Sales
Group sales increased by 3% (5% in constant currency) to €37,520 million (2020: €36,277 million). The impact of the COVID-19 pandemic had a negative effect1 of an estimated 0 to -1 percentage points on currency-adjusted sales growth. Currency translation effects had a negative impact of 2%. These resulted in particular from the appreciation of the U.S. dollar and various Latin American currencies, mainly the Brazilian real and the Argentine peso, against the euro.
In detail, the sales performance of the business segments2 was as follows:
- Sales of Fresenius Medical Care decreased by 1% (increased by 2% in constant currency) to €17,619 million (2020: €17,859 million). Organic sales growth was 1%. Currency translation effects lowered sales by 3%. The sales decline was mainly driven by negative exchange rate effects, partially offset by organic growthOrganic growthGrowth that is generated by a company’s existing businesses and not by acquisitions, divestitures, or foreign exchange impact., which was achieved despite COVID-19 and a lower reimbursement for calcimimetics, as well as higher contributions from acquisitions. Higher sales of machines for chronic treatment, home hemodialysis products and renal pharmaceuticals were offset by a negative exchange rate effect and lower sales of products for acute care treatments.
1 An overview of the effect of COVID-19 is provided in the chapter Overall business development
2 The following description of sales relates to the respective external sales of the business segments. Consolidation effects and corporate entities are not taken into account. Therefore, aggregation to total Group sales is not possible.
Sales by region
Download(XLS, 35 KB)| € in millions | 2021 | 2020 | Growth | Currency translation effects | Constant currency growth | Organic sales growth | Acquisitions | Divestitures | % of total sales |
|---|---|---|---|---|---|---|---|---|---|
| North America | 14,363 | 14,801 | -3% | -3% | 0% | -1% | 1% | 0% | 38% |
| Europe | 16,888 | 15,813 | 7% | 0% | 7% | 5% | 2% | 0% | 45% |
| Asia-Pacific | 3,938 | 3,705 | 6% | 0% | 6% | 6% | 0% | 0% | 11% |
| Latin America | 1,830 | 1,566 | 17% | -11% | 28% | 24% | 4% | 0% | 5% |
| Africa | 501 | 392 | 28% | 3% | 25% | 25% | 0% | 0% | 1% |
| Total | 37,520 | 36,277 | 3% | -2% | 5% | 4% | 1% | 0% | 100% |
Sales by business segment2
Download(XLS, 36 KB)| € in millions | 2021 | 2020 | Growth | Currency translation effects | Constant currency growth | Organic growth | Acquisitions | Divestitures | % of total sales |
|---|---|---|---|---|---|---|---|---|---|
| Fresenius Medical Care | 17,619 | 17,859 | -1% | -3% | 2% | 1% | 1% | 0% | 47% |
| Fresenius Kabi | 7,193 | 6,976 | 3% | -1% | 4% | 4% | 0% | 0% | 19% |
| Fresenius Helios | 10,891 | 9,818 | 11% | 0% | 11% | 7% | 4% | 0% | 29% |
| Fresenius Vamed | 2,297 | 2,068 | 11% | 0% | 11% | 11% | 0% | 0% | 5% |
| Total | 37,520 | 36,277 | 3% | -2% | 5% | 4% | 1% | 0% | 100% |
Order intake and order backlog Fresenius Vamed
Download(XLS, 35 KB)| € in millions | 2021 | 2020 | 2019 | 2018 | 2017 |
|---|---|---|---|---|---|
| Order intake | 1,290 | 1,010 | 1,314 | 1,227 | 1,096 |
| Order backlog (December 31) | 3,473 | 3,055 | 2,865 | 2,420 | 2,147 |
- Fresenius Kabi increased sales by 3% (by 4%1) to €7,193 million (2020: €6,976 million). Organic sales growth was 4%. Negative currency translation effects (1%) were mainly related to the devaluation of the U.S. dollar, the Argentine peso, and the Brazilian real against the euro. We recorded continued demand for essential medicines and medical devices for the treatment of COVID-19 patients particularly in the United States and Europe, partially offset by fewer elective treatments. In North America, supply constraints for individual products due to temporary production delays as well as increased competitive pressure put an additional strain on sales. In Asia-Pacific, we recorded strong growth, mainly due to the continuing normalization of the number of elective treatments in China and a sustained recovery in other Asian markets. In the course of the year, growth in China slowed down due to initial negative price effects from successful participation in VBP (volume-based procurement) tenders.
