Thank you for joining us for today's presentation of ALK's quarter two results and full year outlook. Let's start by turning to slide number 2, where I will introduce our presenters and the agenda. My name is Per Plotnikof, and I'm Head of Investor Relations. With me today are ALK's CEO, Carsten Hellmann, and our CFO, Søren Jelert. Today, we'll look at our Q2 performance sales trends across our regions and portfolio and then the financials. Then we'll give you an update on our strategic priorities before covering the pre-announced full year outlook. Then we will end today's call with the usual Q&A session. If you please turn to slide 3, I'll hand over to Carsten to get started.
Thank you, Per, and thank you all for joining us today. Let me kick things off by giving you the Q2 highlights. I'm happy to report that we delivered our best Q2 result on the back of a better than expected performance. A growth in local currencies of 17% and 20% in reported currencies. This is indeed a strong result, meaning that organic sales growth for the first half year is now at 14% in local currencies and 16% reported. Profits are up 38%, and the EBITDA margin is now at 17%.
We saw double-digit sales growth in all three sales regions and a bounce back in our biggest region, Europe, after sales were held back slightly in Q1 by a number of factors, including COVID, lower Jext replacement rates, and a brief supply interruption that affected some SCIT venom products, as we explained last quarter. European sales were up 14% in Q2, and the tablet portfolio grew 21%, and we saw very good performance from Jext with strong post-COVID replacement rates. Momentum in Europe is strong, which is why we upgraded our full-year outlook on revenue and earnings a few days ago. As a result of higher sales and improved margins, overall operating profit for the quarter increased by 123%.
In Q2, the biggest headline on our strategy progress was the initiation of a phase 1 clinical trial with our peanut SLIT tablet, which we'll discuss in detail later. We also remain on track with our two phase 3 pediatric trials with the house dust mite and tree tablets. We also signed an important and significant expansion to our agreement with the contract manufacturer Catalent to secure long-term access to increased manufacturing capacity for tablets in line with our long-term sales ambitions. With these highlights, I'll hand over to Søren now, who will take a look at the Q2 financials in more detail. Please turn to slide four, please.
Thanks, Carsten. As you can see, quarter two was a solid quarter for ALK, with broad-based double-digit sales growth from all three regions. In Europe, as Carsten mentioned, we saw sales bouncing back strongly after the headwinds in first quarter. Quarter two sales were up 14% on the strong performance of tablets and Jext, while sales of SCIT further recovered. We also managed to resolve the release issues that were affecting a few of our venom SCIT products in first quarter. Tablet sales were up 21%, primarily on the ongoing uptake of ITULAZAX, ACARIZAX and GRAZAX, which continue to increase the percentage of new patients that they are capturing. Once again, our biggest market, Germany, delivered double-digit growth and increasing capture rates for new patients.
Other important markets in Central and Northern Europe also recorded double-digit growth, while sales in France were down, although less than first quarter. The core momentum in Europe is solid, even though we may see fluctuations quarter to quarter. In North America, we saw growth of 19% driven by all segments. In particular, diagnostics and non-allergy-related life science products contributed to the growth. Revenue from international markets were up 30%. This reflected high levels of shipments to China, while tablet shipments to Japan, as expected, were modest in this quarter due to phasing of shipments. Both China and Japan continue to see good in-market momentum, although both markets were temporarily impacted by recent resurgence of COVID. However, this is not something we expect to significantly impact this year's supply of shipments. Now let's take a closer look at the product categories on slide number 5.
Revenue from the tablet portfolio continued to grow in line with our full year expectations. Global tablet sales were up 18% in the second quarter. Europe was the key driver and capture rates remained solid. Combined, SCIT and SLIT-drops sales increased by 4% on growth from international markets, especially China. Growth from bulk SCIT products in North America improved compared to first quarter. Sales of other products were up 50%, mainly on strong growth in Jext sales and the sales of other products in North America. As expected with Jext, we saw much higher replacement rates compared to the previous two quarters, but we also saw a positive effect from the temporary supply disruptions that have been affecting competing products.
