About 1 million kids in California have asthma, and 1 in 3 with active symptoms miss at least a week of school every year.
Albuterol, also known as a rescue inhaler, relaxes the muscles around
the airways in the lungs to treat sudden breathing issues and
can avert emergencies and emergency room visits. The 2025–26 California
budget included funding to supply California’s public, charter and
transitional kindergarten through grade 12 (TK–12) schools with a free,
annual emergency stock of two 90-microgram-per-actuation albuterol
metered-dose inhalers and 25 single-use disposable spacers, which help
deliver the albuterol more effectively, for three years. Private
schools may purchase products for $9.50 per inhaler — saving up to 80%
off the cash price — and $93.75 per 25-pack of spacers, a 35% savings
(plus sales tax and shipping fees). All schools will be able to
purchase additional refills at the same CalRx® price.
“The American Lung Association applauds
Governor Newsom and the State of California for taking this important
step to protect the health of students by providing albuterol inhalers
to schools at no cost,” said Kesa Bruce, Director of Advocacy, American Lung Association.
“For a child experiencing an asthma emergency, immediate access to
albuterol can be lifesaving, and this initiative will help ensure that
a student’s ability to breathe safely at school does not depend on
where they live or their family’s ability to afford medication.
Expanding access to this essential treatment will make California
schools safer, reduce health disparities, and give students with asthma
greater security to learn, play, and thrive.”
Asthma is one of the leading causes of school absenteeism. This
initiative is a significant step in keeping our kids safe and in class
— offering schools access to the resources they need to keep kids safe,
and providing on-site resources like this helps keep kids from missing
valuable classroom time.
“As a pediatrician and the parent of a child with asthma, I know how
frightening it can be when a child needs an inhaler at school and
doesn’t have one available,” said Chair of the American Academy of Pediatrics, California, Eric Ball, MD, FAAP.
“No parent should have to worry that a preventable gap in access could
become an emergency. This initiative gives schools an important
additional tool to help keep children safe.”
To support implementation, CalRx® is partnering with the California
School Nurses Organization (CSNO) to provide asthma and stock albuterol
training guidelines to public school districts at no cost. The training
includes techniques for recognizing symptoms of respiratory distress,
protocols for the emergency use of an albuterol inhaler in an
educational setting, and follow-up procedures for calling 911 and
notifying parents or guardians. Private schools may access it at their
own cost ($45 for CSNO members and $200 for non-CSNO members). CDPH and
CalRx® will host a statewide webinar on August 25, 2026, for
California’s TK–12 school community to learn more about this initiative
and how to access these free products.
"We applaud Governor Newsom for increasing access to life-saving asthma medications in California’s schools,” said Director Anne Kelsey Lamb, MPH, Regional Asthma Management & Prevention, a project of the Public Health Institute.
“California has been leading the way in comprehensive asthma
management, including Medi-Cal coverage of home-based asthma
interventions and innovative policies to reduce outdoor air pollution.
Providing access to quick-relief medications, with appropriate training
for school staff, is a critical component of a comprehensive approach
to improving asthma outcomes — another example of California's
leadership that will quite literally help children breathe easier."
Amneal will launch an easy-to-use ordering solution so schools can
receive a dependable supply of these products, shipped directly to
school districts or school sites under the statewide albuterol standing
order. After three years, the system will remain accessible for all
schools to continue ordering products directly from Amneal.
An albuterol “standing order” is currently
available for school use and is signed by Dr. Erica Pan, CDPH Director
and State Public Health Officer, eliminating the need for schools to
obtain an individual physician’s prescription. California’s TK–12
schools, school districts, county offices of education, charter
schools, and private schools can utilize the standing order by
completing an online application. School entities interested in
applying for the albuterol standing order can visit the CDPH website or contact SafeSchoolsTeam@cdph.ca.gov for more information.The bigger picture The
CalRx® School Albuterol Access Initiative removes barriers to accessing
albuterol inhalers in California’s TK–12 schools by establishing a
statewide distribution solution aligned with the standing order,
enabling rapid response to respiratory distress that can be sudden and
life-threatening. This initiative aligns with California's broader
strategic efforts to improve school health, expand medication access,
and support consistent school attendance. More on CalRxIn
2019, the Governor’s first executive order was to lower prescription
drug costs and ensure fair and transparent pricing is accessible to all
Californians — resulting in the CalRx® initiative. To date, no
other state has partnered to offer its own affordable medication
available for public purchase to compete with other market-priced
products.
The School Albuterol Initiative is the third life-saving and
cost-saving drug initiative launched under the CalRx® initiative. The
CalRx Biosimilar Insulin Initiative made CalRx® biosimilar insulin
glargine pens available to California pharmacies for $45 and to
consumers at a suggested retail price of no more than $55 per five-pack
of 3 mL pens — a substantial reduction from current retail market
prices. CalRx-branded over-the-counter (OTC) naloxone HCL nasal spray,
4 mg, costs only $19 — a more than 50% cost decrease from the original
market price — and in a single quarter after CalRx naloxone’s entry
into the market, overall generic naloxone prices declined by 22%.
For updates on the upcoming CalRx® albuterol ordering solution and training for schools, visit the CalRx website or contact info@calrx.ca.gov. About AmnealAmneal
is a U.S.-based pharmaceutical company focused on expanding access to
high-quality, affordable medicines. As the manufacturer of CalRx®
naloxone, Amneal has supported the state’s efforts to increase access
to life-saving treatments, helping the state save millions of dollars
as the primary supplier for California’s Naloxone Distribution Project
since May 2024. In April 2026, Amneal launched a generic albuterol
inhaler product, following U.S. FDA approval in December 2025, further
expanding access to an essential respiratory medicine |
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