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.
“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.”
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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 CAtoday@nytimes.com. We’ll be sharing more in upcoming editions of the newsletter.
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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 CAtoday@nytimes.com.
