ALK-Abelló A/S (ALKB) Earnings Call Transcript & Summary

November 11, 2021

Nasdaq Copenhagen DK Health Care Pharmaceuticals earnings 41 min

Earnings Call Speaker Segments

Per Plotnikof

executive
#1

Hello, everyone, and welcome to today's presentation of ALK's quarter 3 results together with an updated outlook for the full year. Could you please turn to Slide #2, where I'll introduce you to today's presenters and our agenda. My name is Per Plotnikof. I'm Head of Investor Relations. And with me today are ALK's CEO, Carsten Hellmann; and our CFO, Søren Jelert. And today, we will look at our Q3 performance, sales trends across our regions and portfolio and the 9-month financials. And then we will give you an update on our 4 strategic priorities before talking you through our improved full year outlook. And finally, we will end today's call with the usual Q&A session. So if you would please turn to Slide #3, and then I will hand over to Carsten and we'll get started.

Carsten Hellmann

executive
#2

Thank you, Per, and thank you, everyone, for joining us today. First, let me give you the highlights. In a very strong Q3, we delivered revenue growth of 20% with sales growth across all 3 of our regions. This was also fueled by a 41% increase in sales of our tablets and a further recovery in sales of our legacy products and the continuing gradual normalization of visits to allergy clinics. This compares against a Q3 last year that showed 7% overall growth with tablet sales up 52%. Overall, operating profit EBITDA was better than expected, up 114% to DKK 124 million. This was influenced by the sales growth and an improved gross margin, but also included planned increases in R&D and sales and marketing spend. In Q3, we also maintained focus on the execution of our long-term strategy. This was progress in Germany, our biggest -- there was progress in Germany, our biggest market, where national prescription guidelines were again updated to emphasize initiating new AIT patients onto registered products only. And remember, last year, ALK became the first company in Germany that market only registered AIT products for the main allergens. Just after the quarter ended, we also successfully completed the formulation feasibility study in partnership with Catalent, which confirmed that the Zydis fast dissolving tablet technology used in our respiratory allergy tablets is also suitable for use in the clinical development of a peanut food allergy product. Finally, we continue to see the benefit of the investments made in our manufacturing and supply operations, which remained robust throughout the quarter. With that quick look at the highlights, I'll hand over to Søren now who will take a look at the Q3 financials in more detail. So please now turn to Slide 4.