All in all, we are well on course to deliver on our guidance of double-digit growth in 2022. This brings us to slide 6 and the P&L. Half year revenue was up 14% in local currencies at DKK 2.2 billion, and higher US dollar had a positive currency impact so that reported growth was 16%. The gross margin improved by 3 percentage points to 63% reflecting increased sales of tablets in particular and production efficiencies. Although this was somewhat offset by increased shipments to Torii in Japan at lower margins. EBITDA increased by 38% in reported currencies to DKK 379 million, corresponding to an EBITDA margin of 17%. Capacity costs increased 11% in local currencies.
Sales and marketing spend were up 13% due to investments in market expansion in China, a high activity level, as well as restructuring costs to close down our activities in Turkey, where market conditions has become unsustainable for our products. Finally, free cash flow was positive by DKK 93 million. This reflects changes to working capital, build-up of capacity tablet production, upgrades to the legacy production, and investments in the in-house adrenaline auto-injector currently in development. A quick note here. Free cash flow did not include any repayment of mandatory rebates that we flagged in the annual report, and we now expect these payments to be lower than originally anticipated for 2022 and instead take place in 2023. All in all, a very strong first half of the year, which led us to upgrade the outlook a few days ago.
Now let's move on to the brief strategy stage on slide 7 and over to Carsten again.
Thank you, Søren. Let me give you a quick update on the Q2 progress on our long-term strategic priorities, each of which you can see summarized on this slide. In the U.S., we continue with our work to overcome the long-established market barriers to our tablet adoption. This takes a number of forms, hereunder using digital patient engagements to mobilize patients, working with the prescribers, and pursuing pediatric and adult indications for the house dust mite tablet. Our work to complete and commercialize the tablet portfolio aims to sustain and build on the successful commercial momentum we currently enjoy, as evidenced by expectations for full-year sales growth of 20% or more. We are doing this by augmenting the portfolio in key areas and by accessing new patient groups and new territories.
Our pediatric trials of the house dust mite and tree tablets remain on course for completion in 2023. Meanwhile, following the clinical trial waiver we received in Q1, we continued preparations for regulatory submission of the house dust mite tablet in China later this year. As we have reported several times in the past years, our pediatric trial of the house dust mite tablet in allergic asthma were impacted by a major reduction in asthma exacerbations due to behavioral changes during COVID. Based on a dialogue with the authorities, we've decided to end this trial since we now expect to be able to meet the key commitments made by and agreed in the pediatric investigation plan. The next step will be to unblind the trial, analyze the data, and report the results.
Since house dust mite-induced allergic asthma is a comorbidity of allergic rhinitis, we still expect to gain full pediatric coverage with via our allergic rhinitis trials. Also, as said many times before, the situation with this trial does not impact our ambitions, nor commercial or any other results in the long term. Our consumer engagement efforts continue to mobilize patients via our digital engagement platforms. We saw impressive growth in the number of patients mobilized up to 160,000 in the first half of 2021 to 500,000 in 2022. Furthermore, we launched our digital klarify ecosystem in four new countries: Austria, Czechia, Slovakia, and Switzerland. As I mentioned before, we made some important progress on our New Horizons priority in Q2, where we initiated phase 1 development of our peanut allergy tablet.
Work also continued on the two adrenaline auto-injector projects toward the planned submission to the U.S. FDA in 2024. Optimize for excellence covers the work we're doing to be bold and lean, rationalize our portfolio, simplify our manufacturing processes, and upgrade the regulatory documentation for core legacy products and build capacity for the longer term. As mentioned in the highlights, a major achievement in Q2 was the signing of an expanded agreement with a contract manufacturer, Catalent, which secures priority access to expanded manufacturing capacity for the tablet portfolio, which means that we now have safeguarded the volumes in line with our growth ambitions toward 2030. We also submitted 493 regulatory changes covering 103 legacy products to 40 different regulatory authorities to improve efficiency and reduce complexity.
