Why does medical Botox cost more than cosmetic Botox?

Question

I have Botox injections for a hemifacial spasm. My insurance no longer pays for the Botox so I began asking questions. Apparently, Botox can only be supplied for medical applications in 100 unit vials. My doctor uses less than 30 units, but I pay for 100 and the rest is disposed of. Why can smaller vials (50 units) be supplied for cosmetic procedures only? Do any neurologists charge per unit? Maybe insurance paid procedures are not questioned?

Jean M. Casello, MD · Answer

This is a very good question. Both of the products are exactly the same. However they are packaged differently. Tpically medical botox comes in vials of 200units and cosmetic botox is usally in 50-100 units. There are two divisions of the company that sell the product for it's intended use.. You can not purchase "medical" botox if you are using it for a cosmetic indication.  These rules come from the FDA and insurance companies pay based on what it is being used for. Hope this helps.

Alix J. Charles, MD · Answer

Thank you for your question.  There may be a few different reasons for this.  Technically, the package insert for Botox states the bottles are for single patient use only, and once re-constituted it must be used within 48 hours.  Almost no physician follows this in practice because it has been shown to not be relevant.  If your doctor contaminates the Botox vial with a needle that was already used on you, then they cannot use that vial for any other patient and must throw away the unused portion.  Lastly, if your doctor can't use a full vial of reconstituted Botox before it expires, then they will most likely charge you for the entire vial.  I suggest you talk to your doctor about all of this and see if you can't figure out a work around.  Either that or fight your insurance company to get coverage!  Best of luck to you.

Douglas Taranow, DO, FACOS · Answer

The two Botox are identical.  Botox is available in 50 unit vials as well.  You could ask your physician to use the standard 30 'medically indicated' units you are used to and then use the 20 remaining for cosmetic issues (if you are already paying for it).Best of luck

Melvin Elson, MD · Answer

The only difference between the 2 is the label on the box--they are exactly the same.  Any doctor can get 50, 100 or 200 units. What you are finding out is that insurance companies are not in business to help you but to make money. For medical issues treated with Botox fight them!

Why does medical Botox cost more than cosmetic Botox?

Answers (4)

Answer: Cosmetic and medical Botox

Answer: Cosmetic and medical Botox

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Why does medical Botox cost more than cosmetic Botox?

Answers (4)

Answer: Cosmetic and medical Botox

Answer: Cosmetic and medical Botox

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.