Mind the gap: a German case study on the discrepancy between geographic accessibility and real-world utilization of botulinum toxin therapy

The results indicate that BoNT-A is recognized and provides therapeutic benefit from the perspective of the treating physician, but structural and economic barriers hinder the use of this therapy. Interestingly, even in a well-resourced system with broad geographic access to specialized care, significant treatment gaps may persist. Recommendations include standardized reimbursement structures, improved education, and increased cross-sector collaboration.