Surprise Hits: Botox gets injected into the market -- and faces stiff competition

Many years ago, a friend afflicted with blepharspasm (uncontrolled blinking) told me she was about to undergo a new treatment in which the toxin that caused botulism would be injected into the muscle of her eye. I was aghast but said nothing -- until a week later, when I met her again, and her incessant blinking had miraculously stopped, to her great relief.

That was my first encounter with Botox, a drug that has become an accepted standard for facial cosmetic improvement, and something of a whipping boy for our beauty- and youth-obsessed culture. Allergan (AGN) reported 2007 sales of $1.2 billion for its drug, most often used to erase wrinkles, frown lines, and crow's feet. Botox injections run $350 to $500 a pop, and its effect lasts from up to six months.

Allergan is about to get some competition. Paris-based companies Medicis Pharmaceutical (MRX) and Ipsen sell a similar drug, Dysport, in Europe, and are seeking FDA approval to market it here under the name Reloxin. The drug is expected to undercut Botox's price, as is Johnson & Johnson (JNJ), now working through clinical trials to gain approval for its botulinum-based PurTox.

In a sense, these drugs offer a kinder, gentler plastic surgery. Botox and its rivals aren't surgical, permanent, or horribly expensive, and Botox has few documented side effects (other than occasional turtle mouth). In the end, it's not really much more self-indulgent than a good haircut or an expensive pair of shoes. It's even become a bit of a recession-era craze among some unemployed middle-aged execs who rely on its effects to improve a job search. Any realist knows you're much more likely to land a job when you look mahhhvelous.

Tom Barlow is a wrinkled writer who wonders if there is a relationship between the renewed popularity of zombie movies and the Botox craze.

Be sure to check out all 20 recent products that became Surprise Hits.

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