Limited coverage criteria – rivastigmine
Last updated on March 21, 2025
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Generic name |
rivastigmine |
|---|---|
Strength & form |
1.5 mg/3 mg/4.5 mg/6 mg capsule |
Special Authority criteria |
Approval period |
|---|---|
|
For the treatment of mild to moderate Alzheimer’s disease, Alzheimer’s disease with a vascular component, Alzheimer’s disease with Parkinsonian features (Lewy bodies), or mixed dementia with Alzheimer’s disease, in patients with:
AND
AND
|
Initial: 6 months Renewal: 1 year for first renewal, and indefinite coverage on second renewal |
Practitioner exemptions
- None
Special notes
- Coverage is not available for patients switching from one cholinesterase inhibitor to another due to ineffectiveness (clinical failure), because there is insufficient evidence that switching to a different cholinesterase inhibitor will provide a better therapeutic effect
- Patients must be assessed on a regular basis (every 6 months) to ensure continued therapeutic benefit
- Criteria applicable to all plans, including Plan G