My understanding is that there is no way any vial of insulin anywhere, at this point in time, should cost enough to produce for US$35 asking price to be unprofitable. See [1] and [2] for example. This would need to increase with inflation, of course.
Regardless, the bill didn't pass. Arguments like this were probably the reason why.
[1] https://www.mayoclinicproceedings.org/article/S0025-6196(21)... [2] https://www.medcentral.com/endocrinology/diabetes/the-high-c...
The vetoed bill (SB 90 of 2023) did not address the price of insulin, only the allowable insurance copay for insulin. The fact that this, without addressing the actual price, would just shift the costs from copays to premiums was called out in the veto message.
Also note that, with CalRx's insulin initiative ready to deliver at the same time the bill goes into effect, SB 40 of 2025 which set the same copay cap as SB 90 of 2023, was signed by Newsom this week.
It seems like insulin is a lot more affordable there and it's obviously an economically sustainable rate because companies keep selling it to Canada.
How much does it cost in Canada anyways?
The patent for insulin glargine (Lantus) and insulin aspart (NovoLog) expired over a decade ago, though kind of amusingly Sanofi holds an active patent on “putting more Lantus in a vial than you usually would”
https://patents.google.com/patent/US9345750B2/en
I could be wrong but off the top of my head the only insulin I can think of that’s probably under patent is Afrezza, which is cool as hell because it’s inhalable and ultra-quick
It is also worth noting that this week Newsom signed SB 40 0f 2025, which did exactly the same thing in this area as the vetoed SB 90 of 2023, no doubt because the price side was also being adddressed simultaneously, with CalRx insulin to be on available in January when SB 40 goes into effect.
Because this worked so well for home insurance.
$35 in 2025 dollars buys as much as $32.92 in 2023 dollars [1]. At what point does it become unprofitable for anyone to manufacture and deliver? (Not the out-of-patent stuff nobody wants to take that can be made for $3/vial. The long-acting and ultra-fast formulations people actually use when given a choice.)
And unlike with home insurance, in an insulin shortage, people die. You need a CalFIRE mechanism, a seller of last resort, who will purchase the insulin at any price on the market and sell it at $35 for such a scheme to work.
State-controlled production removes that surprise factor. It's a much better system than price regulation.
[1] https://www.usinflationcalculator.com