Unless of course you mean the expense of thousands of dead or permanently disabled diabetics, that is the correct ballpark! (3)(4)
(1) https://www.diabetes.org/about-us/statistics/about-diabetes
(2) https://www.forbes.com/sites/debgordon/2022/06/20/4-out-of-5...
(3) https://www.cbsnews.com/news/insulin-prices-2019-diabetes-ra...
(4) https://www.reuters.com/world/us/exclusive-us-diabetes-death...
California has about ~2 million diabetics (1) and even when factoring in type 2, most of them (2) will require insulin at some point. The scale is still in the millions.
(1) https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CDCB/CDPH%20Do...
Well, no, it's the state government. It has powers that it absolutely can use that other market participants cannot.
> As long as they don't use illegal means to establish market position (i.e., coercion, etc.), there are no laws against them competing with private markets.
State governments, acting as sovereigns, are immune from federal antitrust (Parker immunity doctrine), and can, therefore, use what would otherwise be illegal means (including coercion) to exclude others from the market.
And the state could alternatively pass laws regulating private behavior. But sometimes having a state agency instead of a law is the less burdensome option.
And in this particular case, the reason that California is jumping into the market is because the private merchants have artificially increased prices to pad their profits and pay their executives, at the expense of thousands of people who are now struggling to afford an essential (and a historically ridiculously cheap) medication.