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Gov. Newsom Announces Partnership With Drugmaker to Produce Affordable, State-Branded Insulin

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A white middle-aged man with a dark suit and tie gesticulates while speaking behind a dais on which is written "$30 insulin by CalRx" with freezers full of medicine behind him.
Gov. Gavin Newsom speaks about his plan to have insulin available to everyone for $30 during his tour of the state of California, at the Kaiser Permanente central refill pharmacy in Downey on Saturday, March 18, 2023. (Keith Birmingham/MediaNews Group/Pasadena Star-News via Getty Images)

Updated Sunday at 2 p.m.

The state of California and a generic drug manufacturer announced a 10-year partnership Saturday to produce affordable, state-branded insulin that they hope will rival longtime producers and push down prices for a medication used by millions of Americans.

The product is not expected on store shelves until at least next year, and it was difficult to predict what effect it would have on a market already shaken by change. Earlier this week another major insulin maker promised steep price cuts as pressure builds on drugmakers and insurers to slash the cost of the drug.

For those who have been fighting for insulin access, it is a welcome win. “I am elated. I was getting texts all yesterday and the day before,” said Kevin Wren, a patient advocate and volunteer with California #Insulin4All. “This is huge for everyone with diabetes.”

Wren said the price of insulin has risen exponentially since he was diagnosed with diabetes in 2001. “I survived when many have not,” Wren said. He added that something like this on the state level is a win for everyone, especially for those with insulin-dependent diabetes in California.

“We're getting another, other major win in the fight for insulin access,” he said. Back in 2009, he rationed his own insulin because he didn’t have enough money to afford the cost of rent and groceries in addition to insulin — “making one vial last twice as long by having smaller doses or using less and just letting my blood sugar run high, which makes you feel terrible,” Wren said.

#Insulin4All is trying to work at the federal level to advocate for a price cap on insulin nationwide.

Democratic Gov. Gavin Newsom said he hoped California’s emergence as an insulin-maker would prompt prices to collapse. Research has shown that prices for the drug have more than tripled in the past couple of decades.

“We are intent to make this about market disruption,” Newsom said at a ceremony announcing the pact at a pharmaceutical warehouse near Los Angeles. He called it “a game changer” for 8 million Americans who use insulin to treat diabetes.

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Many questions remain. The state and its partner, the nonprofit Civica, have yet to locate a California-based manufacturing facility. Regulatory approvals will be needed. Newsom said a 10-milliliter vial of the state-branded insulin would sell for $30, but it's possible competitors could slash their prices and undercut the state product.

“Is this perfect? We don't know yet,” Newsom acknowledged at one point.

Just days ago, President Joe Biden said his administration is focused “intensely” on lowering health care costs, including pressuring pharmaceutical companies to lower the costs of insulin. Legislation enacted last year capped co-payments for insulin at $35 per month for Medicare beneficiaries. Biden has proposed extending that cap to all Americans.

Novo Nordisk said Tuesday that it will slash some of its U.S. insulin prices up to 75% starting next year. The announcement comes less than two weeks after rival Eli Lilly said it will drop some of its prices by 70% or more later this year.

Anthony Wright, executive director of Health Access California, a statewide consumer health care advocacy group, welcomed Newsom's announcement, saying efforts by California and others to develop a competing generic are likely a factor in getting insulin manufacturers to cut their prices.

Still, there are obstacles.

“The work to develop a generic, get FDA approval and set up manufacturing will take real time,” Wright said in an email. “There may even be more time in the effort to get doctors to prescribe the drug, insurers and [pharmacy benefit managers] to include it on their formularies and patients and the public to accept and ask for it.”

There could be other risks. State analysts have warned that California's entry into the market could prompt other manufacturers to reduce the availability of their drugs, a potential unintended consequence.

State lawmakers approved $100 million for the project last year, with $50 million dedicated to developing three types of insulin and the rest set aside to invest in a manufacturing facility.

A middle aged woman in a white dress with a face mask talks with a white middle aged man as he smiles with onlookers behind them.
Dr. Tanya Spirtos, president-elect of the California Medical Association (left), speaks briefly with Gov. Newsom (center) following a press conference. (Francine Orr/Los Angeles Times via Getty Images)

Even with the challenges of entering a competitive, established market, Newsom said taxpayers would have “very ample protections.”

If for whatever reason the deal didn't work out to the state's benefit, “there’s all kinds of provisions that would allow us to ... pull out,” he said.

According to state documents, the proposed program could save many patients between $2,000 and $4,000 a year. In addition, lower costs could result in substantial savings because the state buys the product every year for the millions of people on its publicly funded health plans.

The state also is exploring the possibility of bringing other drugs to market, including the overdose medication naloxone. The drug, available as a nasal spray and in an injectable form, is considered a key tool in the battle against a nationwide overdose crisis.

“We are not stopping here,” Newsom said.

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This post includes additional reporting from KQED's Lakshmi Sarah

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