{"id":15128,"date":"2026-08-17T09:00:00","date_gmt":"2026-08-17T09:00:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=15128"},"modified":"2026-08-17T09:00:00","modified_gmt":"2026-08-17T09:00:00","slug":"newsom-promotes-affordable-insulin-but-californias-generic-label-off-to-a-slow-start","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=15128","title":{"rendered":"Newsom Promotes Affordable Insulin, but California\u2019s Generic Label Off to a Slow Start"},"content":{"rendered":"

SAN FRANCISCO \u2014 At a Walgreens in this city\u2019s bustling Japantown neighborhood, pharmacist Margaret On stocks two boxes of long-acting insulin pens from California\u2019s new prescription drug label, CalRx<\/a>, emblazoned with the state\u2019s iconic grizzly bear.<\/p>\n

Although she hasn\u2019t dispensed any, On plans to keep them on hand. \u201cIt\u2019s good to have if a patient comes in and doesn\u2019t have health insurance,\u201d she said. \u201cOr just in case of emergencies.\u201d<\/p>\n

Seven months after the launch of its own low-cost insulin brand, state health officials said California has distributed more than 120,000 five-pen packs of insulin glargine priced at $55 each, significantly less than the $89 to $411 that the state says most popular brand names charge before any retail markups or consumer discounts.<\/p>\n

While it represents a tiny amount of the state\u2019s insulin pipeline, it marks the first time a state is competing against the three biggest<\/a> insulin drugmakers \u2014 Eli Lilly, Sanofi, and Novo Nordisk \u2014 under its own prescription drug label. CalRx, Gov. Gavin Newsom\u2019s experimental initiative, has dual aims: to act as an emergency supplier for people who are uninsured or can\u2019t afford their prescriptions, and to disrupt the nation\u2019s deep-pocketed pharmaceutical industry, which cost the U.S. $467 billion<\/a> in 2024, the federal government reported in June.<\/p>\n

Newsom, a Democrat considering a presidential run in 2028, is expected to make healthcare a central pillar<\/a> of his national platform as he concludes his second and final term as governor. To create the state brand of generic drugs, California inked a $50 million contract with Civica<\/a>, a Utah-based nonprofit drugmaker, to develop the CalRx insulin, known as a biosimilar. Though major distributors make the drug available in pharmacies around the state, uptake has been limited.<\/p>\n

Newsom\u2019s goal is to saturate the insulin market and offer generic versions of drugs either high in cost or low in supply, or that can improve public health. The state is also distributing free naloxone, used in a nasal spray to reverse opioid overdoses, and trying to bring albuterol inhalers to public schools for students with asthma emergencies. In the next two years, the state plans to launch epinephrine injectables, commonly known by the brand name EpiPen, which are used to treat severe allergic reactions, as well as a state-branded medication to treat tuberculosis.<\/p>\n

Before he leaves office in January, Newsom said, he wants to add generic GLP-1 medications to compete with brand-name drugs such as Ozempic and Wegovy. The drugs have exploded in popularity<\/a>, but employers have raised concerns<\/a> about their cost.<\/p>\n

Taking on drug costs is a winning political issue for both Democrats and Republicans, who have for years tried to rein in soaring healthcare spending<\/a> as Americans feel the pinch of high prices at pharmacy counters, in doctors\u2019 offices, and from health insurance premiums. The U.S. spends roughly twice as much per capita<\/a><\/a><\/a> on prescription drugs as other industrialized countries. Six in 10 adults in the U.S. say they\u2019re worried about being able to afford their prescription drug costs, according to a poll last winter by KFF<\/a>, and 4 in 10 say they\u2019ve tried to save money such as by skipping doses and not filling prescriptions.<\/p>\n

In February<\/a>, President Donald Trump launched TrumpRx<\/a> to potentially lower out-of-pocket costs for consumers. But TrumpRx doesn\u2019t produce drugs; rather, it directs consumers to find more affordable medications with coupons or on drugmakers\u2019 websites. Newsom, in contrast, is trying to drive down the underlying price of medicines by increasing the manufacturing and availability of generic drugs.<\/p>\n

While some people with diabetes may benefit from CalRx insulin, California\u2019s generic drug effort is largely symbolic at this time, said Geoffrey Joyce, director of health policy at the Schaeffer Center at the University of Southern California. \u201cThere is some value, but it\u2019s for a very limited number of drugs for just a fraction of the population,\u201d Joyce said.<\/p>\n

And TrumpRx isn\u2019t helping at a large scale either, Joyce added, because many medications it advertises have cheaper generic versions available elsewhere. It would be better, he said, to develop large-scale initiatives that tackle key drivers of the high cost of drugs, for rare cancers for instance, and produce safer and higher-quality medicines.<\/p>\n

\u201cWhat you really need is a national effort that focuses on vulnerabilities like supply shortages and increasing the supply of generic products for higher-priced drugs,\u201d Joyce said.<\/p>\n

Market Disruptor<\/strong><\/p>\n

CalRx aims to make insulin more affordable and accessible for the nearly 3.7 million<\/a> California adults diagnosed with diabetes. Newsom last year singled out the three major drugmakers that control more than 90% of the global insulin market, while also targeting intermediaries known as pharmacy benefit managers for promoting higher-priced drugs over cheaper generic alternatives.<\/a><\/p>\n

Patients with health insurance often receive discounts at the pharmacy counter and do not pay sticker prices, yet those discount programs can be hard to navigate and patients can face restrictions. While drugmakers and pharmacy benefit managers said they\u2019ve already initiated $35-a-month caps<\/a> on out-of-pocket costs and pass price discounts on to consumers, Newsom argues that consumers still struggle to afford their medications.<\/p>\n

