Fresenius Medical Care AG & Co. KGaA ("the Company"), the world's largest provider of Dialysis Services and Products, today announced that Lawrence A. Rosen will resign as Member of the Management Board of Fresenius Medical Care and Chief Financial Officer (CFO) to pursue other opportunities outside the company. Mr. Rosen will continue in his position with Fresenius Medical Care for the time necessary to ensure a smooth transition of the CFO responsibilities. Lawrence A. Rosen has been CFO of Fresenius Medical Care since November 2003. Fresenius Medical Care expects to name a new Chief Financial Officer soon.

"We thank Larry for his significant contributions to our company and wish him all the best for his new position," said Dr. Ben Lipps, Chief Executive Officer of Fresenius Medical Care and Chairman of the Management Board. "Fresenius Medical Care continues to have a very strong financial position and Cash Flow generation and only minor long-term refinancing needs before 2011. We expect to continue with our strong business performance across all segments and regions for the year 2009."

The European Commission has approved Removab (catumaxomab) for the treatment of malignant ascites with immediate effect. It is the first drug worldwide with a regulatory label for the treatment of malignant ascites and provides an important new therapy approach. The approval is based on the results of a large international phase II/III pivotal study which demonstrated a statistically significant improvement of the primary endpoint puncture-free survival. Patients receiving Removab had a four-fold increase in puncture-free survival over a therapy with puncture alone.

The European Commission's decision will apply to all EU member states. Removab will initially be launched in Germany within the next few weeks and will subsequently be introduced in other European countries. With its trifunctional mode of action Removab represents a new generation of antibodies using the body's own immune system to help fight the tumor cells. It is approved for the treatment of malignant ascites in patients with EpCAM positive carcinomas where standard therapy is not available or no longer feasible. The antibody will be administered as four intraperitoneal infusions with ascending doses following a paracentesis.

Malignant ascites is most common in ovarian, pancreatic and gastric cancers with an incidence of 20 to 50% of all cases. Malignant ascites develops late in the course of the cancer disease and regularly has a strong impact on the patient's quality of life. Removab effectively destroys cancer cells in the peritoneal cavity and therefore attacks the primary cause of ascites formation leading to a significant improvement in the quality of life.



About the Pivotal Study
The study involved 258 patients with malignant ascites due to carcinomas. Of those, 129 suffered from ovarian cancer while another 129 had non-ovarian cancers.
Patients received paracentesis followed by four intraperitoneal infusions of Removab within 11 days, or paracentesis alone (control group).
The trial met its primary endpoint with high statistical significance. Patients treated with Removab showed a median puncture-free survival (primary endpoint) of 46 days compared with 11 days in the control group (p< 0.0001) (Hazard Ratio: 0.254). Puncture-free survival was defined as the period between the last infusion and the first subsequent necessary paracentesis or death, whichever occurred first. The median puncture-free time – a secondary endpoint which did not include the data from patients who died before the next ascites puncture was due – was 77 days versus 13 days (p< 0.0001).

The most common side effects observed during the trial, such as fever, nausea and vomiting were all due to Removab's postulated mode of action. These side effects were predictable, limited, manageable and mostly fully transient.

Malignant Ascites
Malignant ascites can be caused by different carcinomas. Abdominal spread of cancer cells leads to an accumulation of fluid in the abdominal cavity and is associated with a poor prognosis. The most commonly used treatment of malignant ascites is puncture (paracentesis), which has to be carried out on average every one to two weeks and can lead to complications such as infection and fluid or protein deprivation. The trifunctional antibody Removab is known to kill cancer cells in the peritoneal cavity and therefore attacks the primary cause of ascites formation.
The most common carcinomas causing malignant ascites are: ovarian, gastric, colorectal, pancreatic, breast and endometrial.

Epithelial Cell Adhesion Molecule (EpCAM)
EpCAM is a tumor associated antigen expressed on the vast majority of carcinomas (epithelial tumors). EpCAM is expressed on tumor cells in the majority of effusions (ascites) due to carcinomas.

Trifunctional Antibody Removab® (catumaxomab)
Removab with its trifunctional mode of action represents the first antibody of a new generation. The therapeutic objective of Removab is to generate a stronger immune reaction against cancer cells. Removab binds to three different cell types simultaneously: One arm of the antibody recognizes and binds to T cells, the other arm binds EpCAM (epithelial cell adhesion molecule) that is expressed in many types of carcinomas. In addition, immune effector cells with Fc receptors (such as macrophages, monocytes, dendritic cells and natural killer cells) bind to the Fc region of Removab. This simultaneous binding subsequently results in the co-stimulation and activation of T cells and accessory cells, enabling the generation of a strong immune response against cancer cells.
Preclinical data for trifunctional antibodies also suggest a potential long-lasting effect to prevent cancer recurrence. Removab is further developed in various indications (e.g. gastric and ovarian cancer) addressing the underlying cancer.
Catumaxomab is a trifunctional antibody licensed from TRION Pharma GmbH.

Summary First Quarter 2009:

• Net revenue: $ 2,560 million, + 2%
• Operating income (EBIT): $ 396 million, + 2%
• Net income attributable to Fresenius Medical Care AG & Co. KGaA: $ 198 million, + 7%
• Earnings per share: $ 0.67, + 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 first quarter of 2009.