Before we move to the outlook, let's just in the next, let's just focus in on the exciting news about the new peanut tablet on slide eight. First, some background on what is a significant unmet medical need for millions of people. Food allergies affect an estimated 2.5% of the global population. The main allergies are to peanut, tree nut, milk, and eggs, and they usually occur in children before they reach school age. But peanuts and tree nuts allergy often persist into adulthood. Peanut allergy alone is so widespread that affects an estimated 2.5 million children in Europe and in the U.S. That translate into a lot of parents who constantly worry whether a tiny exposure could trigger a life-threatening situation for their child.
Just to illustrate the unmet medical need here, the current standard clinical intervention for peanut allergy is still emergency care. This is a very important development program for ALK, and potentially for people with food allergies. If you turn to slide 9, I'll tell you a little about the clinical trial we just initiated. The phase one trial of our peanut allergy tablet is called ALLIANCE. It brings together a number of objectives. We want to assess tolerability and safety of a single daily sublingual tablet, and we want to identify the optimal starting dose, updosing regimen, and maintenance dose. Around 100 patients will take part in approximately 15 centers, all in North America. The cohorts will include adults, adolescents, and children, and the trial builds on more than 20 years of experience in setting up clinical trials and developing our existing respiratory tablet portfolio.
We are all very excited about this program, and we aim to obtain multiple important information output from this trial, which we'll report on next year. In terms of timings, in first half 2023, we'll have the first take on tolerability and the starting dose, and then in H2, second half, we'll have additional information on the tolerability and the updosing scheme. Now let's turn to the next slide, where Søren will talk you through the outlook.
Our full-year outlook was upgraded a few days ago based on a strong sales momentum and a robust outlook for the remainder of the year. As a reminder, revenue growth is now expected at 10%-13% and is expected to be broad-based across all sales regions. Tablets remain key to this, and we now see overall global sales growth from the tablets at a minimum of 20% in 2022. In addition, we now expect mid- to single-digit growth from the remaining non-tablet portfolio. The midpoint of the projected revenue range now assumes that total sales in Europe will grow by approximately 10%, while sales growth in North America is still expected at around 10%, and growth in international markets is expected to exceed 10%.
As in previous years, we expect product shipments to Japan and China to fluctuate between the quarters. The higher end of the revenue range assumes continued strong sales growth, including higher tablet growth in Europe and improved sales of legacy products, while the lower end factors in pricing pressures in Europe, possible inability to meet market demands of some of our legacy products in the US and/or increased negative effects from COVID, which may result in some volatility across quarters. EBITDA is now projected between DKK 675 million and DKK 750 million due to the better sales outlook. CapEx is still expected around DKK 400 million based on the higher EBITDA and only a partial repayment of rebates in 2022 of some specific acute rebates, we now assume that the free cash flow will be around DKK 0.
With this, I'll hand you back to Per, who will then kick off the Q&A session on slide 11.
Thank you, Søren, and thank you, Carsten. This concludes the main part of our presentation, so we will now move on to the usual Q&A session, where we are happy to take any of your questions. Operator, please go ahead.
At this time, if you'd like to ask a question, please press the star and one on your touch tone phone. You may remove yourself from the queue at any time by pressing star two. Once again, that is star and one to ask a question. We'll pause for a moment to allow questions to queue. Once again, that is star and one, and we will wait just another moment. We'll take our first question from Michael Novod from Nordea Markets.
Yeah, thanks a lot. It's Michael Novod from Nordea Markets. Two questions to the peanut program. First of all, how should we think around the when the phase 1 data reports? I know it's still sort of probably in the first half of 2023, but most of thinking around how can you sort of progress even sort of normal speed or even faster speed in terms of moving straight into a potential phase 3 program. That was the first question, then I have a follow-up.
Hi, Michael, this is Carsten. I don't know for sure, but of our first expectation on beginning of 2023. These data here is very important because as we are on a totally new technology, but within what we know, the tablets, it means a lot about what the tolerability is and what the dosage is and what the upscaling of the patients will be. These data will be so incremental on what we can do afterwards. I believe in a year's time from now, we will have those data, maybe earlier. I think we know a lot already, and with these 100 patients in the program, we'd get the first data out there second half this year, I think we'll know a lot more.
Because if you imagine, in a tablet, the volume of peanut we're inducing is very low compared to any other technologies out there. We have a lot of hopes, but hope is not a strategy. Let's talk about it in nine months time. That's my best guess right now.