Søren Jelert

executive
#3

Thanks, Carsten. As said, third quarter was a very good quarter for ALK, delivering solid double-digit growth across our sales regions of Europe, North America and international markets. Sales were up 15% in Europe and were once again particularly strong in the Nordics and Central Europe. This was driven by tablets, which were up 32%. We continued to see ITULAZAX and GRAZAX perform well. This was supported by an early uptake of a recent launch of adolescents indications of ACARIZAX in France. Sales of legacy products, in particular, SCIT, showed a positive momentum, and they continue to recover some of the lost ground of previous years due to discontinuations and COVID. As in previous quarters, Germany delivered double-digit growth, and we saw the shift towards registered evidence-based AIT treatments continue. National reimbursement guidelines recommending that AIT patients should be initiated onto registered products have been reinforced, and we expect this will continue to drive the market transition towards evidence-based medicine. In North America, revenue was up 23%, as our sales continue to recover from the impact of COVID, especially in the U.S. as doctors focus on bringing patients back into their clinics and hospitals. Tablet revenue increased 67% as margins improved. However, we continued to see modest sales volume in the U.S. Sales in international markets were up 51% with a positive impact from product shipments to Japan and China. What is also encouraging is the in-market sales development in these 2 markets. In Japan, Torii delivered in-market tablet growth of 52% in the third quarter, and our partner continued to do a great job. Torii now expect total in-market tablet sales in 2021 of approximately DKK 900 million. In China, we also saw good in-market sales trends with year-to-date growth of new treatment starts exceeding 50%. Now let's take a closer look at the product categories on Slide 5. In quarter 3, tablets continued to be the key growth driver for ALK with 41% growth. Combined SCIT and SLIT-drops sales were -- continued their recovery of COVID lockdowns and were up 5%, reflecting increased SCIT sales and SLIT-drops sales were declining largely due to the ongoing transition to tablets in France. Sales of our other products recovered further in third quarter and were up 15% as COVID eased its grip on sales of diagnostics, life science products and PRE-PEN. In third quarter, Jext sales in Europe improved in single digits. However, in the U.K., in particular, we saw an impact from lower pen replacement rates by patients, which are likely linked to COVID. This brings us to Slide 6 and the P&L. Profitability was better than expected because of the strong sales and improved gross margins. Revenue for the first 9 months were up 14% in local currencies. The lower U.S. dollar, in particular, had a negative currency impact, so that reported growth was 13%. The gross margin improvement of 2 percentage points to 60% reflected increased sales of tablets in Europe, although this was somewhat reduced by shipments to Torii in Japan, which carry lower gross margins. Behind this positive development is also the fact that we are currently spending a little less in product supply than planned. The trend is right and support our long-term margin expansion targets. EBITDA increased 20% to DKK 398 million despite the planned 35% increase in R&D spend. Sales and marketing costs were up 11% on more normalized activity levels. Free cash flow was positive of a total of DKK 149 million, driven by improved earnings and changes to the working capital. Finally, it is worth mentioning that currently, we have unused cash and credit facilities of DKK 1.4 billion. Now let's move on to a brief strategy status on Slide 7 and over to Carsten again.

Carsten Hellmann

executive
#4

Thank you, Søren. Just a quick reminder that earlier this year, we updated our strategy in pursuit of a sustained high growth of 10% or more and to improve our profitability of 25% EBIT margin in 2025. And as you see here, we expect the tablets to be the primary drivers of growth, and we will support the success by becoming relevant to ever more allergy sufferers. Our 4 strategic pillars are: to succeed in North America; to complete and commercialize the tablet portfolio, digital consumer engagement and new horizons; and to optimize for excellence. And through these, we aim to extend our leadership in respiratory allergy short term, driving strong, sustainable growth, while we also seek to accelerate long-term growth opportunities, both expanding in the pediatric segments and to enter into the food allergy segment and expanding our presence in anaphylaxis and other activities. The goal is an ALK capable of delivering sustainable high growth of 10% or more annually and earnings growth of 25% in '25. In Q3, we made further progress towards all of these, and I'll summarize the highlights on Slide 8. So please turn to Slide 8. Let's start with North America. On the left side of this slide, from a broad business point of view, the ongoing easing of COVID restrictions in the U.S.A. continues to benefit sales, particularly legacy products and hospital-based products. With sales up 67% on tablets, we have also been helped by the improved ability and willingness to visit allergy clinics as well as an updated coupon system that meant that higher realized selling prices. Of course, tablet revenue still represents very small numbers in absolute dollar terms, and our focus remains on the long haul efforts to build prescription [ depth ] among allergists who recognize the benefits of the tablets and to expand the prescriber base into other specialties, and we're committed to see this long-term journey through. Moving to the column to the right. We continue to make progress with the further clinical development of the tablets and patient recruitment is moving ahead as planned on our 2 important allergic rhinitis trials in pediatric patients with house dust mite and tree allergies. With the Europe and North America-based pediatric house dust mite trial for allergic asthma, it will still take a little while before we can access -- assess any impact from COVID on the number of asthma events. We expect to have a clear picture during first half of next year. Meanwhile, the China registration trial for the house dust mite tablet remains on hold due to the international travel restrictions, but we are in dialogue with the authorities there to discuss possible next steps. Looking at the third column of the slide -- of this slide, our digital engagement platform, klarify, gained further traction by the end of the quarter. And by the end of the quarter, we have mobilized more than 300,000 consumers in 2021 to take action on the allergy, for example, via the find a doctor functionality. The important next step for this initiative is to create a direct link to patients being prescribed AIT treatment. And the numbers are currently low and we continue to test and trial [ concepts ] to better connect patients with prescribers at the final stages of this patient journey and to subsequently or to improve treatment adherence. As mentioned, work on our new horizon priority recently took a significant step forward when we completed the feasibility study on whether Catalent Zydis fast dissolving tablet formulation, the same technology that we use in our respiratory tablets, is suitable for the future food allergy products. The success of this trial gives us a green light to accelerate into Phase I development with a peanut allergy tablet, and we expect to initiate this in the first half of next year. Meanwhile, the next partnership with [ Grand Pharma ] for China, which we announced in Q2 continue as planned with the aim of launching China's first adrenaline pen potentially as soon as next year in the China Greater Bay Area. We also continued on our projects to develop a new adrenaline pen for the U.S. market with a target of an FDA submission in '24. Finally, on the lower right, you will see some highlights from our optimize for excellence priorities. This includes the extensive work we're doing to rationalize our portfolio, simplify our manufacturing processes and upgrade the regulatory [ documentation ] for core legacy products. So far this year, we submitted 1,334 regulatory changes covering 133 products to 40 different regulatory authorities. So a lot of work has been done. As a result of simplifying our portfolio in this way, and thanks to the significant investments we have made in our manufacturing and supply operations over recent years, I'm also happy to report that despite the challenges being reported by other companies and industries, our supply chain, inventory levels and distribution channels have remained robust throughout Q3. With that, I'll hand back to Søren, who will talk you through our updated outlook for 2021 on Slide 9.

