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'Mr. Botox' Case Raises Some Brows

A Hollywood wife's injury-by-Botox lawsuit puts doctors' relationships with drug makers in the spotlight

August 22, 2004|Denise Gellene | Times Staff Writer

They call him "Mr. Botox" for good reason.

Arnold W. Klein, dermatologist to the stars, claims to have pumped the anti-wrinkle drug into more faces than inhabit the entire city of Newport Beach. He has talked up the purified toxin at small charity events in expensive restaurants and at international conferences in glittering halls.

Along the way, he has received hundreds of thousands of dollars in fees from Botox manufacturer Allergan Inc., which pays him for acting as a "media spokesman" for the drug and lending a hand with other consulting chores.

Such arrangements typically are secret, but Klein's contract surfaced in a medical malpractice case filed by Hollywood wife Irena Medavoy against the Irvine-based drug company and the Beverly Hills doctor.

The injury-by-Botox lawsuit, set for trial this month in Los Angeles Superior Court, provides a rare look at the relationships between drug companies and the physicians who consult for them. Klein, along with dozens of others, has lined up behind Allergan's biggest drug to serve as both advisor and cheerleader.

Klein not only served as a mouthpiece, but he also agreed to review advertising plans and offer advice on clinical trials, according to a copy of his contract in the court record. His duties included teaching other doctors to inject the anti-wrinkle drug.

And he wasn't alone. Forty doctors were groomed by Allergan's public relations experts to act as media spokesmen for Botox, and the company had 300 doctor's offices and medical clinics in its official network of Botox training centers, court documents show.

Jerome Kassirer, a former editor of the New England Journal of Medicine, said Allergan, in asking more from some physicians than medical advice, was "turning doctors into sales reps."

As for Klein, Kassirer said: "It is clear he is being paid to promote the drug."

Medavoy's suit against Klein and Allergan made headlines when it was filed last year, and not only because she was the wife of movie producer Mike Medavoy, the studio chief behind "Rocky" and "Annie Hall." Klein, 59, was a clinical professor at UCLA's David Geffen School of Medicine, an unpaid position, and well known in Hollywood, where his celebrity patients included Elizabeth Taylor and Michael Jackson. Last month, UCLA announced that some of Klein's friends had anonymously pledged at least $1 million to endow a dermatology chair in his name.

Medavoy, 45, claims in her suit that Botox shots administered by Klein made her ill and that Klein and Allergan misled her about the drug's safety. He and the company have denied the allegations.

Klein's contract with Allergan, as outlined by Allergan's director of aesthetic marketing in court documents, provided Klein with quarterly payments of $25,000 for all his consulting duties. If Klein attended meetings at the request of Allergan, he received an additional $10,000 a day, plus travel expenses. When local sales reps scheduled an appearance for him, Klein collected $2,000 to $4,000.

He or his company, Minimally Invasive Aesthetics, received a total of $499,000 from Allergan between September 2000 and December 2003, court records show. Kassirer, the former medical journal editor, now a professor at Tufts University School of Medicine, called the amount "huge -- far in excess of anything I have heard anywhere."

Allergan general counsel Douglas S. Ingram would not discuss Klein's contract. However, Ingram said that consulting deals were common in the drug business and that none of the company's contracts was unusual. He said consultants provided the company with medical insights and advice and were not recruited to promote drugs.

Providing Guidance

The industry relies on guidance from consultants "to develop and make available better products to the medical community and patients," Ingram said, adding: "Dr. Klein is an expert in the use of Botox and has been benefiting patients with Botox for many years."

Neither Medavoy nor Klein would comment for this story. Medavoy's lawyer, Arthur Leeds, didn't return calls. Klein's lawyer, Howard Weitzman, said he didn't want to discuss the case before its Aug. 31 trial date.

Although consulting contracts between academics and drug companies are widespread, some high-profile deals recently have come under scrutiny. The National Institutes of Health, the nation's premier medical research organization, was criticized last year for allowing its top scientists to advise drug companies. The NIH is revising its ethics policy to prevent conflicts of interest.

Ingram said Klein wasn't acting on behalf of Allergan in his medical practice. "Nothing could be further from the truth," he said.

There's no question that Klein has been an enthusiastic booster of Botox. Klein lectures extensively on Botox in the United States and around the world, according to his own website. South Koreans call him "Mr. Botox," Klein once said. Last year, the British style magazine Harpers & Queen named him Hollywood's top Botox doctor.

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