Stelara Cost in 2026: Prices & How to Save
A single 90 mg syringe of Stelara carries a list price of $25,497.12. If you're on the every-8-weeks schedule for Crohn's disease, that's roughly $166,000 a year for one medication.
Here's what almost nobody tells you at the pharmacy counter: eight ustekinumab biosimilars have hit the US market since 2023, and one of them sells for $360 a syringe. Same active ingredient. Same FDA standards. Roughly 1.4% of the brand's list price. Getting access to that price depends almost entirely on what you and your prescriber think to ask for.
At a glance
- Stelara's list price is $25,497.12 per 90 mg dose; retail cash prices reported by discount services in early 2026 ranged from roughly $17,000 to $43,000 per syringe depending on strength and pharmacy
- There is no generic Stelara — it's a biologic, so the lower-cost versions are called biosimilars
- Eight ustekinumab biosimilars are FDA-approved, launching at 80% to 90% below Stelara's list price
- Yesintek launched with a wholesale cost near $3,000 per dose; Starjemza is sold direct to patients at $360 per syringe plus $55 refrigerated shipping
- Medicare's negotiated maximum fair price for Stelara took effect January 1, 2026 at 66% below the 2023 list price — but that only helps Part D enrollees
- Annual cost depends heavily on your condition: psoriasis dosing runs every 12 weeks, IBD dosing every 8 weeks
How much does Stelara cost without insurance?
Stelara (ustekinumab) comes in three at-home forms: a 45 mg prefilled syringe, a 90 mg prefilled syringe, and a 45 mg single-dose vial. There's also an IV form used only for the first dose in inflammatory bowel disease, given in a clinic and billed under medical benefits rather than pharmacy benefits.
Cash prices for the syringes vary wildly by pharmacy and ZIP code, which tells you something about how little the "retail price" of a specialty biologic actually means.
| Version | Reported cash price (per dose) | Source & date |
|---|---|---|
| Stelara 45 mg/0.5 mL syringe | ~$21,681 | GoodRx, October 2025 |
| Stelara 90 mg/mL syringe | ~$43,358 | GoodRx, October 2025 |
| Stelara 45 mg/0.5 mL syringe | ~$17,085 | SingleCare, February 2026 |
| Unbranded ustekinumab 45 mg | ~$5,191 | SingleCare, February 2026 |
| Wezlana 90 mg (biosimilar) | ~$7,046 | SingleCare, February 2026 |
Two things jump out. First, the same 45 mg syringe was quoted at $21,681 and $17,085 four months apart by two different services — a $4,600 spread on identical product. Second, the unbranded version made by the same manufacturer, with the same formula, was quoted at less than a third of the brand price.
That second point is the whole story of Stelara pricing in 2026.
Why there's no Stelara generic
Stelara is a monoclonal antibody that blocks interleukin-12 and interleukin-23, two immune signaling proteins that drive inflammation in plaque psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis. It's grown in living cells, not synthesized in a chemical reaction.
You can't copy a living-cell product atom for atom the way you can copy a small molecule like methotrexate. So biologics don't get generics. They get biosimilars — versions proven to be highly similar to the original with no clinically meaningful differences in safety, purity, or potency.
Some biosimilars also carry an interchangeable designation. That matters practically: an interchangeable biosimilar can be substituted at the pharmacy without your prescriber writing a new prescription, subject to your state's substitution law. A non-interchangeable biosimilar has to be prescribed by name.
Ask which category yours falls into. It changes how much work getting the cheaper version takes.
The ustekinumab biosimilars available in 2026
Wezlana was first, approved in 2023. Then the floodgates opened. Here's the current field, with the discount each manufacturer announced against Stelara's list price at launch:
| Biosimilar | Suffix | Announced launch discount |
|---|---|---|
| Yesintek | ustekinumab-kfce | ~90% (WAC around $3,000) |
| Steqeyma | ustekinumab-stba | 85% |
| Selarsdi | ustekinumab-aekn | 85% |
| Pyzchiva | ustekinumab-ttwe | 80% |
| Otulfi | ustekinumab-aauz | Launched at a discount to Stelara |
| Imuldosa | ustekinumab-srlf | Launched at a discount to Stelara |
| Wezlana | ustekinumab-auub | First to market, 2023 |
| Starjemza | ustekinumab-hmny | Sold direct at $360/syringe |
Starjemza deserves its own paragraph. Approved in May 2025, it's being sold straight to patients at $360 per syringe with a $55 next-day refrigerated shipping charge. Not $360 after a rebate, or $360 if you qualify for something. $360.
