Stelara Cost in 2026: Copay, Biosimilars and How to Pay Less

Stelara cost in 2026 comes down to three numbers that are rarely printed together: a reported list price of $25,497.12 every eight weeks for the 90 mg dose as of February 2025 (3), a Medicare negotiated price of $4,695 for a 30-day supply effective January 1, 2026 (1), and whatever your own plan decides you owe. Almost nobody pays list. Checked 2026-09-29.

If you are staring at a bill, a formulary letter or a copay card that suddenly stopped working, the question of stelara cost is not abstract. Many of us living with Crohn's have opened an Explanation of Benefits and felt the floor tilt. What follows is built from primary documents you can open yourself. For how the medicine works, see our patient guide to Stelara (ustekinumab) for Crohn's disease.

Key Takeaways

• Stelara cost at list was reported as $25,497.12 every eight weeks for the 90 mg maintenance dose as of February 2025, checked 2026-09-29 (3).
• Medicare's negotiated price is $4,695 for a 30-day supply in 2026, a 66% discount from the $13,836 list price for a 30-day supply in 2023 (1).
• The STELARA withMe program advertises as little as $5 per dose, but only for commercial or private insurance, and it excludes Medicare, Medicaid, TRICARE, Department of Defense and VA coverage (6).
• Eight ustekinumab biosimilars are FDA approved, with launch pricing reported at roughly 80% to 90% below list, and an unbranded version announced at 95% less (3)(4)(5).
• A discount off list price is not a lower copay. Biosimilar savings often land with the insurer or pharmacy benefit manager before they reach you.

What Stelara Actually Costs in 2026

There is no single Stelara cost. The reported list price was $25,497.12 every eight weeks for the 90 mg dose as of February 2025, checked 2026-09-29 (3). That figure is the starting point for negotiation between manufacturers, insurers and pharmacy benefit managers, and it is almost never what a patient pays. What you owe depends on which benefit the dose is billed through.

List price versus what anyone actually pays

Stelara for Crohn's is billed through two different systems, and that is where most surprise bills begin. The first dose is an intravenous induction infusion, dosed by body weight at an infusion center or hospital outpatient department, and it runs through your medical benefit. The facility bills its own fee for the chair, nursing time and observation, separate from the drug. Many of us only discover this when two bills arrive instead of one.

Maintenance is different. The 90 mg subcutaneous injection every 8 weeks is dispensed by a specialty pharmacy under your pharmacy benefit, usually on a specialty tier with percentage coinsurance rather than a flat copay.

Before you start, or before your plan year resets, ask your clinic's billing office for three numbers:

1. The drug cost, for induction and maintenance separately.
2. The administration cost, the facility and nursing charge, which the copay card does not cover.
3. Your coinsurance percentage on the specialty tier, plus your deductible and out-of-pocket maximum.

Without those three, any estimate is a guess. Ask for a written good-faith estimate.

The STELARA withMe Copay Card: What It Covers and What It Does Not

The STELARA withMe Savings Program states that eligible patients may pay as little as $5 per dose (6). That figure is real, but it is fenced by eligibility rules and an annual cap most patients never read until the card stops paying.

Eligibility

The program requires commercial or private insurance, explicitly including Health Insurance Marketplace plans, and requires that you have an out-of-pocket cost for the medicine (6). It asks for no income information, which makes it far easier to enroll in than patient assistance.

Check the disqualifier first, because it rules out many readers: the program excludes anyone using Medicare, Medicaid, TRICARE, Department of Defense or Veterans Administration coverage (6). That reflects federal anti-kickback rules and applies to essentially all branded copay cards.

The limits nobody reads

Four terms in the program document deserve your attention (6):

• An annual maximum benefit applies, set at the manufacturer's discretion. Once you hit it, the card stops paying for the rest of the calendar year.
• Program terms expire at the end of each calendar year. What was true last December is not automatically true this January.
• The program does not cover the cost of administering the treatment. The infusion facility fee is yours.
• Patients whose health plan partners with SaveOnSP, or a similar non-essential health benefit maximizer, are not eligible.

Two mechanics apply depending on billing. Under the pharmacy benefit, the card gives instant savings at the counter using a BIN, Group and ID number. Under the medical benefit, you pay first and submit an Explanation of Benefits for a rebate. Confusing the two is a common reason a patient believes the card failed when it was never applied.

