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

Management Report

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Management Report

Operations and Business Environment

Research and Development

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As of December 31, 2008, 1,562 people were employed in research and development in the Group (2007: 999). Of that number, 427 were employed at Fresenius Medical Care (2007: 357), 1,019 at Fresenius Kabi (2007: 550), and 116 at Fresenius Biotech (2007: 92). The large increase at Fresenius Kabi is mainly due to the first-time consolidation of APP Pharmaceuticals and Dabur Pharma as of September 1, 2008.

The table shows a historical comparison of R & D expenditure and the number of employees working in R & D:

	2008	2007	2006	2005	2004
R & D expenses (in million €)	207*	184	167	149	133
R & D employees	1,562	999	911	856	819

Our main research sites are in Europe. Production-related research is also carried out in the United States and in China. Our research and development projects are mainly conducted in-house; external research is commissioned only on a limited scale.

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