Ajinomoto Co., Inc. (2802) Earnings Call Transcript & Summary
June 26, 2025
Earnings Call Speaker Segments
Masataka Kaji
executive[Interpreted] Good morning, everyone. Thank you very much for joining us despite your busy schedule for Medical Food Business Strategy Meeting for Ajinomoto Co., Inc. I am Kaji from IR Department. I'll be serving as a moderator. Let me introduce participants today. Representative Executive Officer, President, Nakamura.
Shigeo Nakamura
executive[Interpreted] Nakamura speaking. Thank you.
Masataka Kaji
executive[Interpreted] Representative Executive Officer and Executive Vice President, Shiragami.
Hiroshi Shiragami
executive[Interpreted] Shiragami speaking. Thank you.
Masataka Kaji
executive[Interpreted] Executive Officer and Senior Vice President, General Manager of Bio & Fine Chemicals Division, Maeda.
Sumio Maeda
executive[Interpreted] Maeda speaking. Thank you.
Masataka Kaji
executive[Interpreted] Executive Officer and Vice President, In Charge of Finance and Investor Relations, Mizutani.
Eiichi Mizutani
executive[Interpreted] Mizutani speaking. Thank you.
Masataka Kaji
executive[Interpreted] Deputy General Manager, Bio & Fine Chemicals Division, Michael Lish.
Michael Lish
executiveThis is Mike.
Masataka Kaji
executive[Interpreted] President, Ajinomoto Cambrooke, Inc., Rick Jentis. CEO of Nualtra Limited, Mark Lane. Those are the 7 presenters today. And for the overall proceeding, at the outset, Nakamura will give us opening remarks and then growth strategy of Medical Food business by Maeda, followed by Rick Jentis and Mark Lane's presentations on Ajinomoto Cambrooke and Nualtra initiatives and growth strategies presented. And finally, we'll take questions for all the presentations. And the whole segment is scheduled to last 1 hour and 30 minutes. And today's slide deck will be posted to the IR section of the website of Ajinomoto, Inc. And as for the briefing, this will be recorded, including Q&A session, and video will be posted to the IR section of our company on a later date. Let's get started without further ado. Nakamura-san, over to you.
Shigeo Nakamura
executive[Interpreted] Thank you very much for joining us despite your busy schedule to join our business strategy meeting. So what I would like to get the message to you is that the whole company is working together to further evolve ASV initiatives. We are tackling the challenge of achieving the 2030 roadmap ahead of the schedule by accelerating growth based on speedily and properly approach. In the medical food business, we'll grow by expanding the market using the Ajinomoto Group's network and entering new areas, while also enhancing the value of existing products. Furthermore, by integrating the food products and bio and fine chemicals areas, we will fully leverage the strengths of our AminoScience to contribute to the well-being of all people who need nutritional supplements. Our purpose is contributing to the well-being of all human beings, our society and our planet with AminoScience. For example, Ajinomoto is sold even in the remote regions of Amazon rainforest in Brazil, contributing to people's meals and enjoyment. We feel a deep sense of respect for the pioneering spirit and contribution to society demonstrated by our predecessors across various businesses, countries and regions within our group and regarded as a mission to carry it forward. Having inherited ASV management and our purpose from our predecessor, we're now incorporating the concept of speedily and properly approach into our management, aiming to further speed up and scale up our businesses, while striving to realize this purpose. Medical food, the theme of today's briefing is an area where we can integrate our food product business and bio and fine chemical businesses, leveraging the strengths of both. By integrating the technical expertise, know-how and human resources cultivated in each field, we aim to provide more attractive value and contribute to the growth of our company. For people, meals are not just about nutrient intake, delicious meals and communication over the tables are sources of enjoyment, and this is no different for patients with illnesses as well. We will grow our business by providing medical foods that meet the nutritional needs for those who require them, while balancing taste and contributing to the well-being of those who need nutritional supplement, thereby realizing ASV, the creation of economic and social value. In addition to accelerate the evolution of ASV management, I have introduced the concept of properly into the high-speed development system, cultivated in the Electronic Materials business, and we will implement it throughout the Ajinomoto Group. The high-speed development system is an approach that utilizes people, materials, money, information and time as management resources to respond quickly to changing markets and consumer needs. We anticipate customer needs, make assumptions, prepare in advance, provide multiple solutions and verify and improve products to meet new needs. An example from the medical food business is Altrini, a nutritional supplement for children launched in Europe in 2024. Altrini combines high nutritional value with great taste and features super hero theme character. By quickly understanding customer needs, we have advanced concept in character design, enabling short time to market. We continue to improve the product. And we are rolling out a high-speed development system across the Ajinomoto Group, incorporating not only speed but also concept properly to build a business that earns the trust for our customers and the market. So leveraging AminoScience strength and spreading high-speed development system company-wide, we'd like to create ASV values and also new products and new businesses that are comparable to ABF, and that is regarded as our mission. And we all get united to pursue the evolution of ASV management, realization of purpose and business growth. So now I'd like to ask Maeda to talk about Medical Foods business strategy.