Revenue
Net revenue for the first quarter of 2009 increased by 2% to $2,560 million (8% at constant currency) compared to the first quarter of 2008. Organic revenue growth worldwide was 8%. Dialysis services revenue grew by 4% to $1,923 million (8% at constant currency) in the first quarter of 2009. Dialysis product revenue decreased by 5% to $637 million (an increase of 8% at constant currency) in the same period.

North America revenue increased by 6% to $1,774 million. Dialysis services revenue grew by 5% to $1,577 million. Average revenue per treatment for the U.S. clinics was $338 in the first quarter of 2009 compared to $326 for the first quarter of 2008 and $335 for the fourth quarter of 2008. This development was based on an increase in underlying reimbursement rates and stable EPO utilization. Dialysis product revenue increased by 14% to $197 million and was led by sales of the newly licensed intravenous iron products and strong sales of the 2008K hemodialysis machines.

International revenue was $786 million, a decrease of 7% (an increase of 11% at constant currency) compared to the first quarter of 2008. Dialysis services revenue reached $346 million, a decrease of 1% (an increase of 18% at constant currency). Dialysis product revenue decreased by 11% to $440 million. Sales grew by 6% based on constant currencies, led by strong pharmaceutical sales and sales of products for acute care treatments.

Earnings
Operating income (EBIT) increased by 2% to $396 million compared to $389 million in the first quarter of 2008. Operating margin remained unchanged at 15.5% in the first quarter of 2009 compared to the first quarter of 2008.

In North America, the operating margin decreased by 110 basis points from 16.4% to 15.3% in the first quarter of 2009 primarily due to higher personnel expenses, increased pharmaceutical costs and the impact of one less dialysis day in the first quarter of 2009 compared to the first quarter of 2008. These effects were partially offset by increased dialysis treatment rates and sales of the newly licensed intravenous iron products.

In the International segment, the operating margin increased by 170 basis points to 18.7% due to reduced manufacturing costs and operating expenses.

Net interest expense for the first quarter of 2009 was $74 million compared to $83 million in the same quarter of 2008. This positive development was mainly attributable to lower short term interest rates.

Income tax expense was $116 million for the first quarter of 2009 nearly equal to the first quarter of 2008, reflecting effective tax rates of 35.9% and 37.3%, respectively.

Net income attributable to FMC AG & Co. KGaA for the first quarter of 2009 was $198 million, an increase of 7%.

Earnings per share (EPS) for the first quarter of 2009 rose by 6% to $0.67 per ordinary share compared to $0.63 for the first quarter of 2008. The weighted average number of shares outstanding for the first quarter of 2009 was approximately 297.7 million shares compared to 296.6 million shares for the first quarter of 2008. The increase in shares outstanding resulted from stock option exercises in 2008 and in the first quarter of 2009.

Cash Flow
In the first quarter of 2009, the Company generated $156 million in cash from operations, representing approximately 6% of revenue. The cash flow generation benefited from a decrease in Days Sales Outstanding (DSO) in the first quarter of 2009 compared to the fourth quarter of 2008 of two days but was negatively affected by higher other working capital requirements.

A total of $111 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions was $45 million compared to $39 million in the first quarter of 2008. A total of $36 million in cash was used for acquisitions net of divestitures. Free Cash Flow after acquisitions and divestitures was $9 million compared to $6 million in the first quarter of last year.


Patients – Clinics – Treatments
As of March 31, 2009, Fresenius Medical Care treated 187,476 patients worldwide, which represents a 6% increase in patients compared to the same period last year. North America provided dialysis treatments for 127,121 patients, an increase of 4%. Including 31 clinics managed by Fresenius Medical Care North America, the number of patients in North America was 128,763. The International segment served 60,355 patients, an increase of 11% over last year.

As of March 31, 2009, the Company operated a total of 2,448 clinics worldwide. This is comprised of 1,714 clinics in North America (1,745 including managed clinics), an increase of 5%, and 734 clinics in the International segment, an increase of 12%.

Fresenius Medical Care delivered approximately 7.04 million dialysis treatments worldwide during the first quarter of 2009. This represents an increase of 5% over the same quarter last year. North America accounted for 4.74 million treatments, an increase of 2%, and the International segment delivered 2.30 million treatments, an increase of 11%.

Employees
As of March 31, 2009, Fresenius Medical Care had 65,670 employees (full-time equivalents) worldwide compared to 64,666 employees at the end of 2008. The increase of approximately 1,000 employees is primarily due to 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 2.82 at the end of the first quarter of 2008 to 2.64 at the end of the first quarter of 2009. At the end of 2008, the debt/EBITDA ratio was 2.69.

Refinancing of Notes
On April 27, 2009, the Company issued euro denominated notes totaling €200 million in anticipation of retiring the existing €200 million Euro Notes issued in 2005 which are due in July 2009. The newly issued Euro Notes consist of 4 tranches having terms of 3.5 and 5.5 years with floating and fixed interest rate tranches. The initial average interest rate is 6.95%.

Rating
There have been no rating changes in the first quarter of 2009, Standard & Poor's Rating Services rates the Company's corporate credit as ‘BB' with a ‘negative' outlook.

