Fresenius Medical Care Fresenius Kabi Fresenius Helios 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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Home arrow Consolidated Financial Statements arrow Notes arrow General Notes arrow 2. Acquisitions and divestitures

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2. ACQUISITIONS AND DIVESTITURES

ACQUISITIONS AND DIVESTITURES

The Fresenius Group made acquisitions of € 3,853 million and € 618 million in 2008 and 2007, respectively. Of this amount, € 3,053 million were paid in cash and € 800 million were assumed obligations in 2008.

Fresenius Medical Care

In the year 2008, acquisition spending of Fresenius Medical Care in an amount of € 220 million related mainly to the purchase of dialysis clinics and license agreements. In July 2008, Fresenius Medical Care entered into license and distribution agreements to market and distribute intravenous iron products. For further details on these license and distribution agreements, please see Note 18, Goodwill and other intangible assets.

Fresenius Medical Care made acquisitions of € 262 million in 2007. The main acquisition took place on November 26, 2007, as Fresenius Medical Care completed the acquisition of all of the common stock of Renal Solutions, Inc., (RSI), an Indiana corporation with principal offices in Warrendale, Pennsylvania, United States. The RSI acquisition agreement provided for total consideration of up to US$ 204 million, consisting of US$ 20 million, previously advanced to RSI in the form of a loan, US$ 100 million paid at closing, US$ 60 million paid in November 2008, US$ 3 million receivable related to a working capital adjustment, which was received in 2008, and up to US$ 30 million in milestone payments over a three year period contingent upon the achievement of certain performance criteria, none of which were due or paid in 2008. In 2007, Fresenius Medical Care recorded a liability of US$ 27.4 million representing the net present value of the US$ 30 million milestone payments as it was deemed beyond reasonable doubt that the future performance criteria would be achieved. Furthermore, acquisitions of € 115 million were mainly attributable to the purchase of dialysis centers.

Fresenius Medical Care sold the perfusion business unit of Fresenius Medical Care Extracorporeal Alliance (FMCEA) during the second quarter of 2007. In 2006, FMCEA’s perfusion business contributed revenue of approximately € 83 million. The US perfusion business was deconsolidated effective May 9, 2007.

Fresenius Kabi

Acquisitions in 2008
In the year 2008, Fresenius Kabi spent € 3,612 million which mainly referred to the acquisitions of APP Pharmaceuticals, Inc. (APP), United States, and Dabur Pharma Ltd., India. 

    Acquisition of APP Pharmaceuticals, Inc.
In July 2008, Fresenius Kabi has signed definitive agreements to acquire 100% of the share capital of APP. APP is a leading manufacturer of intravenously administered generic drugs (IV generics) in North America. Through the acquisition of APP, Fresenius Kabi enters the US pharmaceuticals market and achieves a leading position in the global IV generics market. APP focuses on IV generics for hospital use and distributes its products in the US and Canada. The company employs around 1,400 people and has modern production facilities in Illinois, New York and Puerto Rico as well as a distribution company in Toronto, Canada. In 2008, APP achieved sales of US$ 777 million and an adjusted EBITDA of US$ 317 million.

After receipt of all necessary regulatory approvals and fulfillment of further closing conditions, Fresenius Kabi has completed the acquisition of APP on September 10, 2008. APP shareholders received a Cash Purchase Price of US$ 23.00 per share. Based on the Cash Purchase Price, the transaction values the fully diluted equity capital of APP at approximately US$ 3.7 billion. Furthermore, the shareholders received a registered and tradable Contingent Value Right (CVR) that could deliver up to US$ 6.00 per share additionally, payable in 2011, if APP exceeds a cumulative adjusted EBITDA target for 2008 to 2010. In addition, US$ 0.9 billion of net debt was assumed. The net debt was refinanced by the financial instruments described below.

The acquisition was financed with the following mix of debt and equity:

  • Mandatory exchangeable bonds with an aggregate nominal amount of € 554.4 million (US$ 871 million) (see Note 23, Mandatory Exchangeable Bonds)
  • Capital increase in an amount of approximately € 289 million (US$ 453 million) (see Note 27, Shareholders’ Equity)
  • Senior secured credit facilities in an amount of US$ 2.45 billion (see Note 21, Debt and liabilities from capital lease obligations)
  • Bridge Credit Agreement of US$ 1.3 billion  (see Note 21, Debt and liabilities from capital lease obligations)