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GET SAVINGS AND SUPPORT FOR
YOUR PATIENTS ON BRIVIACT

Help give patients a single point of contact throughout
their treatment journey with UCBCares.

Enroll your patients
Health Care Professional Smiling
Prescription Coverage Support, Icon

Prescription Coverage Support

  • Performs benefits investigations
  • Initiates prior authorization and/or tier medical exception requests (if required) for completion
Copay Card Enrollment, Icon

Copay Card Enrollment*

Helps eligible commercial patients enroll in the BRIVIACT Patient Savings Program.

Bridge Product, Icon

Bridge Product

Up to 1 month of medication at no cost may be available for eligible commercial patients who experience a prolonged delay in obtaining insurance coverage for BRIVIACT.

Local Pharmacy Fulfillment, Icon

Local Pharmacy Fulfillment

Once insurance coverage is confirmed, patients can select their pharmacy of choice for prescription fulfillment and pickup.

Patient Assistance Program, Icon

Patient Assistance Program

Works with uninsured and underinsured patients who may not be able to afford BRIVIACT to find alternative support.

For insured, underinsured, and uninsured patients who are prescribed BRIVIACT

 

Enroll your patients in UCBCares® in just 3 simple steps:

Steps to Enroll in UCBCares®
Number 1, Icon

Enroll with an e-Rx to Sonexus Health Pharmacy (NCPDP #5910206).

Number 2, Icon

UCBCares will communicate directly with your patient to obtain authorization and determine the next steps based on insurance coverage. A full benefits summary will be sent to both you and your patient.

Number 3, Icon

UCBCares will advise you on your patient’s pharmacy of choice so you can send the prescription there for fulfillment.

NCPDP=National Council for Prescription Drug Programs.

 

To learn more about our product support services, contact UCBCares

Call, Blue Icon

Call
833-948-2394
Monday–Friday
9 AM to 6 PM ET

Help your patients get the medication they need.

UCB is committed to making BRIVIACT accessible for the majority of eligible patients across the US

ABOUT

2

OUT
OF

3

patients could have access to BRIVIACT first1

This means they should not have to try and fail other antiseizure medications, including generics, for their insurance to cover BRIVIACT.§

9

OUT
OF

10

commercial patients have formulary access to BRIVIACT2

§Formularies can change and many health plans offer more than 1 formulary. Please check directly with the health plan to confirm coverage for individual patients.


 

UCB may help eligible patients find ways to save on their prescription.

Savings are available for eligible BRIVIACT patients

BRIVIACT Patient Savings Program

Side View of BRIVIACT® Patient Savings Card

Eligible patients pay as little as $10 per
30-day supply of BRIVIACT

Check patient eligibility

 
 

Help eligible patients start on BRIVIACT.

Help eligible patients get started with a free 2-week trial of BRIVIACT

New patients may be eligible for a FREE Trial Voucher with a 14-day prescription.

14-Day Trial Voucher

BRIVIACT® 14-day voucher

Contact your representative to receive
a patient voucher for a 14-day supply
of BRIVIACT.



 

BRIVIACT Patient Assistance Program may be able to help if your patients do not have health insurance or otherwise cannot afford BRIVIACT.

To learn more about the BRIVIACT Patient Assistance Program and check eligibility:

 

*Savings card is not valid for use by patients who are covered by any federally funded or state-funded healthcare program (including, but not limited to, Medicare [Part D and Medigap] and those who are Medicare-eligible and enrolled in an employer-sponsored health plan for retirees, Medicaid, any state pharmaceutical assistance program, TRICARE, VA, or DoD), or for cash-paying patients. A valid BRIVIACT prescription consistent with the approved FDA labeling is required. Other Eligibility Criteria and Terms apply. Full Eligibility Criteria and Terms are available at www.BRIVIACT.com or upon request by calling UCBCares at 833-948-2394.

