The move is a bold and direct challenge to the top three insulin manufacturers in the U.S. — Ely Lilly, Sanofi and Novo Nordisk — who control 90% of the market and whom Newsom accused of price gouging consumers for years. In addition to the lower cost, the CalRx branded insulin brings an unprecedented level of transparency to an industry shrouded in secrecy and best by backroom deals with middlemen. Each vial will have a QR code that links to the $55 maximum price, so consumers will know exactly how much their health plan or pharmacy has added on top.
“This is really disruptive,” said Mariana Socal, a health policy professor at Johns Hopkins University. “This is bringing real competition to the market. It’s really opening up new possibilities for patients and plans.”
The Kaiser Permanente Richmond Medical Center on March 19, 2024. (Martin do Nascimento/KQED)
Her research shows that health insurers could provide the CalRx insulin to patients for $0 in cost sharing or copays and still save money and according to Newsom, Blue Shield of California has already added CalRx insulin to its formulary. For patients with high-deductible plans or no insurance, buying state insulin directly from the pharmacy could save up to $4,000 per year.
For the 3.5 million Californians who have diabetes, CalRx insulin could have a material impact not just on their wallets, but their health, too. Many patients say they have had to ration insulin because of the high cost, or choose between their medication or groceries. Being without insulin for even a short time can have dire health consequences.
“I was once out of insulin for five hours, and that put me in the ICU for two weeks,” said Niketa Calame-Harris, who has Type 1 diabetes. She said she now has neuropathy, or nerve pain, and gastroparesis, a digestive condition that causes nausea and abdominal pain, as a result of having limited access to insulin earlier in her life. “Seeing the dollar signs drop in front of insulin costs, which is literally the vial of life for millions of children and adults living with diabetes, gives me hope in humanity.”