Bayer's Kerendia on course for NHS use in heart failure
Bayer building in Reading, UK.
Thousands of people in England and Wales with a type of chronic heart failure (CHF) could soon be eligible for treatment with Bayer's Kerendia, a new type of drug that acts by blocking overactive mineralocorticoid receptors.
Final draft guidance from the health technology assessment (HTA) agency NICE recommends that Kerendia (finerenone) becomes an option for patients with symptomatic CHF with a left ventricular ejection fraction of 40% or more. That covers what is known as heart failure with mildly reduced ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF).
Of the estimated 635,000 people in England who have heart failure, half have preserved or mildly reduced ejection fraction, according to NICE, which has estimated that up to 280,000 people could be eligible for Kerendia once the guidance comes into effect in August.
There were around 100,000 hospitalisations in England for heart failure in 2023 to 2024, making it one of the leading causes of avoidable hospital admissions.
"Heart failure with preserved ejection fraction or mildly reduced ejection fraction represents a substantial and growing challenge for patients, clinicians and the NHS," said Dr Carol Whelan of the Royal Free Hospital in London, one of the UK's leading heart failure specialists.
"Too many patients experience repeated hospital admissions, poor quality of life and an unacceptably high risk of death," she added. "As our population ages and the burden on patients and the healthcare system continues to rise, improving outcomes for this large and historically underserved patient population is increasingly important."
Kerendia was approved by the MHRA in April as a treatment for CHF based on the FINEARTS-HF study, which showed a statistically significant improvement in cardiovascular outcomes in HFmrEF and HFpEF patients, including a reduced risk of cardiovascular death, hospitalisation for heart failure, and urgent heart failure visits.
Welan went on to say that the Kerendia recommendation is "a welcome development, providing clinicians with an additional evidence-based treatment option that could help address an important unmet need in heart failure care."
Unlike other mineralocorticoid receptor antagonists (MRAs) like spironolactone, finerenone is nonsteroidal, with fewer side effects, and so may be used by more people, according to NICE.
Kerendia is already used by the NHS as an add-on treatment for stage 3 and 4 chronic kidney disease (CKD) with albuminuria linked to type 2 diabetes in adults, having been backed for that use by NICE in 2023, but extending its use into CHF is viewed as the key to meeting Bayer's blockbuster sales target for the drug.
Sales are already tracking up well, rising 79% to around $936 million in 2025, and 84% to $318 million in the first three months of this year.