Sumio Maeda
executive[Interpreted] Thank you very much, Mr. Nakamura. I am Maeda, General Manager of the Bio & Fine Chemical Division. Before the presentations from the heads of the 2 companies, I will talk about what medical foods are, what areas our group is operating in and what strategies we have for future growth. Many of you attending today's briefing may be unfamiliar with medical food and may not be well informed about Ajinomoto Group's focus on this area. This is because the business is primarily centered in North America and Europe. Our medical food business is conducted, as you can see on the right, by 2 subsidiaries, Ajinomoto Cambrooke, which was acquired in 2017 and is on the left is based in -- or this is based in the United States and in the left, Nualtra, which was acquired in '22 and is based in Ireland, and they operate in the U.S. and Europe and also export to South America and Oceania. And sales for the medical food business has already exceeded JPY 10 billion, making it a high-profile business that exceeds the overall profit margin of the company, and it continues to achieve high growth. First, I'll explain briefly on medical food. Medical food is foods that supplement nutrition for people who have a problem, consuming and digesting foods due to specific diseases or nutritional conditions. For example, individuals who are unable to metabolize specific amino acids due to congenital conditions require dietary therapy using medical foods that do not contain those amino acids. Medical foods differ from general foods or supplements in that they typically require prescription. In this regard, they are closer to pharmaceuticals than to general foods or supplements that can be purchased by anyone. Medical foods are used under insurance reimbursement system, though the details vary by country and region. This means that a portion of purchase cost is subsidized by the government programs. Some countries have a well-established system, while others still lack the necessary infrastructure or regulations. Ajinomoto Group's strength lies in its ability to provide products and services across a whole range of categories, food supplements, medical foods and pharmaceuticals. For example, for issues such as obesity and diabetes or for those who really strong wish to lose weight, our food business offers products and menu suggestions that contribute to a balanced diet. When improving metabolism or controlling weight through exercise, we provide support with support supplements such as aminoVITAL. And for those who lack specific nutrients, we offer supplements to make up for them. On the other hand, for individuals with specific medical conditions or nutritional challenges who can access doctors' prescription, medical foods are available. In some regions for those with serious illnesses, pharmaceuticals may be required. Our high-quality amino acid raw materials have been used in traditional insulin drug products for diabetes since 1980s. And our AminoScience is also highly compatible with the new anti-obesity drugs that have recently gained attention. This ability to address health care issues with multiple approaches is a key strength of Ajinomoto Group. As mentioned earlier, we have 2 major subsidiaries in North America and Ireland. Our product lineup is also divided into 2 main categories: medical foods for individuals with specific diseases and for those with specific nutritional conditions. The left side is -- in blue is for people with specific diseases such as inborn errors of metabolism, epilepsy or protein allergies and is mainly developed by Ajinomoto Cambrooke. The right side is for people with specific nutritional conditions, such as malnutrition and obesity and is a category in which Nualtra excels. As you are aware, Ajinomoto Group has been conducting research on amino acids and health as well as amino acids and deliciousness for over 110 years. As you can see, the diseases and nutritional conditions in this slide are actually close affinity to Ajinomoto Group's research areas. Within those categories, we offer a diverse range of products that not only provide nutritional functions but also deliciousness. Let me explain in more detail. We first discussed products for individuals with specific diseases. This category includes medical foods that customers consume throughout their lives. For example, phenylketonuria or PKU is an amino acid metabolism disorder where the body cannot break down phenylalanine, a type of amino acid from birth. PKU typically shows no symptoms right after the birth. But if left untreated, it can lead to neurological symptoms such as development delays by several months to 2 years of age. Since phenylalanine is present in foods containing protein, a nutrient essential for healthy individuals, patients must restrict their intake of such foods. This means that they cannot consume typical meat, fish, soy products or eggs, which is quite an issue. By incorporating medical foods into their meals, patients can limit phenylalanine while maintaining a balanced nutrition intake. The slide shows an example of daily meals, giving you an idea of the available dietary options. For example, our ready-to-drink products for PKU patients, GLYTACTIN and low-protein bread and pasta help patients consume nutrition in a balanced and tasty way. We also develop products to ensure that despite severe dietary restrictions, patients can still enjoy their daily meals. For those who are suffering from specific diseases, they are very much looking forward to their daily meals. And on this, Rick Jentis of Ajinomoto Cambrooke will speak later on this aspect. On the other hand, these are products targeted at individuals with specific nutritional conditions such as malnutrition, type 2 diabetes, obesity and dysphagia. A key characteristic is broad scope and a large number of potential users. We offer high calorie and nutritional supplement products for undernourished elderly individuals and children as well as products and support programs for those dealing with obesity and diabetes. For example, we provide support programs in collaboration with health care professionals to help patients maintain motivation and make lasting behavioral changes in their nutritional management. As mentioned earlier, obesity and weight control are significant social issues today. Nualtra has seen remarkable growth in recent years, driven in part by products and programs that significantly improve type 2 diabetes caused by obesity and lifestyle diseases. And we are seeing concrete progress, which will be touched upon by Mark Lane from Nualtra later on. Now let me briefly explain how these products reach patients by using the slide on the medical food value chain. It differs by country or region, of course. But once the patient is diagnosed and prescribed treatment, a doctor or dietitian may recommend medical food. Patients typically purchase products at pharmacies, which then handle the insurance claims. Again, the system varies by region. But in the Western countries, where robust reimbursement systems for medical foods are well established and where we primarily operate, namely U.S., U.K. and Ireland, medical foods are often covered by insurance or government subsidies, resulting in low out-of-pocket cost for patients. Since medical foods are often more expensive than ordinary food products, the reimbursement systems are crucial. Furthermore, in countries with such systems, overall health care and pharmaceutical costs are expected to be reduced. As of 2024, the global medical food market exceeds JPY 2 trillion, driven by factors such as aging population, rising lifestyle-related diseases, diversified needs and expanding reimbursement systems, the market is expected to sustain annual growth of over 5%. The major players in the market are global companies listed here, but we aim to expand our share and grow our business by focusing on segments where our AminoScience expertise gives an edge. Ajinomoto Group is still a small player in this market, but by concentrating on diseases and nutritional conditions compatible with AminoScience, we are achieving high growth rates. While the overall market is growing at about 5% annually, our medical food business is growing at a CAGR -- or CAGR of over 20%. As mentioned earlier, our sales have already exceeded tens of billions of yen with high profit margins. We are progressing ahead of expectations toward our 2030 growth road map. Rather than blindly pursuing scale, we aim to leverage our AminoScience strength to selectively target winnable areas and double our sales by fiscal year 2030 compared to fiscal year 2024, thereby contributing to the well-being of those in need of nutritional support. This slide illustrates the concept of synergies within the Ajinomoto Group aid at driving future growth. We will integrate our deliciousness design technology, nutritional and physiological knowledge of amino acids and intangible assets such as human resources and networks from both our Food and Bio & Fine Chemical businesses. As Mr. Nakamura mentioned earlier, medical food is a hybrid field that combines our strength in food and biotechnology, enabling accelerated growth. We aim to deliver high-value medical foods that enrich lives by enhancing both deliciousness and nutritional functionality. Building on this maximized synergies, this slide presents our growth strategy. It is very simple. We will first solidify our foundation, then expand into new regions and disease areas. First, lower left, in terms of the existing products and markets, we will further enhance quality, including taste and functionality, thereby strengthening market penetration. Then upper left, we will explore new markets using the Ajinomoto Group's global network. For example, in Vietnam, Ajinomoto Vietnam and Cambrooke have started patient trials. Although Vietnam lacks an insurance system, we are working with authorities so that we can propose a reimbursement framework going forward. Also, lower right, we will expand our products and capabilities and extend into new therapeutic areas such as pediatric and oncology-related nutrition. We want to diversify our product lineup, thereby meeting various needs. By accelerating these efforts through innovative product development, leveraging AminoScience, we will pursue sustainable growth. Today, as you can see on this slide, we are joined by Rick Jentis, President of Ajinomoto Cambrooke; and Mark Lane, CEO of Nualtra. The 2 leaders will present the key initiatives being led at their respective countries. I personally look forward to visiting Boston and Ireland every year to engage in discussions and dialogues, not only with Rick and Mark, but also with the local leadership teams. In addition, Mike Lish, Deputy General Manager of the Bio & Fine Business Division and Head of the Amino Acids Department is also here today, and we are working together as a Global One team. Please listen to their presentations. Rick, please go ahead.
