Newsom Promotes Affordable Insulin, but California’s Generic Label Off to a Slow Start

In San Francisco's Japantown neighborhood, a Walgreens pharmacist named Margaret On displayed two boxes of long-acting insulin pens from California's new prescription drug label, CalRx. Although she hasn't yet dispensed any, On intends to keep them readily available for patients without health insurance or in case of emergencies.

Seven months after the introduction of the affordable insulin brand, state health officials reported that California has distributed more than 120,000 packs containing five pens each of insulin glargine at a price of $55 per pack. This represents a significant reduction from the typical cost of $89 to $411 for popular brand names, even before accounting for retail markups or consumer discounts.

This marks the first instance of a state competing with the three leading insulin manufacturers – Eli Lilly, Sanofi, and Novo Nordisk – under its own prescription drug label.

Governor Gavin Newsom, a Democrat eyeing a presidential bid in 2028, launched this initiative as part of his healthcare agenda. The dual objectives of CalRx are to serve as an emergency supplier for uninsured or financially strained individuals and to challenge the pharmaceutical industry, which spent $467 billion in the U.S. in 2024, according to a June federal report.

The state contracted with Civica, a Utah-based nonprofit drugmaker, for a $50 million deal to develop CalRx insulin, also known as a biosimilar. While major distributors make the drug available in pharmacies across California, adoption has been slow. Newsom aims to saturate the insulin market by offering generic versions of high-cost or low-supply drugs, as well as those that can improve public health.

In addition to insulin, the state is also distributing free naloxone for reversing opioid overdoses, bringing albuterol inhalers to public schools for students with asthma emergencies, and launching epinephrine injectables for treating severe allergic reactions. By the end of Newsom's tenure, he hopes to add generic GLP-1 medications to compete with brand-name drugs like Ozempic and Wegovy.