Briviact Availability in 2026: A Provider Briefing

Briviact (Brivaracetam), the SV2A ligand approved for partial-onset seizures, continues to present access challenges for patients despite the absence of a formal supply shortage. For neurologists, epileptologists, and primary care providers managing patients on Briviact, understanding the current landscape is critical to ensuring continuity of care.

This article provides an up-to-date clinical and logistical overview of Briviact availability, generic status, cost considerations, and tools to help your patients maintain uninterrupted treatment.

Current Status: No Formal Shortage, but Persistent Access Issues

As of early 2026, Briviact is not listed on the FDA Drug Shortages Database or the ASHP drug shortage list. Manufacturing by UCB, Inc. remains uninterrupted, and the drug continues to be distributed through standard pharmaceutical channels.

However, clinicians should be aware that many community pharmacies — particularly chain pharmacies — do not routinely stock Briviact. This creates a de facto access barrier for patients, especially those in rural areas or those newly prescribed the medication.

Timeline of Key Developments

• February 2016: FDA approval of Briviact for adjunctive treatment of partial-onset seizures in patients ≥16 years
• May 2018: Expanded indication to include monotherapy for partial-onset seizures in patients ≥16 years
• November 2021: Expanded indication to include adjunctive therapy in pediatric patients ≥1 month of age
• 2024-2025: FDA approval of generic Brivaracetam from multiple manufacturers (Aurobindo, Lupin, MSN, Sunshine, Zydus)
• 2026: Generic distribution ongoing but not yet widespread at retail pharmacy level

Prescribing Implications

The availability situation has several practical implications for prescribers:

Prior Authorization and Step Therapy

Most commercial and Medicare Part D plans place Briviact on a specialty or non-preferred tier. Common payer requirements include:

• Step therapy: Documentation of inadequate response to or intolerance of Levetiracetam (generic Keppra)
• Prior authorization: Clinical justification for Briviact over lower-cost alternatives
• Quantity limits: Some plans limit supply to 30 days per fill

When initiating Briviact, proactively submitting prior authorization can prevent dispensing delays. For patients transitioning from Levetiracetam due to behavioral adverse effects (irritability, aggression, mood disturbance), document these specifically in the PA request, as this is a well-recognized clinical rationale.

Generic Substitution Considerations

With generic Brivaracetam now FDA-approved, prescribers should be aware that:

• Pharmacies may automatically substitute the generic unless "Dispense as Written" (DAW) is specified
• For seizure medications, some patients and clinicians prefer to maintain brand consistency. The American Epilepsy Society has historically expressed caution regarding generic substitution of AEDs.
• If a patient is stable on brand-name Briviact, discuss the implications of generic substitution proactively

Dosing Reminders

For reference, the standard Briviact dosing protocol:

• Adults: Start at 50 mg twice daily (100 mg/day). Adjust based on response: range 50-200 mg/day.
• Hepatic impairment (all stages): Start at 25 mg twice daily (50 mg/day). Maximum 75 mg twice daily (150 mg/day).
• Concomitant Rifampin: Increase Briviact dose by up to 100% (double the dose)
• IV formulation: Available for temporary use when oral administration is not feasible (limit 4 consecutive days)

For a detailed clinical overview, see our article on Briviact uses and dosage, and for interaction specifics, see Briviact drug interactions.

The Availability Picture

Understanding where Briviact is and isn't available helps you guide patients effectively:

• Chain pharmacies (CVS, Walgreens, Rite Aid): Inconsistent stocking. Many locations do not carry Briviact unless a regular patient fills there.
• Independent pharmacies: Often more willing to special-order and tend to provide more personalized service for specialty medications.
• Specialty and mail-order pharmacies: Generally reliable sources. Many insurance plans offer mail-order options with 90-day supplies.
• Hospital and clinic pharmacies: Typically stock IV and oral formulations.

Cost and Access in 2026

The financial landscape for Briviact in 2026:

• Brand-name list price: Approximately $1,511 per month (UCB published WAC for 2026)
• Generic Brivaracetam: Pricing still evolving as distribution expands. Expected to be significantly below brand pricing.
• UCB Savings Card: Eligible commercially insured patients pay as little as $10/month. Not valid for government-insured patients.
• UCBCares Patient Assistance: Free medication for qualifying uninsured/underinsured patients. Contact: (844) 599-2273
• Discount cards (GoodRx, SingleCare): May reduce cash price for uninsured patients, though savings on brand-name Briviact are limited

For a comprehensive patient-facing cost guide, see how to save money on Briviact. For provider-specific financial guidance to share with patients, see our provider's guide to helping patients save on Briviact.

Tools and Resources for Your Practice

Several tools can streamline Briviact access for your patients:

Medfinder for Providers

Medfinder allows you and your staff to check real-time pharmacy availability for Briviact in your area. This can be integrated into your prescribing workflow to direct patients to pharmacies that have the medication in stock, reducing callbacks and patient frustration.

UCBCares Provider Portal

UCB offers provider-facing resources through UCBCares, including prior authorization support, samples, and patient assistance enrollment. Contact: 833-948-2394.

Clinical Alternatives

When Briviact is not accessible, clinically appropriate alternatives for partial-onset seizures include:

• Levetiracetam (Keppra): Same drug class (SV2A ligand), widely available generic, low cost. Consider behavioral side effect profile.
• Lacosamide (Vimpat): Sodium channel mechanism, well-tolerated, available in multiple formulations. Monitor PR interval.
• Cenobamate (Xcopri): Dual-mechanism AED with strong efficacy data. Requires slow titration. Consider for refractory patients.
• Perampanel (Fycompa): AMPA receptor antagonist, once-daily dosing. Schedule III; monitor for behavioral effects.

For patient-facing alternative information, see alternatives to Briviact.

Looking Ahead

The entry of multiple generic manufacturers into the Brivaracetam market is a positive development for access and affordability. As generic distribution matures through 2026 and beyond, we can expect:

• Broader retail pharmacy stocking as generic cost decreases
• Reduced prior authorization barriers as payers reclassify generic Brivaracetam to preferred tiers
• More competitive pricing across the market

In the interim, proactive prescribing practices — including early prior authorization, directing patients to stocking pharmacies, and leveraging patient assistance programs — remain the most effective strategies for ensuring continuity of care.

Final Thoughts

Briviact remains an important tool in the epilepsy treatment armamentarium, particularly for patients who have not tolerated Levetiracetam. While supply is adequate at the manufacturing level, real-world access challenges persist at the pharmacy level. By staying informed about availability, using tools like Medfinder for Providers, and proactively addressing insurance barriers, you can help your patients maintain uninterrupted seizure control.

For a step-by-step clinical workflow, see our companion article: How to help your patients find Briviact in stock.