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When a business chooses to operate outside the law and with arrogant disregard for the health of its customers, those unethical choices will eventually catch up with the company. That’s what’s happening now with Allergan and its paralyzing cosmetic, Botox.

For years I’ve been writing about the dangers of Botox and the marketing practices of Allergan. A major lawsuit against the company has always seemed inevitable, so you can put this one in the “I Told You So” category.

Ever since Allergan realized that Botox could earn huge profits, the pharmaceutical giant has been using a business model that treats FDA regulations and patient safety as nothing but minor obstacles on its road to even bigger sales. Instead of following the rules and making patient safety its top priority, Allergan has done everything within its marketing power to get Botox into the hands of more doctors and into the veins of more seekers of that famous “Frozen Face” look, especially its target market of women 35-55 with incomes above $55,000.

The irony of this class action lawsuit is that, unlike many others filed against Allergan, it did not come from the FDA or from a Botox patient who experienced a personal injury or the family of a patient who suffered a wrongful death.

Instead, this lawsuit has come from Allergan’s own partners in the glorification of Botox. Dr. Ivan Goldsmith of Las Vegas, who is the lead plaintiff, and more than 100 other doctors have brought the suit. They charge that Allergan has been scamming them by promoting a business model that has only two possible outcomes for the doctors. Either they must break the law or they must lose money.

The basis of their lawsuit is that Allergan charged doctors more for a vial of Botox than they could possibly earn for treatments if they used the toxin in each vial for only one patient, which inconveniently happens to be what the law requires. In order to earn the huge profits that Allergan promised, the doctors would have to spread the contents of each vial among several patients, and that’s a violation of the most basic rules of hygiene, as well as the regulations that cover Botox.

But Allergan never lets little annoyances like laws, hygiene, and patient safety stand between it and its profits. The company has actually built its business by falsely marketing Botox for off-label uses. The only FDA-approved cosmetic use for Botox is the treatment of glabellar lines, which are the wrinkles between the eyebrows, but Allergan does everything possible to obscure that limitation. One Botox brochure proudly states that the product has “20 uses in 75 countries”.

A typical Botox treatment requires about 20 units of the neurotoxin, and the cost is between $300 and $500 per patient. However, the suit charges that the price of a vial of Botox ranges from $400 to more than $1000, which makes it tough to for a doctor to treat only one patient and turn a profit.

Originally, Allergan sold Botox only in 100-unit vials. In May 2008, Allergan introduced 50-unit vials, but they still contain 30 units more than a typical treatment requires. That means that the doctors either have to waste 30 units and lose money or use the contents of the vials on more than one patient and make money.

Allergan, of course, has always promoted the off-label, multi-patient, “Botox Party” approach, and has marketed it heavily and successfully. That system was working well for Dr. Goldsmith until another doctor pointed out to him that each Botox vial has a single use limit.

That bit of sad news was the beginning of this lawsuit, but don’t feel any sympathy for the doctors involved. They’re hardly innocent. By filing the lawsuit, they’ve admitted their own wrongdoing. They were treating patients with a Black Box drug even though they had not read the label, which states, “Botox is supplied in a single use vial.” Through their own negligent actions, the doctors were exposing their patients to HIV, Hepatitis B and Hepatitis C.

This is a lawsuit without any good guys. Allergan has made a practice of falsely marketing Botox and trying to cheat the doctors who are actually responsible for delivering it to the end users. That’s a bad business model.

Doctors who administer a potent drug without reading the label are putting their patients in grave danger. Together, Allergan and many doctors have made Botox treatment even riskier than it already is.

Anyone needing help for a Botox problem can talk to an experienced lawyer by contacting us. There is no charge. All work is performed on a contingency basis. If we don’t collect, you owe nothing. We never charge for taking a call or making one.


Richard Alexander