Following the announcement that the state of California will launch its own brand of insulin, “CalRx,” with an affordable price of $11 per pen, starting January 1, 2026, people with diabetes and groups Advocating for the Health officials applaud the initiative. This measure follows a collaboration with Civica and a $50 million investment in its development.

This will happen almost three years after this partnership was first announced to sell state-brand generic drugs at lower prices. The cost per unit of insulin that CalRx will offer is almost 90% cheaper than the same drug sold by Lantus, a pharmaceutical company.

The partnership between California and Civica is not an isolated effort. Governor Newsom has emphasized that this initiative is part of a series of proposals to offer prescription drugs at lower prices, including the sale of naloxone to combat the overdose crisis.

Diabetic Patients

Diabetes is a chronic metabolic disease characterized by elevated blood glucose levels due to a defect in the production or action of insulin. There are two main types: type 1 diabetes, where the pancreas produces little or no insulin, and type 2 diabetes, which occurs when the body becomes resistant to insulin or doesn't produce enough. This disease can cause severe complications in organs such as the eyes, kidneys, nerves, and heart.

Type 2 diabetes is the most common and is associated with factors such as obesity, a sedentary lifestyle, and genetics. Diagnosis is made through blood glucose testing, and treatment includes diet, exercise, and medication, including insulin if necessary. Controlling the disease is key to avoiding serious complications and improving quality of life.

Insulin and its uses

Insulin is a polypeptide hormone produced and secreted by the beta cells of the islets of Langerhans in the pancreas. Its main function is to allow glucose to enter the body's cells, especially muscle and fat cells,allowing these cells to use glucose as an energy source.

In addition, insulin promotes the storage of glucose in the form of glycogen in the liver and muscles, and when there is excess glucose, it facilitates its transformation into fat for storage in adipocytes. It also influences the metabolism of fats and proteins, facilitating the formation of fats and the transport of amino acids for the formation of proteins, while inhibiting the breakdown of fats.

This hormone is essential for the control of blood glucose levels, and a deficiency or improper use of it can cause disorders such as diabetes. It was discovered in 1921, and its use is essential in the treatment of type 1 diabetes and, in some cases, type 2.

Insufficiency and its supply

Insulin insufficiency mainly occurs when the pancreas does not produce enough insulin or when the body's cells do not respond adequately to the available insulin (insulin resistance). Causes include genetic factors, obesity (especially abdominal fat), a sedentary lifestyle, a high-carbohydrate diet, certain hormonal disorders, medications, and conditions such as type 1 or 2 diabetes.

In insulin resistance, although the pancreas initially produces more insulin in response to the high demand, over time it cannot sustain that production, generating a relative deficiency that leads to insulin insufficiency and elevated blood glucose. Additionally, chronic inflammation produced by excess fatty tissue and toxicity from high glucose levels also contribute to this insufficiency.

Insulin should be administered at different times depending on the type of insulin and the patient's needs. Rapid-acting or rapid-acting insulin is usually administered before meals, ideally 15 to 20 minutes before eating, to control the postprandial rise in blood sugar. However, there are exceptions; for example, if the patient is ill and cannot tolerate food, it should be administered immediately after eating. While slow-acting or long-acting insulin is typically administered once a day, at the time prescribed by the physician, which can be at any time or before dinner depending on the specific insulin. In more complex regimens, basal insulin can be used once a day, and then rapid-acting insulin can be added at the meal with the highest postprandial blood glucose. In patients with hypoglycemia, it is important to adjust the dose and consume carbohydrates before administering rapid-acting insulin.

Accessing CalRx Insulin

The steps patients must follow to access CalRx insulin,California's low-cost insulin, which will be sold starting January 1, 2026, are as follows:

This program seeks to eliminate intermediaries and dramatically reduce the cost of insulin for patients, facilitating affordable and direct access throughout California.