You are already aware that 2025 has brought seismic shifts in the biosimilar world, especially around Stelara (ustekinumab).
So, what’s new? A tidal wave of biosimilars is in full swing, and PBMs are leading the charge with private-label branding, formulary exclusions, and tighter specialty pharmacy control.
What’s Really Going On: Key Market Moves
1. A Biosimilar Explosion, and PBMs Call the Shots
- As of early 2025, multiple biosimilars to Stelara—Wezlana, Selarsdi, Pyzchiva, Yesintek, among others—have hit the market, some directly through PBM-aligned distribution channels.
- These biosimilars have launched with massive discounts, typically 80–90% below Stelara’s list price
- Providers like Lumicera (specialty arm of Navitus) removed Stelara from the formulary as of July 1, 2025, in favor of an unbranded biosimilar, a move they claim will result in significant patient savings per year.
2. Formulary Exclusions and Vertical Integration
- Many PBMs are excluding Stelara and favoring their own private label biosimilars, amplifying control via vertical integration
- Some payers remain reluctant to include biosimilars if there’s no affiliation with the private-label distributor
3. What Truly Drives Adoption? Price and PBM Influence
- Nearly all Stelara biosimilars share the same clinical profile, formulations, and indications, which means net cost is the main differentiator
- By mid-2026, payers covering more than 80% of patients are expected to remove Stelara from their formularies, making biosimilars the preferred option.
45 mg or 130 mg IV? What Stelara Dosing Means for Your Workflow and Bottom Line
Choosing between Stelara 45 mg and 130 mg IV isn’t just about dosing; it’s about how each option affects your workflow, reimbursement, and patients.
Here’s how the doses differ and impact your practice:
45 mg Subcutaneous (SC):
- Convenient for patients and practices: Can be administered in-office or self-injected at home.
- Streamlines your workflow: Less chair time and fewer infusion resources needed.
- Reimbursement is simpler: Typically billed under medical benefit with fewer moving parts.
130 mg Intravenous (IV):
- More control, but higher complexity: Administered in infusion suites, requiring more staff time and resources.
- Potentially higher margins: However, billing is more complex and subject to payer scrutiny.
- May align with payer preferences: some plans may incentivize IV use depending on formulary strategy.
While biosimilars replicate both formulations, you’ll need to assess:
- Clinical feasibility & workflow impact: Does your practice prefer the convenience of SC vs. the controlled infusion setting?
- Reimbursement dynamics: Does the payer favor certain dose forms based on margins or cost–benefit models?
Alternatives: Tremfya and Clinical. Financial Strategy
While Stelara dosing choices are front and center, it’s equally important to consider alternatives, especially agents like Tremfya, which continue to hold a strong position in specific indications.
When weighing Stelara Biosimilars vs Tremfya:
- Think clinical appropriateness first, including disease indication, prior response, and patient considerations.
- Don’t ignore formularies and costs; most PBMs may favor biosimilars heavily, while some plans might still include Tremfya if contracts are favorable.
What This Means for You
The 2025 Stelara biosimilar rollout isn’t just another product launch; it’s a reshaping of how payers, PBMs, and practices interact.
With private label biosimilars quickly dominating formularies and discounts reaching up to 90% below list price, your revenue landscape is shifting fast.
Add to that the different reimbursement realities of 45 mg SC vs 130 mg IV, plus alternatives like Tremfya jockeying for access, and it’s clear: your practice can’t afford to take a wait-and-see approach.
How Remedy GPO Helps You Navigate This Maze
We understand that navigating this rapidly shifting terrain isn’t simple. That’s where we step in:
Strategic insights & formulary intelligence
We help you anticipate PBM moves, like formulary exclusions or preferred private-label products, so you’re not caught off guard.
Dose-specific guidance
Whether you’re using Stelara 45 mg SC or 130 mg IV, we break down billing, supply, and clinical suitability, helping you match decisions to your practice’s strengths.
Alternatives evaluation
Together, we assess when switching to Tremfya or another agent might be a smarter choice, both clinically and financially.
Transparent contracting support
Unlike opaque vertical models, we help you evaluate real cost, rebate pass-through models, and negotiate with clarity.
Partner With Us to Navigate the Biosimilar Era
At Remedy GPO, we understand that these decisions impact more than your bottom line; they shape patient care, access, and the sustainability of your practice.
That’s why we bring you clinical clarity, financial modeling, and strategic foresight to help you choose the right path forward.
Now is the moment to act. By partnering with us, you can turn biosimilar market turbulence into an advantage for your patients, your practice, and your future.
Connect with Remedy GPO today and let’s make the most of this biosimilar market, together.
