• Sales: € 6.9 billion, +21 % at actual rates, +15 % in constant currency
• EBIT: € 985 million, +26 % at actual rates, +20 % in constant currency
• Adjusted net income*: € 240 million, +13 % at actual rates, +10 % in constant currency

• Strongly improved Operating and Free Cash Flow
• Fresenius Medical Care and Fresenius Kabi confirm guidance for 2009, Fresenius Helios and Fresenius Vamed raise their outlook

Group outlook for 2009 confirmed
Based on the Group's strong H1 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 income* 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). 

*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. These effects are not cash relevant.

Strong sales growth across all business segments
Group sales increased by 15 % in constant currency and by 21 % at actual rates to € 6,895 million (H1 2008: € 5,710 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 11 % in constant currency with organic sales growth contributing 7 %. In North America sales grew by 21 % in constant currency, mainly due to the consolidation of APP Pharmaceuticals from September 2008. Strong organic growth rates were achieved in the emerging markets, reaching 14 % in both Asia-Pacific and Latin America.

Continued strong earnings growth
Group EBITDA increased by 21 % in constant currency and by 26 % at actual rates to € 1,260 million (H1 2008: € 998 million). Group operating income (EBIT) grew by 20 % in constant currency and by 26 % at actual rates to € 985 million (H1 2008: € 781 million). The Group's EBIT margin increased to 14.3 % (H1 2008: 13.7 %).

Group net interest was € -294 million (H1 2008: € -167 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 € 43 million and includes valuation changes of the fair redemption value of the Mandatory Exchangeable Bonds (MEB) of € 33 million and the Contingent Value Rights (CVR) of € 10 million. These effects are not cash relevant.

The adjusted Group tax rate* was 30.5 % (H1 2008: 34.2 %).

Noncontrolling interest increased to € 240 million (H1 2008: € 192 million), of which 94 % was attributable to the noncontrolling interest in Fresenius Medical Care.

Adjusted net income** grew by 10 % in constant currency and by 13 % at actual rates to € 240 million (H1 2008: € 212 million). Adjusted earnings per ordinary share increased to € 1.49 and adjusted earnings per preference share increased to € 1.50 (H1 2008: ordinary share € 1.36, preference share € 1.37). This represents an increase of 7 % for both share classes in constant currency.

*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.

**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. These effects are not cash relevant.

Reconciliation to net income according to US GAAP
The Group's US GAAP financial results as of June 30, 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 below reconciles adjusted net income to net income according to US GAAP in H1 and Q2 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 € 274 million or € 1.69 per ordinary share and € 1.70 per preference share.

*Net income attributable to Fresenius SE.


Continued investments in growth
Fresenius Group spent € 283 million for property, plant and equipment (H1 2008: € 332 million). Acquisition spending was € 156 million (H1 2008: € 292 million).

Operating cash flow increased by 25 %
Operating cash flow increased by 25 % to € 600 million (H1 2008: € 481 million), driven by strong earnings growth and tight working capital management. Net capital expenditure was € 292 million (H1 2008: € 332 million). Cash flow before acquisitions and dividends more than doubled to € 308 million.

Balance sheet
Fresenius Group's total assets increased by 2 % to € 20,953 million (December 31, 2008: € 20,544 million), there was no significant currency translation effect. Current assets increased by 6 % to € 5,400 million (December 31, 2008: € 5,078 million). Non-current assets grew by 1 % to € 15,553 million (December 31, 2008: € 15,466 million).

Total shareholders' equity increased by 3 % to € 7,169 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 1 % to € 8,859 million (December 31, 2008: € 8,787 million).

As of June 30, 2009, the net debt/EBITDA ratio (pro forma the acquisition of APP Pharmaceuticals and excluding special items) improved to 3.4 (December 31, 2008: 3.6).

Number of employees increased
As of June 30, 2009, Fresenius increased the number of its employees by 4 % to 127,692 (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. Removab was launched in Germany in May 2009. Market launch is under way in other European countries.

Fresenius Biotech's EBIT was € -22 million in H1 2009 (H1 2008: € -20 million). For 2009, Fresenius Biotech expects its EBIT to reach € -40 million to € -45 million. The previous guidance foresaw 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 190,081 patients in 2,471 dialysis clinics. 

• Continued strong organic sales growth of 8 %
• Outlook 2009 fully confirmed

Fresenius Medical Care achieved sales growth of 3 % to US$ 5,323 million (H1 2008: US$ 5,177 million). Organic growth was 8 %. Currency translation effects had a negative impact of 6 %.
Dialysis services revenue grew by 6 % to US$ 3,977 million (H1 2008: US$ 3,769 million), an increase of 9 % in constant currency. Sales of dialysis products were US$ 1,346 million (H1 2008: US$ 1,408 million). In constant currency, dialysis products sales increased by 8 %.

In North America sales increased by 8 % to US$ 3,650 million (H1 2008: US$ 3,382 million). Dialysis services revenue grew by 7 % to US$ 3,254 million. Average revenue per treatment for the U.S. clinics was at US$ 344 in Q2 2009 compared to US$ 327 for Q2 2008 and 338 US$ for Q1 2009. This development was based on an increase in commercial payor revenue and slightly increased EPO utilization. Sales outside North America ("International" segment) were US$ 1,673 million (H1 2008: US$ 1,795 million). In constant currency, sales growth was 10 %.

EBIT was US$ 813 million, 1 % below the previous year's period partially due to currency translations effects (H1 2008: US$ 818 million), resulting in an EBIT margin of 15.3 % (H1 2008: 15.8 %). This development was primarily due to higher personnel expenses, increased pharmaceutical costs and 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 economies of scale from revenue growth. Net income* increased by 6 % to US$ 419 million (H1 2008: US$ 397 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.

• Continued strong organic sales growth of 7 % (excl. APP and Dabur)
• EBIT margin increases to 19.3 %
• Outlook 2009 confirmed

Fresenius Kabi increased sales by 34 % to € 1,500 million (H1 2008: € 1,121 million). Organic sales growth was 7 % (excl. APP and Dabur as they were consolidated as of September 1, 2008). Net acquisitions contributed 29 % to sales. Currency translation had a net negative impact of 2 %. This was due to the depreciation of currencies e.g. in Great Britain and Brazil against the euro, whereas positive translation effects resulted from the strengthening of the Chinese yuan.

