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BRIVIACT® (brivaracetam) CV is a prescription medicine used to treat partial-onset seizures in people 1 month of age and older. It is not known if BRIVIACT is safe and effective in children younger than 1 month of age. 

Savings

Save on your prescription
Eligible patients may pay as little as $10 per 30-day supply of BRIVIACT*

Follow these easy steps to save on your BRIVIACT prescription:

BRIVIACT Patient Savings Card

BRIVIACT Patient Savings Card will expire at the end of the calendar year.

  • Check your eligibility
  • Register to activate your BRIVIACT Patient Savings Card
  • Present your card at the pharmacy to save on your prescription

SIGN UP FOR SAVINGS

Need a savings card? Answer a few questions to check your eligibility and register for a BRIVIACT Patient Savings Card. Please note: all savings cards expire at the end of the calendar year.

Check your eligibility

DID YOU RECEIVE A BRIVIACT SAVINGS CARD FROM YOUR HEALTHCARE PROFESSIONAL?

If you have a BRIVIACT Patient Savings Card that was issued this year, activate it here. Please note: all savings cards expire at the end of the calendar year.

ACTIVATE MY SAVINGS CARD

*See eligibility criteria and terms

Eligibility Criteria and Terms: This 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. Offer good only in the US, including Puerto Rico. This card may only be used with a valid BRIVIACT prescription consistent with the approved FDA labeling 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.

TO PATIENT: When you use this card, you are certifying that you meet the complete Eligibility Criteria and Terms and that you have not submitted, and will not submit, a claim for reimbursement under any federal, state or other governmental programs for this prescription. If you have any questions regarding the BRIVIACT Patient Savings Program or wish to discontinue your participation, please call 1-888-786-5879 (8:30 am – 5:30 pm ET, Monday – Friday and 8:30 am – 2 pm ET, Saturday).

TO PHARMACIST: Your acceptance of this card and your submission of claims for the BRIVIACT Patient Savings Program are subject to the Terms and Conditions established by OPUS Health. Submit the claim to the Primary Third-Party Payer first, then submit the balance due to OPUS Health as a Secondary Payer as a co-pay only billing using Other Coverage Code indication. You will receive the remaining balance, plus a handling fee, in your next reimbursement from OPUS Health.

BRIVIACT Patient Assistance Program

UCB, the maker of BRIVIACT, remains committed to helping epilepsy patients gain access to the medicines we manufacture. 

The BRIVIACT Patient Assistance Program may provide medication at no cost to eligible patients who are unable to pay for their BRIVIACT prescription.

To find out if you might be eligible for assistance, please call ucbCARES® at 833-948-2394 or email ucb-support@cardinalhealth.com.

Or, get started by checking your eligibility and submitting the application form online.


Program Instructions and Application Form

X

Looking for help getting UCB medications?

Ensuring that you have access to UCB medicines is our top priority. Click here if you are experiencing problems getting your prescription or contact our ucbCARES team at:

CALL

1-844-599-2273

EMAIL

UCBCares@ucb.com

UCB Cares

Offers a range of prescription support services for eligible patients enrolled in ucbCARES

Prescription
Coverage Support

Copay Card
Enrollment*

Local Pharmacy
Fulfillment

Bridge
Product

Additional
Assistance

Enrollment simply requires your doctor to send your electronic prescription for a UCB neurology medication to ucbCARES

What to expect as a patient (once your doctor enrolls you in ucbCARES):

ucbCARES will reach out to you shortly after your doctor enrolls you. You can expect a call from this phone number: 833-948-2394.

Once you provide your consent to receive support from ucbCARES, your insurance coverage will be assessed and prior authorization will be completed by your doctor (if required).

If your prescription insurance coverage is verified§, ucbCARES will contact you to confirm your pharmacy of choice for prescription fulfillment and pickup.

ucbCARES can also assist you with enrollment into UCB’s copay program, if you’re eligible.

ucbCARES will contact your doctor to have your prescription sent to your pharmacy of choice for pickup.

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.

*Additional resources will be discussed if coverage is unavailable or unverified.

Contact ucbCARES

CALL
833-948-2394
Monday-Friday, 9 AM to 6 PM ET

*

Savings cards are 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. Offer good only in the US, including Puerto Rico. Additional eligibility terms and restrictions apply.

