an interview.

“The problem is that the reduction is a huge price difference,” he said, noting that daily insulin shots – which have been around for a long time – are cheaper than a new insulin product with patent.

The Canadian Drug Agency, which reviews drugs and recommends whether they should be reimbursed under public drug plans, estimates that Awiqli’s cost will be $1,350 per year per patient.

The agency recommended on its website that Awiqli be funded for the treatment of Type 2 diabetes, but on the condition that the price be lowered to match the much lower cost of regular insulin injections.

It is not yet known whether private insurers will pay for the more expensive weekly injection option for patients who prefer it, but Novo Nordisk was hopeful.

“We are seeing early signs that independent drug plans are seeing the value Awiqli offers to patients with Type 1 and Type 2 diabetes,” spokeswoman Kate Hanna said in an email.

This report by The Canadian Press was first published on June 17, 2024.

The Canadian Press’s health coverage is supported in partnership with the Canadian Medical Association. CP is solely responsible for this content.

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