Rick Jentis
executiveThank you, Maeda-san. It's a pleasure to be here today and have the opportunity to share about the Ajinomoto Cambrooke business. We can go to the next slide. I'd like to start with sharing a bit about Ajino Cambrooke's commitment. At Cambrooke, everything starts with our commitment to help improve patient lives. We remain relentlessly committed to our patient communities through outstanding nutrition options and superior service. It's important to highlight that this commitment to the community includes not only the patient, but their families and their health care providers. For people with chronic health conditions, who require daily dietary therapy, we elevate their quality of life through great tasting, effective nutrition solutions. And this links us to the Ajinomoto mission of helping people to eat well and live well. Next slide, please. We maintain a focus in 3 key areas. The first is a focus on our patients who we are providing our care for. The second is around delivering great products that can help meet their specific needs and help them live their best lives. And our third area of focus is on the people, the associates inside our company who are responsible for demonstrating our compassion and ensuring the quality and efficacy of our solutions. We can go to the next slide, please. I wanted to go a little bit deeper into the 3 areas of patient populations that we focus on. The first group are patients who are born with inborn errors of metabolism. This is a range of metabolic diseases where the patients are unable to metabolize an individual or a set of amino acids. These conditions usually require dietary therapy for life, where they will need to have specialized diets that help them to avoid the offending amino acid. The second patient group that we focus on are those who have to follow a medical ketogenic diet. This main group of patients is those with intractable epilepsy, but the diet is also showing promise in additional patient populations. In epilepsy, patients are initially put on an Rx medication. And if they do not respond to that medication, the medical team may try another antiepileptic or they may move them to a ketogenic diet. Ketogenic diets have been shown to reduce the frequency and severity of seizures and in some cases, actually eliminating the seizures entirely. The third broad group that we support are GI allergy patients. These are patients who can have a severe allergic reaction to a specific or multiple proteins and -- or it could be triggered by multiple proteins, sorry. Our products in this category also support GI conditions ranging from eosinophilic esophagitis to short gut syndrome. The use of specialized amino acid formulas can help these patients to avoid the allergic triggers and also improve absorption of key nutrients. Next slide, please. We help patients to navigate the complex pathways to access medical nutrition products that Maeda-san had shared. The way we do this is by building strong relationships with doctors and dietitians and helping to educate them about the advances in metabolic and ketogenic therapies. In some clinics, we'll work with the staff to host sampling events or cooking classes to help patients learn more about their options. We also will support pharmacies and home care companies, who serve our patients and help them access our wide range of solutions. In some cases, the home care company will even have us drop ship the product directly to the patient and then the home care company will manage getting the reimbursement through insurance. In cases where patients struggle to find a pharmacy or a home care company who can support them or who can take their insurance, we offer CAMBROOKEcare, which is a full-service program to help patients navigate medical food coverage and reimbursement option. Next slide, please. So CAMBROOKEcare is a great example of a program that's rooted in our overall mission of being committed to our communities. So I want to share a little bit more about the foundation of our company and why patient support is so important to us. Cambrooke story starts with a typical family. Lynn & David Paolella have 3 children. Their oldest child was born healthy, but their younger 2 children, Cameron and Brooke, hence Cambrooke, were both born with PKU, an inborn error of metabolism that affects their ability to metabolize phenylalanine. Back in the late '90s, there were very few options and the products that did exist did not taste good. Lynn will often share stories about how her children were always hungry and that led her to take action. She developed a range of low-protein foods and working with her husband, they founded Cambrooke Foods in 2000. Over time, they expanded the portfolio to include formulas and later to support other conditions. Cambrooke has led the way with a number of pioneering innovations that we'll talk about in a few slides. But we are proud to have joined Ajinomoto in 2017, and it's been a great match. I'd like to share a brief video that maybe helps tell this story in another way. So if we could go to the next slide and share the video, please. [Presentation]
Rick Jentis
executiveCan you go to the next slide and one more, please. Thank you. So in North America, ACI participates in the 3 main segments I talked about earlier, which we believe is a category size of approximately $160 million. While there is no syndicated data sources for sales or market share, based on our internal surveys, we believe that we are the market leader in the ketogenic diet, and we hold a strong #2 position in the inborn errors of metabolism segment. In the companion low-protein food market, which is linked to our founding story, we maintain a clear market leadership. We recently entered the severe protein allergy market and have been making steady inroads, and we see a strong opportunity to continue to lever Ajinomoto's AminoScience to bring new solutions to patients who require amino acid diets. We can go to the next slide, please. Within these categories, we have a strong portfolio that offers clear points of difference. In the inborn errors and metabolism segment, where we offer the GLYTACTIN brand, we have a variety of great-tasting RTDs, ready-to-drink and powder products, leveraging GMP technology. GMP stands for glycomacropeptide, and this is a specialized peptide that has taste properties more similar to intact protein, but it is very low in tyrosine and phenylalanine. This makes it a great solution for patients with TRU or PKU. Cambrooke, working with the University of Wisconsin, has pioneered -- had pioneered the introduction of this ingredient into the marketplace back in 2010. We also offer a range of over 60 low-protein foods to bring variety to patients' diets. From breads to pastas, pizza enchiladas, we help patients enjoy their meal time. In the KetoVie segment, our formula has a unique nutrient blend that better meets the needs of ketogenic patients without the need for added supplements. We also are the only company to offer a plant-based ketogenic formula, or a peptide-based ketogenic formula. And finally, in the severe protein allergy segment, we formulated our products without corn syrup solids to address parents and HCP concerns related to carbohydrate sources. Our use of tapioca as the carbohydrate source has been well received and proven effective with patients who are struggling on other formulas. And if we can go to the next slide, please. Thank you. Our strong engagement with patient communities and their HCPs is a key component of how we win in the marketplace. It starts with our founder story and reinforcing our connection with the community. We ensure that we remain present in ways that are relevant to the customers. We hold cooking classes to help teach patients and dietitians how to cook low protein foods. These classes can be held at metabolic clinics, local community centers, metabolic camps or even in rented kitchen spaces. These events also offer an opportunity for us to showcase our full portfolio of products and drive patient trial. We bring education to the community through digital methods as well, whether on social media or through a new podcast that will be launching later this summer. We continue to educate the next generation of clinicians to support our patient communities, and we also provide in-person training at our Cambrooke Academy. Can we go to the next slide, please. And as I mentioned, we have been historically a leader in bringing innovative solutions to the market. And coming in 2025, we will have a new amino acid hydration product, so a sports drink-type product that utilizes amino acids to also help patients address their protein needs. We've partnered with Ajinomoto Foods North America to create a low-protein gyoza, which is a great advancement in the market in terms of normal diet. And then we have new category disruptions that will be coming within the SPA category as well as the metabolic category. We can go to the next slide, please. I wanted to dig in a little more on how we're partnering with Ajinomoto to bring this next generation of innovation. As I mentioned, we're developing a low-protein gyoza in conjunction with the team at Ajinomoto Foods North America, what's been great is that they have phenomenal technology around food and taste, and we were able to bring the scientific knowledge around nutrition and formulation for our particular patient populations. To address shelf-life challenges and taste challenges associated with some of our high fat powder products, we've worked with the Ajinomoto research team to identify the sources of fat oxidation and have designed new manufacturing processes to better protect our fat molecule. We've also worked with the Ajinomoto development team to address sensory challenges often associated with amino acid products. Through detailed taste mapping and taste masking technologies, we are able to develop -- deliver improved sensory profiles on our products, thus better delighting the customers. Finally, as we look to expand into new disease territories, our R&D colleagues are helping to evaluate and support clinical trials to help demonstrate the efficacy of the nutritional solutions we offer in helping nutritional management of targeted conditions. This research has the potential to increase the size of the categories we serve several fold. Next slide, please. Ajinomoto has also helped Cambrooke with its ambition to expand globally as we've now expanded into over 20 countries. And we have plans to enter new countries such as Vietnam, as Maeda-san mentioned recently. Next slide, please. We have a clear vision for our 2030 roadmap. As I said, it starts with our relentless commitment to our patient communities, building on our founded by family built by community foundation. Over the next few years, we'll focus on strengthening our foundation through expanding our capacity, automating our business processes and expanding our sales force and reach. And as we look to the midterm, we'll drive accelerated growth with our innovation, our social media and consumer activations as well as our geographic expansion. All of this built on the basis of a great group of people and associates dedicated to our patients and the culture of our company. Thank you. With that, I'd like to turn it over to Mark Lane, who will share a bit about Nualtra. Mark?
