All business segments make an overall contribution to increasing the quality and efficiency of health care.
Fresenius Medical Care ensures patient health and product safety by providing a safe environment in its clinics. Fresenius Medical Care considers the quality and safety of its products and services to be the foundation of its success.
Fresenius Kabi’s corporate philosophy “caring for life” expresses the company’s commitment to improving the quality of life of its patients. The quality and safety of its products and services is thus of paramount importance to Fresenius Kabi.
Fresenius Helios hospitals are characterized by high standards of treatment quality, hygiene standards, patient safety, and quality of care.
Fresenius Vamed bases its quality processes on clearly defined and generally established standards.
Fresenius’ goal is to continue building on its strength in technology, its competence and quality in patient care, and its ability to manufacture cost-effectively. Developing products and systems that provide a high level of safety and user-friendliness and enable tailoring to individual patient needs is an inherent part of our strategy of sustainable and profitable growth. We will continue to develop ever more effective products and treatment methods for critically and chronically ill patients in order to offer best-in-class medical standards. Digitalization is playing an increasingly important role – whether it is in health care facilities or in production. It drives innovative technologies and treatment concepts and can contribute to solving numerous challenges in the health care system (see Sustainability Report).
Fresenius Medical Care will focus on creating the future of health care for chronically and critically ill patients across the renal care continuum and critical care solutions. Fresenius Medical Care also strives to identify new opportunities in value-added technologies and approaches on an ongoing basis, for example through the Fresenius Medical Care Ventures fund, which invests in start-ups and early-stage companies in the health care industry.
Fresenius Kabi focuses its research and development activities on products for the therapy and care of critically and chronically ill patients. With our products we want to support medical advancements in acute and post-acute care and improve patients’ quality of life. We are also committed to providing access to high-quality, state-of-the-art therapies for an increasing number of people worldwide. Our development expertise covers all relevant components such as drug raw materials, pharmaceutical formulations, primary packaging, medical technologies for the application of drugs and infusions, as well as production technology. In the area of biosimilarsBiosimilarsA biosimilar is a drug that is “similar” to another biologic drug already approved., we have specialized in the development of products for the treatment of oncological and autoimmune diseases, making affordable treatments accessible for even more patients.
Fresenius Helios’ goal is to foster knowledge sharing across its international hospital network and use innovation to develop ever better health care services and therapies for its patients. In order to comprehensively drive forward digitalization, the company is focusing on the further expansion of the IT infrastructure in the hospitals and the online patient portal, which accompanies our patients before, during, and after their stay in hospital. In Germany, Helios has set itself clear goals: by the end of 2022, additional medical data such as nursing care documentation and medication should be available in the digital patient file at all clinics. The Helios patient portal is also to be introduced at all clinics. Moreover, Fresenius Helios is also focusing on health apps for the chronically ill. As a result of the COVID-19 pandemic, telemedical applications are increasingly in demand ‒ more than 8,900 video consultations were booked by patients in 2021. The company will continue to expand this service in its health care facilities and offer it on a shared platform. Medical consultations are already being conducted via video. Numerous facilities already offer such video consultations on a regular basis (see Sustainability Report). Moreover, Fresenius Helios is driving forward initiatives focused on occupational medicine for company employees, as well as prevention programs.
Fresenius Vamed’s goal is to realize further projects in integrated health care services and to support health care systems more efficiently. In addition, state-of-the-art standards such as the use of Building Information Modeling (BIM) in the construction of health care facilities, new concepts for operational management through the application of innovative technologies, and digitalization measures contribute to the improvement of medical care as well as to the relief of medical professionals.
Fresenius is committed to continuously improving Group profitability and capital efficiency. For example, our financial medium-term goals foresee that over the coming years we will increase net income1,2 more strongly than sales (see Group sales and earnings).
To contain costs, we initiated a cost and efficiency program in 2021 and achieved initial cost savings. The measures to sustainably increase profitability and operational excellence are targeted to lead to cost savings of at least €150 million p.a. after taxes and minority interest in 2023, with some further potential to increase thereafter. Further information on the cost and efficiency program and the Fresenius Group’s strategic roadmap can be found further down at Cost and efficiency program.
By focusing on our operating cash flow and employing efficient working capitalWorking capitalCurrent assets (including deferred assets) - accruals - trade accounts payable - other liabilities - deferred charges. management, we are expanding our scope for investment and improving our balance sheet ratios. We also aim to optimize our weighted average cost of capital (WACC). To this end, we are focusing on a balanced mix of equity and debt and striving to achieve a net debt / EBITDA3 ratio within a range of 3.0× to 3.5×.
