💊 Allermi: how to build an 8-figure allergy care product

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Read time: 5 mins 31 seconds

Quick personal update

If you’ve been following this newsletter, you know I’ve been building a startup called Pikes.

We’ve narrowed in on one core thing: helping consumer brands create product images and videos that actually look on-brand, with perfect text consistency.

Here are some example images I made for Allermi:

Pikes is already being used by 200+ brands to:

If you’re building a brand, I’d love for you to try it out. It’s free to get started!

Shani Bocian-Steinberg, an art history graduate with zero tech experience, just built an 8-figure personalized allergy care empire. 

In 2021, Shani turned down a job at the University of Chicago to move back home and build Allermi with her allergist dad. Fast forward to 2025, she's now doing 8-figure annualized revenue while serving tens of thousands of customers with the world's first custom allergy nasal spray.

Her secret weapon = a 30-year-old formula her Stanford allergist father had been mixing by hand in his office.

Today, I'm breaking down Shani's exact playbook on how she spent 2 years solving manufacturing and regulatory challenges before GTM and her growth framework for acquiring the first 100 customers through Reddit and Facebook groups and scaling to 8 figures.

Shani's path to Allermi started with a family formula that had been working for 30 years. 

Her father, Dr. Robert Bocian, is an MD/PhD allergist at Stanford who noticed in the early 1990s that existing allergy medications weren't effectively treating his patients' nasal congestion.

As a scientist, Dr. Bocian started researching and tinkering. He developed a custom formula that combined multiple active ingredients to address different symptoms simultaneously. 

However, Dr. Bocian's solution was quite manual. He would print long instructions for patients to take to the pharmacy, buy multiple medications, and mix them at home using specific measurements. Patients called it "Bocian's Potions," and it became well-known in the Bay Area for actually working when everything else failed.

Shani had been using this formula her whole life. The lightbulb moment for Allermi came when Shani discovered telemedicine platforms like Curology while away at college and grad school. She was using these services to get skin medications online when she couldn't easily see her home primary care provider.

Holding her dad's nasal spray in her hand, mixing it the way he taught her, she had the realization: 

Curology became her inspiration. They were compounding medications, combining active ingredients exactly like her dad was doing. The difference was they had built the infrastructure to do it at scale with proper regulatory compliance.

The pull from this idea was so strong that after graduating from her Master’s in education program at Brown, Shani turned down a job opportunity at UChicago to build Allermi, the Curology for allergy care.

Unlike most consumer product brands, allergy care products are quite complex to build.

Shani had to overcome significant manufacturing, regulatory, and technical hurdles before she could bring her product to market. In this case, the typical lean startup playbook simply doesn’t apply. 

Building an innovative medical product requires a very different approach.

In fact, it took Shani 2 years and nearly $1M in personal investment to bring Allermi to be market ready. 

The clinical rationale was already proven through Dr. Bocian's 30 years of patient experience. The formula addresses rhinitis aka nose allergy by targeting multiple symptoms with different active ingredients:

Traditional medications only address one symptom. Patients would need to take multiple nasal sprays, yet nasal tissue gets oversaturated and can't absorb that much liquid. 

Allermi combines the active ingredients in powder form without dilution, then adjusts concentrations based on individual symptoms.

To strengthen Allermi’s credibility, they conducted 53 randomized studies and published 18 peer-reviewed papers supporting the product’s efficacy.

This scientific foundation is the core advantage that sets Allermi apart.

Beyond proving the efficacy, there were many hurdles that the Allermi team had to overcome to bring the product to market.

a) Formula refinement

Dr. Bocian's original formula worked in his small laboratory, but it needed significant refinement for scale. 

Requirements included:

b) Manufacturing and delivery mechanism

Similarly, to manufacture and deliver personalized allergy care at scale, they’ve had to wrestle with questions such as: Should Allermi manufacture and store inventory, or should each prescription be individually compounded? And what type of doctor–patient relationship makes online prescribing and cross-state shipping possible?

c) Technology infrastructure

Unlike e-commerce, Allermi had to create a complete telemedicine platform from scratch. 

