People in England with a type of chronic heart failure could benefit from a new treatment option. Final draft guidance from NICE recommends finerenone for adults with chronic heart failure with preserved or mildly reduced ejection fraction.
Heart failure with preserved or mildly reduced ejection fraction happens when the left side of the heart doesn'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 symptoms including breathlessness, fatigue and ankle swelling. People with the condition often need to be admitted to hospital and this can have a significant impact on their quality of life and independence. Many people with chronic heart failure also live with other long-term conditions, including chronic kidney disease, diabetes and high blood pressure, 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.
"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 Today’s final draft guidance means there is a further effective treatment available on the NHS for people with this type of heart failure.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," commented Helen Knight, director of medicines evaluation at NICE
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 to 2024, making it one of the leading causes of avoidable hospital admissions. We estimate up to 280,000 people could be eligible for finerenone.
NICE expects to publish its final guidance on finerenone in August 2026.
