The membership model for beauty services have caught on with salons and spas for a few years now. They offer members savings on services they get frequently, and ensure regular business for the provider. Win win. These loyalty programs are now making their way into the aesthetic space. In September, Allergan, the manufacturer of the neuromodulator Botox and the dermal filler Juvéderm, revamped their long-standing points-based rewards program, Allē. Instead of redeeming points for a cash discount, patients can now redeem them for specific Allergan products and treatments. On Nov. 4, Evolus, the makers of Jeuveau (prabotulinumtoxinA-xvfs, a type of botulinum toxin neuromodulator), launched Club Evolus, a membership program. The concept is not unlike the more conventional programs at salons specializing in blowouts and manicures: for a monthly fee of $49, clients can get treated with 20 units of Jeuveau once every 90 days with a participating provider.
For Evolus, the impetus behind starting the membership program was a shift in consumer purchasing behavior. “Millennials, our core audience, increasingly prefer memberships and subscription models,” says Tomoko Yamagishi-Dressler, Evolus’ chief marketing officer. Another reason was the feedback from doctor’s offices and aesthetic practices that patients wanted more savings and the ability to visit more frequently, despite their financial constraints.
Evolus is uniquely positioned to be flexible on the pricing of Jeuveau, because while it is a prescription injectable approved by the FDA to temporarily improve the look of moderate to severe frown lines between the eyebrows (aka the ‘11’s’), it isn’t approved for medical applications like some of its competitors. Jeuveau is permitted for aesthetic use only and is not FDA-approved in the treatments of, say migraines, the way Botox is. “This is an advantage for Evolus because products with therapeutic indications require pricing parity across both cosmetic and therapeutic uses. We don’t have the same restrictions as companies do with reimbursed products,” says Yamagishi-Dressler. Since therapeutic use of neuromodulators approved for that purpose is often covered by insurance plans, it has an impact on their pricing, an issue Evolus doesn’t face because of its purely cash-pay and aesthetics-only business model.
TZR did a bit of number crunching to see how, if at all, this membership model would help patients who get regularly treated with neuromodulators for aesthetic reasons. Twenty units of Jeuveau is the quantity that is FDA-approved for glabellar frown lines, though providers decrease or increase that based on the patient's need. Dr. Rishi Chopra, M.D., a board-certified dermatologist practicing at UnionDerm in New York City, and a Jeuveau participating provider, estimates between 10 and 20 units of Jeuveau are used for the galbella. (His estimates for the forehead is 10-20 units, 5-15 units for crow's feet, and neck bands a.k.a. platysma are 30-60 units). So, 20 units of Jeuveau, on average, would be sufficient for a small area of the face. When you factor in that dermatologists in cities like New York and Los Angeles often charge per area injected, and it’s safe to say the cost is closer to $500 per area, Club Evolus’ pricing begins to look attractive. According to the company’s calculations, on average, patients enrolled in Club Evolus return to get treated every 100 days. “With Club Evolus, patients might save an average of $93 per treatment,” says Yamagishi-Dressler.
The maximum benefit will be reaped by patients who already get injected regularly. “Most of my patients are already on a routine schedule that includes neuromodulators, laser, filler, etc. so this type of membership fits seamlessly into their regimen,” says Chopra. “It’s a forward-thinking strategy that I believe represents the future of aesthetics, making it easier for patients to maintain results and age gracefully.”
Evolus hopes that by having more frequent and consistent touchpoints between patient and provider, it will help build trust and the opportunity to create a customized treatment plan for patients based on their goals. “I typically recommend routine treatments rather than a haphazard schedule to ensure consistent and natural-looking results,” says Chopra. Another added bonus for patients is the fact that they will not be hit with a service fee charged by the injector’s office or practice, as there are no additional or hidden fees.
Dr. Claire Wolinsky, M.D., a board-certified dermatologist at Spring Street Dermatology in New York is unsure whether the math makes sense for dermatologists’ offices, which have overheads to pay and need to factor in their time, expertise and cost of doing business. “Who’s paying the doctor,” she asks? (Evolus says they work in partnership with affiliated practices by covering the patient savings, and allowing participating providers earn credits toward a Jeuveau reward vial.)
From a treatment point of view, she questions what happens if a patient needs more areas injected for optimal facial harmony, and 20 units are not enough to do it. “Twenty units can treat the 11s, or the eyebrows, one or the other. If they're getting one area for $150 and then I say, it's another $500 to add another area at normal pricing, patients are going to say no. They're not going to want the regular pricing,” she says.
And on the flip side, she often tells patients to stretch their time between appointments if they’re good candidates for it. “Not everyone needs a neuromodulator visit [every three months]. You could coast for another month.” Finding a trained and skilled provider willing to do this will be key for patients, she says.
While Club Evolus might benefit patients who are already on a regular ‘tox schedule, it does beg the question about whether more infrequent patients might now pressure their injector to use up their 20 unit quota, adding more areas or quantities that they might not really need. That comes down to whether individual injectors are willing to set expectations beforehand and say no if the need arises. Chopra, for instance, emphasizes the importance of a balanced, evidence-based approach. “We focus only on areas that truly need treatment, avoiding unnecessary injections that could lead to an overdone/frozen appearance or increase the risk of complications. By setting these expectations early on, patients feel confident in a structured, customized approach that aligns with their aesthetic goals,” he says.
Thus far, access to injectables has been capped by cost: getting your forehead paralyzed with toxin isn’t cheap, after all. Membership programs like this widen the playing field, allowing in patients who might have been held back by their financial status. As in most cases, access is a good thing, with the caveat that you’re a good candidate to begin with, and that you find a trained and forthright provider who can be honest with you, mirrors your aesthetic judgment, and knows when to say no.
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