From the San Francisco Chronicle about laws taking effect on Jan 1 2026:
Senate Bill 40 by Sen. Scott Wiener, D-San Francisco, will require large health insurers regulated by the state to cap insulin copays to $35 for a 30-day supply starting Jan. 1. The same requirement will kick in for individual and small group health plans in 2027.
The new price caps will take effect at the same time Gov. Gavin Newsom has said California-branded insulin will be available in pharmacies. CalRx-branded insulin will have a list price of $55 for five insulin pens, significantly less than the $89 to $300 cost range for similar products currently on the market. That effort is part of Newsom’s signature CalRx program, which works with pharmaceutical companies to develop low-cost drugs no longer protected by patents in an effort to drive down prices.
The CalRx insulin product is interchangeable with Lantus, a commonly used brand-name insulin. It is a long-acting insulin analog.
Another bill taking effect Jan. 1 — SB41, also by Wiener — seeks to lower drug costs more broadly by imposing new regulations on pharmaceutical middlemen known as pharmacy benefit managers. That bill will prohibit pharmacy benefit managers from steering patients to specific pharmacies and limit their ability to profit from drug sales.
The sad part is none of these $35.00 caps apply to those without insurance and/or without a pharmacy benefit. I have receipts from 2016 (granted they are old, but I doubt the retail price has gone down) sowing $450.00/vial retail for Humalog. If you want to get angrier, it costs $8-10/vial to manufacture and distribute.
I think the CalRx thing is completely outside of insurance, and you can just go to the pharmacy and buy it whether or not you have insurance. It’s ≤$30 for a 10mL vial and ≤$55 for a 5-pack of 3mL pens. It’s long-acting insulin glargine (like Lantus) and presumably only sold in California.
So perhaps that takes care of one (of a zillion) high medical expenses for 11% of the US population. Hopefully CalRx will expand to more medicines over time.
I appreciate the comments and they highlight my concern long term. While the costs seem to be controlled, in fact they seem limited to certain populations. What they actually appear to be is cost shifts (except the Ca plan), vice reductions, mostly to either the state and/or national governments while keeping the payments to PBMs, insurance, and manufacturers the same, if not higher. The effect is the industry still gets paid exorbitantly for products and everyone seems to pay more thru taxes to the government. What’s seems needed is action to limit costs charged if what seems a monopoly.
@pugmommy the CalRx insulin was initiated specifically because California as a State was spending too much $$ on insulin costs for uninsured/underinsured state residents. They first started by trying to bargain down the prices with the “big 3” mfrs, and when that didn’t work they started an Initiative to make private labelled insulin for both California residents and once production levels are high enough, residents of surrounding states.
As a bonus, insured California residents will be able to take advantage of the new insulin /pricing structure as well.
That is an awesome update - with good news as well! I just may have to move back to San DIego (don’t know yet, I’m too much of an east coast girl - but anyway). That is wonderful. I’ve been tracking the various “attempts” nationally, and sadly, it’s only people with coverage who benefit. WOOHOO Californians and their Governor! (Maybe you should bring back the term “governator”?)