Søren Jelert

executive
#5

Thank you, Carsten. Our full year outlook has been updated to reflect the year-to-date performance. The current full year outlook is as follows: we now expect double-digit revenue growth of 11% to 12%, with tablets continuing to be the key with sales growth expected to exceed 25%. This is further supported by an improved outlook for sales of SCIT and SLIT-drops. EBITDA is now increased to between DKK 500 million and DKK 550 million. R&D is still expected around DKK 625 million. And I will -- and we will still foresee a gradual normalization of sales and marketing spend compared to last year, which was impacted by COVID. This year, we expect the sales and marketing to revenue ratios a little above 30%, a development that is in line with our long-term targets. Free cash flow has also improved and is now expected to be positive of around DKK 200 million, reflecting higher earnings, CapEx of around DKK 250 million and an upfront payment received from Grand Pharma. In addition, we now expect the one-off working capital payment of DKK 175 million, which relate to accrued rebates that it will be postponed or deferred to 2022. With this, I'll hand you back to Per and the Q&A session on Slide 10.

Per Plotnikof

executive
#6

Thank you, Søren, and thank you, Carsten. And this concludes the main part of our presentation. So we now move to the usual Q&A session, where we'll be happy to take any of your questions. Operator, please go ahead.

Operator

operator
#7

[Operator Instructions] Our first question comes from the line of Jesper Ilsoe of Carnegie.

Jesper Ilsoe

analyst
#8

First question, maybe you could provide an update on the expected time lines on pipeline readouts, i.e., when we should expect data. So you will start peanut allergy Phase I here next year. So is it fair to assume data early 2023? On the children trials, which you say are progressing as planned, is it fair to assume Phase III data around mid-2023? And on the China study, perhaps you can elaborate a bit more on what alternative solution you could do, i.e., do you need to fly them into a different country? Can you do it in China? What can we actually do, so what are the possibility and implications on China? And then when we could expect to see some data on these 2 adrenaline programs? And then I can just follow up with the question afterwards.

