Objective: To estimate the budget impact of switching from Rivastigmine capsules to Rivastigmine Transdermal Adhesives in Brazilian Public Health System. Methods: A simulation model from Public Health System perspective, with a time horizon of three years was developed. In order to explore the minimum and maximum possible budget impact, two scenarios were performed. In the scenario A the patients are kept in the current treatment dosage profile using transdermal adhesive. In scenario B the patients are successfully switched to higher doses using transdermal adhesives as label and clinical studies recommendations. The capsules formulations analyzed were: 1.5 mg; 3 mg; 4.5 mg e 6 mg. The transdermal formulations evaluated were 5 cm² and 10 cm². The indication of target dose of 10 cm² rivastigmine transdermal adhesives provides efficacy similar to the highest doses of capsules was based on clinical and pharmacological trials. Data from medication unit's dispensation were collected from public health database, ranging from October 2004 to September 2007. Cost information was collected from official reimbursement list. The rate of switching from capsules to transdermal adhesives was based on randomized controlled trial related to caregiver preference. Results were converted in US Dollars (R$ 1,8/USD 1.00). A one-way sensitivity analysis was performed. Results: In scenario A it was estimated that the government could obtain a reduction of USD$2.7 million, or 6.02% of expenses. A reduction of 37% of pharmacy dispensation activities was associated with lowest health service resource utilization. On the other hand in scenario B government expenses are 6.36% higher (USD$3.2 million) but with reduction of 31% of pharmacy dispensation activities. All scenarios are sensible to transdermal adhesives costs. Conclusion: Rivastigmine transdermal adhesives would be advantageous to Brazilian Public Health System providing budget savings with lower resource utilization. Although higher dosage of medication increases expenses, pharmacy dispensation activities would be lower.