Botox® is not the only botulinum toxin (BT), just the most expensive

Study shows the potential for more than $6 million savings if plans switch from high-cost Botox® to lower-cost BT therapies to treat certain neurologic conditions

Prime analyzed health care claims from 15 million commercially insured members and found 58,000 BT claims totaling more than $76 million in 2018 (Migraine treatments accounted for 60 percent of the Botox spend). Besides migraines, the BT drug class treats three movement disorders – cervical dystonia (CD), limb spasticity (LS) and blepharospasm (BS). Botox has the highest cost of four drugs in the BT class, and accounted for 93 percent of BT spend. Other drugs in the BT drug class (like Abobotulinumtoxin A and Incobotulinumtoxin A) are priced between one-quarter and one-third less than Botox.

Prime’s ability to study medical claims found that shifting treatments from Botox to the equally effective, lower cost BT therapies would save an estimated $6.3 million annually. Because BT is administered in the doctor’s office, the study evaluated and found the timing of doses was not different between the BT products. Therefore, the number of expected administration visits would not increase if switching to a different BT product.