Good morning and welcome to IDEXX 's 2025 Investor Day. W arm welcome to those of you here in our room at our global headquarters in Westbrook, Maine, and welcome to those joining us virtually through our webcast. I'm Jay Mazelsky, President and CEO of IDEXX Laboratories. We'll be joined by our management team this morning, who will go through a number of growth drivers in the business, and I believe we have a very informative program planned for you. Let me quickly set up the day and go through the agenda and some of the topics that I'll set up for the presenters who will follow. First, I'll speak about the company, our strategy, and some of the initiatives, key initiatives that the leadership team will highlight. I'll be followed by Dr. Tina Hunt, who heads up our Strategy, Corporate Development, and Global Commercial team.
Dr. Hunt will spend some time on the sector, sector development, and some of the underlying growth drivers. She'll be followed by Dr. Martin Smith, who heads up R&D, Manufacturing, and Supply Chain. Dr. Smith will talk about some of the depth and, I think, technical depth of our innovation engine and its sustainability. We'll have a short break and come back and be followed by Mike Lane, who heads up our Reference Lab business, our technology-enabled service platform. He'll talk about the depth and breadth of our menu, as well as a spotlight oncology, which sits or resides on the Reference Lab. Dr. Michael Erickson will follow. He leads our Point-of-Care business and will really talk about the transformation in Point-of-Care, highlight some of the innovations and the direction in that business.
Then Michael Schreck, who leads our customer-facing software, Corporate Accounts, and Customer Experience group, will talk about vendor software, the role it's playing with practices, both independent and corporately owned, and the way they use it to support and really optimize workflow. We'll come back from the break. George Fennell, who leads our Commercial team, will facilitate a conversation with Dr. Brian Greenfield of Animal Clinic Northview. Dr. Greenfield has generously agreed to spend time talking about the state of the state in the industry and the veterinary profession and his partnership with IDEXX . Andrew Emerson will complete the formal part of the program as our Chief Financial Officer and talk about the finances and financial review. We'll have time at the end for questions and answers.
With that, let me just briefly pause here and mention the Safe Harbor disclaimer, a copy of which is also on our website that you can refer to and w ith that, let's begin. A key point to understand about IDEXX and the IDEXX bussiness model is that there's a very significant opportunity still in front of us. We measure this in decades and at $45 billion plus TAB. The realization requires a set of strategies. Those strategies support the sector development. Key amongst them is innovation, and we're proceeding at an incredible pace and acceleration for innovation across all dimensions of the business: point-of-care, reference lab, and customer-facing software. Also, our model is supported by a large integrated commercial ecosystem, very much aligned with our customers' priorities with the focus on international expansion.
The net result of that is a long-term, durable growth opportunity with high returns, which reflect the value that we, as a company, bring from a differentiated solution standpoint. Our business strategy is very much aligned with our company's purpose. As a growth company, being purpose-driven has some significant advantages in terms of employee engagement and professional motivation amongst our team. As we advance our growth strategy, we're committed to creating a positive and lasting impact on the health and well-being of pets, people, and livestock. This morning's discussion is going to primarily focus on the Companion Animal Group because that's the largest part by far of our portfolio. For those of you who may be more interested in delving deeper into topics of corporate responsibility, I would refer you to our 2024 Corporate Responsibility Report. It's on our website, and you can go deeper into that.
We've deployed a consistent strategy over time. As you can see from the chart, the result of it has been a highly durable recurring revenue stream. In fact, this durable recurring revenue stream now represents over 80% of the company's total revenue. This growth has been supported by key drivers. This morning, we're going to speak at length about these drivers: diagnostics innovation, industry-leading multimodality solutions, and product development supported by pace and depth. Fast-growing customer-facing software. Customers increasingly tell us they appreciate that we're targeting the first vertical health SaaS for animal health, as opposed to the type of fragmented application solutions they live with today. A direct commercial model with a focus on global expansion. We'll speak about the importance of this global commercial model in terms of creating customer partnership and intimacy, and really awareness and education.
Before we go into the strategies, I'd like to talk about the sector and the sector landscape as a whole. On that, we see it as very, very attractive with long-term tailwinds that reinforce the potential growth of the business. It starts with an expanded pet population and pets living longer. We'll share with you just how much longer they are living. It really is a fairly dramatic improvement just over, you know, a generation. Younger generations of pet ownership now form the majority of pet-forming households. We know there's a propensity to spend for the care and well-being of their pets. Rapid innovation is supporting an increased standard of care, and it's in some cases very dramatic. This just isn't in diagnostics. It's also in therapeutics, specialty diets, new financing models like healthcare insurance.
While staffing and inflation challenges persist, and not trying to in any way minimize those, we've seen in large measure stabilization in these trends in which to be able to build off going forward. Dr. Hunt will spend some time and really go into these trends with some details and share with you some information that's new and I think pretty revealing. For us, the key to developing the sector and realizing the long-term potential is increased utilization of diagnostics. We're presenting this in a little bit of a different way in terms of quartiles. In the U.S., this has grown about 50 basis points a year across wellness and non-wellness. During the pandemic, it was a little bit faster than that 50 basis points. The key thing to keep in mind is it doesn't just happen.
We have to work, as well as others have to work hard at creating awareness and education and a change in belief system to drive diagnostics utilization. This is where our focus on innovation and commercial engagement comes into play as enablers to really support best practice standards within the veterinary community. Our strategy, to take a step back, is multifaceted. We try to lift all boats, independent of where the customer may be today in terms of diagnostics usage, left and right. We believe that based on education and partnership, all of our customers would benefit from a patient care standpoint in using more relevant diagnostics testing.
The other thing that we have learned over time is by focusing on those customers in the two right quartiles, they tend to have a very strong belief system as a foundation in the importance of diagnostics, the role it plays in achieving their missions, and can be inspired through education and new innovation, perhaps become the top 2% or 5%. I think that's an important insight. Independent of where the practice is today in terms of overall use of diagnostics, the foundational role of diagnostics to their mission, I think, is very well understood amongst practice owners and veterinarians and their staff. This chart really speaks to the evolution of the mix in favor of services over time and diagnostics being a direct or indirect driver of about 80% of the activity within the practice, t herapeutics and vaccines and specialty diet prescriptions and all of those pieces.
These increases have helped the clinics grow appreciably over that time period. About 15 years, you can see they've more than doubled. Diagnostics is a multiplier to growth. You've seen it's grown faster and it's accelerated from period one to period two. It's not surprising, y ou can't treat unless you diagnose. When you treat, you often need to provide follow-up monitoring. You can't assess the health status and establish a baseline of a healthy pet unless you first diagnose. All this foundational role is a key part of the practice themselves. The other piece to keep in mind about diagnostics as a category within the practice is it's a profit center. In fact, it's the largest profit center in the practice as a percentage of EBITDA basis. It represents almost a third of the total profits. It's not surprising if you think about it.
Not only do most veterinarians capture the cost of the test, but also their activity and the activity of the staff and the procedure itself. The key takeaway, the key thing to keep in mind is about the alignment of diagnostics to practice economics. Not only is it good medicine, but it's also good practice economics. There's this alignment between what the practice is trying to do and the benefit we're trying to achieve in terms of growing diagnostics utilization. Now let's get into the strategies. How do we drive this diagnostics utilization? How do we really drive over time this increase in relevant testing use? It starts with R&D. This is a view of spend. We keep $1.2 billion fixed. You can see to 20 years and then the last seven years. If we project on a go-forward basis, 4+ years.
We are recognizing that there's some inflation in here. We are accelerating our spend as a company. We believe that the role of innovation to address our customers' most challenging clinical or medical problems, as well as business problems, is justified. We invested, and Dr. Smith will speak to this this morning, we invested in instrument platforms, biomarker assay discovery and development, customer-facing software, getting all these pieces to work together in a seamless way. It's my experience, having been in product development for decades, both in human health and now animal health, that the competencies, the deep competencies we developed across all these disciplines, are very rare, if not unique. Companies tend to be good at instrument development or software, but not all three. We've had to develop these deep competencies and capabilities in all three.
It very often isn't possible to take a solution that's been developed for human health. It has the wrong economics, form factor, ease of use, reliability. Everything about it doesn't necessarily translate in the right way for our environment. There is something that we have focused on and really built up. We think what are sustainable capabilities. The other piece about this, even though the quantity of spend has a quality of its own, is we look to be efficient in discipline. One way we're able to do that is we get leverage across reference labs and point-of-care. We develop a biomarker, for example, SDMA for our reference lab business, and over time, were able to successfully port it to our catalyst in point-of-care. That's not it. We also focus on making sure the investments support disease states. After all, patients are more than a test. They come in sick,
we need to be able to provide a portfolio of testing solutions that support that. These disease states tend to be billions in addressable size, which is important. We look to be able to create sustainable differentiation in each. In the case of vector-borne disease, for example, it's a performance category. Through peer-reviewed research, it supports that our tests perform at the highest levels in the marketplace. We also, through SNAP Pro, were able to bring our rapid assay testing into the IDEXX diagnostics ecosystem. In the case of parasitology with fecal antigen and detecting the proteins, we detect these earlier and more of them, far in advance of being able to see an ova under the microscope. In the case of renal, we started about a decade ago and said, you know, there's got to be a better test than creatinine.
SDMA demonstrated that we could detect kidney impairment, functional impairment, much, much earlier than SDMA and save lives in the process of doing that. We didn't stop there. We also have GF23, which is for therapeutic delivery, and Cystatin B, which is acute kidney injury, and being able to distinguish between progressive and stable kidney disease. More recently, we have focused on oncology. We've been in oncology testing and interpretation and support for decades. It's mostly been on the later stages of disease. The patient comes into the practice. They're already clinically symptomatic. The outcomes are more challenging in that case. Being able to detect earlier is super important. I'm excited to share with you some updates on that. We're not standing still. Before we do that, I do want to set the table and talk a bit about the overall TAM or opportunity.
The thing to keep in mind is you're going to see a number of different charts this morning that describe the size of the opportunity. This is the broadest possible one. It's global. It's cats and dogs. It's in aid and diagnosis, as well as diagnostic screening. $2.5 billion is what we peg this opportunity at today. Just to quickly go through the definitions of how we think about aid and diagnosis versus screening. Pretty intuitive based on the name. In aid and diagnosis, a pet comes into the practice, has symptoms, clinically symptomatic, consistent with cancer, but it could be other things. The veterinarian wants to run a test, or they have validated through our tests or others that the patient has cancer. They begin a therapeutic path and then want to be able to monitor it through remission. That's an aid and diagnosis.
Screening, just like the way it sounds. A healthy dog may come into the practice, needs to be screened because of age, or they may be an at-risk breed and w e offer a test and plan to offer more tests to be able to screen. The thing to keep in mind about cancer, as we talk about it this morning, it is very complex in and of itself and relative to some of the other disease states that I shared with you. The heterogeneity of cancer types and subtypes, the biomarker discovery piece that you need to be able to identify cancer with the type of performance that our veterinary customers are looking for makes it complex. By the way, this is the type of challenge that we at IDEXX , our scientists and medical folks just love, t hey rally to it, t hat's why they're here.
It's the spring in their step. We're excited to be able to support that. An important question, obviously, is we've had canine lymphoma on the market less than five months now. How's it doing? What's the reception been? It's been, I can tell you, it's been outstanding. Customers tell us that we've hit the sweet spot. It's an important part of the tool set that they feel that they need and that pet owners want. To date, we're about 3,400 practices who have submitted a test to us. What's very gratifying from my perspective, from our collective perspective, is that 15% of these test submissions are coming from competitive customers. It's gratifying in the following sense. Veterinarians are saying, it's not about who my primary reference lab provider is, i t's about the patient and providing the best possible care for that patient.
If it comes from the other guy across the street, then we're going to send it to them, even if it requires breaking workflow, maybe having a viable blood sent to them and a second viable blood sent to IDEXX . We think that that's strong validation in addressing an unmet need, and one we're excited to be able to support. Performance has been outstanding. With some more data, we've been able to say it's 99% plus specificity. Very rare false positives. Very often when we get a call from a veterinarian and she may say, you know, I suspect this is a false positive, we'll recommend waiting, testing, you know, four weeks, eight weeks down the road. In a handful of cases, they have come back as positive, the patient really developing lymphoma. It's an important, I think, validation of the quality of the test.
We've been able to achieve our published turnaround times of two to three days. We've priced it for inclusion, and we'll talk more about what that strategy entails this morning. As a result of spending time with key opinion leaders and European and international customers, our field organization made the decision to launch this internationally in the coming year. More to come on that. It's very exciting. That's not all. I'm excited to announce the expansion of the IDEXX Cancer Diagnostics Panel to also include mast cell tumor detection for canines, and one other test yet to be announced, all coming in 2026. You know, mast cell is a very common type of skin cancer in dogs.
Just to give you some background. I t's part of the immune system, and when the mast cell becomes cancerous, it tends to manifest itself as a lump or nodule on the skin of the canine. Now, between canine lymphoma and canine mast cell tumor, those represent over 1/3 of the most common type of tests. Now we have a panel which, from a critical mass standpoint, starts to get there. There'll be one other test that will continue to be able to grow. Because of the technical achievements in biomarker discovery and development and testing platforms, we're very excited to say we think the performance is going to be excellent. We're still working through that. It'll be the same type of turnaround time of two to three days, and our intention is to be able to price it around where we are today. Keep it accessible.
Keep it as part of this broader commercial sector development strategy. We're still on track to be able to achieve the majority of common cancer types in dogs as part of a broader panel, and that'll be achieved in 2028. Again, very exciting. This is something we know that our customers, and you'll see some data in terms of how veterinarians think about mast cell cancer types and its prevalence and the key part of the practice. It fits very much in with a broader toolset, integrated toolset we're developing, where you can screen and then through in-view FNA testing for lumps and bumps, really interrogate that suspicious lump or bump or nodule and determine whether or not it has mast cell cancer. We'll spend more time this morning. We'll talk about exactly what that looks like from a clinical workflow standpoint.
Keep in mind, mast cell cancer, it's a little bit different than lymphoma cancer in terms of the ability to treat it out of the general practice. In the following sense, if you have a test that you can detect it and validate that, in fact, that pet has cancer, in the vast majority of cases, the veterinarian can treat it. They'll treat it through surgically removing the cancer itself. They'll then perhaps send the biopsy, send it in for histopathology, pathology interpretation. If it comes back positive or you get some additional grading information, they may decide at that point to administer chemotherapy. There's a lot of oral type of chemotherapy solutions on the market. You can do that out of the general practice. You don't have to send that pet to a specialist. That's important because
you'll see some data in terms of why that's important, because there just aren't enough specialists, oncologists out there to support the one in four dogs, one in five cats who develop cancer over their lifespan. Customers will also tell us it's not just about the test, t hey want access to our specialists, internal medicine pathologists. When they get a difficult case, they want to be able to run some ideas off of somebody who's been a practicing oncologist who's board certified. We offer that. It's free of charge when you use our diagnostics. It's something that they value in great measure. As we develop this cancer testing and care management sector or opportunity, we believe that that's a key differentiator for the company. Let me now take this in-view solution and maybe frame it as part of our broader point-of-care portfolio.
We're a vision quest to really transform point-of-care testing. Dr. Erickson is going to speak to that at length this morning. We're going to do that through innovation. Sometimes innovation takes the form of menu extension or expansibility for catalysts. For example, over the last year, we introduced SmartQC, pancreatic lipase, cortisol. We call that technology for life. Sometimes we do it through completely new platforms like inView Dx, which takes very well high-volume characterized use cases and really automates it. We eliminated the slide prep, saved 10- 20 minutes on that front, establishing highly consistent, reliable results. We're able to bring these, I think, transformational point-of-care analyzers to our customers because we follow important first principles that we've come to appreciate and realize and through experience know how important they are. First principle is performance.
It should be as good or better than what you find at the reference lab. Better often comes down to you have a fresh sample, like in the case of urine and in sedative. Secondly, we design for technology for life, menu extensibility, so that when a customer buys a solution a week ago, it has no more feature or capability than the customer who bought a Cat One as an example or inView Dx as time passes 10 years ago, a n important first principle. Number three, we recognize that veterinary technicians are not laboratory technicians, that they have a set of responsibilities this wide, and they can't take 20 minutes to prepare a slide and do it consistently, as well as do all the other responsibilities that they're tasked with doing. We design our system from a sample preparation and management standpoint for load and go.