The follow-up is actually relating to what you say there's a much smaller amount of allergen coming in via the tablet. What is sort of the target profile of this product? Is it sort of to induce the best possible efficacy and then maybe still having a safe drug, but compromising it a bit, but clearly focus on the efficacy? Or is it to be more on the safe side and have an easier product to use because it's super safe, then it may not be as efficacious as other stuff we see? More to understand the product profile and the target profile you're going for.
I mean, safety is apparent because you, when it's peanut, you die if it's not safe. We need to have a safe product, but we also need to have efficient product like we have with the other ones. I think, Mike, the best way to say it is that remember that this is not traditional immune therapy as we know it from the respiratory tablets. What you most likely will get approved is that you can prove that the chances that you get an event is much lower than without taking the tablet. If you have a safe product, and you can do with a very low dosage and prove that the risk of you getting an event and going into shock is significant, then we have the right product, and that would be a product beating all competition.
Okay, super. Thanks a lot.
We'll take our next question from Jesper Ilsøe from Carnegie.
Yes. Hello. Thanks for taking the question. Firstly, just on your expanded agreement with Catalent to, as you say, prepare for future growth. Can I just ask, can we read anything into it regarding demand, or is it basically just you being well prepared? Perhaps, just a question on the timing. Why do you make this agreement now and not say in a year? Just on the timing of the agreement, and then I have a follow-up afterwards.
I think this is Søren Jelert speaking. I think we are extremely happy that we have very proactively engaged with Catalent this time, and we have had a long partnership with them. It's clear that over the last years, as you also know, that tablets have suddenly become very meaningful and sizable. For us, it's been important that we are also seen as a strategic partner to them, and that they basically can scale up to the needs that we see and jointly and timely as we see them coming. For that, actually, we secured now a much higher visibility in terms of the outlook towards 2030 for us to make sure that we can deliver. Here, remember also in this timeframe, we have also China kicking in, for instance.
We simply needed to be on the forefront so that they can plan well and essentially still be responsible also for the CapEx they will need to put on the table and basically also make sure that we have a priority to that and not sell it to someone else. In many ways, we see this as a sort of proactive handling of a risk that ensures that we can continue growing the business in the market while they'll be able to deliver top quality tablets to ALK. Both of us have a lot to win from being proactive ahead of the game here.
Okay. Makes sense. Just to follow up on the gross margin. Again, this quarter, very strong, up 3% versus last year and more than 2% for the first half, yet you still guide 1%-2% for an improvement versus 2021. Can you just explain why you don't say a bit more bullish on the gross margin this year? And perhaps more importantly, talk about the trends when you look into 2023 and 2024 on the gross margin, given the strength you've seen in the recent quarters and also, of course, the recent years. Thanks.
Super good question, and well spotted that we maintained the 1%-2%. I think we have a strong underlying performance. Of course you can say, is it exactly the midpoint of 1%-2% or where are we? I think it's great that we are now coming out with a strong performance here after second quarter. Actually, so far following still the improvement when we sell tablets outside Japan, it has a positive impact. When Japan is in there, it's a little bit lower. That completely follows the plan we have promised you all along. Of course, when we move into 2023, we have all along said the powering will also be our increased efficiencies and the programs we're running on the past products.
They will still take some time before they start to kick in and actually be basically put on the the products are staying on our inventories and then eventually also expressed so you can see them in the gross margins. I think 2023 will be too early to see a kicker on it, but we will follow the plan with a gradual improvement. That's actually what we are anticipating right now.
Thanks so much. Our next question comes from Martin Parkhøi from SEB.
A couple of questions, and I will take them up front, the first one on the supply disruptions for Jext You mentioned on the decks when, in the third quarter, you guys gave an update of where it looks now, and that hasn't changed, but that was assumed for the second half of the year anyways. Secondly, just around CapEx on the sort of commercial for Corona because you saw some pick up from particularly the delayed or starting to reduce COVID. Can you quantify how much of the growth in the categories at the end of Q3 was actually kind of in that from the first quarter?
