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Will California’s Plan to Make Its Own Insulin Work?

California is taking the unprecedented step of manufacturing its own insulin, part of a broader effort by state and federal legislators to lower prescription drug costs.

Two weeks ago, Gov. Gavin Newsom announced that California had awarded a $50 million contract to Civica, a nonprofit organization, to produce low-cost insulin under the state’s own label that would eventually be available for purchase. The supply would be prioritized for the estimated one million Californians with diabetes who use insulin, but would also potentially be available for some of the remaining seven million Americans outside the state who need the treatment.

“This is a big deal, folks,” Newsom said at a news conference in Downey on March 18, standing in front of refrigerators stocked with insulin. “This is not happening anywhere else in the United States.”

But California’s goal of offering cheaper medicine than brand-name companies may be much harder to achieve now, the health journalist Benjamin Ryan recently wrote in The New York Times. The major drug makers that Newsom was hoping to undercut — Eli Lilly, Sanofi and Novo Nordisk — recently announced big price reductions, mostly in the 70 percent range, that are slated to begin by Jan. 1 on some of their insulin products.

That may be for a number of reasons, including a new Medicare cap on monthly co-payments for insulin, and the threat of penalties from Medicaid for companies raising their prices faster than inflation. The companies also increasingly rely on revenue from newer drugs for diabetes and obesity.

“California revels in being the world’s fifth-largest economy and likes to throw its considerable weight around,” Benjamin told me. But, he said, “a lot has changed in the insulin market just in the past few weeks, and a lot more could continue to change before the California insulin program gets its cut-price treatment to people with diabetes.”

The average price of insulin has more than quadrupled in 20 years. By manufacturing its own generic insulin through its CalRx Biosimilar Insulin Initiative, California hopes to undersell pharmaceutical companies and compel them to lower their prices to remain competitive. But Civica’s products still need federal approval, and it will probably take at least two years before they become available for sale.

So it’s unclear whether California’s insulin will be that much cheaper than the big-brand names once the new price cuts are imposed and the state’s generics arrive on the market. Newsom, nevertheless, said he would welcome being undersold, as it would be an indication of a successful market disruption. The results will be important: Maine, Michigan and Washington have all begun exploring similar programs.

“The best-case scenario is that the CalRx plan provides some sunshine on a path forward to state interventions in curbing drug prices,” Jacob S. Sherkow, a professor of law and medicine at the University of Illinois Urbana-Champaign, told Benjamin.

More on California

“A lot of previous attempts in that area have just failed completely, either by dint of economics or through legal challenges,” Sherkow continued. “This is one way that states can get back in the business of providing public goods.”

For more:

Read Benjamin’s full article.

The rest of the news

Reparations: It could cost California more than $800 billion to compensate Black residents for generations of over-policing, disproportionate incarceration and housing discrimination, The Associated Press reports.

Gas price law: Newsom signed a new law that gives state regulators the power to penalize oil companies for making too much money, The Associated Press reports.

Affirmative action: For decades, Richard Kahlenberg, a liberal scholar, has pushed for a class-conscious approach to college admissions. Now Kahlenberg has joined forces with the Students for Fair Admissions in Supreme Court cases against Harvard and the University of North Carolina, which could end race-conscious affirmative action.

Flooding: Newsom removed a promised $40 million for restoring floodplains, which help protect communities from excessive flooding, from the state’s budget this year. San Joaquin Valley legislators are pushing back, CalMatters reports.

Opioid crisis: State Democrats voted down and set aside bills that would have increased punishments for fentanyl dealers, The Los Angeles Times reports.

SOUTHERN CALIFORNIA

Extreme weather: For some businesses, the heavy rainfall in Southern California has been a boon, but for others, it has caused financial hardship, The Los Angeles Times reports.

Toxic waste: Scientists recently discovered that vast amounts of the harmful chemical DDT never broke down since being produced and dumped near the Los Angeles coast in the 1940s and 50s, The Los Angeles Times reports.

CENTRAL CALIFORNIA

A newspaper with no reporters: The Salinas Californian, the main local news source for the 163,000 residents of Salinas, has had no reporters since December, The Los Angeles Times reports.

NORTHERN CALIFORNIA

Reparations: The Berkley Unified School system may pay reparations to students who are descendants of enslaved people. The plan is still in its preliminary stages, and the district is creating a task force to make recommendations to the school board by January, The San Francisco Chronicle reports.

Sentencing surge: Since District Attorney Brooke Jenkins of San Francisco took office last summer, the number of cases with jail or prison sentences has spiked while fewer cases have been closed with incarceration alternatives, The San Francisco Chronicle reports.

What we’re eating

Dosas.

Where we’re traveling

Today’s tip comes from David Hayashida, who lives in Greenbrae. David calls Blake Garden in the Bay Area a “hidden gem”:

“There are many beautiful public gardens in the San Francisco Bay Area. My favorite is Blake Garden in Kensington.

The garden is owned by the University of California, Berkeley, managed by its Department of Landscape Architecture and Environmental Planning, and serves as an educational “outdoor laboratory” for plant identification and design.

Blake Garden is nestled on a hillside in a residential neighborhood in Kensington and is home to over a thousand species of plants, including many native plants. There are several distinctive rock outcroppings on the property, as well as interesting garden features created by the U.C. Berkeley faculty, students and staff. Well-maintained walking paths weave through the grounds.

A historic mansion — the Blake House — stands near the entrance and previously served as the residence for the University of California president. There are wonderful views of San Francisco Bay. It’s quiet, peaceful and uncrowded, and the garden staff is eager to share botanical and design knowledge.”

Tell us about your favorite places to visit in California. Email your suggestions to [email protected]. We’ll be sharing more in upcoming editions of the newsletter.

Tell us

What foods do you consider quintessentially Californian? Sourdough bread? Almonds? Citrus fruits? Raisins?

Tell us your favorite Golden State dish or snack, and include a few sentences about what it means to you. Email us at [email protected].

We may include your email response in an upcoming newsletter or in print. By emailing us a response, you agree that you have read, understand and accept the Reader Submission Terms in relation to all of the content and other information you send to us (“Your Content”). If you do not accept these terms, do not submit any content.

And before you go, some good news

In 2007, Shantha Suraweera helped form the Orange County Cricket Association to promote cricket, which is unfamiliar to many Americans but which fans say is the second-most-popular sport in the world.

Cricket has since taken off in Southern California. The Orange County organization has developed into a league with about 14 teams, and there’s been a steady rise in interest in the sport, especially among children, The Orange County Register reports.

“It’s in the initial stages like soccer 20 to 30 years ago, but there’s still good potential for another new sport” in the United States, Suraweera told The Register.

And now there’s talk of a full-fledged cricket stadium being built in Irvine.

“I got goose bumps, that’s how excited I am,” Pulkit Khare, a cricket fan who lives in Rancho Santa Margarita, told the outlet.

Thanks for reading. I’ll be back tomorrow. — Soumya

P.S. Here’s today’s Mini Crossword.

Briana Scalia, Isabella Grullón Paz and Bernard Mokam contributed to California Today. You can reach the team at [email protected].

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