Stelara expenses: Discounts, financial aid, and extra resources
In the realm of biologic drugs, Stelara (ustekinumab) is a popular choice for managing conditions such as ulcerative colitis, Crohn's disease, plaque psoriasis, and psoriatic arthritis. However, the cost of this medication can vary significantly, depending on a multitude of factors.
The average cost per injection or infusion of Stelara in the U.S. is roughly around $1,000 to $1,060. But, the good news is, biosimilars for Stelara are available and are generally priced about 30% lower, at approximately $700 to $780 per dose.
For insured individuals, many health plans cover Stelara and its biosimilars, often placing them in higher drug cost tiers with copayments or coinsurance that vary widely. These can range from $15 copays to 40% coinsurance capped at $250-$750 per month, depending on the plan's formulary and drug tier. Prior authorization requirements and utilization management protocols may apply, influencing access and out-of-pocket costs.
For non-insured or underinsured patients, the cost burden can be high. However, manufacturers typically offer patient assistance programs or copay cards to reduce the cost. Biosimilars, being priced lower, already offer potential savings, and some specialty pharmacy programs may have additional support for these agents.
It's important to note that biosimilars increase market competition and help lower prices overall, encouraging payers and providers to prefer them due to the reduced cost per infusion.
In summary, the cost of Stelara and its biosimilars can depend on factors such as insurance coverage, pharmacy, treatment plan, and participation in cost-savings programs. If you don't have health insurance, talk with your doctor or pharmacist for potential options.
For detailed information about copay assistance or current program details, checking with the manufacturer Janssen (for Stelara) or biosimilar makers' websites and specialty pharmacies is recommended. Websites like Medicine Assistance Tool and NeedyMeds also provide details about drug assistance programs and ways to save on prescriptions.
If you have questions about insurance considerations, contact your doctor or insurance provider. In some cases, Medicare may require an approval review for Stelara coverage, and if Stelara is received as an infusion, there may be costs for the visits to receive the doses. If Stelara is received as a subcutaneous injection, the cost of single-dose, prefilled syringes can be obtained from the pharmacy or insurance provider.
Remember, the exact costs depend on insurance plan specifics, site of care, and negotiated prices. Confirm with insurers and specialty pharmacies for personalized cost and assistance programs.
- AbbVie, the manufacturer of Stelara, has biosimilars available for the medication, which are priced approximately 30% lower than the original.
- Financially, health insurance can play a significant role in managing the costs of Stelara, with many health plans covering it, though copayments or coinsurance fees may vary.
- Medicaid coverage for Stelara may require an approval review, and there may be costs associated with infusion visits to receive the doses.
- Healthcare providers and pharmacists can provide guidance for patients without insurance or with limited coverage, who may benefit from patient assistance programs or copay cards offered by manufacturers.
- For individuals seeking to manage personal finance expenses related to medical conditions, such as ulcerative colitis or skin conditions, reviewing insurance coverage and exploring savings programs can help reduce costs.
- A major player in the financial landscape of biologic drugs, Stelara's cost can heavily depend on factors such as insurance coverage, treatment plan, and participation in cost-savings programs like CDI (Copayment Discount Programs) or financial assistance from science-driven companies.
- Science and medical advancements, such as the creation of biosimilars, can help lower the overall cost of healthcare, allowing healthinsurance companies and providers to prefer these options due to their reduced financial impact.
- Specialty pharmacies can offer additional support for managing health-and-wellness costs, particularly for patients utilizing biosimilars and medications for specific medical-conditions like anthrax.