Moody's continued to rate the Company's corporate credit as ‘Ba1' with a ‘stable' outlook.

Fitch rates the Company's corporate credit as ‘BB' with a ‘negative' outlook.


Outlook for 2009 fully confirmed
For the full year 2009, the Company expects to achieve revenue of more than $11.1 billion, which is more than 8% growth in constant currency.

Net income attributable to FMC AG & Co. KGaA is expected to be between $850 million and $890 million in 2009.

In addition, the Company expects to spend $550 to $650 million on capital expenditures and $200 to $300 million on acquisitions. The debt/EBITDA ratio is projected to remain below 2.7.


Ben Lipps, Chief Executive Officer of Fresenius Medical Care, commented: "We are pleased to have a strong start into the year, which is fully in line with our guidance for 2009. We have made good progress in 2009 despite the 2008 cost increases, which we are attempting to mitigate, and the volatile currency environment. Our underlying business continues at its excellent 8% organic growth rate. Our global expansion of products and services is on target and we are confident that we will achieve our targets in 2009."

Conference Call
Fresenius Medical Care will hold a conference call to discuss the results of the first quarter of 2009 on Thursday, April 30, 2009, at 3.30 p.m. CEDT / 9.30 a.m. EDT. The Company invites journalists 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 meeting.

• Sales: € 3.4 billion, +21 % at actual rates, +15 % in constant currency
• EBIT: € 477 million, +27 % at actual rates, +20 % in constant currency
• Adjusted net income*: € 110 million, +10 % at actual rates, +6 % in constant currency

• Strong sales and earnings growth
• Positive impact of currency translation
• All business segments fully on track - guidance for 2009 confirmed

*Net income attributable to Fresenius SE; adjusted for the effects of mark-to-market accounting of the Mandatory Exchangeable Bonds (MEB) and the Contingent Value Rights (CVR) relating to the acquisition of APP Pharmaceuticals.

Group outlook for 2009 confirmed
Based on the Group's strong first quarter financial results Fresenius fully confirms its positive outlook for 2009. Group sales are expected to grow by more than 10 % in constant currency. Organic growth is projected to be in a 6 to 8 % range. Adjusted net income1 is expected to increase by approximately 10 % in constant currency.

Fresenius plans to invest € 700 to 750 million in property, plant and equipment (2008: € 764 million).

Strong sales growth across all business segments
Group sales increased by 15 % in constant currency and by 21 % at actual rates to € 3,373 million (Q1 2008: € 2,798 million). Organic sales growth was 8 %. Acquisitions contributed a further 7 %. Currency translation had a positive impact of 6 %. This is mainly attributable to the average US dollar rate improving 13 % against the euro.

Sales growth in the business segments was as follows:

In Europe sales grew by 12 % in constant currency with organic sales growth contributing 8 %. In North America sales grew by 18 % in constant currency. Organic growth was 7 %. The strong increase in constant currency sales is mainly due to the consolidation of APP Pharmaceuticals from September 2008. Acquisitions contributed 11 %. Strong organic growth rates were achieved in the emerging markets, reaching 16 % in Asia-Pacific and 14 % in Latin America.

Strong earnings growth
Group EBITDA increased by 21 % in constant currency and by 27 % at actual rates to € 613 million (Q1 2008: € 483 million). Group operating income (EBIT) grew by 20 % in constant currency and by 27 % at actual rates to € 477 million (Q1 2008: € 377 million). The Group's EBIT margin was 14.1 % (Q1 2008: 13.5 %).

Group net interest was € -145 million (Q1 2008: € -84 million). Lower average interest rates on liabilities of Fresenius Medical Care were more than offset by incremental debt relating to the acquisitions of APP Pharmaceuticals and Dabur Pharma and currency translation effects.

The other financial result was € 77 million and includes valuation changes of the fair redemption value of both the Mandatory Exchangeable Bonds (MEB) and the Contingent Value Rights (CVR).

The Group tax rate was 33.4 % (Q1 2008: 35.2 %).

Noncontrolling interest increased to € 111 million (Q1 2008: € 90 million), of which 93 % was attributable to the noncontrolling interest in Fresenius Medical Care.

Adjusted net income1 grew by 6 % in constant currency and by 10 % at actual rates to € 110 million (Q1 2008: € 100 million). Both adjusted earnings per ordinary share and adjusted earnings per preference share increased to € 0.68 (Q1 2008: ordinary share € 0.64, preference share € 0.64). This represents an increase of 3 % for both share classes in constant currency.

Reconciliation to net income according to US GAAP
The Group's US GAAP quarterly financial results as of March 31, 2009 include the effects of mark-to-market accounting of the Mandatory Exchangeable Bonds (MEB) and the Contingent Value Rights (CVR) relating to the acquisition of APP Pharmaceuticals. Those special items are recognized in the financial result of the "Corporate/Other" segment. Adjusted earnings represent the Group's business operations in the reporting period.

The table reconciles adjusted net income to net income according to US GAAP in the first quarter of 2009:

Both the Mandatory Exchangeable Bonds and the Contingent Value Rights are viewed as liabilities and therefore recognized with their fair redemption value. Valuation changes will lead to gains or expenses on a quarterly basis until maturity of the instruments.