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

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.

§

Additional resources will be discussed if coverage is unavailable or unverified.

Important Safety Information

What is BRIVIACT?

BRIVIACT® (brivaracetam) CV is a prescription medicine used to treat partial-onset seizures in people 1 month of age and older. It is not known if BRIVIACT is safe and effective in children younger than 1 month of age.

What is the most important information I should know about BRIVIACT?

BRIVIACT is a federally controlled substance (CV) because it can be abused or lead to dependence. Keep BRIVIACT in a safe place to prevent misuse and abuse. Selling or giving away BRIVIACT may harm others and is against the law.

Like other antiepileptic drugs, BRIVIACT may cause suicidal thoughts or actions in a very small number of people, about 1 in 500 people taking it.

Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you:

  • thoughts about suicide or dying
  • attempts to commit suicide
  • new or worse depression
  • new or worse anxiety
  • feeling agitated or restless
  • panic attacks
  • trouble sleeping (insomnia)
  • new or worse irritability
  • acting aggressive, feeling angry, or being violent
  • acting on dangerous impulses
  • an extreme increase in activity and talking (mania)
  • other unusual changes in behavior or mood

Do not stop BRIVIACT without first talking to a healthcare provider.

  • Stopping BRIVIACT suddenly can cause serious problems.
  • Stopping a seizure medicine suddenly can cause seizures that will not stop (status epilepticus).

Who should not take BRIVIACT?

Do not take BRIVIACT if you are allergic to brivaracetam or any of the ingredients in BRIVIACT.

What should I tell my healthcare provider before starting BRIVIACT?

Before taking BRIVIACT, tell your healthcare provider about all of your medical conditions, including if you:

  • have or had depression, mood problems, or suicidal thoughts or behavior.
  • have liver problems.
  • have abused or been dependent on prescription medicines, street drugs, or alcohol.
  • are pregnant or plan to become pregnant. It is not known if BRIVIACT will harm your unborn baby.
  • are breastfeeding or plan to breastfeed. It is not known if BRIVIACT passes into your breast milk.

What should I avoid while taking BRIVIACT?

Do not drive or operate machinery until you know how BRIVIACT affects you. BRIVIACT may cause drowsiness, tiredness, dizziness, and problems with your balance and coordination.

What are the possible side effects of BRIVIACT?

BRIVIACT may cause serious side effects, including:

  • See “What is the most important information I should know about BRIVIACT?”
  • Nervous system problems. Drowsiness, tiredness, and dizziness are common with BRIVIACT, but can be severe. See “What should I avoid while taking BRIVIACT?” BRIVIACT can also cause problems with balance and coordination.
  • Mental (psychiatric) symptoms. BRIVIACT can cause mood and behavior changes such as aggression, agitation, anger, anxiety, apathy, mood swings, depression, hostility, and irritability. Irritability and anxiety are common with BRIVIACT, and can be severe. People who take BRIVIACT can also get psychotic symptoms such as hallucinations (seeing or hearing things that are really not there), delusions (false or strange thoughts or beliefs), and unusual behavior.

The most common side effects of BRIVIACT in adults include:

  • sleepiness
  • dizziness
  • feeling tired
  • nausea and vomiting

Side effects of BRIVIACT in children 1 month to less than 16 years of age are similar to those seen in adults.

These are not all the possible side effects of BRIVIACT. For more information, ask your healthcare provider or pharmacist. Tell your healthcare provider about any side effect that bothers you or that does not go away. Call your doctor for medical advice about side effects. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. You may also report side effects to UCB, Inc. at ucbCARES (1-844-599-CARE [2273]).

Please see additional patient information in the Medication Guide. This information does not take the place of talking with your healthcare provider about your condition or your treatment. For more information, go to www.BRIVIACT.com or call 1-844-599-2273.

 

We recognize that coronavirus may be top of mind. Our focus, as always, is the health and safety of our patients. Now, more than ever, we recommend speaking with your specialist on specific questions you may have regarding treatment and overall health. You can also contact our ucbCARES® team for product-specific questions directly at 1-844-599-2273. Hours of operation continue as Monday-Thursday, 8 AM-8 PM ET and Friday, 8 AM-5 PM ET.