Nevertheless, current industry dynamics offer ALK a unique window of opportunity. A trend towards allergy self-medication such as over-the-counter (OTC) symptom-suppressants, along with patent expiries for other important treatments, has resulted in large pharma companies choosing to de-prioritise partnering with allergists. However, ALK is perfectly positioned to fill this void via its newly formed commercial organisation and strong business to business (B2B) sales model in North America which has long fostered strong relationships with specialists.

Central to success will be using ALK's expertise and shared interests with allergists to drive better access and outcomes for all AIT-eligible patients, reaching out with support, disease information and treatment options via specialist sales representatives, digital platforms, and via referral systems that encourage them to consult an allergist. ALK's new house dust mite SLIT-tablet will play a pivotal role in this strategy.

During the past year, ALK has built a local pharma organisation in North America on top of its existing allergenic extracts business – almost quadrupling its field-force to 80 people – and has gained a deep understanding of the overall allergy and respiratory market and its structural barriers. Using a highly targeted, commercial approach building on an understanding of the businesses of the most relevant allergy specialists, ALK will demonstrate how the tablets can expand the number of patients who benefit from AIT, reinforcing and revitalising the role of allergy specialists.

The updated strategy – which builds upon ALK's successful European business and recent investments in North America – places succeeding with the tablet portfolio at its core, and has four key components: 1) Establish and succeed in North America; 2) Complete the tablet portfolio for all relevant ages; 3) Patient engagement systems and adjacent business; and 4) Optimise and reallocate ALK's resources.