Neuromodulator Market Trends: New Toxins, Pricing, and Practice Strategy

Dr Sue Ellen Cox discusses how clinicians can navigate the rapidly expanding neuromodulator market by balancing scientific differentiation, duration of effect, pricing, loyalty programs, and patient preference. Learn how newer toxins may reshape aesthetic practice economics, why commoditization remains a concern, and how physician expertise and consistent outcomes continue to drive patient trust and treatment success.

Transcript

Hi, I'm Dr Sue Ellen Cox. I'm medical director of Aesthetic Solutions, which is in Chapel Hill, North Carolina, and I'm a board-certified dermatologist, past president of the American Society for Dermatologic Surgery a few years ago. 

As the neuromodulator market becomes increasingly saturated, what factors should clinicians prioritize when choosing which toxins to carry?

Dr Cox: I think the most important factor for physicians to assess is really the science behind the product. And with all things the same, if the science is great, then other factors come into play. But these products really are different. We have products that are short-acting, like BoNT/E, which take effect within 4 hours and last for about 2 weeks to a month. We have relabotulinumtoxin, which is a new liquid toxin that is by Galderma, and that one has a median of 9 months duration. So 50% of the patients may last 9 months, 50% may not, but that's certainly longer than the other products that we have on the market currently. There's another product that is coming to market, or actually under investigation right now, early investigation, so it probably won't come to market for a while. It's a product by Ipsen, and that has a combination of serotype A and B together. And so these all are differentiating scientific factors, and I think the physicians really have to look at that, look at the field of effect versus the precision of the molecule when injecting it. And these are determining factors in how we're going to use our products in our daily practices. 

How do non-clinical factors—like pricing, loyalty programs, and brand recognition—compare to clinical performance in shaping real-world practice decisions?

Dr Cox: The non-clinical factors I think are very important. I think price obviously is one. What does the practice have to pay for the product that they're going to use? Again, if the price is less for the physician, then maybe they're going to use that product more frequently than taking another product that may be fairly equivalent but be more expensive. I mean, that just makes sense. Your relationship with your rep is going to make a difference. Some patients will have had experience with one product and they may say, I really only want that product. Or maybe they've had experience with a product and say, I don't want that one. I want something else. So then it would be important for a practice to have more than one product to be able to offer the patient. Training for the physician. Physician, when they're training in residency, they may have been trained by one company and only have comfort with using the product of that company. So those are soft factors that are going to come into play when choosing a product. 

With more products entering the market, do you expect neuromodulators to become commoditized, and how might that impact patient care and practice economics?

Dr Cox: Well, I certainly hope that commoditization doesn't happen because that's a race to the bottom. We've all seen things kind of go down in price, down in price, and down in price. And then after a while, it makes no sense. for reputable physicians who spent their life training to be offering these things. So I think that what's going to be important is that physicians be very well trained, be able to deliver very good, predictable results, and keep the price at a price premium as opposed to commoditization where everything is brought to the bottom. So I think that's very important. You see med spas that kind of open. Like my patients have actually sometimes frequented them and they always come back. And I'm like, well, why did you come back? That was less expensive. And they say, well. you know, the provider changed and I got brow ptosis or, you know, they didn't inject me the same way that I had been injected before and it's a different person, different training, they might have taken a weekend course. So it's really important to have consistency to be a physician that has, you know, experience and knowledge and knows functional anatomy as opposed to just learning an anatomy from a book.