Net income* (including special items) was € 164 million or € 1.02 both per ordinary share and per preference share.

Net income attributable to Fresenius SE.

Continued investments in growth
Fresenius Group spent € 128 million for property, plant and equipment (Q1 2008: € 154 million). Acquisition spending was € 112 million (Q1 2008: € 216 million).

Cash flow development
Operating cash flow of € 182 million was below previous year's € 278 million mainly due to an increase of inventories. Net capital expenditure was € 147 million (Q1 2008: € 161 million). Cash flow before acquisitions and dividends was € 35 million (Q1 2008: € 117 million).

Balance sheet
Fresenius Group's total assets increased by 2 % in constant currency and by 5 % at actual rates to € 21,537 million (December 31, 2008: € 20,544 million). Current assets increased by 5 % in constant currency and by 7 % at actual rates to € 5,436 million (December 31, 2008: € 5,078 million). Non-current assets grew by 1 % in constant currency and by 4 % at actual rates to € 16,101 million (December 31, 2008: € 15,466 million).

Total shareholders' equity increased by 3 % in constant currency and by 6 % at actual rates to € 7,372 million (December 31, 2008: € 6,943 million). The equity ratio (including noncontrolling interest) improved to 34.2 % (December 31, 2008: 33.8 %).

Group debt increased by 2 % in constant currency and by 5 % at actual rates to € 9,199 million (December 31, 2008: € 8,787 million). The acquisition financing of APP Pharmaceuticals was successfully completed in January 2009. As of March 31, 2009, the net debt/EBITDA ratio (pro forma the acquisition of APP Pharmaceuticals and excluding special items) was 3.6 (December 31, 2008: 3.6).

Number of employees increased
As of March 31, 2009, Fresenius increased the number of its employees by 4 % to 126,849 (December 31, 2008: 122,217).


Fresenius Biotech
Fresenius Biotech develops innovative therapies with trifunctional antibodies for the treatment of cancer. In the field of polyclonal antibodies, Fresenius Biotech has successfully marketed ATG-Fresenius S for many years. ATG-Fresenius S is an immunosuppressive agent used to prevent and treat graft rejection following organ transplantation.

On April 22, 2009, the European Commission granted Fresenius Biotech the approval for Removab (catumaxomab) for the treatment of malignant ascites with immediate effect. It is the first drug worldwide with a regulatory label for the treatment of malignant ascites and provides an important new therapy approach. The European Commission's decision will apply to all EU member states. Removab will initially be launched in Germany within the next few weeks and will subsequently be introduced in other European countries.

Fresenius Biotech's EBIT was € -10 million in the first quarter of 2009 (Q1 2008: € -9 million). For 2009, Fresenius Biotech confirms its guidance of an EBIT of € -40 million to € -50 million.


The Business Segments

Fresenius Medical Care
Fresenius Medical Care is the world's leading provider of services and products for patients with chronic kidney failure. As of March 31, 2009, Fresenius Medical Care was treating 187,476 patients in 2,448 dialysis clinics.

• Strong organic sales growth of 8 % achieved
• Outlook 2009 fully confirmed

Fresenius Medical Care achieved sales growth of 2 % to US$ 2,560 million (Q1 2008: US$ 2,512 million). Organic growth was 8 %. Currency translation effects had a negative impact of 6 %. Sales in dialysis services revenue increased by 4 % to US$ 1,923 million (Q1 2008: US$ 1,844 million). In dialysis products sales were US$ 637 million (Q1 2008: US$ 667 million). In constant currency, dialysis products sales increased by 8 %.

In North America sales increased by 6 % to US$ 1,774 million (Q1 2008: US$ 1,668 million). Dialysis services revenue grew by 5 % to US$ 1,577 million. Average revenue per treatment for the U.S. clinics was at US$ 338 in the first quarter of 2009 compared to US$ 326 for the first quarter of 2008 and 335 US$ for the fourth quarter of 2008. This development was based on an increase in underlying reimbursement rates and stable EPO utilization. Sales outside North America ("International" segment) were US$ 786 million (Q1 2008: US$ 844 million). In constant currency, sales growth was 11 %.

EBIT increased by 2 % to US$ 396 million (Q1 2008: US$ 389 million) resulting in an EBIT margin of 15.5 % (Q1 2008: 15.5 %). The margin development mainly reflects higher personnel expenses, increased pharmaceutical costs and the impact of one less dialysis day in the first quarter of 2009 compared to the first quarter of 2008. These effects were partially offset by increased dialysis treatment rates and sales of the newly licensed iron products. Net income* increased by 7 % to US$ 198 million (Q1 2008: US$ 186 million).

Fresenius Medical Care fully confirms its outlook for 2009: the company expects to achieve revenue of more than US$ 11.1 billion, which is more than 8 % growth in constant currency. Net income* is expected to be between US$ 850 million and US$ 890 million in 2009.

* Net income attributable to Fresenius Medical Care AG & Co. KGaA

For further information, please see Fresenius Medical Care's Press Release at www.fmc-ag.com.  


