How to save on Stelara: Copay card, patient assistance & more

In this article:

• How much does Stelara cost?
• How to save money on Stelara
• Is there a cheaper alternative to Stelara?
• Bottom line

In this article

• How much does Stelara cost?
• How to save money on Stelara
• Is there a cheaper alternative to Stelara?
• Bottom line

For people with chronic inflammatory illnesses like psoriasis, psoriatic arthritis, and inflammatory bowel disease (which includes Crohn’s disease and ulcerative colitis), using the injectable drug Stelara (ustekinumab) may reduce their symptoms and make it easier for them to manage their illnesses. Stelara is in a class of drugs called biologics, which uses living cells to block some of the proteins known to cause inflammation. 

RELATED: Stelara infusion: What to expect

Stelara is also a specialty drug, which means it’s usually only available from certain pharmacies and requires special handling, according to Christie Kunde, Pharm.D., of Informed Rx. This can also make Stelara cost more or limit insurance coverage. If you’ve been prescribed Stelara and are looking for ways to lower the price of your prescription, we have information that can help. Here are our top tips for saving money on Stelara.

How much does Stelara cost?

According to Stelara’s manufacturer, Janssen Biotech, Inc., the list price of Stelara is $25,497.12 for an eight-week supply. For many people, Stelara is only affordable with insurance coverage, savings cards, patient assistance programs, or government assistance.

Insurance coverage can vary greatly, so it’s important to contact your health insurance company for details about whether it covers Stelara and, if so, what you can expect to pay for it. Many commercial and private insurance plans provide coverage for Stelara, but some only cover it for certain uses. For example, they might cover it for inflammatory bowel disease but not for psoriasis or psoriatic arthritis. 

Stelara cost with Medicaid and Medicare 

In general, Medicaid and Medicare cover Stelara for the treatment of autoimmune conditions, but prior authorization—approval from your health insurance plan to receive a drug or service not normally covered—is usually required. “That’s because of the high cost of the drug, the type of medication it is (a monoclonal antibody treatment), and the indications for use,” says Christina M. Madison, Pharm.D., founder and CEO of The Public Health Pharmacist.

Medicaid coverage varies by state, though, and Medicare Part D plans vary as well, so talk to your healthcare provider or insurance provider about any additional steps needed to receive coverage for Stelara. If prior authorization is needed, you may have to show your insurance company proof that Stelara is a medically necessary drug for your treatment plan, such as a history of trying at least one lower-tier drug to treat your condition.

Although Stelara is sometimes given as an infusion by a healthcare provider instead of a self-administered injection, it is still usually covered under Medicare Part D, which helps patients pay for prescription medicines. Under Part D, you may be responsible for paying a deductible and one or more copays or out-of-pocket medication costs (in addition to your monthly premium) before you reach a cap on your spending that relieves you from any further expenses for the rest of the calendar year. Medicare offers an online tool you can use to compare plans that cover Stelara.

As recently as 2022, the average out-of-pocket cost of Stelara for a person enrolled in Medicare was more than $2,000 per year. In 2023, Stelara was one of 10 drugs selected for the first cycle of Medicare drug price negotiations, which will hopefully lower the price of certain high-spending, brand-name, Medicare Part B and Part D drugs that lack competition. Negotiated prices under the new law will be effective in 2026. Manufacturers that don’t comply will have to pay a tax and penalties.

How to save money on Stelara

​Are you wondering what your savings options are for your Stelara prescription? Here are the best ways to cut your costs.

1. STELARA withMe Savings Program 

Janssen Biotech, Inc. has a support program called Janssen CarePath to help eligible patients save money on Stelara. Through the website, you can access the STELARA withMe Savings Program, which is available to most commercially and privately insured patients who are prescribed Stelara. 

