How much is Stelara without insurance?

In this article:

• What is the generic for Stelara?
• Is Stelara covered by insurance?
• How much does Stelara cost without insurance?
• How to get Stelara without insurance

In this article

• What is the generic for Stelara?
• Is Stelara covered by insurance?
• How much does Stelara cost without insurance?
• How to get Stelara without insurance

Stelara (ustekinumab) is an intravenous prescription drug that can treat a range of autoimmune diseases, including Crohn’s disease, ulcerative colitis, plaque psoriasis, and active psoriatic arthritis. The drug’s list price without insurance coverage is over $25,000 every eight weeks. That number might look intimidating at first glance, but Stelara’s price can vary based on several factors, and patients have reliable ways to make it much more affordable. 

RELATED: Stelara infusion: What to expect

What is the generic for Stelara?

There’s currently no generic alternative for Stelara, but in 2023, the Food and Drug Administration (FDA) approved a biosimilar substitute called Wezlana. Stelara belongs to a drug class called biologics, which means it comes from living cells instead of chemical synthesis. Biosimilars are almost identical to biologics and can treat the same diseases. It’s unclear when Wezlana will hit the market—or how much it will cost when it does—but biosimilars are often cheaper than their biologic counterparts. 

Is Stelara covered by insurance?

“Coverage for treatments like Stelara, as well as its biosimilars, can be influenced by a variety of factors, including the specific condition being treated, the severity of the disease, prior treatments attempted, and the specific approvals the treatment has received for different conditions,” says Achillefs Ntranos, MD, a neurologist in private practice in Beverly Hills, California. Some health insurance plans will cover Stelara, and certain Medicare Part D plans will as well. According to the Centers for Medicare & Medicaid Services, Medicare Part D plans spent over $1.5 billion on Stelara claims from over 16,000 Americans in 2021.

Even when it’s covered, however, private insurance plans often require copays and coinsurance, so there still may be some out-of-pocket costs.

How much does Stelara cost without insurance?

Without insurance or other discounts, the list price of Stelara is $25,497 per 90 mg prefilled syringe, according to the drug’s manufacturer, Janssen Biotech, Inc. Patients typically need a subcutaneous injection every eight weeks, which could add up to more than $150,000 per year without insurance or discounts.

“Getting a drug approved by the FDA is a very expensive process,” says rheumatologist Stella Bard, MD. In fact, a study published in 2020 estimated that the cost of bringing a new drug to market can range from $766 million to $2.8 billion. It can take several years and requires clinical trials to prove that the medication is safe for the general population. “You have to employ many people to prove drugs are safe and efficacious,” says Benjamin Gibson, Pharm.D., a pharmacist, speaker, and medical writer. “You also have to recruit people to be in an experiment.” 

“It’s also very expensive to develop biologic drugs,” Dr. Bard adds. To make these drugs, doctors make copies of live cells, which can be a complex and time-consuming process. In the lab, scientists have to make sure each batch of these complicated cells is identical, increasing research, development, and manufacturing costs.

Even though it’s a complex drug, Stelara isn’t the only one approved to treat inflammatory conditions. “With the upcoming introduction of biosimilars, there may be a potential impact on the market dynamics, including pricing, ” Dr. Ntranos says. “However, the specific effects will depend on factors like competition, demand, and insurance coverage policies.”

Plus, there are alternatives to Stelara that might be more affordable for certain people. Always get medical advice from a healthcare provider about which drug might work best for you.

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see the latest drug prices.

How to get Stelara without insurance

The thought of paying full price for Stelara—and similar brand-name medications—might make some patients shudder. But the good news is even uninsured patients don’t necessarily need to pay completely out of pocket. Here are some ways to save money on Stelara.

1. Get a SingleCare prescription discount card

Anyone can sign up to receive SingleCare coupons, which can save money on a range of over-the-counter and prescription medications. SingleCare negotiates directly with pharmacies to get discounts at over 35,000 locations nationwide. You can use the SingleCare savings card even if you have commercial insurance or Medicare coverage, but you can’t use them at the same time.

2. Manufacturer assistance and coupons

Patients who have private health insurance that doesn’t cover Stelara’s full cost can potentially enroll in Janssen CarePath’s Stelara withMe program. To qualify, you can’t be enrolled in any government-sponsored insurance plans, but eligible enrollees might pay as little as $5 per dose out of pocket. For uninsured patients, Janssen’s parent company, Johnson & Johnson, has . If you don’t have insurance and meet the other eligibility requirements, the program may cover the entire cost of your medication for up to one year. 

3. Ask about biosimilars

Biosimilars are drugs that are almost identical to their reference biologics. They’re often cheaper too, since their clinical trials aren’t as extensive as they are for biologics. In October 2023, the FDA approved Wezlana, a biosimilar for Stelara. 

It’s unclear when Wezlana will hit the market, or how much it will cost. But “the availability of biosimilars is crucial for increasing access to treatment options for patients, potentially at a lower cost. It’s important for patients to discuss with their healthcare providers the most appropriate treatment plan, considering all available options, including the newly approved and forthcoming biosimilars,” Dr. Ntranos says. 

RELATED: FDA approves Wezlana for inflammatory conditions

4. Search for the best price

Like many products, prescription drug prices can vary between sellers. In fact, some pharmacies might sell certain drugs for hundreds more than their competitors, according to a study from the U.S. Public Interest Research Groups. Your usual go-to pharmacy might be convenient, but calling around to different locations could lead to significant savings.

5. Look into nonprofit assistance

Some nonprofit organizations offer prescription assistance and help connect patients to financial resources. Patient Advocate Foundation’s Co-Pay Relief is one of the most prominent, and the PAN Foundation offers grants for people with certain conditions. Enrollment often requires you to meet specific program requirements, but eligible patients can potentially save money on their Stelara medication costs.