Fresenius Medical Care Reports Strong Start for 2011 and Raises Guidance for Full Year 2011

BAD HOMBURG, Germany--()--Fresenius Medical Care AG & Co. KGaA (NYSE: FMS) (FWB: FME):

1st Quarter 2011 Summary:

           
Net revenue $3,036 million +5%
Operating income (EBIT) $445 million +5%

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

$221 million

+5%

Earnings per share $0.73 +4%
 

Fresenius Medical Care AG & Co. KGaA (“the company” or “Fresenius Medical Care”; Frankfurt Stock Exchange: FME / New York Stock Exchange: FMS), the world’s largest provider of dialysis products and services, today announced its results for the first quarter of 2011.

Revenue

Net revenue for the first quarter of 2011 increased by 5% to $3,036 million (+5% at constant currency) compared to the first quarter of 2010. Organic revenue growth worldwide was 3%. Dialysis services revenue grew by 5% to $2,285 million (+5% at constant currency) and dialysis product revenue increased by 6% to $751 million (+5% at constant currency).

North America revenue increased by 1% to $1,977 million including the impact of the new Medicare end-stage renal disease prospective payment system in the United States. Organic revenue growth was 1%. Dialysis services revenue grew by 1% to $1,782 million with a same market growth of 4%. Average revenue per treatment for U.S. clinics decreased to $348 in the first quarter of 2011 compared to $355 for the corresponding quarter in 2010 reflecting the targeted implementation of the new prospective payment system. Dialysis product revenue decreased by 2% to $195 million mainly due to lower pricing of renal drugs, partially offset by higher sales of dialysis products.

International revenue increased by 14% to $1,055 million. Based on constant currency, revenue grew by 13%. Organic revenue growth was 6%. Dialysis services revenue was $503 million, an increase of 23% (+21% at constant currency). Dialysis product revenue increased by 8% to $552 million and increased by 6% at constant currency, mainly driven by higher sales of peritoneal dialysis products, dialyzers, bloodlines, and products for acute care treatments.

Earnings

Operating income (EBIT) for the first quarter of 2011 increased by 5% to $445 million compared to $425 million in the first quarter of 2010. This resulted in an operating margin of 14.7% for the first quarter of 2011 compared to 14.8% for the corresponding quarter in 2010.

In North America, the operating margin increased from 15.7% to 15.8%. The margin development was mainly influenced by the favorable development of pharmaceutical costs and the negative effects of the implementation of the new Medicare end-stage renal disease prospective payment system in the United States.

In the International segment, the operating margin decreased from 16.4% to 16.2%.

Net interest expense for the first quarter of 2011 was $72 million, compared to $67 million in the first quarter of 2010. This development was mainly attributable to a higher debt level.

Income tax expense was $124 million for the first quarter of 2011 compared to $128 million in the first quarter of 2010 and reflecting effective tax rates of 33.3% and 35.6%, respectively.

Net income attributable to FMC AG & Co. KGaA for the first quarter of 2011 was $221 million, an increase of 5%, compared to the corresponding quarter of 2010.

Earnings per share (EPS) for the first quarter of 2011 rose by 4% to $0.73 per ordinary share compared to $0.70 for the first quarter of 2010. The weighted average number of shares outstanding for the first quarter of 2011 was approximately 302.3 million shares, compared to 299.6 million shares for the first quarter of 2010. The increase in shares outstanding resulted from stock option exercises in the past 12 months.

Cash flow

In the first quarter of 2011, the company generated $175 million in cash from operations, representing approximately 6% of revenue. The cash flow generation was supported by increased earnings and negatively influenced by an unfavorable development of DSOs, primarily related to the introduction of the new Medicare end-stage renal disease prospective payment system in the United States and raised inventory levels.

A total of $113 million was spent for capital expenditures, net of disposals. Free cash flow before acquisitions was $62 million compared to $250 million in the first quarter of 2010. A total of $339 million in cash was spent for acquisitions and investments, net of divestitures. Approximately $300 million of the expenditures was a minority investment in Renal Advantage Partners LLC, the parent company of Renal Advantage, Inc. Additionally, we have entered into agreements to provide renal products, pharmaceutical supplies and other services to Renal Advantage and Liberty Dialysis Inc.

Free cash flow after acquisitions, investments and divestitures was -$277 million, compared to $168 million in the first quarter of 2010.

Please refer to the attachments for a complete overview on the first quarter of 2011 and the reconciliation of non-GAAP financial measures included in this release to the most comparable GAAP financial measures.