The fourth first principle is it needs to fit within the workflow, be integrated, be able to run the test, capture the test results, invoice the customer through PINs, and really support it. When we do that and do that well, we see really remarkable uptake and receptivity in the overall amongst our customer base. There may be some of you in the audience who are highly perceptive, visually perceptive, and see our fifth premium analyzer on the slide. That's IDEXX MultiCue Dx. It fits all those first principles. All those first principles. It's been designed to fit all those first principles. There's a strong connection in a clinical and workflow sense to what I've just described, what's important to our customers. We're making really good product development progress on it.
Today, I'm not going to go through the testing category or the launch plan, except to say we're making solid progress. As we get closer to launch, we'll provide some additional details. What I will talk about is inVue Dx because it's on the market today and doing extremely well. As you know, and it's part of our Q2 earnings call, we upped the forecast to 5,500 units as a result of customer enthusiasm. Consumables are tracking very well the expected usage. We're getting very good feedback on it. Menu expansion is increasing really on a bi-monthly, every two-week basis in terms of continuing to put out menu extensions in ear cytology and blood morphology. By the end of the year, we'll have fine-needle aspirate testing for lumps and bumps. Really a very robust menu that supports cytology across the spectrum.
Dr. Erickson will speak to how we're thinking about future menu extensions and just sort of sizing what that opportunity looks like. I will say just from an economic standpoint, as Andrew talks about our growth algorithm and how we think about the benefits of a new instrument launch, they're very substantial. There are direct economic benefits in terms of revenue from the instrument and the consumables. There are indirect benefits in terms of multiplier from it gives us access to competitive accounts. George will tell you that it helps the productivity of the field selling a suite this big versus this big. We know that there's also, as part of our IDEXX 360 and other programs, it allows us to extend the relationship we have with customers. Lots and lots of benefits. It's a big deal when we launch an instrument at IDEXX.
It really drives productivity just beyond the clinical and medical contributions we make. As we size out what this looks like from an opportunity going forward, we finished 2024 at 147,000 placements. We think the opportunity on a global basis is many factors larger than that. In the U.S., for existing platforms, even though it's our most advanced market in terms of diagnostics usage, still tons of opportunity. Internationally, you can see the darker colors on the slide even more so because in some country markets, it's more embryonic. Of course, for the new platforms, inVue MultiCue Dx, we broke that out. Those are more greenfield opportunities and very, very sizable. We're excited. We feel like there's tremendous runway to transform point-of-care from a technology and bringing labs to the clinic. Let me now quickly segue into talking about the reference lab business. This is a technology-enabled service business.
It's a key modality for us. It's a surprisingly complex business to get right and to run. It involves deep science in terms of developing biomarkers for them. It's a lot of work behind that. If you think about just being an extension of the customer's practice, which is what they want from us and keeping the complexity behind them, it's very complex from a full value chain standpoint. Picking up the sample at the right time, bringing it to the right lab, running the right test, tracking it through the reference lab, providing the result. From a transportation and logistics standpoint, you need to have very deep capabilities to be able to do this well. Again, the way the customer wants to think about testing capability is we're just an extension of their practice.
We need to keep the complexity back office and front office just to deliver a pleasing experience. This is a business that requires, in addition to being logistics and transportation experts, a heavy investment of IT and information management system that involves automation and digitization and really being able to deliver millions of results in a timely way without errors. When you do that well, it's reflected in the type of statistics you see in front of you, where from a sample pickup and processing accuracy standpoint, four nines plus, four nines plus, which is outstanding. From an NPS, world class is 50. We're deep into world class level. There's deep advocacy and support for that. Our customers tell us it's not just about the reference lab, and Michael and I will speak at depth to that this morning.
It's also about the software that ties it all together, that integrates it, that helps support workflow, that optimizes workflow, that supports team collaboration and productivity, that enables digital communication with their clients, that really has a technology stack and an application portfolio that is designed and developed for animal health, as opposed to sort of the fragmented islands of applications today. We're very proud that we are increasingly seen as the first company to develop a vertical SaaS technology stack for animal health from the ground up. We continue to drive it. It's a key area of investment focus for the company, with increased emphasis on the pet owner engagement application, the digital connection with the younger generations who want to interface with the practice and their veterinarian in that way. Michael Schreck will spend some time this morning talking about that and what that looks like.
Just maybe to wrap up the innovation piece. T his is a picture we've shown this in the past. I think it's a good depiction of how we think about innovation. It starts with the customer, in our case, the veterinarian, his or her customer, the patient, and the pet owner at the center of everything we do. They expect from us as table stakes, best-in-breed modality solutions, point-of-care and reference labs. We endeavor to deliver that. They want it all to work together. They want it to be seamless, supportive of their workflow, supportive, giving them the flexibility to practice in a way they want to. We layer on additional complementary layers of innovation. Think business model, for example, paper run and auto-replenishment is a great example of that. The net result of that is what you see on the right-hand side of the slide.
Customers stay with us, which is a part of our growth algorithm. Our brand promoter score at the IDEXX level, so that's all in, is deeply into world-class levels. Our product availability number, the way to think about that through the customer lens is it allows them to focus on their patient. They don't have to worry about, you know, is the IDEXX test, can I get the IDEXX test? When is it going to come to me? Is it going to be accurate? This allows them to really focus on why they're in business and what they do best. As important as innovation is, we believe that the commercial investments that we make and our commercial ecosystem are equally important. It's really about the partnership with the customer, establishing customer intimacy, being aligned with their priorities, supporting what they want to get done.
We know there's no better way to do that than to be able to understand their practice needs, call on them frequently, have a relationship, be trusted, be subject matter experts when there's a question to create awareness and education and support. The only way to do that is through commercial density. It's by assigning a few enough accounts per account manager, per our professional service vets and field service representatives so that they can visit these practices frequently. They're not only there when they want to try to sell something. That's what we endeavor to do. We've had nine commercial expansions in the last four years. As you know, as part of the Q2 earnings call, I announced four more, three of which are international, one that includes really expanding what we're doing in the U.S.
due to the size of our portfolio and some of the opportunities that we see. These will be in-seed ready and really moving up the productivity curve strongly by January 1st, of this year . I'm often asked, you do this and how do you know when to do it? Or what are some of the unanticipated, perhaps, benefits of that? What we find is when we call on customers, they use more diagnostics. They have a propensity to use more of our entire portfolio. These are some numbers, updated numbers that we've shared in the past, not just for the U.S., but also for Germany and Australia and New Zealand. What you see is they're growing strongly, the ability to really use all of our portfolio. Michael Schreck, as part of the software piece, will give you a different cut in it through the software lens.
I think the message is through the customer perspective, it all works better together. It gives them the flexibility to practice how they want to practice. It's a key element of our growth strategy. In response to this, we often get the question, aren't you cannibalizing reference labs? Or will you bring out a new point-of-care analyzer? Does that result in a decrease in reference labs? It doesn't. I think our data and experience shows that testing begets testing. As you use more point-of-care, you use more reference labs and vice versa. Part of this comes down to those customers on the right-hand side of the chart having a strong belief in diagnostics. It really comes down to they have this belief system. They realize there's a foundational role. It helps them achieve their practice and patient objectives. They use more diagnostics.
When you test in clinic and you want to get a quantitative viral load, you want to biopsy a tissue and send it in for histopathology and pathology interpretation, you use more reference labs. The other thing that I would point out is that wellness testing is done in reference labs. Wellness testing is a big thrust for the business, for the profession, for a lot of reasons. It engages and anchors this client experience. It's good medicine. You find things that are seemingly not there. These are healthy pets that, in fact, aren't healthy. By doing wellness testing, you really drive the reference lab business also. This is new data. This is an interesting cut. What this shows is that our corporate customers and corporate customers more generally are doing more wellness testing than the sector as a whole. This is U.S. data.
This is where we have excellent PIMS. The mean of blood work inclusion in wellness visits is 12% in the U.S. You've seen that number repeatedly, and you'll see it this morning. For the corporate account customers, three out of the four quartiles are above that 12% U.S. sector average. In fact, some appreciably above. The top five corporate groups, these are very big practices. They're doing wellness testing and blood work inclusion in the high teens, low 20s. They do it. There's a couple of reasons that they're doing it. One is they see this as a growth strategy. It's just much harder to grow through acquisitions for a lot of reasons, including the cost of money and the availability of clinics. They're looking to really grow organically. The second thing is they can operate at scale.
Once they decide to do something, it's not like just pushing a button, and they can go from zero to 1,000 clinics overnight. They can move much faster at scale once they decide that it's good business and good medicine. We believe IDEXX is extremely well positioned to support these customers through our programs and through our field organization, w herever they are, we are and w e can bring expertise, campaigns, and program educational support to help drive this change and help the customers achieve these objectives. Now, let me take this up a level and tie together the cancer strategy and wellness testing, which is such a key priority for the industry as a whole. The way blood work inclusion, remember, about 50 basis points a year historically has grown. It's really from left to right. The clinical, those patients that come into the practice are medicalized.
About half those patients, 47% of those patients, undergo some diagnostic tests. Sometimes it's just heartworm or a fecal test. A much smaller subset of that, 12%, that's the number I showed you previously, have blood work inclusions, so chemistry and/or hematology. It's been hard work. We've done it, o thers have done it. We've lifted the boats. It's 50 basis points a year, blood work inclusion. There's an opportunity to change this paradigm, to go from right to left. You're going to see some very interesting data from Dr. Hunt and Mike Lane this morning that just shows how veterinarians and pet owners are thinking about cancer testing. It's very emotive. It resonates with them. They recognize, based on the age of the dog and the breed of the dog, there's much higher risk. It's something that they're willing to pay for. We've priced it for access.
The turnaround time means that they don't have to wait weeks to get a result back. We think that this is a potential game changer. As we go from canine lymphoma, a single test as part of the panel, the canine lymphoma and mast cell tumor detection, one other one next year, the value proposition gets more and more compelling. We develop a critical mass and have a chance to grow faster than that 50 basis point. This is when we talk to customers. I spoke with a number of corporate groups personally. This very much resonates with them. They get it. Their medical staff is very supportive. Obviously, they have to get the pieces in place, but it's a key part of our strategy. Let me now begin to tie some of these pieces together.
As a result of the sector tailwinds that I shared with you, the innovation strategy of solving our customers' most challenging medical as well as business problems, a commercial model that's a partnership model of subject matter experts trusted by our customers, aligned with their priorities, we believe that there's an enduring opportunity for long-term attractive growth. We peg this out 20- 25 years. That's how compelling we believe the opportunity is. From a sector opportunity, we peg the growth possibilities or opportunity in a high single digit. It's a little bit faster internationally than the U.S., as you might suspect, based on some discussions, but that IDEXX, and Andrew will go through the growth algorithm, 10%+ opportunity, again, faster internationally than the U.S. Andrew will sort of build this up through the different building blocks of the growth algorithm.
We can grow faster as a result of our leadership position, as a result of our differentiation and the contributions that we deliver on behalf of the customer. Let me tie it all together before handing this off to Dr. Hunt, which is a, I'm going to end where I started, which is a key point to understand about our business at IDEXX and our business model, is that there's a significant opportunity still in front of us. We measure this opportunity in decades at $45+ billion. We realize that it's just not going to fall out of the sky, that we have to develop it, our strategy to develop it the next three hours.
You're going to hear about innovation and innovating faster than ever before across a very broad spectrum of the business: point-of-care, reference lab, customer-facing software modalities, a commercial model, which is second to none, which is trusted by our customers, which has the time and capacity to visit our customers to understand the opportunities that are aligned with their priorities to support their practice objectives, with a clear eye towards expansion in our international geographies, which is much earlier in development than here in the U.S. The net result of that is a long-term durable growth opportunity with high returns, reflecting the value and differentiation that we as a company bring. I'm going to turn the podium over to Dr. Hunt, who's going to talk about the sector and some of the growth drivers in the sectors and the opportunities as we see it. So Dr. Hunt?
Good morning. It's great to be here with all of you again. If your family is anything like mine, pets are probably woven in your lives also. Some of you may remember my German Shepherd, Ishka, who has been part of the family for years, along with our two cats. This year, our family had a new addition. My 23-year-old son, who lives in a tiny apartment in New York City, adopted a cat named Nala. He's been wanting a pet of his own since he left the house because, as he told us, my life doesn't feel complete without pets. That deep connection between people and their pets is what makes what we do at IDEXX so special. The pet healthcare industry is at a defining moment. As Jay shared, innovation is expanding what is possible in care, and pet parent expectations are rising faster than ever.
IDEXX is playing an important role in this transformation. What sets us apart is our proven ability to develop the sector end to end, from breakthrough innovations to belief-building education to driving global adoption, all grounded in deep customer centricity. Cancer is a clear example of that. It's globally relevant, emotionally resonant, and it makes wellness a shared priority between clinics and their pet families. To understand where this industry is headed, let's first look at the strong underlying sector trends that are shaping future demand, starting with one of the most relevant, the evolving pet population. The surge in pet ownership over the past few years has reshaped the veterinary landscape. Historically, the net pet population in the U.S. has grown at about 1%, a trend that we expect will continue into the future.
Between 2020 and 2022, millions of households added pets, driving a 12% increase in the total U.S. pet population. We saw similar adoptions pretty much everywhere around the world. These pandemic-era pets are now aging, and they're entering life stages where their healthcare needs rise and diagnostics move from occasional, nice to have, to essential. At the same time, pets are living longer. We now get more time with our pets, more years, more memories. Every pet parent wants more birthdays. We track this through a longitudinal data set of about 2 million pets who have access to medical care in the U.S. The average lifespans have increased by nearly two years since 2020. Those extra two years translate into a 22% increase in the diagnostic spend over the life of a pet.
While cats may not have nine lives, it is wonderful to see that 18% increase in their average lifespan. That said, cats are masters at hiding pain and disease, and they will often suffer in silence. Without regular checkups and diagnostics, the conditions can often go unnoticed. When cats do come in, they're often very sick. Feline visits, as you can see, have been increasing. Still, last year, only 30% of the cats came in for a health visit compared to 70% of dogs, leaving a tremendous opportunity to provide the care that cats deserve. Practices are adapting from cat-only clinics to low-stress environments. The industry is shifting to meet the needs of the feline patients. This is signaling a broader mindset change that will result in better care and stronger health outcomes for cats.
Given the unique needs of feline care, IDEXX has a purpose-built portfolio that is designed just for cats. It is focused on areas that matter most for the feline biology, such as diabetes, hyperthyroidism, feline-specific infectious diseases. Some of you may be surprised to learn that one in three cats, one in three, will develop some sort of kidney disease over their lifetime. Anyone who's had a cat with kidney issues knows how hard it is, both for the cat and for the pet family. That is why innovations from IDEXX , like SDMA, Cystatin B, FGF23, are so important. They help a veterinarian assess the full kidney health status of the pet. That commitment to cats also carries through in our future innovation pipeline. We're developing new ways to help veterinarians detect and manage feline conditions earlier and more effectively.
Our goal is to help veterinarians practice the caliber of medicine and experience that they aspire to provide. Over the past six years, we have seen modest but meaningful growth in the total number of clinical visits, primarily driven by the growing pet population. What lies ahead because of the population growth could shape the sector in new and important ways. We're entering a phase where aging pets and rising expectations will be shaping the next wave of demand. Clinics will need to be ready with the right tools and capacity to meet that demand. There are two important things for us to take away from this data. As you can see, as pets get older, diagnostic intensity increases. It's just like us humans. Aging brings greater complexity. The light blue bars are the average diagnostic spend for U.S. practices. What's most compelling is the dark blue.
That represents the top third of clinics. These clinics are doing 50% more diagnostics than their peers across all age groups. That tells us two things. Firstly, there is real and replicable headroom to elevate care across the industry. Second, consistent use of diagnostics not only ensures better health outcomes, as Jay highlighted, it facilitates better business performance. This opportunity is only accelerating as a pandemic-era pet, that large cohort of pets, enter into higher care stages of life. Most of these pets are now entering or in adulthood when diagnostic usage starts rising sharply. Let me first explain this chart. The bars show the clinical visits by age group, and the green line is the number of the percent of visits that include diagnostics. This is a snapshot in time, but it's an ongoing phenomenon.