- Fresenius Helios increased sales by 11% (11%1) to €10,891 million (2020: €9,818 million). Organic sales growth was 7%. Acquisitions contributed a total of 4% to sales growth. The Eugin Group contributed €133 million to sales in 2021, with first-time consolidation as of April 1, 2021. Fresenius Helios’ sales in 2021 continued to be negatively impacted by a lower number of elective treatments due to COVID-19. Helios Germany’s sales increased by 6% to €6,733 million (2020: €6,340 million). The acquisitions of the Malteser Hospitals and the DRK (German Red Cross) Kliniken Nordhessen contributed 4% to sales growth. Organic sales growth of 2% was positively influenced by regular price increases for flat rates per case (DRG) in Germany and a positive case mix. Overall, Helios Germany recorded a decline in case numbers of 2% on an annual basis. The follow-up regulation to the Act on Economic Relief for Hospitals, which was in force until the end of May 2021, was able to mitigate part of the negative effects. Helios Spain increased sales by 16% (17%1) to €4,021 million (2020: €3,475 million). Organic sales growth was 15%. The increase was driven by sustained high demand for treatment as well as for occupational health care services. Hospitals in Latin America performed well. They contributed 4% to sales growth in constant currency.
- Fresenius Vamed increased sales by 11% (11%1) to €2,297 million (2020: €2,068 million). Sales in the project business increased by 13% to €717 million (2020: €633 million). In the project business, there were delays due to travel restrictions, restricted supply chains, and interrupted project execution, which also impacted sales. Sales in the service business grew by 10% to €1,580 million (2020: €1,435 million). Fresenius Vamed’s services business showed a positive development in high-end services and a recovery of case numbers in the rehabilitation business in 2021. The technical services business was robust. Order intake in the project business increased by 28% to €1,290 million (2020: €1,010 million). Fresenius Vamed increased its order backlog by 14% to €3,473 million (December 31, 2020: €3,055 million). Fresenius Vamed is the only business segment within the Fresenius Group whose business is also significantly influenced by order intake and order backlog.
1 In constant currency
Earnings structure
In 2021, Group net income1 before special items increased by 4% (5% in constant currency) to €1,867 million (2020: €1,796 million). COVID-19 had an estimated effect of -1 to -5 percentage points on Group net income growth. In 2021, earnings per share1 before special items increased by 4% (5% in constant currency) to €3.35 (2020: €3.22). The weighted average number of shares was 558.1 million.
Reported Group net income1 increased by 7% (8% in constant currency) to €1,818 million (2020: €1,707 million). Reported earnings per share1 increased by 7% (8% in constant currency) to €3.26 (2020: €3.06).
Group EBITDA before special items decreased by 4% (-2% in constant currency) to €6,854 million (2020: €7,132 million). Group EBITDA reported was €6,825 million (2020: €7,100 million).
Group EBIT before special items decreased by 8% (-6% in constant currency) to €4,252 million (2020: €4,612 million). Group EBIT reported decreased by 5% (-3% in constant currency) to €4,158 million (2020: €4,385 million).
