Shield Therapeutics plc provides an update on its plans to commercialise Accrufer in the USA and its cash position. Accrufer® was approved in July 2019 by the FDA for the broad indication of treatment of iron deficiency in adults. Since then Shield has conducted an extensive process to identify and appoint a commercialisation partner for the US market and, through this process, the Group and its advisers have engaged with a wide range of interested parties. Since this process began Shield has received numerous indicative proposals from potential commercialisation partners and, whilst some of these reached late stages of negotiation, they did not proceed to completion due to adverse business events specific to the counterparties concerned and unrelated to Accrufer®. The Group remains in discussions with a number of potential commercialisation partners for the US marketing rights to Accrufer® but it is now clear that a transaction will not be completed before the end of 2020. The length of time that the process has taken and the late-stage setbacks incurred have been frustrating for both the Board and shareholders but Shield's understanding of the US iron therapy market has developed significantly over the last year, and the market itself has also evolved in that time, in large part due to the COVID pandemic. Discussions with potential commercialisation partners have demonstrated to Shield that it is realistic for companies without large sales and marketing infrastructure to launch a product such as Accrufer® in the US. The COVID pandemic has accelerated the trend towards greater reliance on telesales, e-detailing and on-line marketing, reducing the need for very large sales teams. The COVID pandemic has also accentuated some of the advantages that Accrufer®, a well-tolerated and effective oral treatment, offers over intravenous (IV) iron replacement therapy as it avoids the need for patients, usually with underlying health issues, to visit hospitals or clinics to be infused. Furthermore, Shield believes that the first US launch of an oral HIF inhibitor for chronic kidney disease (CKD) patients, anticipated in First Quarter 2021, is likely to increase the need for effective and well tolerated oral iron replacement therapy.