Reloxin: New Tox on the Block

Jennifer, a 49-year-old teacher from Chicago, sticks to a tight budget on purses and shoes -- but not Botox.

"It's a choice," explained Jennifer, who requested that her last name not be used to preserve her privacy.

She has viewed the wrinkle-busting jabs as a worthwhile splurge for nearly seven years, receiving injections every four months.

But it is an expensive choice. Botox -- the brand name for Allergan Inc.'s formulation of botulinum toxin type A -- is pricey for patients, in large part because physicians pay more than $500 to obtain a single vial of the popular drug. One vial may be barely enough to treat the facial lines of two patients.

And even as the popularity of the injectable cosmetic procedure has increased -- with the American Society for Aesthetic Plastic Surgery estimating that 2.46 million procedures were carried out in the United States last year -- so have the costs.

So when news of Reloxin, a possible rival to Botox, surfaced last week, some surmised that the newcomer may challenge its more established predecessor with a lower price tag and similar results.

Reloxin, which is now used for cosmetic purposes in about two dozen countries, would first require approval from the Food and Drug Administration, which could render a decision as soon as the second half of this year.

Jennifer's plastic surgeon, Dr. Otto Placik, said that if this approval comes to pass, its lower price point could be attractive to patients and doctors alike.

"There is antipathy toward Allergan from the physician's standpoint," Placik said. "Allergan has taken advantage of their monopoly. Botox has gone up in price every year, [which in turn] has decreased physician profit margin."

But though Reloxin contains the same active ingredient as Botox, studies have already revealed that the drugs act in subtly different ways.

"[Reloxin] disperses a little more beyond the area of injection than Botox does," noted Dr. Robert Singer, chairman of the nonsurgical procedures committee of the American Society for Aesthetic Plastic Surgery. "Because it disperses more, there has to be a greater knowledge on the part of the individual doing the injecting to avoid problems like eyelid drooping, brow drooping and other complications."

Cost of Botox May Be Big Factor, Doctors Say

And since research has shown that Reloxin is between a fifth and a third the strength of Botox, physicians who opt to use it may find themselves facing a learning curve when it comes to using the new offering.

"The dosages may not be exactly equivalent, so it might not be as straightforward as it seems," said Dr. John Canady, president of the American Society of Plastic Surgeons.

Still, for the patients who in many cases shell out several hundred dollars per treatment, cost may be a primary concern.

Dr. Brian Lester, a dermatologist in Brookline, Mass., who uses Botox in his practice regularly and has had more than five years of experience with the product, said that he felt that lower costs could be a big selling point -- particularly since the cost to physicians has risen about 20 percent to 25 percent over the last three to four years.

"I think, especially for new patients, some of that business will be moved over to this new product," he said. "I think that more competition could be good for the marketplace in terms of driving the costs down for wrinkle treatments."

Canady agreed.

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