In Europe, sales reached € 772 million, driven by 5 % organic growth. In North America, sales increased to € 347 million (H1 2008: € 63 million) due to the acquisition of APP Pharmaceuticals. In the Asia-Pacific region Fresenius Kabi achieved sales of € 235 million. Organic sales growth was 11 %. Sales in Latin America and Africa increased to € 146 million, driven by 19 % organic growth.

EBIT grew by 60 % to € 290 million (H1 2008: € 181 million). EBIT includes a € 14 million non-cash charge related to the amortization of APP intangible assets. The EBIT margin increased to 19.3 % (H1 2008: 16.1 %). Net interest increased to € 157 million (H1 2008: € 34 million) due to the acquisition financing. Net income* was € 85 million (H1 2008: € 97 million).

Sales at APP Pharmaceuticals increased by 18 % to US$ 408 million in H1 2009. Adjusted EBITDA** increased by 31 % to US$ 171 million. EBIT grew by 51% to US$ 129 million. EBIT includes a US$ 18 million non-cash charge related to the amortization of intangible assets. The EBIT margin improved to 31.7 %.

Operating cash flow of Fresenius Kabi increased by 84 % to € 166 million (H1 2008: € 90 million), driven by tight working capital management. Given only moderate growth in capital expenditures, cash flow before acquisitions and dividends more than doubled to € 110 million (H1 2008: € 44 million).

Fresenius Kabi 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 Pharmaceuticals 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.

• Continued high organic sales growth of 5 %
• 130 bps EBIT margin increase at established clinics to 9.3 %
• Sales outlook 2009 fully confirmed, EBIT guidance raised

Fresenius Helios increased sales by 12 % to € 1,164 million (H1 2008: € 1,040 million). Strong organic growth of 5 % was again driven by a significant increase in patient numbers. Net acquisitions contributed 7 % to overall sales growth.

EBIT grew by 20 % to € 100 million (H1 2008: € 83 million) due to the excellent business operations of the established clinics. The EBIT margin increased to 8.6 % (H1 2008: 8.0 %). Net income* improved by 43 % to € 53 million (H1 2008: € 37 million).

At HELIOS' established clinics, sales rose by 5 % to € 1,081 million. EBIT improved by 22 % to € 100 million. The EBIT margin increased to 9.3 % (H1 2008: 8.0 %). The acquired clinics (consolidation <1 year) achieved sales of € 83 million and a near break-even EBIT.

Fresenius Helios fully confirms its sales outlook and raises its EBIT outlook for 2009: the company expects to achieve sales of more than € 2.3 billion. EBIT is projected to reach € 190 to 200 million. The previous guidance was € 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.

• Excellent sales growth of 40 %
• Major order acquired in German project business
• Outlook 2009 raised

Fresenius Vamed achieved excellent sales growth of 40 % to € 247 million (H1 2008: € 177 million). Organic sales growth was 34 %. The clinics in the Czech Republic acquired from Fresenius Helios contributed 6 %. Sales in the project business rose by 52 % to € 150 million (H1 2008: € 99 million). Sales in the service business increased by 24 % to € 97 million (H1 2008: € 78 million).

EBIT was € 9 million, unchanged from previous year. Significant sales growth driven by a strong project business in H1 2009 diluted the EBIT margin to 3.6 % (H1 2008: 5.1 %). Net income* of € 8 million was € 1 million below previous year's level.

The excellent development of order intake and order backlog continued: Fresenius Vamed reported an order intake of € 156 million (H1 2008: € 170 million, including the ~€ 80 million order for the Tauern Spa World, Kaprun, Austria). In Q2 2009, Fresenius Vamed increased its order intake by 51 % to € 68 million (Q2 2008: € 45 million). The order backlog of € 577 million remained close to its all-time-high of € 595 million (December 31, 2008: € 571 million).

Fresenius Vamed was awarded a € 50 million order from the city of Cologne for the planning and turnkey construction of an extension to the maximum care hospital Cologne-Merheim. This is the largest project order the company has so far received in Germany. The project is scheduled to start in the third quarter 2009. The construction work will take approximately two years.

Fresenius Vamed raises its outlook for 2009 and expects to grow both sales and EBIT by approximately 10 %. Previously, both sales and EBIT were expected to grow by 5 to 10 %. 

* Net income attributable to VAMED AG


Analyst Conference
As part of the publication of the H1 results 2009 a conference call will be held on August 4, 2009 at 2.00 p.m. CEDT (8.00 a.m. EDT). You 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 largest provider of dialysis products and services, has launched a new therapy programme for peritoneal dialysis (PD). ‘P3', the first comprehensive PD care concept of its kind, was introduced at the 9th European Peritoneal Dialysis Meeting "EuroPD" in Strasbourg, France this week.

In contrast to the mere provision of individual products and services, ‘P3' for the first time provides PD therapy as an integrated care programme, incorporating all aspects of treatment, from the PD machine, or "cycler", and related equipment to special software and services for the monitoring of treatment safety and quality. With this holistic approach, ‘P3' aims to support physicians and nurses in adjusting treatment even more closely to a patient's individual needs – improving the overall quality of PD therapy.

This aim is reflected in the programme's name: ‘P3' stands for ‘Protect', ‘Preserve' and ‘Prolong'. ‘Protect' refers to Fresenius Medical Care's portfolio of PD cyclers and equipment, which include special safety features such as automatic bag connection and highly intuitive, easy-to-understand design. Such elements offer advanced protection from infections as well as from incorrect handling, which is especially important as many patients undergo treatment at home. ‘Preserve' alludes to the Company's PD fluids, which, due to their physiological pH and low amount of glucose degradation products, contribute particularly well to the preservation of a patient's peritoneal membrane and residual renal functions. ‘Prolong', finally, refers to the aim of ‘P3' to prolong high-quality treatment outcomes, for example through complementary therapies for the control of a patient's body fluid balance or special monitoring software to individually adjust and optimize a patient's treatment parameters.

"It is Fresenius Medical Care's mission to deliver excellent care to patients through innovative programs, the latest technology, continuous improvement and a focus on superior customer service. ‘P3' is a further step on this mission, helping our PD patients to be more successful on dialysis so they can live their lives to the fullest", says Dr. Teresa Portela, Marketing Director Home Therapies at Fresenius Medical Care.

In peritoneal dialysis, or PD, the patient's peritoneum is used as the dialyzing membrane. A sterile dialysis solution is introduced and discharged through a catheter that has been surgically implanted into the patient's abdominal cavity. The solution removes toxins along with excess water. The patient administers the treatments several times a day or during the night supported by a machine, the cycler.

