Veozah — Medical Mutual

Initial criteria

• Symptoms of disease are moderate to severe
• Patient has tried a 30 day trial of at least one menopausal hormone therapy OR provider and patient have determined that menopausal hormone therapy is contraindicated or does not have a favorable risk/benefit profile
• OR Patient has tried a 30 day trial of at least two guideline recommended non-hormonal therapies from two different classes OR provider and patient have determined that other non-hormonal therapies for the treatment of vasomotor symptoms due to menopause are contraindicated or do not have a favorable risk/benefit profile
• Total bilirubin is not elevated for the evaluating laboratory
• Baseline liver function tests have been done to determine that transaminases are not ≥ 2 times the upper limit of normal

Reauthorization criteria

• Patient continues to meet initial therapy criteria A, B, and C
• Patient has experienced at least 50% reduction in frequency or severity of vasomotor symptoms associated with menopause
• Liver function tests have been done or are planned every 3 months for the first year of therapy and transaminases have not exceeded 2 times the upper limit of normal

Approval duration

initial 3 months; reauth 6 months