Fresenius Kabi
Fresenius Kabi offers infusion therapies, intravenously administered generic drugs and clinical nutrition for seriously and chronically ill patients in the hospital and out-patient environments. The company is also a leading provider of medical devices and transfusion technology products.

• Strong sales and EBIT growth
• Outlook 2009 fully confirmed

Fresenius Kabi increased sales by 32 % to € 722 million (Q1 2008: € 545 million). Organic sales growth was 7 %. Net acquisitions contributed 28 % to sales. Currency translation had a net negative impact of 3 %. This was mainly due to the depreciation of currencies in Great Britain, Brazil and South Africa against the euro, whereas positive translation effects resulted from the strengthening of the Chinese yuan.

In Europe, sales reached € 376 million, driven by 5 % organic growth. In North America, sales increased from € 30 million in the first quarter of 2008 to € 168 million in the first quarter of 2009 due to the acquisition of APP Pharmaceuticals. Organic sales growth was 3 %. In the Asia-Pacific region Fresenius Kabi achieved organic sales growth of 10 % to € 111 million. Sales in Latin America and Africa increased to € 67 million, driven by 20 % organic growth.

EBIT grew by 59 % to € 138 million (Q1 2008: € 87 million). EBIT includes a € 7 million non-cash charge related to the amortization of APP intangible assets. The EBIT margin increased to 19.1 % (Q1 2008: 16.0 %). Net interest increased to € 79 million (Q1 2008: € 17 million) due to the acquisition financing. Net income* was € 38 million (Q1 2008: € 46 million).

Sales at APP Pharmaceuticals were US$ 192 million in the first quarter of 2009. Adjusted EBITDA** was US$ 81 million and EBIT was US$ 61 million.

Fresenius Kabi fully confirms its outlook for 2009: the company targets sales growth in constant currency of 25 to 30 %. Further, Fresenius Kabi forecasts an EBIT margin in the range of 19.5 to 20.5 %. Currency translation effects may impact Fresenius Kabi's margin as APP provides a significant earnings contribution from the US$ area. This guidance is based on the US$/€ exchange rate from the beginning of 2009.

Special items relating to the acquisition of APP Pharmaceuticals are included in the segment "Corporate/Other".

* Net income attributable to Fresenius Kabi AG
** Non-GAAP financial measures - Adjusted EBITDA is a defined term in the indenture governing the Contingent Value Rights (CVRs), however it is not a recognized term under GAAP.


Fresenius Helios
Fresenius Helios is one of the largest private hospital operators in Germany. The HELIOS Kliniken Group owns 62 hospitals, including five maximum care hospitals in Berlin-Buch, Erfurt, Krefeld, Schwerin and Wuppertal. HELIOS treats about 600,000 in-patients per year at its clinics and operates a total of more than 18,000 beds.

• Excellent sales and earnings growth
• Outlook 2009 fully confirmed

Fresenius Helios increased sales by 13 % to € 577 million (Q1 2008: € 509 million). Net acquisitions contributed 8 % to overall sales growth. Strong organic growth of 5 % on a like-for-like basis was again driven by a significant increase in patient numbers.

EBIT grew by 16 % to € 44 million (Q1 2008: € 38 million) due to the excellent business operations of the established clinics. The EBIT margin was 7.6 % (Q1 2008: 7.5 %). Net income* improved by 33 % to € 20 million (Q1 2008: € 15 million).

At HELIOS' established clinics, sales rose by 5 % on a like-for-like basis to € 536 million. EBIT improved by 16 % to € 44 million. The EBIT margin increased to 8.2 % (Q1 2008: 7.5 %). The acquired clinics (consolidation <1 year) achieved sales of € 41 million and a marginally negative EBIT.

Fresenius Helios fully confirms its outlook for 2009: the company expects to achieve sales of more than € 2.3 billion. EBIT is projected to increase to € 180 to 200 million.

* Net income attributable to HELIOS Kliniken GmbH


Fresenius Vamed
Fresenius Vamed offers engineering and services for hospitals and other health care facilities.

• Strong order backlog ensures further growth
• Outlook 2009 fully confirmed

Fresenius Vamed achieved strong sales growth of 57 % to € 116 million (Q1 2008: € 74 million). The clinics in the Czech Republic acquired from Fresenius Helios contributed 8 %. Organic sales growth was 49 %. Sales in the project business rose by 94 % to € 68 million (Q1 2008: € 35 million). Sales in the service business increased by 23 % to € 48 million (Q1 2008: € 39 million).

EBIT was € 4 million, unchanged from previous year. Significant sales growth driven by a strong project business in the first quarter of 2009 diluted the EBIT margin to 3.4 %
(Q1 2008: 5.4 %). Net income* of € 4 million was also at previous year's level.

Fresenius Vamed reported an order intake of € 88 million (Q1 2008: € 125 million).

Order backlog increased by 4 % to € 592 million, close to its all-time high of € 595 million in the first quarter of 2008 (December 31, 2008: € 571 million).

Fresenius Vamed fully confirms the outlook for 2009 and expects to achieve both sales and EBIT growth of 5 to 10 %.