1 Net income attributable to the shareholders of Fresenius SE & Co. KGaA
Group return ratios
Download(XLS, 35 KB)| in % | 2021 | 2020 | 2019 | 2018 | 2017 |
|---|---|---|---|---|---|
| EBITDA margin1 | 18.3 | 19.7 | 20.1 | 18.1 | 18.5 |
| EBIT margin1 | 11.3 | 12.7 | 13.2 | 13.6 | 14.3 |
| Return on sales (before taxes and noncontrolling interests)1 | 10.0 | 10.9 | 11.2 | 11.9 | 12.3 |
| 1 Before special items | |||||
Statement of income (Summary)
Download(XLS, 39 KB)| € in millions | 2021 | 2020 | Growth |
|---|---|---|---|
| Sales | 37,520 | 36,277 | 3% |
| Cost of goods sold | -27,209 | -25,961 | -5% |
| Gross profit | 10,311 | 10,316 | 0% |
| Selling, general and administrative expenses | -5,453 | -5,430 | 0% |
| Other operating income and expenses | 105 | 250 | -58% |
| Research and development expenses | -805 | -751 | -7% |
| Operating income (EBIT) | 4,158 | 4,385 | -5% |
| Financial result | -506 | -659 | 23% |
| Income before income taxes | 3,652 | 3,726 | -2% |
| Income taxes | -833 | -903 | 8% |
| Net income | 2,819 | 2,823 | 0% |
| Noncontrolling interests | 1,001 | 1,116 | -10% |
| Net income attributable to Fresenius SE & Co. KGaA1,2 | 1,867 | 1,796 | 4% |
| Net income attributable to Fresenius SE & Co. KGaA1 | 1,818 | 1,707 | 7% |
| Earnings per ordinary share in €1,2 | 3.35 | 3.22 | 4% |
| Fully diluted earnings per ordinary share in €1,2 | 3.35 | 3.22 | 4% |
| Earnings per ordinary share in €1 | 3.26 | 3.06 | 7% |
| Fully diluted earnings per ordinary share in €1 | 3.26 | 3.06 | 7% |
| Average number of shares | 558,061,878 | 557,451,759 | 0% |
| EBITDA2 | 6,854 | 7,132 | -4% |
| Depreciation and amortization2 | -2,602 | -2,520 | -3% |
| EBIT2 | 4,252 | 4,612 | -8% |
| EBITDA margin2 | 18.3% | 19.7% | |
| EBIT margin2 | 11.3% | 12.7% | |
| 1 Net income attributable to the shareholders of Fresenius SE & Co. KGaA | |||
| 2 Before special items | |||
EBIT development by business segment was as follows:
The presentation of the business segments’ earnings development is provided before special items. The special items are reported in the Corporate / Other segment.
- Fresenius Medical Care’s EBIT1 decreased in constant currency by 21% to €1,915 million (2020: €2,499 million). This was mainly due to adverse COVID-19-related net effects, inflationary materials cost increases, higher personnel expense, and the remeasurement effect on the fair value of investments. These effects were slightly mitigated by an improved U.S. payor mix, in particular due to an increased number of patients with Medicare Advantage coverage. The EBITEBIT (Earnings before Interest and Taxes)EBIT does include depreciation and write-ups on property, plant and equipment. EBIT is calculated by subtracting cost of sales, selling, general and administrative expenses, and research and development expenses from sales. margin1 decreased to 10.9% (2020: 14.0%). EBIT reported decreased by 17% in constant currency to €1,852 million (2020: €2,304 million), and the EBIT marginEBIT marginEBIT margin is calculated as the ratio of EBIT to sales. was 10.5% (2020: 12.9%).
- Fresenius Kabi’s EBIT1 increased by 5% (7% in constant currency) to €1,153 million (20201: €1,095 million). The increase in constant currency was driven primarily by emerging markets and the business in Europe. The increase in constant currency was supported by COVID-19-related demand and good peformances in the emerging markets and in Europe. The EBIT development was negatively impacted by competitive price pressure in North America and initial negative price effects following successful participation in the volume based procurement (VBP) tender process in China. The EBIT margin1 was 16.0% (2020: 15.7%).
