Biosimilars represent an opportunity to improve access and affordability for our community. Univera Healthcare has advocated for the use of biosimilars since 2018 when we were the first standalone health plan to prefer a biosimilar in a major drug category. Today we include biosimilars in all drug categories in which biosimilars are available.
Stelara (ustekinumab), a blockbuster biologic drug, is indicated for certain autoimmune conditions such as psoriasis, psoriatic arthritis, ulcerative colitis and crohn’s disease. The first biosimilar launched earlier this year, and there have been multiple different biosimilars approved in the U.S. since.
Univera Healthcare offers multiple formulary options for our large employer groups, dependent on the funding arrangement. As of October 1, 2025, Univera Healthcare commercial formularies include preferred biosimilars Yesintek and Selarsdi along with the reference drug Stelara.
- Yesintek and Selarsdi are considered low wholesale acquisition cost (WAC) biosimilars.
- Both Yesintek and Selarsdi are interchangeable biosimilars, meaning pharmacies can dispense these instead of Stelara without prior physician approval.
This strategy applies to 3 Tier Open, Preferred Value Formulary, and Exchange Closed Formulary. All three drugs Stelara, Yesintek, and Selarsdi will be Tier 2 in 2026; however, Stelara will be non-preferred.
- Stelara will have step therapy, requiring a trial of any one preferred product (based on the indication) for NEW STARTS ONLY starting 1/1/26. Existing members will not be impacted.
Through our partnership with Express Scripts (ESI), we also offer the National Preferred Formulary (NPF) to our self-funded employer groups:
- Effective January 1, 2026, Stelara will be excluded for new starts.
- Effective July 1, 2026, Stelara will be excluded for all members.
- The preferred biosimilars on NPF will include Yesintek, Selarsdi, and ustekinumab-ttwe (by Quallent).
Our clients will continue to see savings from the increase in competition the biosimilars have brought for whichever formulary is chosen.
Biosimilars are safe, effective, Food and Drug Administration (FDA) approved medications. Adding biosimilars to the list of medications covered by our health plan gives members who need these types of medications a choice, increasing our communities’ access to affordable medications.
