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Why Insulin Costs Matter in California
For many Californians living with diabetes, the cost of insulin has been a persistent burden. Insulin is essential for people with type 1 diabetes and used by many with type 2 diabetes to regulate blood sugar levels. Historically, insulin prices in the United States have been among the highest in the world, frequently forcing patients to ration doses or skip treatment due to cost.
To address this, California has passed new policies designed to reduce financial barriers to insulin — including a state-branded insulin product priced at $11 per pen and a cap on out-of-pocket costs for insulin prescriptions.
What the CalRx Insulin Program Is
California’s CalRx Insulin Initiative is part of a broader state effort to lower the cost of prescription drugs. The program contracts with nonprofit drug manufacturer Civica Rx and a partner manufacturer to develop biosimilar versions of insulin that can be sold at far lower prices than many branded products.
Starting January 1, 2026, Californians will be able to buy state-branded insulin glargine pens for a suggested retail price of no more than $55 for a five-pack — which averages out to about $11 per pen at participating pharmacies. These pens are interchangeable with existing long-acting insulin products such as Lantus.
State officials say the goal is to make insulin pricing more transparent, affordable, and predictable for people who depend on it for daily use.
California’s Insulin Price Cap Explained
Alongside the CalRx insulin plan, California has also enacted a state insulin price cap under Senate Bill 40. Under this law, insulin cost-sharing for people with covered health plans is limited to no more than $35 per month for a 30-day supply.
This cap applies to many state-regulated insurance plans and is designed to protect consumers from high insulin costs at the pharmacy counter.
By combining the CalRx insulin pricing with the broader copay cap, California’s policies aim to give patients multiple routes to access affordable insulin and reduce out-of-pocket spending.
Why These Policies Matter for People With Diabetes
Insulin affordability is a matter of life and health. When patients cannot afford insulin, they may underuse it or ration doses, which can lead to serious diabetes complications such as:
- dangerously high blood sugar (hyperglycemia)
- increased risk of long-term vascular damage
- hospitalization
- diabetic ketoacidosis
- nerve, kidney, or eye damage
Affordable access helps ensure that people with diabetes can follow medically recommended dosing and care plans without financial barriers.
How This Affects Your Care
If you or a loved one uses insulin, these changes could significantly lower your prescription costs starting January 1, 2026. Patients should speak with their healthcare provider or pharmacist about:
- whether CalRx insulin will work with your treatment plan
- how your insurance covers insulin under the new copay cap
- options for filling prescriptions at participating pharmacies
Healthcare providers can help manage your diabetes care and explain how these new pricing policies apply to your situation.
Looking Ahead
California’s CalRx insulin program is one of the most ambitious state-level efforts in the nation to directly tackle high drug prices, and it may serve as a model for other states in the future.
While CalRx currently focuses on long-acting insulin glargine pens, ongoing development may expand access to other types of insulin and low-cost medications in the years ahead.
At BASS Medical Group, our providers are committed to supporting patients with diabetes in navigating changes in medication pricing, access programs, and comprehensive care.