Fresenius Medical Care, the world's largest provider of dialysis products and services, today announces the presentation of the first results from the CALcium acetate MAGnesium carbonate evaluation study (CALMAG study) for the new phosphate binder OsvaRen® at the Renal Week 2009 in San Diego, USA.1 The CALMAG study examines efficacy and safety of OsvaRen®.

The poster will be presented:

• 29th of October 2009, 10 am – 12 midday
• Poster board: TH-PO615
• Lead investigator: Prof. Angel Luis Martín de Francisco, Universidad de Cantabria, Santander (Spain).

"Investment in the CALMAG study underlines our commitment to the best treatment for dialysis patients", said Dr. Emanuele Gatti, Chief Executive Officer of Fresenius Medical Care for the regions Europe, Latin America, Middle East and Africa. "These results bring us one step closer to our vision of truly integrated care."

Background information:

About the CALMAG study
The CALMAG study is a 24-week randomised, controlled, multicentre, head-to-head clinical study comparing the efficacy of two phosphate binders, OsvaRen® (calcium acetate/magnesium carbonate from Fresenius Medical Care) and sevelamer hydrochloride (Renagel® from Genzyme Corporation) in patients with chronic kidney disease on dialysis. The CALMAG study was conducted in five European countries.

About OsvaRen®
OsvaRen®, consisting of 435 mg calcium acetate (110 mg calcium) and 235 mg magnesium carbonate (60 mg magnesium), allows effective and safe control of serum phosphorus levels in patients on dialysis. Elevated serum phosphorus levels are an independent predictor of mortality in patients with chronic renal failure and require effective treatment for better achievement of K/DOQI2 and KDIGO3 target ranges. OsvaRen® is now approved in 28 European countries for the treatment of hyperphosphataemia associated with chronic renal insufficiency in patients undergoing dialysis. OsvaRen® is not yet available in all countries and prescribing information may differ between countries. Please consult your local prescribing information. For more information about OsvaRen®, please visit our website www.fmc-renalpharma.com.

Important safety information
OsvaRen® is contraindicated in patients with hypophosphataemia, hypercalcaemia, elevated serum magnesium levels of more than 2 mmol/L and/or symptoms of hypermagnesaemia, AV-block III or Myasthenia gravis. Common adverse events reported with OsvaRen® include soft stools, gastrointestinal irritation like nausea, anorexia, sensation of fullness, belching and constipation, diarrhoea. Drug-drug interactions may occur with some medications and should be taken into consideration when instructing patients on how to take OsvaRen®. Patients should be informed to take OsvaRen® with meals and to adhere to their prescribed diets.


References: 

1. de Francisco ALM et al. A controlled randomised comparison of calcium acetate / magnesium carbonate (OsvaRen®) to sevelamer hydrochloride (Renagel®) in hemodialysis patients: the CALMAG study (2009).
   J Am Soc Nephrol 20: TH-PO615
2. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease.
   Am J Kidney Dis (2003) 42, p1-p201. 
3. KDIGO Guideline for Chronic Kidney Disease -Mineral and Bone Disorder.
   Kidney International (2009) 76 (Suppl 113), p1–p130.

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.

• Sales: € 10.4 billion, +19 % at actual rates, +15 % in constant currency
• EBIT: € 1.5 billion, +24 % at actual rates, +19 % in constant currency
• Adjusted net income*: € 368 million, +14 % at actual rates, +12 % in constant currency

• Ongoing sales and earnings growth across all business segments
• Fresenius Medical Care improves guidance
• Fresenius Kabi confirms guidance - number of product approvals at APP Pharmaceuticals increased
• Fresenius Helios raises earnings guidance
• Fresenius Vamed confirms guidance
• Excellent cash flow results in significantly reduced leverage

Group outlook for 2009 fully confirmed
Based on the Group's strong 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 income* is expected to increase by approximately 10 % in constant currency.

Fresenius plans to invest € 700 to 750 million in property, plant and equipment.

* 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. Both are non-cash charges.

Strong sales growth across all business segments continued
Group sales increased by 15 % in constant currency and by 19 % at actual rates to € 10,429 million (Q1-3/2008: € 8,761 million). Organic sales growth was 8 % for the first three quarters and increased to 9 % in the third quarter. Acquisitions contributed a further 7 %. Currency translation had a positive impact of 4 %. This is mainly attributable to the average US dollar rate improving 10 % against the euro in the first three quarters of 2009.

Sales growth in the business segments was as follows:

In Europe sales grew by 11 % in constant currency with organic sales growth contributing 8 %. In North America sales grew by 20 % in constant currency, mainly due to the consolidation of APP Pharmaceuticals from September 2008. Strong organic growth rates were achieved in the emerging markets, reaching 13 % in Asia-Pacific and 12 % in Latin America.

Continued strong earnings growth
Group EBITDA increased by 19 % in constant currency and by 24 % at actual rates to € 1,911 million (Q1-3/2008 adjusted: € 1,546 million). Group operating income (EBIT) grew by 19 % in constant currency and by 24 % at actual rates to € 1,496 million (Q1-3/2008 adjusted: € 1,209 million). The Group's EBIT margin increased to 14.3 % (Q1-3/2008 adjusted: 13.8 %).

Group net interest was € -439 million (Q1-3/2008: € -271 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 € -30 million and includes valuation changes of the fair redemption value of the Mandatory Exchangeable Bonds (MEB) of € -3 million and the Contingent Value Rights (CVR) of € -27 million. Both are non-cash charges.

The adjusted Group tax rate* was 30.8 % (Q1-3/2008 adjusted: 34.2 %). This decrease was largely driven by the revaluation of a tax claim at Fresenius Medical Care in Q2 2009.

Noncontrolling interest increased to € 363 million (Q1-3/2008: € 293 million), of which 94 % was attributable to the noncontrolling interest in Fresenius Medical Care.

Adjusted net income** grew by 12 % in constant currency and by 14 % at actual rates to € 368 million (Q1-3/2008 adjusted: € 324 million). Adjusted earnings per ordinary share increased to € 2.28 and adjusted earnings per preference share increased to € 2.29 (Q1-3/2008 adjusted: ordinary share € 2.06, preference share € 2.07). This represents an increase of 11 % at actual rates and 9 % in constant currency for both share classes.

The Group's US GAAP financial results as of September 30, 2009 and as of September 30, 2008, 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. In the previous year's period, the Group's US GAAP financial statements include in addition several special items relating to the acquisition of APP Pharmaceuticals. Please see page 14 of this Investor News for the reconciliation to earnings according to US GAAP.