Carsten Hellmann

executive
#9

Thank you, Jesper. This is Carsten answering. For the 2 first questions regarding peanut in children, here, we'll see completion of the children in '23, and you'll also see the first readout from peanut also in the beginning of '23. So I can confirm that. Regarding China, it's more up in the air exactly when we can see it. The different optionality we do have is whether we can -- from not do the clinical trial at all to have to do a clinical trial. And within that spectrum, we see whether we can maybe do [ chamber trials ] in China, whether it opens up or not. But we still expect a '24, '25 filing and approval of the Chinese market for our dust mite tablet. So it's only a matter of the COVID delay right now. And whether we can maybe make a simpler version of the trial or maybe do something different, and that's to be -- is already discussed and to be decided by the authorities. We have a lot of exchange with the authorities right now. Regarding the different pens, remember, we have 2 parallel projects which we're investing in, one with an external partner, the Windgap and then our own [ Genesis ] project. And we still expect, no matter what, to file for FDA approval no later than 2024 on either both pen or one of the pens, depending on how it goes. So that's where we stand right now.

Jesper Ilsoe

analyst
#10

Okay. Just on the latter. So is it fair to assume some data during 2022? Because as you recall, you previously flagged for data potentially during 2021, but now it's more on a recurrent basis that it could come up. But just to understand when we should actually see some data on adrenaline.

Carsten Hellmann

executive
#11

Yes. But remember, it's 2 different projects. The Windgap one, where we said we'll have some first readouts end of this year, but that was whether it was a project that did not fly or not, and we have not seen any evidence it will not fly yet. So we will, of course, continue that project as well as our own Genesis project, where we are investing a 3-digit million into developing that product over the years. And I don't know exactly what you mean readout. Of course, if we have any information that any of those projects will not fly, and we have to stop it, we will tell you. We had a situation, as you know, a year ago, where we were doubtful whether it could fly the Windgap at all, and we knew there would be some [ stability data ] coming out end of this year. Now we will be into '22 before we have sort of the next milestone. And should some of that turn out to be negative, we will tell you about it. Otherwise, it's something we just continue to do. We will -- we are very firm on the objective to submit in '24 one or both of the products. So we continue with both until either both or one of them fails or goes the right way.

Jesper Ilsoe

analyst
#12

Perfect. Then the second question, just on the margin expansion when we look into 2022. So on the gross margin, it looks very strong this quarter, and you also upped the guidance on gross margin. So when we look into next year, is it fair to assume that if current trends continues on the top line, that it -- we could also see approximately this 2 percentage point increase in the gross margin? And also on R&D, you previously guided the market on the Q2 call about the R&D level in '22 around DKK 650 million to DKK 700 million. Is this also a fair reflection given what you are doing right now? And then other consideration on margin expansion that we could expect into next year.

Søren Jelert

executive
#13

Yes. Thank you, Jesper, for some good questions. And I think it's fair to say that we are very positively reporting out on the gross margin and have been very working extremely dedicated and focused to gain this more or higher gross margin momentum. And I think third quarter here, at least the year-to-date, is a solid proof with these approximately 2 percentage points up compared to last year is now more solid as you have a little bit more runway to it. And of course, it leads also to -- so in the higher end of this year, right around the 60% mark where we started off saying 58%, I believe, with a 1% to 2% gain. Now we -- I think it's solid to assume that we will be around the 60%. And then you will, of course, push me to another 2 percentage points next year. I think it's a little early. I think we are on the same track as you are in the case that we are probably at this 1 to 2 percentage points because it a little bit depends on how the mix pans out next year. But what we are extremely focused on is that the underlying improvement programs are running as they should. And that should definitely give you some visibility into that we are towards the 70%, that's our long-term strategy. So yes, we do not consider this a one-off improvement. We see that as a continued improvement. And then we can always debate whether it's going to be 61% or 62% next year. One thing is for sure, that we seem to have a higher consistency in the margin improvement now. So that's that one. And then when it comes to R&D, it's absolutely correct that we last time said DKK 650 million to DKK 700 million. We stand firm on that. And that includes still Carsten's assessment of the trial progress. So that is still a solid estimate and what we are aiming for.

