Evolus is the upstart in the medical aesthetics sector, whose brand, Jeuveau, is riding a youth- and digital-oriented approach to challenge Allergan’s market-leading Botox for wrinkle-smoothing supremacy. As the first company to launch in that category in a decade, Evolus’ management, many of whom are Allergan vets, deliberately diverged from their former employer’s playbook. 

“We believe we have the latitude to do some things a little differently,” the company’s president and CEO, David Moatazedi, told me for a story I wrote last week. In the piece, I explained how this break from tradition is being powered by a “culture shift” at the company. But what’s potentially more interesting is the justification given: that Jeuveau, which is the firm’s only marketed product, is a purely aesthetic, non-reimbursed drug, and thus affords the company more latitude in how it markets than if it were selling, for example, an oncology drug.

Moatazedi reassured me during our interview that the firm has no plans to enter the therapeutic space, as Allergan has. In addition to its approval for cosmetic injection, Botox is approved to treat migraines and bladder dysfunction, so it’s eligible for federal reimbursement, but not so for Jeuveau.

This is what gives Evolus room to operate differently. For instance, the CEO has noted in the past that the firm doesn’t have to report payments it makes to doctors to the government’s open payments database. Being in aesthetics also allows it to be more customer-centric, calling clinicians outside of normal business hours.

But as Evolus moves away from staid marketing tactics like the 30-second TV spot, it’s also wading into some familiar and, in the view of some, problematic territory.

About halfway down last week’s piece, I noted how Evolus’ advisory board meeting, which doubled as a launch event for the company, “drew scrutiny from those who feel the venue was extravagant for an event hosted by a manufacturer in order to educate doctors.”

Moreover, the corporate shindig featured staged social-media opps designed to engage potential prescribers, like an Evolus-themed runway and confetti-throwing station. One thing led to another, and many of the HCPs posted photos of themselves on Instagram with the props in the background, Jeuveau’s #newtox hashtag and terms like “happy toxin,” which reportedly were not part of the corporate marketing, all without disclosing that their trip was paid for. 

I wasn’t the first to point this out. In May, The New York Times reported that the meeting conjures echoes of “an earlier, anything goes era of pharmaceutical marketing that the industry largely abandoned after a series of scandals and billion-dollar fines.” Pharma adopted a voluntary code of conduct years ago, and extravagant trips are frowned upon.

I don’t want to turn this into a referendum on the Cancun event, which the company said was akin to meetings run by its competitors. You can read Moatazedi’s explanation in the earlier piece. Yet this case study bears watching. There are indeed legitimate reasons for messaging in a more digital- and social-savvy way in the aesthetics sector. If you’re a plastic surgeon, selfies are a very important part of your practice. Cardiologists? Not so much. 

Botulinum toxin is a potent drug, though, one with a black-box warning. And, as in the case of all prescription drugs, promotion of benefits must be balanced by risks so patients can make an informed choice.

Moatazedi told me that after the Evolus resort meeting, some of the physicians had said that they would begin proactively disclosing in their social media posts if they had received any company sponsorship. 

And that’s a good thing, because their social-media messaging could set a precedent when it comes to marketing for other cosmetic interventions like breast implants, facial filler or fat treatments. These are typically not reimburse-able, either. And what of the rival wrinkle-smoothing brands? It’s not too hard to imagine makers of these aesthetic products taking a page out of the Evolus playbook, despite those products’ very real side effects and benefits.

What do you think: Does this set a precedent for marketing by other aesthetic companies? Let me know in the comments section below, or directly at marc.iskowitz@haymarketmedia.com.