- The EBIT1 of Fresenius Helios increased by 10% (10% in constant currency) to €1,127 million (2020: €1,025 million). The EBIT1 margin was 10.3% (2020: 10.4%). The increase was mainly driven by a good development of elective treatments. This was partly offset by higher costs for personnel, personal protective equipment, and selected medical products. The Eugin Group contributed €19 million to operating earnings (EBIT) in fiscal year 2021, with first-time consolidation effective April 1, 2021. The EBIT1 of Helios Germany increased by 2% to €613 million (2020: €602 million). The EBIT1 margin was 9.1% (2020: 9.5%). The EBIT of Helios Spain increased by 22% (24% in constant currency) to €514 million (2020: €420 million). The EBIT margin was 12.8% (2020: 12.1%). Good organic sales growth led to improved fixed-cost coverage. The hospital acquisitions in Colombia also contributed to growth.
- The EBIT1 of Fresenius Vamed increased by 248% (248% in constant currency) to €101 million (2020: €29 million). The EBIT margin1 was 4.4% (2020: 1.4%). The increase was mainly the result of the weak prior-year basis, which was adversely affected by COVID-19 effects due to foregone or postponed elective treatments combined with higher costs for extensive measures to combat the pandemic.
Development of other major items in the statement of income
Group gross profit remained on the prior year’s level at €10,311 million (2020: €10,316 million, increased by 2% in constant currency). The gross margin decreased to 27.5% (2020: 28.4%). The cost of sales increased by 5% to €27,209 million (2020: €25,961 million). Cost of sales as a percentage of Group sales increased to 72.5% (2020: 71.6%).
Selling, general, and administrative expenses consisted primarily of personnel costs, marketing and distribution costs, and depreciation and amortization. These expenses including other operating income and expenses, increased by 3% to -€5,348 million (2020: -€5,180 million), mainly due to the rise in personnel costs and acquisitions. Selling, general, and administrative expenses as a percentage of Group sales was 14.3% and remained on the prior year’s level (2020: 14.3%). R & D expenses increased by 7% to €805 million (2020: €751 million). The increase resulted from higher expenses at Fresenius Medical Care and Fresenius Kabi.
Depreciation and amortization was €2,602 million1 (2020: €2,520 million1). The ratio as a percentage of sales was 6.9%1 (2020: 6.9%1). Group personnel costs increased to €15,610 million (2020: €15,128 million). The personnel cost ratio was 41.6% (2020: 41.7%).
The Group financial result before special items improved to -€504 million (2020: -€654 million), mainly driven by successful refinancing activities and ongoing favorable market conditions. The Group financial result reported was -€506 million (2020: -€659 million).
The Group tax rate before special items was 22.6% (2020: 23.1%) and thus in line with expectations. The Group tax rate reported was 22.8% (2020: 24.2%).
Noncontrolling interests before special items were -€1,033 million (2020: -€1,248 million), of which 91% were attributable to the noncontrolling interests in Fresenius Medical Care.
1 before special items
Reconciliation Fresenius Group
To present the underlying operational business performance and in order to compare the results with the scope of the guidance provided for fiscal year 2021, key figures are presented before special items.
Net income 2021 includes special items from expenses related to the Group-wide cost and efficiency program, revaluations of contingent biosimilarsBiosimilarsA biosimilar is a drug that is “similar” to another biologic drug already approved. purchase price liabilities and costs for the FME25 program at Fresenius Medical Care (FMC). Net income 2020 includes special items from goodwill impairment at Fresenius Medical Care in Latin America and revaluations of contingent biosimilars purchase price liabilities.
The special items shown within the reconciliation tables are reported in the Corporate segment.
