Stelara carries a list price of roughly $13,836 for a 30-day supply, making it one of the most expensive drugs in the United States. That price reflects a combination of factors: the high cost of manufacturing biological drugs, decades of patent protection that blocked competitors, a rebate system that inflates sticker prices, and the sheer market power of a drug approved for four different conditions. The good news is that prices are finally dropping, with biosimilars hitting the market in early 2025 and a Medicare-negotiated price set to take effect in 2026.
Biologics Cost More to Make Than Standard Drugs
Stelara is a monoclonal antibody, a type of biologic drug grown inside living cells rather than assembled from chemical ingredients the way a typical pill is. That distinction matters enormously for cost. Manufacturing a biologic requires specialized facilities designed to keep living cell cultures alive, contamination-free, and producing a consistent protein. The downstream processing alone, filtering out impurities and verifying that each batch has the correct three-dimensional protein structure, adds layers of expense that simply don’t exist for conventional medications.
Building and maintaining these facilities requires massive capital investment. The factors that drive cost include protein expression levels in the host cells, regulatory compliance at every step, and the scale of production. A single manufacturing error can ruin an entire batch worth millions of dollars. These production realities don’t fully explain a $13,000 monthly price tag, but they do explain why biologics as a category sit at the top of drug spending charts and why biosimilar competitors take longer to develop than generic versions of simple pills.
Patent Protection Kept Competitors Out for Years
Stelara was first approved by the FDA in 2009 for psoriasis, and Johnson & Johnson steadily expanded its uses to psoriatic arthritis, Crohn’s disease, and ulcerative colitis. Each new indication required large clinical trials, and each trial generated data that strengthened the drug’s market position. Patents and regulatory exclusivity periods kept biosimilar manufacturers from launching competing versions for well over a decade.
Without competition, there was no market pressure to lower the price. Between 2016 and 2023, the average cost of a Stelara injection under Medicare Part D increased by 84 percent. That kind of price growth is common with biologics that face no direct competitors: the manufacturer can raise prices year after year, knowing patients and insurers have no alternative.
The Rebate System Inflates the Sticker Price
The price you see quoted for Stelara, the wholesale acquisition cost, is not what most insurers actually pay. A significant share of Johnson & Johnson’s gross Stelara revenue goes back out the door as rebates to pharmacy benefit managers, discounts through the 340B drug pricing program, and manufacturer copay assistance cards. The Colorado Division of Insurance conducted an affordability review of Stelara and found that a substantial portion of national gross sales was spent on these price concessions, though the exact percentage was redacted from the public report.
This system creates a perverse dynamic. The list price gets set high so the manufacturer can offer large rebates to insurers and PBMs, who prefer big discounts on paper. But patients whose insurance requires coinsurance (a percentage of the drug’s cost rather than a flat copay) end up paying based on that inflated list price. The people who bear the most financial pain from high sticker prices are often the ones with the least negotiating power.
Medicare Patients Pay Especially High Costs
A federal watchdog report found that Medicare and its enrollees paid substantially more when Stelara was covered under Part D (the pharmacy benefit, for self-injected doses) than under Part B (the medical benefit, for doses given in a doctor’s office). In 2021, the annual cost per enrollee was 80 percent higher under Part D than Part B. The gap comes down to how each program negotiates prices: Part B ties reimbursement to average sales prices, while Part D pricing is more exposed to list price inflation.
To make matters worse, coverage rules have shifted so that enrollees who once received Stelara injections in their doctors’ offices now have to obtain it through a pharmacy. That means many are being moved into the higher-cost Part D pathway, potentially facing larger out-of-pocket bills than they had before.
Biosimilars Are Finally Arriving
The competitive landscape changed in early 2025. Amgen launched Wezlana, the first Stelara biosimilar, in January 2025. Teva’s Selarsdi and Sandoz’s Pyzchiva followed in February. All three have been granted interchangeable status by the FDA, meaning pharmacists can substitute them for Stelara without needing to contact the prescriber, similar to how generic drugs replace brand-name pills. Amgen held a brief period of interchangeability exclusivity, which expires on April 30, 2025, after which all approved biosimilars can compete on equal footing.
Early pricing signals are dramatic. Reports indicate that these biosimilars entered the market with discounts as steep as 85 percent off Stelara’s list price. That kind of discount is unusual for biosimilars, which historically launch at 15 to 30 percent below the brand, but it reflects how aggressively manufacturers are competing for market share given the drug’s enormous sales volume.
Medicare Price Negotiation Adds More Pressure
Stelara was one of the first 10 drugs selected for Medicare price negotiation under the Inflation Reduction Act. The negotiated price, set to take effect in 2026, is $4,695 for a 30-day supply. That represents a roughly 66 percent reduction from the 2023 list price of $13,836. This negotiated rate applies to Medicare enrollees specifically, but the combination of government negotiation and biosimilar competition is likely to pull prices lower across the broader market as well.
For patients currently on Stelara, the practical question is whether your insurer or pharmacy will switch you to a biosimilar. Because these products are designated as interchangeable, the switch can happen at the pharmacy counter in most states. If you’re paying coinsurance on the brand-name product, asking your doctor or pharmacist about switching to one of the biosimilars could meaningfully reduce your costs right now, without waiting for the 2026 Medicare price to kick in.