AfliberceptBevacizumabDenosumabEculizumabEpoetin alfaFilgrastimInfliximabNatalizumabPegfilgrastimRanibizumabRituximabTocilizumabTrastuzumabUstekinumab
7 biosimilars bill against Stelara (J3358). On average they are paid ↓ 30.5% relative to the reference product per 1 MG in 4Q26.
| Product | Code | CMS description | Per 1 MG | vs. reference | CMS 8% add-on note | 8 quarters |
|---|---|---|---|---|---|---|
| Stelara | J3358 | Ustekinumab, iv inject, 1 mg | $10.249 | Reference | – | |
| Wezlana | Q5138 | Inj, wezlana, iv, 1 mg | $2.273 | ↓ 77.8% | Yes | |
| Steqeyma | Q5099 | Inj ustekinumab-stba, 1 mg | $2.89 | ↓ 71.8% | Yes | |
| Yesintek | Q5100 | Inj ustekinumab-kfce, 1 mg | $3.08 | ↓ 69.9% | Yes | |
| Pyzchiva | Q9997 | Ustekinumab-ttwe iv inj 1 mg | $8.591 | ↓ 16.2% | Yes | |
| Imuldosa | Q5098 | Inj ustekinumab-srlf, 1 mg | $9.27 | ↓ 9.6% | Yes | |
| Ustekinumab-AEKN | Q9998 | Inj ustekinumab-aekn, 1 mg | $10.48 | ↑ 2.3% | No | |
| Otulfi | Q9999 | Inj ustekinumab-aauz 1 mg | $13.246 | ↑ 29.2% | No |
Payment limits are from the CMS 4Q26 file. Which products are grouped together comes from the site’s biosimilar groups list (reference/biosimilar_groups/2026-10-17T183707Z_d3109bb50c53.csv), checked by hand; it is not a CMS file. “CMS 8% add-on note” shows whether CMS’s notes say the 8% of reference product add-on was applied.
| Product | Spending 2024 | Units 2024 | Spending per unit 2024 | Spending 2025 (prelim.) | Claims 2025 | Share of claims 2025 | Spending 2026 (Q1) |
|---|---|---|---|---|---|---|---|
| Stelara J3358 | $10,295,766.21 | 832,771 | $12.36326218 | $5,855,626.80 | 1,252 | 96.5% | $742,104.20 |
| Wezlana Q5138 | – | – | – | – | – | – | – |
| Steqeyma Q5099 | – | – | – | $46,511.70 | 11 | 0.8% | – |
| Yesintek Q5100 | – | – | – | $143,424.26 | 34 | 2.6% | $340,609.57 |
| Pyzchiva Q9997 | – | – | – | – | – | – | – |
| Imuldosa Q5098 | – | – | – | – | – | – | – |
| Ustekinumab-AEKN Q9998 | – | – | – | – | – | – | – |
| Otulfi Q9999 | – | – | – | – | – | – | – |
Spending, units and claims are CMS figures; spending per unit is CMS’s own average for 2024. Units are billing units, which can differ between codes, so compare units only between codes billed per the same amount. Shares are this site’s calculation from CMS claims. CMS may count spending differently in its quarterly and yearly files, so treat changes between 2024 and 2025 with care.
From CMS’s Physician & Other Practitioners by Geography and Service file, which covers drugs billed by physicians and other practitioners, mostly in offices. Drugs billed by hospital outpatient departments are not in it. For these products it covers 53.6% of 2024 Medicare units. CMS leaves out a state’s row for a product when fewer than 11 patients received it, so small states may undercount.
Hover over a state to see its figure. Territories and states with no data are in the table.
| State | Services (billing units) | Biosimilar share |
|---|---|---|
| Texas | 48,230 | 0.0% |
| Florida | 42,952 | 0.0% |
| California | 39,007 | 0.0% |
| Georgia | 23,140 | 0.0% |
| Pennsylvania | 21,320 | 0.0% |
| New York | 20,051 | 0.0% |
| Ohio | 17,954 | 0.0% |
| Illinois | 16,555 | 0.0% |
| North Carolina | 14,859 | 0.0% |
| Colorado | 12,871 | 0.0% |
| Maryland | 12,611 | 0.0% |
| Michigan | 12,611 | 0.0% |
| New Jersey | 11,740 | 0.0% |
| Mississippi | 10,530 | 0.0% |
| Washington | 9,881 | 0.0% |
| Missouri | 9,230 | 0.0% |
| South Carolina | 8,840 | 0.0% |
| Minnesota | 7,930 | 0.0% |
| Tennessee | 7,801 | 0.0% |
| Kansas | 7,150 | 0.0% |
| Virginia | 6,500 | 0.0% |
| Arizona | 6,120 | 0.0% |
| Arkansas | 5,980 | 0.0% |
| Oklahoma | 5,980 | 0.0% |
| Connecticut | 5,720 | 0.0% |
| Massachusetts | 5,331 | 0.0% |
| Oregon | 4,033 | 0.0% |
| Alabama | 3,945 | 0.0% |
Sources: 2026-06-25_DSD_PTB_RY26_P06_V10_DYT24_HCPCS-260602.csv, 2026-05-21_MUP_PHY_R26_P05_V10_D24_Geo.csv.gz, 2026-07-23_qddptb_r2603_p06_v10_dqt2601_260722.csv (data.cms.gov).