Then finally, just on the sales efforts and the guidance are, because before you had the low end of the full year guidance out, we had been on the phone with a peer talking about pricing, you know, supply and COVID. Can you quantify it a little bit? Because COVID, of course, has already been there in the first half of the year. Talking about that looking forward, 14% on the top line. Why should I be bullish in the second half? This is Carsten Hellmann. On the second and the third part of your question, you're right. We are putting in some risk factors because we don't know where we're going now. There is a lot of rumors about some price hikes from different governments around the world.
We just put it in as one of it. As you can see, we said 10%-13%, so the bottom is 10%. You can quantify that many DKK millions in totality from the point that we can drop there. Yes, there might be some disruptions here and there that they can sort of yes. I think actually in totality, we are in a good range now, so we certainly expect to hit the midpoint of this guidance of 11.5%. Of course, as I said, we don't know where we're going now. Last two years we've been saying, obviously, I'm not saying now COVID is over, and then it hit full throttle again in October, November.
We just factor that in, but it's not really like this is factors where we're waiting for the red or the blue light to turn on to see if it hits or not. It's a more generic type of risk factors we just factor in. Obviously there's a number of work to do here for me, but I'm pretty okay with the guidance we have today and where we hit the midpoint, and we'll certainly do all we can to do better. For the Jext, it's a little more. There's different things in the Jext. We had a lot of uptick in the Jext, if you remember.
In first half, we were probing, and there was quite a lot of, you say, quote-unquote, feedback about what's happening, what's going on with Jext, where we talked about this prolonged shelf life. We talked about the people didn't replace their Jext for the same reason every other time. You know, they didn't replace the Jext we expected because they hadn't been out in the house. There was not going to football matches, you know, whatever school and so on. So forth, they didn't use them, but they did now. We saw a huge rotation rate coming in right now as we expected. I think that's going to continuously be back on track there.
At the same time, as you know that EpiPen seems to have some supply issues, and we are all in manufacturing and trying to supply all the different markets with everything we got to cover that. I think the good news for us in Jext is that since we've so the last years have been working on having sustainable manufacturing, good qualities and so forth. Before when EpiPen was out, we got the business. When EpiPen came back, we lost it again. We can see now in Europe that we have a constant market share, and we also keep something every time we get out. I think this is only an upside for us, and we use it as much as we can, of course. It's not that we have unlimited capacity.
We might have from time to time some issues in other supply, but as the demand is so increasing, I think we look okay. Yeah, a question on the tablets. I think the question was related to whether we saw an increased effect, I guess, you said in Europe on the tablets sales. I think the answer to this is we actually did see a better underlying performance in the second quarter, and it was actually across our portfolio of products in Europe that was up in the second quarter on the tablets. Hello?
My next question comes from Benjamin Jackson from Jefferies.
Thank you very much. Hi, Carsten. Firstly, congratulations on the very strong Q2 and overall. I have a question regarding the online engagement. We have seen klarify being launched in additional four countries during this quarter, with a total number of countries now starting to be well material. Could you just remind us how far along this rollout is? And also if there is any positive results that you're able to share from the digital world for the current moment? The same question is regarding New Horizons. We have covered this in the past, and I know you get this question quite often, but just regarding the external look, are there any more nuances to this progress?
Are we nearing any sort of inflection point where you might start to focus more on just one of them or are both of them continuously delivering on the internal success criteria, so to speak? Thank you. This is Carsten on the klarify. Yes, we are rolling it out, and it is going to be a global engagement system. We've mobilized, I think it was 375,000, you know, people to take action on allergy just in the U.S. There are things happening and even more in Europe. We know from when they engage with us, what they're doing on the app, what they're looking at.
We know they find a doctor, we know they go to the doctor, but I cannot for GP, GDPR reasons see what exactly happened in the doctor's office because they do not share the patient journal with us. However, what we can see, those countries where we've been now for a couple of years have a klarify universe where the tablet sales or the business itself has been particularly ongoing. We know there's something there. What we're doing there right now is just continuing to refine that and maybe even get better and follow up post the doctor's office visits to have a continued engagement and dialogue with the patient to figure out, are you in compliance? Do you like it? You know, the prescription and so whatever happens and so forth. That we're working with.
