Subject: Kerendia PA 4871-A P11-2025

Drug

KERENDIA  (finerenone)

Policy:

Indications

FDA-approved Indications

Kerendia is indicated to reduce the risk of:

• sustained estimated glomerular filtration rate (eGFR) decline, end-stage kidney disease, cardiovascular death, non-fatal myocardial infarction, and hospitalization for heart failure in adult patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2DM).
• cardiovascular death, hospitalization for heart failure, and urgent heart failure visits in adult patients with heart failure with left ventricular ejection fraction (LVEF) ≥ 40%.

Coverage Criteria

Chronic Kidney Disease (CKD) Associated with Type 2 Diabetes (T2DM)

Authorization may be granted when the patient has a diagnosis of chronic kidney disease (CKD) associated with type 2 diabetes (T2DM) when ONE of the following criteria is met:

• The patient is currently receiving a maximally tolerated dose of an angiotensin-converting enzyme inhibitor (ACEi) OR angiotensin receptor blocker (ARB).
• The patient has experienced an intolerance to an ACEi or ARB.
• The patient has a contraindication that would prohibit a trial of an ACEi or ARB.

Heart Failure with Left Ventricular Ejection Fraction (LVEF) ≥ 40%

Authorization may be granted when the requested drug is being prescribed to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits when the following criteria is met:

• The patient has a diagnosis of heart failure with left ventricular ejection fraction (LVEF) greater than or equal to 40 percent.

Duration of Approval (DOA)

• 4871-A: DOA: 12 months

Place of Service:

Outpatient

The above policy is based on the following references:

1. Kerendia [package insert]. Whippany, NJ: Bayer HealthCare Pharmaceuticals Inc.; July 2025.
2. Lexicomp Online, AHFS DI (Adult and Pediatric) Online. Waltham, MA: UpToDate, Inc.; 2025. https://online.lexi.com. Accessed September 27, 2025.
3. Micromedex® (electronic version). Merative, Ann Arbor, Michigan, USA. Available at: https://www.micromedexsolutions.com/ (cited: 09/27/2025).
4. Chronic Kidney Disease and Risk Management: Standards of Medical Care in Diabetes – 2025. Diabetes Care. Jan 2025;48:S239-S251.
5. KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney International. 2022;102(Suppl 5S):S1-S127.

Copyright Aetna Inc. All rights reserved. Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna or its affiliates. Treating providers are solely responsible for medical advice and treatment of members. This Clinical Policy Bulletin may be updated and therefore is subject to change.

April 19, 2026