Patients – Clinics – Treatments

As of March 31, 2011, Fresenius Medical Care treated 216,942 patients worldwide, which represents a 9% increase compared to the previous year’s figure. North America provided dialysis treatments for 138,392 patients, an increase of 4%. Including 21 clinics managed by Fresenius Medical Care North America, the number of patients in North America was 139,887. The International segment served 78,550 patients, an increase of 20% over the prior year’s figure.

As of March 31, 2011, the company operated a total of 2,769 clinics worldwide, which represents an 8% increase compared to the previous year’s figure. The number of clinics is comprised of 1,823 clinics in North America (1,844 including managed clinics), and 946 clinics in the International segment, representing an increase of 3% and 19%, respectively.

During the first quarter of 2011, Fresenius Medical Care delivered approximately 8.17 million dialysis treatments worldwide. This represents an increase of 9%, compared to last year’s figure. North America accounted for 5.24 million treatments, an increase of 4%. The International segment delivered 2.93 million treatments, an increase of 19%.

Employees

As of March 31, 2011, Fresenius Medical Care had 74,844 employees (full-time equivalents) worldwide, compared to 73,452 employees at the end of 2010. This increase of more than 1,300 employees is due to overall growth in the company’s business and acquisitions.

Debt/EBITDA ratio

The ratio of debt to Earnings before interest, taxes, depreciation and amortization (EBITDA) increased from 2.30 at the end of the first quarter of 2010 to 2.55 at the end of the first quarter of 2011. The debt/EBITDA ratio at the end of 2010 was 2.38.

Rating

Standard & Poor’s Ratings Services continues to rate the company’s corporate credit as ‘BB’ with a ‘positive’ outlook. Moody's continues to rate the company’s corporate credit as ‘Ba1’ with a ‘stable’ outlook, and Fitch continues to rate the company’s corporate credit as ‘BB’ with a ‘positive’ outlook. 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.

Issuance of senior notes

In February 2011 Fresenius Medical Care issued $-denominated and €-denominated senior unsecured notes due 2021 in the respective principal amounts of $650 million and €300 million. The coupon for the $ senior notes is 5.75%, while the coupon for the € senior notes is 5.25%. The net proceeds amounted to approximately $1,035 million.

Acquisition of dialysis service business from Euromedic

On Jan. 4, 2011, Fresenius Medical Care announced the signing of a purchase agreement to acquire International Dialysis Centers (IDC), Euromedic’s dialysis service business for a purchase price of €485 million. Fresenius Medical Care is thus expanding its activities in the dialysis care market, especially in Eastern Europe, where IDC treats over 8,200 hemodialysis patients. The transaction remains subject to necessary regulatory approvals by the relevant anti-trust authorities and is expected to close in the second quarter of 2011. Upon completion, the acquired operations will add approximately $180 million in annual revenue and are expected to be accretive to earnings in the first year after closing of the transaction.

Outlook for 2011 raised

Based on the strong financial results in the first quarter of 2011 and the elimination of the so-called “transition adjustment” imposed on dialysis facilities (as part of the new Medicare end-stage renal disease prospective payment system) in the United States, the company raises its outlook for the full year 2011.

Revenue is now expected to grow to above $13 billion. Previously, the company expected revenue between $12.8 billion and $13.0 billion.

Net income attributable to FMC AG & Co. KGaA is now expected between $1.070 billion and $1.090 billion. Previously, the company expected net income between $1.035 billion and $1.055 billion.

For 2011, the company still expects to spend around 5% of revenue on capital expenditures and approximately $1.2 billion on acquisitions. The debt/EBITDA ratio is expected to be below or equal to 2.8 by the end of 2011, likewise unchanged from the previous guidance.

“We are pleased to report a successful first quarter of 2011 with strong operational performance – despite the expected implementation challenges posed by the new Medicare end-stage renal disease prospective payment system in the United States,” said Ben Lipps, chief executive officer of Fresenius Medical Care. “We would again like to express our appreciation to the Centers for Medicare & Medicaid Services (CMS) and the Administration for making this correction, and for their willingness in the past years to work with the entire kidney care community in the process of establishing the new reimbursement system, helping to improve the quality of life of all dialysis patient covered by Medicare.”

Conference call

Fresenius Medical Care will hold a conference call to discuss the results of the first quarter of 2011 on Wednesday, May 4, 2011, at 3:30 p.m. CEDT / 9:30 a.m. EDT. The company invites investors to view 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.

