ALK and ARS Pharmaceuticals have announced a strategic four-year agreement to co-promote Neffy (epinephrine nasal spray) to approximately 9,000 pediatricians across the United States. The partnership focuses on expanding access to the first and only FDA-approved needle-free treatment for Type I allergic reactions, including anaphylaxis.
Under the agreement, which becomes effective at the end of May 2025, ALK will accelerate the build-up of its US pediatric sales channel by deploying a dedicated sales force of approximately 60 representatives. The targeted pediatricians currently account for nearly 10% of all epinephrine auto-injector prescriptions in the US market.
Strategic Importance for Both Companies
The co-promotion agreement builds upon an existing partnership established in November 2024, when ALK secured exclusive rights to commercialize Neffy globally, with exceptions for the USA, Australia, New Zealand, Japan, and China. This new arrangement specifically addresses the US pediatric market segment.
"We are excited about expanding our partnership with ARS Pharma, which we firmly consider a win-win situation for all parties," said Peter Halling, ALK's CEO. "More children, caregivers, and prescribers in the USA get access to an effective and needle-free anaphylaxis treatment. Although the agreement initially will have a limited financial impact for ALK, we are strengthening our capabilities in the USA."
For ARS Pharmaceuticals, the agreement accelerates their market penetration ahead of the critical back-to-school season, when many families seek anaphylaxis treatment options.
"As a result of broad coverage from leading pharmaceutical benefit managers and health plans, millions of patients nationwide now have improved access to Neffy," said Richard Lowenthal, co-founder, president, and CEO of ARS Pharma. "This partnership extension with ALK allows us to efficiently reach healthcare professionals who represent about 55% of all community-use epinephrine prescriptions in the United States."
Financial Structure and Responsibilities
The agreement follows a cost-sharing and performance-based revenue model. ARS Pharma will pay ALK for the majority of direct costs related to sales force activities. Additionally, ALK will be eligible for performance-related revenue sharing when net sales exceed certain market share thresholds from targeted pediatrician prescribers.
Key terms include:
- Neffy will hold the primary position for ALK sales representatives during the first two years, shifting to co-primary position during the final two years
- ARS Pharma will compensate ALK through quarterly base fee payments
- Performance-based payments begin in the second year, with ALK receiving 30% of net revenue exceeding specified market share thresholds
- The threshold increases to 50% market share during years three and four
ARS Pharma retains responsibility for all other US commercialization activities, including marketing, medical affairs, market access, production, distribution, pharmacovigilance, quality, and safety. The company also maintains termination options, including upon change of control.
Addressing a Critical Unmet Need
The partnership addresses significant challenges in anaphylaxis treatment adherence. According to data cited by the companies, approximately 40 million Americans experience Type I allergic reactions. Of the 20 million diagnosed and treated for severe reactions over the past three years, only 3.2 million maintained active epinephrine auto-injector prescriptions in 2023, and only half consistently carried their prescribed device.
Even among those who carry auto-injectors, more than 50% either delay or completely avoid using the device during emergencies. Common barriers include fear of needles, portability issues, safety concerns, reliability questions, and device complexity.
Neffy offers a needle-free alternative for patients aged 4 years and older who weigh at least 33 pounds (15 kg). The 1 mg dose for children is expected to become available in May 2025, coinciding with ARS Pharma's planned direct-to-consumer campaign launch.
Market Impact and Future Outlook
While ALK expects the agreement to contribute to revenue growth from 2025 onward, the initial financial impact will be limited with a modest negative effect on earnings (EBIT) when excluding potential synergies with ALK's existing product portfolio. The company stated that the agreement does not change its revenue and earnings outlook for 2025, and long-term financial ambitions remain unchanged.
For ARS Pharma, operating expenses are projected to increase by approximately $3 million per quarter starting in Q3 2025, though 2025 cash flow will not be impacted.
Beyond immediate financial considerations, both companies view the partnership as strategically valuable for their broader allergy treatment portfolios. ALK noted that the agreement may support its respiratory allergy immunotherapy tablet portfolio, recently approved for young children, and prepare the company for potential future entry into food allergy treatments.
"By expanding direct promotion with ALK, the global leader in allergy immunotherapy with substantial experience in the allergy space, we can ramp up quickly ahead of the peak summer season to ensure Neffy is optimally positioned as a needle-free, safe and effective treatment option for children with severe allergic reactions," added Lowenthal.
