Dominique Pezziardi oversees International Commercial Operations for Stallergenes Greer, a global biotechnology company specialising in allergy therapeutics. With more than 1,200 employees globally – over 600 based in France – the company maintains a unique positioning as a Swiss-headquartered organisation with deep French industrial roots. Under Pezziardi’s 13-year tenure across strategic, global marketing and operational leadership roles, the company has reclaimed market leadership in France whilst establishing the country as a key centre for manufacturing and research, supplying products to markets around the world. Approximately 30 percent of the world population is affected by one or more allergic conditions, and it is expected that by 2050, several billion people will suffer from allergies. The increasing prevalence and intensity of allergies is a trend that has continued in the industrialised world for more than 60 years.
To begin, could you clarify the group’s corporate structure and explain the strategic role France plays within Stallergenes Greer?
Headquartered in Switzerland, Stallergenes Greer is a private global biotechnology company, specialising in the research, development and production of allergen immunotherapy (AIT) and diagnostics. AIT, by repeatedly exposing patients to small, controlled doses of an allergen, helps the immune system build long-term tolerance and reduce sensitivity to allergic diseases.
Our French site, where approximately 50 percent of our workforce is located, is our historical base in Europe and home to a significant portion of our production activities. France supplies AIT treatments to 45 markets worldwide. Our sublingual liquid formulation, alongside tablets for mites and grass pollens are manufactured here. We also produce injectables for venom allergies – Hymenoptera allergies including bee, wasp, and hornet treatments. These life-saving products are comparable to food allergy treatments.
All these products are manufactured – from the processing of source materials to final formulation, including filling, and quality control – then packaged and shipped from this facility, which serves as our global manufacturing hub. Our French operations play a strategic role in the worldwide Stallergenes Greer network, alongside our other major sites in the United States, which each contribute to our global reach and capabilities.
Our research and development operations are also based in France, where our scientists collaborate closely with our manufacturing teams, a key advantage for conducting biological research, which demands constant interaction with live materials.
Our global clinical and medical teams are also based in France. Most recently, they completed a major Phase III clinical trial which confirmed the safety and efficacy of our sublingual AIT treatment for children and adolescents suffering from birch pollen allergies, which cause allergic rhinoconjunctivitis.
France plays a central role with its legacy, production capacity and expertise, and commercial strength making it a key asset within our global network.
How central is France in the European region to the global allergen immunotherapy market?
Europe represents our largest global market and is critical to our business. France holds particular commercial importance for three key reasons: our historical presence in the market, our deliberate focus on this region as allergy rates continue to rise among the population, and our continued growth and market share gains.
Several factors explain our strong position in France. Our legacy certainly plays a role. Stallergenes was founded here, building substantial brand equity within our ecosystem, notably among allergologists. Equally important is France’s healthcare system, which provides comprehensive reimbursement for AIT, thus ensuring broad patient access.
That said, the situation is different across Europe. Italy, despite having a similar population size, offers only selective reimbursement for immunotherapy, varying by product and region. This creates significant disparities in patient access to treatment.
Despite these favourable market conditions in France, we are also subject to recurring, government-imposed price reductions. These constraints require us to constantly reassess our investment strategy to safeguard both employment and profitability, conditions that are essential to sustaining and growing the business.
Recognising the full value of immunotherapy has become essential for healthcare policy. Our extensive clinical trials and landmark real-world studies have demonstrated that immunotherapy is the only treatment that both manages disease progression and prevents disease development. It can prevent allergic rhinitis from worsening and stop the progression to asthma.
From a public health perspective, this represents a transformative opportunity to reduce the long-term burden of allergic disease.
Beyond reimbursement and brand legacy, the therapeutic area itself demonstrates growth, with allergy prevalence increasing. How should healthcare systems respond?
Pollen seasons are becoming longer and allergy symptoms more severe. These trends are driving steady growth in demand for allergy care. Today, nearly 30 percent of the global population is affected by allergies, and this figure is expected to rise to several billion people by 2050. Allergies are no longer a seasonal nuisance; they’re a growing public health issue. Yet healthcare systems face a structural challenge: a shortage of allergists. We don’t lack treatments. We lack trained specialists to deliver them.
A persistent challenge is the effort by allergist associations to secure more university training positions and full recognition of allergology as a medical specialty. In France for instance, only around 30 new allergists are trained each year, far below what’s needed to meet national demand. Addressing this gap is essential to ensure timely diagnosis, improve patient care pathways and reduce long-term healthcare costs. Strengthening medical education and expanding specialist training must become a public health priority to respond to the scale of allergic conditions in the population.
