originally elly lily, novo nordis, and sanofi had a stranglehold on the different types of "extended release insulin" they were behind the lack of generics for a while. until they were able to come up with alternatives insulin not based on the formulaitons of the 3 companies.

In most likely scenarios the social amortization should cover everyone including production/transportation labor.

Realistically the transportation and labor side is the most expensive, yeah. If the economy of scale gets solid enough in like year 2 of the program it probably could be cut down in price further, but California's a huge state that may have trouble lowering distribution costs.