In reality, the medications that you are taking, are not only the products of the decisions of the healthcare team. There are many 'commercial' factors.
Let's say in hypertension guidelines, it's listed that ACEI or ARB will be the first line treatment. But which one in these groups are to be used?
Unless you are having other diseases, like kidney failure, or chronic liver disease, which will affect the choice of drug in more precise way, I don't think the healthcare team really have the clear idea of which one to give you.
So in the end, which one to use?
To use those more familiar one.
Well, that's the trick behind it. Those you are familiar with, are either those very established, existed for a long long time, and appeared to be very safe; or, those new drugs that the drug companies keep promoting to the healthcare team.
Normally, the healthcare team will tend to forget about the drugs that are existed very long time with good safety profile. Those, will be only extensively mentioned in text book. It is kind of 'uncool' of the young doctors or pharmacists to deal with them.
So, which left the latter one: Those new drugs that the drug companies keep promoting about.
New drugs mean: New, with lesser safety profile, and slightly (sometimes significantly, but quite rare) more effective than the old drugs; and of course, claimed to be having lesser side effects.
How intensive is the promoting?
Well, you can see the name of the drugs on the pens, the folders, notebooks, reference books, and even guidelines printed by drug companies.
The healthcare team is basically brainwashed by the drug companies every day.
Plus, the obviously biased data provided by the drug companies, with nicely designed charts and figures.
To some lucky ones, they might have incentives if they prescribe more than certain amount of the certain drugs.
How nice. The healthcare team has so so much to gain.
What about the price that the public bear?
More expensive, but just slightly better, with unknown risk ahead.