NICE final draft guidance recommends new treatment for chronic heart failure

Thousands of people in England with a type of chronic heart failure are eligible for a new treatment option following its approval by NICE. 

NICE has today (15 July 2026) issued final draft guidance that recommends finerenone (also called Kerendia and made by Bayer) for adults with symptomatic chronic heart failure with preserved or mildly reduced ejection fraction.  

Heart failure with preserved or mildly reduced ejection fractionhappens when the left side of theheartdoesn't fill properly with blood during the diastolic (filling) phase. This means the heart is unable to pump enough blood to meet the body's needs. Heart failure with preserved or mildly reduced ejection fraction means the reduction in blood pumped is smaller than for heart failure with reduced ejection fraction.  

Heart failure can cause debilitating symptoms including breathlessness, fatigue and ankle swelling. People with the condition often experience repeated hospital admissions, which can have a significant impact on their quality of life and independence. Many also live with other long-term conditions, including chronic kidney disease, diabetes and hypertension, making treatment more complex.  

Finerenone is a type of treatment called a mineralocorticoid receptor antagonist (MRA).  Unlike other MRAs, finerenone is nonsteroidal and so may be used by more people. 

Evidence shows that adding finerenone to usual care reduces the total number of worsening heart-failureevents (including the need forpeople with heartfailure to visit hospitalurgently or having to stay in hospital)by around 18% comparedwith a placebo plus usual care. Finerenonemay alsoreducetherisk ofdying from a cardiovascular event such as a heart attack or stroke, or othercauses  

Of the estimated 635,000 people in England who have heart failure, half have preserved or mildly reduced ejection fraction. There were around 100,000 hospitalisations in England for heart failure in 2023/24, making it one of the leading causes of avoidable hospital admissions. Around a quarter of people with heart failure die within the first year of their diagnosis and over half within 5 years. 

NICE estimates up to 280,000 people could be eligible for finerenone. 

Helen Knight, director of medicines evaluation at NICE, said: Heart failure can have a profound effect on people's daily lives, often leading to repeated hospital admissions and a reduced quality of life. 

We're committed to bring the best care to people fast, while at the same time ensuring value for money for the taxpayer. Today's draft guidance means there is a further effective treatment available on the NHS for people with this type of heart failure. Not only does finerenone have the potential to help them live well for longer, but it could also save the NHS money and free up space by reducing their risk of having to go to hospital for unplanned emergency treatment.  

Ends  

Notes to editors

1. The final draft guidance for finerenone for treating chronic heart failure with a preserved or mildly reduced ejection fraction is available on the NICE website at https://www.nice.org.uk/guidance/indevelopment/gid-ta11651/documents 
    
2. NICE expects to publish final guidance on finerenone in August 2026. 
   
   
3. Current standard treatment for heart failure with preserved or mildly reduced ventricular ejection fraction is usually a diuretic (sometimes called a water tablet') to get rid of extra fluid in the body.  
   
   
4. Most people with this type of heart failure also have additional treatments including angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARBs), betablockers, mineralocorticoid receptor antagonists (MRAs) or sodium-glucose co-transporter 2 (SGLT2) inhibitors (dapagliflozin and empagliflozin). 
   
   
5. Usually developing gradually over time, chronic heart failure is often the result of a number of conditions including heart attack, coronary artery disease, atrial fibrillation and high blood pressure.  
   
   
6. Symptoms of heart failure commonly include breathlessness, fatigue and ankle swelling. It is a chronic condition that affects survival and quality of life.