Net income*** (including special items) was € 339 million or € 2.10 per ordinary share and € 2.11 per preference share.

* 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.
** 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. Both are non-cash charges.
*** Net income attributable to Fresenius SE.

Continued investments in growth
Fresenius Group spent € 442 million for property, plant and equipment (Q1-3/2008: € 502 million). Acquisition spending was € 186 million (Q1-3/2008: € 3,760 million, mainly due to the acquisition of APP Pharmaceuticals).

Strong cash flow achieved
Operating cash flow increased by 52 % to € 1,120 million (Q1-3/2008: € 736 million), driven by strong earnings growth and tight working capital management. Net capital expenditure was € 446 million (Q1-3/2008: € 496 million). Cash flow before acquisitions and dividends nearly tripled to € 674 million (Q1-3/2008: € 240 million).

Balance sheet
Fresenius Group's total assets were € 20,632 million (December 31, 2008: € 20,544 million). In constant currency, total assets increased by 3 %. Current assets increased by 6 % to € 5,408 million (December 31, 2008: € 5,078 million). Non-current assets decreased by 2 % to € 15,224 million (December 31, 2008: € 15,466 million).

Total shareholders' equity increased by 4 % to € 7,237 million (December 31, 2008: € 6,943 million). The equity ratio (including noncontrolling interest) improved to 35.1 % (December 31, 2008: 33.8 %).
Group debt decreased by 4 % to € 8,476 million (December 31, 2008: € 8,787 million).

As of September 30, 2009, the net debt/EBITDA ratio was 3.1 and significantly improved from 3.6 at December 31, 2008 (pro forma the acquisition of APP Pharmaceuticals and excluding special items).

Number of employees increased
As of September 30, 2009, Fresenius increased the number of its employees by 6 % to 129,218 (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. Removab was launched in Germany in May 2009. Market launch is under way in other European countries. As of September 30, 2009, Fresenius Biotech achieved Removab sales of more than € 1 million.

Fresenius Biotech's EBIT was € -32 million in the first three quarters of 2009 (Q1-3/2008: € -32 million). For 2009, Fresenius Biotech expects its EBIT to reach € -40 million to € -45 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 September 30, 2009, Fresenius Medical Care was treating 192,804 patients in 2,509 dialysis clinics.

• Continued strong organic sales growth of 8 %
• Q3 EBIT margin improved to 15.6 (Q2 2009: 15.1 %)
• Improved guidance for 2009

Fresenius Medical Care achieved sales growth of 4 % to US$ 8,212 million (Q1-3/2008: US$ 7,890 million). Organic growth was 8 %. Currency translation effects had a negative impact of 5 %.

Dialysis services revenue grew by 6 % to US$ 6,124 million (Q1-3/2008: US$ 5,753 million), an increase of 9 % in constant currency. Sales of dialysis products were US$ 2,088 million (Q1-3/2008: US$ 2,137 million). In constant currency, dialysis products sales increased by 8 %.

In North America sales increased by 9 % to US$ 5,600 million (Q1-3/2008: US$ 5,153 million). Dialysis services revenue grew by 8 % to US$ 4,994 million. Average revenue per treatment for the U.S. clinics increased to US$ 348 in Q3 2009 compared to US$ 333 for Q3 2008 and 344 US$ for Q2 2009. This development was mainly based on reimbursement increases and increased utilization of pharmaceuticals. Sales outside North America ("International" segment) were US$ 2,612 million (Q1-3/2008: US$ 2,737 million). In constant currency, sales growth was 9 %.

EBIT increased by 2 % to US$ 1,265 million (Q1-3/2008: US$ 1,240 million), resulting in an EBIT margin of 15.4 % (Q1-3/2008: 15.7 %). This development was mainly due to higher personnel expenses, price increases for pharmaceuticals 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 income* increased by 7 % to US$ 645 million (Q1-3/2008: US$ 603 million).

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

Net income* is now expected to be between US$ 865 million and US$ 890 million in 2009. Previously, the company expected the net income to be in the range of US$ 850 million and US$ 890 million for the full year 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.

• Organic sales growth accelerated to 8 %
• EBIT Margin increased to 19.4 %
• Outlook 2009 confirmed

Fresenius Kabi increased sales by 31 % to € 2,274 million (Q1-3/2008: € 1,734 million). Organic sales growth was 8 % in the first three quarters and increased to 9 % in the third quarter. Net acquisitions contributed 25 % to sales. Currency translation had a net negative impact of 2 %. This was mainly due to the depreciation of currencies in Great Britain and Brazil against the euro, whereas positive translation effects resulted from the strengthening of the Chinese yuan.

In Europe, sales reached € 1,159 million, driven by 5 % organic growth. In North America, sales increased to € 527 million (Q1-3/2008: € 134 million) due to the acquisition of APP Pharmaceuticals. In the Asia-Pacific region Fresenius Kabi achieved sales of € 361 million. Organic sales growth accelerated to 15 %. Sales in Latin America and Africa increased to € 227 million, driven by 16 % organic growth.

EBIT grew by 52 % to € 441 million (Q1-3/2008: € 290 million). EBIT includes a € 20 million non-cash charge related to the amortization of APP Pharmaceuticals' intangible assets. The EBIT margin increased to 19.4 % (Q1-3/2008: 16.7 %). Net interest grew to € 231 million (Q1-3/2008: € 64 million) due to the acquisition financing. Net income* was € 136 million (Q1-3/2008: € 149 million).

Sales at APP Pharmaceuticals increased by 16 % to US$ 632 million. APP Pharmaceuticals achieved significant sales growth in the product portfolio excluding Heparin in Q3, leading to a sales growth of 4 % in the first three quarters 2009. Adjusted EBITDA** grew by 20 % to US$ 260 million. EBIT was US$ 198 million. EBIT includes a US$ 27 million non-cash charge related to the amortization of intangible assets. The EBIT margin improved to 31.3 %. The number of product approvals from the FDA (Food and Drug Administration) has currently increased to seven, following only one approval in the first half of 2009.

Operating cash flow of Fresenius Kabi more than doubled to € 311 million (Q1-3/2008: € 144 million). This was primarily achieved through a tight working capital management. Given only moderate growth in capital expenditures, cash flow before acquisitions and dividends more than tripled to € 224 million (Q1-3/2008: € 69 million).

Fresenius Kabi 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 Pharmaceuticals 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.

