The UK’s National Institute for Health and Care Excellence (NICE) has recommended Bayer’s non-steroidal heart failure drug, Kerendia (finerenone), for use in the National Health Service (NHS), as the condition remains one of the leading causes of avoidable hospitalisations within England.
Following the UK health watchdog’s debut of its final draft guidance, which the agency expects in August 2026, English chronic heart failure (CHF) patients with preserved or mildly reduced ejection fraction will now be eligible for access to the next-generation mineralocorticoid receptor antagonist (MRA).
The drug acts by reducing vascular inflammation and the mineralocorticoid signalling-induced scarring in the muscular layer of the heart wall. Kerendia also exhibits its CHF-treating effects by reducing sodium retention in the kidneys, which can diminish the burden of pumping excess fluid on the heart.
Unlike similar MRAs available through the NHS, such as Pfizer-developed generics spironolactone and eplerenone, Kerendia holds the potential to treat CHF across a wider patient population due to its non-steroidal nature. According to NICE, around 280,000 people across England are likely to be eligible for treatment with Kerendia.
Bayer has also designed the drug to be more selective than its predecessors, meaning it is generally associated with a lower rate of sexual side effects linked to the interference in sex hormone activity.
Kerendia’s NICE recommendation further expands the drug’s role within the NHS, as NICE previously gave it the go-ahead for use in adult patients with stage 3 or 4 chronic kidney disease linked to type 2 diabetes back in 2023 – provided they had a presence of the blood protein, albumin, in their urine.
Treating heart failure in England
Bayer secures a NICE recommendation for Kerendia as the agency estimates that 635,000 patients across England live with heart failure, of which half have preserved or mildly reduced ejection fraction.
With 100,000 hospitalisations linked to heart failure between 2023 and 2024, it is also one of the leading causes of avoidable hospital admissions – highlighting the need for effective preventative and treatment-based interventions.
Once it reaches patients in England, Kerendia will join a treatment arsenal populated by SGLT2 inhibitors like Boehringer Ingelheim and Eli Lilly’s Jardiance (empagliflozin) and AstraZeneca’s Forxiga (dapagliflozin), which both got the NICE green light in CHF with preserved or mildly reduced ejection fraction back in 2023, as well as legacy MRAs and loop diuretics to manage fluid overload in the body.
According to Helen Knight, NICE’s director of medicines evaluation, Kerendia not only holds the potential to help boost patient quality of life, but it also offers the chance to “save the NHS money and free up space” by diminishing the risk of hospitalisation for unplanned emergency treatment.
Back in March 2026, the UK's Medicines and Healthcare products Regulatory Agency (MHRA) and NICE launched an aligned pathway to expedite the medicines regulation process.