Accumulators, Maximizers and SaveOnSP: Why Your Copay Card Can Stop Working

If your copay card worked in January and stopped in May, you have probably met a copay accumulator or a maximizer. These are plan design features, not errors, and they are the least-explained reason a patient's Stelara cost jumps mid-year with no change in the drug, the dose or the pharmacy.

A copay accumulator lets your plan accept the manufacturer's assistance money but refuse to count it toward your deductible or out-of-pocket maximum. The cap gets spent on claims that never move your own totals, and when it runs out you face a deductible you thought you had met.

A copay maximizer goes further. It resets your copay to match the manufacturer's annual maximum, spreads that across the year, and again excludes it from your accumulators. The drug is often reclassified as a "non-essential health benefit" to allow this.

SaveOnSP and similar vendors administer these arrangements for employers. That matters directly here, because STELARA withMe states that patients whose plan partners with SaveOnSP or a similar non-essential health benefit maximizer are not eligible for the program at all (6). You can be disqualified by a vendor contract you never signed and were never told about.

Detection is hard, since most patients only find out when the card stops. On your Explanation of Benefits, look for a specialty drug flagged as excluded from essential health benefits, an oddly round copay repeating every fill, or manufacturer payments that never move your deductible.

Two calls are worth making. Ask the STELARA withMe program whether your plan is flagged, then ask HR or your benefits administrator in writing: does our plan use a copay accumulator, a maximizer, or a specialty carve-out vendor?

Ustekinumab Biosimilars: Eight Approved and What They Cost

Eight ustekinumab biosimilars referencing Stelara have FDA approval, and reported launch discounts run from roughly 80% to 95% below list (3)(4)(5). That is the largest structural change to Stelara cost in a decade. Whether any of it reaches your out-of-pocket cost is a separate question, and often the answer is no.

The approved list

Per the FDA's biosimilar product information page, the approved ustekinumab biosimilars are Wezlana (October 2023), Selarsdi (April 2024), Pyzchiva (June 2024), Otulfi (September 2024), Imuldosa (October 2024), Yesintek (November 2024), Steqeyma (December 2024) and Starjemza (May 2025) (5).

Interchangeability is worth understanding plainly. A biosimilar is a highly similar version of a biologic with no clinically meaningful differences. An interchangeable biosimilar has met an additional FDA standard that can let a pharmacist substitute it without contacting your prescriber first. The FDA's page links Wezlana's approval as interchangeable and does not carry that notation for the others (5), and substitution also depends on your state's pharmacy law. For the wider picture, see our patient guide to biosimilars in Crohn's disease.

Discounts so far

Pyzchiva launched at roughly 80% below list, Selarsdi at about 85% off, and Yesintek at a wholesale acquisition cost of approximately $3,000, about a 90% discount (3). An unbranded ustekinumab-aekn was announced at 95% less than Stelara, expected to be available January 1, 2026, checked 2026-09-29 (4).

Now the honest part. A discount off list price is not a lower copay. These are wholesale prices, your coinsurance is calculated against whatever your plan negotiated, and rebates often land with the insurer or pharmacy benefit manager first. You can be switched to a product priced 90% lower and pay what you paid before. Ask your specialty pharmacy for a projected out-of-pocket figure before the switch.

Medicare: The Negotiated Price and the $2,100 Cap

Stelara was in the first round of Medicare drug price negotiation. The negotiated Maximum Fair Price is $4,695 for a 30-day supply for 2026, against a list price of $13,836 for a 30-day supply in 2023, a 66% discount, effective January 1, 2026 (1). This applies to Medicare Part D only. It sets no price for commercial insurance or for the uninsured.

In 2023, about 23,000 Medicare Part D enrollees used Stelara, accounting for $2,988,560,000 in Part D gross covered prescription drug costs (1).

For what you actually pay, the Part D redesign matters more than the negotiated price. For 2026, Part D has a $615 deductible and a $2,100 annual out-of-pocket threshold, after which an enrollee generally pays nothing more for covered Part D drugs that year (2). A specialty biologic typically reaches that cap early, which makes the yearly total predictable even though the first months hurt.

That front-loading is what the Medicare Prescription Payment Plan addresses. It spreads your out-of-pocket costs into monthly installments across the plan year. It does not reduce the total, but it turns one impossible month into twelve.

If Your Insurer Switches You, or You Have No Insurance

A letter moving you to a different ustekinumab product is a formulary decision, not a clinical one. You are allowed to ask why. If coverage is refused outright, our walkthrough of prior authorization and appeals for Crohn's disease covers the process.

