NICE has recommended Bayer’s non‑steroidal MRA Kerendia (finerenone) for NHS use in adults with chronic heart failure and preserved or mildly reduced ejection fraction, with final guidance due in August 2026. Kerendia reduces vascular inflammation, cardiac scarring and kidney sodium retention and may be suitable for a broader patient group than older steroidal MRAs. NICE estimates about 280,000 people in England could be eligible; roughly 635,000 people live with heart failure and there were around 100,000 related hospitalisations between 2023 and 2024. An MHRA–NICE aligned pathway launched in March 2026 may speed access to new medicines like Kerendia.
NICE Recommends Bayer’s Kerendia for NHS Use in Heart Failure — Final Guidance Expected August 2026
NICE has recommended Kerendia for use by England's NHS. Credit: Seacalm / Shutterstock.com.
The UK’s National Institute for Health and Care Excellence (NICE) has recommended Bayer’s non‑steroidal mineralocorticoid receptor antagonist (MRA) Kerendia (finerenone) for use on the National Health Service for adults with chronic heart failure (CHF) who have preserved or mildly reduced ejection fraction. NICE said the recommendation follows its draft guidance, with a final guidance document expected in August 2026.
How Kerendia Works
Kerendia reduces vascular inflammation and blocks mineralocorticoid signalling that contributes to scarring in the heart muscle. It also lowers sodium retention by the kidneys, reducing fluid overload and easing the workload on the heart.
Advantages Over Older MRAs
As a non‑steroidal MRA, Kerendia may be suitable for a broader group of CHF patients than older steroidal MRAs available on the NHS (such as spironolactone and eplerenone). Bayer has designed Kerendia to be more selective at its target receptor, which is generally associated with fewer hormone‑related side effects, including sexual side effects linked to interference with sex hormone pathways.
Patient Numbers and Public Health Impact
NICE estimates roughly 280,000 people in England could be eligible for Kerendia. The agency also estimates that about 635,000 people in England live with heart failure, roughly half of whom have preserved or mildly reduced ejection fraction. Between 2023 and 2024, approximately 100,000 hospitalisations were linked to heart failure, making it one of the leading causes of avoidable emergency admissions in England.
Place in Treatment Pathway
If adopted into routine care, Kerendia will join existing therapies for CHF on the NHS, including SGLT2 inhibitors such as Jardiance (empagliflozin) and Forxiga (dapagliflozin), which received NICE approval for this indication in 2023, plus legacy MRAs and loop diuretics used to manage fluid overload.
Helen Knight, NICE's Director of Medicines Evaluation, said Kerendia could help improve patients' quality of life and reduce emergency admissions — potentially saving the NHS money and freeing up hospital capacity.
NICE previously approved Kerendia in 2023 for adults with stage 3 or 4 chronic kidney disease associated with type 2 diabetes, provided albuminuria (the presence of protein albumin in urine) is present.
Regulatory Context and Next Steps
In March 2026, the UK Medicines and Healthcare products Regulatory Agency (MHRA) and NICE launched an aligned pathway to accelerate regulation and access to new medicines; steps under that initiative may support more rapid patient access to therapies such as Kerendia once final guidance and commissioning arrangements are completed. Implementation will depend on the final NICE guidance, local NHS commissioning decisions, and supply arrangements.
Bottom Line: The NICE recommendation signals an important step toward wider NHS access to Kerendia for a substantial cohort of heart failure patients. Final guidance is expected in August 2026, after which local adoption and patient access timelines will become clearer.
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