Step one: convert to clinical equivalence
A unit is a product-specific measure, not a universal one.
- Botox (onabotulinumtoxinA) and Xeomin (incobotulinumtoxinA) dose roughly 1:1 to each other.
- Dysport (abobotulinumtoxinA) doses at approximately 2.5:1 to 3:1 versus Botox — you use more units, so a lower per-unit price is partly an illusion.
- Jeuveau (prabotulinumtoxinA) doses close to 1:1 with Botox and is generally positioned as a value alternative in that 1:1 lane.
- Daxxify (daxibotulinumtoxinA) doses in its own range and is sold on duration, not unit price.
- Letybo (letibotulinumtoxinA), a newer entrant, competes primarily on acquisition cost in the ~1:1 lane.
Until you normalize to "what does it cost me to treat the same glabella to the same result," every price comparison is dollars-to-pesos.
Step two: layer in rebates and loyalty
Your real acquisition cost is list minus what you actually capture. Manufacturer rebates, volume tiers, and the consumer loyalty stacks (Allē for the AbbVie portfolio, Aspire for Galderma, Evolus Rewards for Jeuveau) all move the number — sometimes enough to flip which product is cheaper between two clinically comparable options.
The catch most owners miss: splitting volume across two toxins can drop you out of a volume tier or dilute your loyalty standing, raising the loaded cost of your primary product. The second toxin is never free; it's paid for in lost tier leverage on the first.
Step three: duration changes the denominator
For a duration-positioned product like Daxxify, cost-per-unit is the wrong denominator entirely. The right ones are cost per month of effect and cost per visit. If a patient genuinely stretches from a 3-month to a 4–5-month interval, a higher per-treatment cost can still win on annual spend, chair time, and rebooking friction — or it can simply raise your cost with no interval benefit for that patient. It's patient-specific, and you should treat it that way.
What to do
- Build a one-page loaded-cost model with four columns: net acquisition cost, dosing-conversion factor, captured rebate value, and typical duration. Compare treatments, not units.
- Pick a workhorse and commit volume to it to hold your best tier and loyalty position. Fragmented buying is how you quietly pay more for everything.
- Add a second toxin only for a real job — a duration option for the patient who hates coming in, or a price option for a specific segment — not because a rep bought you lunch.
- Re-run the model every contract season. Pricing, rebate structures, and tiers move, and the cheapest-to-you product 18 months ago may not be the one today.
The injectors should weigh in on feel, onset, and diffusion. But the decision about which toxin anchors your business is a finance decision wearing a clinical costume — and it should be made on loaded cost per equivalent treatment, with the rebate math actually done.
