Reloxin: New Tox on the Block

March 23, 2009— -- 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."