Operator

operator
#14

Our next question comes from the line of Michael Novod at Nordea.

Michael Novod

analyst
#15

This is Michael from Nordea. So first of all, on the peanut project, could you elaborate a bit on sort of the plans post potential positive proof-of-concept data? And was that sort of going to be an accelerated program or whether you more see it now as a sequential program, Phase II, Phase III? And then, of course, also then elaborate a bit on potential sort of commercialization time lines for the peanut program. I know it's early, but just to give some flavor on this. And then secondly, on the Grand Pharma, just a clarification. So has it already -- I guess it should have already had launched, but I think, Carsten, you said that it could launch in the Greater Bay Area in the first half of '22. Why hasn't it launched if it's the case of going on the market until '22?

Carsten Hellmann

executive
#16

Thank you, Michael. This is Carsten. We -- the Grand Pharma, if we start with that one, Grand Pharma is now trying to and getting approval at about 28 different hospitals in South Bay area. So you can debate when I say launch, that's when we start seeing sales. So it is launched. But the way you launch it in Greater Bay Area, when you leverage this Hong Kong license we do have is that they go in hospital by hospital and get an exemption to the registration and then allowed to launch in that hospital category. And I think they're operating with about 28 hospitals right now. We expect to see measurable sales numbers. I'm not assuming we're not getting anything this year, but measurable sales numbers from 2022, that's what I meant about that. So they are already up and running. There's no delays or anything like that. It's just the process of getting it into the market. Regarding peanut, we don't really know whether we can accelerate the time lines. I think it's very good news that the feasibility study proved positive. We are definitely not holding back on any investment or money to accelerate. I think what we're working on right now is, of course, to fully understand how many up-dosings do you need and how should we set it up. We will do that first half next year. We see those readouts and exactly how it's going to pan out, then we will decide what is the fastest way and the fastest route to market no matter what. This is a critical opportunity we do have. It's a fantastic accelerator should it work out. Whether you can do a parallel Phase II and III, it's -- we don't know that yet, but it's as a full program fully invested, it's with the teams behind it and a lot of R&D work. So we mean this series is not just a bubble. It's really a program and a project right now. Still, it's post '25, which we also know that the adrenaline plans are. But as I said many times, the 10% growth we have is based on the organic things we can see, the visibility we can see, then we're investing in some accelerators/backup for adrenaline for children and for food that comes post '25 to make ALK even stronger and bigger. So that's the plan.

Operator

operator
#17

And our next question comes from the line of Carsten Lonborg of SEB.

Carsten Madsen

analyst
#18

Carsten from SEB. I was just hoping I could get a little bit more color on the performance in your largest market, Germany, which seems to be driving a lot of growth for you guys. I don't know how much detail you're willing to give, but I'm, of course, hoping for a lot, both in terms of growth contribution and also what you're seeing right now in the market in terms of conversion to tablets, your market share, et cetera. And then second question, coming back to the gross margin again, the improvement from Q2, I know it's hard to just use 1 quarter as a reference here, but the improvement from Q2 is quite impressive. And I know you're saying that you're just working. It's bits and pieces here and there. But is there anything sort of meaningful that impacts the gross margin in this quarter? Essentially, you are adding DKK 60 million in top line from Q2 to Q3, and you are adding DKK 53 million in gross margin. So the DKK 60 million [ North America ] margin is 90% if you can do that kind of basic math. So hoping for a little bit more color on the gross margin, if possible.

