Revenue
Group revenue increased by 9% (4% in constant currency) to €40,480 million (2021: €37,520 million). In fiscal year 2022, the challenging macroeconomic environment with its direct impact on customer and patient behavior had a negative impact on Group revenue. The reported figures are positively impacted by currency translation, in particular due to the strong U.S. dollar. Excluding estimated COVID-19 effects1, the Fresenius Group achieved currency-adjusted revenue growth of 4% to 5% in the fiscal year.
1 An overview of the effect of COVID-19 is provided in section Overall Business Development
Revenue by region
Download(XLS, 35 KB)| € in millions | 2022 | 2021 | Growth | Currency translation effects | Constant currency growth | Organic growth | Acquisitions | Divestitures / others | % of total revenue |
|---|---|---|---|---|---|---|---|---|---|
| North America | 16,106 | 14,354 | 12% | 12% | 0% | -1% | 1% | 0% | 40% |
| Europe | 17,877 | 16,885 | 6% | 0% | 6% | 5% | 1% | 0% | 44% |
| Asia-Pacific | 4,141 | 3,949 | 5% | 5% | 0% | 0% | 0% | 0% | 10% |
| Latin America | 2,182 | 1,830 | 19% | -3% | 22% | 19% | 3% | 0% | 5% |
| Africa | 534 | 502 | 6% | 0% | 6% | 6% | 0% | 0% | 1% |
| Total | 40,840 | 37,520 | 9% | 5% | 4% | 3% | 1% | 0% | 100% |
Revenue by business segment2
Download(XLS, 35 KB)| € in millions | 2022 | 2021 | Growth | Currency translation effects | Constant currency growth | Organic growth | Acquisitions | Divestitures / others | % of total revenue |
|---|---|---|---|---|---|---|---|---|---|
| Fresenius Medical Care | 19,398 | 17,619 | 10% | 8% | 2% | 2% | 1% | -1% | 47% |
| Fresenius Kabi | 7,850 | 7,193 | 9% | 5% | 4% | 3% | 1% | 0% | 19% |
| Fresenius Helios | 11,716 | 10,891 | 8% | 1% | 7% | 6% | 2% | -1% | 29% |
| Fresenius Vamed | 2,359 | 2,297 | 3% | 1% | 2% | 2% | 1% | -1% | 5% |
| Total | 40,840 | 37,520 | 9% | 5% | 4% | 3% | 1% | 0% | 100% |
Order intake and order backlog Fresenius Vamed
Download(XLS, 35 KB)| € in millions | 2022 | 2021 | 2020 | 2019 | 2018 |
|---|---|---|---|---|---|
| Order intake | 1,241 | 1,290 | 1,010 | 1,314 | 1,227 |
| Order backlog (December 31) | 3,689 | 3,473 | 3,055 | 2,865 | 2,420 |
In detail, the revenue performance of the business segments2 was as follows:
2 The following description of revenue relates to the respective external revenue of the business segments. Consolidation effects and corporate entities are not taken into account. Therefore, aggregation to total Group revenue is not possible.
- Revenue of Fresenius Medical Care increased by 10% (2% in constant currency) to €19,398 million (2021: €17,619 million). Organic revenue growth was 2%. Currency translation effects had a positive impact of 8%. Healthcare Services revenue increased by 11% to €15,418 million (+2% at constant currency, +1% organic). At constant currency, this was mainly driven by organic growthOrganic growthGrowth that is generated by a company’s existing businesses and not by acquisitions, divestitures, or foreign exchange impact. in EMEA, including the effects of hyperinflation in Turkiye, Asia-Pacific and Latin America, which was partially offset by the impact of COVID-19 on organic growth in North America.
Healthcare Products revenue grew by 6% to €3,980 million (+2% at constant currency, +2% organic). At constant currency, higher sales of in-center disposables were offset by lower sales of machines for chronic treatment.
- Fresenius Kabi increased revenue by 9% (4% in constant currency) to €7,850 million (2021: €7,193 million). Organic growth amounted to 3%. Currency translation effects had a positive impact of 5%. They mainly resulted from the U.S. dollar. Revenue in the biopharmaceuticals business increased significantly year-on-year and amounted to €188 million in fiscal year 2022. In North America, however, continuing competitive pressure and challenges in the supply chains impacted revenue development. In Asia-Pacific, organic growth was primarily impacted by price declines in connection with NVBP (National Volume-Based Procurement) tenders in China.