Bridge product is available for BRIVIACT® (brivaracetam) CV. Eligible patients must be at least one month of age or older, have commercial insurance, have a valid prescription consistent with the FDA-approved product labeling for BRIVIACT® (brivaracetam) CV, and have experienced a delay in, or have been denied coverage for BRIVIACT by their commercial insurance plan. Eligible patients may receive treatment at no cost for up to fifteen (15) days, with a one-time fifteen (15)-day renewal for a total of thirty (30) days maximum, if a prior authorization request has been denied, or coverage remains unavailable for the patient. Program is not available (1) to patients whose prescriptions are reimbursed, in whole or in part, under Medicare (including Medicare Part D), Medicaid, or any other federal- or state-funded health care programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), (2) where a patient’s insurance covers the drug, (3) to uninsured or cash-paying patients, or (4) where otherwise prohibited by law. Product shall be dispensed pursuant to program rules and federal and state laws. Patients may be asked to re-verify insurance coverage status during participation in the program. No purchase necessary. Patients have no obligation to continue using BRIVIACT®. Program is not health insurance, nor is participation a guarantee of insurance coverage. Limitations may apply. This program cannot be combined with any other savings, free trial, or similar offer for the specified prescription. The patient, or healthcare provider on the patient’s behalf, must not submit any claim for reimbursement for free product provided under this program to any third-party payer. UCB reserves the right to end or amend this program without notice.

Federal regulations currently do not permit the transfer of unfilled electronic prescriptions for schedule II-V controlled substances.

UCBCares is provided by UCB and is intended to support the appropriate use of UCB products. The UCBCares program may be amended or canceled at any time without notice. Eligibility terms and restrictions apply.

Important Safety Information

WARNINGS AND PRECAUTIONS

  • Suicidal Behavior and Ideation: Antiepileptic drugs, including BRIVIACT, increase the risk of suicidal behavior and ideation. Monitor patients taking BRIVIACT for the emergence or worsening of depression; unusual changes in mood or behavior; or suicidal thoughts, behavior, or self-harm. Advise patients, their caregivers, and/or families to be alert for these behavioral changes and report them immediately to a healthcare provider.
  • Neurological Adverse Reactions: BRIVIACT causes somnolence, fatigue, dizziness, and disturbance in coordination. Somnolence and fatigue-related adverse reactions were reported in 25% of adult patients taking at least 50 mg per day of BRIVIACT compared to 14% of adult patients taking placebo. Dizziness and disturbance in gait and coordination were reported in 16% of adult patients taking at least 50 mg per day of BRIVIACT compared to 10% of adult patients taking placebo. The risk is greatest early in treatment but can occur at any time. Monitor patients for these signs and symptoms and advise them not to drive or operate machinery until they have gained sufficient experience on BRIVIACT.
  • Psychiatric Adverse Reactions: BRIVIACT causes psychiatric adverse reactions, including non-psychotic and psychotic symptoms. These events were reported in approximately 13% of adult patients taking at least 50 mg per day of BRIVIACT compared to 8% of adult patients taking placebo. A total of 1.7% of adult patients taking BRIVIACT discontinued treatment due to psychiatric reactions compared to 1.3% of patients taking placebo. Psychiatric adverse reactions were also observed in open-label pediatric trials and were generally similar to those observed in adults. Advise patients to report these symptoms immediately to a healthcare provider.
  • Hypersensitivity: BRIVIACT can cause hypersensitivity reactions. Bronchospasm and angioedema have been reported. Discontinue BRIVIACT if a patient develops a hypersensitivity reaction after treatment. BRIVIACT is contraindicated in patients with a prior hypersensitivity reaction to brivaracetam or any of the inactive ingredients.
  • Withdrawal of Antiepileptic Drugs: As with all antiepileptic drugs, BRIVIACT should generally be withdrawn gradually because of the risk of increased seizure frequency and status epilepticus.

DOSING CONSIDERATIONS

  • Dose adjustments are recommended for patients with all stages of hepatic impairment.
  • When BRIVIACT is co-administered with rifampin, an increase in the BRIVIACT dose is recommended.

ADVERSE REACTIONS

In adult adjunctive therapy placebo-controlled clinical trials, the most common adverse reactions (at least 5% for BRIVIACT and at least 2% more frequently than placebo) were somnolence and sedation, dizziness, fatigue, and nausea and vomiting symptoms. Adverse reactions reported in clinical studies of pediatric patients were generally similar to those in adult patients. Adverse reactions with BRIVIACT injection in adult and pediatric patients were generally similar to those observed with BRIVIACT tablets. Other adverse events that occurred in adult patients who received BRIVIACT injection included dysgeusia, euphoric mood, feeling drunk, and infusion site pain.  

BRIVIACT is a Schedule V controlled substance.

Please see full Prescribing Information

References Savings

References


  1. Managed Markets Insight & Technology, LLC, database as of August 2021.
  2. Data on file. UCB, Inc.

Reference

  1. BRIVIACT® (brivaracetam): US prescribing information. Smyrna, GA: UCB, Inc.