He has criticized pharmaceutical companies for gouging Californians and contended that the industry\u2019s discounting schemes don\u2019t adequately address inflated prescription drug spending, which in the U.S. rose 7.9% in the most recent reporting year.<\/p>\n

In his announcement last year that CalRx insulin would go on sale in January 2026, Newsom said the industry had been using discounts to distract consumers from solutions that could bring overall prices own. \u201cOne of the things that all of us should be increasingly concerned about is announcements around caps, announcements around discounts,\u201d he said.<\/p>\n

In January, California joined dozens of other states<\/a> in setting insulin price caps<\/a>. It also passed a law<\/a> attempting to ban price inflation practices<\/a> by pharmacy benefit managers.<\/p>\n

Representatives for drug companies and pharmacy benefit managers said insulin is largely an affordable medicine in the U.S., arguing that consumers have benefited from discounts.<\/p>\n

\u201cWhile insulin prices, set solely by pharma companies, may be high in some instances, the amount patients are paying out of pocket has declined significantly,\u201d said Christine Rex, senior director of state public affairs for the Pharmaceutical Care Management Association, which represents pharmacy benefit managers.<\/p>\n

Reid Porter, a spokesperson for Pharmaceutical Research and Manufacturers of America, which represents brand-name drugmakers, said PBMs have driven up costs for consumers by excluding lower-cost medicines from their lists of covered drugs. \u201cToo often, patients face a system in which insurers and PBMs exclude coverage of those medicines on formularies because of supply-chain incentives,\u201d he said.<\/p>\n

Where To Find CalRx Insulin<\/strong><\/p>\n

CalRx insulin has been slow to reach pharmacies around the state, and in interviews, patient advocates said many people with diabetes aren\u2019t aware it\u2019s an option.<\/p>\n

In Sacramento, pharmacist Sharon Ngo, who works at a Safeway pharmacy, was surprised to learn that California had a long-acting insulin product on the market. She didn\u2019t know that CalRx insulin was interchangeable with Lantus, which was on back order for roughly two weeks.<\/p>\n

\u201cI had no idea this was available,\u201d she said as she took notes on a pad of paper. \u201cWe\u2019re going to give this a try.\u201d<\/p>\n

CalRx insulin has a suggested retail price of $55 a pack and is available with or without insurance. California has inked deals with four health insurers to cover CalRx insulin on their health plan formularies, potentially making it cheaper, depending on copays. They include Anthem Blue Cross, Blue Shield of California, the Valley Health Plan for Santa Clara County employees, and the Federal Employees Health Benefits Program, according to the state Department of Health Care Access and Information.<\/p>\n

Pharmacist Margaret On keeps two boxes of California\u2019s new generic insulin product under the CalRx brand on hand in case of emergencies. (Angela Hart\/KFF Health News)<\/p>\n

Elizabeth Landsberg, the department\u2019s director, said the state is working to get more insurers to cover CalRx insulin and to provide it at more pharmacies. The state doesn\u2019t know how many boxes have been dispensed. However, Landsberg said it was more meaningful that the state had reached agreements with three major pharmaceutical wholesalers<\/a> to distribute its product in California. Currently, CalRx insulin is available on Amazon and at Costco, as well as at some retail and grocery store pharmacies including CVS, Walgreens, and Walmart.<\/p>\n

\u201cWhat we\u2019re really trying to do is change market behavior and offer both affordable and transparent pricing,\u201d Landsberg said. \u201cThe rebates and discounts are hard for consumers to understand and can change at any time, so we are trying to be straightforward and say, \u2018Let\u2019s not play this shell game anymore.\u2019\u201d<\/p>\n

Allan Coukell, chief government affairs and public policy officer at Civica, said the company first partnered with the state on long-acting insulin that helps patients keep blood sugar steady for 24 hours or more. Next, it plans to help California develop rapid-acting insulin, which is used to pull elevated glucose down within minutes, to compete with brand names such as Humalog and NovoLog.<\/p>\n

Health insurance companies welcomed the state\u2019s efforts, in part because they could help save money they pay out on prescriptions.<\/p>\n

\u201cMaking this drug available is really about helping people improve their health,\u201d said Paul Markovich, CEO of Blue Shield of California\u2019s parent company. \u201cAnd the more supply we can get on the market, the more we can get rid of the profit motives in the pharmaceutical industry.\u201d<\/p>\n

One July afternoon in the Southern California city of Corona, Chris Noble went to a CVS pharmacy to get a box of CalRx insulin. The pharmacist didn\u2019t have any on hand, but Noble, a healthcare organizer with Type 1 diabetes, was told he could get a prescription filled in 24 hours.<\/p>\n

\u201cI have insurance, but I see myself using this if I\u2019m traveling and something happens like my insulin pump malfunctions,\u201d he said. \u201cNow I know I can go to a CVS and get insulin within a day.\u201d<\/p>\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/em><\/p>\n

This article<\/a> first appeared on KFF Health News<\/a> and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<\/p>","protected":false},"excerpt":{"rendered":"

SAN FRANCISCO \u2014 At a Walgreens in this city\u2019s bustling Japantown neighborhood, pharmacist Margaret On stocks two boxes of long-acting insulin pens from California\u2019s new prescription drug label, CalRx, emblazoned with the state\u2019s iconic grizzly bear. Although she hasn\u2019t dispensed any, On plans to keep them on hand. \u201cIt\u2019s good to have if a patient…<\/p>\n","protected":false},"author":0,"featured_media":15129,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-15128","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/15128"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=15128"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/15128\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/15129"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=15128"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=15128"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=15128"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}