Mark Lane
executiveThank you, Rick. Hello, and a warm welcome to the Nualtra section. My name is Mark, and it's a privilege to be able to share our progress to date and perhaps give you some insights to the world of medical nutrition here in the U.K. and Ireland. Next slide, please. And I start, if I may, with a polite reminder that malnutrition is not only a health care problem, but it's also a social one. But what is it? At its basic level, it's a state in which your body's macro and micronutrient requirements are not being met by your diet. It is not weight management. It is under nutrition, and it's usually related to an underlying disease or a condition of frailty. Now most products can be used as a sole source of nutrition because our products are nutritionally complete. But the reality is that most patients just need to supplement additional micronutrients in particular, but also calories, but they must be good calories. Now malnutrition affects more than 3 million people in the U.K. and Ireland, and I call it a hidden problem. Unlike obesity that you see in schools, in the workplace and in the public generally, malnutrition is often institutionalized. That means that our patients are very often in hospital or other care settings like nursing homes. The health economic costs are substantial and studies show that malnourished patients see their doctors more often, recovers more slowly from disease and stay longer in hospital. And the cost of the state health care systems that we supply in the U.K. and Ireland exceeds EUR 25 billion per year, and the prevalence is sadly growing. Now we believe that malnutrition is avoidable and Nualtra offers solutions to both patients and health care professionals, and that is why the government pays for our products. And the typical prescription cycle is displayed on the next slide, if you would. Now there's a lot going on here. But in summary, we focus on driving clinical preference for our products to health care professionals. We do not market directly to patients. There are many influences in the health care system, but there's only one prescriber. And we focus primarily on clinical dietitians of all specialties as well as health carers and prescribing support pharmacists. They are our customers that recommend what brands the doctors prescribe. And they are physically supplied in exactly the same process as pharmaceutical products. Now this cycle is the same for all companies in our markets. But one of our point of differentiation is the fact that we have a very deep understanding and insight to the local prescription pathways. We have one health care system in England, for example, but there's over 500 smaller organizations that deliver health care to their local populations. It is true customer intimacy. And I'll speak a little bit later on about that. Now another differentiator is illustrated in the top right-hand side of this slide, and it's our nationwide product sample service. We make certain that dietitians have very fast access to great tasting samples that arrive at the patient's home a matter of hours after they are requested. It is the largest and most efficient sample service in the U.K., but there are many other things that make us unique. Next slide, please. Being founded by a dietitian, Paul Gough, is unique in our market. And in fact, I believe it's unique across the whole of Europe. Our focus is primarily within the regulated prescription model, but we are a medical food business only. We are not a pharmaceutical company or a food company that happens to supply nutritional supplements. Now Paul led this business till 2017, and this is the business we are today. We provide those solutions to disease-related malnutrition and most of our patients are adults. It's the clinical evidence for medical food and our regulatory framework that sets us apart from retail fortified foods, and that is why our business is 95% reimbursed by the state. Now we don't manufacture, but we are a customer-focused business and all of our consumers are patients. Now Paul is one of many registered health care professionals that work inside our company, and many of us have medical nutrition patients in our families, me included, and our world revolves around them. Purpose and future vision are anchored in this notion. We exist to give patients the best possible experience of medical nutrition, and we aim to be the most trusted provider. It's what we call better lives. Run the video for me, please, if you would. [Presentation]
Mark Lane
executiveThank you. A message from real employees of the business there. Next slide, please. So I believe and everybody that works in the company believes that we have a very special culture. And it is anchored in the values that we hold true. You can see them across there at the bottom of the slide. These are not just something we simply say. It's something we do and it's something that we feel every day. Many would say that our proximity to patients is one of the best examples of Ajinomoto shared value. And I would agree with them. Well, it's been an eventful time over the last 13 years as we've transitioned through the phases of getting to where we are today. Our mission now is to scale. And we've had a very good start. Revenue since the first full year before we joined the Ajinomoto Group has quadrupled, and we now have even more ambitious growth in our 2030 road map. The foundation for future growth can be seen on the next slide, please. And to realize our ambitions, we are laser-focused on protecting what we've already built and growing from the core markets in which we operate, whilst exploring exciting growth in other disease-targeted nutrition areas. The method to our commercial model is to be the best at establishing 3 themes: where we play, how we play and how we win. Where we play, we're very selective with specific health care channels in the U.K. and Ireland that have the highest value, and we've been able to build a formula of disruption that works time and time again. How we play is with the very best products that are formulated to achieve maximum compliance? I say to my guys, often the best supplement is one that is drunk. So we focus very heavily on taste technology. And also a very unique blend of value-added services that make us integral to the success of our customers. And how we win is with our energetic employees who are 100% aligned to our ambition and who know exactly how each of them contribute to the overall vision. With other factors that I'll come on to explain shortly, we've been able to stay ahead of the competition and prescription data, which is publicly available in the last 12 months leading up to February this year proves that we have been the fastest-growing medical food company in the U.K. and Ireland for 8 years running. We are quite literally on a rocket ship as we build it. Next slide, please. And this slide demonstrates that there's a direct correlation between the numbers of patients that our products treat and our revenue, meaning that helping to treat patients and commercial success go hand in hand. On the left, you can see volume of patient servings that we've sold over the last 13 years, which span across 4 clear stages of our growth to date. On the right, I used the chart there to illustrate our performance against the only U.K. and Irish competitor of a similar size. They entered the markets before us, and we matched their sales for a while. That inflection point of growth you see there came after we were released from COVID lockdown and the rest is history. Next slide, please. And we pride ourselves on giving health care professionals compelling reason to first choose Nualtra, not the product brands. We don't want them hunting for specific products across all the competitors. And for that reason, we position our products to be utilized across a great number of disease states or pathologies. And on this slide, I've attempted to group up the main categories for which they're used from sole-source nutrition for patients who cannot eat and