How to Help Your Patients Save Money on Pyzchiva: A Provider's Guide to Savings Programs

Specialty biologic costs are one of the leading barriers to patient adherence. Even with insurance coverage, Pyzchiva (ustekinumab-ttwe) can carry substantial co-pays. And for uninsured or underinsured patients, the cost of a specialty biologic can be prohibitive without assistance.

This guide is designed for providers and their teams — summarizing every major savings program available for Pyzchiva in 2026, along with practical guidance on enrollment and eligibility. For patient-facing information, see our article: How to Save Money on Pyzchiva in 2026.

Understanding Pyzchiva's List Price vs. What Patients Actually Pay

Stelara's list price is approximately $25,497 per 8-week 90 mg dose. Sandoz launched Pyzchiva at approximately 80% below Stelara's list price, making the Pyzchiva list price roughly $5,099 per 90 mg dose — a meaningful reduction but still far beyond what most patients can pay out of pocket. The actual patient cost depends on:

• Insurance formulary tier placement for Pyzchiva vs. competing biosimilars
• Whether the patient has met their deductible
• Whether co-pay assistance programs are in effect and applicable
• Whether the plan uses accumulator or maximizer programs that absorb co-pay assistance value

Program 1: Sandoz Pyzchiva Co-Pay Assistance Program

The primary manufacturer savings program for Pyzchiva is Sandoz's co-pay card program, which can reduce commercially insured patients' out-of-pocket cost to as little as $0 per treatment.

• Eligibility: Commercial insurance required. Not available to patients with Medicare, Medicaid, CHIP, TRICARE, or other government-funded programs.
• Savings: Out-of-pocket cost as low as $0 per treatment (maximum limits may apply)
• Enrollment: Patients or your staff can enroll at pyzchiva.com or call 1-855-726-3698 (1-855-SANDOZ-8)
• Key limitation: Not compatible with accumulator adjustment or maximizer programs. If your patient's plan uses these programs, co-pay card value may not count toward their deductible or out-of-pocket maximum, effectively nullifying the savings.

Program 2: Sandoz Patient Assistance Program (PAP)

For patients who are uninsured or underinsured and meet income eligibility criteria, Sandoz's patient assistance program may provide Pyzchiva at no cost or significantly reduced cost.

• Who qualifies: Uninsured or underinsured patients who meet income requirements. Your social worker or care coordinator can help assess eligibility.
• How to apply: Contact Sandoz at 1-855-726-3698 or visit pyzchiva.com/support-services for details.

Medicare Patients: Key Cost Considerations in 2026

Patients enrolled in Medicare cannot use Sandoz's commercial co-pay program. However, the 2025 Medicare Part D redesign introduced significant changes that benefit high-cost biologic patients:

• Part D out-of-pocket cap: Starting in 2025, Medicare Part D beneficiaries have a $2,000 annual out-of-pocket cap. Once met, the plan covers 100% of Part D drug costs for the remainder of the year.
• Medicare Prescription Payment Plan: Allows patients to spread out-of-pocket costs across the year, avoiding large upfront costs for biologics filled in January before the deductible is met.
• Extra Help (Low-Income Subsidy): Low-income Medicare patients may qualify for this federal program, which reduces premiums, deductibles, and co-pays. Encourage eligible patients to apply at SSA.gov or by calling 1-800-772-1213.

Formulary Navigation: The Most Impactful Cost-Reduction Strategy

Prescribing the formulary-preferred ustekinumab biosimilar for each patient is often the single most effective way to reduce their out-of-pocket cost. Because all ustekinumab biosimilars are clinically equivalent, prescribing whichever biosimilar is preferred by the patient's PBM can:

• Reduce the patient's co-pay tier (from specialty to preferred specialty)
• Eliminate step therapy requirements and PA denial appeal processes
• Speed up time-to-treatment significantly

Accumulator and Maximizer Programs: A Key Challenge

Accumulator adjustment programs and benefit maximizer programs are used by many large employer-sponsored health plans to prevent manufacturer co-pay assistance from counting toward patients' deductibles and out-of-pocket maximums. These programs significantly reduce the value of manufacturer co-pay cards. If your patient's plan uses these programs, the Pyzchiva co-pay card savings will not reduce their total annual cost — they will still owe their full deductible and out-of-pocket maximum beyond what the card covers.

In these cases, escalate to the Sandoz PAP, explore whether switching to the formulary-preferred biosimilar changes the accumulator applicability, or discuss appeal options with the patient's HR department.

Practical Resources for Your Practice

• Sandoz HCP support: pyzchiva.com/pro — prescribing information, patient enrollment forms, PA resources
• Sandoz patient support line: 1-855-726-3698 — for PA support, specialty pharmacy routing, and patient enrollment
• GoodRx for cash-pay options: goodrx.com — coupon pricing starting around $4,087 for Pyzchiva 90 mg for uninsured patients needing temporary assistance

medfinder for pharmacy location: Visit medfinder for providers to help patients locate pharmacies that have Pyzchiva in stock near them.