An evening organized by a pharmacist raises ethical questions for doctors

This month, the best-known plastic surgeons and cosmetic dermatologists met over a weekend at the Ritz-Carlton in Cancun, Mexico, to learn in detail an injection that promises to soften wrinkles, Jeuveau, put on sale last week. .

The manufacturer of Jeuveau, Evolus, presented the event as a meeting of the advisory council. However, it apparently also served as a luxurious launch party for Jeuveau, a product that the company hopes to compete against the Botox brand in a crowded market that also includes two other competitors.

More than a dozen reputed doctors have talked about the event on their social networks with enthusiasm – under the corporate label: #Newtox – without revealing that Evolus had taken charge of the costs of their trip. The Federal Trade Commission (FTC) is asking users to reveal their relationships with companies when promoting their products on social networks, become a powerful platform. The medical experts also mentioned that these tactics evoked a past era of pharmaceutical marketing in which everything was allowed and that the sector was largely abandoned after a series of scandals and billions of dollars in fines.

There were opportunities to socialize by the pool, free gifts and a seaside party, an environment that a plastic surgeon from Manhattan described to his 187,000 faithful as "all that the Fyre Fest should have been".

"Life here is made of BUTTERFLY", published for 74,000 followers, Melanie Petro, a plastic surgeon from Alabama, accompanied by a photo of her posing on a podium with the logo of butterfly Evolus.

Manhattan plastic surgeon, Lara Devgan, has written to her worshipers from the pool overlooking the Ritz-Carlton Sea. "Here, make good waves with Newtox," he said.

Bonnie Patten, executive director of Truth in Advertising, a non-profit monitoring group, said the FTC rules most likely required disclosure of theft payment or hotel stays in network publications. . social that promotes a product. A spokesman for the FTC said the commission did not usually comment on some cases.

"This is extremely problematic because, in general, it is considered that health professionals are very reliable people," said Patten. "The same goes for their followers, who are turning to them to be experts in their field."

In an interview, Devgan said it was common for pharmaceutical companies to cover their expenses at medical conferences and that he did not think it was necessary to reveal this information. He indicated that he would not give preference to Jeuveau over his competitors and said that he said so much in his video. "I'm trying to be very neutral with my presence in social networks and traditional media," he said.

Petro said that he had gone to Cancun to learn more about the product and that he had come back very impressed. He said that he was not thinking of giving Jeuveau a promotion, but that he would consider telling his supporters that Evolus paid for his trip. "I would never want to be dishonest with them," he said.

David Moatazedi, executive director of Evolus, said the event in Cancún was a standard meeting of the advisory board, similar to that organized by competing companies, and that doctors did not receive any payment nor any incentive to promote society. The company also noted that doctors sometimes used the labels of products of other manufacturers in their publications, such as #Botox.

However, Moatazedi admitted that the company offered doctors something he called "special moments for social networking", such as the Evolus-themed podium or confetti launching station.

"We wanted the breaks at this meeting to be equally productive for the doctors, and many of them want to inform their patients about new technologies," Moatazedi said.

Evolus sold its unconventional approach to Wall Street investors as a way of distinguishing its product from Allergan's Botox, which dominates 70% of the market for injections for wrinkle mitigation, worth more than $ 1,000 million. dollars. Jeuveau, approved in February by the Food and Drug Administration (FDA), is the only Evolus product.

The company is now turning to the millennial generation of selfies – which is increasingly interested in aesthetic processes – with brightly colored advertising and a social media campaign rich in emoticons. Moatazedi told Wall Street badysts that they should consider Evolus a "high-performance beauty" company rather than a traditional pharmaceutical company.

Last November, Moatazedi told investors that his company was not obliged to report payments to physicians in the corresponding federal database under the Transparency Act, as Evolus did not sell any products repaid by government programs such as Medicare. or Medicaid.

"This means that sales representatives and managers can interact very closely with customers and perform these activities outside of their traditional work hours," Moatazedi told Wall Street badysts at a results report, last November.

"They do not hide anything and do not try to go against the law," said Michael Moretti, executive director of Medical Insight, a market research firm in the industry. of beauty. "They are just marketing as they can, and their competition is not."

Others felt that the company and the doctors treated the product too informally, especially since it was an FDA-approved drug with a serious warning box. Like Botox, Jeuveau is a form of botulinum toxin that, once injected, can spread to other parts of the body, which can lead to difficulty swallowing and breathing in atypical cases.

Pharmaceutical companies pay doctors to attend advisory committee meetings and cover catering services during educational events, but their practices are much more limited than before, several companies have paid billions of dollars in fines for having been accused of having marketed their products inappropriately.

Today, most companies declare to adhere to the code of the industry that prohibits the organization of extravagant trips, "entertainment or entertainment" and the distribution of gifts for personal use. Any food service offered must be "modest".

During the weekend in Cancun, doctors published photographs of personalized items with the Evolus logo they gave them, including sandals, beach towels and water bottles.

Doctors who attended the event said that the company's marketing strategy would not affect their medical decisions and that they had been invited to a weekend work to provide their expert advice.

"I use my knowledge and experience to research and evaluate a product to determine if I can use it in my practice," said Christopher Zoumalan, a Beverly Hills plastic surgeon who published related content at the event for its 21,500 members. followers on Instagram. "It has nothing to do with the company inviting me to dine in Cancun or anywhere else."

Evolus said that he did not consider that it violated the rules of the FTC and that doctors were only compensated for his specialized medical advice.

Moatazedi said that the whole of Jeuveau's advocacy work included the right balance of risks and benefits, and said that the terms "happy toxin" were not part of Evolus' marketing strategies. "It's probably something that doctors do themselves," he concluded.