* Net income attributable to VAMED AG


Analyst Conference
As part of the publication of the results for first quarter of 2009 a conference call will be held on April 30, 2009 at 2.00 p.m. CEDT (8.00 a.m. EDT). All journalists are cordially invited to follow the conference call in a live broadcast over the Internet at www.fresenius.com see Investor Relations / Presentations. Following the call, a recording will be available.

Fresenius Medical Care, the world's leading provider of products and services for dialysis patients, opened its first Swedish dialysis clinic in Trelleborg. Fresenius Medical Care was selected as the clinic operator by the regional government in Skåne (southern Sweden) during a tender.

"Offering patients the best possible treatment demands the highest quality and efficiency," said Dr. Emanuele Gatti, Chief Executive Officer of Fresenius Medical Care for the regions Europe, Latin America, Middle East and Africa. "We are very pleased that our portfolio convinced the tender committee. Now we cannot only offer innovative technologies but also with our unique treatment concepts our entire dialysis expertise."

The new dialysis clinic was renovated and equipped according to the latest scientific and technical standards in about five months at a cost of around 1.4 million Euro. The approximately 700-square-meter clinic is near the public hospital and can care for up to 40 dialysis patients at its 13 stations. The team – one nephrologist and care personnel – will initially treat about 30 patients.

Fresenius Medical Care plans on opening additional dialysis clinics in Sweden in the mid-term. The Company founded a local subsidiary, Nephrocare Sverige AB, which is based in Sollentuna near Stockholm.

By the end of 2008, around 2.3 million patients received treatment for end stage renal disease around the world. The kidneys of these patients are unable to filter metabolic toxins and excess water from the blood for excretion through the urine. More than 1.7 million patients rely on regular, life-saving dialysis treatment – either at a dialysis clinic or at home – to prevent these toxins from accumulating in the blood and damaging other organs. Sweden currently has about 3,800 dialysis patients.

Fresenius Medical Care will offer patients in Trelleborg hemodialysis, which accounts for about 89 percent of all dialysis therapies worldwide. In hemodialysis, blood is filtered outside the patient's body using an artificial kidney (dialyzer). The patient's circulation is monitored and controlled by a dialysis machine.

Fresenius Medical Care AG & Co. KGaA ("FME"), the world's largest provider of Dialysis Services and Products, today announced, that the United States Attorney's Office for the Eastern District of New York (Brooklyn) has completed its investigation of Fresenius Medical Care's North American subsidiaries. The Office informed FME that no action will be taken against the company and its subsidiaries, including Spectra Renal Laboratories, and Renal Care Group Inc. (RCG), which Fresenius Medical Care acquired by merger on March 31, 2006. No allegations were filed against FME or RCG, nor were any fines, penalties, or changes in policy or business practices requested. Fresenius Medical Care and Renal Care Group both received subpoenas in October 2004. Both companies thereafter cooperated fully with the investigation.

Dr. Ben Lipps, Chief Executive Officer of Fresenius Medical Care and Chairman of the Management Board stated, "We are pleased with the outcome of the investigation and the fact that it is now closed."

Fresenius Medical Care is the world's largest integrated provider of products and services for individuals undergoing dialysis because of chronic kidney failure, a condition that affects more than 1,770,000 individuals worldwide. Through its network of 2,448 dialysis clinics in North America, Europe, Latin America, Asia-Pacific and Africa, Fresenius Medical Care provides dialysis treatment to 187,476 patients around the globe. Fresenius Medical Care is also the world's leading provider of dialysis products such as hemodialysis machines, dialyzers and related disposable products. Fresenius Medical Care is listed on the Frankfurt Stock Exchange (FME, FME3) and the New York Stock Exchange (FMS, FMS/P).

For more information about Fresenius Medical Care visit the Company's website at www.fmc-ag.com.

Fresenius Medical Care AG & Co. KGaA, the world's largest provider of dialysis services and products, has launched a new website focusing on dialysis medications ("renal pharmaceuticals"). At www.fmc-renalpharma.com, doctors as well as patients and the interested public are now able to find information about Fresenius Medical Care's pharmaceutical expertise.

The website provides information about the effectiveness of dialysis medication, proper treatment types, Fresenius Medical Care´s partners and the company itself. In addition, it includes a comprehensive glossary, a space for current news as well as a calendar of trade fairs and other events. The website also offers general information about dialysis medication and related areas of care, providing valuable information to non-specialist individuals. In-depth information about individual dialysis drugs is password protected due to the Medication Advertising Law and is only available to doctors and other medical personnel.

An additional feature of the Renal Pharma website is Dia-PhoCal (also available at www.diaphocal.com). This is an interactive training tool on bone mineral metabolism. Doctors and hospital employees can learn about the interaction between calcium, phosphate, parathormone (which regulates the calcium balance in the blood) and calcitriol (Vitamin D created by the kidneys) in dialysis patients and observe how these parameters in bone metabolism react to the introduction of various drugs. In adherence to Medication Advertising Law, Dia-PhoCal is also protected by a password.

Currently the site is available in English only. In future, further language versions as well as additional information about new products and especially information targeted to patients will be made available.

Fresenius today announced its intention to issue Senior Unsecured Notes through its subsidiary Fresenius Finance B.V., subject to market conditions. The offering is currently anticipated to be €125 million in principal amount. Proceeds of the Notes offering will be used to repay short-term debt of the company.

