New Daily Heart Pill Approved: Who Gets Aficamten on the NHS

What has been approved

A new once-daily pill for a serious inherited heart condition cleared both of its regulatory hurdles on the same day, in what the agencies involved present as a milestone for how quickly new medicines reach NHS patients. Aficamten, sold under the brand name MYQORZO and made by Cytokinetics, received its marketing authorisation from the Medicines and Healthcare products Regulatory Agency on 29 July, and NICE published final guidance recommending it for NHS use on 30 July 2026, two weeks faster than its standard process. The drug treats obstructive hypertrophic cardiomyopathy, a condition in which the heart muscle becomes thickened and stiff, obstructing blood flow out of the heart and causing exhaustion, dizziness, breathlessness, chest pain and a racing or irregular heartbeat. Around 1 in 500 people in the UK has hypertrophic cardiomyopathy, and in roughly half of cases it is inherited, which is why a diagnosis often ripples through families. NICE estimates around 6,600 people in England stand to benefit from the new treatment, and NHS England is required to make it available within 30 days of the final guidance, putting NHS access on a late-August timetable.

Who qualifies and how it works

Aficamten is approved for adults with symptomatic obstructive hypertrophic cardiomyopathy whose limitations fall into New York Heart Association classes 2 or 3, the system doctors use to describe how much a heart condition restricts daily activity, covering people with mild to marked limitation of ordinary physical activity. It is recommended as an add-on to standard care, which includes beta-blockers, certain calcium-channel blockers or disopyramide, or on its own where those treatments cannot be used. The science is targeted: aficamten is a reversible cardiac myosin inhibitor, binding to the myosin protein in heart muscle cells to reduce the excessive contraction that characterises the condition, helping the heart pump more smoothly and reducing the obstruction to blood flow. Clinical trials showed it helps people exercise more easily and reduces symptoms. Treatment involves regular monitoring of heart function, including echocardiograms, to find and maintain the right dose of the tablets, which come in strengths from 5mg to 20mg. NICE assessed it as likely to be as effective as mavacamten, the only comparable treatment already on the NHS, with the practical advantage that patients may need fewer monitoring scans in the early stages.

Why the same-day double decision matters

The unusual feature of this approval is the choreography. Licensing by the MHRA and value assessment by NICE have historically run in sequence, and the gap between a drug being legally available and being NHS-funded is where patients wait. For aficamten the two ran together, with NICE using a cost-comparison approach: because mavacamten is already recommended for the same population, the company needed to demonstrate that aficamten's costs are similar or lower, a faster route than a full cost-effectiveness appraisal, supported by a confidential discount agreed with the NHS. NICE says it is now publishing guidance 30% faster for medicines than before April 2024, and its director of medicines evaluation described the approval as demonstrating the value of aligning licensing and value decisions. The MHRA's healthcare access director called it an important milestone for the UK's regulatory system while stressing that safety standards were fully met. For patients the institutional plumbing translates simply: the second treatment of its kind reached the NHS pathway weeks earlier than it would have under the old sequence, and the model is likely to be repeated for future medicines.

What patients and families should know

The patient charity Cardiomyopathy UK, which submitted evidence from its community to the NICE appraisal, welcomed the decision as offering genuine choice: mavacamten has until now been the only treatment of its kind, and an alternative that may require fewer early echocardiograms could prove a more accessible route for some. People currently living with obstructive HCM who think they may qualify should raise the new option with their cardiology team rather than their GP in the first instance, since prescribing and dose monitoring sit with specialist services, and NHS availability begins within 30 days of the guidance. Relatives of those diagnosed should be aware that because the condition is inherited in around half of cases, cardiology services commonly offer screening to first-degree relatives, a conversation worth having independently of any new drug. As with all newly authorised medicines, the MHRA keeps aficamten's safety under close review, and anyone who suspects a side effect should speak to their doctor, pharmacist or nurse and can report it directly through the Yellow Card scheme online or via the MHRA Yellow Card app. This article reports the regulatory decisions and is not medical advice; treatment decisions for individual patients rest with their specialist team. Related: our money guides, bills section, comparison guides and the latest UK news.

Frequently asked questions

What is aficamten and what does it treat?

A once-daily pill, sold as MYQORZO, for symptomatic obstructive hypertrophic cardiomyopathy. It reduces excessive contraction of thickened heart muscle, easing the obstruction to blood flow and improving symptoms.

Who can get aficamten on the NHS?

Adults in England with symptomatic obstructive HCM in New York Heart Association classes 2 or 3, as an add-on to standard care or alone where standard treatments cannot be used. NICE estimates around 6,600 people qualify.

When will aficamten be available on the NHS?

NHS England must make it available within 30 days of NICE publishing its final guidance on 30 July 2026, so access begins by late August. Prescribing sits with specialist cardiology services.

How is aficamten different from mavacamten?

Both are cardiac myosin inhibitors for the same condition. NICE assessed aficamten as likely to be as effective, and patients may need fewer monitoring echocardiograms while finding the right dose.

Is hypertrophic cardiomyopathy inherited?

In roughly half of cases, yes. Around 1 in 500 people in the UK has the condition, and cardiology services commonly offer screening to close relatives of someone diagnosed.