are often fed directly through a tube to supplementation and also specific management of disease symptoms. And in most cases, we adopt a high-speed development system to bring these products to market. In some cases, these products are supported by services that have become integral for health care professionals themselves, both in terms of clinical and health economic outcomes. As you heard earlier, our first ever pediatric products were launched recently, and there's more exciting categories to come later this year and in 2026. Next slide, please. So a few words here on the market from me. The market is very buoyant. I've been in this business for 26 years, and I've never seen it so buoyant. Patient demographics have been favorable for many years because patients are living longer with more complex health needs. And there's a raised awareness of the role that nutrition has to play in patients' recovery. The market can be approximately split 50-50 between standardized liquids for general states of malnutrition and the rest is more specialized product, both in powder and dysphagia, as you heard earlier. And the current market growth, the moving annual total for the last recorded 12 months is running at 6% in volume. Nualtra's growth has been 23% over the same period. But importantly, value is growing twice as fast, and that's because health care professionals are increasingly favoring liquid solutions. They're more convenient formulations and Nualtra are ideally placed to win with those tailwinds in the market. And when we win, patients win. An increasing number of the most vulnerable people in the community can benefit from our products and Nualtra are #3 in the market for the categories in which we compete. Our growth is the envy of the competitors, but there's still plenty more headroom for market share. Last year, Nualtra was #1 for percentage and absolute volume growth over the last 12 months. In fact, we were responsible for nearly 50% of the total volume growth in the market in the U.K. Next slide, please. So I mentioned value-added services previously. And across the bottom of this slide, I show some examples under the branding Forefront. We have a superb online trading tool called Discover for health care professionals to get certified around their knowledge of nutrition. ForefrontRx is very smart and it's a unique data insights modeling tool. So health care -- people in working in health care systems can track prescribing trends against their clinical pathways. No one has anything like that in the market. And we have the U.K.'s only appropriate prescribing program, which we also brand Forefront. And that's where we offer to partner with medicines management pharmacists, and we review patient regimens inside doctor surgeries, making certain that patients who would benefit from these types of products receive them and indeed, deprescribe patients where they no longer need them. A rising above the noise in the market, as you heard in the video, is one thing, but ultimately, our success falls down to the people who live every day by our mission of customer intimacy. Knowing customers better than they know themselves and building strong relationships on trust cannot be copied by competitors. It is a critical ingredient to our success. Next slide, please. So having the right people in our teams is important. So finding talented people irrespective of where they are located is the reason that we operate a hybrid working model. The map on the right here shows you our 2 very small offices in the U.K. and Ireland, along with the European locations of our contract manufacturers who produce exclusive formulas for us. On the left, I've exploded the map of the U.K. and Ireland so that you can see the locations of all of our employees and their designations. 2/3 of the people in my organization are customer-facing. And because we use the -- or utilize rather the pharmaceutical wholesale and distributor supply chain, we run very lean in terms of back office and indeed, overall head count. So that's what we do, and that's how we've succeeded to date, which leads us nicely to a glimpse of the future. If you would move to the next slide, please. And it starts with how we plan to work closely with the Ajinomoto Group. Colleagues across the company are supporting us with plans to expand across target countries in Europe. The market discovery research for that work is now being complete. So depending on the specific country, we'll be moving forward with plans to invest in our own people in country, distributor agreements and also potential for opportunities in mergers and acquisitions. And we are doing this at a time when the Ajinomoto Group are helping with advances in taste technology and developing international formulations for cow's milk protein intolerance products. Most exciting though, I think, is our investment in the clinical trials for Amino L40, which have been running for 2 years now in Beaumont Hospital in Ireland. Now they've been designed for use for patients with liver disease who have sarcopenia, which is disease-related muscle loss. The hospital-based trials have just concluded actually, and the results are so encouraging. The study write-ups are starting this month. So all in all, the future is very bright with many opportunities to work in partnership with the Ajinomoto Group, as we look to try and commercialize the power of amino acids in the medical market. Next slide, please. Now this is a visual representation of our 2030 road map. It illustrates several exciting milestones that we will achieve along the way, none more exciting than in '28 to '29, which is creating our center of excellence in Ireland. It will be our new European headquarters, and it will host all of our clinical study work, our product innovation hub as well as manufacturing. Next slide, please. So this is my penultimate slide, and it's a summary of the 3 imperatives for the next 6 years. These are my must achieve initiatives. We must protect and grow our core business. It's what we do every day. It's business as usual. But our future effort in this area is to accelerate volumes through our patient acquisition strategies that we know work. And that will include a process of continuous product improvement of what we have on the market today. And products essential is the second pillar that you see there, innovating new solutions. They're primarily focused on therapeutic nutrition, so not standardized nutrition for frailty or enhanced recovery. And in some cases, we'll be managing the disease itself, for example, with diabetes without your life, not just the symptoms. And finally, we play to win in new markets, as I've already mentioned, which includes an exciting direct-to-consumer play that has already started in the U.K. and of course, entry into the first wave target European markets. And I think on to my final slide, please. So I wanted to leave you with this message, a final message. Our market is very buoyant, importantly, has very high barriers to entry. There's been 2 global businesses launched in the U.K. in the last 5 years, and both have retreated in haste. So it's a perfect opportunity for us to keep growing. And it's a market in which we are leading that growth, but I know we still have much to do. And my challenge is really to point our resource at the greatest opportunities that we have and continue to develop the talented people you see here in this photograph. This is actually my whole team in Nualtra alongside colleagues from Cambrooke International based over Cyprus during our annual conference, which this year, I was delighted to be able to take everybody to Japan, to Tokyo and Kawasaki. It was a wonderful experience for everyone. So I don't only have a team who's fully energized, but now I have a team who's very much feeling a part of the Ajinomoto family. Thank you.
Operator
operator[Interpreted] Thank you very much, Rick and Mark. Now we'd like to go into Q&A session. [Operator Instructions] The first question from Mizuho Securities, Saji-san, please.
