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Nova Scotia Pharmacare ADHD Exception Status Form

Nova Scotia Pharmacare covers some long-acting ADHD medications as exception status drugs, and this one-page form requests coverage of methylphenidate (Biphentin and generic brands) or lisdexamfetamine (Vyvanse and generic brands). The prescriber records the drug and dose requested and the earlier stimulant trials that gave unsatisfactory results. Pharmacare checks the request against criteria set by the Atlantic or Canadian Expert Advisory Committees.

Who completes it

The prescriber completes the whole form, including the patient's name and health card number, the requested drug and dose, the trial history, and their name, address, licence number and signature.

Submitting and payment

How to submit it
Mail or fax the form to Nova Scotia Pharmacare Programs, or, for providers in the Pharmacare ESD Pilot with an Ocean account, submit the request online through Ocean.

Good to know

  • The maximum reimbursed dose is 80 mg daily for methylphenidate (Biphentin) and 60 mg daily for lisdexamfetamine (Vyvanse).
  • Biphentin requires prior extended-release methylphenidate with unsatisfactory results; lisdexamfetamine requires unsatisfactory results with extended-release methylphenidate, dexamphetamine or mixed salts amphetamine.
  • Each trial is recorded with the product tried and its outcome. Some methylphenidate products, including Foquest, are full benefits listed in the Nova Scotia Formulary.
  • This version is dated 10/2025; Nova Scotia warns that ESD forms may be added or changed at any time, so check the current form before submitting.

Get the official form

Download the current version from the source each time; forms change without notice.

Request for Insured Coverage of Agents for Attention Deficit Hyperactivity Disorder

Official pagePDF

Fill it with Vero

Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

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Frequently asked questions

Does Nova Scotia Pharmacare cover Vyvanse for ADHD?

Lisdexamfetamine (Vyvanse and generic brands) can be covered as an exception status drug when the patient has tried extended-release methylphenidate, dexamphetamine or mixed salts amphetamine with unsatisfactory results. The prescriber documents those trials and their outcomes on this form. The maximum reimbursed dose is 60 mg daily.

Do all methylphenidate products need this Nova Scotia form?

No. The form points prescribers to the Nova Scotia Formulary for the methylphenidate products that are full benefits, including Foquest. The exception status request applies to Biphentin and its generic brands, for patients who tried other forms of extended-release methylphenidate with unsatisfactory results.

Can I submit the Nova Scotia ADHD form online?

Providers with an Ocean account can send exception status drug requests online through Ocean under the Pharmacare ESD Pilot. Otherwise the paper form goes to Nova Scotia Pharmacare Programs by mail or fax, using the details printed at the bottom of the form.