FLASH: Stelara will be a nonformulary medication effective 4/1/25.

Effective April 1, 2025, Stelara (ustekinumab) will be a nonformulary medication, and all non-Medicare patients will need to switch to an ustekinumab biosimilar for covered treatment.

Several biosimilars have been approved by the Food and Drug Administration (FDA) over the last several months, and they’re now covered on our formulary at the preferred specialty tier with prior authorization. Per the FDA, these products have no clinically meaningful differences and they share the same indications as Stelara. Covered products include select NDCs of Wezlana, Otulfi, Selarsdi, Yesintek, Steqeyma and Pyzchiva. Wezlana, Selarsdi, Yesintek and Pyzchiva have patient-assistance programs which may lower the monthly cost for eligible patients.

To better facilitate this transition, no new prior authorizations will be needed to switch products as long as the member has been filling Stelara consistently or has an active prior authorization on file. Patients and prescribers impacted have already received individualized letters notifying them of this change.

Providers should begin to substitute patients to a covered ustekinumab biosimilar in advance of the 4/1/25 Stelara formulary removal. This will ensure a smooth transition and decrease any therapy disruptions.

Thank you for your valued partnership.