Hiroshi Saji
analyst[Interpreted] There are 2 questions. The first one is Ajinomoto Cambrooke. I have a question to Rick. Page 11, the products that are shortly launched, something that's different like low-protein gyoza amino acid hydration, which is closer to Ajinomoto in terms of relationship that are going to be launched. So at this timing, you are going into those new areas. What are the triggers? Is there any background, particular reasons behind these movements? That's the first question. And then Page 13, distribution partner is you're going through to go into businesses, and there are so many countries that are included. What is the time frame that you have in mind for to cover more than 20 countries? What are your plans? What is the scale of each country and the timing of each country? That's the first question. And then the second question is Nualtra. I'd like to ask this question to Mark. The first question is Slide 7. May 2022, there's a big growth that was started. So at this timing, what happened at this point in time? Why you are able to make that much difference from competitors in terms of growth rate? Can you elaborate more on that? And especially, as you explained, very interesting sample provision services as strength, and that was what you explained. So is there any unique business model that was behind this phenomenal growth? Can you explain more about that?
Sumio Maeda
executiveThank you very much, Saji-san. So let me just take that question first and then ask Rick and Mark to add more. So there are 2 questions. The first question is about low-protein gyoza and the collaboration with Ajinomoto, what was the trigger? And so basically, since the acquisition of the companies, we have been building our foundation, and we were pursuing synergy whereby we were able to do. And then on a step-by-step basis, we have been making progress. And now we are into the frozen food business. And so we have built a team, but I will let him explain more. And the other question to Rick, the schedule and timing of each country, which region. And so let me answer the question first. There are some confidential parts. So in terms of timing and scale, we may not be able to disclose too many details. But as we go into those countries or regions, what are the philosophy behind that, that can be disclosed and probably explained by him. So there is a system and the market. We -- then there are many markets where there are already competitors. So in which sequence and what timing that will not be disclosed. So those 2 questions will be answered. Ajinomoto collaboration trigger for that and then overseas entry, can you explain more about that?
Rick Jentis
executiveSure. Thank you. Thank you for the question. So the key trigger for the innovation that we have coming right now in both the amino acid hydration and gyoza are really driven by our desire to help patients, who are suffering with PKU and other allied disorders to have as normal a life as possible. And so we have a lot of interactions with them at community events where we ask them what are the things that they feel are missing or that they would like to have. The sports drink was one that had risen up. And so what we balanced was how could we create something that was different from general sports drinks in the marketplace. One of the key needs for patients who have inborn errors of metabolism is to maintain an appropriate level of protein intake throughout the day of their modified proteins. And so by giving them a sports drink, it really helps these kids who are in that 10- to 25-year-old who are highly active to have something that feels very similar to what their friends are drinking, but that's also helping them with their diet. In the case of the partnership with AFNA, we had a number of our suppliers who had challenges during COVID, some who went out of business. And so we wanted to rebuild the variety of offerings that we have. We have about 60 different food items. Several of them are frozen foods already. So we have that frozen distribution network. And so working with AFNA was just almost a no-brainer. It was a simple solution, and it was just a matter of figuring out how we work together, learning how to collaborate with inside the Ajinomoto family, and we have a product that tastes great, and they've helped us overcome some technical challenges in terms of the dough that we were using because our dough has to be very specialized. And it's just been a really positive story for us and we believe for our patients. As we look to your second part of your question about our expansion into other markets, what I would tell you here is that these are the countries that we already are actively selling product in. So we have built relationships over -- again, we joined Ajinomoto in 2017. And over the last 8 years, we've been able to slowly market by market find appropriate partners who could help us reach our audience who had the right level of care, the right level of knowledge to help us bring different products into market. And so what we do, we find the local player. We build a relationship with them. We help provide them with training on how we, as Cambrooke, want to go to market and then we activate the sales program in that market with that local distributor partner. So hopefully, that answers your question. And if there's follow-ups, happy to take those.
Sumio Maeda
executive[Interpreted] Thank you very much. Now I would like to ask Mark Lane to answer the question on Page 7. Since 2022, there was a rapid growth that started, it seems. So what was the trigger behind that? So let me share with you my understanding. In 2020, they joined Ajinomoto Group and Nualtra already had very good team members and good products with a good potential for growth. But with Ajinomoto's capital, with that, they were determined to grow, but then the COVID-19 hit the market. So the 2 years of the preparation period on a remote basis, we are talking about Cambrooke products that will be sold through them. And so in autumn 2022, the first visit after COVID-19 was the first one in 2022, so it's been 2 years since they joined that we visit them in person, and they actually led to the acceleration of growth. But that's how I understood it. So I'd like to ask Mark Lane to answer more questions.
Mark Lane
executiveI think you did a better job of answering that question than I would do. There was -- there were a lot of factors. Of course, COVID damaged the market. We were incidentally the only company in the U.K. and Ireland that survived through COVID itself. The lockdowns afterwards and emerged the winner with more volume because we did not go out of stock of any product throughout that time. Even the global businesses had volume restrictions in marketplace through raw material scarcity. So that was one element. Another, and I think probably most important variant for us was some other companies chose to furlough staff and put them off work. We didn't. We worked every hour through the whole time of COVID. And we work very specifically on prescribing guidelines to work with health care professionals to make sure when they can go out and prescribe again that we were #1 on the list. That was very successful, and we got a lot of momentum from that afterwards. But it also coincided with the launch of our juice product. We brought the first product in a tetra pack format which the market had been in plastic bottles for many, many years, and that was exceptionally successful in its first year doing 10x what we thought, actually added around 8% to the total revenue. So many different factors. And Ajinomoto, of course, played their part as well, not restricting me on working capital and inventory management helped a great deal to make certain our products were where the patients needed them always. Is there a second question about sample service?
Sumio Maeda
executive[Interpreted] That was the answer, Saji-san. In October 2022, after 2 years, Ajinomoto and Nualtra met in person. So we hugged each other. So we were able to confirm that they were actually existent physically because before that, we only had interaction on a remote basis only. So does that answer your question, Saji-san?
Hiroshi Saji
analyst[Interpreted] Well, in a unique model, the sample provision system, which I found was quite interesting. So can you maintain your competitive advantage through this service?
Sumio Maeda
executiveYes. Mark, can you add? But for this flow, I think other companies can establish this system. But what I always find surprising talking to Nualtra team members is that they always consider what doctors would think and how the dietitians would talk to patients. They have well informed about value chain. So even if they can mimic the system informality, but intangible assets with expertise and human resources may not be able to be copied, but I would like to let Mark explain more.
Mark Lane
executiveThank you. That's a good answer. I would add that whilst there are limits to how many differentiating factors you can produce in a product's nutritional specification because of European rules, we have to focus on other things. The sample services is just one of those. The way it works in reality is that a dietitian accesses our website orders before 2:00 p.m. that day and it arrives at the patient's doorstep the following morning. It is critical we get there first because patients will ask for the product, which they've tasted first. In terms of maintaining that competitive advantage, we keep innovating. We keep making improvements to the sample service. We give analytics to dietitians on what is used and how many products are tasted. We look at different ways to innovate the one-click ordering system online, and we mix up the types of products that are available in that case, but our business model does not rely only on the sample service. So we have many other things. And I should say for the benefit of everybody that works in Nualtra, our love for these patients, our love for this market is infectious. And I would invite anybody to come and spend some time with the people in the organization, perhaps at one of our conferences and the people that I have from Ajinomoto really do feel that. We are all mission focused, and that is the most important thing.
