This retrospective Indonesian cohort compared medical charges among 76 adult cardiogenic shock survivors receiving dobutamine–milrinone escalation or dobutamine alone. Propensity weighting used pretreatment covariates to adjust cost comparisons. Escalation was associated with higher intensive cardiovascular care unit costs (cost ratio 2.711; 95% CI 1.912–3.844) and total hospital costs (cost ratio 2.321; 95% CI 1.372–3.929). Combined inotrope acquisition accounted for 4.3% of intensive cardiovascular care unit expenditure in the escalation group, compared with 30.9% for therapeutic and interventional procedures. The retrospective, single-center, survivor-only design limits interpretation.
In this survivor cohort, drug acquisition accounted for a small share of expenditure associated with inotrope escalation. These findings inform resource-use discussions but do not establish comparative clinical benefit or causal cost effects.
Study limitation: The retrospective, single-center, survivor-only design limits generalizability and leaves potential confounding despite propensity weighting.
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