Fresenius Medical Care Reports Strong Third Quarter and Nine Months Results; Improved Guidance for 2009

Summary Third Quarter 2009:

• Net revenue $ 2,889 million + 6%
• Operating income (EBIT) $ 451 million + 7%
• Net income attributable to Fresenius Medical Care AG & Co. KGaA $ 225 million + 9%
• Earnings per share $ 0.76 + 9%

Summary First Nine Months 2009:

• Net revenue $ 8,212 million + 4%
• Operating income (EBIT) $ 1,265 million + 2%
• Net income attributable to Fresenius Medical Care AG & Co. KGaA $ 645 million + 7%
• Earnings per share $ 2.16 + 6%

Bad Homburg, Germany – Fresenius Medical Care AG & Co. KGaA ("the Company" or "FMC AG & Co. KGaA"), the world's largest provider of dialysis products and services, today announced its results for the second quarter and first half of 2009.

Third Quarter 2009:


Revenue

Net revenue for the third quarter of 2009 increased by 6% to $2,889 million (10% at constant currency) compared to the third quarter of 2008. Organic revenue growth worldwide was 8%. Dialysis Services revenue grew by 8% to $2,147 million (10% at constant currency) in the third quarter of 2009. Dialysis Product revenue increased by 2% to $742 million (an increase of 8% at constant currency) in the same period.

North America revenue increased by 10% to $1,950 million. Organic revenue growth was 8%. Dialysis Services revenue grew by 10% to $1,741 million. Average revenue per treatment for the U.S. clinics increased to $348 in the third quarter of 2009 compared to $333 for the same quarter in 2008 and $344 for the second quarter of 2009. This development was mainly based on reimbursement increases and increased utilization of pharmaceuticals. Dialysis Product revenue increased by 14% to $209 million and was led by pharmaceutical sales, especially of the newly licensed intravenous iron products.

International revenue remained nearly unchanged at $939 million, compared to the third quarter of 2008. Based on constant currency, revenue grew by 9%. Organic revenue growth was 7%. Dialysis Services revenue was $406 million, an increase of 2% (+12% at constant currency). Dialysis Product revenue decreased by 2% to $533 million. Product sales grew by 6% based on constant currencies, led by increased pharmaceutical sales and sales of dialyzers.

Earnings

Operating income (EBIT) increased by 7% to $451 million compared to $422 million in the third quarter of 2008, resulting in an operating margin of 15.6%, equal to the operating margin for the third quarter of 2008. Compared to the second quarter of 2009 this represents a 50 basis points improvement. The third quarter operating margin was favorably impacted by an increase in revenue per treatment, an excellent cost management in the U.S. and a decrease in bad debt expenses. The operating margin development was negatively influenced by increased prices for pharmaceuticals, the impact of the launch of a generic version of PhosLo® in the U.S. market and unfavorable exchange rate effects in the International segment.

In North America, the operating margin was unchanged at 16.7%, as in the third quarter of 2008. The margin was favorably impacted by an increase in revenue per treatment, including commercial payor revenue, higher utilization of EPO and Medicare reimbursement increases, an excellent cost management in the U.S. and a decrease in bad debt expenses thanks to higher cash collections on receivables. This was offset by cost increases for pharmaceuticals related to both price and utilization, as well as the impact of the launch of a generic version of PhosLo® in the U.S. market and increased depreciation expense.

In the International segment, the operating margin increased by 60 basis points to 16.7% due to lower production costs resulting from lower prices for raw material and energy as well as economies of scale and lower bad debt expenses, which was partially offset by unfavorable foreign exchange rate effects.

Net interest expense for the third quarter of 2009 was $75 million compared to $87 million in the same quarter of 2008, mainly due to lower short-term interest rates.

Income tax expense was $131 million for the third quarter of 2009 compared to $120 million in the third quarter of 2008, reflecting effective tax rates of 35.0% and 35.7%, respectively.

Net income attributable to FMC AG & Co. KGaA for the third quarter of 2009 was $225 million, an increase of 9%.

Earnings per share (EPS) for the third quarter of 2009 rose by 9% to $0.76 per ordinary share compared to $0.69 for the third quarter of 2008. The weighted average number of shares outstanding for the third quarter of 2009 was approximately 298.3 million shares compared to 297.2 million shares for the third quarter of 2008. The increase in shares outstanding resulted from stock option exercises in the past twelve months.

Cash Flow

In the third quarter of 2009, the Company generated $443 million in cash from operations, an increase of 41% compared to the third quarter of 2008 and representing approximately 15% of revenue. The cash flow performance was positively influenced by increased earnings and a favorable development of the Days Sales Outstanding.

A total of $139 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions was $304 million compared to $155 million in the third quarter of 2008. A total of $26 million in cash was used for acquisitions net of divestitures. Free Cash Flow after acquisitions and divestitures was $278 million compared to $116 million in the third quarter of last year.

Nine Months Ended September 30, 2009:

Revenue and Earnings

Net revenue was $8,212 million, up 4% from the first nine months of 2008. At constant currency, net revenue rose 9%. Organic growth was 8% in the first nine months of 2009.

