Dobutamine: a drug utilization evaluation

During a recent fiscal year, a 243% increase in dobutamine costs--which were associated with increased drug use--was observed at Brigham and Women's Hospital in Boston. As a result of this increase, a drug usage evaluation was concluded to determine: the indications for which dobutamine was being prescribed, whether or not dopamine could be used in place of dobutamine, and any anticipated cost savings realized by targeting dobutamine prescribing. Forty-six consecutive patients who were receiving dobutamine for hypotension, congestive heart failure, or decreased urine output were evaluated during a 3-month study period. The results indicated that dopamine could have been used as initial therapy in the majority of patients. In only 3 patients was dobutamine considered the drug of choice. Furthermore, the institution could have reduced drug costs by more than $50,000 if the use of dobutamine could have been reserved for its most appropriate indications.