in new markets - Fresenius Medical Care

for further growth - Fresenius Kabi

for better health - Fresenius Helios

for greater efficiency - Fresenius Vamed

Seizing opportunities > in new markets

Asia is an important growth market for Fresenius Medical Care. Approximately 620,000 patients with chronic kidney failure are currently being treated in this region, and every year this number increases by about 10 to 11%. We will continue to take advantage of this growth potential. The significant demand for dialysis services offers substantial opportunities to expand our network of clinics in the Asian countries.

In 2008, Fresenius Medical Care achieved sales of US$ 606 million in the Asia-Pacific region. Our goal is to continue our strong organic growth and to increase sales to more than US$ 800 million in constant currency by 2010.

FRESENIUS MEDICAL CARE IN ASIA
	2008	2007	Change
Sales (in million US$)	606	541	12%
Employees (December 31)	3,558	3,095	15%
Dialysis patients (December 31)	9,158	7,789	18%
Dialysis treatments (million)	1.34	1.21	11%
Dialysis clinics (December 31)	125	105	19%

in new markets - Fresenius Medical Care

Seizing opportunities > for further growth

With the acquisition of APP Pharmaceuticals, Fresenius Kabi has achieved a leading position in the global market for intravenously administered generic drugs. APP Pharmaceuticals has a strong drug registration portfolio pending and over 70 products under development, opening up new growth opportunities.

At the same time, we are seizing the opportunity of introducing selected Kabi products into the US, with initial focus on parenteral nutrition. We are also planning to launch selected APP IV drugs outside the US.

APP PHARMACEUTICALS IN FIGURES
	2008
Sales	US$ 777 million
EBITDA, adjusted*	US$ 317 million
EBITDA margin, adjusted*	40.8%
Employees (December 31, full-time equivalent)	1,487
Production facilities	3
Produkte	>100
Number of products	~17%

Seizing opportunities > for better health

At Fresenius Helios, our commitment is to provide the highest medical quality and care. We aim to offer advanced and proven best-in-class diagnosis and treatment methods for the benefit of our patients. We continuously invest in high-quality, state-of-the-art medicine, and aim to measure and improve the quality of medical care.

Our target ist that our quality indicators should be better than the German average. With a mortality rate of SMR < 1, this was accomplished, among others, for major illnesses shown below.

HELIOS QUALITY INDICATORS
Indications/ standardized mortality rate (SMR)*	2008 SMR	2007 SMR
Acute myocardial infarction	0.73	0.79
Heart failure	0.73	0.85
Stroke	0.83	1.01
Acute cerebral infarction	0.81	0.99
Pneumonia	0.71	0.85

Seizing opportunities > for greater efficiency

Fresenius Vamed is a leading international provider of services in the planning, construction, and management of health care facilities. Our complete value chain and our more than 25 years of international experience are key to providing effective support for hospitals at every stage of their life cycle, and thus contributing towards their successful operating performance. For us, each project is another opportunity to prove our competence.

Hospitals face the dual challenge of increasing efficiency and reducing expenditure. We support hospitals by offering comprehensive process know-how and by taking over medical-technical services and management functions.

VAMED SERVICES

Service contracts* for	140 clinics
	~ 50,000 beds
among others:
Vienna General Hospital and University Clinics (AKH)	~ 2,100 beds
Charité Hospital Berlin	~ 3,200 beds
University Clinic Hamburg-Eppendorf	~1,370 beds
Prince Court Medical Center, Kuala Lumpur	~ 330 beds
Al Ain Hospital, Abu Dhabi	~ 450 beds

READ MORE ABOUT FRESENIUS VAMED >>

for greater efficiency - Fresenius Vamed

Fresenius Group

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Fresenius Group

To our Shareholders

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Dr. Ulf M. Schneider

To Our Shareholders:

We seized our opportunities in the past year, expanding our business with confidence and determination. Fresenius Kabi was our main focus. With the acquisition of APP Pharmaceuticals, Fresenius Kabi gained a leading global position in the field of generic IV drugs. In addition, APP Pharmaceuticals provides Fresenius Kabi with a North American platform for its product portfolio, offering attractive mid-term growth opportunities. The APP Pharmaceuticals acquisition is the latest move in a series of significant strategic initiatives – such as the acquisition of the German hospital operator HELIOS Kliniken in 2005 and the US dialysis provider Renal Care Group in 2006..

Our other business segments also took full advantage of their business opportunities in 2008. Fresenius Medical Care continued its growth strategy in renal pharmaceuticals, broadening its product range with the addition of IV iron formulations. Fresenius Helios was a leading player in the German hospital privatization process and acquired six new clinics. Fresenius Vamed successfully leveraged its expertise in hospital projects and services, winning important new contracts.

Opportunities for growth are not only offered by acquisitions. Cutting-edge products and services, uncompromising quality, and international expansion help to improve the level of medical care for our patients around the globe. They also provide significant opportunities for organic growth. We present some of these opportunities in this annual report.

In addition to our significant strategic steps, we achieved excellent financial results in the past year. Sales grew to € 12.3 billion, an increase of 13 percent in constant currency. We saw outstanding organic growth in all our business segments. Net income before special items relating to the acquisition of APP Pharmaceuticals also increased by 13 percent in constant currency to € 450 million. Fresenius coped very well with the challenging business environment in 2008 and I would like to sincerely thank the Group’s employees for their achievements, exceptional commitment, and hard work.

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