- Fresenius Helios increased revenue by 8% (7% in constant currency) to €11,716 million (2021: €10,891 million). Organic revenue growth amounted to 6%. Acquisitions, in particular at Helios Spain and Helios Fertility, contributed a total of 2% to revenue growth. Divestments reduced revenue by 1%.
Helios Germany’s revenue increased by 4% to €7,021 million (2021: €6,733 million), mainly driven by increasing admissions and a return to a pre-COVID patient structure by year-end. Acquisitions had no impact (0%) on revenue growth.
Helios Spain’s revenue increased by 10% (in constant currency: 10%) to €4,441 million (2021: €4,021 million). Organic growth amounted to 9% and was driven by continued high demand for treatments. Furthermore, hospitals in Latin America showed pleasing development. Acquisitions contributed 1% to revenue growth.
Helios Fertility’s revenue was €250 million (2021: €133 million). The difficult macroeconomic environment resulted in lower utilization due to postponed treatments. In the prior year, the business was only consolidated on a pro rata temporis basis.
- Fresenius Vamed’s revenue increased by 3% (2% in constant currency) to €2,359 million (2021: €2,297 million). The organic growth was 2%. In the project business, revenue decreased by 6% to €674 million (2021: €717 million). The decline was mainly driven by the ongoing difficult macroeconomic environment. Revenue in the services business increased by 7% to €1,685 million (2021: €1,580 million), mainly due to increased workloads as capacity restrictions in the rehabilitation business no longer applied.
Order intake in the project business was €1,241 million (2021: €1,290 million). Fresenius Vamed increased its order backlog by 6% to €3,689 million (December 31, 2021: €3,473 million).
Fresenius Vamed is the only business segment within the Fresenius Group whose business is also significantly influenced by order intake and order backlog.
Earnings structure
In 2022, Group net income1 before special items decreased by 7% (12% in constant currency) to €1,729 million (2021: €1,867 million). COVID-19 had an estimated effect of 4 to 0 percentage points on Group net income growth in constant currency. In 2022, earnings per share1 before special items decreased by 8% (13% in constant currency) to €3.08 (2021: €3.35). The weighted average number of shares was 561.3 million.
Reported Group net income1 decreased by 25% (29% in constant currency) to €1,372 million (2021: €1,818 million). Reported earnings per share1 decreased by 25% (30% in constant currency) to €2.44 (2021: €3.26).
Group 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. before special items decreased by 1% (-6% in constant currency) to €6,808 million (2021: €6,854 million). Group EBITDA reported was €6,294 million (2021: €6,825 million).
Group EBITEBIT (Earnings before Interest and Taxes)EBIT does include depreciation and write-ups on property, plant and equipment. EBIT is calculated by subtracting costs of revenue, selling, general and administrative expenses, and research and development expenses from revenue. before special items decreased by 6% (-11% in constant currency) to €4,004 million (2021: €4,252 million). Group EBIT reported decreased by 20% (-25% in constant currency) to €3,321 million (2021: €4,158 million).
1 Net income attributable to the shareholders of Fresenius SE & Co. KGaA
Group return ratios
Download(XLS, 35 KB)| in % | 2022 | 2021 | 2020 | 2019 | 2018 |
|---|---|---|---|---|---|
| EBITDA margin1 | 16.7 | 18.3 | 19.7 | 20.1 | 18.1 |
| EBIT margin1 | 9.8 | 11.3 | 12.7 | 13.2 | 13.6 |
| Return on revenue (before taxes and noncontrolling interests)1 | 8.5 | 10.0 | 10.9 | 11.2 | 11.9 |
| 1 Before special items | |||||
Statement of income (Summary)
Download(XLS, 39 KB)| € in millions | 2022 | 2021 | Growth |
|---|---|---|---|
| Revenue | 40,840 | 37,520 | 9% |
| Cost of goods sold | -30,115 | -27,209 | -11% |
| Gross profit | 10,725 | 10,311 | 4% |
| Selling, general and administrative expenses | -6,744 | -5,453 | -24% |
| Other operating income and expenses | 207 | 105 | 97% |
| Research and development expenses | -867 | -805 | -8% |
| Operating income (EBIT) | 3,321 | 4,158 | -20% |
| Financial result | -507 | -506 | 0% |
| Income before income taxes | 2,814 | 3,652 | -23% |
| Income taxes | -697 | -833 | 16% |
| Net income | 2,117 | 2,819 | -25% |
| Noncontrolling interests | -745 | -1,001 | 26% |
| Net income attributable to Fresenius SE & Co. KGaA1,2 | 1,729 | 1,867 | -7% |
| Net income attributable to Fresenius SE & Co. KGaA1 | 1,372 | 1,818 | -25% |
| Earnings per ordinary share in €1,2 | 3.08 | 3.35 | -8% |
| Fully diluted earnings per ordinary share in €1,2 | 3.08 | 3.35 | -8% |
| Earnings per ordinary share in €1 | 2.44 | 3.26 | -25% |
| Fully diluted earnings per ordinary share in €1 | 2.44 | 3.26 | -25% |
| Average number of shares | 561,264,305 | 558,061,878 | 1% |
| EBITDA2 | 6,808 | 6,854 | -1% |
| Depreciation and amortization2 | 2,804 | 2,602 | 8% |
| EBIT2 | 4,004 | 4,252 | -6% |
| EBITDA margin2 | 16.7% | 18.3% | |
| EBIT margin2 | 9.8% | 11.3% | |
| 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 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.. The special items are reported in the Corporate segment.