By 2030, we expect to see 30% more senior visits and 20% more geriatric visits. As the clinic visits increase, so will the need for diagnostics. The next wave of demand is coming. Clinics who plan and build capacity now will avoid the stress and burnout that they experienced during the pandemic. Let's go a level deeper and look at one of the most common diagnostics. It's a foundational diagnostics that is run in clinics every day: blood work. Why is blood work important? Since pets can't tell us what's wrong with them, blood work is a critical tool to understand what could be going on inside the body and to uncover any hidden health issues. We're seeing a steady increase in how often blood work is run, 50 basis points every year.
Even with that momentum, only one in five pets coming in for a health checkup get the benefit of this powerful diagnostic tool. The right side shows a much sharper story. Blood work use climbs steeply with age. As blood work moves from occasional to more routine, it unlocks a substantial medical value. IDEXX-led research based on samples from 220,000 patients demonstrates that clinically relevant abnormalities are found in seemingly healthy pets at all ages. The rate of those findings increases dramatically as pets get older, as they become mature and senior, and it reinforces the medical importance of regular preventive screening. This was before we introduced Cancer Dx, which will only add to the value of wellness screening. The good news is the younger generations already place high importance on proactive wellness. Millennials and Gen Z, like my son, are reshaping what it means to be a pet parent.
These younger generations now make up the largest segment of pet owners. For them, pets are unquestionably family, inseparable from their daily rhythm of life. They expect care that is more personalized for their pet. They're more engaged in healthcare decisions than any of the generations before. With greater access to data than ever before, they seek advice, share stories, and build beliefs online. That shared belief is powerful and w hen that belief meets the medical recommendations of the veterinarian, they're ready to say yes. The data shows that the main barrier to diagnostics isn't acceptance. It's whether the conversation happened at all. There is a huge variation in how often veterinarians will recommend diagnostics based on their assumptions on the pet parent's ability to afford. Acceptance varies little by financial status.
Most pet parents, even those on tighter budgets, are willing to make trade-offs, skip vacations, delay purchases in order to take care of their pet. They prioritize their pet's care. This is a fundamental mismatch. It's not a demand problem. It's a supply problem. The opportunity is clear. Equip veterinary practices to offer diagnostics more confidently and consistently because diagnostics are the engine behind the system of care. They not only enable early detection, they set care in motion. Up to 80% of a practice's activity can be tied to diagnostics, including medical services, therapeutics, and nutrition. For example, a routine blood test can help uncover the onset of early disease, leading to follow-on testing, prescription diet, and better health outcomes. A set of you might reveal a urinary tract infection, resulting in targeted treatment and faster relief for a suffering pet.
This is where IDEXX is highly differentiated, combining diagnostics, software, and communication tools to help clinics operate as one cohesive system. As healthcare needs rise, operating as a cohesive, connected system is going to give clinics the one thing that they need most: time. That was the idea behind our landmark, finding the time study. We extensively mapped workflows in real practices and found that by using better tools and smarter processes, clinics can free up to 2,000 hours annually. That is the equivalent of a full-time veterinarian without making a single hire. That time can be reinvested in patient care, client conversations, or just simply easing the load on busy veterinary teams. The question becomes, how do we unlock that time? With innovation. Innovation plays a critical role, especially in busy practices where every minute matters. That's why our latest innovations are designed to make that time count.
inVue Dx, with its slide-free load-and-go workflow, IDEXX Vet Lab Station at twice the speed. easyvet, giving time back to clinicians to focus on care. Vello, modernizing pet parent engagement and reducing no-shows. Individually, each of these solutions saves time, but together, they create a productivity flywheel that enables clinics to do more with the teams that they have. It's not just about efficiency. Our innovations elevate the level of care that veterinarians can provide. Cancer is a great example to look at on how that comes to life. Cancer is by far the leading cause of death in adult dogs. Many of us, myself included, have felt the impact of this unforgiving disease firsthand. By the time cancer is diagnosed, it is too late, which is why early detection matters so much.
Our global research shows that veterinarians around the world are open to adding cancer screening as part of their preventive care protocols. When they recommend it, the majority of pet parents will say yes. We know this won't be an overnight shift, but building beliefs and growing categories is what IDEXX does best. We've done it multiple times before with vector-borne disease, parasitology, and renal health with SDMA. Now, it's time to make cancer screening the global standard through belief, education, and access. The case for screening becomes even more compelling when we look at breed-specific risk. 13 of the most common dog breeds, that is 13 million pets in the U.S. alone, are at an elevated risk of lymphoma and mast cell tumor starting at the age of four. All breeds have an elevated cancer risk around age seven.
Detecting cancer earlier opens doors to more options and better health outcomes. To bring this benefit to more pets, we also need to rethink how care is delivered at scale. As Mike Lane will share, there simply aren't enough specialists to meet demand. That means that general practitioners will have to lead more through more of that cancer journey. This shift is necessary, and IDEXX is helping make it happen. This is how. It starts with a strong clinical foundation, and we're not doing that alone. We are working with specialists and key opinion leaders to define new standards of care. We're also equipping general practitioners with the tools and confidence to diagnose and manage cancer care effectively. That includes AI-enabled diagnostic support, clear step-by-step case pathways, and communication tools to help guide families through difficult conversations. We're not just launching a test panel.
We're helping transform a care model. Cancer is a defining example of how diagnostics can shape care. The broader opportunity to elevate diagnostic utilization across all categories is significant, especially across a global stage. While there's still ample opportunity for growth in the U.S., international regions represent the largest untapped opportunity. What has fueled growth in the U.S., rising care standards, stronger economics, and growing clinical confidence with tools and technology can be replicated internationally. We have excellent product-market fit, and our reference lab infrastructure meets the needs of these regions. We are tailoring our commercial strategies to address local needs and dynamics. We see this as an IDEXX playbook of sector development and the engine behind the long-term TAM expansion that Jay referenced earlier. In addition to innovation and education, it is powered by consistent presence. It doesn't matter where in the world you are, relationships fuel growth.
The best way to grow relationships is through presence. Today, many of our international sales territories are too large to fully support customer success. As Jay highlighted, we are making focused investments in four regions: three international and a modest expansion in the U.S. These are investments in our people, processes, and productivity.
Designed to deepen relationship through presence. When we show up, we help clinics grow, and their commitment to IDEXX strengthens. That link between presence and performance is very clear. These examples from three international countries make the case. When we engage consistently and directly with customers, clinics grow faster. Why? Because we're not just selling products. We're building trust. We're uncovering needs. We're helping teams get more from the diagnostics in their care protocols. This kind of partnership leads to better care for more pets around the world and helps us deliver on our shared mission with our customers.
Veterinary care is entering a new era, and IDEXX is helping shape what comes next by enabling healthcare teams to scale care, meet the rising demand without compromising quality, equip, enable clinicians to do more, especially in cancer care, extending our reach to more clinics, more regions, more pets, and helping clinics deliver the modern, personalized experience that is more aligned with the expectations of today's and tomorrow's pet parents. This is how we deliver strong, sustainable growth by advancing care for pets and expanding access globally. Now, I'll invite Dr. Martin Smith to share how we are accelerating the innovation that powers this growth for both our clinics and the sector.
Thank you, Tina. Hello, everyone. I'm Martin Smith. I head up R&D and Operations here at IDEXX , and it's my immense pleasure today to stand here and represent the many amazing teams that contribute to our innovation agenda. Over the past three years, we have more than doubled the rate of new product launches. We've taken out 10 months on average from our development project timelines. At the same time, we've built capacity so that we can work on multiple breakthrough technologies simultaneously in view: cancer, molecule. My job today is to take you through some of the ways in which we delivered that performance, tell you about some of our capabilities, and the insights that we've built that are setting us up for now and as we go into the future. You've seen slides like this before.
This is a snapshot of some of our recent launches, and there are several examples of accelerated innovation on this page. I draw your attention to the bottom left: Catalyst, pancreatic light phase, cortisol, SmartQC. Three launches in less than a year. Not one launch a year, three. This is the kind of innovation pace we are striving for. Jay showed you this slide earlier. I've modified it slightly. I got molecule on there. It's no surprise that an increase in investment accelerates innovation. As Jay pointed out, we focus our innovation investments into key core competencies that he describes. We're also building new capabilities. We're installing new and breakthrough and state-of-the-art infrastructure, and we're building more and more insights as we build ever greater returns on investments for our projects as we go faster and faster.
We've always had great products at IDEXX breakthrough technologies throughout the years, as Tina described. We want more. We create problems for ourselves on purpose. We ask specific questions. How can we go faster? How can we do more at the same time? How can we extract more from that invested dollar? This is continuous improvement. Like all good continuous improvement programs, you need a framework. I describe some of those framework pillars here, starting with talent and culture. The right leadership, the right teams, the right organizations, all established to deliver our mission. We've installed from scratch, in some cases, areas like data science and AI, molecular diagnostics, and also manufacturing technology capabilities, all propped up by a world-class engagement campaign. We strive for the best place, the best people, with a culture of and m etrics and meaning. Performance and people. Results and recognition. Metrics drive behaviors.
Behaviors drive our culture. This is a go-get team that comes to work every day to win. Additionally, we invest, as Jay described, in tools, those breakthrough and capable state-of-the-art technologies that help us solve our problems every day. I'll talk about a couple of those in a few slides: biomarkers, pilot infrastructure, and then, of course, no surprise, everything is propped up and underpinned with process. The act of product development, or New Product Development called NPD, is really, really complicated. Multitudes of teams coming together for a singular mission: launch. You need a disciplined program management capability, really, really robust processes that are continually revamped, and the introduction of risk assessments so that we're able to identify when risks may occur and actually mitigate them before they cause delay to our projects. Process underpins everything that we do. Absolutely a key enabler.
One of the process schemas that we're spending a lot of time on, and Tina talked about this, is bringing that exquisite customer intimacy into our New Product Development, NPD, processes. We operate with a process, what's known as Quality Function Deployment. Within that is a process called Customer-critical To Quality, CTQ. This is identifying and translating those parameters that customers expect from our products: performance, turnaround time, quality, consistency, precision. The active CTQ mapping allows us to take those parameters of interest and importance for our customer directly into our NPD programs and even to the level of the factory floor. What do I mean? Those parameters that the customer expects from us, we can actually translate directly to the levers and knobs that we turn on our manufacturing equipment, even the raw material tolerances that we need to produce our products.
Really, really powerful early engagement of the customer, driving our requirements down to the factory floor. I mentioned quality. A key dynamic in the delivery of quality is another area that we've invested quite heavily in, known as Design For Manufacturing and Assembly, DFMA. DFMA is a way in which you can organize workflow ease, manufacturing simplicity, reduction of error, reduction of rework. You design for manufacturability, you design for serviceability, you design for inventory plan, you design for spare part management. It actually drives the quality that we're expecting. Now, let me give you an example here. If you look into the middle of the page, you can see the gray box there. That is our Catalyst One instrument. An absolutely outstanding instrument. It operates with somewhere in the region of 71 months mean time between failures.
That means for almost six years, I think over six years, it doesn't break down. Used every day, multiple times, world-class, exquisite performance that you would expect with the types of instruments coming from IDEXX . Now, the 650 components in that instrument: motors, circuit boards, wires, engines, chassis, you name it, screws, they're all in there. You get the picture. Now, let's roll on to inVue. Through DFMA, that instrument is built with 150 components. That's DFMA at its zenith. With just 150 components, we control quality. We really reduce rework. We increase our yields, and we deliver the quality that's expected through that CTQ program that I described. Not only that, DFMA and the reliability and consistency that we drive in production allow us to deliver those unprecedented availability timelines that Jay talked about. We operate with 99% on-time to delivery for customer requests.
Customers never, ever have to think about where their product from IDEXX is coming from. Another way to accelerate is with the identification and the installation of what I'll call technology platforms or technology flywheels. Really straightforward concept. Identify and invest into a technology base. You do it and invest once, and then you use it as a flywheel going forward for the downstream product developments from that, reusing those technology bases. We've got a variety of these technology platforms here at IDEXX that we use over and over again for our product development. I list a few here on the left-hand side: hardware, components, consumables, chemistry, algorithm designs. We can reuse these technologies over and over again for our product developments. Again, another straightforward example. ProCyte One into inVue.
We've reused a variety of technologies that were once developed for ProCyte One that we now redeploy within inVue. About 40% of the embedded software is taken from ProCyte One and into inVue. We have the same central processing unit and control centers from one instrument to the next. The same design convention, chassis, layout, again, from one instrument to the next. We do it once, and we don't have to spend time doing it again. This type of reuse of technology platforms is one of the ways we were able to bring, as a product development project, IDEXX, two years faster than the project that was ProCyte One. inVue is really leveraging the technology reuse as I've described. Really, really key enabler for our pace. Perhaps the biggest breakthrough that we've had over the last three years is what I'll call a biomarker engine or a biomarker factory.
The installation of this capability has slashed unbelievable amounts of time from our delivery. Remember, biomarkers feed the pipeline for the assay content that we deliver. Really, really breakthrough capabilities. Like all good engines or factories, I can depict it in terms of unit operations. I can show within that process where I'm using tools like AI, driving greater insights, faster decision-making, more accurate analyses. I can also identify in this factory where I use automation, speed up the process, higher throughput. Really, really important. Now, we're showing here a Cancer Dx biomarker engine as an example. Before I go into some of the step descriptions here, let me just describe for you what a biomarker is. A biomarker is a molecule, could be a protein, an antibody, a metabolite, a chemical, a piece of RNA, a piece of DNA, all these types of biological molecule content.
What we do in discovery, we take a healthy sample and an unhealthy sample, a diseased sample. We're actually looking at the profile differences between those biomarkers. A biomarker in disease may be up-regulated, get more of it, or down-regulated, or it may change. We're looking for those differences between healthy and disease. I mentioned samples. You don't get any process without samples. Samples are the lifeblood of a biomarker campaign. We're really fortunate here at IDEXX, and I think this is a key differentiator. We have hundreds of thousands of samples going through our reference labs every day. I can wake up in the morning, check my email, "Hey, there was a positive lymphoma in Australia yesterday. I have the opportunity to get that sample right there." In effect, our 80+ reference lab network across the globe is our biobank. It's unbelievable the power that that drives for us.
This is a cancer example, as I described. This second step is unique to cancer diagnostic biomarker discovery. It's what I'll call primary cell culture. We've worked out how to take the progenitor cells that are the last moment a normal cell before it turns into a cancer cell through a process called transformation. We can literally watch that once normal cell transform to cancer. We can take that cell, and we have single-cell capability and sensitivities with our analytics. I can take that normal progenitor, I can compare it to the now transformed cell, and I'm looking for biomarker differences between the two. This is not a dog limping into a clinic with stage four cancer. If I take those samples from that patient, what am I going to get? I'm going to get biomarker discovery for a late-stage disease. As Tina described, we think that's too late.
We want literally the earliest stages of disease onset, and that's what we're doing with this primary cell capability that we've created. It's our true belief, and you'll hear this again from Mike Lane, that early detection, and we're delivering that, plus early treatment equals better life outcomes. Once a biomarker is identified, we have to create the reagents that can see that biomarker in a relevant test and also in relevant test formats. Stage six here, you can see reagent marker formatting. I show a 96-well plate here, a higher throughput format, the types of content that we will put into reference labs. We validate through clinical study. That's how we generate our claims. You saw some of the data that Jay described came out of clinical study and then into manufacturing.
Absolutely breakthrough capabilities that we've invested into here and are now delivering, slashing years out of our original campaigns now down to months. We're really fortunate here at IDEXX in that we have direct co-location of R&D and manufacturing. It certainly makes my job easier in what I do, I can actually spend time with my teams under the same roof, sharing the same rooms, the same laboratories in some cases. We have that deep organic synergy and connection propped up with the types of process that I described. New Product Development, NPD, yes, it's about the cool science I described, some of that with biomarkers. At its heart, the definition of New Product Development is the creation, validation, and turnover of a capable manufacturing process. That's it. That's my definition of new product development. Why do I say that?
