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Johns Hopkins Health Plans

New Preferred Self-administered Ustekinumab Product and Prior Authorization Requirements for US Family Health Plan

Effective Date: Nov. 1, 2026

Health Plans Affected: US Family Health Plan (USFHP)

Type of Change: Prior Authorization, Formulary Change

Explanation of Change:

Effective Nov. 1, 2026, Stelara® (ustekinumab) will be a non-preferred product under the US Family Health Plan. Otulfi® (ustekinumab-aauz), a biosimilar to Stelara®, will be the preferred product and is considered a direct alternative. Otulfi is subject to prior authorization.

To submit a pharmacy benefit prior authorization request to USFHP:

  • Providers may complete and fax the prior authorization form for the specific medication being requested to the Johns Hopkins Health Plans Pharmacy department at 410-424-4037. Supporting clinical documentation is required.
  • Note: Please do not use CoverMyMeds to submit USFHP prior authorizations. The use of this tool may result in coverage determination delays.

For more information about USFHP pharmacy benefits and additional details about submitting prior authorization requests, please visit the USFHP Pharmacy and Formulary page.