==Objective==* Determining the factors driving the adoption of invasive Invasive medical procedures for such as Botox are rapidly entering the consumer applicationspace. This report shows how Botox rapidly advanced from a medical procedure to a household word, and how other procedures -- such as nanotechnology-based or stem cell-based procedures -- can make the same transition in the years to come.
==Problem Statement ==We conclude that three factors are essential for this transition:* To derive # The most important factor is the time to market for invasive procedures for consumer applications like'''[[#Botox - A Technical Overview|readiness of technology]]''', its proven effectiveness and safety# Nanotechnology for skincare or hair careThe second factor is the '''[[#Expert Buzz|''expert buzz'']]''': Once the experts bless a new technology, its adoption accelerates remarkably# StemThe third factor is '''[[#Consumer Buzz|''consumer buzz'']]''' or word-of-cell therapymouth
==Methodology==We have modeled these factors for Botox and can provide the data for other emerging technologies as well, and thus predict their adoption.
*We decided to follow the 'analogy' method {| class="wikitable" style="font-size:90%" border="1" cellpadding="5" cellspacing="0" align="center"|- style="background:lightgrey"! Year!! Milestone|-! 1990 | Botox use for determining smoothing wrinkles [[#Who Drove the time it takes for consumer adoption of invasive medical procedures. Adoption?|discovered]]*For the purpose of this study, we decided to study the consumer adoption of |-! 1994| Off-label Botox and apply the learning from Botox story to determine the timescale for consumer adoption usage [[#Annual Sales of other new invasive procedures. * Botox was considered appropriate since it is an invasive procedure for skin treatment. Procedures|starts]]* Botox is similar in that it's adoption is driven by 'expert opinion' which will also be the case for Invasive Nanotechnology therapy and Stem|-cell therapy.! 1997 | [[#Expert Buzz|Expert buzz]] picks up|-! 1998| [[#Consumer Buzz|Consumer buzz]] intensifies|-! 1999| Number of Botox procedures [[#Market Overview|skyrockets]]|}
== Study Goals for '''[[Botox ==Analysis - Methodology|Click here]]''' for more details on our methodology.
* To determine/measure the 'expert buzz' and 'consumer buzz' required for 'wide scale' adoption of an invasive procedure among experts. * To determine the market drivers that create the 'expert buzz'==Dolcera approach==
== Study Method to determine 'Expert buzz' required for consumer adoption==[[Image:botox-approach.jpg|center|600px]]
* Study the number of expert articles published discovering and eulogizing ==Botox miracle - A Technical Overview==* Determine A Botox injection is a diluted form of botulinum toxin type A which is injected into facial muscles to paralyze or weaken the number of experts muscles that form wrinkles. Botulinum toxin is a medication and a neurotoxic protein produced by the voice required to reach out to thembacterium Clostridium Botulinum. It is the most toxic protein known.
== Study Method to determine 'Consumer buzz' for Botox as a market driver == * Study the number of articles published in consumer media space eulogizing/talking about Botox* Study the media vehicles in which these articles are published* Determine from the articles published, the number of media vehicles required and the number of 'voices' (Journalists) required to create a 'consumer buzz'* Analogy to the internet world will be the number of powerful 'voices' required at the minimum to create a strong 'online buzz' (with a multiplier for the number of powerful voices thrown in to account for media fragmentation) == Data collection and data sources == * We used secondary research for data collection* Botox procedure data has been taken from ASAPS (American Society of Aesthetic Plastic Surgeons)* Databases used to search articles are Factiva and Google scholar* Search query used is::* botox, botulinum toxin: to find the total number of articles published on botox:* botox and wrinkles, botox and frown, botox and lines: to find skin care articles using botox* Determined the correlation between the number of articles published and number of botox procedures* Analyzed the articles published to determine the market drivers ==Technical overview==Botox injection is a diluted form of botulinum toxin type A which is injected into facial muscles to paralyze or weaken the muscles that form wrinkles. Botulinum toxin is a medication and a neurotoxic protein produced by the bacterium Clostridium botulinum. It is the most toxic protein known with an LD50 of roughly 0.005-0.05 µg/kg. '''It is sold commercially under the brand names:'''* BTXA, Dysport, Myobloc, Neurobloc and Xeomin which are used in the treatment of muscle spasms., and
* Botox Cosmetic and Vistabel are available for cosmetic treatment.
===How botox procedure a Botox Procedure is performedPerformed===* A Botox procedure usually takes 5-15 minutes and there is no need for any anesthesia.
* The procedure is not entirely painless and the small needle does sting. Some physicians may numb the area with a topical anesthetic prior to the injection.
* Before the injections, all the sites are premarked and cleaned with an antiseptic solution.