Søren Jelert

executive
#19

Yes. So I think I'm a happy horse on that one. But anyway, the gross margin, it's absolutely correct that we are continuously, also quarter-on-quarter, going up. And if you compare third quarter last year with third quarter this year, we are actually up almost 5%, and that is very much driven by the tablets. Here, there are conversations still of -- when we sell more Torii, it takes down the gross margin a little bit due to the remuneration model we have. But solidly, the underlying other tablets have actually been accountable for almost 3.5% gross margin points. But then you need to deduct the impact of Torii. So we say approximately 3 percentage points from quarter-to-quarter is linked to the tablets. Then there are a number of other minor things, but the reality is that it's tablet-driven. There is a little bit -- we sell a little bit more SCIT in Europe. That gives a little bit more margin points. And then we also had a depreciation or a write-off in third quarter last year. That's also 0.5 percentage points. So I don't -- I wouldn't put too much attention to those, but more look at the fact that we consistently improve our margins by selling tablets. And that has been the story for the last many quarters. So hopefully, that is -- I don't know whether that was a color. I think it's an easy color because it's a tablet color. So that's fairly easy to explain. Then you had another question on Germany. It's absolutely true that Germany is the star performer for us on a single market standpoint. And it's, of course, on the basis of a full portfolio being live on the tablets in Germany that consistently is beefing up our performance, whether it's ITULAZAX or is GRAZAX. I mean that's the clear -- the 2 biggest vehicles behind the growth. And for Germany, for us, we are above -- solidly above 10% growth in Germany. And it is very close to being our biggest single market. But also here, although it might be a little bit boring, it's the tablets that's driving the growth. And in addition to that, there have been this focus on evidence-based medicine. And here, it's a little early to say how much it has impacted ALK. But again, if you are a doctor who knows that products are going away and you can go to an evidence-based producer as we are and have a good portfolio with all the tablets that we have, then there is an increased likelihood that some of these old products that has been discontinued has moved our way. So currently, we are leading in Germany in evidence-based, no doubt about that. But even if you take the older products, we're also market-leading in Germany. So in many ways, we're extremely satisfied with the performance in Germany. And I think it's going to be very interesting to see how the long-term effect of this -- the authorities wanting basically to take out the nonevidence-based medicine. When and how that will fall into our basket, I don't know. But I'm absolutely sure we're going to get our fair share of this. So it's more a question of when that will be enforced.

Operator

operator
#20

Our next question comes from the line of Benjamin Silverstone at ABG Sundal Collier.

Benjamin Silverstone

analyst
#21

Congratulations on the very strong quarter. I have 2 questions for me. The first one is just in terms of supply chain robustness. Could you just give us a brief update on how you saw it in the quarter and how you see it going forward, let's say, next 3 to 6 months? And then the second question is in terms of dividends. So based on the strong momentum that you are seeing and being on track to solid profitability, could you please just remind us how we should think about potential dividend and share buyback going forward?

Carsten Hellmann

executive
#22

This is Carsten, and I'll try to at least answer one of them. The supply chain, of course, you have a very calm duck on the surface and a lot of moving legs under the surface of the water when you have a situation with COVID, because it's not onlya one line of issues you will have in the supply chain. It goes up and down in different countries and regions from day to day almost. However, I will, though, say that those issues that have been predominantly in getting the right materials for production like bags and filters and so forth, we have solved that, and I think we are covered well into next year as well. Always remember, we are carrying, for the tablets, almost 1 year's inventory. So I think we're pretty well off for the next couple of years. And also another thing, for example, ALK's total transportation cost is in the range of DKK 30 million. So yes, transportation cost can double, but it won't really affect our P&L that much. And you will see also, if you look at gas and electricity and others, it's in the same range. So I think if you look at the whole world that is so shaky right now, ALK will not come out in the next quarters with a lot of excuses due to supply chain disruptions to what we can see today. We are more in the black swan events type of stuff, but not in the running of the business. So I think that's good. It's not up to me to talk about dividends and share buybacks. This is my Board and shareholders to do that. But of course, I think there's a lot of shareholders who have been recognizing that we have a strong, sustainable, fast-growing company right now. So maybe you should ask that at the general assembly in March.

Operator

operator
#23

[Operator Instructions] Currently, the last question in the queue comes from the line of Thomas Bowers at Danske Bank.