Non-medical switching

Non-medical switching means being moved off a product that is working for you for reasons of cost rather than how you are doing, and that is reasonable to question. Ask whether your prescriber will submit a letter of medical necessity, and whether the plan has a formulary exception process.

If the switch goes ahead, three steps protect you:

• Confirm the exact product and dose in writing, since biosimilars carry distinct names and suffixes.
• Check whether new copay program enrollment is needed. Each manufacturer runs its own, and STELARA withMe does not transfer.
• Watch for a gap between your last covered dose and the first new one. An eight-week interval stretching to twelve while paperwork moves is the real risk, not the molecule.

No insurance at all

With no coverage, the copay card is unavailable, because it requires commercial insurance (6). Three routes remain: manufacturer patient assistance foundations, which may supply medicine at no cost; hospital charity care and financial assistance policies, often the better route for the facility fee; and cash-pay pricing on a biosimilar, worth quoting with a specialty pharmacy.

Unlike the copay card, these require income documentation, so gather tax returns, pay stubs and proof of residency first. If you are comparing biologics on price, our breakdown of Entyvio cost without insurance applies the same method to a different drug.

What to Do With This

Your Stelara cost is decided by plan design, not by list price. Find out whether your plan uses an accumulator or a maximizer, whether your dose runs through the medical or pharmacy benefit, and what your specialty tier coinsurance is. Those three answers predict your year better than any published price.

Two limits on all of this. Every figure here is United States specific, and coverage rules differ by country, so readers elsewhere should check with their national patient organization or treating centre. And prices change, terms expire each December and formularies reset in January, so open the linked source before you act.

Frequently Asked Questions

How much does Stelara cost per month without insurance?

There is no published cash price. The reported list price was $25,497.12 every eight weeks for the 90 mg dose as of February 2025, checked 2026-09-29 (3), roughly $12,750 a month. Uninsured patients almost never pay it. A cash-pay biosimilar, a patient assistance foundation or hospital charity care each produce a far lower figure.

Can I use the Stelara copay card if I have Medicare?

No. The STELARA withMe program excludes anyone using Medicare, Medicaid, TRICARE, Department of Defense or Veterans Administration coverage (6), a restriction that applies to essentially all branded copay cards in the United States. On Medicare, the relevant protections are the negotiated price of $4,695 per 30-day supply for 2026 (1) and the $2,100 annual out-of-pocket cap (2).

Why did my Stelara copay card stop working halfway through the year?

The usual causes are hitting the program's annual maximum benefit, set at the manufacturer's discretion, or a plan-level accumulator or maximizer that consumed the assistance without crediting your deductible (6). A third is that your plan partners with SaveOnSP or a similar maximizer, which makes you ineligible entirely under the program's own terms (6).

Are ustekinumab biosimilars as effective as Stelara?

A biosimilar is approved on the basis that there are no clinically meaningful differences from the reference product in safety, purity and potency. Eight are FDA approved (5). Interchangeability is a regulatory standard about pharmacy substitution, not a statement that the others work less well.

Will a biosimilar actually lower what I pay?

Often it does not. The reported 80% to 95% launch discounts are wholesale prices (3)(4). Your out-of-pocket cost is set by tier placement and coinsurance, and rebates frequently reach the insurer or pharmacy benefit manager first. Ask your specialty pharmacy for a projected figure before the switch.

What should I ask my doctor about the cost of Stelara?

Ask who in the practice handles STELARA withMe enrollments and whether your plan has been checked for a maximizer. Ask whether maintenance is billed through the pharmacy or medical benefit, and for a written estimate separating drug and facility charges. If a switch is proposed, ask in writing whether it is clinical or financial.

References

1. Centers for Medicare and Medicaid Services. Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2026 (Fact Sheet). 2024. Checked 2026-09-29. Read fact sheet
2. Centers for Medicare and Medicaid Services. Draft CY 2026 Part D Redesign Program Instructions Fact Sheet. 2025. Checked 2026-09-29. Read fact sheet
3. Managed Healthcare Executive. Updated: Two More Stelara Biosimilars Launch, Including One that is 90% Off Stelara. 2025. Checked 2026-09-29. Read article
4. Managed Healthcare Executive. MedImpact To Offer Unbranded Ustekinumab-aekn Biosimilar. 2025. Checked 2026-09-29. Read article
5. US Food and Drug Administration. Biosimilar Product Information (FDA approved biosimilars list). 2026. Checked 2026-09-29. View the FDA list
6. Johnson and Johnson. STELARA withMe Savings Program Overview. 2026. Checked 2026-09-29. Read the program terms