About Fresenius Medical Care

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 2 million individuals worldwide. Through its network of 2,769 dialysis clinics in North America, Europe, Latin America, Asia-Pacific and Africa, Fresenius Medical Care provides dialysis treatment to 216,942 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.

Disclaimer

This release contains forward-looking statements that are subject to various risks and uncertainties. Actual results could differ materially from those described in these forward-looking statements due to certain factors, including changes in business, economic and competitive conditions, regulatory reforms, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, and the availability of financing. These and other risks and uncertainties are detailed in Fresenius Medical Care AG & Co. KGaA's reports filed with the U.S. Securities and Exchange Commission. Fresenius Medical Care AG & Co. KGaA does not undertake any responsibility to update the forward-looking statements in this release.

   
Fresenius Medical Care Three months ended
Statement of Earnings   March 31,    
in US$ thousands, except share data 2011   2010 Change
unaudited
 
Net revenue
Dialysis care 2,285,316 2,170,784 5.3%
Dialysis products 751,072 711,345 5.6%
Total net revenue 3,036,388 2,882,129 5.4%
 
Cost of revenue 2,001,289 1,917,837 4.4%
Gross profit 1,035,099 964,292 7.3%
Selling, general and administrative 571,448 517,737 10.4%
Research and development 26,149 23,089 13.3%
Income from equity method investees (7,582) (1,713) 342.6%
Operating income (EBIT) 445,084 425,179 4.7%
 
Interest income (10,421) (5,839) 78.5%
Interest expense 81,986 73,264 11.9%
Interest expense, net 71,565 67,425 6.1%
Income before taxes 373,519 357,754 4.4%
Income tax expense 124,404 127,528 -2.4%
Net income 249,115 230,226 8.2%
Less: Net income attributable to noncontrolling interest 28,414 19,110 48.7%
Net income attributable to FMC AG & Co. KGaA 220,701 211,116 4.5%
 
Operating income (EBIT) 445,084 425,179 4.7%
Depreciation and amortization 135,984 124,458 9.3%
EBITDA 581,068 549,637 5.7%
 
Total bad debt expenses 52,685 60,271
 
Earnings per ordinary share $0.73 $0.70 3.6%
Earnings per ordinary ADS $0.73 $0.70 3.6%
 
 
Weighted average number of shares
Ordinary shares 298,292,972 295,746,635
Preference shares 3,957,435 3,889,994
 
In percent of revenue
Cost of revenue 65.9% 66.5%
Gross profit 34.1% 33.5%
 
Selling, general and administrative 18.8% 18.0%
Research and development 0.9% 0.8%
Income from equity method investees -0.2% -0.1%
Operating income (EBIT) 14.7% 14.8%
Interest expense, net 2.4% 2.3%
Income before taxes 12.3% 12.4%
Income tax expense 4.1% 4.4%
Net income attributable to noncontrolling interest 0.9% 0.7%
Net income attributable to FMC AG & Co. KGaA 7.3% 7.3%
 
EBITDA 19.1% 19.1%
 
   
Fresenius Medical Care Three months ended
Segment and Other Information   March 31,    
in US$ millions, unaudited 2011   2010 Change
 
Net revenue
North America 1,977 1,960 0.9%
International 1,055 922 14.4%
Corporate 4 - 1,676.2%
Total net revenue 3,036 2,882 5.4%
 
Operating income (EBIT)
North America 312 308 1.4%
International 171 151 13.3%
Corporate (38) (34) 13.0%
Total operating income (EBIT) 445 425 4.7%
 
Operating income in percent of revenue
North America 15.8% 15.7%
International 16.2% 16.4%
Total 14.7% 14.8%
 
 
Employees
Full-time equivalents 74,844 69,329
 
   
Fresenius Medical Care
Reconciliation of non U.S. GAAP
financial measures to the most directly Three months ended
comparable U.S. GAAP financial measures   March 31,
in US$ millions, unaudited 2011 2010
 
 
Segment information North America
Net revenue 1,977 1,960
Costs of revenue and research and development 1,315 1,327
Selling, general and administrative 358 327
Income from equity method investees (8) (2)
Costs of revenue and operating expenses 1,665 1,652
Operating income (EBIT) 312 308
In percent of revenue 15.8% 15.7%
 