Sometimes we have to make millions of these tests a year. I got to know that Lot 1 and Lot 147, three years later, are working identically, the same quality, the same consistency, the same yields, the same cycle times, the same cost. Really, really important that we have that capability. That organic and process drive that we have and we can enjoy here with our co-location, that's great, but w e take it further. In our R&D labs here at IDEXX , we've invested into what I will call pilot line infrastructure. We have recreated and have direct and exact simulants of manufacturing processes in our R&D labs. What does that mean? It means that I can develop directly for performance with the product development and at the same time and in parallel design for manufacturability. In parallel. I don't have to do that in a sequential way.
I'm saving that time. It's a pace and scale accelerator for us. It doesn't stop there. We can supercharge our pace if we choose under the right conditions. We can actually launch from those pilot lines and not go through the steps of formal manufacturing, which we could actually do later on. All of the pilot lines we have here at IDEXX are on our quality management system and subordinate to our ISO standards. Now, Jay showed a version of this slide. It's talking about our test modalities and franchises, the areas that we concentrate on. Knowing our areas of concentration is also an accelerator to innovation. Why so? You can build deep, deep bench specifically for the franchise, the right scientific skill, the right medical skill, the right product management capabilities, the deep external networks that drive our credibility into the marketplace.
Taking at pace unmet needs, translating them for our product developments, taking those unmet needs and through a CTQ process that I described, turning those unmet needs into requirements that we drive in our product development programs. That's pace. As you'll notice, there's differences between these areas, and we have to be very careful to make sure we devise skill and capability along those lines. You see parasitology here, very, very interesting and complicated. Often really, really difficult sample types. Very common that we're handling fecal samples here. As you can imagine, the range and shape and size of different samples from a stool standpoint is very, very variable. Not only that, we've actually got to drive those tests into a very high throughput format. You've got to build a test that can work in 96, 384 well plates.
There are also pet behaviors like coprophagy that can actually confound results, and we have to mitigate against those as well. By the way, an extra donut for anyone who can tell me in the break what coprophagy means. When you look at oncology, deep overlay between oncology and hematology. Expertise sitting together, working together, driving outcomes. Jay showed, I also showed that biomarker discovery for this type of complex disease is complicated. We don't have one biomarker that says everything about a single type of cancer. We have panels. Those panels come together, they work in tandem, and drive a singular output of result. Absolutely essential. Of course, the biobank. You can't do anything in cancer without well and qualified samples that are diseased and understood at what disease level and aggression, and then certified healthy samples.
You need that absolute certainty as you drive an oncology campaign and I've already described our network of reference labs that act as our biobank. This is a slide that gets me to work every day. We've always had great technologies at IDEXX , as I've described. What we're talking about here is impact. I'm really, really fortunate in what I do. I get to work on the coolest technologies every day. I get to see those turn into manufacturing products, and I get to see them being used very quickly by our customer base. Seeing the impact that that drives from an organic revenue standpoint is really, really meaningful. You can see we do always and will have revenue contribution from our existing and historic technologies. Breakthrough items always providing revenue for us. We're on the cusp now. We're translating these new innovations, these transformational innovations into oversized growth opportunity.
Transformational products: cancer, inVue, MultiCue. Transformational in that they are new to industry, new to clinic, new to IDEXX , and in some cases creating new medicine. Absolutely the reasons we, as innovators, come to work every day. We want to know and see the impact. It would be remiss of me to give a science and technology talk at a forum like this without giving a little bit of a nod towards data and AI. It's our strong belief here at IDEXX that winners in the data space need to have a variety of attributes available to them. First, large and very clear access to diverse and historic databases. I already mentioned the hundreds of thousands of samples that go through our reference labs, and we've been collecting that for decades. Giant data lakes of relevance.
You need to be able to collect and deliver new data every day. Again, what I just described happens every day, not in the reference lab alone, but also in the clinic. We're collecting all of that data, and in collaboration with our customers, we're also accruing PIMS, customer and pet parent data as well. Lastly, the place in which data and AI-derived insights are consumed. It's no good having all this data if you then can't use it, see it, and engage in it. We have that too. Michael Schreck will talk about VetConnect PLUS and Vello. These are the chosen forums that our customers enjoy and how they consume their data inquiries and AI-induced portals. Now, the purpose of this slide is not to go through it, but just to describe to you a little bit of how we're thinking about our execution here.
Like all good NPD, you ask the question right at the beginning, where does the technology come from? We're going to make it, we're going to buy it, we're going to co-collaborate. You can do the same in data science and AI as well. In the blue bars here, I describe the tech, the types of tech that we're going to use, and map it across the application use cases that we have: Cancer, inVue Dx. There's plenty of others as well. The types of outcomes that we want to drive for ourselves internally and also for our customer experience and enhancement. A total mapping of tech to use case, sequenced and on a roadmap, knowing that is again another enabler for pace. I do have to show one example. Tina described this, Mike Lane's going to describe it as well.
What we're talking about here is Cancer Dx, the test completely enveloped in a data and AI ecosystem, driving further, as Tina described, the episode of care for cancer management with the GP. Think about all this data that we have and being able to, in real time, ask questions of it through AI tools. Set me up with a patient summary before the visit. What sort of things do I need to be looking out for? The patient's arrived. I test. I get a result. What do I do now? Is this what I expected? What sort of therapy should I have? How do I think about dosing? When shall I see the animal again? You send the animal on its way, and now we're into monitoring. What are the clinical signs I should be looking out for? What should I advise the pet parent on to look out for?
Is Fluffy drinking, eating, et cetera, et cetera. These are the data questions, derived data questions we can have DVMs in the moment during their episode of care ask of our data sets. Lastly, and Tina described this too, there are going to be occasions you have to refer to an oncology specialist. Let's ask the data in the moment and in real time to prepare a referral package of meaning, of consistency, and thereby driving efficiency. At the same time, get that same package, but written in the way that a customer or a pet parent will be able to understand. This is a test enveloped with a data ecosystem changing and transforming cancer care management. Hopefully, you've got a little bit of an insight on how we do things, how we've been able to deliver new-to-world transformational content at record pace.
We're innovating across a variety of areas, from biomarkers to instruments to AI and data science. We really do drive the customer intimacy into our process, as I've hoped you've seen, even to the level of the factory floor. This key integration between R&D and manufacturing is absolutely essential. Of course, we utilize customer-relevant data pools. All this driving insights so that we're able to deliver today and go faster and faster into the future. With that, we'll have Mike Lane next. He'll describe to you some of our reference lab details and also take you through our oncology strategies. Before then, we'll have a 10-minute break. Thank you very much.
Good morning and welcome back from break. It's a pleasure to be here with you this morning to share an update on our global reference laboratory strategy, as we pursue the tremendous opportunity that both Jay and Tina shared, and to update you on our enterprise oncology strategy and the significant progress that we're making. Today, I'll share an update on our global reference lab capabilities that we've been developing for over 30 years. I'll share how we take a customer-first approach to innovation in service delivery, focused on a five-star customer experience. As Dr. Smith described, I'll share what this acceleration in innovation means to the reference laboratory and to our reference laboratory customers. I am really excited to share an update on Cancer Dx and our broader oncology offering. Just a handful of months since the introduction of Cancer Dx with lymphoma, and I will translate this into the results that it's delivering.
IDEXX Reference Lab has three reinforcing layers of competitive advantage that we've been building for 30 years. At the foundation is a focus on operational excellence with the customer experience at the core and performance excellence across a global network. We've had a track record of delivering highly differentiated, innovative new menu, and these build on each other. In partnership with our customers, we have a tremendous opportunity to advance the standard of care, elevating patient care. We take a technology and talent approach to innovation. For example, with 800 medical specialists that are around the world and support our customers in a Follow-the-Sun network. This is all supported by highly talented teams leveraging differentiated lab technology platforms, all part of a fully integrated IDEXX diagnostic and software solution. It begins with a global network.
To deliver exceptional service requires dozens of day labs that operate throughout the day as an extension of the veterinary practice. Regional labs operate throughout the night to deliver results by next morning, by 8:00 A.M., especially for sick patient testing. Core labs, like I've shared before, Corn Westheim and other core labs throughout our major markets deliver the full breadth and depth of our differentiated diagnostic menu. Global network in logistics, automation, and technology. Each of our laboratory departments utilizes a combination of automation, digitization, and AI to deliver the most comprehensive, timely diagnostic results in customer experience. This is what I mean by exceptional customer experience. Here you see the Net Promoter Score for Reference Laboratory that Jay mentioned, 64, well above a world-class level.
We work every day to deliver a five-star experience from courier pickup through chain of custody, through our logistics network and laboratory network, through to diagnostic results and interpretation and support for our customers. This supports, in addition, a 97% customer retention rate. You may be wondering, why is the VetConnect PLUS Net Promoter Score here even higher at 71? VetConnect PLUS is foundational to how we deliver the customer experience in the reference lab. Just take a look at this picture with the veterinarian and the pet parent. How easy it is for the veterinarian to share the diagnostic results, to share high-resolution images, to share interpretation support so the pet parent can lean in and make the best decision for their loved pet. VetConnect PLUS is one of a kind, combining and unifying diagnostic results across modalities, point of care, reference lab.
From a reference lab perspective, VetConnect PLUS plays an added role. If you think about reference lab services, different than point of care, with point of care, we're delivering results in the patient window, in that 15-minute window. With reference labs, results may be due later the same day, or next morning, or during the next day, or even in the next couple of days. We keep our customers updated every step of the way to ensure their confidence, to ensure they can keep the pet parent updated, to ensure they can care for that pet in their hands. They can add on through our ecosystem additional testing while that sample is in flight, already left through our logistics network, add on additional testing.
This is a seamless end-to-end digital workflow that we're building in VetConnect PLUS for reference labs, from ordering to results to support and communications with the pet parent. Embedded in the practice management software, but also in the palm of the staff and the veterinarian to know where those results are. The ability to trend and compare these results in patient context, access support for interpretation. This is how our customers consume our differentiated diagnostic experience across a very broad set of diagnostic categories in the laboratory that you see here, from chemistry to urinalysis and microbiology to cardiology. We have about 65,000 practices customers around the world, about 27,000 you see represented here. This is a U.S. view in the gray bar. Almost all the U.S. veterinary practices access something, some testing from the IDEXX Reference Lab.
You can see that they've adopted the breadth and depth of this deep menu at different levels, highlighting the tremendous growth opportunity that we have in front of us. These diagnostic categories, combined with some of the differentiated assays that we've already talked about today and that we'll continue to add, form integrated disease franchises. As you heard, renal health, parasitology, vector-borne disease, and of course, we're doing it again with oncology. We're just beginning to serve the $11 billion TAM that you see represented by just these four disease franchises. Let's take a closer look at renal health. We've been at this for over a decade, adding SDMA to every chemistry panel at no additional charge. That was intentional. Monitoring kidney health is so important that by design, we set a requirement to be able to add it to every panel.
Adding Cystatin B to sick patient panels, additionally, by design, being able to do that at no additional charge. FGF-23, forming an integrated disease franchise, well recognized by veterinarians given the importance that they know of renal health, as well as highly respected key opinion leaders. Here's a quote I'll read from Dr. Larry Cowgill. IDEXX has been at the forefront of kidney health through diagnostic innovation for the past decade. Parasitology, redefining as well, what's possible. This is a huge diagnostic category, the largest therapeutic category, essential for dog and cat, well, non-well diagnostic testing. We fundamentally redefined fecal testing. For over a century, the method had been to look through a microscope for eggs. Whether or not you're looking through a traditional microscope or a more automated instrument microscope today, if you're looking for eggs, you're going to miss infections.
Thanks to what Martin shared, we just changed the game by looking for the protein. Didn't need to find the eggs. Sometimes the eggs aren't present or visible based on the infection cycle. You can see here discovering as much as twice as many infections as a result of this breakthrough technology. You can also see the acceleration in innovation with flea tapeworm in 2022, cystoid osper in 2024, and we'll be introducing our next biomarker to this already highly differentiated panel next year. Let's turn now to oncology and Cancer Dx. Sadly, cancer impacts so many pets. T he pet parents that love them, and the caregivers, general practitioners, and specialists that are caring for them. I've had four dogs; two have died from cancer. We estimate one in four dogs, one in five cats will develop cancer in their lifetime.
You can see on the right side, by far, cancer as the leading cause of death in adult dogs. As Jay noted, this tremendous disease burden represents a $2.5 billion TAM. Jay also highlighted how excited we are about the progress with the start with canine lymphoma, the performance, the price. You may be asking yourself, how is it that IDEXX is able to deliver such an accurate, affordable, actionable, available diagnostic screen in aiding diagnosis? I think Dr. Martin Smith just highlighted some of the elements. I'll amplify on that from a reference lab perspective. When we innovate, we don't just innovate on the biomarker, as you just heard. We innovate on the platform. We do this in the reference laboratory as well. At the point of care, you see our highly differentiated platforms in the form of Catalyst or inVue MultiCue Dx, SetAview.
Similarly, we have highly differentiated platforms in the reference laboratory, leveraging our expertise in instrumentation, automation, information technology, multiplexing, reagent manufacturing. By design, just like we did it with SDMA, just like we did it with Fecal Dx, cystoid osper, by design, we've developed a platform for cancer that allows us to have a cost profile in the lab to have an affordable price to the vet and in turn to the pet parent, that allows us to deliver the turnaround time. By design, it allows us to expand, as Jay noted, and extend and scale globally. With the addition of MassCell, as you heard, in 2026, in one more, and simultaneously leveraging our global network, beginning the expansion internationally in 2026. Importantly, Cancer Dx and inVue Dx, FNA, starting with mast cell, are highly complementary.
They're not only highly complementary together, and I'll show in a moment the integrated disease protocols, diagnostic protocols between themselves, but inVue Dx is also highly complementary with our global pathology network. We have hundreds of pathologists globally, six continents. They form a follow-the-sun network in the inVue Dx install base of customers. When they want additional information, personalized support, perhaps a deeper set of information from a board-certified pathologist, at the touch of a button, they'll be able to send those images 24/7, 365 to an IDEXX pathologist to support them. This combination of an elegant load-and-go point-of-care instrument with a personalized pathology service is going to be a multiplier for reference lab growth. Here's the integrated diagnostic protocol that I referenced.
Importantly, this empowers the general practitioner to diagnose, to screen, to rule in, rule out, to access the broader services from the reference laboratory of anatomic pathology and histopathology and clinical pathology to characterize, to then further monitor. This is tailor-made for the general practitioner by design. Why is it so important? Jay referenced this. It is so important that we empower the general practitioner. Why is this particularly important for mast cell? Mast cell is top of mind, right up there with lymphoma. These are the top two. When you ask a veterinarian, what are the most commonly diagnosed cancers that we're dealing with in the practice, general practitioners say mast cell, lymphoma.
Mast cell often forms, not always, sometimes it's not visible with a lump or bump, but often can form with a lump or bump, which results in a very concerned pet parent, I've been one of them, that's in the practice, and the general practitioner has a lot of questions coming at them about, is this lump or bump okay? Is it cancerous? Is it benign? They get a tremendous amount of questions. With this integrated diagnostic protocol that I shared with IDEXX Cancer Dx, with mast cell, inVue Dx, FNA, they can bring peace of mind to that pet parent very quickly. They've got the tools at the general practitioner level. If they identify something of concern, they'll identify it early when something can be done about it. There's another reason to empower the general practitioner. There just simply are not enough oncology specialists.
If you take a look at the U.S. line here, hundreds of oncology specialists, and we estimate millions of dogs, in this case, living with cancer. Of course, there are cats as well. The disease burden just cannot be fully served by the oncologists. We are empowering the general practitioner with the tools, the technology, the support to help address this disease burden. They are eager to do it. Our goal is to support them every step of the way. Here is the good news, actually the great news. Earlier detection improves patient outcomes. Mast cell is a great example. If you look at these studies, if found early, a single tumor, six years, these are median survival times, prognosis, six years or more. You can see as the disease progresses to five years, to two years, to just a matter of months. E arly detection will improve outcomes.