The Notes are being offered in a private placement and there will be no public offering of the Notes.


About Fresenius SE
Fresenius is a health care group with international operations, providing products and services for dialysis, hospital and outpatient medical care. In 2008, group sales were approx. € 12.3 billion. On March 31, 2009 the Fresenius Group had 126,849 employees worldwide.

Fresenius today announced that it has successfully placed a tap to its 2006 Senior Notes by its subsidiary, Fresenius Finance B.V. An aggregate principal amount of € 150 million was issued at a price of 92.0 % and a coupon of 5.5 %, resulting in a yield to maturity of 7.0 %. The Notes will mature in 2016 and are callable by the issuer from 2011.

The Notes have been offered in a private placement to institutional investors only. The transaction was well received and substantially oversubscribed.

With the issuance, Fresenius has taken advantage of the currently favorable market environment. The Company will use the proceeds to repay short-term debt. Accordingly, its debt maturity profile will improve.

The Company expects to close and settle the offering of the Notes on June 8, 2009, subject to customary closing conditions. The new Notes are expected to be listed on the Luxembourg Stock Exchange and will increase trading liquidity under the existing 2006 Notes.

About Fresenius SE
Fresenius is a health care group with international operations, providing products and services for dialysis, hospital and outpatient medical care. In 2008, group sales were approx. € 12.3 billion. On March 31, 2009 the Fresenius Group had 126,849 employees worldwide.

Summary Second Quarter 2009:

• Net revenue: $ 2,764 million, + 4%
• Operating income (EBIT): $ 418 million, - 3%
• Net income attributable to Fresenius Medical Care AG & Co. KGaA: $ 221 million, + 5%
• Earnings per share: $ 0.74 , + 4%

Summary First Half 2009:

• Net revenue: $ 5,323 million, + 3%
• Operating income (EBIT): $ 813 million, - 1%
• Net income attributable to Fresenius Medical Care AG & Co. KGaA: $ 419 million, + 6%
• Earnings per share: $ 1.41, + 5%

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.

Second Quarter 2009:

Revenue

Net revenue for the second quarter of 2009 increased by 4% to $2,764 million (9% at constant currency) compared to the second quarter of 2008. Organic revenue growth worldwide was 8%. Dialysis Services revenue grew by 7% to $2,054 million (10% at constant currency) in the second quarter of 2009. Dialysis Product revenue decreased by 4% to $710 million (an increase of 7% at constant currency) in the same period.

North America revenue increased by 9% to $1,876 million. Dialysis Services revenue grew by 9% to $1,677 million. Average revenue per treatment for the U.S. clinics was $344 in the second quarter of 2009 compared to $327 for the same quarter in 2008 and $338 for the first quarter of 2009. This development was based on an increase in commercial payor revenue and slightly increased EPO utilization. Dialysis Product revenue increased by 10% to $199 million and was led by sales of the newly licensed intravenous iron products.

International revenue was $888 million, a decrease of 7% (an increase of 9% at constant currency) compared to the second quarter of 2008. Dialysis Services revenue was $377 million, a decrease of 4% (an increase of 13% at constant currency). Dialysis Product revenue decreased by 9% to $510 million. Product sales grew by 6% based on constant currencies, led by increased pharmaceutical and dialysis machine sales and sales of products for acute care treatments.

Earnings

Operating income (EBIT) decreased partially due to currency translation effects by 3% to $418 million compared to $429 million in the second quarter of 2008 resulting in an operating margin of 15.1% compared to 16.1% for the second quarter of 2008.

In North America, the operating margin decreased by 100 basis points from 16.9% to 15.9% in the second quarter of 2009, primarily 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 in October 2008. These effects were partially offset by a strong performance of the dialysis product business, increased commercial payor revenue as well as the effect of economies of scale from revenue growth.

In the International segment, the operating margin decreased by 20 basis points to 17.3% due to unfavorable foreign exchange transaction effects in connection with the purchase of products produced in Europe and Japan coupled with the appreciation of the Euro and Yen against local currencies as well as higher depreciation as a result of increased investment in new production facilities, partially offset by cost savings.

Net interest expense for the second quarter of 2009 was $76 million compared to $82 million in the same quarter of 2008. This positive development was mainly attributable to lower short-term interest rates.

Income tax expense was $103 million for the second quarter of 2009 compared to $126 million in the second quarter of 2008, reflecting effective tax rates of 30.2% and 36.2%, respectively. Tax expense was positively impacted by a non-recurring revaluation of a tax claim.

Net income attributable to FMC AG & Co. KGaA for the second quarter of 2009 was $221 million, an increase of 5%.

Earnings per share (EPS) for the second quarter of 2009 rose by 4% to $0.74 per ordinary share compared to $0.71 for the second quarter of 2008. The weighted average number of shares outstanding for the second quarter of 2009 was approximately 298.0 million shares compared to 296.7 million shares for the second quarter of 2008. The increase in shares outstanding resulted from stock option exercises in the past twelve months.

Cash flow

In the second quarter of 2009, the Company generated $282 million in cash from operations, an increase of 35% compared to the second quarter of 2008 and representing approximately 10% of revenue. The cash flow performance was positively influenced by a favorable development of the Days Sales Outstanding (DSO), especially in North America.