Operating income (EBIT) increased by 2% to $1,265 million compared to $1,240 million in the first nine months of 2008, resulting in an operating margin of 15.4% compared to 15.7% for the first nine months of 2008. This development was mainly due to higher personnel expenses, price increases for pharmaceuticals including Heparin as well as the impact of the launch of a generic version of PhosLo® in the U.S. market. These effects were partially offset by a strong performance of the dialysis product business, increased commercial payor revenue as well as the effect of cost control measures.

Net interest expense for the first nine months of 2009 was $225 million compared to $252 million in the same period of 2008, mainly due to lower short-term interest rates.

Income tax expense was $345 million in the first nine months of 2009 compared to $357 million in the same period in 2008, reflecting effective tax rates of 33.2% and 36.1%, respectively. Tax expense was positively impacted by a non-recurring revaluation of a tax claim recorded in the second quarter of 2009.

For the first nine months of 2009, net income attributable to FMC AG & Co. KGaA was $645 million, up 7% from the first nine months of 2008.

Earnings per ordinary share rose by 6% to $2.16. The weighted average number of shares outstanding during the first nine months of 2009 was approximately 298.0 million.

Cash Flow

Cash from operations during the first nine months of 2009 was $880 million compared to $716 million for the same period in 2008, representing approximately 11% of revenue. The cash flow generation benefited from increased earnings and the favorable development of the Days Sales Outstanding.

A total of $388 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions for the first nine months of 2009 was $492 million compared to $223 million in the same period in 2008. A total of $57 million in cash was used for acquisitions net of divestitures. Free Cash Flow after acquisitions and divestitures was $435 million compared to $93 million in the first nine months of last year.

Please refer to the attachments for a complete overview on the third quarter and nine months ended September 30, 2009.

Patients – Clinics – Treatments

As of September 30, 2009, Fresenius Medical Care treated 192,804 patients worldwide, which represents a 6% increase compared to the same period last year. North America provided dialysis treatments for 130,522 patients, an increase of 4%. Including 31 clinics managed by Fresenius Medical Care North America, the number of patients in North America was 132,158. The International segment served 62,282 patients, an increase of 10% over last year.

As of September 30, 2009, the Company operated a total of 2,509 clinics worldwide. This is comprised of 1,749 clinics in North America (1,780 including managed clinics), an increase of 5%, and 760 clinics in the International segment, an increase of 11%.

Fresenius Medical Care delivered approximately 21.84 million dialysis treatments worldwide during the first nine months of 2009. This represents an increase of 6% year over year. North America accounted for 14.75 million treatments, an increase of 4%, and the International segment delivered 7.09 million treatments, an increase of 10% over last year.

Employees

As of September 30, 2009, Fresenius Medical Care had 67,245 employees (full-time equivalents) worldwide compared to 63,990 employees as of September 30, 2008. This increase of over 3,200 employees is due to the overall growth in the Company's business.

Debt/EBITDA Ratio

The ratio of debt to Earnings before Interest, Taxes, Depreciation and Amortization (EBITDA) decreased from 2.71 at the end of the third quarter of 2008 to 2.62 at the end of the third quarter of 2009. At the end of 2008, the debt/EBITDA ratio was 2.69.

Rating

In the third quarter of 2009, Standard & Poor's Rating Services continued to rate the Company's corporate credit as ‘BB' with a ‘stable' outlook. Moody's also affirmed its rating of the Company's corporate credit as ‘Ba1' with a ‘stable' outlook. As in the previous quarter, Fitch rates the Company's corporate credit as ‘BB' while revising its outlook from ‘negative' to ‘stable'. For further information on Fresenius Medical Care's credit ratings, maturity profiles and credit instruments, please visit our website at www.fmc-ag.com / Investor Relations / Credit Relations.

Outlook for 2009

For the full year of 2009, the Company now expects to achieve revenue of around $11.2 billion (previously $11.1 billion), an increase of around 8% in constant currency.

Net income attributable to FMC AG & Co. KGaA is now expected to be between $865 million and $890 million in 2009. Previously the Company expected the net income to be in the range of $850 million and $890 million for the full year 2009.

In addition, the Company expects to spend $550 to $650 million on capital expenditures and $200 to $250 million (previously $200 to $300 million) on acquisitions. The projected debt/EBITDA ratio has been retained unchanged at below 2.7.

Ben Lipps, Chief Executive Officer of Fresenius Medical Care, said: "We are very pleased with our results in the third quarter of 2009, which reflects an excellent performance by all regions. While we maintained our increased commitment to research and development, our sustained high organic growth globally and good cost containment accounted for this overall successful operating performance. The free cash flow for the third quarter exceeded our expectations and resulted from excellent cash collections in North America. Our strong performance in the quarter provides the basis for us to improve our guidance for the full year 2009."

Conference Call

Fresenius Medical Care will hold a conference call to discuss the results of the third quarter and the first nine months of 2009 on Tuesday, November 03, 2009, at 3:30 pm CET / 9:30 am EST. The Company invites analysts and investors to listen to the live webcast of the call at the Company's website www.fmc-ag.com / Investor Relations / Presentations. A replay will be available shortly after the call.