PBMs to Remove Stelara Reference Products from Formularies in 2026 Amid Biosimilar Pricing War

The introduction of biosimilars to Johnson & Johnson’s Stelara (ustekinumab) in 2025 has sparked significant changes in pharmacy benefit management strategies, leading to a competitive pricing landscape. Pharmacy benefit managers (PBMs), including major players and smaller firms, have implemented private-label strategies, aggressive pricing tactics, and exclusive formulary agreements to expedite the rollout of these biosimilars. This approach contrasts with the more chaotic launch of Humira biosimilars and highlights the evolving dynamics of biosimilar economics within the pharmaceutical industry.

PBMs have leveraged private-label rebating schemes to gain control over pricing power while reshaping market dynamics for Stelara biosimilars. These strategies have resulted in a rapid escalation of competition among manufacturers and PBMs, creating what some describe as a “pricing war.” Express Scripts, one prominent PBM, plans to remove reference products from its 2026 formulary while maintaining distinct pricing standards for biosimilars. The developments surrounding Stelara reflect broader trends in how PBMs are adapting their approaches following lessons learned from previous biosimilar launches like Humira. Industry observers note that these moves underscore the growing influence of private-label initiatives on drug affordability and access within formularies.

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Date: October 7, 2025

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Author

Mark Chiang