Thomas Bowers

analyst
#24

Just a few remaining from my side. So just when we look at the outlook for Q4, so I remember, you have been out saying around 5% to 10% is expected for Q4 and then, yes, double digits for Q3, as we have seen, more than that maybe. So just looking at my back-of-the-envelope calculation here and looking at your guiding out to 11% to 12%. So is it fair to assume that we should be looking at the very low end of this 5% to 10% outlook? And is there anything that we should be aware of, aside from Torii fluctuations, of course, and there's also some tough comps. So anything that could sort of create a little bit of noise for the remainder of the quarter? Or just -- well, it looks, of course, to be quite solid on the tablets, of course. And then maybe just -- maybe I missed it, but can you just add a little bit of color on ACARIZAX, the growth for the quarter in Europe? You highlighted GRAZAX and ITULAZAX, so just a little color on this. And then lastly, just on the rebates that is impacting the cash flow. So I understand it's accumulated from 2018 and onwards. So how certain are you actually that these new time lines will actually be met? So we're not looking, I guess, at a scenario like the price discounts you were waiting from France, I assume. So is it fair to assume that this will definitely happen here in '22?

Carsten Hellmann

executive
#25

Yes. I would like just to start from the last question. The rebates you're talking about, you said the rebates that we have been accruing basically sort of the DKK 175 million just to be sure that I answered that right, yes. No, that's -- I mean it's something that dates back and has been built up in -- from 2018 and then towards 2020. And basically, it's a technical adjustment we did to a product where we were of the opinion that we could have a change price. We were uncertain, hence, back then we started already to [ accrue ]. But the way that the payments in Germany works is that you actually get the money from the different payers in this case. And then basically, you could say we built up cash or in this case, a liability. And that liability, we have known, also communicated to you guys that we do not believe that we are entitled to the DKK 175 million, i.e., that once it goes back to the authorities or the claimers that, and that we believe will be in 2022, that will go out of our books, i.e., out of the balance sheet and through the cash payments. So there's absolutely no P&L impact, so far. So hopefully, that clarifies it. And then when it comes to the fourth quarter, where you're right that we have actually been guiding pretty much what we have also delivered here. We expected a higher third quarter. That's what we've seen. And you're also right in -- when looking into fourth quarter, that it is actually in all fairness quite high comparables in Europe and also when it comes to Japan, and that is still what we anticipate to be the case, that we will not see this high sales to Japan. Hence, a lower growth, and that's why it, at a full year scale, lands around 11% to 12%, which seems to be quite solidly founded in the growth rates you also see now. So at least there's no other specialties, I would say, in fourth quarter as we see them. And then there was a last question. I didn't quite hear that. That was...

Thomas Bowers

analyst
#26

Yes. It was just -- maybe I missed it in your prepared remarks, but just on the ITULAZAX -- sorry, ACARIZAX in Europe, because you highlight ITULAZAX and GRAZAX as the main driver. So I just wanted to -- if you could add some color on our ACARIZAX as well.

Carsten Hellmann

executive
#27

I mean it's right that ACARIZAX is growing, it has been for some time. And our comments here was more that we have seen a benefit of the adolescence launch in France on ACARIZAX. That's basically the core, you can say, new kid on the block in this case that drives growth, but it's not dramatic. So it follows the patterns we have seen so far. But every time you can reconfirm growth, that's also beneficial for us.

Operator

operator
#28

As there are no further questions on the phones at this time, I'll hand the floor back to our speakers.

Per Plotnikof

executive
#29

Thank you all for joining today's call, and thank you all for your good questions. And as you can see from Slide #11, we have scheduled a series of road show sessions and other presentations over the coming months that we hope that you will join. And in addition, as you know, you're always welcome to call me, Søren or Carsten if you have additional questions. With that, I will wish you all a good day, and I will end today's session. Thank you, and goodbye.

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