Pet parents know this. In fact, we surveyed them. 94% agree with this. Why is that? They have seen it. They have seen it in human health. They have seen it with breast cancer, colon cancer, melanoma, and lymphoma. They are ready to have this conversation with the general practitioner to include cancer screening as part of the wellness testing and the care for their pets. There is even more good news. When caught early, especially, it is highly actionable. Here you see existing therapeutic approaches: in blue for lymphoma, green for mast cell. In addition, for mast cell, surgical removal is certainly one of the steps. Highly actionable. In purple, you see relatively recent innovations in therapeutics. We fully expect, based on the advancements in diagnostics that we are bringing, that we will see an acceleration in therapeutic innovation.
The outlook for this tremendous disease burden is very positive to be able to improve it and improve the outcomes for patients. When you take these first-in-world innovations, you combine it with affordably priced, by design, menu that is cost-effective. You add in the motivation and the emotional connection that pet parents have with cancer, w e believe there is an opportunity to unlock the preventive care opportunity. You can see that on the slide on the left. We have been making steady progress. If you look at the demonstrated best practice of the top 30% of practices, they are including blood work and wellness visits at 2x the level, highlighting the tremendous opportunity in front of us. When we partner with practices to advance wellness care, as well as non-well, with these new-to-world innovations, we support their growth. When our customers grow, we grow.
When we grow, we have high profit drop-through based on this capability that we have developed in reference labs. We have steady margin expansion. Importantly, it allows us to reinvest in the strategies that I have shared with you today: customer experience, innovation, technology, and talent. In summary, we are inspired by the unmet needs of pets around the world, the pet parents that love them, the GPs, and the specialists that care for them, to continue to advance this highly already advanced capability that we have in global reference laboratories. As a technology-enabled global services platform, what we do is not easy. Every day, we are focused on a five-star customer experience, from courier pickup through logistics and laboratory network to results and interpretation and personalized support. We see Cancer Dx in our broader oncology offering as ready to unlock this preventive care and utilization opportunity.
In closing, I'd like to thank the thousands of reference lab employees and more broadly across IDEXX that are supporting our customers every day, working alongside them, and in turn, supporting the delivery of the innovation, the customer experience, and the results that I've shared today. Thank you. I'd like to now introduce Dr. Michael Erickson. Dr. Erickson leads our point-of-care business and will share the tremendous innovations that we have happening at the point of care and the value that they bring our customers.
Okay. Thank you very much, Mike, and good morning, everybody. It's great to be back with you to share an update on our point-of-care diagnostic strategy. Today, I'll build on what you've heard already this morning, focused on how we're harnessing transformative innovation to shape the future of point-of-care diagnostics and drive growth together with our customers. I'll talk about our new-to-world point-of-care platforms and how they drive step function boosts to diagnostic quality and to practice productivity. I'll talk more about how we've significantly accelerated Catalyst Technology for Life menu expansion. I'll also take some time to spotlight innovations in our diagnostic imaging and our rapid assay businesses, which stand alongside VetLab as key parts of our overall point-of-care solution suite. Finally, I'll describe how all of this innovation fuels significant growth and value creation for our customers and also for IDEXX across multiple lines of business.
I always like to anchor the conversation in the importance of point-of-care diagnostics as viewed through the practice lens. I want you to picture that beloved family pet being rushed into the practice. The pet and its human pet parents, they're in deep distress. Of course, the pet can't explain what's wrong. The pet can't tell the doctor where it hurts. In this moment, the veterinarian is facing a cascade of high-stakes questions. What's making this pet sick? Should I start aggressive therapy now or should I wait? Is it safe to go into surgery? The doctor needs trusted diagnostic answers, and there is not time or capacity for complicated, messy sample workflows. The wrong call in this moment could lead to delayed treatment or bad outcomes.
Our IDEXX point-of-care diagnostic solutions bring our world-class reference laboratory performance standards right into this and equal one practice environment that I'm talking about, providing the veterinarian with trusted answers in real time and the confidence to take the right medical action while the pet is still in the practice. We're arming practice teams with in-clinic diagnostic capabilities that they've never had before, packaged into small footprint, high-technology platforms with high accuracy, elegant load-and-go workflow, complete end-to-end integration across the suite and into the practice ecosystem, and Technology for Life platform expansion.
We deliver to these very high standards that we set all around the world, more than 500,000 times every day, and on behalf of more than half a million practice team members, we continue to drive this kind of execution across the business. Last year was an exceptional year for premium analyzer placements, and record placements continued again into this year, setting a new high watermark in the second quarter. With strength across VetLab, including competitive catalyst, and led by inVue Dx, with 2,400 placements in the quarter and elevated expectations for 5,500 placements this year. O ur global installed base of premium analyzers now exceeds 155,000. This combination of high-quality placements, expanding menu and utilization, and very high levels of loyalty together drive our consistent double-digit growth in our VetLab consumable annuity stream. We see a lot of runway to continue propelling this kind of growth. We have line of sight to over 400,000 premium placement opportunities around the world.
Collectively, this represents a more than three and a half fold expansion over where we stand today. We know how to go after this kind of opportunity with our commercial team members working in the field side by side with our customers in their practices, helping them to adopt these innovations into their practice protocols. We just keep setting the bar higher, shaping the future of point-of-care diagnostics together with our customers. This includes new-to-world platforms purpose-built by IDEXX to transform the intended category of veterinary diagnostics. I will talk a little bit more about inVue Dx here shortly. With to MultiCue Dx, I will simply say that you can be sure it will address diagnostic categories of high relevance to our customers in a manner that sets new performance standards, and it will be completely additive to our existing VetLab suite.
Across these platforms, we continuously bring forth new clinically relevant test menu and big leaps forward in the software and workflow. All of this that I am describing, all of this innovation is only possible because of our deeply integrated IDEXX Innovation in Manufacturing platform capabilities that you heard Martin talk about a little bit earlier this morning. We are not slowing down. We are accelerating. Take, for example, Technology for Life on Catalyst. We have a multi-decade track record of bringing new IDEXX-developed test menu to Catalyst. We have significantly accelerated this strategy, as you heard Jay describe, delivering three new valuable additions to Catalyst in the last 12 months and w e have a full roadmap looking into next year and years beyond that. You may be asking, how does that create value?
You have to start with the fact that Catalyst is the most versatile and high-performing analyzer platform in the sector, providing 42 parameters and six preloaded clips across chemistry, electrolyte, and immunoassay testing. If you don't have Catalyst, this array of testing modalities requires two or three disparate instruments. We keep expanding this menu of high-value specialty slides like pancreatic lipase. All of this drives more reasons to test on Catalyst, more utilization, more recurring revenue across the entire installed base, and with every new placement. It also drives more competitive Catalyst placements, more second Catalyst placements, and deep customer loyalty. When we roll out a new test across our large Catalyst installed base, we consistently see rapid uptake. The latest example of this is Catalyst pancreatic lipase. We're not even 12 months into this launch, and already more than half the customers are running this test.
Our next major new test for Catalyst launched just last month, and that's Catalyst cortisol. This has been our number one most requested test for Catalyst. It addresses a critical customer need for accurate in-clinic measurement of cortisol in dogs, particularly low cortisol, what's called Addison's disease, also known as the great pretender because it presents with these nondescript symptoms like vomiting and lethargy. Addison's is life-threatening. Doctors do not want to miss this diagnosis. If it is diagnosed, it requires urgent treatment. Now, with Catalyst cortisol, veterinarians can confidently rule out or diagnose Addison's at the point of care, and they can also manage high cortisol cases, what's known as Cushing's syndrome. Like pancreatic lipase, when we add cortisol to Catalyst, it makes Catalyst an even more valuable platform.
In fact, new menu on Catalyst has contributed to a more than doubling of platform economic value since we launched Catalyst One around a decade ago. This is the power of technology for life, realized through the incredible extensibility of Catalyst. Our newest platform, inVue Dx, brings this same type of extensibility to the massive category of in-clinic cytology. As I've said before multiple times, when it comes to our new platforms, we have zero interest in being incremental. Our aim is to transform the category. That's what inVue Dx is doing in cytology. Cytology has been done the same way for well over 100 years, requiring manual preparation of a glass slide. We made the giant leap to eliminate the slide, and we built a platform that sees cells like never before. It is hard to overstate just how game-changing this is when compared to conventional cytology.
inVue Dx's advanced optics and AI unlock deep cellular insights and drive actionable diagnostic interpretations. Unlike microscopes, inVue Dx is constantly learning with AI updates coming every two weeks. Because it sees more, one run on inVue Dx provides the diagnostic content equivalent of fully preparing, staining, and reading 10- 20 glass slides. There are literally hundreds of variations on how to make slides in the practice. There are no standards for this, and that can drive a lot of variability. Finally, when slides are made, they're stained with repeated dips into a jar of stain that's used oftentimes for days or sometimes weeks. We've looked at this. We know these jars can be rife with contamination like bacteria. With inVue Dx, there's zero contamination. Sample preparation and the workflow is 100% consistent every time.
This drives diagnostic quality, and it drives repeatability, which is really important for things like rechecks when you want to be able to compare the results between visits to see if there's an improvement in the patient condition. Going slide-free also eliminates all the time-consuming work of actually making the slide. It transforms the workflow into an intuitive load-and-go experience with accurate results in around 10 minutes and no specialized training required. 10- 20 minutes saved per patient, well over 90% of the hands-on time freed up for more valuable tasks. This is like giving a practice one to two hours of technician time back every single week. For a corporate group with 1,000 practices, this is like handing them 50 veterinary technicians that they can deploy into revenue-generating activities.
inVue Dx, as I mentioned, addresses a large array of applications: blood morphology, ear cytology, fine needle aspirates or FNA coming later this year, and wide potential for future expansion. All of this ensures that there are multiple complementary reasons for using inVue Dx. The vast majority of our customers are running both ear cytology and blood morphology, o ur overall utilization and revenue per instrument are tracking right to our assumptions with FNA still to come. Looking through a longer-term technology for life lens at everything that you see up here on the screen, there are over 150 million cytologies being done today all around the world that could benefit from this breakthrough technology. You think about that. The sheer amount of trapped capacity from all of that manual slide making is pretty staggering, as is the opportunity to really elevate the quality of the diagnostics being done. I mentioned blood morphology.
Because inVue Dx is an integral part of the VetLab suite, it was purpose-built to pair hand-in-glove with ProCyte to provide the industry's first comprehensive hematology assessment at the point of care. This combines blood morphology with the complete blood count or CBC. This is an area where, again, the challenge of doing blood morphology with a glass slide has just been a barrier to this standard of care, quite frankly. With inVue Dx and ProCyte, there's no glass slide, and this is completely automated. In fact, over 95% of the morphologies being run on inVue Dx are run together with CBC on ProCyte. I should also add that demand for ProCyte Dx and ProCyte One is very strong all around the world, with high attached to Catalyst as part of the VetLab suite.
Specifically for ProCyte One, as you can see on this chart here, we beat our stated five-year placement goal by a full year, and we've just kept growing since then. The coming addition of FNA will add another reason for using inVue Dx. Today, there are well over 12 million FNAs being done annually. We know, though, that that dramatically underrepresents the true opportunity. Most pets, when they come in, have multiple skin masses. We know that only around 10% get aspirated. Again, it's the challenge of doing FNAs on a glass slide. It's a limit to timely insights. It could potentially leave cancerous masses undetected and delay access to life-extending therapy. inVue Dx FNA provides actionable insights on every FNA sample, with an initial focus on the identification of mast cell tumors. This is the top concern when it comes to skin masses and where early detection is just super critical.
For complex cases, as Mike Lane referenced, FNA on inVue Dx will also offer an optional one-click digital review by an IDEXX board-certified pathologist, with additional insights being integrated back into the patient record in as little as two hours, no glass slide required, and it also drives incremental revenue in the IDEXX Reference Lab. Let's take another quick look at that mast cell cancer workflow that Mike shared. Whether mast cell cancer is detected by Cancer Dx as part of wellness screening or prompted by a concerned pet parent who discovers bumps while snuggling with their pet at home, in either of these cases, the GP faces this critical question of which of these masses is cancerous and t hat's where inVue Dx automates the identification of mast cell tumors. It eliminates the guesswork with that one-click pathology review option that I mentioned. Usually, as Jay spoke to, treatment entails surgical removal of the mass.
They may opt for histopathology or additional treatment, and then Cancer Dx provides ongoing monitoring for recurrence. Across all of this, this combination of FNA on inVue Dx and Cancer Dx in the IDEXX Reference Laboratory provides integrated multimodality tools for GPs to be able to manage these high-stakes mast cell cancer cases. This is a giant leap forward in cancer care for pets. I now want to turn to another part of our point-of-care solution offering, IDEXX SNAP. This is another area where we're advancing diagnostic standards through innovations to assays and multimodality workflow. There's no question that SNAP is the trusted standard for rapid testing in the over $1 billion vector-borne disease screening category. It's backed by over 350 peer-reviewed studies. It's loved by customers all around the world. There are more than 750 million SNAPs that have been run since the platform's inception nearly three decades ago.
On average, a SNAP is run every second of every day. You may know that SNAP has played an outsized role in helping to establish regular preventive care bloodwork here as part of a wellness screen. It started with screening for heartworm and Lyme with SNAP, and over time, we expanded that protocol to include full bloodwork. Last year, I shared how we're bringing that same strategy to Europe, only focused on canine leishmania in place of Lyme. As a reminder, leishmania is a devastating zoonotic disease. It's endemic to Southern Europe, particularly the south of France, Spain, and Italy. Any dog that's living in or traveling to these really popular regions needs to be tested at least every year. The protocol, by the way, is any positives found with screening need to be sent to a reference lab for confirmation testing prior to starting treatment.
Last year, we launched SNAP Leish 4Dx. This is providing the first-ever end-to-end solution in the category: accurate point-of-care screening for leishmania and three other vector-borne diseases with a single sample, full compatibility with the IDEXX SNAP Pro analyzer, hands-free SNAP workflow, full charge capture, results on VetConnect PLUS, and all of those benefits. Finally, a streamlined process for confirmation testing in the IDEXX Reference Labs is built into the price of the SNAP. This is what we call IDEXX Anywhere Leishmania. We've been very pleased to see early success with this. It's been helping to drive double-digit growth in our European vector-borne disease business. I've talked about rapid assay. I talked about VetLab. I also promised you an update on diagnostic imaging. This is another example of our ecosystem approach to shaping the future of point-of-care diagnostics.
Our IDEXX Digital Radiography, or DR, imaging systems are a valuable part of our overall point-of-care solution suite. It turns out for veterinary imaging that a top issue is radiation safety in the practice. That's particularly true when you consider that over 75% of veterinary technicians are women of childbearing age. Our IDEXX DR systems are benchmarked to have unmatched image quality and lowest radiation dose. Our customers really appreciate our leadership on radiation safety, and they value our integrated approach that combines DR systems together with valuable software and service extensions. We've seen strong growth here, as Jay shared on the Q2 call. We have over a 95% attach of our cloud imaging workflow software called Web PACs, and that drives solid SaaS revenue growth in our software and diagnostic imaging line.
We also have very high attach of our tele-radiology consulting services, which, by the way, embed AI in the loop with our incredibly talented IDEXX radiologists and cardiologists all around the world, driving next-level quality and accuracy and workflow efficiency. That drives recurring revenue growth in the reference labs. This is another example of innovative point-of-care platforms elevating the standard of care for diagnostics in the practice, but also driving recurring revenue growth across multiple IDEXX lines of business. In closing, I want to thank all the IDEXX teams that support our point-of-care businesses around the world. I'm inspired by what they do every day to expand access to these higher standards of point-of-care diagnostics. Our strategy of innovation-fueled growth across new platforms, new assays, new software, AI, is driving substantial value for customers and for IDEXX.
We see enormous long-term runway to continue driving this kind of innovation and growth and delivering the future of point-of-care diagnostics. With that I want to thank you. I'd like to invite my colleague, Michael Schreck, to the stage. Michael Schreck is the Executive Vice President and General Manager for Veterinary Software, Corporate Accounts, and Customer Experience. Michael?
