Many make the mistake of classifying botox as a cosmeceutical. But the fact is, according to the company, that botox is a serious pharmaceutical product. Raju Nagi, Director, Sales, Botox India, chats with Nandini Patwardhan about botox
Why do you say that botox is not a cosmeceutical?
We cannot look at botox as a pure cosmeceutical in the sense that most cosmeceuticals would either be OTC products or would be products that patients can self administer. Botox is a very serious pharmaceutical product that needs to be administered by the trained physician. Indication wise, we are in the cosmetics market, but the cosmeceutical market per se is not the point we are not looking at that.
How is botox positioned in India?
At the moment, if you look at botox today worldwide, bulk of the business comes in from cosmeceutical applications. In India though, bulk of the market is actually from therapeutic indications. Therapeutic indications include movement disorders, spasticity (cerebral palsy in children is a big indication). Therefore, in India, at the moment, botox is like a speciality pharmaceutical product. As far as the cosmetic angle is concerned, that is taking care of the hyperkinetic lines (that is wrinkles for you and me), the market here is still in a nascent stage and we need to understand the insights better here.
How will you describe your consumer group in India?
Look at the typical Indian consumer vis-à-vis the typical European, or the American. In Europe and America, even the masses have caught on to botox, as sensitivity towards how you look is so important. That sensitivity is still not here. If you look at the markers from here, you will see that primarily the personal care category in the country is largely driven by bar soap sales, as compared to the developed part of the world, where hygiene sales are mainly driven by liquid soaps. Now these are pointing to the fact that issues that are mass issues in the West have still not caught on. Therefore, the issues like sensitivity about facial aesthetics are still in the nascent stage for us.
The main consumers for the cosmetics market in India would be SEC A+ consumers—people who are aware of the offerings, mostly celebrities who are involved with performing arts and who have to look good—or the SEC A+++ kind of consumers. These consumers will possibly have disposable incomes of US $25,000 and above, or an income of Rs 10 lakh and above, and who consult doctors for suggestions and advice on whether they should or should not use botox.
But for botox, the real market is people like you and me, and that would basically be the upper middle class. And the upper middle class is an area where one needs to tread carefully to ensure that the basics are addressed first. They are the guys, who are going to be more educated and who will have more questions, issues like perceptions, and misconceptions will come from this very consumer group. This is the real market we are working on.
What has driven acceptance of botox in the country?
Part of the acceptance comes from awareness. If awareness about the product is not there, then obviously, the way the product is going to be perceived will be different from what should be. And there will also be myths and misconceptions. So our focus is to spread awareness about the product and to ensure that these myths and misconceptions are dealt with. This is because in a product category like botox, which has to be administered by a trained doctor, there is a fear of negative publicity if the doctors are not trained well to administer the same. We also take a lot of care to ensure that the doctors who administer botox to the consumers get absolutely trained, as to how to use the product, which muscle groups to inject in? The last thing we want is doctors not being trained enough to administer the product, or they doing so in the wrong way.
How has it been for botox in India?
We received the first approval from the Drug Controller’s office for therapeutic indications in 1994 and for cosmetic indications (which is for facial lines), in 2006.
From 1994-2006, therapeutic indications were where the bulk of company effort was concentrated. We were working closely with neuro-physicians, because they were the key customers for botox for therapeutic indications. After receiving the approval for cosmetic indications in 2006, we actually started working on the cosmetic front and today we are working closely with doctors like dermatologists (cosmetic dermatologists), aesthetic plastic surgeons, in terms of teaching them basics of botox and primarily how botox has to be used, its advantages, benefits etc.
What about clinical trials for Botox?
Our approvals are based on the clinical trials that we have carried out, because botox is a special pharmaceutical product. We have multi-centre trials that go across various locations in the world simultaneously. These are exactly the same clinical trials as mandated by USFDA. At botox, research efforts are still going on, because when we talk of botox, we talk of a portfolio of products within one product. This is because the product can be used for something as normal as facial aesthetics, and also for something as serious as movement disorders and spasticity.