Nicole Smith-Holt

Rule Changes

Leading insulin affordability advocate

On January 1, 2026, two unprecedented insulin programs launched simultaneously: nonprofit Civica Rx began distributing insulin glargine pens for $55 per box, while California became the first state to sell its own CalRx-branded insulin at the same price point—both undercutting branded products by up to 90%. The coordinated launches mark the first major breach in a pricing fortress built by three pharmaceutical giants who control 90% of the U.S. insulin market. Unlike existing insulin, these products require no insurance forms, no rebates, no hidden markups. Just one transparent price available to anyone.

Updated Feb 10