HCTZ, lisinopril, and amlodipine are effective drugs often used together. Most people require two or three different medications to fully control blood pressure (just like Margaret). Occasionally, patients require even more drugs.
The three top drugs are low cost older drugs. HCTZ, first available in 1959, costs pharmacies only $4.29 for one patient’s annual supply. Lisinopril (introduced in 1987 and costs pharmacies $6.33 per year per patient) and amlodipine (introduced in 1992 and costs pharmacies $5.66 per year per patient) are also inexpensive.
There are newer drugs, but they aren’t breakthroughs. Many resemble existing medications or are simply combinations of already available drugs. For most patients, they are not worth their significant extra cost. For example, azilsartan, a new angiotensin receptor blocker introduced in 2011, costs a pharmacy $2,000 per year per patient.