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In April, the FDA approved the usage of another cosmetic wrinkle remover, which like Botox Cosmetic®, is derived from botulinum toxin. To be marketed as Dysport by Medicis Pharmaceutical Corp., it will be a direct competitor to Botox Cosmetic® which is sold by Allergan Inc. It has been used with great success since 1991 in Europe where Botox Cosmetic® is also very popular.

Though derived from botulinum toxin, these two products are not identical and do have several differences which will be sorted out in the future with greater experience. Dysport has a more rapid onset of action, typically one to two days versus the three to five days seen with Botox Cosmetic®. It also has a greater spread for a more diffuse effect, requires fewer injection points and may last slightly longer than Botox Cosmetic®. However, it does have significantly more adverse side-effects. Botox Cosmetic®, though requiring more injection points, is far more precise, predictable and has a lower risk of adverse problems.

Dysport should be available for clinical use here within the next month or two. Pricing is not yet established but will likely undercut the cost of Botox Cosmetic® in order to acquire patients and market share. Its presence will be a win-win situation for patients, allowing for more than one treatment option as well as providing competition which may lead to more favorable pricing and incentives.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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