• Organic sales growth accelerated to 6 %
• Excellent earnings development at the established clinics
• Sales outlook 2009 confirmed, EBIT guidance raised

Fresenius Helios increased sales by 13 % to € 1,768 million (Q1-3/2008: € 1,568 million). Strong organic growth of 6 % was again driven by a significant increase in admissions. Net acquisitions contributed 7 % to overall sales growth.

EBIT grew by 20 % to € 152 million (Q1-3/2008: € 127 million) due to the excellent business operations of the established clinics. The EBIT margin increased to 8.6 % (Q1-3/2008: 8.1 %). Net income* improved by 39 % to € 82 million (Q1-3/2008: € 59 million).

At HELIOS' established clinics, sales rose by 6 % to € 1,646 million. EBIT improved by 22 % to € 154 million. The EBIT margin increased to 9.4 % (Q1-3/2008: 8.1 %). The acquired clinics (consolidation <1 year) achieved sales of € 122 million and € -2 million EBIT.

Fresenius Helios confirms its sales outlook for 2009 and expects to achieve sales of more than € 2.3 billion. EBIT is now projected to reach more than € 200 million. The previous guidance was € 190 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.

• Sales increased by 36 %
• Order backlog at new all-time-high, strong order intake achieved in Q3
• Outlook 2009 fully confirmed

Fresenius Vamed achieved excellent sales growth of 36 % to € 393 million (Q1-3/2008: € 290 million). Organic sales growth was 29 %. The clinics in the Czech Republic acquired from Fresenius Helios contributed 7 %. Sales in the project business rose by 46 % to € 244 million (Q1-3/2008: € 167 million). Sales in the service business increased by 21 % to € 149 million (Q1-3/2008: € 123 million).

EBIT grew by 7 % to € 15 million (Q1-3/2008: € 14 million). Significant sales growth driven by a strong project business diluted the EBIT margin to 3.8 % (Q1-3/2008: 4.8 %). Net income* of € 13 million was € 1 million below previous year's level due to a decrease in interest income as a result of lower interest rates.

The excellent development of order intake and order backlog continued: Fresenius Vamed increased the order intake by 29 % to € 313 million (Q1-3/2008: € 242 million). In Q3 2009, Fresenius Vamed more than doubled its order intake to € 157 million (Q3 2008: € 72 million). Fresenius Vamed was awarded a >€ 80 million order for the turnkey construction of a general hospital in Gabon. The project is scheduled to start in the fourth quarter of 2009. The construction work will take approximately two years.

The order backlog reached the new all-time-high of € 640 million (December 31, 2008: € 571 million).

Fresenius Vamed fully confirms its outlook for 2009 and expects to grow both sales and EBIT by approximately 10 %. 

* Net income attributable to VAMED AG


Analyst Conference
As part of the publication of the results of the first three quarters of 2009 a conference call will be held on November 3, 2009 at 2.00 p.m. CET (8.00 a.m. EST). You 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 largest provider of dialysis services and products, today announced a transition to a new management board structure, drawing entirely on internal management strength. The Chairman's contract has been extended and a Deputy Chairman of the Fresenius Medical Care Management Board has been appointed which defines a successful leadership succession path. The Company has also appointed a new Chief Financial Officer. A new Fresenius Medical Care Management Board position for Global Manufacturing Operations has been established to provide stronger manufacturing coordination on a global basis. This will allow the Regional Chief Executive Officers more opportunity to expand the Renal Therapy and Service Business.

The contract of the Chairman of the Management Board and Chief Executive Officer Dr. Ben J. Lipps has been extended until December 31, 2012.

Effective January 1, 2010, Rice Powell has been promoted to be Deputy Chairman of the Fresenius Medical Care Management Board and Chief Executive Officer of Fresenius Medical Care North America. Rice has been with the Company since 1997, and has been the Co-CEO of Fresenius Medical Care North America and CEO of the Renal Therapies Group. Rice has been a member of the Fresenius Medical Care Management Board since 2004 and has more than 30 years of experience in the health care industry.

Mats Wahlstrom, Co-CEO of Fresenius Medical Care North America and a member of the Fresenius Medical Care Management Board, has informed the Company of his intention to reduce his full-time responsibilities with the Company effective during January 2010. He has been with Fresenius Medical Care since 2002 and was a member of the Fresenius Medical Care Management Board since 2004. Mats will step back from his responsibilities as a member of the Management Board but has accepted to stay on the Board of Directors of Fresenius Medical Care North America and continue as a senior advisor to the Chairman of the Fresenius Medical Care Management Board for a period of five years. In that capacity Mats will support the Company's focus on new therapies and services, global services expansion and leadership development.

Michael Brosnan has accepted the position as the Chief Financial Officer of Fresenius Medical Care effective January 1, 2010, and in this capacity will join the Fresenius Medical Care Management Board. For the past seven years, he has served as Chief Financial Officer and member of the Board of Directors of Fresenius Medical Care North America. Mike joined the Company in 1998 as Vice President of Finance and Administration for Spectra Renal Management, the Company's laboratory services organization. Since then, Mike has held several executive positions in North America. Prior to joining Fresenius Medical Care, Mike held senior financial positions at Polaroid Corporation and was an audit partner at KPMG.

Effective January 1, 2010, Kent Wanzek will be named to a new position on the Fresenius Medical Care Management Board with responsibility for Global Products Manufacturing Operations. Kent has been the President for Operations of the Renal Therapies Group at Fresenius Medical Care North America since 2006. Prior to joining the Company in 2003, Kent had several senior executive positions including Philips Medical Systems and Baxter Healthcare Corporation.

Dr. Emanuele Gatti, whose contract has been extended, will assume the responsibility as Chief Strategist for Fresenius Medical Care in addition to his capacity as a member of the Management Board and Chief Executive Officer for Europe, Middle East, Africa and Latin America. Under his successful leadership Fresenius Medical Care has grown to serve 50,000 patients, has become the leading manufacturer of dialysis products in this region and has set a new standard for quality and innovation.

Roberto Fustė will continue his position as Chief Executive Officer of Fresenius Medical Care Asia Pacific, which will ensure further successful leadership. During the last eight years and under the leadership of Roberto, Asia Pacific has grown from annual revenue of $86 million in 1997 to over $650 million annualized revenue today. Fresenius Medical Care Asia Pacific is projected to achieve annual revenue of over $1 billion by 2012.

The area of law, compliance and intellectual property will continue to benefit from Dr. Rainer Runte's leadership whose contract also had been renewed. Rainer will additionally become responsible for human resources in Germany (Labor Relations Director) and oversee the implementation of the Company's business development initiatives. Rainer joined Fresenius Medical Care in 1990 and was appointed to the Fresenius Medical Care Management Board in 2002.