The program can help adults and children ages 6 and older access a year’s supply of Stelara for as little as $5 per dose, and there are no income requirements for eligibility. However, the amount you’ll pay with the program still depends on the benefits of your health insurance plan, including deductibles and other shared costs, so make sure you know your plan benefits or talk to a savings program representative if you have questions. You can reach a representative online or by calling 844-494-8463. 

There are three ways to enroll in the Stelara withMe savings program and receive your Stelara savings card:

1. Creating an account and enrolling online
2. Calling 844-494-8463
3. Faxing or mailing an enrollment form to the fax number or address listed on the form

2. Janssen Patient Assistance Program

The manufacturer of Stelara offers the Janssen Patient Assistance Program for insured patients who are facing access and affordability challenges. You may be eligible for the program if you:

• Have a commercial or employer-sponsored insurance plan or government coverage, including Medicare and Medicaid
• Live in the United States or a U.S. territory
• Are receiving outpatient treatment from a healthcare provider licensed in the United States
• Have a prescription for a Janssen medication, such as Stelara
• Spend more than 4% of your gross annual household income on prescription drugs (for Medicare Part D beneficiaries)
• Have an annual income of less than $87,480 for a one-person household, $118,320 for a two-person household, and $210,840 for a five-person household.

If you qualify for the Janssen Patient Assistance Program, you may receive free Stelara for up to one year. You can apply online or fax an enrollment form to 833-512-0497.

3. Government-funded assistance 

All states except Alaska, Hawaii, Nebraska, Oklahoma, and West Virginia offer pharmaceutical assistance programs to help residents pay for their prescriptions. The Medicare website has a tool you can use to look up programs available in your state. 

If you’re a Medicare beneficiary with limited income, you may want to consider Medicare Extra Help to help pay for Stelara. In order to qualify for Extra Help in 2024, beneficiaries must meet annual income and resource limits. Resources include money in savings accounts, real estate, and investments. Income limits are $22,590 for an individual and $30,660 for a married couple. Resource limits are $17,220 for an individual and $34,360 for a married couple.

Is there a cheaper alternative to Stelara?

There are some cheaper alternatives to Stelara, says Dr. Madison, but they often have more serious side effects and may not be appropriate for all ages or for treating the specific condition you have. However, she says you can ask your healthcare provider about these cost-saving options:

• Mesalamine: $179.63 for 120, 1.2 g delayed-release tablets with a SingleCare coupon
• Sulfasalazine: $9.00 for 120, 500 mg tablets with a SingleCare coupon
• Oral glucocorticoids like prednisone or prednisolone: $2.64 for 10, 20 mg prednisone tablets and $5.04 for 30 mL of 15 mg/5 mL prednisolone solution with SingleCare coupons 
• Methotrexate: $10.23 for 24, 2.5 mg tablets with a SingleCare coupon

“Unfortunately, the alternative biologic drugs that work like Stelara are also specialty drugs,” Dr. Kunde explains. While they’re often less expensive than Stelara, they’re not necessarily affordable by many people’s standards. 

“Biologics have biosimilars, which are similar to [a generic form of the drug],” Dr. Kunde explains. “Humira and Remicade treat conditions like [the ones treated by] Stelara and have cheaper biosimilars available.”

For example, if you used SingleCare’s prescription discount card when paying for a prescription for Hulio, one of Humira’s biosimilars, your cost could be $998.02 for two kits of 40 mg/0.8 mL pens instead of $6,379.57—an out-of-pocket cost savings of more than $5,000.

RELATED: FDA approves Wezlana for inflammatory conditions

Bottom line

Because Stelara is a specialty drug, it’s not available in retail pharmacies, so we can’t provide an estimate on the available savings for Stelara. Pharmacy negotiations are ongoing, however, and medication prices vary from one pharmacy to the next. Sometimes, prices change slightly based on consumer demand. Until the cost of Stelara goes down, the STELARA withMe Savings Program can make it more affordable. You and your healthcare provider may also want to discuss more affordable Stelara alternatives, which can be made even more affordable with a SingleCare prescription discount card.