I’m diabetic. What should I know about insulin price changes in 2026?

As of January, California is the first state in the country to partner with a nonprofit to develop, produce and sell its own insulin as a solution to the widespread unaffordability of the life-saving hormone that helps the body process or store blood sugar from food.

The nonprofit Civica will develop a CalRx Insulin Glargine pen – referred to as “biosimilar insulin,” meaning it references a U.S. Food & Drug Administration-approved product and has no “clinically meaningful differences from their reference product in terms of safety, purity, and potency.”

This CalRx pen can be substituted for Lantus and other branded insulin glargine, according to a spokesperson from the state’s Department of Health Care Access and Information (HCAI).

“California didn’t wait for the pharmaceutical industry to do the right thing — we took matters into our own hands,” Gov. Gavin Newsom said in an October news release about the CalRx insulin. “No Californian should ever have to ration insulin or go into debt to stay alive — and I won’t stop until health care costs are crushed for everyone.”

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CalRx aims to be another competitor in the field by introducing a lower-cost alternative — and possibly put “pressure on other manufacturers to lower their prices as well.”

According to the state and Civica, the suggested retail price is:

• No more than $30 for a 10mL vial of insulin
• No more than $55 for a 5-pack of 3 mL pens

According to the HCAI spokesperson in an email to KQED, the “out-of-pocket cost may be lower, depending on insurance coverage.”

Advocates for people with diabetes see the production as a win.

“We look forward to the rollout of CalRx® insulin in January,” said Christine Fallabel, director of state government affairs at the American Diabetes Association, in an email to KQED. “Any meaningful step to improve insulin affordability and provide additional options is a win for people with diabetes.”

Fallabel also pointed to the recent passage of Senate Bill 40 — which prohibits high copayments for a month’s supply of insulin — as another state decision that helps with accessibility.

The initiative could provide major financial relief for nearly 3.5 million Californians who have been diagnosed with diabetes, a majority of whom have Type II diabetes – where the body cannot use insulin correctly. Type 1 is when the body produces little to no insulin.

Type 1 or Type 2 diabetes can impact energy levels and organ functions. Insulin shots – or, in some cases, diabetes pills – help with major body functions. The National Diabetes Statistics Report found that 38.4 million people have diabetes – almost 12% of the country’s population.

Read on to learn more about changes to the price of insulin in California, how prescriptions will work and where to find more resources.

What is the predicted price of CalRx Insulin?

Difficulty accessing affordable insulin — specifically buying it — in America is a well-documented and widespread issue due to a market dominated by three major companies.

Insulin is seven to 10 times more expensive in the United States compared to other countries, despite being affordable to produce, according to a 2023 article by the Yale School of Medicine. In fact, it explains that “the same vial of insulin that cost $21 in the U.S. in 1996 now costs upward of $250.”

What should I do if I am paying more than $55?

According to the HCAI spokesperson, “CalRx and Civica cannot mandate the final price to the consumer as this would conflict with antitrust and competition law.”

But the spokesperson stated in the email that Civica is planning to include a QR code on the side of the boxes, so consumers can report if they have paid more than $55 for the product.

“At which point Civica would contact the pharmacy for remediation,” the spokesperson said.

Where can I get CalRx insulin? Do I need a prescription?

You do not need to apply to access the new insulin, and there are no eligibility requirements. You do not need insurance.

“Broad wholesale distribution will allow any California pharmacy to order CalRx insulin glargine,” the state explained in the email. Mail-order pharmacy outreach is still ongoing.

People interested in the CalRx insulin can “ask their pharmacist or doctor if they can switch their prescription to CalRx insulin glargine,” continued the HCAI spokesperson. Since the CalRx insulin is interchangeable with other brand names, you would not need a new doctor’s prescription.

“Health plans will be responsible for communicating about CalRx insulin glargine with their provider and patient networks,” said HCAI.

Can people in other states access it?

According to the HCAI spokesperson, “Yes, Civica Rx’s glargine insulin will be available in other states under Civica Rx’s label.”

Where can I learn more information?

• CalRx website
• CalRx fact sheet
• American Diabetes Association’s Center for Information
• Insulin Basics for Diabetes
• Civica Insulin
• T1International

KQED’s April Dembosky contributed to this report.