Ben Lipps, Chief Executive Officer of Fresenius Medical Care and Chairman of the Management Board, said: "We are pleased with the decision to appoint Rice Powell Deputy Chairman of the Fresenius Medical Care Management Board and to appoint Michael Brosnan Chief Financial Officer as well as the creation of a new Board position for Global Product Manufacturing under Kent Wanzek's leadership. Rice Powell's successful record and his extensive management experience within Fresenius Medical Care and the health care field qualify him superbly for the Deputy Chairman position and I look forward to working with him closely in this role. Michael Brosnan, with his knowledge of Fresenius Medical Care and his proven financial experience, is an excellent addition to the Management Board.

We are deeply grateful to Mats Wahlstrom for his leadership during a period of rapid growth and consolidation in North America. During Mats tenure, the number of patients treated in North America grew from approximately 79,000 patients in 2002 to nearly 131,000 patients in 2009 with significant improvement in quality and financial performance. We are particularly proud of his leadership in the seamless integration of Renal Care Group and his development of a very strong management team. I personally would like to thank Mats for his exceptional contribution over the last years and I am pleased to be able to continue to rely on his judgment and guidance as we move forward.

These changes in the Fresenius Medical Care Management Board will serve the Company well as it faces future challenges and opportunities. The fact that all appointments have been filled internally reflects the strength and depth of our management team and will ensure a smooth transition going forward."

Ulf Mark Schneider, Chairman of the Supervisory Board of Fresenius Medical Care Management AG, said: "The dialysis industry is facing significant change with major growth opportunities in international markets and the introduction of the bundled reimbursement system in the U.S. In this context, we are very pleased that Ben Lipps will continue to lead this company as Chairman of the Management Board. With his four decades of dialysis industry experience and his outstanding track record in building our company he will provide proven leadership and stability in this important period.

At the same time, we are pleased to elevate Rice Powell to the new position of Deputy Chairman of the Management Board. Building on his significant accomplishments in our North American organization this role will prepare Rice for succeeding Ben in leading our company. We are very confident that Ben and Rice, together with the newly structured Management Board, will continue to successfully develop the company."


New Management Board Fresenius Medical Care

Dr. Ben J. Lipps, 69
Chief Executive Officer (CEO) and Chairman of the Management Board

Rice Powell, 54
CEO for North America and Deputy Chairman of the Management Board

Mike Brosnan, 54
Chief Financial Officer (CFO)

Roberto Fusté, 56
Chief Executive Officer for Asia-Pacific

Dr. Emanuele Gatti, 54
Chief Executive Officer for Europe, Middle East, Africa, Latin America and Global Chief Strategist

Dr. Rainer Runte, 50
Member of the Management Board responsible for Law, Compliance & Corporate Governance and Intellectual Property, Labor Relations Director for Germany

Kent Wanzek, 50
Member of the Management Board responsible for Global Production

Fresenius Medical Care AG & Co. KGaA ("the Company") today announced that it has been selected by the National Health System (NHS) in the United Kingdom to manage dialysis care for 12 renal units across the North of England.

These clinics will provide dialysis treatments for more than 400 patients for approximately 7 years in North East and South Yorkshire and Lincolnshire. Patients will remain under the care of their NHS physicians, while benefiting from Fresenius Medical Care's dedication, proven experience and expertise in hemodialysis.

This pioneering program – part of the British Government's involvement in independent sector partnerships to deliver more choice and faster treatment to NHS patients – will see new renal dialysis units developed and existing hospital facilities extended. While new satellite centers will open the door to more patients and increase capacity, investment will also result in the installation of state-of-the art equipment and the latest technology, as well as the staff training and education.

Dr. Emanuele Gatti, Chief Executive Officer for the regions Europe, Middle East and Africa, commented: "We are very honored that Fresenius Medical Care has been chosen to work in partnership with the NHS to manage this innovative renal services program in the United Kingdom. We now have an outstanding opportunity to improve capacity for hemodialysis patients in the UK and provide easier access to services. Patients and the healthcare system at large can clearly benefit from our global expertise in renal care and our fully vertically integrated business model."

According to Kidney Research UK, a charity funding research that focuses on kidney disease, between 600 to 800 patients per one million population need renal replacement therapy in form of dialysis or transplant for survival. Kidney Research expects the number of end-stage renal disease (ESRD) patients to increase by about 5% annually.

Fresenius Medical Care AG & Co. KGaA ("the Company") today announced that its wholly-owned subsidiary, FMC Finance III S.A. had extended the expiration date of its Exchange Offer to the holders of its 6-7/8% Senior Notes due 2017. The Notes will be unconditionally guaranteed by the Company, Fresenius Medical Care Holdings, Inc. and Fresenius Medical Care Deutschland GmbH. The Exchange Offer to holders of the Senior Notes will now expire at 5:00 p.m., New York City time, on February 7, 2008.

FMC Finance III S.A. is offering to exchange up to $500,000,000 aggregate principal amount of 6-7/8% Senior Notes due 2017 which have been registered under the Securities Act of 1933 ("New Notes") for a like principal amount of its outstanding 6-7/8% Senior Notes due 2017 ("Old Notes"). The Exchange Offer was originally scheduled to expire at midnight, New York time, on January 24, 2008.

At the close of business on January 24, 2008, approximately $499,885,000 out of $500,000,000 aggregate principal amount of Old Notes, including $8,785,000 aggregate principal amount tendered by guaranteed delivery procedures, have been received by U.S. Bank National Association, the Exchange Agent for the Exchange Offer.

The terms of the New Notes are identical in all material respects to the terms of the Old Notes, except for the elimination of certain transfer restrictions, registration rights and the conditional right to receive additional interest. The Exchange Offer is being made for all outstanding Old Notes and is not conditioned on any minimum principal amount of Old Notes being tendered for exchange.

Fresenius Medical Care AG & Co. KGaA ("the Company") today announced that the Portuguese Ministry of Health and Anadial, the national association of privately run dialysis centers, agreed on a new reimbursement model for ambulatory care to hemodialysis patients. The new model "Comprehensive Price Payment" is an integrated and quality-driven approach that bundles a variety of dialysis related services and products. That requires the implementation and functioning of an integrated disease management model in order to achieve, simultaneously, health benefits, quality improvement and system rationalization. Including the new additional services in this reimbursement model, the Company expects the reimbursement rate to increase by about 50%.