* Once the procedure is performed results last anywhere from 4 to 6 months.
===Botox Is commonly used to treatTreatments===
* Forehead lines
* Crow's feet (lines around the eye)
* Frown lines
===Side effects of botoxBotox===
Botox is not without side effects. However, the side effects are minor and resolve rapidly. The most common side effects include:
* Mild nausea
* Flu like symptoms
* Headache
* Redness
* Pain at injection site
No severe side effects have been reported, but the dermatologist or medical practitioner administering Botox injection should be experienced.
No severe side effects have been reported, but the dermatologist or medical practitioner administering botox injection should be experienced[http://articles.directorym.com/Botox_Side_Effects-a1182167.html Source: Articles.DirectoryM.com]
[http://articles.directorym.com/Botox_Side_Effects==Market Overview==Initially, Botox was marketed for its medical applications in treating various muscle-a1182167.html Source: articlesrelated conditions but later, its marketing was broadened to include its cosmetic application—smoothing out frown lines between the eyebrows.directorym]
==Market overview==Initially botox was marketed for its medical applications in treating various muscle-related conditions but later its marketing was broadened to include its cosmetic application—smoothing out frown lines between the eyebrows.<br> ===Y-o-Y sale Annual Sales of botox proceduresBotox Procedures===
[[Image:botox procedures time line.jpg|center|800px|thumb|[http://www.surgery.org/press/statistics.php Source: ASAPS]]]
Conclusions:-* Safety of botox Botox was proven through invasive muscular and neurological procedures very well till by 1992.* In 19921990, a serendipitous discovery showed Botox effect on 'smoothing wrinkles'.* Consumer adoption happened through off label use (6 years before FDA approval for cosmetic use) due to 'Expert Buzz'expert buzz' and an existing demand for a 'wrinkle smoothing' product (as shown from number of Collagen procedures that numbered 400,000 in 1997).* Experts were willing to recommend/try Botox on their patients due to two factors: (A) Safety of Botox (in higher doses for invasive muscular and other disorders) and (B) It's proven discovery to smooth wrinkles .* Suddenly , experts got a substitute for collagen procedures that took more a few months to show perceptible results (as shown below).
===Procedures of Botox Vs vs Collagen===Botox and collagen are both invasive procedures used for smoothing of wrinkles and facial lines. With the increase in off-label use and popularity of botox Botox, the market share of collagen has decreased.
[[Image:sales-bc.jpg|center|600px|thumb|[http://www.surgery.org/press/statistics.php Source: ASAPS]]]
[[Image:compare-bc.jpg|center|700px|thumb|[http://en.wikipedia.org/wiki/Collagen Source: wikipedia], [http://en.wikipedia.org/wiki/Botulinum_toxin#Medical_uses wikipedia], [http://www.botoxforum.com/botoxcost.htm botoxforum]]]
===[[Image:botox procedures as a percentage.jpg|center|600px|thumb|[http://www.surgery.org/press/statistics.php Botox procedures as a percentage of total cosmetic procedures===, Source: ASAPS]]]
[[Image===Who Drove the Adoption?===Both experts and consumers did. Among the early adopters and supporters were the following:botox procedures as * Dr Little injects himself with Botox, a percentagegood advertisement for both its safety and effectiveness* Dr.jpg|center|600px|thumb|[httpBrin says tests on 60 patients show that the toxin can relieve furrowed brows, crow's feet and other deep wrinkles* Researchers at the University of British Columbia have already used Botox to treat 18 patients with deep furrows in their foreheads* Tracey Ross (Model/Actress)://www"I had deep groves in my forehead, and they're gone after Botox procedures"* Madonna, Celine Dion, Kirstie Alley and Tom Cruise are all fans of Botox treatment.surgery* Dr Arnold Klein, who is Hollywood's king of collagen, said that latest beauty booster is an injection of Botox, the toxin that causes botulism, which gets rid of forehead furrows by simply paralyzing the facial muscles.org/press/statistics.php Source: ASAPS]]]
===An Analysis of 'Consumer Expert Buzz' ===* The below graph indicates In 1990, a serendipitous discovery was made by Mr. and Mrs. Carruthers, both medical practitioners, that Botox smoothed skin wrinkles.* Alastair Carruthers, a dermatologist, published a seminal article on the number cosmetic application of Botox in 1992.* Till 1992, safety of Botox use in invasive procedures was proven. Botox had also won FDA approval for at least 3 invasive procedures by then.* Between 1992 and 1997, 36 journal articles published on use the benefits of Botox for 'wrinkle smoothening' over timecosmetic procedures on skin were published. * These articles were enough to create buzz in the 15,000 approx. strong community of Dermatologists in the USA.