For a Crohn's patient dosing every 8 weeks, that's roughly $2,700 a year including shipping, against a brand list price around $166,000. Mark Cuban's Cost Plus Drugs has also added a Stelara biosimilar to its catalog, which is another sign that the transparent-pricing channel is where the real savings live.
Savings tip: If your prescription is written for brand-name Stelara and your biosimilar isn't interchangeable, the pharmacy legally cannot swap it. Call your prescriber's office and ask them to write a new prescription for a specific biosimilar by name. It's a five-minute phone call that can change your annual cost by five figures.
What Stelara actually costs you per year
Per-syringe prices are misleading because dosing schedules differ so much by condition. The annual math is what matters.
Plaque psoriasis and psoriatic arthritis: After loading doses at week 0 and week 4, maintenance is one injection every 12 weeks — about 4.3 doses per year. Dose is 45 mg if you weigh 100 kg or less, 90 mg if you weigh more.
Crohn's disease and ulcerative colitis: A single weight-based IV infusion to start, then 90 mg by injection every 8 weeks — about 6.5 doses per year. Some patients are moved to every 12 weeks.
Run those numbers against list price and against the cheapest biosimilar channel:
| Scenario | Doses/year | At Stelara list ($25,497/dose) | At $360/syringe direct |
|---|---|---|---|
| Psoriasis, q12w maintenance | ~4.3 | ~$110,000 | ~$1,550 |
| Crohn's/UC, q8w maintenance | ~6.5 | ~$166,000 | ~$2,340 |
Those brand figures are list prices, and almost no one pays list. Insurers negotiate rebates you never see, which is precisely why the number on the pharmacy's screen means so little. But if you're uninsured, in a deductible phase, or on a high-deductible plan, list price is a lot closer to your reality than anyone likes to admit.
Does insurance cover Stelara?
Most plans do, with strings attached. Coverage data compiled by Managed Markets Insight & Technology as of September 2025 showed Stelara prefilled syringes covered for roughly 87% of commercial enrollees, 95% of ACA plan enrollees, 76% of Medicare enrollees, and 99% of Medicaid enrollees.
The catch is what sits in front of that coverage. Across every one of those channels, roughly three-quarters of enrollees faced prior authorization, and 72% to 80% faced step therapy — meaning you have to fail on a cheaper drug first before the plan will pay for this one.
Increasingly, the cheaper drug the plan wants you to try is a ustekinumab biosimilar. Several PBMs have added Selarsdi, Yesintek, and others to preferred formulary tiers, and some have launched private-label versions. If your plan pushes you toward a biosimilar, that's not your insurer being difficult. It's the one place where their incentive and yours line up.
Medicare price negotiation and what changed in 2026
Stelara was in the first round of drugs selected for Medicare price negotiation under the Inflation Reduction Act. The negotiated maximum fair price took effect January 1, 2026, set at 66% below Stelara's 2023 list price.
Worth being precise about who this helps. The MFP applies to Medicare Part D. If you're on commercial insurance, uninsured, or paying cash, the negotiated price does nothing for you directly. Its indirect effect — pushing J&J to compete harder on net price against a wall of biosimilars — probably matters more to the rest of us.
Ways to lower what you pay
Ask for the biosimilar by name. This is the single most valuable thing you can do. The spread between brand Stelara and the cheapest ustekinumab runs into tens of thousands of dollars a year. Bring the list above to your appointment.
Ask about the unbranded ustekinumab. J&J sells an unbranded version of its own product — same manufacturer, same formula, no brand name on the box. Discount services quoted it near $5,191 for a 45 mg syringe in early 2026, versus $17,085 for the branded box.