- Fresenius Medical Care’s EBIT1 decreased by 5% (13% in constant currency) to €1,817 million (2021: €1,915 million). In constant currency, the decrease was mainly due to a lower number of 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. treatments in North America and higher personnel costs, as well as inflation and cost increases in the supply chains. This was partly offset by financial support from the U.S. government to offset certain costs related to COVID-19. The EBIT margin1 decreased to 9.4% (2021: 10.9%). EBIT reported decreased by 18% (25% in constant currency) to €1,512 million (2021: €1,852 million), and the EBIT marginEBIT marginEBIT margin is calculated as the ratio of EBIT to revenue. was 7.8% (2021: 10.5%).
- Fresenius Kabi’s EBIT1 decreased by 6% (14% in constant currency) to €1,080 million (20211: €1,153 million). EBIT development was characterized by rising cost inflation, supply chain challenges, and continued competitive pressure. The EBIT margin1 was 13.8% (2021: 16.0%). Excluding the acquisition of Ivenix and the acquisition of the majority stake in mAbxience, the EBIT margin1 was 14.4%2.
- The EBIT1 of Fresenius Helios increased by 5% (5% in constant currency) to €1,185 million (2021: €1,127 million). The EBIT1 margin was 10.1% (2021: 10.3%). The increase was mainly driven by increasing admissions and a return to a pre-COVID patient structure by year-end.
The EBIT1 of Helios Germany increased by 2% to €623 million (2021: €613 million). The EBIT1 margin was 8.9% (2021: 9.1%). Increased costs for the increased use of external personnel due to COVID-19-related employee absences impacted earnings. EBIT was also slightly impacted by rising cost inflation.
The EBIT of Helios Spain increased by 8% (8% in constant currency) to €556 million (2021: €514 million). The EBIT margin decreased to 12.5% (2021: 12.8%) despite increased cost inflation.
The EBIT of Helios Fertility was €21 million (2021: €19 million). In the prior year, the business was only consolidated on a pro rata basis. The EBIT margin decreased to 8.4% (2021: 14.3%). The decrease was due to the difficult macroeconomic environment, which resulted in lower utilization due to postponed treatments.
- The EBIT1 of Fresenius Vamed decreased to €20 million (2021: €101 million). The EBIT margin1 was 0.8% (2021: 4.4%). Earnings were significantly lower than the prior-year figure (€101 million) and the earnings forecast (around €100 million) due to the continuing difficult conditions at the end of 2022.
Weak revenues due to the economic environment with increased costs in particular and negative non-recurring effects from the writedown and reassessment of claims and court cases weighed on earnings in the project business.
The service business reported solid revenue, but one-time effects and the macroeconomic environment had a negative impact on profitability, in particular as a result of write-downs due to delayed business initiations that did not materialize as planned.
1 Before special items
2 Excluding acquisition of Ivenix and mAbxience
Development of other major items in the statement of income
Group gross profit increased by 4% (decreased by 1% in constant currency) to €10,725 million (2021: €10,311 million, increased by). The gross margin decreased to 26.3% (2021: 27.5%). The cost of revenue increased by 11% to €30,115 million (2021: €27,209 million). Cost of revenue as a percentage of Group revenue increased to 73.7% (2021: 72.5%).
Selling, general, and administrative expenses consisted primarily of personnel costs, marketing and distribution costs, and depreciation and amortization. These expenses, excluding other operating income and expenses, increased by 24% to €6,744 million (2021: €5,453 million), mainly due to the rise in personnel costs, acquisitions and currency translation effects. Selling, general, and administrative expenses as a percentage of Group revenue was 16.5% (2021: 14.5%). R & D expenses increased by 8% to €867 million (2021: €805 million). The increase resulted from higher expenses at Fresenius Kabi.
