Alternatives to Stelara If You Can't Fill Your Prescription

When Stelara (ustekinumab) is unavailable, unaffordable, or simply not covered by your insurance, you don't have to go without treatment. Today there are multiple effective biologics, small molecules, and other therapies for the conditions Stelara treats — including plaque psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis. The right alternative depends on your specific condition, disease severity, insurance coverage, and previous treatment history.

Always discuss any medication changes with your prescriber before stopping or switching Stelara.

Option 1: Ustekinumab Biosimilars (Same Drug, Lower Cost)

The first thing to consider isn't a different drug at all — it's a biosimilar version of ustekinumab. As of 2026, eight FDA-approved ustekinumab biosimilars are available in the US. These products contain the same active ingredient as Stelara and have demonstrated comparable safety and effectiveness. Seven of the eight are designated interchangeable, meaning your pharmacist can substitute one without a new prescription.

Wezlana (ustekinumab-auub): First to market (Jan 2025), interchangeable, available through Optum pharmacies only

Pyzchiva (ustekinumab-ttwe): By Sandoz/Samsung Bioepis, 80% below Stelara WAC, interchangeable

Yesintek (ustekinumab-kfce): By Biocon Biologics, ~90% below Stelara WAC (~$3,000 per dose), interchangeable

Selarsdi (ustekinumab-aekn): By Teva/Alvotech, 85% below Stelara WAC, interchangeable

Steqeyma, Otulfi, Imuldosa, Starjemza: Additional biosimilar options with $0 copay programs for commercially insured patients

Alternatives for Plaque Psoriasis and Psoriatic Arthritis

If biosimilars still aren't accessible, several other biologics are FDA-approved for psoriasis and psoriatic arthritis:

Skyrizi (risankizumab): An IL-23 inhibitor approved for plaque psoriasis, psoriatic arthritis, and Crohn's disease. Dosed once every 12 weeks (after loading doses). A strong alternative for patients who are IL-23 responders.

Tremfya (guselkumab): An IL-23 inhibitor approved for plaque psoriasis and psoriatic arthritis. Also made by Janssen, which may simplify insurance coverage.

Cosentyx (secukinumab): An IL-17A inhibitor with strong efficacy for psoriasis, psoriatic arthritis, and ankylosing spondylitis.

Taltz (ixekizumab): Another IL-17A inhibitor approved for psoriasis and psoriatic arthritis.

Humira (adalimumab) and biosimilars: A well-established TNF inhibitor for psoriasis and psoriatic arthritis. Multiple affordable adalimumab biosimilars are now widely available.

Otezla (apremilast): An oral PDE4 inhibitor for psoriasis and psoriatic arthritis. No injections, no lab monitoring — a convenient option for moderate disease.

Alternatives for Crohn's Disease and Ulcerative Colitis

For inflammatory bowel disease (IBD), there are several biologics and small molecules that may be considered as alternatives to Stelara:

Skyrizi (risankizumab): FDA-approved for both Crohn's disease and ulcerative colitis. An IL-23 inhibitor that works similarly to Stelara but targets only IL-23 (not IL-12). Has shown strong efficacy in clinical trials.

Entyvio (vedolizumab): A gut-selective integrin inhibitor approved for both Crohn's and UC. Because it works locally in the gut, it has a favorable safety profile with a lower risk of systemic infections.

Remicade (infliximab) and biosimilars: A TNF inhibitor with a long track record in IBD. Multiple biosimilars (Inflectra, Avsola, Zymfentra) make it more affordable.

Humira (adalimumab) and biosimilars: Another TNF inhibitor used for Crohn's disease in adults and pediatric patients.

Rinvoq (upadacitinib) or Xeljanz (tofacitinib): Oral JAK inhibitors approved for UC (and Rinvoq for Crohn's), offering a pill-based alternative to injections or infusions.

How to Talk to Your Doctor About Switching

When considering a Stelara alternative, bring these talking points to your appointment:

Which alternatives are covered under my specific insurance plan?

Would a ustekinumab biosimilar work for me instead of brand Stelara?

Do I have any factors (e.g., infection history, cancer risk) that would make certain alternatives less appropriate?

Can I get a bridge supply of Stelara while transitioning to a new medication?

If your issue is locating Stelara rather than choosing an alternative, check out: Why Is Stelara Hard to Find? Explained for 2026 for tips on breaking through access barriers.