1 Net income attributable to the shareholders of Fresenius SE & Co. KGaA
2 Before special items
3 Both net debt and EBITDAEBITDA (Earnings before Interest, Taxes, Depreciation and Amortization)EBITDA is calculated from EBIT by adding depreciations recognized in income and deducting write-ups recognized in income, both on intangible assets as well as property, plant and equipment. calculated at LTM average exchange rates; before special itemsBefore special itemsIn order to measure the operating performance extending over several periods, key performance measures are adjusted by special items, where applicable. Adjusted measures are labelled with “before special items”. A reconciliation table is available within the respective quarterly or annual report and presents the composition of special items., pro forma closed acquisitions / divestitures. For pro forma acquisitions, the missing pro forma EBITDA for the full 12 months is included.
For divestments, the EBITDA contribution of the last 12 months is deducted.
Fresenius’ goal is to ensure and expand its long-term position as a leading international provider of products, services, and therapies in the health care industry. To this end, and to geographically expand our business, we plan to grow organically as well as through selective small to medium-sized acquisitions, complementing our existing portfolio. We are constantly seeking new above-average growth opportunities in developing as well as in emerging countries. Our aim is to strengthen our activities in these regions and successively introduce further products from our portfolio into these markets.
Fresenius Medical Care is the worldwide leader in dialysisDialysisForm of renal replacement therapy where a semipermeable membrane – in peritoneal dialysis the peritoneum of the patient, in hemo dialysis the membrane of the dialyzer – is used to clean a patient’s blood., with a strong market position in the United States. Future opportunities in dialysis will arise from the further global expansion of dialysis services products.
Fresenius Kabi is the market leader in infusion therapy in Europe and Latin America.
In clinical nutrition therapy, Fresenius Kabi is market leader in Europe as well as in the key markets in Asia-Pacific (including China); in Latin America, Fresenius Kabi is one of the three leading providers of clinical nutrition.
In the area of IV generic drugs, Fresenius Kabi is one of the leading companies in the U.S. market. In the biosimilars product segment, Fresenius Kabi started with launches of its first biosimilar product, Idacio, in Europe in 2019. In 2021, the company continued to launch Idacio in several European countries and has received marketing authorization in selected countries in Latin America and Asia-Pacific, as well as in Israel and Canada. In addition, Fresenius Kabi is one of the leading suppliers in the field of transfusion technology and medical devices.
With 90 hospitals, Fresenius Helios operates in nearly all of Germany. Building on this, Fresenius Helios is now in a position to develop new patient care models. To benefit from the trend towards outpatient treatment, Helios Germany has been expanding outpatient service offerings. Helios Spain has attractive growth opportunities through the expansion and construction of hospitals, and potential for further consolidation in the highly fragmented private hospital market in Spain. Fresenius Helios will exploit upcoming opportunities for cross-border synergies in areas such as laboratory services and joint purchasing. The cross-border exchange of experience and knowledge is creating the economic prerequisites for the further internationalization of our hospital business. In the field of fertility services, the company intends to grow organically and through acquisitions.
Fresenius Vamed plans to further strengthen its position as a global specialist for projects and services for hospitals and other health care facilities. In Central Europe, Fresenius Vamed is one of the leading providers of rehabilitation services. Furthermore, the collaboration with Fresenius Helios has been further intensified. This applies, for example, to technical services and purchasing, where both companies are cooperating on selected products.
Statements on market position according to company research
The commitment of our more than 300,000 employees worldwide is key for the success and sustained growth of Fresenius. We firmly believe in a culture of diversity, as we are convinced that different perspectives, opinions, experiences, and values enable Fresenius to continue successfully growing as a global health care company. To tackle the upcoming challenges, attracting new employees is key for the growth of our company. We regularly participate in recruiting events and career fairs to attract new talent, and invite our management to meet future Fresenius employees at the “Meet the Board” career day. In the past two years, these events were held virtually or in compliance with special hygiene measures in accordance with the general conditions. Not only do we try to attract new talent, but also do everything we can to retain and develop our employees over the long term. We offer a variety of flexible working-time models and incentive programs to ensure that our long-term needs for highly qualified employees are met. Furthermore, we offer our employees opportunities to develop their careers in an international and dynamic environment.
Path to accelerated growth
Fresenius has defined a strategic path to pursue accelerated profitable growth and hence to strengthen the Group and each of its business segments by tapping new sources of capital and prioritizing segment capital allocation. All our stakeholders continue to benefit from the advantages of the Group’s current structure, which offers stability through diversification as well as efficiency through economies of scale, access to attractive debt financing and tax savings.
All of Fresenius’ business segments have excellent market positions and ample meaningful growth opportunities. Properly balancing the objectives of all our stakeholder groups requires an even more targeted approach to capital allocation. While Fresenius continues to believe in the virtues of vertical integration, The Company is keen to gradually re-balance the relative weights of its products and service businesses.