Thank you. Thank you. Is my mic on? Yeah. It's great to be with you. For the third year in a row, I'm the caboose to the mic train, and I hope to bring it home. Every minute across the IDEXX network, there are over 500 diagnostic tests being processed. As you've heard from my colleagues, they're increasingly being contextualized via VetConnect PLUS, enriched via AI, and ultimately actioned in our software workflow. That's the transformation that I'm excited to share with you today, which is this powerful intersection between world-class software and world-class diagnostics. It's a combination that historically has delivered an enriched diagnostic experience. What I'm going to share with you today is how it's reshaping the dynamics in the visit, both frequency of and quality of. That drives accelerated growth for our customers. Let's dive in.
I don't normally quote Bob Dylan in things like this, but times, they are changing. Did I get it? How did I do? The importance of software in this industry has elevated. Practices and corporates are turning to us with huge demand for modern software. Consequently, what we're seeing is an acceleration of cloud growth, moving from on-prem to a cloud-based software system. That makes sense because there are just benefits that I'll talk about in a minute that are important to making that migration. As you know, IDEXX has prepared for this moment. We declared that we would be a cloud-first software company in 2021. We knew that there would be literally tens of thousands of practices that would be making this migration, and we needed to be ready to support that type of industry transition. It's happening.
Of course, I'll talk a little bit about artificial intelligence, like my colleagues have as well. We have deep digital assets at IDEXX that are proprietary and powerful. We obviously have digital workflow in an integrated ecosystem. As a consequence, our software ecosystem brings more diagnostics, more insight, more impact with every visit. Here's a bit of a roadmap for my presentation today. I'm going to hit these five themes. Ultimately, I'm going to talk about what Jay referenced, which is the first vertical SaaS platform purpose-built for animal health and how that platform unlocks practice growth, elevated practice productivity, and that that's especially true when it's combined with our world-class diagnostics. This triple arch highlights how we've approached the platform differently than anyone else in the industry. It addresses all three user types in one integrated stack.
As you can see, the inner arch, which is the practice, is where everyone else's PIMs begin and end. We've added an enterprise layer to support our corporates, who I'll touch on in a minute, need support for organic growth. We've now added a pet parent layer, all integrated in the customer experience. You'll note, as you've heard from my colleagues, this is deeply embedded in our global diagnostic ecosystem so that no matter who you are as a persona in our software, it feels connected and integrated. This has resulted in a platform that we've built that is the first of its kind that supports enterprise and pet parents and means that the digital workflow can support an entire visit cycle. If the clinician and the pet parent want to stay in a digital experience, they can.
We know increasingly the rising generations, as I've shared in the past, don't know how to answer the phone. We know this is critical. More importantly, it adds incredible productivity. We've also built this platform so that it's expandable, modern, and capable of new partners through a plug-and-play API, and that our unique data assets and models will allow us to deliver personalized insight directly to the clinician, directly to the pet parent at the most relevant moment. This whole program of creating this platform allows us to add more and more value in support of our customers. Obviously, when we do that, that creates opportunities for IDEXX as well. This is an illustration of our vertical SaaS suite and the integrated key elements in it.
You can get a sense for each new cloud customer we add, and each step up this stair step creates incredible value for our customers because they get a fully integrated experience as opposed to stitching together a bunch of applications on their own and storing that in the lunchroom on a server. This is different. It starts with payments. Jay touched on that. This is critical because practices miss charges, real charges. They deliver services and don't get paid if they don't have integrated payments at a surprisingly high rate. Similarly, pet parents need affordability. We've added financing capabilities to the platform so that the pet parent doesn't feel like they can't show up for the visit because they can't pay the bill. As you've heard, we believe in digital workflow. We think that's how you deliver AI-enriched experiences. That shouldn't stop at the exam room.
It should go all the way into the surgical domain. Our workflow allows that to happen and orchestrates an entire practice staff to deliver care in sometimes life and death situations. This also automates diagnostic triggers. These are the kinds of things that we're integrating more deeply into our platform. I'll touch on Vello, which is our pet parent application that I mentioned last year. I'll give you an example of artificial intelligence being embedded in our workflow. Where are we in this industry migration from on-prem to cloud? Practices and corporates are moving faster than ever. That's because these benefits matter. They now have anywhere access. They can now make sure they're on the latest versions without having to do anything. For our corporates, we've now delivered a level of deep security that's consistent with their enterprise nature.
We have multi-location capability so that corporates can push out important things to their practices. Now the results speak for themselves. We're seeing a 2x acceleration in practices who want to switch. They want to move from an on-prem to a cloud base in a higher degree. This is no longer an early adoption story. We're now in the early majority. That's why we prepared for this moment to support cloud migration at scale. Where are these migrations coming from? Where are they going? Our research suggests there's real pressure building with legacy on-prem providers. In this example, it's one representative player, gives you a sense for the percentage of the base that's considering switching. That's enormous to have 42% of your base considering switching in the next two years. You contrast that with easyvet, where it's almost a nominal percentage of people that would be thinking about switching from easyvet.
That's really a powerful thing that gets to where are they going. Well, easyvet has been the number one choice since we've been measuring this and t hey continue to be the number one choice for those intending to switch. That lead has actually expanded as we grew eight points on this metric in the last year. When you put these two data sets together, it gives you a sense for why IDEXX is experiencing such rapid cloud growth. As we talk about as a team, we're gratified by that, but we're never satisfied. It's kind of an IDEXX thing. We're more committed than ever to strengthening this platform to support our customers in this time and this level and this scale of migration. Where are we seeing that happening the most? It's with our corporate customers. Their landscape has totally changed.
Where they were driving their growth inorganically, that's not an option today. The cost of capital is high. Multiples have remained high. As a consequence, M&A is not an engine for expansion anymore. There's a real operational pivot that these leadership teams are making and t hey need to drive organic growth. They recognize that a disparate set of legacy PIMs across hundreds, if not thousands, of practices will not allow them to deliver an organic growth platform. Also, the corporate buyers are more discerning than ever about the level of software that they're buying. We like that because they're raising the bar. They're looking for proven partners who will deliver on what Mike Erickson talked about, which is technology for life. Software is all about technology for life. It can change tomorrow, and it will change 10 years from now.
That's how corporates are looking at it, not only today, but tomorrow. This is all good news for IDEXX because we built an enterprise layer on our platform, and easyvet is the most advanced enterprise platform available. Also, IDEXX made an extraordinary and unrivaled commitment to be a world-class software provider. We also know that corporates are looking and saying, that's a team I want to bet on long term. Consequently, you can see that our new sales to corporates have gone up six times in just three years. It's doubled in terms of acceleration in the last 12 months. When you combine independent migration with that kind of corporate acceleration, you see growth like this. You can get a sense for how committed we are to cloud in that this year, we're approaching 100% of everything that we placed is cloud.
When you do that for four years in a row, it radically changes your install base, both in size and in mix. You get a sense here where five years ago, we were a little over a quarter of our base was cloud and e xiting 2025, we'll be closer to 2/3. This is the flywheel we anticipated and prepared for, where cloud adoption at scale combined with suite expansion, buying more of that integrated platform from us, would create more customer value, whether you're an independent or a corporate. What I'm really excited about is I'm going to share data that we've never shared before about what happens when you add diagnostics to this equation. This is a really interesting example. Jay shared a version of this concept, which is easyvet was acquired in the middle of 2021.
As you can see, only a little more than a third of those users were using both of our diagnostics. In just a short period of time, four years, we're approaching half of that same cohort. We're approaching half are using both of our diagnostics. To give you context, that lift represents $17 million of incremental recurring revenue for the company. We think this is driven by two key factors. One is, as Mike Lane shared earlier, the VetConnect PLUS experience is world-class inside of the easyvet platform. It also does something that no other platform can do, which is it programs in the standard of care and then automates that workflow and then automatically triggers diagnostics through that workflow. That's an extraordinary thing. It's naturally something that's very valuable to our customers.
Our field teams and our corporate sales teams are increasingly seeing software as a way to reinforce an elevated standard of care and amplify the IDEXX innovations that we've been talking about. There's more runway to go. To give you context, the cornerstone on this metric is at 59%. This is the more traditional view we share with you, which is what happens when you have our software and our modalities. You grow faster. In this case, almost twice as fast. Obviously, in turn, that supports IDEXX's growth. When customers pair best-in-class software with best-in-class diagnostics, we all grow faster. I promised to share an example, a real-life example of AI. This is a heat map. You get a sense this is when clinicians are completing their post-visit notes. They're doing it outside of work time, whether it's on the weekend or after hours.
We rolled out last quarter an AI-capable note-taking automation tool. It will listen to the visit and in real time populate that health record. The staff feedback has been phenomenal with quotes like, "This is a game changer," or, "Thank you for not having any more pajama time." This is re-gifting time back to the practice. They're saving on average six hours per week per clinician. That's like 15% more capacity without adding staff. As you've heard from my colleagues, we're very committed to artificial intelligence across the enterprise. Our goal is to create intelligent workflows and customer experiences across all of our touchpoints. Let me turn to Vello for a moment. You may remember this is our differentiated pet owner engagement application that we introduced last year to you.
You may recall it's built uniquely to support an entire visit cycle that can be digitally supported between the pet parent and the practice, both before, during, and after the visit. It reduces time wasted chasing pet parents and playing telephone tag. Vello, in particular, changes the wellness visit dynamics. Let me show you how. Before the visit, every one of the pet parents will receive an invitation to add a higher level of diagnostics to their screening package, whether it's bloodwork and in the future, cancer. We know, as Tina talked about the supply problem, we're changing that entire dynamic because once the pet parent interacts with that invitation, a signal goes to the practice management system to tell the clinician the state of mind of that pet parent, creating more confidence and clarity in that clinician to have a discussion about the importance of preventive care.
Practices are seeing positive visit growth, even with the industry backdrop that we have and t hey're seeing better quality of visits, where the pet comes fasting. They didn't forget the fecal sample. We're getting both frequency uplift and quality. This all translates to better practice revenue growth and, in turn, IDEXX 's growth. I'm really excited. This is what's coming next. We're going to launch our next-generation version of Vello early next year. That will accelerate wellness adoption through personalization, deep personalization, and, as my colleagues have talked about, Cancer Dx messaging directly to the pet parent. We believe cancer, as Tina shared, is an emotional gateway to the preventive care adoption. Pet parents want it, we know. We know with Cancer Dx, they want it even more if they were just asked. Clinicians, I think there was near 90%+, said they would add this to a wellness panel.
This is an example where Abby gets a very personalized message to her breed, her age, and her medical history. With one touch, the pet parent can add that to a visit or say, "I'm interested in learning more about that," or even, "I'm not interested," which gives the clinician clarity about the visit. During the visit, we can deliver value with our partners that support therapies or nutrition to make care more affordable. Maybe most importantly, we're going to celebrate the negative test. Those pet parents will be able to post that on social media, which our research says is the number one thing that the pet parent wants to do after a visit, that they're good, solid pet parents. In this case, they'll be celebrating that Abby is cancer-free. We then add a personalized care plan that the vet has configured.
With one touch of a button, that plan gets activated, and in this case, forward book, which is a huge opportunity in this industry. As Tina said, our ultimate mission is to create more birthdays for Abby and all the pets that we serve. We're honored that so many customers have responded positively to our vertical SaaS efforts. It's powered a high growth, high margin, high gross profit software and imaging business. This happened thanks to our 1,000+ now software professionals around the world. Together, we've built something that's a powerful standalone business, but more importantly, can power diagnostics and better standard of care. I want to close with this. Our cloud platform helps practices be more productive and grow faster. This is the headline. When IDEXX , diagnostics, and software come together, customers see more visits, better visits, and faster growth. We're just getting started.
We think we're still in the early innings of the power of a vertical SaaS platform in transforming the future of animal health. Thank you. Next, George Fennell will be having a conversation with Dr. Brian Greenfield. Before we do that, we're going to take a 10-minute break. Thank you.
Good morning, everybody, and welcome back. We are going to continue our Investor Day program here and break up the presentations with a bit of a fireside chat. If you can imagine a clicker or a woodpile in front of us, my name is George Fennell. I work with our commercial organization around the world. These are the teams that interact directly with our customers. What I'm about to do for the next 25 minutes is just that, interact with one of our customers. I am joined here on the stage virtually by Dr. Brian Greenfield of Animal Clinic Northview. He and I are going to have a proper conversation about a number of the topics that my colleagues spoke about this morning, really an understanding of the state of the state and what he is seeing in his practice in Cleveland, Ohio.
I'm going to first have Brian introduce himself and a little bit about the team at Animal Clinic Northview and maybe an interesting educational background about Michigan and the Ohio State, a very interesting combination.
Thank you, George. I appreciate it. Thanks for having me. I did go to the University of Michigan undergrad, and then from there to Ohio State University for veterinary school. Any of you out there know that combination is like oil and water. It's an interesting tidbit. I live with it. I deal with it. I'm pretty normal other than that. I joined Animal Clinic Northview in 1998 when I graduated. I think I was the fifth or sixth vet there. We had about 25 people. Now we are 34 vets, about 175 strong. The building that you see behind you or behind me is about 36,000 square feet. We're a hybrid practice, which is a little bit unusual in the space. We do general practice. We're a 24-hour ER, and we do a good amount of advanced care.
I think this really fits well with a lot of what IDEXX is trying to do, especially with the shortage of specialists out there, which we definitely see. It really creates opportunity for practices like mine to continue to grow and perform advanced care, as well as be people's everyday vet. I've been there for 27 years. My partner, Dr. Randy, and I run this place. It's crazy town. Everything that you guys are saying about time and pressure and stress and what's happening in the veterinary world, it's true. The slide that was shown with the lab tech earlier on, I think.
Michael Erickson?
The lab was way cleaner than any lab ever is, by the way. The lab tech's hair was blurred in the slide. I said I leaned over to George. I said, that's exactly how it is in practice. P eople are flying in a million directions. We've got hundreds of people in the building at any given time, a full ICU, six surgeries going on, and 34 exam rooms. It's crazy pants. Any of these things that can help with efficiencies are super important to us.
Brian, thanks for sharing that. There's not many practices that expand eight exam rooms at a time. Animal Clinic Northview does that because of those ambitions. I'd like to maybe start by just having you share with the gathering here this morning what are some of the trends that you are noticing as it relates to care intensity. Clinic visits is often a backdrop of discussion. What are you seeing with your clientele at the hospital, maybe even in the last 6- 12 months, if you're detecting anything differently?
There certainly has been a lot written about decreasing numbers of client visits in the last year or so. We haven't really appreciated that too much in our practice , but we've maybe flattened a little bit. In our world, that's probably we did experience it. A lot of people ask, how do you respond to that? Some of it, you can respond to it through some surgical price changes, but t he best way to respond to that, and what we really have done, is just to continue to focus on best medicine for clients. What we've found is that we've continued to have practice growth because maybe if you did have one or two less clients that day, you're still spending the same amount of time with your existing clients. This happened in 2007. I don't know.
There's not a lot of people in here that were doing what they do today in 2007, but I remember it. I remember it flattened a little bit for about a year. It came right back. My general sense is, especially I would say even over the last three to four weeks, we're seeing visits really start to ramp, especially in urgent care and emergency. The past month at our office has been pretty crazy. I think some of these trends that we've read about, we've heard about, you guys run metrics on, my general sense is that's changing.
In Tina's setup, she talked about this dynamic with pandemic puppies and kittens that are sort of moving through this health care continuum, Brian, sort of facing middle age and getting into senior status. I'd like your perspective on sort of two dynamics, the clinical trends, what happens clinically as patients age, and then what implications does that have for you as you look forward over the next several years and think about the health care that might be arriving at Animal Clinic Northview.
Well, I first look back to the pandemic period, which nobody wants to live through again. Business was nuts during that period. You're getting people in and out through drop-offs and a window. I remember the volume of new puppies that we saw during that period. Certainly, as these patients are starting to age, they're certainly going to be needing more diagnostics. There's going to be more problems. There's definitely going to be a blip. A lot of the Gen Zers that adopted these pets, it's my opinion that they are incredibly dedicated to these pets. I think a lot of them, these were puppies that they bonded with during the pandemic. It's part of their families. I think we're going to find that this generation is absolutely ready to run the test, do the diagnostic. What does it take, Doc? I think it's coming.
