BRIVIACT® (brivaracetam) CV is indicated for the treatment of partial-onset seizures in patients 4 years of age and older.

As the safety of BRIVIACT injection in pediatric patients has not been established, BRIVIACT injection is indicated for the treatment of partial-onset seizures only in adult patients (16 years of age and older).

Approved For Pediatric Patients (4 Years of Age and Older)

BRIVIACT® (brivaracetam) CV is indicated for the treatment of partial-onset seizures in patients 4 years of age and older.

As the safety of BRIVIACT injection in pediatric patients has not been established, BRIVIACT injection is indicated for the treatment of partial-onset seizures only in adult patients (16 years of age and older).

Approved For Pediatric Patients (4 Years of Age and Older)

Co-Pay/Savings

Co-pay/Savings

Affordability and accessibility matter

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

BRIVIACT® (brivaracetam) CV Patients May Pay as Little as $20 per Month with the Patient Savings Card

9 out of 10 commercial patients have formulary access to BRIVIACT® (brivaracetam) CV and most have unrestricted access.3

Savings

BRIVIACT® Patient Savings Program

Eligible patients* pay as little as $20 per 30-day supply of BRIVIACT with the BRIVIACT Patient Savings Program

Ask your sales representative for details about the program.

  • *Patients are responsible for a minimum of $20 out-of-pocket expense per 30-day supply. This card will then be applied toward any remaining out-of-pocket expense up to a maximum of $100. Most patients who have commercial prescription insurance are eligible. If you have any questions regarding your eligibility or benefits or if you wish to discontinue your participation, call the BRIVIACT Savings Program at 1-888-786-5879 (8:30 AM – 5:30 PM EST, Monday-Friday and 8:30 AM – 2:30 PM EST, Saturday). This savings card is not valid for use by patients who are covered by any federal or state funded healthcare program (including, but not limited to, Medicare [Part D and Medigap], Medicaid, any state pharmaceutical assistance program TRICARE, VA, or DoD). Offer good only in the U.S., including Puerto Rico. This card is good for use only with a valid BRIVIACT prescription at the time the prescription is filled by the pharmacist and dispensed to the patient. The maximum annual benefit amount is $1300 per calendar year. Void where prohibited by law, taxed, or restricted. This offer cannot be combined with any other promotional offer. UCB, Inc. reserves the right to rescind, revoke, or amend this offer without notice at any time. No cash value. Not eligible for sale, purchase, trade, or counterfeit.

Assistance

When a prior authorization is required, PARx Solutions® and CoverMyMeds® can provide assistance

PARx Solutions and CoverMyMeds offer prior authorization (PA) assistance through an electronic-based system that standardizes the medical necessity request process for most insurance providers, and for patients with commercial, Medicare Part D, and Medicaid coverage*

When a prior authorization is needed, PARx Solutions and CoverMyMeds can provide assistance.

BRIVIACT® (brivaracetam) CV PARx Solutions Logo and Percent of Prior Authorizations Approved

PARx Support Solutions for Prescribers (PASS)

  • PARx Solutions helps prescribers easily navigate the PA process by providing digital PAs via secure web-based and pharmacy-driven support

Get started in 4 simple steps:

  1. Physician completes and submits universal insurance PA request form.
  2. PARx completes proper PA health plan form.
  3. PARx submits form to proper health plan.
  4. PARx works with office if additional information is needed and follows up on outcome of submission.

For more information, visit www.parxsolutions.com.

BRIVIACT® (brivaracetam) CV CoverMyMeds Logo and Percent of Prior Authorizations Approved

Pharmacy-initiated PA requests

  • If a prescription is submitted to a participating pharmacy and requires a PA, CoverMyMeds facilitates the approval process by delivering a PA to your office for completion, signature, and submission to the health plan
  • More than 90%14 of retail pharmacies participate in CoverMyMeds

Physician-initiated PAs

  • CoverMyMeds also offers a web-based portal that can help your office by automating the PA process, saving prescribers and staff time and ensuring patients receive their medication faster

Get started online at www.covermymeds.com, by email at help@covermymeds.com, or by phone at 1-866-452-5017.

