Civica has announced a contract with Biocon Biologics that allows them to distribute a private label version of Semglee, insulin glargine-yfgn, a Lantus biosimilar. The insulin will be available starting January 1 2026. Civica’s press release says the insulin costs $45 and the recommended retail price is $55 which is less exciting than the BreakthroghT1D announcement of “no more than $55 for anyone”. The insulin will be branded as CalRx in insulin in California. Civica is the company California contracted with to produce an aspart biosimilar.
Oh, that’s great news! I heard Civica was up and running. This is one of those semi secret antitrust strategies that has been running in the background for so long that I tend to forget about it, but it could be pretty successful.
If we can get Lispro out of them, both they and us are made.
Civica came out of the Mayo originally - c. 2019. They moved fast on this. There were some really powerful players involved to get this up and running. It was a monopoly breaking strategy. We are indebted to the cancer community for this. They hope that if we pave ground, that we will reach out a hand and pull them up to safety.
Folks! I am in the cali-weird. Let be purely honest with you on this CalRX insulin. That was talked about in 2019. I think Gov. Gavin Newsom is trying to do anything to boost his public rating here and in the US for his presidential campaign in 2028. He certainly didn’t care about this for the past several years. Not to be a total pessimist, but I would not get my hopes up for 2026 unless they have been silently working on this. And there is still Walmart insulin.
Civica started (as an idea) in 2019 at the Mayo Clinic. They considered setting up shop in Utah, but CA got it in the end. It’s intended to be a mechanism for market disruption. State governments were not uninvolved throughout the process. That’s part of why this effort to establish manufacturing moved so fast.
CA has a history of small startups trying to manufacture insulin. That goes back a long ways. They are a large state with a lot of resources, so that prob has something to do with the agreement to setup there. CA might have been more practical than Utah.
The glargine (aka Lantus; they’re biochemically identical and glargine is the generic) is, as Chris said originally, Biologics’ “semglee” but rebranded as, I guess, California State Insulin, maybe? It’s widely available both as semglee (a manufacturer name) and glargine-yfgn (seriously, that) which names the protein itself, different name, same as Lantus.
The $55 is for 5 3mL (I think) pens. Biologics also produce vials (which is what I could get in Oregon when I was last on an ACA plan). Looks like the new guvner is channeling Biologics’ own marketing:
To quote from that page:
Our product is available as branded SEMGLEE and as an unbranded version of SEMGLEE
It’s available now so I guess it will be available, rebranded, on Jan 1 in CA. Nobrainer as we say on the West Coast.
Yeah, yeah in 2027 for people with insurance. In 2026 only the tech bros get the cap; people on large group employer policies. People who were also certainly paying less than that already (I was on a large group employer policy when I lived in CA, it was a while back but I’m pretty sure my employer wouldn’t want employees to get upset about insulin costs).
Oregon did the cap this year; the effect for me would have been significant had I remained on the ACA because each of these changes pull the yearly expenditures down by an amount sufficient to shift the deductible/OOPMax limits out by a month or two. I still pay the same, it just takes longer.
For everyone living in the real world none of this matters. Most of it is in 2027 or in promises. What really does matter now is to see what is on offer because, for us, we have to take real care over what our insurance covers because we will need it and it changes every year.
I trust all us boomers have re-upped Medicare by now; October 15 was 9 days ago.
If you are on an employer plan, don’t you have your resumé in your draw at all times? You never know until the pink slip falls.
For everyone else remember you can choose on November 1, so start shopping now (CA and OR at least both have window shopping available today.)
This is why Newsom announces this now. We are all scurrying around like excited rabbits trying to find the right insurance; for the month of autumn we care and this is the best he can do.
This will run and run but quite frankly I don’t give a damn about the cost of insulin. I care about the cost of really good diabetes care and insulin is but a small part of that.
I care even more about the cost of good healthcare for all Americans. Prescriptions are 9% of the total US healthcare cost, 80+% is docs and hospitals.
If CA were to pay for all the prescriptions of all CA residents their healthcare costs would drop by 9% but they are going up by around that same amount in CA this year:
Scroll down to get to your locality or insurance company.
Find “Table 1” and look at the “shop and switch” column. For us, think about how irrelevant our insulin cost is when our endo, our pump, our CGM is now dominating the costs.
Whack-a-mole, the insulin mole has been whacked. Wow, we were great, where’s the next mole? That really is me being sarcastic.
MN implemented a $30 copay cap in Jan of this year.
But the state doesn’t control large employer plans - that’s the Feds, so I get a cap, but friends of mine don’t.
In MN, the state copay caps cover around 70% of the population, but they would need the feds onboard to cover the other 30%.
Denver is going to try for full out price caps. They are the first. They may have already passed the law, but I don’t think it went into effect yet. They were the first state to do insulin copay caps. I don’t recall which medication the price caps are for - it’s not insulin.
The link mentions impending litigation. That’s one of the problems w/ price caps implemented by the state - they end up in court for 5 years. If the state sues preemptively, they can get those copay caps as a settlement. Either way, the state ends up in court for years and it’s super resource intensive for every state to try this. They don’t like it. They want help from the feds. The feds are striking at the problem from a couple different angles, where they see problems coming down the pipeline. For example, exploring their leverage at an international level.
What is the turmoil?
It’s that the Feds are running some tests on executive power versus agency power. You see this playing out via the big banks vs the federal reserve and in our drug pricing business. We have assurances that the insulin stuff WILL be handled, after they run these tests. Once we have a ruling from the Supreme Court, a ruling should come quickly.
The overall, big picture to recognize here is that once a monopoly exists (which the government has found to be true), we have already lost because you can’t put Humpy Dumpty (the markets) back together again. It’s a giant cluster ■■■■. The government failed, over a twenty to forty year period, in it’s responsibility to prevent that problem from happening.