The "Comprehensive Price Payment" model will include all necessary dialysis services, the deployment of dialysis-related products, laboratory services and other complementary medical tests and the administration of renal drugs for anemia management, bone management, blood pressure and cardiovascular control as well as vitamins.

The new reimbursement structure will provide for payment of a national reimbursement rate per week per patient. The main characteristic is that the amount of this reimbursement will directly depend on the fulfillment of certain treatment results and quality control parameters with the dialysis services provided. The therapeutic goals include, among others, the adequacy of dialysis, targets for hemoglobin levels, bone metabolism status, water quality as well as outcome measures such as mortality rate and hospitalization days. These goals mirror the good practices guidelines, both national and international, for dialysis care to patients, which will serve as support for contractual monitoring. The establishment of auditing, information, monitoring, attendance and evaluation mechanisms is a prerequisite for a participating dialysis provider.

Furthermore, the Portuguese Ministry of Health and Anadial agreed to continuously develop studies that will examine the inclusion of other modalities and treatment components such as the construction and maintenance of vascular access, hospitalization and patient transport into the comprehensive price payment.

The Company aims to fully adapt its dialysis care model to the new reimbursement structure for hemodialysis patients within its own network as of March 1, 2008.

Fresenius Medical Care Portugal is the largest private dialysis provider with annual revenues of approximately $128 million in 2007 for patient care and dialysis products. At the end of 2007, the Company provided dialysis treatment for about 4,100 patients in 33 dialysis clinics. According to internal estimates about 1,300 patients per one million population need renal replacement therapy in the form of dialysis or transplantation for survival. The number of dialysis patients is expected to increase by about 4% annually.

Ben Lipps, Chief Executive Officer of Fresenius Medical Care, commented: "Portugal is the first European country opting for a bundled reimbursement model in dialysis. The introduction of a bundled rate for the treatment of hemodialysis patients in Portugal equally benefits all those involved: the quality of life of dialysis patients can be significantly improved, health care spending for social systems and insurers remains controllable and dialysis companies gain the freedom to manage their cost structure while maximizing patient services. With our fully vertically integrated business model that includes patient care and dialysis products, Fresenius Medical Care is very well positioned to be the partner-of-choice to tackle the future challenges with growing patient numbers and – at the same time – financial burdens to social systems that derive from a disease like chronic renal failure."

Summary Fourth Quarter 2007

• Net revenue : $ 2,569 million, + 9%
• Operating income (EBIT): $ 428 million, + 21%
• Net income: $ 197 million, + 30%
• Earnings per share: $ 0.67, + 29%

Summary Full Year 2007

• Net revenue : $ 9,720 million, + 14%
• Operating income (EBIT): $ 1,580 million, + 20%
• Net income: $ 717 million, + 34%
• Earnings per share: $ 2.43, + 33%

Dividend Proposal

• Ordinary Share: € 0.54, + 15%
• Preference Share: € 0.56, + 14%

Fresenius Medical Care AG & Co. KGaA ("the Company"), the world's largest provider of Dialysis Products and Services, today announced its results for the fourth quarter and full year of 2007.

Fourth Quarter 2007:

Revenue
Net revenue for the fourth quarter 2007 increased by 9% to $2,569 million (6% at constant currency) compared to the fourth quarter 2006. Organic revenue growth worldwide was 4%. Dialysis Services revenue grew by 6% to $1,856 million (4% at constant currency) in the fourth quarter of 2007. Dialysis Product revenue increased by 18% to $713 million (10% at constant currency) in the same period.

North America revenue increased by 3% to $1,706 million. Dialysis Services revenue grew by 1% to $1,526 million. Excluding effects of the divestiture of the perfusion business, Dialysis Service revenue increased by 3%. Average revenue per treatment for the U.S. clinics decreased by 1% to $325 in the fourth quarter 2007 compared to $328 for the same quarter in 2006. At the same time, due to extremely good cost containment, the comparable costs per treatment decreased by 2% to $266 per treatment also contributing to a further margin expansion of 70 basis points in North America. Dialysis Product revenue increased by 17% to $180 million again well above market led by strong sales of our 2008K hemodialysis machines, peritoneal dialysis products and the phosphate binding drug PhosLo.

International revenue was $863 million, an increase of 24% (12% at constant currency) compared to the fourth quarter of 2006. Organic revenue growth of the international segment was 7%. Dialysis Services revenue reached $331 million, an increase of 35% (22% at constant currency). Dialysis Product revenue rose by 18% to $533 million (7% at constant currency), led by strong peritoneal dialysis products and dialyzers.

Earnings
Operating income (EBIT) increased by 21% to $428 million compared to $354 million in the fourth quarter 2006. Operating income for the fourth quarter 2006 includes costs of $25 million related to restructuring costs and in-process R&D. Excluding these effects, operating income for the fourth quarter 2007 increased by 13%. The operating margin improved from 16.1% in the fourth quarter 2006 excluding the one-time costs to 16.6% in 2007.

In North America, the operating margin increased from 17.1% (excluding the effects of one-time items) by 70 basis points to 17.8% due to the new PhosLo business, higher product sales and decreased operating costs per treatment. In the International segment, the operating margin also increased by 70 basis points to 18.4% mainly due to higher growth in the emerging markets and increased efficiencies.

Net interest expense for the fourth quarter 2007 was $90 million compared to $96 million in the same quarter of 2006. This positive development was mainly attributable to lower average interest rates and a lower debt level.

Income tax expense was $135 million for the fourth quarter of 2007 compared to $99 million in the fourth quarter of 2006, reflecting effective tax rates of 39.8% and 38.5%, respectively.

Net income for the fourth quarter 2007 was $197 million, an increase of 30%. Net income increased by 16% when compared to the fourth quarter 2006 excluding the effects of one-time items in 2006.

Earnings per share (EPS) for the fourth quarter of 2007 rose by 29% to $0.67 per ordinary share compared to $0.52 for the fourth quarter of 2006. The weighted average number of shares outstanding for the fourth quarter of 2007 was approximately 296.3 million shares compared to 295.0 million shares for the fourth quarter of 2006. The increase in shares outstanding resulted from stock option exercises in 2007.

Cash Flow
In the fourth quarter of 2007, the Company generated $309 million in cash from operations, representing approximately 12% of revenue, clearly ahead of our target. The extremely strong cash flow generation was primarily supported by higher earnings and a stable working capital.

A total of $184 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions was $125 million compared to $266 million in the fourth quarter of 2006 on a reported basis. A total of $118 million in cash was used for acquisitions.

