VEOZAH (fezolinetant)

Veozah (fezolinetant)

Self-Administration – Oral

Diagnosis considered for coverage:

• Moderate to severe vasomotor symptoms: Indicated for the treatment of moderate to severe vasomotor symptoms due to menopause.

Coverage Criteria:

For diagnosis of moderate to severe vasomotor symptoms:

• Diagnosis of moderate to severe vasomotor symptoms due to menopause, AND
• Trial and failure, contraindication, or intolerance to both of the following:
  • Menopausal hormone therapy (e.g., Premarin, Bijuva, Estrogel, etc.)
  • Non-hormonal therapy (e.g. paroxetine mesylate, venlafaxine, clonidine, etc.) 

Reauthorization Criteria:

For diagnosis of moderate to severe vasomotor symptoms:

• Documentation of positive clinical response to therapy (e.g., decrease in frequency and severity of vasomotor symptoms from baseline, etc.) 

Coverage Duration: 

• Initial: 6 months
• Reauthorization: 6 months

Authorization is not covered for the following:

The use of this drug for indications not listed in this policy does not meet the coverage criteria established by the Western Health Advantage (WHA) Pharmacy and Therapeutics (P&T) Committee.

Additional Information: 

• North American Menopause Society (NAMS) (2022), Endocrine Society (2015), and ACOG (2014) guidelines recommend MHT as the gold standard treatment for relief of VMS. For nonhormonal treatment, NAMS (2023) recommends SSRIs/SNRIs, fezolinetant, and gabapentin.

Policy Updates:

• 11/14/2023 – New policy approved by P&T.

References:

1. Veozah Prescribing Information. Astellas Pharma US, Inc. Northbrook, IL. May 2023.