Exelon — Cigna
mild to moderate dementia associated with Parkinson’s disease
Preferred products
- generic donepezil tablets and orally disintegrating tablets (does NOT include donepezil 23 mg tablets)
- generic galantamine tablets or oral solution
- generic galantamine extended-release capsules
- generic rivastigmine capsules
- generic rivastigmine transdermal system
Initial criteria
- If the patient has tried one Step 1A Product, approve a Step 2A Product.
Approval duration
1 year