In 2012, total cost for heart failure (HF) was $30.7 billion and by 2030, it is projected to increase to $69.7 billion [1]. Hospitalizations for HF are a major reason for increased cost burden [2]. Loop diuretics are a part of standard therapy in symptomatic HF patients to decrease hospitalizations. Data from small randomized trials and observational studies have shown superiority of torsemide in reducing HF hospitalizations compared to furosemide [3–8]. Despite that, >80% HF patients are on furosemide and