A total of $139 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions was $143 million compared to $30 million in the second quarter of 2008. A total of $ 5 million in cash was generated from divestitures net of acquisitions. Free Cash Flow after acquisitions and divestitures was $148 million compared to a negative $28 million in the second quarter of last year.

First Half of 2009:

Revenue and Earnings

Net revenue was $5,323 million, up 3% from the first half of 2008. At constant currency, net revenue rose 9%. Organic growth was 8% in the first six months of 2009.

Operating income (EBIT) decreased partially due to currency translation effects by 1% to $813 million compared to $818 million in the first half of 2008, resulting in an operating margin of 15.3% compared to 15.8% for the first half of 2008. This development was 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 in October 2008. These effects were partially offset by a strong performance of the dialysis product business, increased commercial payor revenue as well as the effect of economies of scale from revenue growth.

Net interest expense for the first six months of 2009 was $149 million compared to $165 million in the same period of 2008. This positive development was mainly attributable to lower short-term interest rates.

Income tax expense was $214 million in the first half of 2009 compared to $237 million in the same period in 2008, reflecting effective tax rates of 32.2% and 36.3%, respectively. Tax expense was positively impacted by a non-recurring revaluation of a tax claim.

For the first half of 2009, net income attributable to FMC AG & Co. KGaA was $419 million, up 6% from the first half of 2008.

In the first six months of 2009, earnings per ordinary share rose 5% to $1.41. The weighted average number of shares outstanding during the first half of 2009 was approximately 297.9 million.

Cash flow

Cash from operations during the first six months of 2009 was $437 million compared to $401 million for the same period in 2008, representing approximately 8% of revenue. The cash flow generation benefited from the favorable development of the Days Sales Outstanding (DSO), especially in North America.

A total of $249 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions for the first six months of 2009 was $188 million compared to $69 million in the same period in 2008. A total of $31 million in cash was used for acquisitions net of divestitures. Free Cash Flow after acquisitions and divestitures was $157 million compared to a negative $23 million in the first half of last year.

Please refer to the attachments for a complete overview on the second quarter and first half 2009.

Patients – Clinics – Treatments

As of June 30, 2009, Fresenius Medical Care treated 190,081 patients worldwide, which represents a 6% increase compared to the same period last year. North America provided dialysis treatments for 129,163 patients, an increase of 4%. Including 31 clinics managed by Fresenius Medical Care North America, the number of patients in North America was 130,795. The International segment served 60,918 patients, an increase of 10% over last year.

As of June 30, 2009, the Company operated a total of 2,471 clinics worldwide. This is comprised of 1,731 clinics in North America (1,762 including managed clinics), an increase of 5%, and 740 clinics in the International segment, an increase of 10%.

Fresenius Medical Care delivered approximately 14.36 million dialysis treatments worldwide during the first six months of 2009. This represents an increase of 5% year over year. North America accounted for 9.69 million treatments, an increase of 3%, and the International segment delivered 4.67 million treatments, an increase of 11% over last year.

Employees

As of June 30, 2009, Fresenius Medical Care had 66,364 employees (full-time equivalents) worldwide compared to 64,666 employees at the end of 2008. The increase of approximately 1,700 employees is primarily due to 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 2.86 at the end of the second quarter of 2008 to 2.78 at the end of the second quarter 2009. At the end of 2008, the debt/EBITDA ratio was 2.69.

Rating

In the second quarter of 2009, Standard & Poor's Rating Services continued to rate the Company's corporate credit as ‘BB', while revising its outlook from ‘negative' to ‘stable'.

Moody's continued to rate the Company's corporate credit as ‘Ba1' with a ‘stable' outlook.

Fitch rates the Company's corporate credit as ‘BB' with a ‘negative' outlook.

Outlook for 2009 fully confirmed

For the full year of 2009, the Company confirms its outlook and expects to achieve revenue of more than $11.1 billion, an increase of more than 8% in constant currency.

Net income attributable to FMC AG & Co. KGaA is expected to be between $850 million and $890 million in 2009.

In addition, the Company expects to spend $550 to $650 million on capital expenditures and $200 to $300 million on acquisitions. The debt/EBITDA ratio is projected to be below 2.7.

Ben Lipps, Chief Executive Officer of Fresenius Medical Care, commented: "Our organic growth rate remained at an excellent 8% in the second quarter of 2009, driven by the strong performance of newly launched products and steadily increasing demand for our high-quality dialysis services. In addition, we continued to see improvements in quality as evidenced by a reduction in hospitalization days in the U.S. that clearly benefit the patients and payors. We also continued to advance proven therapy approaches while planning for the likely healthcare reform in the U.S. Given the emerging pay-for-performance concepts in dialysis services, we are very well prepared to realize further growth well into the future. We confirm our guidance for the full year."

Conference Call

Fresenius Medical Care will hold a conference call to discuss the results of the second quarter and the first half year of 2009 on Tuesday, August 04, 2009, at 3:30 pm CEDT / 9:30 am EDT. The Company invites investors to listen to the live webcast of the call at the Company's website www.fmc-ag.com in the "Investor Relations" section. A replay will be available shortly after the call.