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Botox

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When the FDA (Food and Drug Administration) approved Botox for cosmetic use in 2002, it helped launch a cultural phenomenon that included Botox parties, Botox gift cards and Botox humor.

Botox, scientifically referred to as botulin, is an injectable muscle relaxant that smoothes foreheads and crows feet, and is the top non-surgical procedure performed worldwide, with more than 3.1 million performed in 2011, according to the International Society of Aesthetic Plastic Surgeons.

Homer's BotoxBotox humor has become part of our entertainment landscape, as this Homer Simpson cartoon shows.

The company that markets Botox, Irvine, Calif.-based Allergan, is the current market leader. But Botox’ market success has attracted much competition. There at least seven competing botulin products but none can yet match Botox in sheer market awareness.

  • Treatable areas – Botox is only FDA approved to treat the “11s” – lines that form between your brows. Off-label it is also used to treat horizontal forehead lines, crows feet and the tiny “bunny lines” on each side of the nose, plus Botox can give a gentle lift to the brows. The three most common areas typically treated include crow’s feet, forehead and the lines in-between the brows, also called the glabella.
  • Units – Allergan sells Botox in units of 50, 100 and 200 vial bottles, so most doctors charge by the unit. Crows feet around the eyes take anywhere from two to 24 units, with a median of 14. Forehead lines reportedly take anywhere from eight to 20 units, with a median of 17. The glabella ranges from 16 to 35, with a median of 26. Bunny lines from four to 10 units, with a median of 7.
  • Pricing – Most providers charge between $10-16 per unit of Botox, with the U.S. average being $13 per unit, depending on where you live. Some doctors charge by the “area” but this pricing tactic should be avoided at all cost, no pun intended. Prices by unit are more easily compared. As a reference, Beverly Hills plastic surgeons have advertised Botox specials as low as $450 for three areas. In 2005, the national average cost of a Botox injection was around $375 per area injected.
  • Crows feet pricing – Based on the above unit and pricing scenario, a botox treatment for crows feet should cost about $182 on average, a forehead treatment $221 on average, glabella $299 and bunny treatment $91. All four areas would add up to about $800 on average, again depending on where you live.
  • Competition – Allergan’s closest competitor in the botulin field is Medicis Pharmaceutical’s Reloxin, known in the U.S. as Dysport. Xeomin, from Germany-based Merz Pharma, claims to be “free of complexing proteins,” eliminating, for example, the need for cool storage. Mentor Corporation is developing Purtox, a “highly purified” botulinum toxin product, which is in Phase III clinical trials in the U.S.

The popularity of Botox has resulted in nearly $2 billion in sales for maker Allergan in 2013, up from just $300 million in 2012. Not bad for a drug derived from a deadly poison.

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