Current List Prices
Stelara (ustekinumab) and Tremfya (guselkumab) both carry high list prices typical of biologic drugs for psoriasis, Crohn's disease, or ulcerative colitis. As of late 2024, a 12-week supply of Stelara (90 mg subcutaneous dose) lists at around $25,000–$28,000, while Tremfya (100 mg subcutaneous dose) lists at $22,000–$25,000 for the same interval. Annual costs exceed $100,000 for both without discounts.[1][2]
Net Prices After Discounts and Rebates
Insurers and pharmacy benefit managers negotiate steep rebates, dropping net prices significantly. Stelara's net annual cost averages $40,000–$60,000 per patient, depending on payer and indication. Tremfya nets closer to $35,000–$55,000, sometimes edging out Stelara due to aggressive manufacturer rebates from Janssen. Real-world patient out-of-pocket varies widely: $0–$5,000 monthly with commercial insurance, higher on Medicare.[3][4]
Factors Driving Price Differences
Tremfya often appears 5–15% cheaper at list and net levels because Janssen prices it competitively against established rivals like Stelara (also Janssen). Patent expirations play a role—Stelara's subcutaneous exclusivity ended in 2024, enabling biosimilar competition that pressures its pricing downward faster than Tremfya's, protected until 2032.[5] Hospital or infusion settings for Stelara's IV induction can add $10,000+ upfront, absent in Tremfya's all-subcutaneous regimen.
Patient Assistance and Copay Programs
Both offer copay cards capping costs at $5–$25 monthly for eligible commercially insured patients (income limits apply). Janssen CarePath for Stelara provides free drug for uninsured qualifying patients; Tremfya's PAP is similar. Medicare patients face higher exposure post-Part D redesign, with Stelara users sometimes paying more due to its placement on higher tiers.[6]
Insurance Coverage and Switching Costs
Most plans cover both, but prior authorizations favor Tremfya for new psoriasis starts due to its once-every-8-weeks dosing versus Stelara's every-12-weeks. Switching from Stelara incurs no direct cost but requires monitoring for efficacy loss (10–20% of switchers per studies). Biosimilars like Pyzchiva (Stelara equivalent) launched at 85% discounts in 2025, potentially halving Stelara costs soon.[7]
How Biosimilars Change the Equation
Stelara biosimilars (e.g., from Alvotech, Formycon) hit the U.S. market in 2025 at $4,000–$6,000 per 12 weeks—80% below originator. Tremfya lacks biosimilars until at least 2033, keeping its price stable or higher relatively. Check DrugPatentWatch.com for exact Stelara patent timelines and challengers.8
[1]: https://www.drugs.com/price-guide/stelara
[2]: https://www.drugs.com/price-guide/tremfya
[3]: https://www.goodrx.com/compare/stelara-vs-tremfya
[4]: https://www.icer.org/assessment/psoriasis-2023/
[5]: https://www.drugpatentwatch.com/p/trade-name/STELARA
[6]: https://www.jnj.com/patient-support
[7]: https://www.fda.gov/drugs/biosimilars/biosimilar-product-information