Do I have to try regular methylphenidate before BC PharmaCare will cover Concerta?

Not necessarily regular methylphenidate only, but BC PharmaCare's published limited-coverage criteria for Concerta do require a prior stimulant trial before Special Authority can be considered, and approval is never guaranteed. This is a British Columbia PharmaCare rule, not an OHIP rule and not a CADDRA rule. The official methylphenidate limited-coverage page describes coverage for patients six years of age and older with ADHD who need twelve hours of coverage and who have tried immediate-release or sustained-release methylphenidate or immediate-release or sustained-release dextroamphetamine with unsatisfactory results after a minimum one-week adequate trial, or who had intolerance. A documented immediate-release or sustained-release methylphenidate trial can meet that criterion, and a documented immediate-release or sustained-release dextroamphetamine trial can also meet it; it is not only Ritalin, and CADDRA's first-line language does not rewrite the PharmaCare form. Concerta and Foquest, including listed generics where the page names them, appear on that methylphenidate limited-coverage page; the prescriber still submits Special Authority. Rules, coverage and referral pathways vary by province and can change; confirm the current position with the relevant institution or provincial program. References: https://www2.gov.bc.ca/gov/content/health/accessing-health-care/bcs-primary-care-system/provincial-attachment-system https://www.canada.ca/en/health-canada/services/drugs-medication/prescription-stimulants.html https://www.nice.org.uk/guidance/ng87/chapter/recommendations

This is only my personal experience in B.C., not advice for anyone else. I had already tried dextroamphetamine tablets for two weeks with poor coverage in the afternoon. My prescriber used that trial on the Concerta Special Authority form instead of making me do a separate Ritalin month. Approval still took a while and Fair PharmaCare left me with a deductible. I am not saying every file is accepted this way.