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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23. MANDATORY EXCHANGEABLE BONDS

To finance the acquisition of APP, Mandatory Exchangeable Bonds (MEB) in an aggregate nominal amount of € 554.4 million were launched. Fresenius Finance B.V. subscribed for these MEB issued by Fresenius Finance (Jersey) Ltd. at 100% of their principal amount. Afterwards, the MEB were on-lent to Fresenius SE who placed the MEB in the market. The bonds carry a coupon of 55/8% per annum and will mature on August 14, 2011. Upon maturity, the bonds will be mandatorily exchangeable into ordinary shares of FMC-AG &Co. KGaA with a maximum of 16.80 million and a minimum of 14.24 million shares being deliverable, subject to antidilution adjustments with respect to FMC-AG & Co. KGaA (e.g. in case of corporate actions). The MEB are not redeemable in cash.

The initial minimum exchange price was set to € 33.00 and the initial maximum exchange price was set to € 38.94 (i.e. 118% of the initial minimum exchange price). Pursuant to the terms and conditions of the MEB, both the holder and the issuer may procure for the exchange of the bonds before maturity. In principal, the issuer, Fresenius Finance (Jersey) Ltd., may procure the exchange of all of the outstanding MEB for shares of FMC-AG & Co. KGaA at the maximum exchange ratio calculated on the relevant exchange date plus payment of any accrued and unpaid interest and a makewhole amount. Furthermore, the MEB shall be mandatorily exchangeable at the maximum exchange ratio plus such payments if the corporate credit ratings of Fresenius SE fall below certain benchmarks and such benchmarks are subsequently not reinstated. Moreover, in the event of a change of control of Fresenius SE or FMC-AG & Co. KGaA, each holder of the MEB may elect to exchange its MEB at the maximum exchange ratio plus such payments. Each holder of the MEB may also exchange his MEB at the minimum exchange ratio calculated on the relevant exchange date without payment of accrued interest or any make-whole amount.

Fresenius SE guarantees in favor of Fresenius Finance (Jersey) Ltd. the payment of certain interest payments by Fresenius Finance B.V. Furthermore, it secures the delivery of the underlying shares of FMC-AG & Co. KGaA for exchange via a pledge agreement. In addition, Fresenius SE has undertaken to the holders of the bonds that neither it nor any of its material subsidiaries provides any security of its assets for certain capital market indebtedness, without at the same time having the holders share equally and rateably in such security.

The derivative financial instruments embedded in the MEB are measured at fair value and are shown separately under the balance sheet item prepaid expenses and other current assets.