Here’s what you need to know:
Coverage of Stelara (ustekinumab) through PacificSource Health Plans will change to biosimilar formulations.
Will I still be able to prescribe Stelara?
Stelara is the brand name of the active ingredient ustekinumab, which is now available in other, more cost-effective formulations, so we will no longer provide coverage for the brand Stelara after August 1, 2025.
Will patients need a new prescription and prior authorization?
Yes, they’ll need a new prescription. Providers can send this authorization to their patients’ pharmacies.
All formulations of ustekinumab require prior authorization. PacificSource will honor existing authorizations for members switching directly from Stelara.
Which ustekinumab biosimilars will be covered?
- Selarsdi (Teva/Alvotech)
- Yesintek (Biocon)
Questions?
We’re here to help. Call our Pharmacy Help Desk at 844-877-4803, Monday through Friday, 8:00 a.m. to 5:00 p.m. TTY: 711. We accept all relay calls.
You can also email us at ProviderNet@PacificSource.com.
For more prescription drug resources, visit PacSrc.co/provider-rx-info.