Botox is now an iconic brand of cosmetic product that is instantly recognizeable. Originally approved for use in 2002 to temporarily smooth frown lines between the eyebrows, it has grown in the past decade to be a near 2 billion dollar-a-year business. While there are numerous approved and off-label medical uses for Botox, the amount used for its pure cosmetic effects is reported to be about half of all its sales.
Botox is so well known and has such doctor and patient loyalty that it dominates the cosmetic toxin market reportedly accounting for 85% of all sales. Two other cosmetic neurotoxins are also available for clinical use, Dysport and Xeomin, but they have failed to make a significant dent into Botox’s dominance. This is because they do not provide any product improvements…they are not substantially different in effectiveness or duration and they are not significantly cheaper.
This may all change in the near future, however, as Johnson & Johnson has recently announced that they will seek FDA approval next year for an anti-wrinkle drug. They have developed a neurotoxin that is designed to be comparable to Botox in terms of effectiveness and safety. Clinical trials have been done and are ongoing but whether it will be ‘better’ than Botox is not clear. My suspicion is that it will be essentially the same as a botulinum toxin or some derivative as not yet been found that acts quicker, has a more profound effect or, most importantly, lasts longer.
But J & J has one advantage that Botox’s other competitiors don’t have. They are a 70 billion dollar giant with huge name recognition. They can put the muscle behind the marketing and have a sales force that can help drive the product into the marketplace. Through their more recently acquired Mentor subdivision, which is the largest manufacturer of breast implants, it can team up to offer incentives to both plastic surgeons and patients alike to use their product. This will likely allow them to leapfrog right past Dysport and Xeomin to be come the ssoft drink equivalent of Pepsi to Coke.
Plastic surgeons and patients alike love Botox and patients certainly yearn for it to last longer or cost less. While J & J’s yet unnamed neurotoxin probably won’t last longer or work any sooner after injection but the competition it brings may ultimately lead to some economic benefits for the consumer.
Dr. Barry Eppley
Indianapolis, Indiana