 
Dialysis products revenue incl. and excl. internal sales
North America
Dialysis products revenue incl. internal sales 377 366
less internal sales (182) (166)
Dialysis products external sales 195 200
International
Dialysis products revenue incl. internal sales 644 591
less internal sales (92) (80)
Dialysis products external sales 552 511
 
Reconciliation of cash flow from operating activities to EBITDA 1)
Total EBITDA 581 550
Interest expense, net (72) (67)
Income tax expense (124) (128)
Change in working capital and other non-cash items (210) (6)
Net cash provided by operating activities 175 349
 
Annualized EBITDA
Operating income (EBIT) last twelve months 1,944 1,785
Depreciation and amortization last twelve months 514 476
Non-cash charges 47 51
Annualized EBITDA 2,505 2,312
 
 
1) EBITDA is the basis for determining compliance with certain covenants in Fresenius Medical

Care's long-term debt instruments.

 
   
Fresenius Medical Care March 31, December 31,
Balance Sheet   (unaudited)   (audited)
in US$ millions 2011 2010
 
Assets
Current assets 5,715 5,153
Intangible assets 8,902 8,833
Other non-current assets 3,497 3,109
Total assets 18,114 17,095
 
Liabilities and equity
Current liabilities 3,469 3,790
Long-term liabilities 6,478 5,501
Noncontrolling interest subject to put provisions 291 280
Total equity 7,876 7,524
Total liabilities and equity 18,114 17,095
 
Equity/assets ratio: 43% 44%
 
 
Debt
Short-term borrowings 132 671
Short-term borrowings from related parties 36 10
Current portion of long-term debt and capital lease obligations 265 264
Trust preferred securities 651 625
Long-term debt and capital lease obligations, less current portion 5,313 4,310
Total debt 6,397 5,880
 
   
Fresenius Medical Care
Cash Flow Statement        
Three months ended March 31, 2011 2010
in US$ millions, unaudited
 
Operating activities
Net income 249 230
Depreciation / amortization 136 125
Change in working capital and other non-cash items (210) (6)
Cash flow from operating activities 175 349
 
Investing activities
Purchases of property, plant and equipment (117) (106)
Proceeds from sale of property, plant and equipment 4 7
Capital expenditures, net (113) (99)
Free cash flow 62 250
 

Acquisitions and investments, net of cash acquired and purchases of intangible assets

(339) (84)
Proceeds from divestitures - 2
Acquisitions and investments, net of divestitures (339) (82)
Free cash flow after investing activities (277) 168
 
Financing activities
Change in accounts receivable securitization program (510) (214)
Change in intercompany debt 24 -
Change in other debt 862 21
Proceeds from exercise of stock options 2 17
Distributions to noncontrolling interest (25) (34)
Contributions from noncontrolling interest 4 8
Cash flow from financing activities 357 (202)
 
Effect of exchange rates on cash 17 (3)
Net increase (decrease) in cash 97 (37)
 
Cash at beginning of period 523 301
Cash at end of period 620 264
 
           
Fresenius Medical Care
Quarterly Performance Scorecard - Revenue                    
Three months ended March 31, 2011 cc 2010 cc

in US$ thousands, except per-treatment revenue,

unaudited

 
North America
Net revenue 1,977,288 1,959,689
Growth year-over-year 0.9% 10.5%
 
Dialysis care 1,782,001 1,760,389
Growth year-over-year 1.2% 11.6%
U.S. per treatment 348 355
Per treatment 340 348
Sequential growth -1.9% -0.6%
Growth year-over-year -2.2% 5.0%
 
Dialysis products
Incl. internal sales 376,716 365,416
Growth year-over-year 3.1% 6.0%
External sales 195,287 199,299
Growth year-over-year -2.0% 1.3%
 
International
Net revenue 1,055,233 922,223
Growth year-over-year 14.4% 13.0% 17.4% 7.6%
 
Dialysis care 503,315 410,395
Growth year-over-year 22.6% 21.2% 18.5% 8.9%
Per treatment 172 170 166 152
Sequential growth 1.7% -4.3%
Growth year-over-year 3.4% 2.2% 10.0% 1.1%
 
Dialysis products
Incl. internal sales 643,954 591,306
Growth year-over-year 8.9% 7.6% 17.6% 7.4%
External sales 551,917 511,828
Growth year-over-year 7.8% 6.4% 16.4% 6.7%
 
cc = at constant exchange rates
 
   
Fresenius Medical Care
Quarterly Performance Scorecard - Dialysis care volume        
Three months ended March 31, unaudited 2011 2010
 
