Fresenius Medical Care Fresenius Kabi Fresenius Helios Fresenius Vamed
in new markets - Fresenius Medical Care
for further growth - Fresenius Kabi
for better health - Fresenius Helios
for greater efficiency - Fresenius Vamed
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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%
 

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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%
 

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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
 

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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
 

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PROCUREMENT

An efficient management of the value chain is important for Group profitability. Global procurement management, which assures the availability of goods and services as well as the consistent quality of the materials used in production, is a key element. In an environment characterized by ongoing cost containment pressure from health insurers as well as price pressure, security of supply and quality play a crucial role. For this reason we are constantly striving to optimize our procurement processes, to tap new procurement sources, and to achieve the best possible pricing structures while remaining flexible and maintaining our strict quality and safety standards.

Within the Fresenius Group global procurement is coordinated centrally, enabling us to bundle similar requirements and negotiate global framework agreements. These central coordinating offices organize purchases for the production sites and arrange comprehensive quality and safety checks of purchased materials and goods. Current market and price developments are analyzed on an ongoing basis. In 2008, the cost of raw materials and supplies and purchased components and services was € 4,204 million (2007: € 3,769 million).

in million € 2008 2007
Cost of raw materials and supplies 3,668 3,266
Cost of purchased components and
services
536 503
Total 4,204 3,769
   

Fresenius Medical Care

Fresenius Medical Care countered the increased purchasing prices in 2008 by bundling requirements, with a great many raw and other input materials being standardized across regions. We also stepped up our sourcing in regions with for us favorable currency exchange rates. In North America, the financial and economic crisis led in part to significantly higher price demands from suppliers. We are seeking additional suppliers to fuel competition for our procurement volumes. In 2008, we further optimized our procurement processes in the United States in order to achieve cost reductions. Outside the United States, in the International segment, the “Purchasing Excellence” initiative was continued. The aim of this initiative is in Europe to centralize the sourcing processes more strongly and rationalize them in order to save costs. For items purchased in very large quantities such as polysulphone, the material from which the fibers used in our dialyzers are made, we searched intensively for second suppliers in 2008 so as to additionally secure our supplies.

Fresenius Kabi

Fresenius Kabi’s purchasing power was further strengthened by the acquisitions in 2008. The supplier portfolio was also optimized, and product specifications were increasingly standardized. In addition, long-range sourcing strategies have been devised that improve Fresenius Kabi’s purchasing position in relevant markets.

To counter increases in raw materials and energy prices, Fresenius Kabi began extending the global bundling of requirements early on, also acting in coordination with other Fresenius companies. A focus in 2008 was on synergy projects, e. g. for dextrose derived from corn and for process filters used in the production of infusion solutions. Fresenius Kabi uses processed products derived from raw materials of agricultural origin – both milk and corn – in its infusion therapies and enteral nutrition. The price of corn, which is used as a basic raw material for various processed products, rose strongly at times in the course of 2008. Following large price increases for processed milk products, supply grew in 2008. As a result of this development, Fresenius Kabi was able to enhance its negotiating results. A bidding process was developed together with Fresenius Medical Care for joint requirements in the area of solution filters. This will take effect in 2009.