Great question! Unfortunately, the Code doesn't really cover examples like this, so we have to use our musical creativity to make things like this clear for the braille reader.
Without seeing the context in which this example lives, I would probably do something like what I've attached: I'd omit the brackets and transcribe only the music first. Then I would braille the individual intervals separately in a list format, followed by the "formula" printed below the music. You'll need to be sure it's clear which way your intervals are to be read (I'm assuming upwards since this is probably a theory book) and you'll need to let the reader know you've omitted the brackets in the music.
Take a look and see what you think. It could be a place to start and give you some other ideas!