NHS cleared to use Astellas' non-hormonal menopause drug

Around half a million women in England will soon be able to access a non-hormonal treatment for hot flushes associated with menopause, after Astellas' Veoza was cleared for NHS use.

Final draft guidance from reimbursement agency NICE recommends Veoza (fezolinetant) as a once-daily, oral treatment for moderate-to-severe vasomotor symptoms (VMS) of menopause, like hot flushes and night sweats. VMS affect about 70% of women going through menopause and can have a major impact on daily life by disrupting sleep, concentration, relationships, and the ability to work.

Veoza is the first drug in the NK3 antagonist class to be backed for NHS use, and can be used when conventional hormone replacement therapy (HRT) is unsuitable, for example in women who have a breast cancer diagnosis, those with deep vein thrombosis or pulmonary embolism, and in some cases of diabetes or heart disease. It will also be an option for women who do not wish to take HRT.

Astellas asked NICE to review Veoza for that specific use, even though the drug was approved by the UK Medicines and Healthcare products Regulatory Agency (MHRA) with a broader label in 2023. It was initially turned down (PDF) by the agency in April 2025.

Dr Sue Mann, National Clinical Director in Women's Health for NHS England, said Veoza is "another vital treatment option which could help hundreds of thousands of women experiencing menopause to better manage their symptoms and feel more in control of their health."

Since it was first approved, another drug in the neurokinin antagonist class has been cleared by the MHRA, Bayer's NK1 and NK3-acting Lynkuet (elinzanetant), but NICE has not yet started the appraisal process that could lead to NHS use.

"In community settings, I meet women every week who are struggling with debilitating menopausal symptoms and limited treatment options," commented Anita Powell, founder of The Menopause Alliance charity.

"NICE's guidance recognises this reality," she added. "The next step must be ensuring that local services are equipped to deliver timely, informed care so women do not continue to fall through the gaps."

The NHS list price for Veoza is £44.80 per 28-tablet pack, and NICE said its cost-effectiveness estimates are within the range that NICE considers an acceptable use of NHS resources.

Veoza – sold as Veozah in some markets – is one of Astellas' most important growth products. While its initial rollout was fairly slow, there are signs of an uptick in momentum with global sales growing 44% to JPY 35.2 billion ($222 million) in the first nine months of the company's current financial year.

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