There’s a #NEWTOX in Town!

Move over BOTOX®, ® yet another botulinum toxin hit the US market with FDA approval for cosmetic use, and patient satisfaction with Jeuveau ® has been high.

How is Jeuveau ® different from other neurotoxins?

Jeuveau ® was FDA approved in February and released by Evolus in May. Neurotoxin treatments are the single most popular cosmetic procedure in the U.S. and work by temporarily blocking nerve impulses to muscles that are responsible for some of our facial expressions. BOTOX® ®cosmetic, Dysport ®, Xeomin® ® and Jeuveau ® all contain the same active ingredient: botulinum toxin type A. There are subtle differences in formulation which may affect spread, dose used and/or time of onset.  The very small doses used for facial cosmetic injections have little if any potential to produce negative effects elsewhere in the body, and all of them share this safety level.

Is Jeuveau ® “cheaper”?

Many articles that were written in various news outlets commented that Jeuveau ® would be “cheaper” than BOTOX® ® Cosmetic, and suggested a possible lower price to consumers as a reason some might switch brands. The fact is, the other three neurotoxins are all less expensive than the Allergan brand, the price of which has risen steadily over the years despite competitors entering the market. That price difference, though, when spread over a 100 unit vial, is about $1 less per unit. So, don’t expect a marked price differential.

The three main areas for facial cosmetic injection are the forehead, the region between the brows and the eyes -the “crow’s feet”. Depending on number of areas and dose, typical treatments cost $250 to $650. The injection is repeated every 3 to 4 months for most, though some are able to go 5 to 6 months.

What about “BOTOX® Parties”?

“BOTOX® Party” refers to a social event often conducted in a private home or a salon, where an injector agrees to provide botulinum toxin for a group discount. The American Academy of Dermatology and the American Society of Aesthetic Plastic Surgery have both issued warnings against this practice as they have concerns about the ability of the injector to provide a safe and sterile environment in such situations. Often the injector is less experienced and may not even have regular office hours established somewhere so that a patient with an issue can be seen if there is a question or need for adjustment of the treatment after the fact. We quite often hear from clients who attend such events that their injection “didn’t work” or “didn’t last”. We can only suspect that this was due to insufficient dose being delivered, which leads one to wonder if that “discount” was really a discount at all.

Buyer Beware

Today I saw on Groupon a “deal” for “60 to 120 units” of Dysport ® for $249, offered locally in southern New Hampshire. What they don’t tell you is that Dysport ® units are different than the unit of measure used for the other brands. As the approximate conversion is 3:1, 60 to 120 Dysport ® units would be about 20 to 40 units of one of the others. Problem: $249 is not enough to cover the cost the doctor pays to purchase 120 units of Dysport ®, so you can guess that no one will be getting that dose. And remember, the doctor is not getting the full $249 as Groupon takes out a hefty fee from the sale. This type of vague and deceptive marketing has made it more difficult for the consumer to evaluate options, which is unfortunate. There is no way for the consumer to know how many units is in the syringe.

On the Horizon

Revance Therapeutics continues trials on Daxibotulinumtoxin A for injection (RT002), which in two Phase 3 trials produced results lasting up to 6 months. It may hit the US market as soon as 2020. Of course, longer duration of action means that if you are not happy with the result it will take longer to wear off also. In the end, as with many things, consumers may need to experiment with more than one brand to determine if they have a preference for one over another. Most important is your relationship with your injector, not the brand of purified protein in the syringe.