My patient is a 61 y/0 with diabetes and hypertension. She was on Lisinopril for her hypertension and presented to our clinic with complaints of chronic cough. Her cough was felt to be secondary to lisinopril use and we were considering changing it to Losartan. However, she mentioned that she has been currently having insurance problems in regards to medication coverage and she has been paying for the medications herself. When we searched for Losartan price ,it was priced anywhere between 60-80$ per month. Hence, after discussion with patient and attending, the medication for changed to Amlodipine. Though ACEI/ARB would have helped her better, we mentioned to patient that CCB can also help with diabetic microalbuminaria. My patient is very compliant to healthy lifestyle changes, medications and follow up visit. This scenario shows that in order to treat patients appropriately, we should understand their insurance and social aspects as well.
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