Operator
operator[Interpreted] Now we would like to switch to another person who is joining us from Bernstein Securities. Mr. Marques, the floor is yours.
Miguel Marques
analystI've got a question on Nualtra for Mark, please. So you've talked about significant barriers to entry that you enjoy in your U.K. business, which seem to revolve around the relationships with practitioners and obviously, the sample service that you've talked about. What do the barriers to entry look like in country in Germany and Spain, your priority expansion markets? Do you need to replicate the sample service? And can you do that at a reasonable cost? And maybe why Germany and Spain, why not bigger markets like the U.S. and beyond Europe? It'd be great to understand your thinking about the expansion.
Mark Lane
executiveOf course, yes. So listen, we are [ thoroughbred ] players in the prescription market, which is fully reimbursed, so 0 cost at the point of access to the product for the patients. America is a very different market. It's the biggest on the planet. Total medical nutrition market there is 7 billion versus 5 billion in Europe, but Europe is the biggest pharm -- regulated market on prescription. So that's why Europe, it's on our doorstep, but the capabilities we have are in the health systems and understanding the flow of money and how decisions are taken there. In terms of access to priority markets in Europe, Germany is growing at 10% per annum, Spain, 8%. Italy is around 5% and France 7%. And in those markets, it's not going to be possible to simply Xerox our modus operandi in the U.K. and Ireland and get it done over there. We will do it through local knowledge and local people. We already have boots on the ground in Italy and Germany with the Cambrooke products, and we work very closely with Cambrooke Therapeutics International. The route to market that we take in those countries is yet to be determined. But in most cases, we'll be up against the same competitive. In terms of the barriers to entry in the U.K., in particular, that is around the regulatory framework and the time at which it takes to get products to market. We are fast developers of clinical trials. That is not for the faint hearted. And if you want to play in the hospital space, it's a heavily subsidized model. So cost to entry is huge. I think a better way to answer the question is, could we do what we've done with Nualtra if we launch now? I think the answer is no. It is a very, very different market than it was 13 years ago. There's now 4 very strong players as opposed to historically, there only being 2. So to a certain extent, it's somewhat saturated by the big 4 of which we are one.
Miguel Marques
analystCould I just ask a quick follow-up on that, please? On Slide 9, you showed a total value opportunity of EUR 400 million. And I think that's for England, Wales and Ireland. What would that look like if you think about all your expansion markets as well? What do you think the total addressable market is?
Mark Lane
executiveThe total addressable market in the countries we already identified is EUR 1 billion.
Miguel Marques
analystOkay. So it sounds like these other markets are relatively smaller than the U.K. then if 5 other markets are only EUR 600 million?
Mark Lane
executiveCorrect. Yes. For the categories in which we compete, the U.K. is the biggest market in Europe. It's not the highest priced market. So it won't always be a volume-only play in some of the different markets. In Italy, the reimbursed price is some 40% to 60% higher. In France, it is lower, but the U.K. is the prime market.
Operator
operatorMr. Marques, did that answer your questions?
Miguel Marques
analystYes.
Operator
operatorNow moving on to the next question. From Goldman Sachs Securities, Miyazaki-san, please.
Takashi Miyazaki
analyst[Interpreted] Miyazaki from Goldman Sachs. I have a question to Cambrooke. But once again, in terms of competitiveness, what is the source of competitiveness? That's what I'm interested to know. So the target diseases, so number of players is small or limited because you are in the niche area. Is that where your strength or entry barrier lies? Or like efficacy is where you excel or deliciousness is where you have the biggest strength. So I just mentioned 3 possible ones around the product. But in the product capability, do you have any strengths or any business model or formats that you have strength in that has triggered your growth? So like relationship with physicians and dietitians, communications and networking, is that where your strength is that's why you are growing and you are beating the competitors? What you believe is your strength? That's why I'm interested to know.
Sumio Maeda
executive[Interpreted] Thank you very much, Mr. Miyazaki. I'll just explain first, Maeda speaking, and then let Rick add more. And so with regard to Cambrooke, as Rick's presentation said, what's very unique is that founders are the parents of PKU patients. That's the story. The story is where the strength lies. So if you don't have any food for your own children and the medical foods of other companies wouldn't work, then you wanted to create your own. That's how it started. So the affection to compassion to patients, and it's very -- they relate to how hard it is not to be able to eat. And also, Cambrooke has a very strong relationship with the patient community. It's all in one team. They share the same problems, issues. And so in terms of networking, they are closely related. So we have acquired the whole business as Ajinomoto. So very strong business management capability and quality control and operational capabilities are also incorporated from Ajinomoto. So the parents of the patients started the business. So products are very good. And in terms of epilepsy, whether the number of seizures is larger or not, there is always a word-of-mouth communication between the patients and families of patients. So you can make that strength and strengthen the network and enhance the products, but I'm sure Rick can add more.
Rick Jentis
executiveThank you, Maeda-san. I think you hit a lot of it. A big piece of it, as you've said, is our relationship with the community. And it is a small community. There are maybe 20,000 patients with PKU in the United States, only about 10,000 of them are on diet. And when you look at our relationship and our ability to reach those patients, it's really high. A great example would be there was a family who was vacationing up here in the Boston area last week. And their son who's on our formulas wanted to see where his formulas were made. And so we invited him into the factory and gave him a tour and here's a 13-year-old boy who is interested in the science of the formulas. And so we were able to show him how his product was made. And that kind of just reinvigorates and continues to build that story of our connection to the community that is really hard for our competitors to replicate because they just don't have that, that connection. But we also do have product advantages. As I talked about with GMP, glycomacropeptide, we were the first one to commercialize that. And it was a huge difference because prior to that, the only solutions were amino acid-based products. And so when you can bring in something that's more like an intact protein, it helps to avoid some of the bitterness that comes through with some of the amino acids, especially back in 15, 20 years ago. So it created a whole change. And so Cambrooke is known for our great-tasting products and so -- and then we can bring a variety of different flavors because we have very flexible manufacturing that enables us to produce in small scales that, again, very difficult for competitors to replicate.
Takashi Miyazaki
analyst[Interpreted] I have a question on the -- any changes that you have seen since the Trump administration came in. So we don't have to worry about that. Can you share the thoughts with us?
Sumio Maeda
executive[Interpreted] Thank you. Well, in general, the President has changed and reimbursement system has changed and the Director of the FDA also has changed, but our observation is that for those patients with very critical diseases, government and FDA has said that they would continue to support. So we're closely watching how it's going to play out, but there's no major dramatic problem that have occurred.
Operator
operator[Interpreted] Next, we would like to take -- another question from SMBC Securities -- Nikko Securities, Mr. Furuta.
