Reloxin: New Tox on the Block

"Patients who have to stretch to afford Botox will gravitate to what everyone thinks will be a lower price point for Reloxin," he said.

Allergan, however, does not look ready to budge when it comes to the price of its product.

"Entering into price wars in not something that we engage in," said Allergan spokeswoman Caroline Van Hove, who added that the costs of Botox are justified by the level of research that goes into the development of the product. "For us, it's about quality."

Medicis, the company which would market Reloxin in the United States if it is approved, offered comment on neither their product's price, nor its quality.

"Our legal team has advised us that it is inappropriate to answer any kind of media questions at this time," said Yvonne Klaerner, a spokeswoman for Medicis Pharmaceutical Corp.

The Learning Curve of Cosmetic Procedures

Lester, however, said that he would find it hard to justify switching his patients to Reloxin even if the results were similar but if savings were not involved.

"If it works the same but does not come at any discount, I don't see why we would switch our patients over. It would have to work well, but save patients money."

But those affiliated with Allergan pointed to differences other than cost that they said must be considered.

Dr. Mitchell Brin, chief scientific officer for Botox, said one of the main considerations when it comes to the potential newcomer is how it spreads, or diffuses, once it is injected. Past research on Reloxin has shown that the botulinum toxin in Reloxin tends to spread further with each jab when compared with Botox.

"The injection sites with [Reloxin] are actually different than those of Botox," he said. "When you use a new product, it's like learning a new language."

He said that because of this, the skills that doctors have developed over the years when using Botox would not necessarily translate to Reloxin -- and could even lead to unwanted side effects.

"When treating someone to get an aesthetic result, you want to put it where you want it and have it stay there," he said. "If it can spread to nearby muscles, it may have the [effect] of relaxing muscles you did not want to relax."

Brin said that if the botulinum toxin were to spread too far above the injection site, it could cause the brow to droop. If it were to drift too far below the site of injection, the eyelid could droop.

Singer, however, said that he did not predict that many of these mistakes would occur should Reloxin be approved.

"In the proper hands, I don't think you will see many of [these cases]," he said. "You might see effects like that with Reloxin with someone who has used Botox but does not have the appropriate knowledge about Reloxin. In time, it will even out."

And Canady said that professional organizations would likely step in to help educate member physicians on proper technique.

"[ASPS] will take the lead in education and making sure our members understand the differences," he said.

Will Patients Make a Switch from Botox?

Lester agreed, noting that he is confident that if, indeed, Reloxin wins approval, doctors will quickly learn how to use it safely and effectively.

"I think that at the end of the day, [clinicians] will get insight and knowledge about the product as it comes into use in the U.S."

However, since Botox works well, physicians may initially stick to what they know.

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