Botox vs. Dysport in Santa Barbara

Until recently, Botox has been the only game in town for softening the muscle action of facial muscle muscles to effect an improvement in facial lines and wrinkles.  This of course, is the primary cosmetic use of Botox, and there are many non-cosmetic uses of the Botox as well.  Dysport is now on the scene, also a botulinum toxin type A, but has some differences.  Comparing the recommended dose ratios of Dysport to Botox, it takes about 2.5 times the amount of Dysport as compared to Botox.  Although not dramatic, it seems Botox has an edge with more prolonged effect and higher levels of patient satisfaction.  Perhaps Dysport takes effect a little quicker.

But why bother with Dysport when we have Botox - a product that has one of the highest levels of patient satisfaction of anything we do in our practice?  I had the same question.  (I am not currently injecting Dysport in Santa Barbara, but may, if my patients express interest.  So far, they have not).  Apparently, the cost to achieve a similar effect with Botox is very similar.  Over the last few years, hearing about the coming of Dysport (it's been around for a long time, but like everything it takes many years and dollars to gain FDA approval), I was welcoming something to compete with Botox to help drive my costs, and my patients' costs, down.  Apparently that's not happening, like it has happened in the competition space of fillers: Juvederm-Restylane-Radiesse.  Why?

Well, I don't know the answer to that, and if I find out I will update this post.  But I'm guessing it has something to do with the fact that for Botox (and I bet Dysport too), more Botox is sold for non-cosmetic purposes than cosmetic, and is covered by insurance for these uses.  Because charging less to the cosmetic surgeon for a vial of Botox than to Medicare for the same vial would get Allergan (the maker of Botox) in trouble, it is to Allergan's Benefit to keep the price high.  I bet the maker of Dysport (Ipsen Ltd.) is thinking along the same lines.  I'm not saying that the two manufacturers are fixing the costs though...hmmmm.

Anyway, I say if it ain't broke don't fix it.  Botox ain't broke.

Douglas J. Mackenzie, M.D., F.A.C.S.
Santa Barbara, CA