California Becomes First State to Sell Its Own Insulin: What to Know

• California has launched a program to manufacture and sell lower-cost insulin to people with diabetes.
• State officials say consumers will be able to purchase a five-pack of insulin pens for $55 in January 2026.
• The state has also imposed a monthly cap of $35 per person for out-of-pocket costs for insulin.

Healthcare officials are praising California’s new plan to produce and sell long-acting insulin at a significantly lower rate than current medications for diabetes treatment.

Governor Gavin Newsom recently announced that starting on January 1, 2026, insulin pens will be available for Californians for a maximum of $55 for a five-pack, or $11 per pen.

The price for brand name insulin can range from about $90 to about $400 for a five-pack of pens, according to data compiled by state officials.

This announcement came just days after the governor signed legislation that limits consumer co-payments for insulin to $35 per month. That program is similar to the $35 per month cap Medicare now places on insulin co-payments for its recipients.

“California didn’t wait for the pharmaceutical industry to do the right thing — we took matters into our own hands,” Newsom said in a statement. “No Californian should ever have to ration insulin or go into debt to stay alive.”

Experts say the program is a breakthrough for people with diabetes who depend on insulin.

“Overall, this program is promising, said Kanwar Kelley, MD, a specialist in otolaryngology head and neck surgery, obesity medicine, and lifestyle medicine as well as the co-founder and chief executive officer of Side Health in Orinda, CA.

“The cost of insulin has historically been very high in the U.S., particularly for those without Medicare or insurance. California’s new low-cost state-branded insulin program and out-of-pocket cost cap represent a significant step toward affordability and access.”

“The ADA [American Diabetes Association] applauds any efforts to increase affordability for insulin for people living with diabetes,” said Christine Fallabel, MPH, an author who lives with type 1 diabetes and director of State Government Affairs for the American Diabetes Association (ADA).

“This is an important, incremental step to offer more options for affordable insulin,” Fallabel told Healthline.

The state officially launched the CalRx program in 2020 to make medications more affordable for Californians.

CalRx contracts with manufacturers to produce generic pharmaceuticals.

In 2024, CalRx officials announced they were distributing an over-the-counter naloxone nasal spray used to treat opioid overdoses. The treatment, sold under the brand name Narcan, is available for free in California to eligible organizations. The cost to consumers is a discounted $24 for a twin pack.

Civica Rx has a manufacturing plant in Virginia where it will eventually produce generic variations of the three most common types of insulin — glargine, aspart, and lispro.

For the California project, Civica Rx subcontracted with Biocon Biologics to produce a long-acting version of glargine.

A five-pack 3-milliliter pen of Biocon insulin will be sold to pharmacies for $45 with a maximum retail price of $55.

By comparison, state officials said Rezvolgar, Eli Lilly’s branded insulin, costs pharmacies $88 per five-pen pack. Lantus, Sanofi’s branded insulin, costs pharmacies $92 while Basaglar, another Eli Lilly product, is sold to pharmacies for $313. Toujeo Solostar, another Sanofi product, costs pharmacies $411 for a pack of five pens.

The price of insulin is a major source of concern for people with diabetes. A 2022 survey by Charity Rx reported that almost 80% of people in the United States who use insulin say the price of their essential medication has posed some financial difficulty for them or people they care for.

Some people with diabetes need to inject insulin every day. Experts interviewed by Healthline said that the Cal Rx cost savings could be significant for many Californians.

“The cap will increase access and remove barriers to those who need insulin,” Kelley said. “Placing limits on individual payments will also encourage other manufacturers to reduce their costs. By reducing the red tape around discounted insulin, individuals will no longer need to rely on coupons or savings programs.”

Kelley noted, however, that there may be some potential issues that need to be resolved.

He said the demand for this lower-priced insulin could be high, so the state’s contractors will need to ensure production keeps pace. He added that other companies may reduce their insulin production if their sales decline, causing a gap in supply.

He said some consumers may also be reluctant to switch to the Cal Rx program because they are comfortable with their current system of purchasing insulin.

It’s too soon to tell whether other states will follow suit and adopt California’s low cost insulin program.

“California is a big market state that has considerable tax revenue to be able to implement this plan; other states may not be able to do so on the same scale,” Kelley said.

“[The California program] could serve as a model for other states, but success is not guaranteed,” Kelley said. “Regulatory, market, insurance, supply-chain, and awareness challenges remain.”

“The Federal government has also been interested in decreasing prescription drug prices, especially for drugs like insulin. Their involvement may increase adoption by other states,” Kelley continued.

Kelley noted the success of this program could depend on the company’s ability to scale its production to meet the demand for affordable insulin to avoid any shortages.

Insulin is a hormone produced in the pancreas that sends signals to your body to absorb glucose and use it for energy, or store it to be used later as needed.

Everyone with type 1 diabetes needs to inject insulin to stay alive. About a third of people with type 2 diabetes use insulin injections.

The American Diabetes Association (ADA) estimates that about 8 million people in the United States need insulin injections to survive.

The organization points out that insulin costs 10 times more in the United States than the rest of the world. They report that one in four insulin users in the United States ration their medication due to the cost.

“Insulin is lifeblood for people living with insulin-dependent diabetes,” Fallabel said. “We need it every day to live and, without it, we get very ill and will die.”

The Centers for Disease Control and Prevention (CDC) reports that 38 million people in the United States have been diagnosed with diabetes. More than 90% of those cases are type 2 diabetes.

Type 1 diabetes is an autoimmune disease. It is generally diagnosed in younger adults. Scientists aren’t sure what causes a person to develop type 1 diabetes, but they believe genetics and environmental factors are likely involved.

Type 2 diabetes is usually diagnosed in adults 45 years and older. Healthcare professionals say genetics and lifestyle factors are usually the causes. Obesity, race, family history, and physical activity are considered risk factors.

People with type 1 diabetes need to inject insulin. Most people with type 2 diabetes can manage their condition with lifestyle changes.