The increasing prevalence and intensity of allergies is a trend that has continued in the industrialised world for more than 60 years.

Allergies impact quality of life and can trigger asthma

The limitations resulting from the body’s reaction to allergens are multifaceted but share one common theme: the patient’s quality of life is no longer the same. People who are sensitised to aeroallergens develop allergic rhinitis with symptoms such as a runny nose, itching, watery eyes, respiratory congestion, and fatigue. A less well-known and often underestimated consequence is that allergies put people at a greater risk of developing asthma. People with allergic rhinitis are three times more likely to develop asthma than other people, and the risk for patients with house dust mite-induced allergic rhinitis is about six times higher than those whose allergic rhinitis is caused by grass pollen.

Too many patients don’t get therapy

Allergic rhinitis affects approximately 10% to 30% of adults and 40% of children. Only approximately 12% of people suffering from allergic rhinitis are treated with allergen immunotherapy (AIT) products due to low awareness among physicians and patients, a complex treatment pathway, and a market that is dominated by lower cost symptomatic treatments. AIT is the only treatment that addresses the underlying cause of allergy and may provide both rapid (within a few weeks) and long-lasting (several years) improvement of all symptoms, whereas symptomatic treatments (such as antihistamines and corticosteroids) only temporarily relieve some allergy symptoms.

With a modest proposal rate, the AIT market is underdeveloped, representing approximately €1bn or 12% of the global allergic rhinitis market and is expected to grow by 2% p.a. in the coming years³.

Market growth should result from increased awareness of respiratory allergies, easier access to allergists, the expanded range of administration modes as well as a growing middle class in developing countries that will gain access to medical treatment.

Innovation in science and technology is creating new medical opportunities

Biologics, gene therapies and other new molecularly targeted compositions are starting to deliver on their promise to enable more precise diagnostics and tailored treatments. The development of more patient-friendly treatments (shorter treatment lengths, ease of use) should improve AIT penetration in the allergic rhinitis patient population and its adherence.

In addition, advances in the areas of genetics and informatics are driving a transformation in our understanding of the disease. Innovations in technology also present opportunities to more efficiently and effectively address the growing volume of regulatory requirements, particularly regarding more stringent manufacturing requirements.

Rise in allergies gaining attention from payers, providers and regulators

As more patients seek treatment for their allergies, the AIT industry has gained greater attention from the healthcare community. Healthcare providers are seeking more clinical evidence related to the safety and efficacy of AIT; payers are more tightly controlling access and increasingly requiring data about the economic benefit to maintain coverage for treatment; and regulatory bodies are increasing their scrutiny and enacting more stringent requirements of biologics manufacturers.

1. World Allergy Organization, Immunology and Biologics Symposium 2013. https://worldallergy.org/symposium2013

2. Lotvall, J., R. Pawankar, D. V. Wallace, C. A. Akdis, L. J. Rosenwasser, R. W. Weber, A. W. Burks, T. B. Casale, R. F. Lockey, N. G. Papadopoulos, S. M. Fineman and D. K. Ledford (2012). "We call for iCAALL: International Collaboration in Asthma, Allergy and Immunology." The Journal of allergy and clinical immunology 129(4): 904-905.

3. Market size (€1bn) and expected growth (2%): global data and internal estimates share of AIT market in the global allergic rhinitis market (12%): Visiongain report 2018.