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Use of Botox must be justified

Botox does not qualify as an off-licence medicine, because there are no tangible therapeutic benefits, according to Dr John Hillery.

Dr Hillery's comments come on the heels of a second warning by the medical indemnifier, Medisec, that GPs should not use Botox for cosmetic purposes, and that cosmetic procedures are not covered under the Medisec Master Policy.

Dr Hillery said GPs need to be indemnified for all treatments. Because medical justification for the use of Botox is a "matter of discussion", doctors must be more wary of the balance between risk and benefit, said Dr Hillery.

According to Medisec's May 2006 newsletter, GPs should not get involved in promoting a particular product or its availability at a clinic of any kind or be in arrangement to take a referral fee or equivalent per patient.

The warning came after queries to Medisec. "While the patient may want the product for one purpose, e.g. cosmetic, the practitioner is carrying on a medical practice and is answerable to the Irish Medical Council," says the newletter.