The U.S. medical aesthetics category has experienced growing demand in the last decade, but in order to prop up consumer interest during a pandemic, aesthetic injectable manufacturers are finding they have to step up their efforts in order to remain successful.

Despite being minimally invasive, aesthetic injectables are not inexpensive. The national average for botulinum toxin procedures offered by brand names like Botox was $397 in 2018, and for lip filler brands like Juvederm, it was $682, according to the American Society for Aesthetic Plastic Surgery. With the economic conditions and unemployment rivaling (if not surpassing) those of the Great Depression, and elective procedures still unable to take place, the impact to the aesthetic injectable category could be severe. As such, manufacturers are trying to safeguard their bread-and-butter products through major marketing campaigns and manufacturer coupons.

Allergan has a $100 million stimulus plan in place with the intention of directing the company’s resources to 25,000 local providers, said Colleen McKenna, Allergan’s vp of marketing of facial aesthetics and SkinMedica. Allergan launched a gift card promotion on April 30 to its providers, which can offer their patients a $100 gift card for the cost of $50. McKenna said that 700,000 gift cards were purchased in the first week, which was 300% more than the total number of gift cards sold in 2019. By the third quarter, Allergan will have redesigned its loyalty program, in order to offer additional benefits such as coupons not only on cosmetic procedures but also on vacations and theater tickets. It will also offer more opportunities for patients to earn rewards for getting treatments.

In the coming months, price-sensitive customers may be swayed by generic alternatives. Jeuveau, a competitor to Botox from Evolus, is reportedly 20%-30% less expensive, and RealSelf reported it was the second-most-researched new aesthetic treatment on its website in 2019. However, the medical aesthetic market has been driven by patients asking for procedures based on brand name, meaning that the recognition of Botox is critical to Allergan’s success. Botox (which does have non-aesthetic use cases) represents more than 20% of Allergan’s revenue. Since Jeuveau’s launch in June 2019, it has become a cash cow according to 2019 year-end earnings; it earned $34.9 million in net sales. However, none of the aesthetic manufacturers interviewed for this story suggested they would lower prices.

According to Allergan’s own research of 1,124 members of its loyalty program, 67% anticipate returning to treatments within the first month they’re permitted to, and 98% expect to be back within six months. The loyalty program has 6 million members, and those members spend, on average, 36% more per year on aesthetic treatments and visit aesthetic providers 23% more frequently than those not enrolled in the program. Since 2015, Allergan has targeted younger consumers, ages 19- 34; the age group represents 14% of the botulinum toxin market, according to ASAPS.

Galderma, a privately held company that owns brands like wrinkle filler Restylane and botulinum toxin Dysport, has found its products are routinely used by new aesthetic injectable customers. The company received an FDA approval for a new and longer-lasting (up to a year) lip filler called Restylane Kysse on March 26 and announced the approval on May 5, and the launch is expected to help fuel customer traffic back to practices.

“We have not backed down on our investment [in new products],” said Alisa Lask, Galderma aesthetic business unit vp and general manager. “If you look at the seven FDA approvals we have had, we know 20%-30% of the patients who come in to try new products are new to aesthetics. So the launch of Restylane Kysse will help drive new patients and hopefully help the rebound as well.”

Galderma has begun hosting virtual meetings, including a new virtual reality anatomy training program for its sales force and providers. Galderma will launch a campaign at an undetermined time to support the new Kysse product. The company plans to make Restylane Kysse the No. 1 selling lip filler in two years, overtaking Allergan-owned Juvederm, said Lask.

“We have a pretty robust [marketing] plan to help [drive] consumer demand, and most of that has shifted to digital channels,” said Drew Fine, Galderma vp of aesthetics marketing. “However, there’s too much uncertainty to be able to say exactly when we will turn on all that investment.”

That shift includes moving away from TV ads and print magazine ads to digital ads on Facebook and Instagram, website digital banner ads and OTT ads on Hulu that direct to Galderma’s rewards program. That program has been around since 2015 and has over 1.5 million customers. Through its rewards program, Galderma will also offer a coupon to customers, and the price will be determined on the need to support market recovery. Typically Galderma offers $20-$60 off a procedure for new customers.

Merz, another private company that owns dermal filler Radiesse among other brands, has shifted the aim of its advertising and social media campaigns from providing social awareness to focusing on the company’s support of healthcare workers. The objective was to be sensitive to the current climate, said Bob Rhatigan, Merz Aesthetics global CEO. He added that “when the time is right” the company will resume its publicity and marketing plans, but he did not confirm whether its budget would increase.

“We expect when the restrictions are lifted and it is safe to do so, there will be an immediate spike in patients returning to practices for their routine treatments,” he said. “However, there will also be several months of a rebuilding period for our customers as they get their businesses back up and running.”