Full Year 2007:
The operations of Renal Care Group (RCG) are included in the Company's consolidated statements of income and cash flows from April 1, 2006, therefore, the current results for the full year 2007 are not directly comparable with the results of the full year 2006.

Revenue and Earnings
Net revenue for 2007 was $9,720 million, up 14% from 2006. At constant currency, net revenue rose by 12%. Organic growth was 6% in 2007.

Operating income (EBIT) increased by 20% to $1,580 million compared to $1,318 million in 2006. Operating income for the full year 2006 includes cost of $37 million as a result of restructuring, the transformation of the Company's legal form and in-process R&D, and a gain from the clinic divestitures of $40 million.

Excluding these items, operating income for 2007 increased also by 20%. This performance resulted in an operating margin of 16.3% compared to 15.5% for the year 2006.

Net interest expense for the full year 2007 was $371 million compared to $351 million in 2006. The increase was mainly the result of additional interest expense partially offset by the write-off in 2006 of deferred financing costs related to the 2003 senior credit facility of $15 million, both in conjunction with the financing of the RCG acquisition.

Income tax expense was $466 million for the full year compared to $413 million in 2006, reflecting tax rates of 38.5% and 42.8%, respectively. The tax rate for 2006 was impacted by tax payments in the U.S mainly related to the gain on the divestiture of dialysis clinics in the U.S. Excluding this impact, the effective tax rate for 2006 was at 39.8%.

For the full year 2007, net income was $717 million, up 34% from 2006. Net income for 2007 increased by 25% compared to 2006 excluding the effects of one-time items in 2006.

For the full year 2007, earnings per ordinary share rose by 33% to $2.43. The weighted average number of shares outstanding during 2007 was approximately 295.7 million.

Cash Flow
Cash from operations during the full year 2007 was $1,200 million compared to $908 million for 2006 on a reported basis. Excluding the effects of one-time items, cash from operations was $1,106 million for 2006. The increase compared to prior year was mainly due to increased earnings.

A total of $549 million was used for capital expenditures, net of disposals. Free Cash Flow before acquisitions for 2007 was $651 million compared to $458 million in 2006. The underlying Free Cash Flow before acquisitions and the effects of one-time items for 2006 was $656 million. A total of $228 million in cash was used for acquisitions, net of divestitures. Free Cash Flow after acquisitions for the full year 2007 was $423 million.

Please refer to the PDF-file for a complete overview on the fourth quarter and the full year of 2007.

Patients – Clinics – Treatments
As of December 31, 2007, Fresenius Medical Care treated 173,863 patients worldwide, which represents a 6% increase in patients compared to last year. North America provided dialysis treatments for 121,431 patients, an increase of 3%. Including 33 clinics managed by Fresenius Medical Care North America, the number of patients in North America was 123,273. The International segment served 52,432 patients, an increase of 15% over last year.

As of December 31, 2007, the Company operated a total of 2,238 clinics worldwide. This is comprised of 1,602 clinics in North America, an increase of 3%, and 636 clinics in the International segment, an increase of 16%.

Fresenius Medical Care delivered approximately 26.44 million dialysis treatments worldwide during 2007. This represents an increase of 11% year over year. North America accounted for 18.45 million treatments, an increase of 9%, and the International segment delivered 7.99 million treatments, an increase of 16% over last year.

Employees
As of December 31, 2007, Fresenius Medical Care had 61,406 employees (full-time equivalents) worldwide compared to 56,803 employees at the end of 2006. The increase of 4,603 employees is primarily due to continued organic growth in the U.S. and acquisitions in Asia.

Dividends
The Company will continue to follow an earnings-driven dividend policy. For the eleventh consecutive year, shareholders can expect to receive an increased annual dividend for the fiscal year 2007. At the Annual General Meeting to be held on May 20, 2008, shareholders will be asked to approve a dividend of €0.54 per ordinary share, an increase of 15% from 2006 (€0.47) and €0.56 per preference share, an increase of 14% from 2006 (€0.49).

Debt/EBITDA Ratio
The ratio of debt to Earnings before Interest, Taxes and Amortization (EBITDA) decreased from 3.23 at the end of 2006 to 2.84 at the end of 2007.

Rating
There have been no rating changes in the fourth quarter 2007, Standard & Poor's Ratings Services rates the Company's corporate credit rating as 'BB' with a ‘stable' outlook.

Moody's rates the Company's corporate credit rating as ‘Ba2' with a ‘positive' outlook.

Refinancing of Trust Preferred Securities
At the beginning of February, we refinanced our Capital Trust II and III Trust Preferred Securities. They were mandatorily redeemable after a period of ten years, expiring on February 1, 2008. The stated amount of Capital Trust II was $450 million, with a fixed interest rate of 7 7/8%; the stated amount of Capital Trust III totaled DM300 million, with an interest rate of 7 3/8%. Fresenius Medical Care's existing financing facilities were utilized to affect the refinancing.

Outlook for 2008
For the full year 2008, the Company expects to achieve revenue of more than $10.4 billion, an increase of more than 7%.

Net income is expected to be between $805 million and $825 million in 2008, an increase of 12% to 15%.

The Company expects to spend $650 to $750 million on capital expenditures and $150 to $250 million on acquisitions. The debt/EBITDA ratio is expected to decrease below 2.8 by the end of 2008.

For 2010, Fresenius Medical Care continues to expect revenue of more than $11.5 billion. Earnings after tax are projected to grow in the low- to mid-teens per year.

Ben Lipps, Chief Executive Officer of Fresenius Medical Care, commented: "Our excellent performance in 2007 achieving record revenue and earnings for the year reflects the strong demand for our products and services worldwide. Both, the North American segment and the International segment contributed to this outstanding performance. Overall, we continued to grow above market in our global product business and are the leading provider of dialysis services in all four major regions in the world. We are pleased to have again exceeded our guidance in 2007 and are proposing to deliver our eleventh consecutive dividend increase to our shareholders. We have made good progress on our growth initiatives and with our global presence, we are confident to continue our strong performance in 2008."

Video Webcast
Fresenius Medical Care will hold an analyst meeting at its headquarters in Bad Homburg, Germany, to discuss the results of the fourth quarter and the full year of 2007 on Wednesday, February 20, 2008, at 3.15pm CET / 9.15am EST. The Company invites investors to view the live webcast of the meeting at the Company's website www.fmc-ag.com in the "Investor Relations" section. A replay will be available shortly after the meeting.