  • *Currently, Medi-Cal, Washington State Medicaid, and Wisconsin State Medicaid require the pharmacy to submit prior authorization forms and may not be applicable to this program. This list is subject to change based on plan requirements.
  • Year-to-date average does not indicate or guarantee an individual’s approval for BRIVIACT.

Financial assistance may be available for BRIVIACT® patients

The BRIVIACT Patient Assistance Program may be able to help if your patients do not have health insurance or if they are a Medicare Part D recipient and cannot afford BRIVIACT. Eligible patients are provided a free 6-month supply of medicine and can reapply every six months for continuing support.

To learn more about the BRIVIACT Patient Assistance Program or to find out if your patient might be eligible for assistance, please contact UCBCares at 1-844-599-CARE (2273) or UCBCares@ucb.com, or click below to get started.

Program instructions and application form

Receive a FREE 2-week trial of BRIVIACT®

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

Or call UCBCares at 1-844-599-CARE (2273) or email UCBCares@ucb.com.

Co-Pay/Savings

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 4 years to less than 16 years of age were generally similar to those in adult patients.

BRIVIACT is a Schedule V controlled substance.

Please see full Prescribing Information.

To report suspected adverse reactions, contact UCB, Inc. at UCBCares® (1-844-599-2273) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

References

  1. BRIVIACT (brivaracetam): US prescribing information. Smyrna (GA): UCB, Inc., May 2018.
  2. Gillard M, Fuks B, Leclercq K, Matagne A. Binding characteristics of brivaracetam, a selective, high affinity SV2A ligand in rat, mouse and human brain: relationship to anti-convulsant properties. Eur J Pharmacol. 2011;664(1-3):36–44.
  3. Data on file. UCB, Inc.
  4. Matagne A, Margineanu DG, Kenda B, Michel P, Klitgaard H. Anti-convulsive and anti-epileptic properties of brivaracetam (ucb 34714), a high-affinity ligand for synaptic vesicle protein, SV2A. Br J Pharmacol. 2008;154(8):1662-1671.
  5. Klitgaard H, Matagne A, Nicolas JM, et al. Brivaracetam: Rationale for discovery and preclinical profile of selective SV2A ligand for epilepsy treatment. Epilepsia. 2016;57(4):538-548.
  6. Noyer M, Gillard M, Matagne A, Hénichart J-P, Wülfert E. The novel antiepileptic drug levetiracetam (ucb L059) appears to act via a specific binding site in CNS membranes. Eur J Pharmacol. 1995;286;137-146.
  7. Yan HD, Ishihara K, Seki T, et al. Inhibitory effects of levetiracetam on the high-voltage-activated L-type Ca2+ channels in hippocampal CA3 neurons of spontaneously epileptic rat (SER). Brain Res Bull. 2013;90:142-148.
  8. Niespodziany I, Klitgaard H, Margineanu DG. Levetiracetam inhibits the high-voltage-activated Ca(2+) current in pyramidal neurons of rat hippocampal slices. Neurosci Lett. 2001;306(1-2):5-8.
  9. Lukyanetz EA, Shkryl VM, Kostyuk PG. Selective blockade of N-type calcium channels by levetiracetam. Epilepsia. 2002;43(1):9-18.
  10. Carunchio I, Pieri M, Ciotti MT, Albo F, Zona C. Modulation of AMPA receptors in cultured cortical neurons induced by the antiepileptic drug levetiracetam. Epilepsia. 2007;48(4):654-662.
  11. Rigo JM, Nguyen L, Hans G, et al. UCB 34714: effect on inhibitory and excitatory neurotransmission. Epilepsia. 2004;45(3):56.
  12. PARx Solutions, Inc., November 2017.
  13. CoverMyMeds, LLC, December 2017.
  14. CoverMyMeds. CoverMyMeds website: https://www.covermymeds.com/main/. Accessed October 9, 2017.