OBJECTIVES: Evaluate the economic impact of the use of Levosimendan compared to Dobutamine, in patients with Acute Heart Failure (AHF) in Mexico. METHODS: Literature review was conducted to compare the resource utilization for AHF patients. Further, a budget impact analysis was done to demonstrate economic advantages of using Levosimendan, compared to Dobutamine. An economic model was built based on days in general ward (GW) and intensive care unit (ICU) as parameters. The number of days in GW and/or ICU was multiplied by the cost per GW and ICU, taken from the Mexican Federal Authority data. RESULTS: Length of stay was shorter in case of Levosimendan treated patients compared to Dobutamine ones (2.88 vs. 3.22 in ICU, and 4.15 vs. 5.74 in GW), according to the ALARM-HF study (abstract presented at the ESC-Hear Failure annual congress 2007, Germany).  The medical costs per patient were US$7418 if treated with Levosimendan and US$8680 for a patient receiving Dobutamine, thus a US$1262 difference.  In Mexico, the cost of the treatment of AHF patients is US$500 (1 vial) for Levosimendan and US$76 (10 vials) for Dobutamine (US$424 difference). The final result, including the cost of the drug, shows a difference of 838 USD per patient in favour of the treatment with Levosimendan.  According to international and national literature, the eligible AHF population to receive inotropic treatment in Mexico is approximately 90,240. Assuming that the whole population were treated with Dobutamine, the total cost, would be US$790.1 million. If treated with Levosimendan, the total would be US$714.8 million. This represents potential savings of US$75.6 USD million for the Mexican Public Health System. CONCLUSIONS: The use of Levosimendan, in comparison with Dobutamine, has demonstrated to represent a very important source of potential savings for the Mexican public health system in patients with AHF.