Alternatives to Pyzchiva If You Can't Fill Your Prescription

Pyzchiva (ustekinumab-ttwe) is a biosimilar to Stelara, but it is not the only option for patients with plaque psoriasis, psoriatic arthritis, Crohn's disease, or ulcerative colitis. If your insurance does not cover Pyzchiva, or if you cannot access it through a nearby pharmacy, there are several FDA-approved alternatives your doctor can consider.

This guide breaks down the alternatives by category — other ustekinumab biosimilars, the reference product Stelara, and biologics in other drug classes — so you can have an informed conversation with your prescriber.

Other Ustekinumab Biosimilars (Same Mechanism, Different Brand)

All ustekinumab products work the same way: they block the IL-12 and IL-23 proteins that drive inflammation. The biosimilars listed below are FDA-approved and clinically equivalent to Stelara and to each other. Your insurance plan may prefer one over another.

• Stelara (ustekinumab): The original reference biologic by Janssen/J&J. Pyzchiva is biosimilar to Stelara, meaning they are clinically equivalent. Stelara is very widely available but significantly more expensive, with a list price around $25,497 per 8-week 90 mg dose.
• Wezlana (ustekinumab-auub): Developed by Amgen and launched in January 2025. It was the first interchangeable ustekinumab biosimilar on the US market. It is available exclusively through Optum/UnitedHealth formularies.
• Selarsdi (ustekinumab-aekn): Developed by Alvotech and commercialized by Teva Pharmaceuticals. FDA-approved in April 2024. Available for commercially insured patients.
• Yesintek (ustekinumab-kfce): Developed by Biocon Biologics and FDA-approved in December 2024. Launched February 2025. Interchangeable with Stelara.
• Otulfi (ustekinumab-aauz): Developed by Fresenius Kabi. Interchangeable with Stelara.
• Steqeyma and Imuldosa: Additional ustekinumab biosimilars approved by the FDA in 2024-2025 and entering the market throughout 2025.

IL-23 Inhibitors (Same Target, Different Approach)

While Pyzchiva blocks both IL-12 and IL-23, a newer generation of biologics targets only the IL-23 pathway. Clinical data suggests these IL-23-selective inhibitors may offer stronger skin-clearing results for some patients with plaque psoriasis and psoriatic arthritis.

• Skyrizi (risankizumab): An IL-23 inhibitor by AbbVie approved for psoriasis, psoriatic arthritis, and Crohn's disease. Given as a subcutaneous injection every 12 weeks for psoriasis.
• Tremfya (guselkumab): An IL-23 inhibitor by Janssen approved for plaque psoriasis and psoriatic arthritis. Given every 8 weeks after loading doses.
• Ilumya (tildrakizumab): An IL-23 inhibitor approved specifically for moderate-to-severe plaque psoriasis.

IL-17 Inhibitors

IL-17 inhibitors block a different arm of the inflammatory pathway. They are generally more effective than ustekinumab for achieving complete skin clearance in psoriasis and are also approved for psoriatic arthritis and ankylosing spondylitis.

• Cosentyx (secukinumab): Monthly subcutaneous injection for psoriasis and psoriatic arthritis. One of the most widely prescribed biologics in these conditions.
• Taltz (ixekizumab): Another IL-17A inhibitor approved for psoriasis and psoriatic arthritis, given every 4 weeks.

TNF Inhibitors — Still an Option

Older biologics in the TNF inhibitor class (such as Humira/adalimumab and Enbrel/etanercept) are approved for psoriasis, psoriatic arthritis, and some forms of IBD. Many now have low-cost biosimilar versions available. While they are generally considered less effective than newer IL-12/23 and IL-17 inhibitors for psoriasis, they may be more accessible depending on your insurance plan.

How to Choose the Right Alternative

The right alternative depends on your specific condition, how severe it is, your insurance formulary, and your history with other biologics. Work with your prescriber to evaluate your options. Key questions to ask:

• Which ustekinumab biosimilar is preferred by my insurance plan?
• Would an IL-23-only inhibitor be more effective for my specific condition?
• Are there biosimilar versions of the alternative available to reduce cost?
• Do I have any contraindications that would rule out certain alternatives?

If you are simply having trouble locating Pyzchiva rather than needing a different drug altogether, read our guide on how to find Pyzchiva in stock near you. You can also use medfinder to locate pharmacies that have Pyzchiva — or any of its alternatives — available near you.