Download PDF - The Dermatologist

Pathways: Winter 2005
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handful of pharmaceutical companies,
including Johnson & Johnson.
COSMECEUTICALS IN
THE OFFICE SETTING
Dr. Mary Lupo, a New Orleans
dermatologist who has her own line of
skin care products, said she first considered
embarking on the project in
1989.“I liked [alphahydroxy acids] and
couldn’t get information from companies
on acid concentrations, etc.,” said
Lupo, a clinical assistant professor of
dermatology at Tulane University
Medical School. “It took me until
1994 to find a biochemist I thought I
could work with.” Her product line
came out the next year and now
includes 10 items.
Lupo displays her skin care products
in a pedestal case that takes up
“no more [space] than a chair.” She
also has another case where patients
check out of the office, from which
staff can retrieve products. “The case
has storage underneath, and we have
more products down in our laser
area,” she said.
Lupo estimates that dispensing
products takes “a few hours” a month to
educate patients, monitor inventory,
and otherwise handle the items. In
addition to her own line, Lupo dispenses
two others, Procyte and Kinerase,
and will soon carry a third, Prevage.
How does she choose which
products to offer? “The most important
element in deciding is to believe
in the products you sell and understand
how to recommend them to
patients. It should not be about
money but rather good patient care. If
they are doing well and like their
existing products, I don’t push mine
just to make a sale.”
Dr. Patricia Farris, a clinical assistant
professor of dermatology at
Tulane University Medical Center, in
New Orleans, said she uses herself as
her own guinea pig.“I never buy anything
that I don’t try myself. Personally,
I can’t sell anything I don’t love.
My motto is ‘great products at a great
price point.’”
Farris said most of the fun dispensing
products comes when she
talks with patients about what works
and what doesn’t, “and saving them
money on expensive brands that are
not worth the money” is also pretty
enjoyable. “Patients really appreciate
this and find it a value-added service.”
As for the business end, how
much doctors make depends on how
committed they are to dispensing, she
said. Many dermatologists sell products
in the office. Fewer take the time
to talk with patients about what they
should be using. More often, those
recommendations come from office
staff instead of the physicians themselves,
a practice that should be
reversed, she said.
What happens if a product doctors
sell is no longer produced or for some
reason loses luster—leaving patients on
a limb? That’s a risk, admits Farris.“We
have had problems with products that
are discontinued, but I try to find
something to replace it with that is
comparable.”
While a growing
number of
dermatologists
dispense
cosmeceuticals,
they’re now
competing, often
unsuccessfully,
with the Internet.
Dr. Mark Nestor, director of the
Center for Cosmetic Enhancement, in
Aventura, FL, sells his own line of cosmetic
products, as well as selects others
that he likes.
“If you dispense appropriately and
ethically, we’re essentially giving benefit
to patients that they don’t have otherwise,”
said Nestor, who is also an
associate professor of dermatology and
cutaneous surgery at the University of
Miami School of Medicine.“You can’t
get these cosmeceuticals most are dispensing
elsewhere.”
Nestor’s practice has offered
patients several product lines in recent
years. He also has developed a touchscreen
computer system, called Dermassist,
that guides patients to the
products right for their particular skin
types. Patients who want to buy
something are given a one-month
supply of the item, which they must
pay for out of pocket, since health
insurance doesn’t cover the items. If
the product doesn’t help, Nestor
added, he will work with the patient
to find something better.
While a growing number of dermatologists
dispense cosmeceuticals—
surveys show about 40 percent, Nestor
said—they’re now competing, often
unsuccessfully, with the Internet.
“Some companies and doctors are
looking at this as a quick revenue
source, and that undercuts doctors
who sell them in the office” where
overhead is higher than in cyberspace.
“Patients are coming in saying,
‘You charge me more than what I can
get on the Internet.’”That’s friction no
one wants, he said. As a result, doctors
are increasingly turning to proprietary
product lines that offer brand distinction.
“They make sure it’s a private
label,” he said.
Dr. Kenneth Beer, founder of
Palm Beach Esthetic Center, in West
Palm Beach, FL, has been selling his
own label of skin care products for a
decade. But the label has changed several
times over the years, as Beer struggled
to find a producer with which he
felt comfortable. Usually, the rifts that
forced breakups involved poor packaging
or, more often, weak product and
sales support.“If a company sells you a
product and that’s the last time you
hear from them, and they never come
in to see how things are going, you sit
with inventory, your staff doesn’t want
to sell it, and patients don’t want to
buy it,” he said.
Beer has been buying his current
product line, Palm Beach Esthetic,
from the same New York-based supplier
for the last five years, a relationship
he considers successful. However,
he is about to make a significant shift
away from office-based dispensing by
opening a day spa dedicated to skin
care procedures. The move will free
up his office staff members, who
already are swamped with cosmetic
patients and “don’t have the time or
the desire to deal with products,” he
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