BOTOX & WRINKLES


Posted by Don Peaslee , Feb 23,2002,15:00   Archive
There have recently been a number of magazine and newspaper articles, as well as radio and television reports concerning the use of botulinum toxin as a form of temporary cosmetic surgery. To those of us with blepharospasm, Meige or other dystonias, using Botox for cosmetic surgery seems trivial since many of us rely on that same medication to keep our eyes open.

However, a historical perspective can put a different spin on how we look at this "problem". Dr. Alan Scott originally developed the method for using purified and diluted botulinum toxin to paralyze or relax individual muscles. His intent was to use it to straighten crossed eyes, but he quickly learned it showed more promise in treating blepharospasm. Since he is an ophthalmologist/scientist, not a manufacturer, he looked for a pharmaceutical company to manufacture and market the product. Allergan, one of the largest pharmaceutical houses specializing in ophthalmic drugs showed interest but was concerned that the small number of blepharospasm and other dystonia patients would not be sufficient to give them a profit as well as recover the million dollars that would be required to build a Botox manufacturing facility. Finally, they took the gamble, hoping that other uses for the medication would be discovered.

They established a price in the $300 per vial neighborhood which we patients thought was high, but Medicare and other insurers eventually agreed to this price level. Of course, the doctors can charge whatever they want for their expertise in administering the injections.

Eventually it was discovered that the injections around the eyes also removed the wrinkles in that area. Additional experimentation showed that wrinkles and creases elsewhere on the face would disappear for several months with properly placed injections. Almost overnight Allergan's prayers were answered and they had a use for Botox that quickly started to use five times the amount of the medicine that all the combined dystonia patients use.


What does this mean for blepharospasm/Meige patients? First, it means that other drug companies are going to try to compete. The first of these is Myobloc from Elan Pharmaceuticals. As we know, the more active the market, the more competition there is, and eventually prices are driven down. Second, it means that there will never again be a shortage of our medication. A few years ago, when Allergan was finishing one batch and going to start shipping from a new batch, they miscalculated the time and we experienced a few months when the medicine was not available and many of our patients were functionally blind. Third, the new publicity now lets the whole world know that Botox is not dangerous. Many patients used to refuse the shots, saying, "They're not going to put poison in my face!" Now that they see millions of people taking the injections with no ill effects they are more likely to try them.

The high cost of injections still bothers many of our patients, but an analysis of the cost of the botulinum toxin medication shows that the cost has risen at a slower rate than inflation. We can expect that cost to continue to decline as competition heats up. On the other hand, doctor charges vary widely. If you feel your doctor is charging too much, talk to him/her about it. If you are not satisfied, find another doctor.

There is another aspect to all the new publicity about botulinum toxin injections for cosmetic purposes: our patients have a new opportunity to write to all the newspapers, magazines, radio and TV stations and remind them that botulinum toxin was developed to keep us from being blind, and that there are still thousands of us who rely on it to see. There are still hundreds (perhaps, thousands) of blepharospasm patients who have not been diagnosed, so a mention of "eyelid spasms", "functional blindness", or the word, "blepharospasm", in a news article or radio report may lead to the discovery that an undiagnosed patient has been waiting for.

We blepharospasm patients don't have to be happy that drugs cost too much, but we certainly can be happy that there is a drug (or drugs) that help our condition. Pharmaceutical companies are not social service organizations. They are profit-making companies which charge "what the traffic will bear" for their products. If they cannot make sufficient profit for a product, they will discontinue it. In the case of Botox, we can be exceedingly thankful for its new popularity since it ensures a continued supply and eventually, lower prices.




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Re: BOTOX & WRINKLES

Re : BOTOX & WRINKLES --- Don Peaslee
Posted by Kelly Saffell , Feb 23,2002,19:11 Top of Thread Archive
While I am one of those hounding the media for attention, I agree with you completely that creating a new market will ensure that we get our medication! I remember when they ran out of BOTOX. I was at the doctor getting my injections and they were calling their patients for the rest of the week because I got the last vial. I was SOOOO grateful that I was not on the receiving end of that phone call.



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Re: BOTOX & WRINKLES

Re : BOTOX & WRINKLES --- Don Peaslee
Posted by Lyn Patterson , Feb 23,2002,19:53 Top of Thread Archive
Yes, you are quite right:pharmaceutical companies are not altruistic - the increased demand for the product may lead to lower prices and a certainty of supply.

They say any publicity is better than none - I am sure there are people out there who have BEB and don't know it - so the more we can highlight the legitimate medical uses of Botox whenever we get the opportunity following anti-wrinkle publicity, the more people will become aware of the different conditions out there and it may encourage them to seek treatment via their doctors.

As for the cost to the patient - search for a different doctor if you feel you are paying too much. I was out of pocket over $A50 every time until via the BB I realised I could search out and identify other doctors who use Botox - now I am out of pocket only a couple of dollars and have found a far superior doctor as well. Some doctors are just plain greedy.

Lyn




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Re: BOTOX & WRINKLES

Re : BOTOX & WRINKLES --- Don Peaslee
Posted by Joanne Matuzas , Feb 24,2002,00:53 Top of Thread Archive
Thanks, Don, for this informative post which helps put this whole Botox
and wrinkles versus medical need in great perspective. It has settled some of my annoyance about it and we all need to continue to voice our
thoughts and concerns to the appropriate people, companies, news reporters, etc. And, I must admit, the botox injections together
with its medical and lifesaving effect for me has helped me a bit
cosmetically as well. Did I dare say that??? :<)

Joanne M. San Diego, CA




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Re: BOTOX & WRINKLES

Re : BOTOX & WRINKLES --- Don Peaslee
Posted by June in Toronto (June Floyd,June in Toronto), Feb 24,2002,06:11 Top of Thread Archive
Thanks for writing that Don, we all needed to hear it. I'm so thankful for the botox treatment and know that the cosmetic use of botox will only increase its production. I will, however, continue to write to those that write/talk only about only its cosmetic use and encourage them to mention the medical use of botox.

June in Toronto (beb/meige)




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Re: BOTOX & WRINKLES

Re : BOTOX & WRINKLES --- Don Peaslee
Posted by Alan Phair , Feb 24,2002,08:54 Top of Thread Archive
Don, as usual you gave a great insite into the subject. I don't think that most of us have a problem with the use of the product for wrinkles as much as we do about the lack of information the newsmedia has when covering the use of Botox particularly for Blepharospasm//Meige. It is the referring of BEB as a facial twitch that demands we correct terminology that was used in dark ages. You are right in the positive aspects of it all in that it will make more people aware of our cause but only if we make them aware....Alan



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Re: BOTOX & WRINKLES

Re : Re: BOTOX & WRINKLES --- Alan Phair
Posted by Don Peaslee , Feb 24,2002,11:33 Top of Thread Archive
Hi, Alan,

I didn't get to read the Washington Post article, but from the descriptions of it I read on the BB it certainly must have been frustrating to have blepharospasm described as a "tic". There were certainly enough folks who were exercised about it and wrote, e-mailed or called the paper so they should notice. However, as you mentioned, they are unlikely to do much about it unless you can "get to" an editor with some authority who can make it happen. Good luck on your campaign.




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Re: BOTOX & WRINKLES/Don

Re : BOTOX & WRINKLES --- Don Peaslee
Posted by kathy , Feb 25,2002,09:59 Top of Thread Archive
Thank you for this very educated , well thought out, and easy to understand explanation.
kathy , whose left eye is still squeezing and will not let her be.



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