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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in new markets - Fresenius Medical Care
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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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In procurement management, the quality attributes of the products used are of essential importance. For example, in 2008 HELIOS Kliniken Group sourced new safety syringes for blood collection and vein punctures where, after use, an irreversible guard is automatically fitted over the used syringe, excluding all risk of accidental injury and infection for staff and patients. Statutory regulations only require such safety syringes to be used where the risk of accidental injury from hypodermic needles is particularly high. HELIOS Kliniken Group, however, uses these syringes in all inpatient and working areas.

In 2008, there were further increases in energy and food prices. As a basis for its energy sourcing, HELIOS has created an energy benchmark database that provides transparency for all utilities (electricity, gas/heating oil, heat, water, and waste water) at all clinic locations. Variances in consumption and costs are promptly detected and directly acted upon. HELIOS monitors the price trends on the energy exchanges daily. Because pricing in the energy sector is not determined solely by the actual energy price itself but also by other components such as third-party access fees, HELIOS does not conclude framework agreements for energy supplies. In the second quarter of 2006, HELIOS purchased its electricity for 2007 and 2008. In comparison to what they were when HELIOS contracted, prices rose by over 30% on average. Thanks to the transparency created and to monitoring current price trends, HELIOS is able to take advantage of opportunities to buy energy at the best possible times. For this purpose, HELIOS uses the enPortal online platform with links to about 150 energy utilities in Germany. If HELIOS tags all 57 clinic locations on this platform as buyers of electricity, all potential suppliers can quote within a day for each location. While negotiations without the platform would take about 10 to 12 weeks to complete, HELIOS can conduct the bidding process and the placement of contracts within three to four days.