I think it's around the corner. We've put some thought into it at our practice as far as what do we need to do to prepare for that. I think it's going to be a reality.
You share with me just sort of an interesting lens on this. We bring charts, graphs, tables, and economics to these kinds of trends as a business. Your staff members made an interesting observation about the profile of that pet owner and the bond that they formed during that pandemic period. Could you just sort of share their impression, a different lens than maybe we would look at?
Some discussions I was having at the practice prior to flying out here, I was speaking with some of my lab technicians. I just said, hey, what do you guys think about this dynamic? These people, these pet owners, are they committed to, were these puppies adopted and they're just not going to be cared for very well or a re these people committed? My overall impression, a far majority of people said, no, we actually think these people are more prepared than the existing pet owner. The bonds that they've formed with these puppies and now adult dogs is that strong that they are going to demand the care. Several of my lab techs said that to me.
It's interesting. I think some of us remember the pandemic, and some of us don't want to remember the pandemic. That was a tough time for society to navigate through. We're talking really now about the profile of the new pet owner who formed a v ery special and close bond during a very turbulent time and t hey're now facing those health care decisions in the years ahead. As you've begun to think about it, without disclosing anything proprietary at the hospital, how are you beginning to think about how we would prepare ourselves and the teams to be able to really meet the needs of those clients?
Capacity is going to be the first one, completely. You need to have enough DVMs and enough techs, enough support staff ready to go. No question. That's number one. How do we decide when to hire? We hire when nobody can get an appointment, when all our urgent care and our ER slots are full because people can't get in for routine stuff so i t's time to hire. I think this is a good opportunity to look ahead on that. Make sure you have exam room space. Make sure you have ORs. Make sure you have enough catalysts sitting around.
Plural.
Plural, which we do. They're churning all day long, and it's a valuable tool for us.
Can we talk a little bit about what are the expectations of those clients? L ook, I'm not trying to date you or me, candidly. Over 27 years, you've seen the expectations of clients evolve. As you look ahead, where are those clients expectations for you and the health care team at Animal Clinic Northview? What do they want? What do they expect?
People walk in wanting best medicine, number one. You're not doing them a service if you're not offering that. If you're making assumptions about what you think they can afford, you're absolutely doing a misservice to them. This has been a chronic problem in the profession, my opinion. But these clients are expecting best medicine. They're expecting accurate estimates. They're expecting very clear communication. They like to be communicated with regularly: email, text. When we refill meds for people, we will send texts right out of easyvet and say your meds are ready. If they have a patient in the hospital and they want regular updates, and it doesn't have to be a phone call, it's fine to communicate electronically, whether it's text, electronic, and app. They're expecting transparency. They're expecting accurate diagnosis. They're expecting the ability to send records to them, show them pictures. They want all of that.
They want to be communicated with regularly. That's what they require. It's what they do now in every other aspect of their life.
What they expect in veterinary medicine isn't any different than they would expect outside of veterinary medicine.
When you go to the car dealership, they send you a picture of your car, and then they send you an accurate estimate and video. That's what they want from the vet.
An interesting notion, because you touched on this, but let's get into it now. You had easyvet before we had easyvet.
I did.
Easyvet's enablement to meet those service requirements, take us through that exam. What does the software do to empower you guys clinically? But then what is the client expecting while you're in the exam room?
It's fabulous software. We went live on it in 2018. We were one of the earlier adopters of it and o ur practice was growing. E ven though we were digital and electronic, we were still using some paper. As you expand and get bigger, it becomes completely inefficient to not have software like easyvet. We can manage a case from anywhere in the hospital, especially linked with the digital whiteboard technology, which was SmartFlow and is now Vet Radar. Everybody in the hospital can look into a case. They know where it is, what it's doing, how long they've been somewhere. From a client experience, we're walking into a room. The room tech has already triaged the case, put information right in the room. We have a screen in every room. iPads. You can use whatever you want.
One of the beautiful things of it is all the integrations. The i ntegrations are unbelievable. W e can draw blood work, get urine, grab a fecal, whatever we're doing. I can literally be in the exam room talking to a client about their kid , about what's happening in their life. Behind me on the screen, the results are starting to pop up. It's fabulous. People want to come to the clinic and get the results. Gone are the days of, "I'll call you in two days with the results." Nobody wants that anymore. We get them in, we keep them there, as we get, we can often get diagnoses and treatments started while they're there.
While they're there.
T hey love that. We don't book 15-minute appointments, we book half-hour appointments b ecause we know we want to give the client that full experience there.
How do they respond when you can, let's say you advance medical information to them? Is that in alignment with their expectations these days? Is that a special surprise? H ow would you gauge the ability to transmit what happens in that exam room to the client?
People go to their own doctor and don't have blood results back for a week. This is the same blood work that we're running, and we have it in 20 minutes, if not less in some cases. They love it. They're surprised. The interaction is there. They don't have to bring their dog to a vet a second time. Maybe they need treatment. Maybe you're diagnosing something and you'll get surgery scheduled right there while on that experience and move on. It's a one-stop shop. The integration from a veterinary standpoint is fantastic. We get a memo that pops up, "Hey, you got a test result back." It streamlines everything. It's an unbelievable time saver for the vet and for the client.
When you think about the time savings in the moment, that can obviously be repurposed, but some of that time savings may be needed for this future wave of pet healthcare that's coming. The fact that you guys have that automated now is probably a bit of a tailwind anticipating this advancement.
Radiographs show up. Clients love pictures, right? We can show them cells. Their dog has a UTI. We can show them the bacteria and the white cells. These are things that clients like to see, and they understand what you're telling them when you give them a visual aspect of it. You can email it to them as well, right from the room.
In a way, it empowers them b ecause they are going to then go see the front desk staff. They're going to check out. They're going to get a bill, but they've been empowered in that 30-minute appointment. That is what all of this technology working together really does for them.
We like to get them answers. T hat's the thing. Let's get to the answer and t hey can make a valuable decision for their pet. Let's not guess at it.
Let me touch on this notion. I know how unwavering your medical expectations are. This notion of always wanting to recommend what you believe is in the patient's interest first, without thought for the economic profile or, as Tina noted, the perceived economic profile of the client. How have you culturally instilled that notion with such a big team, Brian, at this point? How do you guys do that?
Yeah, you know, it's the way everybody practices at the practice. When we get new students in, in many cases, they've already rotated through our system. They know how we practice. All I can say is you should never make assumptions about people. At the end of the day, we recommend to all of our staff that you treat that pet the same way you would treat it if it were your own. That is really the end of the day. If you're not doing that, you're doing them a disservice. That's your j ob, and that's why they're here. They're not here for guesswork. They're here for answers. That's what we do with everybody. Not everybody says, do this, that, or the other thing. G reed. But e verybody's been offered it, and if we miss something because a test wasn't run, at least we offered it. But I will say t he vast majority of our clients take our recommendations.
I think there Jay talked about his own notion of first principles. This sounds like an Animal Clinic Northview first principle is that we recommend what we believe is best for the pet without screening that might happen.
I think the new vets that are graduating from vet school these days, I believe that they're coming out with that mentality more than it used to be that way. I think it's a little bit of an old school mentality. We don't need to run this. Your dog's not unlikely to have this, that, or the other thing. I think the new students that are coming out, we started two from Ohio State and one from Purdue this year. They're incredibly sharp, and they come out and they're ready to run diagnostics. They take to the easyvet platform very, very quickly. It's like learning a new language, but once you learn it, you know it forever. We communicate through it. I don't think it's that difficult, really, as long as you're in a room, you're honest with people. You tell them what you would do. You're nice about it. Yep. You have a conversation.
That's great. I want to maybe just turn the page slightly. I know that a lot of the information that you're receiving back there sitting next to me was also new to you this morning . It's very clear. You and I've talked a little bit about IDEXX s' unwavering commitment to oncology and c ancer in dogs. You heard that from all of us today. Can you just talk a little bit about cancer diagnostics in primary care and w hat you see and maybe even some reflections from what you've heard j ust in the last several hours here?
It is 100% true that oncologists are in short supply. Everybody knows that. While they are very valuable in certain cases, general practice needs to absorb the majority of those cases. We see tons of lumps and bumps. I don't remember the numbers that you quoted, but it's true all the time. When you guys introduced the digital cytology machine, that was very helpful. We could get a nice response within a couple of hours in most cases. It's a big part of dogs' lives. It's true, we see a lot of lymphoma. We see a lot of mast cell tumors. We see a lot of sarcoma. It's very, very common.
I can tell you, the last 10 years of my career, how many clients come to me and say, "Doc, don't you just have a cancer test?" The answer is no, we don't have a cancer test. We didn't have a cancer test. We're looking at kidneys and livers and calciums and white counts, and maybe our suspicion of cancer goes up and then w e do additional diagnostics. The availability of a true cancer marker is new for us, and I think that's exciting. I think clients are going to be very appreciative that they can screen and feel good about it. If we find something, then go from there. I'm especially excited about the needle aspirates coming. That's something that I think will take off.
The client's interest and curiosity about cancer, can you say more about that? They're aware of this, aren't they? The pet owner who has a boxer. The pet owner who has a Golden Retriever.
They know their risk. Their breed is high risk for this, that, or the other thing. M ost clients are very knowledgeble and t hey come in and they have some preconceived notions. They say, "Boy, wouldn't it be nice to know if my dog has something I need to." Everybody's unfortunately known somebody, a person or a pet in their life who's had cancer. It's something that everybody can relate to. Early detection is key 100% of the time. It is a very relatable conversation. If you can offer a screening test that's cost-effective, I think a lot of people would be very happy about that.
Now tha t's good, that's good. I think this is something that IDEXX is committed to working with the profession on developing this. As this comes out of the factory or the benches, Martin would describe out through the commercial teams to you, it's something we want to help educate everybody about and going forward. Thank you for sharing that. I just want to touch just very briefly in the remaining couple of minutes about your IDEXX relationship. We've had a long and growing relationship. I know that it's an important one to you. Would you mind just sharing a few words about why that relationship is important to you?
It's important to us because I think IDEXX from the beginning did focus on best medicine, which is a tenet of ours. Six, seven years ago, when you were developing your progesterone slide w e did a lot of reproductive work at our office, so that test was of interest to us. We had a lot of collaboration with IDEXX .
Yes, we did.
Sending samples back and forth and validating. That was actually the last time I was here to meet that team. N ow since th en, we've had a lot more collaboration. The techs at our lab have sent you, I don't know how many thousands of samples to help with the development of lots of things. I will tell you the best part of that is that they feel like they're part of something bigger. T his isn't like sending you the samples so we get a price on something. I t's not that at all. M y staff, you pay people well, you give them good benefits, but the intangible is if they can come into a day and feel like they're making a difference in the animal health world, that's way beyond anything you can pay them or that they even care about.
Yes, strong sense of purpose.
They love it. There is a lot of give and take with your client service reps and the people developing these tests. It just creates excitement and buzz. We also appreciate hearing about things that are coming soon. We like that.
That's why you were here.
That's right. It's pretty cool. It's a good way to go. W e're not just punching a clock. We're having a good time.
I think it's one of the most underappreciated aspects of veterinary medicine, is that very strong thread of purpose. It's bigger than all of us. We're recognizing patients and pets are part of families, and it's part of the bond that they form. It's how they experience life.
Yeah. People want to go home at the end of the day, even though some days in this profession are very difficult. But y ou want to go home at the end of the day and feel like you made a difference in some way and t hat relationship has been part of that for us. I would say.
That's excellent. Maybe, Brian, just in the remaining minute, any pearls of wisdom or advice or thoughts that you're thinking about relative to your profession more broadly. S tepping out of Animal Clinic Northview for a moment, what's ahead for the veterinary profession as you think about this business? 27 years of experience in it. You're not a rookie anymore. How are you thinking about the business going forward?
I think in a very positive way, for sure. There's certainly incredible demand for our services. People are still getting pets. They're going to continue to get pets. The business itself, I think that if you take the time to educate your people, to train your people, to find the best people when you're hiring, and then you employ technology and cutting edge and continuing education and communication, and never forget that the pet in front of you is somebody's pet. It's part of their family. They're there for that reason. I think the profession is incredibly healthy. I think that bond between the pet owner and the vet is very strong. W e've seen massive demand. I think it's going to continue to expand.
Maybe we'll leave it there. We'll thank Dr. Greenfield for his perspective this morning and enriching our Investor Day experience for all of you. At this point in the program, I'll introduce IDEXX's Chief Financial Officer, Andrew Emerson, to move the program forward. Andrew.
Thank you, guys. Thank you, George and Dr. Greenfield. Good morning, everyone. I am Andrew Emerson, IDEXX's CFO. As you can see, my family has a number of pets that are really important to our household. As it turns out, when you have six pets, not only I, but my wife are very well steeped in animal health finances. But as we transition to IDEXX, I think hopefully what you took away from today is we operate a great business in a really attractive sector with significant long-term opportunity. I'm pleased to take you through the financial review where we'll focus really on the growth strategy and the financial approach that we have associated with that. Overall, our mission is really to improve pet healthcare through the use of expanding diagnostics and cloud-based software. We have a focus on innovation, integration, and commercialization.
This strategy really contributes and delivers durable, long-term recurring revenue streams that benefit from scale to drive high ROIC and strong earnings potential over time. This focused, consistent strategy that we have has delivered outstanding financial results over a long period. In the last five years alone, we've outperformed all of our key financial metrics on a multi-year basis and w e continue to grow off of this base into the future. This really is focused on our Companion Animal Group, which is our largest segment of the business and is a set of attractive core businesses that really have a long-term opportunity to continue to grow and contribute high profitability. A key driver of that success over time has been the global expansion of our CAG diagnostic revenue annuity. This represents approximately 80% of the overall company and grew to about $3 billion in 2024.
We've had a long track record of double-digit growth in both the U.S. and our international regions over this time period. Again, we believe we can continue to grow off of this base. Now this really stems from those strong customer relationships that we have and the ability for IDEXX to provide high-quality diagnostic insight about the patient health. That remains our focus, and you'll hear more about that as part of our transition and focus on transformational innovation today. We've been able to grow off of this base in the U.S. and sustain double-digit growth in our international business, even through a period of macro and sector headwinds. Our customers value the IDEXX integration that we have, which is really enabled through our cloud-based software approach. As Michael described, we have a vertical SaaS model that's specifically designed for the animal health industry.
That has supported high growth overall, but also expanded recurring revenue streams. When we think about the opportunity in front of us, adding additional services will help increase AR. Things like integrated payment solutions, Vello, which will help us reach our end consumer, as well as Web PACs in managing diagnostic imaging workflow. We will continue to add technology and AI to support productivity in the clinic, which adds incremental value to our customers. As we think about looking forward, certainly one of the impacts that we've had more recently that's constrained our overall revenue growth has been around clinical visits. Many of you are familiar with this story. We saw an exceptional step up during the pandemic period of clinical visits. Since 2022, we've had declines on this metric impacting the industry.
That really stemmed from staffing challenges within the clinic itself, as well as broad inflation on the consumer that's put pressure on this metric. As you can see, we've also sustained at a clinic level visits that are above the pre-pandemic period. This gives us a base to grow off into the future. We have strong longer-term dimensions that you just heard about from Dr. Greenfield as well, around an expanded and aging pet population, pet owner demographics that support that long-term humanization of pets. IDEXX continues to focus on strategies like personalization with Vello and a ll of this points to increased patient traffic over time. For those seeking veterinary services, as Tina described earlier, we continue to see an increasingly important role of diagnostics in the clinic.
This steady expansion that we've seen over time of 50 basis points of blood work inclusion per clinical visits has led us to 20% in 2024. U.S. benchmarks would highlight there's opportunity to double this over time. What we know is internationally, we're even in earlier stages of this progress. For every 50 basis points on an annual basis that we get this expansion, that's the opportunity for us to deliver 1%- 1.5% global CAG diagnostic recurring revenue growth. Senior pets, those aged seven plus, often have higher inclusion levels within the clinical visit that they have. This provides an opportunity in coming years to outpace that historical norm over time. Strategies with IDEXX Laboratories, like our Cancer Dx pricing, further inspire more comprehensive diagnostic testing over a longer period. That brings me to more of the innovation side. What you heard earlier today was our focus on transformational innovation.