No existing white-label solutions could handle their specific needs. They built separate interfaces for patients and doctors, integrated prescription management, and created the customization logic for adjusting formulas based on symptoms.

d) Regulatory compliance

Laws governing medication distribution are strict and vary state by state. 

Shani and her team spent a lot of time getting Allermi licensed in every state, establishing relationships with compounding pharmacies, and ensuring compliance with FDA regulations for compounded medications.

e) Team and capital

It truly takes a village to build anything great. Besides Shani and her dad, they also brought on Dr. Shuba Iyengar (another allergist who was Dr. Bocian's fellow at Stanford), and Michelle Ha (big pharma background). 

The team invested nearly $1M of personal capital 🤯 across the 2-year development phase to cover tech, compliance, initial inventory, and operational setup. This insane upfront effort also became their biggest moat. 

Shani and her team mostly targeted people with severe, chronic symptoms who had tried multiple medications without success. Not your casual seasonal allergy sufferers.

To get their first 100 customers, they reached out to Reddit and Facebook allergy support groups.

Instead of pitching their product directly, they took a more educational and trust-building approach. For example, one format that worked really well was Reddit AMA. 

This was their headline for a Reddit AMA → 

"Dr. Robert Bocian, a Stanford allergist, here to answer any questions you might have."

This post got 800+ upvotes and 200+ comments. 

MVP

During the initial GTM phase, the tech infrastructure wasn’t fully built out. They relied on Google Sheets to track customers, prescribed drugs manually over the phone, and worked through a clunky EMR system.

However, this manual approach allowed for high-touch customer service and immediate feedback collection. Those early customers also became advocates and provided testimonials that shaped future marketing.

After reaching 100 customers through organic methods, Shani and her team hit a wall.

A telemedicine founder who scaled her own company to a billion in revenue (and is now her advisor) gave her one crucial piece of feedback:

This advice led to hiring their performance marketer/CMO in 2022, marking the transition from organic to paid growth.

Meta advertising became their primary growth engine, driving the 800% growth in 12 months. 

Their creative approach was authentic and simple:

As Allermi scaled, Meta—particularly Facebook and Instagram—proved to be the most efficient and scalable growth channel. Google Ads and SEO followed as the second strongest driver, while doctor referrals began growing organically as more physicians discovered the product.

Current metrics: 

Unlike typical e-commerce, customers can't simply add product to cart and checkout. 

They must complete a doctor consultation, get a prescription, and have it customized. This creates conversion challenges and higher customer acquisition costs, compared to other simple consumer products.

Most people (80%+) never see a doctor for nasal congestion symptoms. 

They either suffer in silence or try to self-treat with drugstore options. Allermi must educate the market about the connection between nasal health and overall health, sleep, exercise, and quality of life.

Competing against established brands like Flonase ($15-20 bottles) while charging premium prices for custom formulations. The value proposition must be clear enough to justify the price difference and consultation process.

1/ Leverage unfair advantages ruthlessly. Allermi’s blend of Dr. Bocian’s 30 years of clinical experience, a science-backed formula, and a personal capital war chest created moats that are nearly impossible to replicate.

2/ Invest heavily in infrastructure before scaling. The 2-year development phase was essential to address manufacturing, regulatory, and technology challenges. Launching too early, without the right infrastructure, could have led to compliance issues and operational failures that might have sunk the business.

3/ Authenticity scales better than production value. Their "ugly ads" featuring Shani and her father talking directly to customers outperformed polished marketing content. In health categories, credibility and authenticity matter more than aesthetic appeal.

4/ Bring in complementary expertise early. Shani had the vision and her father had the science, but scaling required adding people with pharma, medical, and operational backgrounds. The right team mix was just as important as the formula itself.

5/ Start with education in skeptical categories. The team’s approach of providing value through education before selling built trust and credibility in allergy communities. This educational foundation made the eventual sales process more effective and created advocates who helped with word-of-mouth growth.

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See you next Tuesday,

Leo

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