That's one thing that we will want to optimize it. The second one is we will very soon get the first patient through a fully digital system from an onboarding with the klarify universe to a test, to an online consultation and a initiation of a treatment. There's also another dimension to it where, of course, we're trying to work on new channels because if we are going to capture the big, you know, unmet need and huge patient populations that are waiting for us faster, we need also to find ways to open up the funnel that are sort of the gatekeepers, which is the limited amount of doctors, the waiting time and so forth. To see if we can find new models to get a better market access.
Digital is certainly going to be one of them, and the klarify universe is certainly going to be one of them as well. We continue to invest a high level. We will continue to roll it out, and it should be a global thing. I also expect when we get into China with the ACARIZAX universe that these type of digital tools or engagement tools are going to be very, very important to us. I think I've said it many times, and I will obviously in the roadshow this time to understand how the whole healthcare environment are changing right now. What you see is going to happen with the pharmacies, with prescription medicine and engaging for patients to doctors to actually how they get their products are going to be significantly changed in the next five years.
We need to make sure we are exactly where we need to be when this is happening, because with a huge population of patients going into whatever pharmacies or whatever they use, NT systems and other products, that's where also a big patient population are today. To segment those, to screen those, to use the algorithms and AI to identify the right patient populations and then help mobilize and support those are going to be key. We haven't talked much about it, but the team behind, the business behind and the thesis behind the klarify is actually very high. I expect a lot from it, and we are investing a lot in that. That was one thing.
The other thing on adrenaline, I mean, when we were out of money and really had to turn every penny, I mean, of course, we thought about, you know, are we going to have to pick and choose? So far, we had two projects. The Wake Up team in the US has been fully financed. I think they raised something like $24-$28 million recently just to continue to run that part of it. So I think we are out of the woods on that one, but I certainly think it's a plausible and interesting concept, and there's no reason for us to stop that. We will still continue also with the Genesis. We're running exactly to plan for submission and filing and launch.
We have two bets of different concepts, and I would love that too. I don't see any reason for indecision and choose one of them, but let's see. So far, we're now planning to start in the U.S., and we continue to run the risk that the profile. We must be in the U.S. with an EpiPen system. Even with the lower than the lowest generic price point and a better market share in the U.S., it would be a game changer to ALK's market and so on. We just keep pushing.
Thank you very much.
Our next question comes from Thomas Schultz Bowers from SEB.
Yes, thank you very much. It's Thomas Schultz Bowers from SEB. Just a few remaining here. Just to follow up on the previous questions on the SLIT tablets. When you highlight GRAZAX and ITULAZAX as key trials that are worth looking, can you maybe add a little bit of flavor on how GRAZAX is actually doing in real life down to ex-US or symptomatic exposure on this chart? And then on the asthma trial, just to avoid any potential misunderstandings. Bioequivalence implementation, is that primarily for the label in Europe, commitment to the rhinitis and asthma indications, or is there also sort of an element here related to the safety profile in the pediatric setting?
You could say maybe there are potential risks to the allergic rhinitis pediatric label or constituting that MT-12 reads out positive. Just in the interests of following the bioequivalence or the regulatory labels. If any post-market commitments, anything else that you have committed to beyond the MT-11 trial. Thank you.
Let's start with the latter one. No, there's absolutely no risk to the MT-12 trial or labels in any other products, nor is there any commercial or any other type of risk with the outcome of this trial. It was a regulatory requirement that we had, which we fulfilled, and we're discussing with the authorities about. There's nothing there. For us, commercially, it's a non-event, but it's something that we needed to do for housekeeping purposes way back, you know, started maybe even from my time in order to fulfill the regulatory requirements on the process. There's nothing there. For the tablets, all tablets are growing. When you see or hear the comments about ITULAZAX, it's just because ITULAZAX is doing extremely well. GRAZAX is doing extremely well, and so is ACARIZAX.