We're really excited by the momentum that we're building with recent launches. We've created new platforms with inVue Dx and Cancer Dx and in the MultiCue Dx. These are truly incremental greenfield opportunities, which will be additive to our overall CAG diagnostic recurring revenues over time. They're also extensible platforms, meaning we see opportunity for continued menu expansion that drives new diagnostic insight over time to the clinician and continues to build a deeper understanding of patient health. Similar for our technology for life strategy, which Mike talked about earlier, where we continue to deliver new menu on our core catalyst as well. This helps reinforce the belief in diagnostics. Being able to discover more and detect disease earlier allows clinicians to use these tools for better outcomes in the patient.
Overall, we expect innovation to be able to drive 2%+ incremental revenue growth to CAG diagnostic recurring revenues over time. Innovation also supports our ability to expand our customer relationships. While we have over 100% headroom on our core analyzers with Catalyst, ProSight, and SediVue, and we have commercial plans well aligned with the significant opportunity that you see internationally, inVue Dx and MultiCue Dx provide the opportunity to leverage our relationships with customers for broader diagnostic testing and w hat we see is when they take advantage of this broader ecosystem of IDEXX , we do find testing begets testing. They use more diagnostics. They understand what's happening at a deeper level with the patient. This is also a really important base for us. This creates a large loyal base of customers that, as we talked about earlier, has rapid adoption on new menu and specialty testing like cortisol that we launched recently.
Bringing this all together, IDEXX execution, coupled with our innovation agenda, supports the long-term potential for CAG diagnostic recurring revenue growth. Now this chart represents the building blocks for the business overall. What I'd highlight is even in this period where we've had macro and sector headwinds with broad inflation and challenges with staffing, IDEXX execution has continued to deliver solid volume and pricing gains through that period. Now, as inflation eases, we expect price realization to moderate to 2.5%- 4% of revenue growth contribution, more aligned with our historical standard, as well as really building on the value that we're delivering to customers. We see a steady pathway for us to continue to build new customer relationships over time and place core instruments as well. This benefits from high retention and loyalty within our customer base.
The more dramatic step up that you see on this chart is really related to the utilization and innovation. That comes back to our transformational approach focused on these platform technologies. As we build momentum with things like inVue Dx and Cancer Dx, we see the opportunity to continue to expand in this area. We have a robust pipeline for the future, as Martin highlighted. While we have many positive factors that lead us to believe it's a matter of when, not if, clinic visits return to growth, even if they were flat, we see the opportunity to grow this portion of the business by 8.5%- 11% over time. The strong growth in CAG diagnostic recurring revenues really forms the foundation of our overall business growth expectation of 10%+ .
Software, as you can see on this page, that's focused on solving clinic needs like productivity, workflow enhancements, client engagement, provides the opportunity to grow even faster. We can continue to place analyzers which benefit our CAG instrument revenues. Water and LPD also operate in attractive sectors within their areas where we think we can grow mid to high single digits over time in these categories, additive to companion animal, but also synergistic. As we grow, we benefit from high incremental gross margins in the CAG business itself. Gross margin expansion is a really important element for our overall profitability improvement over time. We benefit from a business model and a business being at scale where we get natural tailwinds that as we grow these recurring revenues, we see high flow-through on the drop-through associated with that. We're also not focused only on that growth.
We continue to have lab and operational improvement agendas, things like automation and DFMA, in order to continue to enhance this potential over time and c ombined with net price realization, we see the opportunity to offset inflationary cost pressures through this approach. Our focus on gross margin expansion and operational efficiency really allows us to continue to invest in the long-term nature of the business. R&D, as an example, where we expect to remain +5% of revenues overall, is focused on the pace and breadth of our innovation agenda. We're advancing capabilities that we built over decades, and we're establishing new ones as technology evolves. This is in support of having a robust pipeline of innovation supporting customer solutions. Sales and marketing is about commercial enablement and customer intimacy, where we're translating the value of diagnostics and software to our customers and building strong, trusted long-term relationships.
As we advance commercial expansions, we often see these as fast and high returns because they're focused on growing that CAG diagnostic recurring revenue annuity. In G&A, we expect to continue to advance some leverage in our back office functions while we invest in areas like IT and data in order to maintain this broader integrated network effect. We have a disciplined capital allocation and resource allocation approach. This starts with our strategic growth priorities, our focus on clinically relevant diagnostic insights, delivering a modern customer experience through software and AI, and ensuring we have customer reach to the global customers that we operate with. Whether it's organic investment or M&A, we use the same principles. It starts with our core businesses and solving veterinary clinic challenges. We often find opportunities that plug directly into our extensive ecosystem.
This allows for high profitability and accretive revenue growth potential. While many of the opportunities that we invest in have significantly longer lives than five years, we do look for a return above our cost of capital within that time period. Under this philosophy, since 2017, we've invested $1.7 billion in R&D and M&A alone. This is really focused on enhancing the capabilities we have in diagnostics and software over time. We often see more inorganic opportunities on the software side, and that's where we'll continue to pay attention closely as opportunities arise that we make the appropriate investments to advance our capability set. Through the same time period, we've been able to deliver meaningful growth in ROIC at the same time. As we continue to invest in the business, we will target incremental operating margin improvement.
We've had a steady track record of outperforming our goal of 50- 100 basis points average comparable operating margin gains, and that maintains our goal going forward. We're focused on continuing to drive profitability over time and believe we can do that, which will be gross margin led as we invest back into the longer-term nature of our growth agenda. In 2025, we're on track with that. We're expecting, as we highlighted in our recent guidance, to deliver 50- 80 basis points of comparable operating margin improvement this year. Because we're able to continue to expand our operating margin profile and grow the business meaningfully, that provides the potential for strong free cash flow generation. We also have a long history in this area where we've continued high levels of conversion from net income to free cash flow.
Again, we benefit from a scale business where our capital intensity is relatively low. We typically provide 4%- 5% of revenues towards capital spending, and that's largely on our growth agenda. We see over time the potential to continue at this pace and maintain net income to free cash flow conversion of 80%- 90% over the longer term. Now, our capital allocation principles are really remaining consistent. Our priorities are focused on driving our organic growth business. As we identify M&A opportunities, we continue to invest in that path. However, because of our significant free cash flow generation, we typically have excess capital in regards to the business requirements that we have. We've been able to redeploy that through share repurchases over time very effectively.
Since 2015, we're expecting to actually overdeliver our share repurchase level of capital deployment versus our free cash flow and at levels that are significantly discounted to today's price. While we'll be thoughtful as we continue down this path about our capital allocation methodology, we've seen this as a really good opportunity to continue to leverage how we deploy capital and expect to do that into the future. We're optimistic about the long-term nature of the business. We see the opportunity and potential to continue to grow 10%+ . We're continuing to maintain our focus on operational efficiency and capital allocation methodologies consistent with our past. That can all deliver 15% plus earnings per share on a comparable basis over time.
That's really the foundation building off of our strategies with strong secular tailwinds, the expanded and aging pet population, pet owner demographics, and our robust innovation pipeline that we see a clear pathway to deliver this. That concludes our financial review. I'd like to thank everybody and welcome Jay back on stage for Q&A.
Thank you, everyone. We have time for a few questions. If you have a question, please raise your hand. Members of the IR team will be sharing the number.
Great, thanks. Erin Wright, Morgan Stanley. Can you talk a little bit, let's talk a little bit about inVue and some of the near-term, longer-term opportunity there? The 20,000 placement by your target still holds in the consumables welfare of about $150 million from a dollar perspective. Can we extrapolate that incremental $100 million test volume opportunity by basically adding this to translate your home, basically a $300 million- $400 mill ion annual flow-through from a consumables perspective? Is that the right way to think about it in terms of that incremental opportunity for inVue. The second question is also numbers too, but just the 15%- 20% EPS growth that you had previously in terms of the long-term guidance, it went to 15%+ . Just comment on that. Thanks.
You want to take the first one?
Why don't you take the financial one?
I'll take it. I'll take the financial one. In terms of our earnings per share, 15%+ is still largely in line my annuity 15% to 20%, as you highlighted. Our focus is on making sure that we advance investments for the longer-term potential. At the margin profiles that we're at, we can continue to create significant value by ensuring we have this long-term ability to grow the business into the potential that we see for the $45 billion opportunity in front of us. We are highly focused on that and finding that right balance over time. I wouldn't look at this as a major change, as you could see all the other benchmarks that we have and financial characteristics are right in line with what we would have expected. We're just making sure that we have the capacity and investment cycle to support the long-term potential of the company.
In terms of a placement goal of 20,000 units in five years, we're not updating that at this point. We're just thoroughly in a cycle right now. As we have begun more recently to expand outside the U.S., I think we'll get a better picture of what the end market goal is. The modeling we've done suggests that there's 90,000 or so units of opportunity. We think that's a good model over time as we expand the menu that could potentially go up but I think that remains to be seen. From a menu standpoint, the focus is really on the three right now of the ear cytology, blood morphology, and then FNA for lumps and bumps, as Dr. Michael Erickson indicated. There's a lot of runway in terms of cytology that you can do. That's a multiple of the number of tests today being run.
I think we'll look at that over time. We always, from a technology for life standpoint and menu extensibility standpoint, see a lot of very interesting opportunity.
Chris Schott at JP Morgan. You've got several new platforms ramping. You've had an aging pet population. Could you just talk about the potential for this acceleration in the percent of visits that have a diagnostic tied to them? I think you laid out it's been about 50 bps per year. How much of a step up could we think about as this plays up? Is it a percent a year or something like that? Is that within the realm of possibilities? Maybe a second question tied to this. As we think about visits stepping up, percent of visits with diagnostics stepping up, are vet practices equipped to deal with this acceleration if it plays out? Can this actually flow through to numbers, to volumes, et cetera?
To the earlier discussion, the 50 basis points has been a good benchmark. During the pandemic, as we shared, it did step up for a while to 100 basis points. We did not necessarily see that give back. Some of this comes down to if you take a look at the top quartiles, they're definitely using blood work inclusion at a much higher level. The belief system is there I t's not like there's just a couple of practices. There is very broad adoption. A lot of our sector development strategies are really based on continuing to drive that. As I had mentioned in the earlier part of my talk, we want to lift all boats because we think that diagnostics is underused. Then the top half already has this foundational belief and can use more.
Part of our strategy, both innovation and on the commercial engagement side, is to drive that faster. I'd hesitate right now to speculate how much faster we can drive that. As Andrew showed in his slide, just within the U.S., every 50 basis points translates to a global CAG diagnostics return revenue uplift of between a point and a point- and- a- half. That is pretty significant. We're highly motivated to figure out how to do that. I think we shared with the group some potential strategies that we think are very promising. I do think that the tailwinds of an aging pet population, to the earlier part of your question, is going to help a lot because we know just the level of medicalization as a pet ages is substantial. It really steps up.
I would just add that international is, again, significantly earlier in that. Jay shared some of that information on his slide, which is on an international front. We're about 8% of blood work inclusion per clinical visit versus the 20% in the U.S. Again an opportunity for us to continue to partner with our customers and expand the use of diagnostics over time.
Hey, guys, thanks. Mike Ryskin, Bank of America. On the Cancer Dx, the 3,400 clinics purchasing it. Anything you can say in terms of utilization per clinic, if that's still growing or starting to get a sense for how many tests they run a day, a week, a month? How often are they reordering? Just any metrics you can give us on Cancer Dx adoption there. The second one is going to be on the commercial expansion. You talked about a couple of regions internationally, some expansion in the U.S. I think a point you guys have harped on in the past is that our customers do more testing when we call on them more.
As you've got such a big innovation cycle now in terms of inVue Dx, in terms of Cancer Dx, in terms MultiCue Dx, do you feel like maybe you need to do a little bit more commercial expansion than you would have in the past j ust because every salesperson is going to have that much more menu to talk about, you're going to need to shrink their customer base to give them more time to handle that.
Let me take that second part of the question first. We're definitely not done from a commercial expansion standpoint. To your point, broader portfolio of innovation, the need to really, I think, call on more customers. R eally, I think, indicates that we would benefit from international expansions. There's the pace that we're very disciplined. We want to make sure we have all the pieces in place. There's a tendency to think about this as just adding heads. In fact, you need to make sure your reference lab network is built out. You need to make sure your software systems are appropriately localized. You have the right model that's matured in these geographies. There's a practical limit in terms of how fast you could do that. Otherwise, we'd be expanding at 8-10 a year. We're certainly not doing that.
I would say there's a lot of opportunity to continue to drive footprint. Dr. Hunt shared some numbers, and we're about half of where we want to be outside the U.S. That's also a function of utilization and how fast that utilization increases. To the first part of your question in terms of cancer diagnostics usage, we do track that. We haven't shared that yet, just because it's earlier. As you might guess, the aiding diagnosis is where the first focus is, but we're starting to see a shift into inclusion and preventive care. We think a broader menu will accelerate that shift. It's pretty much developing as we thought we would. Customers they order once, then they order again. It builds. It builds steadily over time. That's just the adoption cycle, the long tail you see in this industry.
All signs positive, and we'll share more as time goes on.
Thank you, David Westenberg from Piper Sandler. I want to talk about the European opportunity. I think you had a graph out there that said you're targeting 26% of clinics. I didn't realize how underpenetrated it was, which now makes a lot more sense with that 13%- 16% international CAG growth. I also thought Mike Lane's slides on the margin expansion and reference lab were very interesting, as well as the contribution margin slide that Andrew had. Can you talk about your under penetration in Europe and how that correlates, how that is going to impact margin expansion opportunity, i f that is growing indeed faster I would have to imagine maybe the fixed costs higher there. I just want to think about margin potential between international and U.S. Can you clarify that 26% touch in Europe? Is that actually correlated with market share?
I would assume your market share is actually higher than 26%.
Yes. Just maybe a clarification on that metric. There's a reach-to-revenue metric and there's a reach-to-customer metric. The reach-to-revenue is these are IDEXX customers. Dr. Hunt showed much higher numbers in the 70s with that metric. The reach-to-customer is the overall geography or country market. These may be smaller clinics. They don't use diagnostics as much. Certainly, they're not IDEXX customers. That's the 26%. I think what that indicates is just a much larger opportunity as we expand to really reach the entire market, whether or not they use IDEXX or not. That comes back down to the commercial footprint. It comes back down to really being able to, over time, do what we did in the U.S. and drive diagnostics utilization, which is about a little bit over a third of what we see in the U.S., that much faster level. Did you want to talk about margin?
I'll just hit on the margin piece of this. In terms of what I shared, we really do benefit by having a business that's at scale already. We have an extensive ecosystem both in the U.S. and places like Europe where we can really leverage that infrastructure and continue to grow our gross margins at incremental levels as we grow over time. But again we're not solely focused on just that growth. We want to make sure we keep an operational discipline in place where we're looking for efficiencies. We're leveraging automation, digitization, AI, and creating new capabilities within that infrastructure. We see long-term potential to grow margin overall through gross margins.
Great, thanks, guys. Jon Block at Stifel. I was told to limit it to one. The Cancer Dx TAMs, maybe if you can just share, what are the ASP assumptions behind those? I was just thinking screening would be better. Is it that $15 for screening and higher, $45- $60 for the aiding diagnosis? Maybe if you can clarify that, and I'll keep it to one. Thank you.
It is, and that's going to evolve over time, obviously. It assumes it's based on a certain amount of mix shift between aiding diagnosis and screening. As the panel expands, there's some built-in inflation in there. We haven't broken out all the different elements of the model, but I think the $1.1 billion includes all our cancer diagnostic tests, including pathology, including telemedicine, those pieces. It's the broadest possible look.
The $2.5 billion is a broad number for oncology in general. To Jay's point, we've broken that down for Cancer Dx specifically. We haven't, again, shared all of the details behind that. I think in terms of the pricing, you would see some differential between the screening and the aiding diagnostics based on what we're trying to do from a pricing perspective.
With that, we're out of time, and we're going to conclude the program. Thank you again for joining us, and look forward to following up with you in a number of different forms over time. Thank you again, and have safe travels.