Stelara vs Skyrizi vs Entyvio: Crohn's Disease Medication Cost Comparison for 2026

Stelara (ustekinumab), Skyrizi (risankizumab), and Entyvio (vedolizumab) are three biologic drugs approved by the FDA to treat moderate-to-severe Crohn's disease when older therapies, including corticosteroids and TNF inhibitors, have not worked well enough. Stelara blocks interleukin-12 and interleukin-23, Skyrizi blocks only interleukin-23, and Entyvio blocks a gut-specific integrin called alpha-4-beta-7 rather than targeting interleukins at all. That mechanism difference matters clinically, but for a patient comparing 2026 prices, the bigger differences are generic and biosimilar status, Medicare price-negotiation status, and which manufacturer runs the patient assistance program. For single-drug detail beyond Crohn's disease, see the dedicated pages for Stelara cost and Skyrizi cost, which cover psoriasis and psoriatic-arthritis dosing separately from the higher Crohn's induction and maintenance doses covered here.

The Inflation Reduction Act of 2022, signed August 16, 2022, gave CMS the authority to negotiate Medicare drug prices directly with manufacturers for the first time. Stelara was one of the first 10 drugs selected, and its Maximum Fair Price of $4,695 per 30-day-supply equivalent took effect January 1, 2026, a 66 percent cut from the pre-negotiation list price. Skyrizi has never appeared on any negotiation round through Round 3, so Medicare pays whatever standard formulary rate applies, with no statutory ceiling. Entyvio was selected for Round 3 in January 2026, one of the first Part B-administered infused biologics to be chosen, and its negotiated price will not take effect until January 1, 2028. Patients should not expect an Entyvio price cut before then.

Payers routinely require step therapy for Crohn's disease biologics, meaning your plan may insist you try a cheaper option, often an adalimumab biosimilar (Humira's generic-equivalent class) or infliximab, before approving Stelara, Skyrizi, or Entyvio. Prior authorization is standard for all three drugs regardless of which one your gastroenterologist prescribes first. The formulary tier a plan assigns to each drug also drives your copay: Stelara now sits on many formularies alongside its biosimilars, while Skyrizi and Entyvio remain sole-source brands with no lower-tier alternative in their own molecule class. The comparison table below lays out cash price, Medicare treatment, generic or biosimilar status, and manufacturer patient assistance program for all three drugs together.

What Crohn's Medication Comparison Costs by Point of Pay (2026)

The price you pay depends almost entirely on WHERE you pay. The same crohn's medication comparison can cost many times more at a hospital than at your local pharmacy:

Why Hospitals Charge So Much

Hospital outpatient infusion centers routinely bill Entyvio's IV formulation, and occasionally Skyrizi's or Stelara's IV induction dose, at two to four times the rate a freestanding infusion center or physician office charges for the identical drug and dose. The markup covers facility overhead, nursing time, and chair-time fees that a hospital adds on top of the drug's acquisition cost. A single Entyvio infusion that costs roughly $9,900 to $10,100 at a physician office can appear on a hospital outpatient bill at $20,000 or more once facility fees are layered in.

Medicare Part A stops paying for any of these three biologics the moment a patient is discharged from an inpatient stay; coverage shifts to Part B for physician-administered doses or Part D for self-injected doses at home. That transition is where Stelara's 2026 Maximum Fair Price of $4,695 kicks in for patients switching from inpatient care to outpatient maintenance, while Skyrizi and Entyvio patients face standard, uncapped formulary cost-sharing. Anyone discharged on a new Crohn's biologic prescription without active Part D or Part B coverage should call 1-800-MEDICARE before the first outpatient dose to confirm which benefit applies.

Site-of-care matters as much as the drug choice itself for all three biologics. Choosing a freestanding infusion center or your gastroenterologist's own infusion suite over a hospital outpatient department can cut the facility portion of an Entyvio, Skyrizi, or Stelara bill substantially without changing the drug at all. Ask your gastroenterology practice directly whether they offer in-office infusion or injection administration before your first dose is scheduled at a hospital.

HCPCS J-Codes: What Appears on Your Bill

Medicare and most commercial plans bill the IV and physician-administered formulations of these three drugs using HCPCS Level II J-codes. Each code represents a 1 mg unit, so the number of units billed should match your prescribed dose in milligrams.

Patient Assistance Programs

Janssen (a Johnson & Johnson company), AbbVie, and Takeda each run a separate income-based patient assistance program for their Crohn's biologic, and eligibility thresholds differ across the three. If you have no insurance and a household income near or above 500 percent of the federal poverty level, your drug may still cost $0 through the correct manufacturer program, but you must apply to the specific company that makes your prescribed drug.

Medicare Part D

Medicare treats these three Crohn's biologics differently depending on where the drug is given. IV induction doses administered in a physician office or hospital outpatient department fall under Part B, with 20 percent coinsurance after the 2026 Part B deductible of $283, except for Stelara's IV induction dose, which also carries the negotiated Maximum Fair Price. Self-injected SC maintenance doses given at home fall under Part D, landing on the specialty tier of your plan's formulary. All out-of-pocket Part D spending across every drug you take, not just your Crohn's biologic, counts toward the same 2026 annual out-of-pocket cap of $2,100.

Extra Help, the Part D Low Income Subsidy, reduces cost-sharing further for Medicare beneficiaries with limited income and resources. In 2026, Extra Help enrollees pay $12.65 per fill for a brand-name specialty drug like Skyrizi or Entyvio, and typically less for Stelara or one of its biosimilars once the plan's specialty-tier structure applies. Extra Help is generally available to beneficiaries with income at or below 150 percent of the federal poverty level. Apply through the Social Security Administration at 1-800-772-1213 or at ssa.gov before applying to any manufacturer patient assistance program, since several manufacturer programs require proof that you applied for or were denied Extra Help first.

Common Crohn's Medication Comparison Billing Errors

Crohn's biologics generate some of the most complex bills in outpatient medicine because a single treatment course mixes Part B infusion charges, Part D specialty-pharmacy fills, and manufacturer copay-card adjustments. Watch for these issues before paying any bill for Stelara, Skyrizi, or Entyvio:

• Pharmacy or infusion center bills more than Stelara's $4,695 IRA Maximum Fair Price for a Medicare Part D fill in 2026, which violates federal law; ask your plan's member services to reprocess the claim.
• A biosimilar (Wezlana, Selarsdi, Pyzchiva, Yesintek, Otulfi, or Steqeyma) billed at the Stelara brand price instead of the lower biosimilar rate.
• Manufacturer copay card applied for a patient who has Medicare, Medicaid, TRICARE, or VA benefits, which is prohibited and can trigger a claim clawback months later.
• Wrong J-code units billed, for example 600 units of J2327 (Skyrizi) charged when only a partial vial was actually administered, inflating the coinsurance owed.
• Hospital outpatient department charging 2 to 4 times the freestanding infusion-center rate for an identical Entyvio or Skyrizi IV dose without disclosing the facility fee separately.
• Step-therapy denial requiring a trial of a cheaper biologic without documenting that the required first-step drug already failed or is medically contraindicated for you.

Frequently Asked Questions