How are these limitations shaping your commercial model and engagement strategy across medical specialties?
Our commercial strategy increasingly requires us to look beyond the traditional allergist community and engage with a broader group of clinicians who are now qualified to prescribe AIT treatments. In France, accredited allergy training programmes allow pulmonologists, ENT specialists and paediatricians to gain certification in allergy management. We are expanding into these specialties thoughtfully and in close collaboration with allergists, ensuring the right capabilities and patient pathways are in place.
In parallel, we have invested in digital tools which can provide significant support. Adherence remains one of the greatest challenges in allergen immunotherapy: out of 100 patients, 30 typically drop off each year, and after three years, only around 30 remain in treatment. This low adherence is not linked to the drug’s efficacy; it is a matter of patient compliance. Our goal is to help patients stay on treatment so they can fully benefit from it. To address this issue, we developed iPUMP®, the first connected assistant in AIT with Aptar Digital Pharma, a leader in connected health. It is designed to improve treatment adherence and optimise outcomes for patients undergoing sublingual liquid treatments. Thanks to this tool, physicians can now differentiate between poor patient compliance and lack of patient response, improving both dialogue and care.
This integrated approach – expanding our prescriber network, implementing practical digital innovations and supporting evolving care models- enables us to tackle structural bottlenecks in the allergy care ecosystem while delivering better patient outcomes.
Much of your portfolio is built on established products. Where do you see the most credible avenues for innovation within allergen immunotherapy?
While much of our portfolio is grounded in long-established immunotherapy technologies, I firmly believe that these foundations remain the strongest platform for meaningful innovation in allergy care. No technology developed to date has matched immunotherapy’s unique ability to rebalance the immune system and deliver lasting benefits after treatment cessation.
Established technologies should not be mistaken for lack of innovation. The measure of success isn’t technological novelty, but patient outcomes. We’ve repeatedly demonstrated that well-targeted, incremental advances can create substantial value for patients and healthcare systems. Cat dander allergy is a strong example: despite its high prevalence, no approved high-concentration treatment was available. By developing such a formulation, we helped fill a gap identified by clinicians. This type of evolution reflects a pragmatic approach to innovation focused on clinical relevance.
The same applies to polyallergic patients, who now represent the majority of allergy profiles. In real-world practice, there is a growing need for treatments that can target multiple allergens simultaneously. By adjusting concentrations or creating compatible mixtures, such as our birch-grass combinations, we can offer single products that meaningfully simplify therapy for both patients and physicians. These targeted, high-impact improvements, are enabled by our proven and adaptable R&D and industrial platform.
Of course, Stallergenes Greer continues to advance our its research beyond our current offerings. We are also exploring promising external innovations across multiple fronts and evaluating next-generation delivery platforms.
Finally, a critical area is biomarkers. Unlike diabetes, allergy lacks a simple, universally accepted indicator of disease control. Developing robust biomarkers would unlock better trials, better targeting and, ultimately, better outcomes.
This combination of pragmatic innovation on a proven platform, complemented by selective exploration of emerging technologies, represents the most credible path forward for AIT.
During pricing and reimbursement negotiations, do you advocate for preferential consideration for medicines manufactured in France?
Significant challenges remain ahead. For France to maintain its position as a leader in pharmaceutical innovation, policymakers must recognise two critical factors: the economic value of innovation and the substantial employment benefits our sector provides. Without this recognition, companies will increasingly choose to invest in countries such as the United States, Italy or Spain, where regulatory and economic incentives create stronger investment cases. Our research, development and manufacturing operations remain anchored in France, with a substantial portion of our production investments concentrated in our French facilities.
We fully recognise the constraints faced by the healthcare system – from budgetary limits to the imperative of ensuring sustainable access to high-quality treatments. These considerations are legitimate and necessary. Acknowledging the strategic importance of domestically manufactured medicines is just as important. Prioritising locally produced treatments delivers enhanced industrial sovereignty, secured supply chains and investments in innovation.
This approach creates a positive cycle: when healthcare systems trust and support local production, it encourages continued investment. This investment fuels innovation, which in turn delivers improved patient outcomes and generates significant economic value.
You operate with both authorised pharmaceutical products and NPP formulations. Could you explain this dual regulatory framework?