Tsukasa Furuta
analyst[Interpreted] This is Furuta from SMBC Nikko. I have 2 simple questions. First, I just want to check the numbers. First, medical food business is beyond JPY 10 billion right now in terms of sales. And I just want to know the split between Cambrooke and Nualtra? And second, the profit margin is above average in the medical food business. So I would like you to elaborate on that. And in 2030, you would like to reach JPY 20 billion, which is double the current size. Cambrooke and Nualtra, and what would be the individual contributions? That is my first question. The second question goes to Mr. Mark in Nualtra. When it comes to Ajinomoto and the synergy between the 2, you have grown in an accelerated manner since 2022. So what kind of synergy do you expect with Cambrooke as well? So that is my second question.
Sumio Maeda
executive[Interpreted] Thank you very much for your question. When it comes to the actual numbers, we cannot disclose many of the internally held numbers. But when it comes to the split between Cambrooke and Nualtra, unfortunately, this we cannot disclose. It doesn't mean that one weighs over the other in a significant way. There is a good balance that is being seen in terms of growth. When it comes to profitability, no percentages can be mentioned right now. But in terms of the overall image, I was in the food business before for a long time. In ASEAN, a strong brand with high market share. That is something that you can expect from the 2 in terms of profitability, even beyond what you would expect in an ASEAN food business. And the second question regarding Nualtra, Mark would explain in detail the expected synergy between the Ajinomoto Group. Ireland government, Ireland insurance players are in negotiation with us. We are thinking about amino acid-based trial, Amino L40 is something that we are pursuing with our own formula. And how it can really shine in the medical food business is what we are focusing on. So Mark can talk on this, and Mike Lish maybe you can add after that.
Mark Lane
executiveI'm happy to take that question, and it's a good one in terms of...
Tsukasa Furuta
analyst[Interpreted] There is an overlap. So going back to the margin, is it over 20%? Is that something I should expect?
Sumio Maeda
executive[Interpreted] I'm not going to mention any percentage. It is good profitability. That's as much as I can say.
Tsukasa Furuta
analyst[Interpreted] Okay. Understood.
Sumio Maeda
executive[Interpreted] Mark, now is your time. Let's talk about the synergy with Ajinomoto.
Mark Lane
executiveThe synergy with Ajinomoto is very important. I spoke to the clinical trials in L40, which we got up and running extraordinarily quickly. The -- I'm able to say that the clinical outcomes for those patients with sarcopenia have been very encouraging to the point where we are going to do [indiscernible] as well as to take the product. In real terms around how we commercialize that, the aim is for prescription and first as a stand-alone product, which would be reimbursed by the Borderline Substances Committee in the U.K., but also as a potential as a blend inside some of our specialized oral nutritional supplements. So many different ways, which we can utilize that. But it doesn't end with L40. I think we should be looking to explore opportunities with [indiscernible] and several other products side of the taste technology that we leverage. There was a question about synergies with Cambrooke with Rick's business. And aside from the fact that Rick and I work very closely together and our teams speak a great deal and share best practice, there's opportunity potentially to take Nualtra products into North America, specifically first, perhaps Canada. Whilst it's big, the market in the U.S.A. is very retail-driven. It's absolutely dominated, as I'm sure Rick will confirm by 2 big players, and it is not a market that we are currently looking at. But also the acquisition of -- or the Cambrooke Therapeutics Company in the U.K. is now part of our business in Nualtra. So I'm already interdependent to Rick's success by driving his products in the British Isles and eventually in Ireland. And from that, we can springboard a dual approach, a complementary approach together to brand-new markets where neither Nualtra or Cambrooke are currently operating so a joint approach there to work on both. But Rick and I host 6 monthly global medical food strategy meetings with -- which are hosted by the amino acids department, Mike's team, where we get together and come up with ways in which we can work together to be a stronger player in both of our markets.
Operator
operator[Interpreted] Thank you very much. So Mr. Furuta, did we answer your question?
Tsukasa Furuta
analyst[Interpreted] Yes.
Operator
operator[Interpreted] Now there are many people who are raising their hands, but we're approaching the time to close the session. So this will be the last question that we can take. So Morita-san from Nomura Securities, please.
Makoto Morita
analyst[Interpreted] Morita from Nomura Securities. There are 2 questions. First one is addressed to Cambrooke. So area expansion going forward has been mentioned. And the strength of Cambrooke is the strong relationship with the patient community, which I found very interesting. But when you go to expand -- going to expand your geographic areas, the strong relationship patients which is strength of Cambrooke. Is it possible to horizontally deploy that to other geographic areas? And second question is about medical food business as a total. Of course, geographic expansion will be something you are aiming for. So what is the M&A potential that you see? That's also I'd like to ask about. And also Cambrooke and Nualtra, so with Ajinomoto has a synergy between these 2 has been understood. But what about Cambrooke and Nualtra as the same medical food business? Is there any synergy that you are seeing? That's my second question.
Sumio Maeda
executive[Interpreted] Thank you very much, Mr. Morita. Of course, I'll give you the general answer first. And if there's any additional comments, I will let somebody answer more. So for geographic expansion, like we will have a connection with patient community in each area. In Vietnam, which was selected among ASEAN countries. So 3 years before, all the top of entities in all ASEAN countries got together to pick which one and then all in consensus to pick Vietnam first because of the number of patients that is available and how serious they are in terms of diseases. And Ajinomoto Vietnam has a very strong relationship with the government and school lunch program has been also held. So they are quite excellent in establishing a business system. And so it will be very convenient to start with Vietnam to establish the relationship with patients and government from scratch. And also, what's missing can be also supported by local affiliates. And if there is something missing, then networking will be added. So as for Cambrooke and Nualtra synergy, as Mark Lane said, every 6 months, there is a strategic and global meeting held. And in Europe, a certain number of Cambrooke products are already sold in Europe. And there is a synergy in terms of products and channels are something that we are making progress in. And in terms of area expansion, of course, networking with patient community, is it capability or production or channel access or different products, we will figure them out. And then in some cases, we'll do capital investments or hire people. So among those, there could be an M&A as one option. But we have seen a lot of markets and Nualtra and Cambrooke are the ones that we wanted to join Ajinomoto Group. That's why we acquired them. So it's not the case that there are so many other good companies for M&A targets. That's how we understand. So in the interest of time, I just gave you the brief answer.
Operator
operator[Interpreted] That concludes the Q&A session. To close the session, I would like to take the floor. This is -- sorry, Mr. Nakamura will take the floor.
Shigeo Nakamura
executive[Interpreted] Thank you very much for your participation today. So this Bio & Fine Chemical, along with the medical food business should be expanded. And the medical food business has an overlap of food business and the fine chemical business. So we would like to carry out new initiatives to expand the platform and venture into new businesses. Thank you very much.
Operator
operatorSo with that, we would like to end this briefing session. Thank you very much for your participation. [Portions of this transcript that are marked [Interpreted] were spoken by an interpreter present on the live call.]
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