Primarily based on its superior profitability and excellent growth prospects, Fresenius Kabi is defined as top priority. With respect to Fresenius Medical Care, which has been particularly hard hit by the pandemic, the transformation program FME25 is expected to result in ever improving profitability and accelerated growth, driving improved valuation for Fresenius’ controlling stake. For Fresenius Helios and Fresenius Vamed, smaller inorganic growth opportunities will continue to be financed from Fresenius Group funds. For larger growth opportunities, Fresenius is open to value-enhancing external equity investments the level of these business segments. An equity increase on Group level would then be redundant and is hence not foreseen.
By setting this course, Fresenius will accelerate the growth of each of our business segments for the benefit of all stakeholders.
Cost and efficiency program
In 2021, Fresenius initiated a cost and efficiency program. First initiatives have already been successfully implemented. This has led to initial cost savings of ~€20 million1 and one-time expenses of ~€80 million1 in fiscal year 2021.
The program was initiated in early 2021 and aims to further safeguard the medium-term targets and sustainably enhance profitability.
Given the good progress, especially driven by the accelerated implementation of initiatives, Fresenius significantly increases its savings target and now expects cost savings of at least €150 million p.a. after tax and minority interest in 2023. Initially, more than €100 million p.a. after tax and minority interest were projected. For the years thereafter, a further significant increase in sustainable cost savings is expected. The savings will be achieved by all four business segments and the corporate center.
Fresenius anticipates that achieving these sustainable efficiency improvements will require up-front expenses of more than €200 million in 2022 and further expenses of around €100 million in 2023, in each case after taxes and minority interest. No further significant expenses are expected thereafter. In line with previous practice, these expenses are classified as special items (see also reconciliation tables on the Economic report).
1 Refers to net income attributable to shareholders of Fresenius SE & Co. KGaA
Fresenius Medical Care announced details of the FME25 program on November 2, 2021. With a significantly simplified future structure of two global operating segments – Care Enablement and Care Delivery – the company orients its operating model along the relevant future value drivers.
Based on the implementation of the new global operating model, Fresenius Medical Care assumes to reduce its annual cost base by €500 million by the end of 2025.
Around 50% of these savings are expected to be realized by 2023. Around 80% of the anticipated one-time investments in FME25, amounting to approximately €450‒500 million, are expected to be made by the end of 2023. The investments will be treated as a special item. The Company thus expects to reach positive net savings by the end of 2023.
Fresenius Kabi has developed a strategic plan to transform the company for the next decade and to better capture new growth opportunities. Given the sustainable growth potential and the company’s already strong market position, Fresenius Kabi will continue to focus on products and services for critically and chronically ill patients. Within this clear direction, Fresenius Kabi has defined three growth vectors:
- the broadening of our biopharmaceutical offering,
- further roll-out of clinical nutrition,
- expansion in the MedTech area.
The focus will be on further developing the portfolio to capitalize on key market and industry trends in order to capture future growth opportunities. In addition, the company will more actively go after growth opportunities in the various regions with increased focus, especially once the pandemic normalizes.
In parallel, Fresenius Kabi will continue to build resilience in its volume-driven IV business.
Furthermore, Fresenius Kabi will improve its global competitiveness and the effectiveness of its organization; a first step is the introduction of a business-oriented instead of a regional organization.
In the new organizational structure, the business units and the regions will be given more accountability to support Fresenius Kabi’s growth targets. At the same time, the interfaces within the company will be streamlined to foster collaboration. The new organization was implemented as of January 2022.
New global IT organization
Fresenius Digital Technology reached a milestone on the path to becoming a modern, global IT organization in 2021. With efficient processes and harmonized IT services, it will optimally support the business segments and their strategies. The aim of the comprehensive transformation process is to simplify the technology landscape, communication, and collaboration within the Group. At the same time, it will increase the efficiency of IT services and make them more cost-efficient.
For Fresenius, sustainability is an integral part of its business model. The company is working to establish global sustainability standards and continuously improve its own sustainability performance. To this end, Fresenius continued to drive forward its ESG (Environment, Social, Governance) initiatives in the fiscal year.
Fresenius has set a climate target for the Group complementing its existing sustainability targets and programs. The company aims to be climate neutral by 2040 and to reduce 50 % of absolute scope 1 and scope 2 emissions by 2030 compared to 2020 levels. Fresenius will continuously assess scope 3 emission impacts for inclusion in our targets.
The Fresenius Group Sustainability Board (GSB) held six meetings to discuss the implementation of regulatory requirements, in particular the EU taxonomy and the Due Diligence Act, as well as Sustainable Finance. Furthermore, sustainability was introduced as a non-financial performance target in the Management Board compensation system in 2021. In July 2021, Fresenius took a further step toward integrating sustainability into all aspects of its business activities by launching its first sustainability-oriented financing instrument. In November 2021, we were again included in the Dow Jones Sustainability Index (DJSI Europe).