Compare specialty pharmacies before you fill. Biologics almost always go through specialty pharmacies, and their cash prices are not uniform. The $4,600 spread on identical syringes noted earlier wasn't a fluke.
Look at cash-pay channels. Direct-to-patient and transparent-pricing pharmacies have been the most aggressive on ustekinumab pricing, precisely because they aren't operating inside the rebate system. Compare their number against your plan's number rather than assuming insurance always wins — with a high deductible, it often doesn't.
Check whether an oral or older option fits your case. For some people with psoriasis or psoriatic arthritis, apremilast — the generic of Otezla — or a conventional DMARD like sulfasalazine or methotrexate is clinically reasonable and costs a small fraction of any biologic. For others it isn't remotely equivalent. That's a conversation with your rheumatologist or gastroenterologist, not a decision to make from a price list.
Use HSA or FSA dollars. Paying with pretax funds effectively discounts the bill by your marginal tax rate.
Never switch or stop a biologic on your own. Flares after an interruption can be worse than the disease you started with, and restarting doesn't always work as well as staying on.
How Stelara compares on cost to other biologics
If your plan denies Stelara or your prescriber is weighing options, cost across the class is worth knowing. All of these treat overlapping conditions, and all now face some form of price competition.
| Medication | Class | Notes on cost |
|---|---|---|
| Stelara (ustekinumab) | IL-12/23 inhibitor | 8 biosimilars, 80–90% below list |
| Humira (adalimumab) | TNF inhibitor | Multiple biosimilars since 2023 |
| Skyrizi (risankizumab) | IL-23 inhibitor | No biosimilar; still brand-only |
| Tremfya (guselkumab) | IL-23 inhibitor | No biosimilar; still brand-only |
| Rinvoq (upadacitinib) | JAK inhibitor | Oral; no generic yet |
Stelara is unusual here in a good way. Being early to the biosimilar cliff means it's now one of the cheaper paths in a very expensive class — if you get routed to a biosimilar rather than the brand.
The bottom line
Stelara's list price is roughly $25,500 a dose, but that number is close to fiction for most patients in 2026. Eight biosimilars have driven the real cost down by 80% to 90%, and at least one is being sold direct to patients for $360 a syringe.
The savings won't find you. Ask your prescriber which ustekinumab your plan prefers, whether it's interchangeable, and what the cash price is if you skip insurance entirely. Then compare that against what CanAmerica Plus and other cash-pay options quote for your specific dose before you fill.
Frequently asked questions
Is there a generic for Stelara?
No. Stelara is a biologic, and biologics don't have generics. They have biosimilars — highly similar versions held to FDA standards for safety and effectiveness. Eight ustekinumab biosimilars are approved in the US, plus an unbranded version of Stelara made by the original manufacturer.
How much is Stelara per month?
Stelara isn't dosed monthly. Maintenance injections come every 8 weeks for Crohn's disease and ulcerative colitis, or every 12 weeks for plaque psoriasis and psoriatic arthritis. Spread across a year at list price, that works out to roughly $9,200 to $13,800 per month equivalent — far less if you're on a biosimilar.
Are Stelara biosimilars as effective as Stelara?
The FDA requires biosimilars to show no clinically meaningful differences from the reference product in safety, purity, and potency. Studies used to support approval compare them head-to-head. Switching between a biologic and its biosimilar should still be a decision made with your prescriber, particularly if your disease is well controlled.
Why is Stelara so expensive?
Biologics are grown in living cell systems, which is slower and costlier than chemical synthesis, and Stelara carried patent protection in the US for well over a decade. Beyond manufacturing, US list prices reflect a rebate system in which high list prices coexist with large undisclosed discounts to pharmacy benefit managers — a gap that hits uninsured and high-deductible patients hardest.
Will Medicare's negotiated price lower what I pay?
Only if you're on Medicare Part D. The maximum fair price effective January 1, 2026 is 66% below the 2023 list price, but it applies to Medicare, not to commercial plans or cash payers. Its knock-on effect on market pricing may help more broadly over time.
This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment. Pricing information is current as of the publication date but may change. Verify pricing directly before making purchasing decisions.
