Endo pulled cellulite treatment Qwo, laid off 90 and booked a $235–250M charge

In December 2022 Endo, the Dublin-based pharmaceutical company, ceased production and sale of Qwo (collagenase clostridium histolyticum-aaes), the first injectable the FDA had approved — in July 2020 — to target moderate to severe cellulite in the buttocks of adult women. CEO Blaise Coleman: 'After careful consideration, we have determined that Qwo does not represent a viable commercial opportunity for Endo.' The reason was concern about injection-site bruising and skin discoloration — nine months after Endo launched a 'Butt First' advertising campaign to spark sales.

The decision laid off 90 full-time employees, delivering annual savings of $50 million to $60 million, and brought a restructuring charge of $235 million to $250 million in the quarter, subject to bankruptcy-court approvals. The clinical answer had fallen short: in the Aphrodite trial, 'although certain study cohorts' results reflected a modest reduction of bruising area and severity, none achieved a consistent level of reduced bruising following initial treatment to adequately alleviate the market's concerns', the company said.

The collapse of the rebound bet landed on a company already in trouble. Less than four months earlier Endo had filed for bankruptcy, committing to a $450 million opioid settlement over its promotion of the painkiller Opana ER, which it pulled from the market in 2017. Endo had planned back in 2020 to cut 560 jobs by 2023 while counting on Qwo's success for a rebound. Qwo's sales were never disclosed separately: its 'other specialty products' category made $86 million in 2021, down 7%, and fell 19% year over year to $39 million in the first half of 2022.

Qwo production and sales ceased; 90 full-time employees laid off; a $235–250M restructuring charge this quarter, against $50–60M in annual savings.

Bruising and skin discoloration at injection sites spooked the aesthetic market the product depended on.

The Aphrodite trial could not show a consistent reduction in bruising, leaving the concern unanswered.

Endo had bet its post-bankruptcy rebound on Qwo while cutting 560 jobs and closing three plants elsewhere.

Sales were sliding regardless — the product category fell 19% year over year in the first half of 2022.

A first-of-its-kind product with visible side effects needs efficacy data before the marketing spend — and a rebound bet that sours inside a bankrupt company takes jobs down with it.

The product remains FDA-approved and available, and Endo said medical practices could still order existing stock while it lasted. But the layoffs and the quarter-billion-dollar charge stacked onto the opioid-driven restructuring, in which the company had already committed to 560 job cuts by 2023 — the rebound Qwo was supposed to fund never arrived.