Fresenius Medical Care Fresenius Kabi Fresenius Helios Fresenius Vamed
in new markets - Fresenius Medical Care
for further growth - Fresenius Kabi
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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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bb) Use of estimates

The preparation of consolidated financial statements in conformity with US GAAP requires the management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

cc) Receivables management

The entities of the Fresenius Group perform ongoing evaluations of the financial situation of their customers and generally do not require a collateral from the customers for the supply of products and provision of services. Approximately 21% and 22% of the Fresenius Group’s sales were earned and subject to the regulations under governmental health care programs, Medicare and Medicaid, administered by the United States government in 2008 and 2007, respectively.

dd) Recent pronouncements

In December 2007, the Financial Accounting Standards Board (FASB) issued Statement No. 160, Noncontrolling Interests in Consolidated Financial Statements – an amendment of ARB No. 51 (FAS 160), which establishes a framework for reporting of noncontrolling or minority interests, the portion of equity in a subsidiary not attributable, directly or indirectly, to a parent. FAS 160 is effective for financial statements issued for fiscal years beginning on or after December 15, 2008. Earlier adoption is prohibited. The Fresenius Group will adopt this standard as of January 1, 2009.

In December 2007, FASB issued Statement No. 141 (revised), Business Combinations (FAS 141(R)). This Statement replaces FASB Statement No. 141, Business Combinations and retains the fundamental requirements in Statement 141 that the acquisition method of accounting (which Statement 141 called the purchase method) be used for all business combinations and for an acquirer to be identified for each business combination. This Statement defines the acquirer as the entity that obtains control of one or more businesses in the business combination and establishes the acquisition date as the date that the acquirer achieves control.

In general, the main points of this Statement are that the assets acquired, liabilities assumed and non-controlling interests in the acquiree are stated at fair value as of the date of acquisition, that assets acquired and liabilities assumed arising from contractual contingencies are recognized as of the acquisition date, measured at their acquisition date fair values and that contingent consideration is recognized at the acquisition date, measured at its fair value at that date.

This Statement applies prospectively to business combinations for which the acquisition date is on or after the beginning of the first annual reporting period beginning on or after December 15, 2008. An entity may not apply it before that date. The effective date of this Statement is the same as that of the related FAS 160. The Fresenius Group will adopt this standard as of January 1, 2009.

In March 2008, FASB issued Statement No. 161, Disclosures about Derivative Instruments and Hedging Activities – an amendment of FASB Statement No. 133 (FAS 161). This Statement changes the disclosure requirements for derivative instruments and hedging activities. Entities are required to provide enhanced disclosures about (a) how and why an entity uses derivative instruments, (b) how derivative instruments and related hedged items are accounted for under FAS 133 and its related interpretations, and (c) how derivative instruments and related hedged items affect an entity's financial position, financial performance, and cash flows.

The requirements of this Statement are effective for financial statements issued for fiscal years and interim periods beginning after November 15, 2008, with early application encouraged. This Statement encourages comparative disclosures for earlier periods at initial adoption. The Fresenius Group will adopt this standard as of January 1, 2009 and will implement its disclosure requirements in 2009.