Limited Coverage Drugs – Methylphenidate extended-release - Concerta® and generics

Generic Name

methylphenidate extended-release

Strength

18 mg, 27 mg, 36 mg, 54 mg

Form

extended-release tablets

Special Authority Criteria

Approval Period

For patients 6 to 18 years of age diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) who require 12 hours of continuous coverage for significant and problematic disruptive behaviour or problems with inattention that interfere with learning AND have been previously tried on one of the following with unsatisfactory results*:

  • immediate‑ or sustained-release methylphenidate

OR

  • immediate- or sustained-release dextroamphetamine.

* See Special Notes below

Up to the patient’s 19th birthday.

Practitioner Exemptions

  • No practitioner exemptions.

Special Notes

  • "Unsatisfactory results" is defined as continuing symptoms of ADHD or functional impairment secondary to ADHD, while on a minimum one week trial of immediate- or sustained-release ADHD medication at an adequate dose. Specific details of drug, dose and duration tried, and unsatisfactory response are required, as applicable.
  • Coverage is not intended for "performance enhancement" in children or youth who do not have symptoms or functional impairment.

Special Authority Request Forms