A recent comment from my Caduet post stated this:

I’m amazed at how drug reps are taught to sneak in the information about putting patients on an unnecessary drug. I’m also always shocked to see how many free clinic patients at our student clinic are put on Norvasc right away.

This is a sad reality. The reason for this is that drug reps don’t leave generic medications. There are a couple of problems with this scenario. First off, not all name-brand hypertensive medications are first-line medications (Norvasc comes to mind).

Secondly, there is the mistaken impression that giving free-care patients sample medication is saving them money. This is deleterious in the long-term, since they are then bound to a more expensive, name-brand medication. It would be more beneficial to start people off on a generic medication (a thiazide or beta-blocker) if cost-savings is truly a concern.

Thirdly, there really should not be a reason why generics cannot treat the majority of hypertension. There are generics in the majority of hypertensive medication classes. The cases where an angiotensin-receptor blocker (ARB) or a combined alpha/beta-blocker (Carvedilol) are needed would be exceptions to this.