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RVNC is a tragic story - cash hemorrhaging launch strategy in aesthetics that good & experienced people knew wouldn’t work. Self dealing and massive ego trips. Daxi could be positioned as THE workhorse toxin for aesthetic practices, paired with a workhorse filler line. Instead… investors got “prestige.”
Therapeutic is everything.
This indicates a transition to therapeutic focus (not a fit on paper for aesthetics).
This is a therapeutic company with aesthetic upside.
Don’t drop it. Stop investing and taking a $400M/year loss on it. Cut it to the bone. Let the new pricing program / couponing grow the business organically. Therapeutic more valuable in long run.
Spot on. The old regime ignored all of this. Focus on therapeutic. Starve cosmetic to avoid another dilutive raise. Let cosmetic market realize by itself that 1:1 Daxi Lite reconstitution is fine and cheap. Maximize therapeutic.
The numbers have already been submitted here in this forum. US toxin therapeutic market sizes, growth rates, and the Daxi study data in CD. Burn $400+/year (don’t event count the former team’s wasted pet projects and the failed HintMD experiment) chasing low ASPs in a very crowded space, or burn it chasing favorable market conditions, better payer mix, with a differentiated product?
If you believe the data, a commercial dollar invested in therapeutic pays back more than a dollar invested in cosmetic. Shocking how under-invested this therapeutic rollout has been.
This is a therapeutic company now. Earnings update needs to be all about therapeutic. Board should be turned over for the drunken spending on the failed aesthetic experiment. Warning signs were all there - clearly a toxic culture. Show investors how therapeutic will be different.
Therapeutic toxin use is growing faster and controlled by a smaller group of decision makers, with fewer competitors, where small clinical differences are meaningful. I understand your position as a cosmetic customer. What should the strategy be from a shareholder perspective? Cut aesthetics to the bone and go all in on maximizing therapeutics profits is one approach. Allergan or Pfizer or JnJ would have taken this approach from day one.
The botched aesthetic opportunity is now a catch 22 for RVNC shareholders. Try this exercise. How would you calculate the profit-maximizing price of a unit of therapeutic DAXI?
Waited too long to cut prices and waited too long to care about the injector. Now must cut cosmetic opex mercilessly. Cosmetic tops out at 20% marketshare, and only after injectors learn it is half the cost of Botox per unit. Run company out of the manufacturing offices if they have to. Invest only in therapeutics. It is everything.
Double dose (high concentration) effect is real and repeatable. Daxi IS basically this trial. They too had low rates of ptosis AND fast resolving ptosis when it occurred. Why is this? If the toxin really worked differently, why is this so - why does the complication resolve so quickly? Is it because most of the concentrated toxin is injected in the middle of the brow? This is more likely. Eols won’t waste money on getting it into the label for aesthetics - core market growing too fast, and injectors learn informally and not strictly per the label. Would be worth it for eols if they had the therapeutic license - aeon could go this route.
That may be true. As a consumer, I would choose it at the same price. But my bigger point is the link between aesthetic and therapeutic pricing. No point dropping price for a couple points of cash pay share. Rvnc therapeutic is potentially much more valuable.
There is now enough experience to know you can’t predict who will get the extended duration. It’s a flip of the coin. That doesn’t work for a premium product - anyone in retail will understand. It would work in therapeutics where recipients are hopeful and playing with house money. Not saying abandon, but experiment failed badly while several layers of the company missed all the warning signs. Shift investment.
None of this really matters in aesthetics. 50% of the patients will be disappointed. They will not get the duration and will be disappointed. Very few patients will continue to pay extra for a little bit better on average. Therapeutics, however, is a different story. Even a few extra days on average means a lot more in terms of benefit to the patient and the payer and the provider. Cutting the cost in aesthetics means cutting the cost in therapeutics. Dear Revance, your strategy failed. Please cut your losses in aesthetics and move to maximize therapeutic profits.
If mistake to keep anyone or anything involved with the RVNC aesthetics launch. Therapeutics is a different animal, entirely, and from now on this company should see itself as a therapeutics company. Bring in a real pharma team. Cut aesthetics to the bone, let go of Nashville, set a filler + tox bundled price, and let btx and eols fight over a double dose strategy. Everything is therapeutics from now on. It’s best for shareholders.
Not surprising. The president worked for strathspey crown. Notoriously clubby and a business model lots of people compared to a Ponzi scheme.
The Realself worth it rating of 50% is EXACTLY what you would expect for a product that delivers longer duration 50% of the time. Right? One simple solution from the beginning: some sort of a treatment guarantee. Skin in the game on all sides.
So here we are - analysts are resetting their models. It’s not a luxury DTC business. Strategy needs a full reset, company has been blowing cash, and something still doesn’t look right: $420 / vial (cute number btw - you can do that stuff when you’re Elon, but not a struggling medical company), 80% margins = ~$100/vial cogs?!!!? Try to square that with the huge gap in payer savings with one fewer treatment, and there’s so much therapeutic value left on the table. Package it all with passing comments about theoretical savings from the Nashville headquarters (which can not be real savings) and writing off the HintMD acquisition. Company expenses need to be cut to the bone, close Nashville and Newport offices, run aesthetics with 100 reps and four marketers. Shift headcount to therapeutic.
Disappointed shareholder here. So much time and money wasted on a launch strategy that would never work. 5 years of commercial investment and many millions of $ wasted. The facts were the same then as they are now: 50% of patients get the 6 month duration, providers will always control the end user cost of a treatment to the patient (they are the retailer), Botox dosing and pricing is the gold standard of the industry, unit-to-unit Daxi has similar efficacy as Botox, non-physicians control the aesthetic injectable market, therapeutic pricing will be tied to aesthetic pricing, therapeutic pricing is less elastic than aesthetic pricing. Breakup with Botox?!?! Most patients think Daxi IS Botox. I saw that ad and couldn’t figure out what the product was. Designer filler?!? RHA filler is a highly discounted HA (e.g. RHA4 launched at 30% the cost of Voluma), now it looks like DAXI will basically be a highly discounted Botox (unit to unit). Probably what they should have started with. The EOLS and Dysport dosing study strategies are smart - but the simplest execution with EOLS.
Questions for the future. Once the aesthetic and therapeutic approval timelines started to get so close, why risk therapeutic opportunity with the aesthetic distraction? How negatively will the therapeutic opportunity be impacted by the botched aesthetic launch pricing? Will aesthetic investment be reduced? Why move the failed aesthetic leader over the crown jewel of the RVNC franchise - therapeutic? What market development work has RVNC invested in to secure reimbursement and accelerate training opportunities? Hoping they get therapeutic right.