[[Image:expert articles botox-skin care.jpg|center|600px]]
===Correlation among Qualitative Analysis of Expert Buzz Articles === The expert articles were published in various leading journals including the noAmerican Academy of Neurology, Journal of Neurology, Neurosurgery & Psychiatry with Practical Neurology, and several more. ==Consumer Buzz==* The below graph indicates the number of articles published on use of Botox for ''wrinkle smoothing'' over time. [[Image:botox-skin care.jpg|center|600px|Number of articles on wrinkle smoothing]] ===Correlation Between Articles and proceduresProcedures===
* We have co-related the number of articles published in media with the use of Botox and find a strong co-relation of 0.89.
* Despite a high co-relation, the number of 65,000 procedures of Botox through off-label used is hard to explain with the publication of in-total 58 consumer articles till 1997 (out of which 35 were published in 1997 alone).
[[Image:botox-correlation.jpg|center|600px]]
==Botox Vs Collagen==
===Comparison of Botox and CollagenConsumer Buzz - A Qualitative Analysis=== ==Consumer buzz==Dcotors, Dermatologists, Surgeons, experts and consumers shared their experiences and gave positive reviews about the use of botox leading to initial buzz. <br> * Expert Buzz started from 1992 onwards with publication of articles for use of Botox for wrinkle smoothing in leading journals (By Caruthers)* Consumer Buzz started from 1992 with just 2 articles. But the big jump in Consumer buzz as measured by number of articles published in leading media is 35 in 1997. * However, by 1997 more than 65,000 Botox procedures had been done. This indicates that the Expert Buzz played a big role in Botox adoption than the Consumer Buzz. Total no. of articles published in consumer media space till 1997 are: 58 '''Various distinct experts that gave reviews are:''' * Ophthalmologist Jean Carruthers* Dermatologist Alastair Carruthers* Dr. Brin* Dr. William J. Binder* Dr. Arnold Klein, Hollywood's king of collagen* Dr. Gerald Imber* Dr. Alster* Dr. Davis* Dr. Kauvar* Dr. Ian Little* Dr. Vito Quatela, N.Y.* Dr. George Brennan, California* Cosmetic surgeons at the University of Michigan Medical Center* Dr. Todd Koch, amherst plastic surgeon* Surgeon Basim Matti* Dermatologist Rhoda Narins* Dermatologist Fredric Brandt* Dermatologist Arsenal
*Doctors, Dermatologists, Surgeons, experts and consumers shared their experiences and gave positive reviews about the use of botox leading to initial buzz.
* Approx. 18 medical experts were quoted in media till 1997 (the inflection point) before the Botox Market took off in a big way. The experts quoted in media [[Botox Experts|are listed here]].
'''Major media Vehicles used are:'''
[[Image:consumer-buzz botox.jpg|center|600px]]
==Expert buzzBuzz vs Consumer Buzz==Medical journals and circulars brought awareness of botox procedures among the dermatologists and surgeons.<br>
Total no. of articles published in medical journals till 1997 are[[Image: 36expert vs consumer buzz.jpg|center|600px]]
== Conclusion ==
[[Image:Botox story in a nutshell.jpg|center|500px|Botox story in a nutshell]]
Various journals and circulars are:* American Academy of NeurologyFor an invasive medical procedure on consumers involving nanotechnology or stem cell therapy, the first obstacle will be to prove its safety.* Journal Once the safety of Neurolythe procedure is established, Neurosurgery & Psychiatry with practical Neurologythen its uptake can be modeled on existing customer base for other invasive procedures like Botox, collagen etc. * International Ophthalmology Clinics* Science Modeling on other invasive procedures is possible, since safety and Medicine* Southern Medical Journal* Clinical Neuropharmacologyefficacy of treatment are the biggest barriers to consumer adoption. * The Annals case of otology, rhinology & laryngology* Journal Botox classically shows that once safety of a procedure is proven, it is the Royal Society of Medicine* Journal of experts that are driving the American Medical Association* Lippincott Williams & Wilkinsconsumer adoption for the new therapy (for an existing well articulated need). * Plastic However, for a completely new need that has never been articulated by the consumers (and Reconstructive Surgeryhence never been met), ''expert buzz'' and '''consumer buzz'' will play an equally important role to drive consumer adoption. * Journal Timescale for building adoption curves will be a function of Dermatological Surgery the amount of buzz created in expert and Oncologyconsumer circles over a period of time. Amount of buzz can be measured by the number of opinion leaders who drive the opinions through various media channels. * Aesthetic Plastic Surgery* Dermatologic Surgery* Survey of OphthalmologyOverall, until the inflection point for Botox, 36 unique journal articles were needed. For the consumer buzz, 58 unique articles published in 58 different vehicles were needed.