I've been using the Exelon patch recently (rivastigmine 9.5mg). The insurance company won't pay for the patch but they will pay for the pill. They initially denied use of the drug in any form. I appealed their initial decision and they then agreed to pay for use of the pill. Neither are in their formulary. 30 patches cost $212 out-of-pocket at my usual pharmacy and so far, I've paid the full price myself. I'm thinking about using the pill but my neurologist says the pill causes a lot of nausea and other intestinal problems. I'm kinda worried because I've always been the type to have problems with nausea, and in addition, I've had ulcers, a hiatal hernia that did a lot of damage to my esophagus because of reflux before it was surgically repaired, and I've also had some of my intestines removed along with my appendix. Colon cancer screening test show I'm bleeding but colon cancer has been ruled out. So, do I really want to swallow something that's going to cause more intestinal problems?

It seems the insurance company doesn't care. It's odd in a way that the insurance company is so unwilling to allow the patch. I've looked at the cost and there isn't a big difference between the pill and the patch. The pill could actually cost more because of a possible need for anti-nausea medication and the possibility of incurring the costs of intestinal damage.

I'm wondering if anyone is using Exelon and if so, do you have any experience with the pill versus the patch? The patch seems to cause occasional, slight nausea. Is it worse with the pill? Is it a lot worse?