ITULAZAX is even better. This has been an amazing product. If you look at the penetration of ITULAZAX after launch compared to ACARIZAX and GRAZAX when they launched, I think it's 3, 4. I think it's really something that's picking up. If you have anybody or know anybody who is using ITULAZAX, they will say they were good for 3 weeks every summer and not having been sneezing earlier, normally. So I think it's a very good product, and it spreads. You know, no, we're not in a. There's no crisis anywhere in any tablets. ITULAZAX is just doing very well. I know you remember a couple years ago, we started to probably sort of halo effect because back then GRAZAX was sort of now fading off.
When we launched ITULAZAX, suddenly we saw GRAZAX growing from like 4% to 20% growth. That halo effect, we actually see also on ACARIZAX and on the other products. That's just because a doctor had a very good result on ITULAZAX with a patient. At that time, another person comes in, and they think, "Oh, maybe I should try the other tablets on this one as well." They come in and say, "Oh, this works very well." I think it's this type is happening as well. We also have, beyond our marketing efforts, the market is also with us in this one.
In relation to ITULAZAX, I guess it has surprised everyone with the strong traction. Is there any? I remember a few years ago when you launched the product that they've been referring to ITULAZAX as sort of being a product that could do sort of somewhere between GRAZAX and ACARIZAX in looking at peak sales. Is that still your assumptions, or are you now closer to ACARIZAX peak sales when you look at the future?
I think it's, of course, a super good question. Please bear in mind when I talk about GRAZAX, it surely also has then challenged the mix eventually. I think when we gave the prior two-week return comment on that, it was at least two or three of GRAZAX. Here then, of course, it depends on how you go about it to ITULAZAX, but it is tremendously good uptake we see. I mean, yes, we do believe that it's at the size of GRAZAX. We believe it will have. I think GRAZAX, of course, has the benefit of being in more geographies essentially. Of course, it's a little bit difficult to compete with that very long term.
Overall, very satisfied actually on ITULAZAX and definitely a competing product to GRAZAX. This comment just to add to what Søren Jelert is saying. We have to remember that even though ALK is a strong company with a big market share, even in Europe. I mean, we're not in Southern Europe yet. We're not in UK yet. I mean, there's a lot of dimensions on which we can grow, what the different products can enter, and how fast they will penetrate, what prices and so forth. It will be up in the air, but we still are in a situation where it's 4% of 1% of the patients are treated. The growth runway is strong for a long time.
At the end, it's a question about where we go into the timing of events. You know, what is what? Which product is launched? Is that across countries? Is that a three country and so forth? How it picks up in the end? I think over 20 years from now, all the products will be very big, and GRAZAX will be the biggest, I'm very sure, for obvious reasons. The other ones will be very big and pretty much the same size, I think.
Great. Thanks for that comprehensive direction.
Anyone again that is star eight one if you'd like to ask a question. Okay, our next question from Jesper Ilsøe from Carnegie.
I'm very grateful for the question. I just have one regarding if you had any plans on additional candidates beyond peanut. If so, what are the potential ones that you target?
Yeah, we have the peanut program right now, but like everything else we do, we do it with a strategic mind long term, meaning that, of course, this should be a food platform. Depending on, let's see how the phase 1 pans out in peanut because that will also give us some notions about what tree nut, egg, and other products could actually look like and what the profile of the product could be, what are the costs to develop and so forth. Of course, like we started with grass and respiratory allergies, now we're starting on food with the peanut. When exactly that's going to happen, I think the phase 1 data on peanut will tell us a lot about the plausibility of food in our tablets and so forth. We are very positive ourselves about that.
There's a positive pre-clinical team that works well with it, and that's been working the last couple of years. We'll see the results, but of course, it's a platform we want to grow.
All right. Thank you.
Anyone again? That is star eight one to ask a question. We'll pause for a moment. It appears we have no questions at this time. I will now turn the program back over to our speakers for any additional closing remarks.
Thank you. Thank you to you all for joining today's call and for all the good questions. As you can see from this final slide, we have a couple of presentations scheduled over the coming weeks, and we hope to see a number of them well represented, hopefully. Also shown here is the data for key results in November. As always, we are most welcome to come and sit down with either myself or any time if you have additional questions. With that, I want to wish you all a good day and an end to today's session. Thank you and goodbye.