Helping Your Patients Find Briviact: A Practical Guide for Providers

As a prescriber, you know that writing the prescription is only half the battle. For patients on Briviact (Brivaracetam), actually filling that prescription can be surprisingly difficult. Despite no formal shortage, many patients report being turned away from pharmacies that don't stock this specialty antiepileptic drug.

This guide provides actionable steps your practice can take to help patients access Briviact consistently, reduce callbacks, and maintain seizure control.

Current Availability Landscape

Briviact is manufactured by UCB, Inc. and remains in active production. It is not on any FDA or ASHP shortage list as of 2026. However, availability at the retail pharmacy level is inconsistent:

• Large chain pharmacies: Many CVS, Walgreens, and Rite Aid locations do not routinely stock Briviact. They can order it, but this may take 1-3 business days.
• Independent pharmacies: More likely to accommodate special orders and may already stock it if they serve neurology patients.
• Specialty/mail-order pharmacies: Most reliable source for consistent access, especially for 90-day supplies.
• Generic Brivaracetam: FDA-approved from multiple manufacturers (Aurobindo, Lupin, MSN, Sunshine, Zydus), but retail distribution is still maturing.

Why Patients Can't Find It

Understanding the root causes helps you advise patients more effectively:

1. Low per-pharmacy demand: Most pharmacies serve only a handful of Briviact patients (if any), making routine stocking impractical.
2. High inventory cost: At approximately $1,511/month list price, pharmacies are reluctant to stock a medication that may sit on the shelf.
3. Insurance friction: Prior authorization delays and step therapy requirements mean prescriptions may sit unfilled, further discouraging pharmacies from stocking it.
4. Generic transition period: As the market shifts from brand to generic, both may be inconsistently available during the transition.

What Providers Can Do: 5 Practical Steps

Step 1: Check Availability Before the Patient Leaves

Use Medfinder for Providers to check which pharmacies near the patient's home or workplace currently have Briviact in stock. Sharing this information at the point of prescribing dramatically reduces the chance of a failed fill.

Consider bookmarking Medfinder on clinic workstations so staff can check availability quickly during the prescribing process.

Step 2: Submit Prior Authorization Proactively

Don't wait for the pharmacy to trigger a PA rejection. If you know the patient's plan requires prior authorization for Briviact:

• Submit the PA at the time of prescribing
• Document Levetiracetam intolerance or inadequate response specifically (this is the most common step therapy requirement)
• Include relevant details: behavioral side effects, seizure breakthrough on alternative AEDs, clinical rationale
• Use UCBCares PA support services if needed: 833-948-2394

Step 3: Recommend Specific Pharmacies

Build a list of pharmacies in your area that reliably stock Briviact or can order it quickly. Recommendations to share with patients:

• Independent pharmacies with neurology patient populations
• Hospital outpatient pharmacies affiliated with your practice
• Mail-order pharmacy options through the patient's insurance plan
• Specialty pharmacies that focus on neurological medications

Having a "pharmacy shortlist" in your EHR or office reference saves time and reduces patient frustration.

Step 4: Enroll Patients in Savings Programs

Cost is a significant barrier to access. Proactively connecting patients with financial assistance improves adherence:

• UCB Savings Card: Commercially insured patients pay as little as $10/month. Enroll at briviact.com/savings
• UCBCares Patient Assistance: Free medication for qualifying uninsured/underinsured patients. Call (844) 599-2273
• Generic option: When available at the pharmacy, generic Brivaracetam can significantly reduce costs

For a complete financial resource guide, see how to help patients save money on Briviact.

Step 5: Have a Backup Plan

For patients at high risk of treatment gaps, document a contingency plan in the chart:

• Identify 2-3 pharmacies confirmed to stock Briviact
• Maintain bridge samples when available from UCB
• Pre-authorize a clinically appropriate alternative AED (e.g., Levetiracetam, Lacosamide) in case of emergency
• Provide the patient with clear instructions on what to do if they can't fill their prescription

Alternative Medications to Consider

When access issues become persistent or cost-prohibitive, clinically appropriate alternatives include:

• Levetiracetam (Keppra): Most closely related to Briviact (same SV2A target). Widely available generic, ~$15-30/month. Consider if the patient tolerated it previously; avoid if switched due to behavioral side effects.
• Lacosamide (Vimpat): Sodium channel mechanism, generally well-tolerated. Available in oral and IV formulations. Monitor PR interval. Cost: ~$500-900/month brand, less for generic.
• Cenobamate (Xcopri): Strong efficacy for focal seizures, but requires very slow titration. Best for stable outpatient transitions, not urgent switches.
• Perampanel (Fycompa): AMPA receptor antagonist, once-daily dosing. Monitor for behavioral effects. Schedule III.

See our patient-facing article on alternatives to Briviact for information you can share with patients.

Workflow Tips for Your Practice

Integrating Briviact access into your clinic workflow reduces friction for both staff and patients:

• Flag Briviact patients in your EHR: Add an alert or tag so staff can proactively check availability and PA status before the patient's appointment.
• Designate a pharmacy liaison: Have one staff member become the go-to person for specialty medication access issues. They can build relationships with local pharmacies and learn the PA process.
• Provide written instructions: Give patients a printed handout with pharmacy recommendations, UCBCares contact information, and Medfinder as a self-service tool.
• Follow up after new prescriptions: A quick call or message 3-5 days after prescribing to confirm the patient successfully filled the prescription can catch access problems early.
• Track refill patterns: If multiple patients report difficulty at the same pharmacy, consider reaching out to that pharmacy's manager to discuss stocking.

Final Thoughts

Briviact access challenges are real, but they are solvable with proactive practice workflows. By checking availability at the point of prescribing, submitting PAs early, directing patients to reliable pharmacies, and leveraging financial assistance programs, you can significantly reduce treatment gaps and improve outcomes for your epilepsy patients.

Medfinder for Providers is a free tool that can help your practice stay ahead of availability issues. For the broader clinical and market context, see our companion article: Briviact shortage: what providers need to know in 2026.