Reconciliation Fresenius Group
Download(XLS, 36 KB)| € in millions | 2021 | 2020 | Growth rate | Growth rate in constant currency |
|---|---|---|---|---|
| Sales reported | 37,520 | 36,277 | 3% | 5% |
| EBIT reported (after special items) | 4,158 | 4,385 | -5% | -3% |
| Revaluations of biosimilars contingent purchase price liabilities | -49 | 32 | ||
| Impairment of Goodwill at FMC Latin America | - | 195 | ||
| Expenses associated with the Fresenius cost and efficiency program | 143 | - | ||
| EBIT (before special items) | 4,252 | 4,612 | -8% | -6% |
| Net interest reported (after special items) | -506 | -659 | 23% | 22% |
| Revaluations of biosimilars contingent purchase price liabilities | 2 | 5 | ||
| Net interest (before special items) | -504 | -654 | 23% | 22% |
| Income taxes reported (after special items) | -833 | -903 | 8% | 6% |
| Revaluations of biosimilars contingent purchase price liabilities | 14 | -11 | ||
| Expenses associated with the Fresenius cost and efficiency program | -29 | - | ||
| Income taxes (before special items) | -848 | -914 | 7% | 6% |
| Noncontrolling interests reported (after special items) | -1,001 | -1,116 | 10% | 8% |
| Impairment of Goodwill at FMC Latin America | - | -132 | ||
| Expenses associated with the Fresenius cost and efficiency program | -32 | - | ||
| Noncontrolling interests (before special items) | -1,033 | -1,248 | 17% | 15% |
| Net income reported (after special items)1 | 1,818 | 1,707 | 7% | 8% |
| Revaluations of biosimilars contingent purchase price liabilities | -33 | 26 | ||
| Impairment of Goodwill at FMC Latin America | - | 63 | ||
| Expenses associated with the Fresenius cost and efficiency program | 82 | - | ||
| Net income (before special items)1 | 1,867 | 1,796 | 4% | 5% |
| 1 Net income attributable to shareholders of Fresenius SE & Co. KGaA | ||||
Reconciliation business segments
Fresenius Medical Care
Download(XLS, 36 KB)| € in millions | 2021 | 2020 | Growth rate | Growth rate in constant currency |
|---|---|---|---|---|
| Sales reported | 17,619 | 17,859 | -1% | 2% |
| EBIT reported (after special items) | 1,852 | 2,304 | -20% | -17% |
| Impairment of Goodwill at FMC Latin America | - | 195 | ||
| Costs related to FME25 program | 63 | - | ||
| EBIT (before special items) | 1,915 | 2,499 | -23% | -21% |
| Net income reported (after special items)1 | 969 | 1,164 | -17% | -14% |
| Impairment of Goodwill at FMC Latin America | - | 195 | ||
| Costs related to FME25 program | 49 | - | ||
| Net income (before special items)1 | 1,018 | 1,359 | -25% | -23% |
| 1 Net income attributable to Fresenius Medical Care AG & Co. KGaA | ||||
Fresenius Kabi
Download(XLS, 35 KB)| € in millions | 2021 | 2020 | Growth rate | Growth rate in constant currency |
|---|---|---|---|---|
| Sales reported | 7,193 | 6,976 | 3% | 4% |
| Revaluations of biosimilars contingent purchase price liabilities | -49 | 32 | ||
| Expenses associated with the Fresenius cost and efficiency program | 58 | - | ||
| EBIT (before special items) | 1,153 | 1,095 | 5% | 7% |
Fresenius Helios
Download(XLS, 35 KB)| € in millions | 2021 | 2020 | Growth rate | Growth rate in constant currency |
|---|---|---|---|---|
| Sales reported | 10,891 | 9,818 | 11% | 11% |
| Expenses associated with the Fresenius cost and efficiency program | 10 | - | ||
| EBIT (before special items) | 1,127 | 1,025 | 10% | 10% |
Fresenius Vamed
Download(XLS, 35 KB)| € in millions | 2021 | 2020 | Growth rate | Growth rate in constant currency |
|---|---|---|---|---|
| Sales reported | 2,297 | 2,068 | 11% | 11% |
| Expenses associated with the Fresenius cost and efficiency program | 0 | - | ||
| EBIT (before special items) | 101 | 29 | -- | -- |