ALK-Abelló A/S (Nasdaq Copenhagen: ALK B), also commonly known as ALK, is a Denmark-based pharmaceutical company which specializes in the development and manufacture of allergy immunotherapy (AIT) products for the prevention and treatment of allergy. It is one of the world’s largest makers of allergy immunotherapy products (also known as ‘allergy vaccines’) with 81% of its revenue coming from sales in Europe.
Sublingual allergen immunotherapy (SLIT) is an effective disease-modifying treatment for moderate to severe allergic rhinitis, but long-term benefit depends on patients completing the recommended three-year treatment course. Real-world evidence on treatment persistence in primary care remains limited. In this prospective, non-interventional, observational study conducted in 17 Norwegian general practices included 204 patients between 6 to 65 years of age. We evaluated one-year persistence, adherence, symptom control, medication use, patient satisfaction and safety among patients treated with the grass and birch pollen SLIT-tablets Grazax and Itulazax. Overall, 78% of patients remained on treatment after one year, exceeding the predefined persistence target of 70%, while self-reported daily adherence remained above 90% throughout the follow-up. Patients reported clinically meaningful improvements in nasal, ocular, bronchial and general allergy symptoms, accompanied by reduced use of symptomatic medication and high treatment satisfaction. Adverse events were common but were predominantly mild or moderate, with no serious treatment-related safety concerns. These findings indicate that SLIT-tablet treatment can be effectively initiated and monitored in routine general practice. Persistence was comparable to that reported from specialist settings, supporting an expanding role for primary care in delivering disease-modifying treatment for allergic rhinitis. Structured follow-up within general practice may contribute to sustained treatment persistence and improve the real-world effectiveness of allergen immunotherapy.
There is a well-documented gap between the prescription of adrenaline auto-injectors (AAIs) and their real-world use during anaphylaxis. Although several aspects of AAI underuse have been investigated, the potential role of shelf life in influencing patient adherence has not been quantified. This study assessed the real-world remaining shelf life of AAIs available at pharmacies in Denmark, Finland, Sweden, and Norway, using pharmacy-level stock data and pharmacy employee-reported perceptions. Across Denmark, Finland, and Sweden, the average remaining shelf life was 9.6 months, and in Norway it was 10.5 months at the point of dispensing. In Denmark, Finland and Sweden, 100%, 91%, and 94% of employees, respectively, considered shelf life an important or very important factor when dispensing AAIs to patients. Our findings suggest that patients and caregivers filling prescriptions for AAIs frequently receive devices with limited remaining shelf life, which may necessitate multiple renewals per year. This has potential implications in terms of adherence to clinical guidelines, dependence of expired devices during emergencies, patient cost, caregiver burden, and overall societal expenditure. These results highlight an unmet need for emergency treatment options with longer shelf life to better support continuous access to life-saving medicine during anaphylaxis.
Although patients in Canada at risk of anaphylaxis are recommended to maintain access to two in-date epinephrine auto-injectors (EAIs) at all times, underuse during emergencies remains common. Multiple factors contribute to this gap, but the impact of real-world shelf life has been understudied. This study examines the remaining in-pharmacy shelf life of EAIs in Canada and considers its potential implications for patient burden, renewal frequency, and anaphylaxis preparedness. In this cross-sectional study, 50 licensed Canadian pharmacists from chain, independent, grocery/mass merchandise, and hospital pharmacies completed an online questionnaire and assessed EAI stock. Participating pharmacists verified all EAI stock on site, including batch numbers and expiry dates, and reported patient disposal practices. Of the 50 participating pharmacists, 49 reported 411 EAI devices across 98 batches. The mean in-pharmacy shelf life at dispensing was 12.8 months, with 47.4% of devices having 12 months or less remaining shelf life. Disposal practices varied and expiry was the most cited reason for disposal. Shortened in-pharmacy shelf life may increase renewal frequency, cost, waste, and the risk that patients carry expired devices or no device during anaphylaxis. Longer-shelf-life epinephrine treatment options or improved distribution chain practices may help reduce patient burden and enhance anaphylaxis preparedness in Canada.