In France, we operate under a dual regulatory model that combines standard pharmaceutical products which hold marketing authorisations, and Named Patient Products (NPP, allergen treatments prepared specifically for each individual), which fall under a specific regulatory exemption.
While they are exempt from marketing authorisation, NPP formulations are nonetheless highly regulated: they are subject to regular review by health authorities and produced under strict quality and compliance standards. Our NPPs follow the same manufacturing principles and quality controls as treatments which hold marketing authorisations.
We operate France’s largest specialised pharmacy for personalised AIT treatments, serving patients through a streamlined process. Allergists submit patient prescriptions via our dedicated digital platform. Licensed pharmacists conduct thorough reviews both before production begins and after manufacturing is complete. Once validated, each treatment is individually manufactured and packaged with personalised labelling, then shipped directly to the patient’s address. Throughout their treatment journey, patients in France maintain direct access to our lab team and customer service for questions and support.
What first drew me to the company 13 years ago was its pioneering approach: we were already implementing individualised treatments well before personalised medicine became a widely recognised healthcare priority. There is nothing more tailored than producing a treatment for a specific patient and delivering it directly to their home. This approach allows for close monitoring, customised dosing regimens and treatment plans adapted to the patient’s allergy profile. It creates a unique, trust-based relationship between the patient, the prescriber and our teams.
Another key strength of the NPP model is its flexibility. It allows us to address rare or specific allergies – such as severe reactions to Alternaria, a highly pathogenic mould species – that would otherwise go untreated due to the costs of traditional pharmaceutical development. Thanks to this flexibility, we offer a broader range of allergens and respond to individual needs. We also offer NPP in countries such as Spain, Italy and Germany, allowing access to many of these formulations beyond France.
Looking ahead, what are your strategic priorities for the French and European businesses over the next two years?
First, we will continue to strengthen the value proposition of sublingual liquid immunotherapy. While tablets are already approved and appropriate for certain patient segments, the Group’s strategy is to invest in generating robust medical evidence to support the continued growth of liquid formulations, notably for additional allergens such as cat dander allergy. The goal is to identify which patient profiles benefit most from each treatment approach, enabling more personalised care.
We’ve also innovated significantly in our approach to evidence generation. Our efficAPSI study, recently published in The Lancet Regional Health Europe, represents the largest real-world evidence study ever conducted using French national health data. We linked our patient database with national healthcare data through validated processes to conduct a large-scale comparative study. Using a robust methodology, we compared 330,000 patients treated with standard antihistamines and corticosteroids against 110,000 patients receiving our therapy. The study, which spans eight years of retrospective data, is remarkable in scale, results and clinical insights.
Its findings are clear: our AIT treatments significantly reduce the risk of developing asthma. This delivers a powerful public health message, with effectiveness demonstrated across multiple allergens, from house dust mites to other common allergens. Our approach combines internal innovation with real-world evidence to engage meaningfully with regulators based on the proven positive benefits for patients. We are committed to conducting additional studies that demonstrate further positive impact of our treatments.
You have served the company for 13 years. Where do you find creative drive and exploratory energy?
I’ve been fortunate to work under leaders who gave me the opportunity to grow across a range of roles, from strategy to global marketing, market access, and communications, and now leading international commercial operations. This diverse experience provided valuable perspectives that continue to inform my decision-making approach. But what truly fuels me is the team. I work with top-tier professionals who are deeply committed and hold themselves to the highest standards. Their dedication pushes me to give my best every day. What drives me is knowing that, together, we’re having a genuine and long-lasting impact for our patients. That’s what makes our work meaningful.
Finally, what message would you like to convey to international stakeholders watching Stallergenes Greer’s next chapter?
We have successfully completed our five-year plan and are actively preparing for our next growth phase. Several major developments are already in progress, supported by our ongoing commitment to strategic investment. Our strategy is clear: defend the core, expand our offering, conquer new geographies and invest in future technologies.
Opportunities are emerging across all four areas — whether through innovation, geographic expansion, or new business models. Take Asia, for example: rising environmental challenges are driving demand for allergy treatment. We’ve just established a long-term partnership in China and signed development agreements, positioning us to play a meaningful role in this fast-growing region. We continue to anticipate needs, set the direction for the different markets, and deliver long-term value for patients and stakeholders.
Multiple major initiatives are now in motion, and we’re only getting started. If you are allergic to routine, come and join us!