North America
Number of treatments 5,241,652 5,034,516
Treatments per day 68,073 65,383
Per day sequential growth 0.6% 2.2%
Per day year-over-year growth 4.1% 4.7%
Same market growth year-over-year 3.7% 4.1%
 
International
Number of treatments 2,933,190 2,474,048
Same market growth year-over-year 5.6% 4.3%
 
   
Fresenius Medical Care
Quarterly Performance Scorecard - Expenses        
Three months ended March 31, unaudited 2011 2010
 
North America
Costs of revenue and operating expenses
In percent of revenue 84.2% 84.3%
Selling, general and administrative
In percent of revenue 18.1% 16.7%
Bad debt expenses
In percent of revenue 2.6% 2.9%
Dialysis care operating expenses/treatment (in US$) 282 289
Sequential growth 0.4% 2.6%
Growth year-over-year -2.5% 2.5%
 
Total Group
Costs of revenue and operating expenses
In percent of revenue 85.3% 85.2%
Selling, general and administrative
In percent of revenue 18.8% 18.0%
Effective tax rate 33.3% 35.6%
 
   
Fresenius Medical Care
Quarterly Performance Scorecard - Cash Flow/Investing Activities    
Three months ended March 31, 2011 2010
in US$ thousands, except number of de novos, unaudited
 
Total Group
Operating cash flow 175,319 349,088
In percent of revenue 5.8% 12.1%
 
Free cash flow before acquisitions 62,159 250,047
In percent of revenue 2.0% 8.7%
 
Acquisitions and investments, net of divestitures 338,792 81,578
 
Capital expenditures, net 113,160 99,041
In percent of revenue 3.7% 3.4%
 
Maintenance 77,056 56,985
In percent of revenue 2.5% 2.0%
 
Growth 36,104 42,056
In percent of revenue 1.2% 1.5%
 
Number of de novos 22 17
North America 15 7
International 7 10
 
   
Fresenius Medical Care
Quarterly Performance Scorecard - Balance Sheet        
March 31, unaudited 2011 2010
 
Total Group
Debt (in US$ millions) 6,397 5,310
Debt/EBITDA 2.6 2.3
 
North America
Days sales outstanding 60 52
 
International
Days sales outstanding 116 111
 
               
Fresenius Medical Care
Quarterly Performance Scorecard                    
Three months ended March 31, 2011 2010
 
North America (U.S.)
Clinical Performance
Single Pool Kt/v > 1.2 97% 96%
Hemoglobin = 10-12 g/dl 73% 65%
Hemoglobin = 10-13 g/dl 88% 87%
Calcium = 8.4-10.2 mg/dl 79% 80%
Albumin >= 3.5 g/dl 1) 84% 83%
No catheter 76% 73%
Phosphate <= 5.5mg/dl 63% 60%
Hospitalization Days per patient

(12 months ending March 31)

9.8 9.9
 
Demographics
Average age (in years) 62 62
Average time on dialysis (in years) 3.7 3.6
Average body weight (in kg) 81 81
Prevalence of diabetes 56% 55%
 
 
Europe, Middle East and Africa
Clinical Performance
Single Pool Kt/v > 1.2 96% 95%
Hemoglobin = 10-12 g/dl 54% 52%
Hemoglobin = 10-13 g/dl 77% 77%
Calcium = 8.4-10.2 mg/dl 77% 79%
Albumin >= 3.5 g/dl 1) 89% 87%
No catheter 82% 81%
Phosphate <= 5.5mg/dl 76% 77%
Hospitalization Days per patient

(12 months ending March 31)

9.8 8.9
 
Demographics
Average age (in years) 64 64
Average time on dialysis (in years) 4.9 4.8
Average body weight (in kg) 71 70
Prevalence of diabetes 28% 28%
 
 
1) International standard BCR CRM470

Contacts

Fresenius Medical Care AG & Co. KGaA
Oliver Maier, + 49 6172 609 2601
Fax: + 49 6172 609 2301
or
North America:
Terry L. Morris, + 1-800-948-2538
Fax: + 1-615-345-5605
ir@fmc-ag.com

Release Summary

Fresenius Medical Care Reports Strong Start for 2011 and Raises Guidance for Full Year 2011

Contacts

Fresenius Medical Care AG & Co. KGaA
Oliver Maier, + 49 6172 609 2601
Fax: + 49 6172 609 2301
or
North America:
Terry L. Morris, + 1-800-948-2538
Fax: + 1-615-345-5605
ir@fmc-ag.com