Depreciation and amortization was €2,804 million1 (2021: €2,602 million1). The ratio as a percentage of revenue was 6.9%1(2021: 6.9%1). Group personnel costs increased to €17,378 million (2021: €15,610 million). The personnel cost ratio was 42.6% (2021: 41.6%).
The Group financial result before special items was -€533 million (2021: -€504 million), mainly driven by increasing interest rates. The Group financial result reported was -€507 million (2021: -€506 million).
The Group tax rate before special items was 23.7% (2021: 22.6%). The Group tax rate reported was 24.8% (2021: 22.8%).
Noncontrolling interests before special items were -€918 million (2021: -€1,033 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 2022, key figures are presented before special items.
Consolidated results for FY / 22 as well as for FY / 21 include special items. These concern: revaluations of biosimilarsBiosimilarsA biosimilar is a drug that is “similar” to another biologic drug already approved. contingent purchase price liabilities, expenses associated with the Fresenius cost and efficiency program (including costs related to the FME25 program), impacts related to the war in Ukraine, transaction costs for mAbxience and Ivenix, hyperinflation in Turkey, retroactive duties, remeasurement of the Humacyte investment, and net gain related to InterWell Health. The special items shown within the reconciliation tables are reported in the “Corporate” segment.
Reconciliation Fresenius Group
Download(XLS, 36 KB)| € in millions | 2022 | 2021 | Growth rate | Growth rate in constant currency |
|---|---|---|---|---|
| Revenue reported | 40,840 | 37,520 | 9% | 4% |
| EBIT reported (after special items) | 3,321 | 4,158 | -20% | -25% |
| Revaluations of biosimilars contingent purchase price liabilities | 23 | -49 | ||
| Expenses associated with the Fresenius cost and efficiency program | 466 | 143 | ||
| Impacts related to the war in Ukraine | 86 | - | ||
| Transaction costs mAbxience, Ivenix | 40 | - | ||
| Hyperinflation Turkey | 12 | - | ||
| Retroactive duties | 9 | - | ||
| Remeasurement Humacyte investment | 103 | - | ||
| Net Gain related to InterWell Health | -56 | - | ||
| EBIT (before special items) | 4,004 | 4,252 | -6% | -11% |
| Net interest reported (after special items) | -507 | -506 | -0% | 5% |
| Revaluations of biosimilars contingent purchase price liabilities | -26 | 2 | ||
| Net interest (before special items) | -533 | -504 | -6% | -0% |
| Income taxes reported (after special items) | -697 | -833 | 16% | 20% |
| Revaluations of biosimilars contingent purchase price liabilities | 1 | 14 | ||
| Expenses associated with the Fresenius cost and efficiency program | -104 | -29 | ||
| Impacts related to the war in Ukraine | -8 | - | ||
| Transaction costs mAbxience, Ivenix | -7 | - | ||
| Hyperinflation Turkey | 0 | - | ||
| Retroactive duties | -1 | - | ||
| Remeasurement Humacyte investment | -27 | - | ||
| Net Gain related to InterWell Health | 19 | - | ||
| Income taxes (before special items) | -824 | -848 | 3% | 7% |
| € in millions | 2022 | 2021 | Growth rate | Growth rate in constant currency |
|---|---|---|---|---|
| Noncontrolling interests reported (after special items) | -745 | -1,001 | 26% | 32% |
| Expenses associated with the Fresenius cost and efficiency program | -102 | -32 | ||
| Impacts related to the war in Ukraine | -35 | - | ||
| Transaction costs mAbxience, Ivenix | -6 | - | ||
| Hyperinflation Turkey | -3 | - | ||
| Remeasurement Humacyte investment | -52 | - | ||
| Net Gain related to InterWell Health | 25 | - | ||
| Noncontrolling interests (before special items) | -918 | -1,033 | 11% | 18% |
| Net income reported (after special items)1 | 1,372 | 1,818 | -25% | -29% |
| Revaluations of biosimilars contingent purchase price liabilities | -2 | -33 | ||
| Expenses associated with the Fresenius cost and efficiency program | 260 | 82 | ||
| Impacts related to the war in Ukraine | 43 | - | ||
| Transaction costs mAbxience, Ivenix | 27 | - | ||
| Hyperinflation Turkey | 9 | - | ||
| Retroactive duties | 8 | - | ||
| Remeasurement Humacyte investment | 24 | - | ||
| Net Gain related to InterWell Health | -12 | - | ||
| Net income (before special items)1 | 1,729 | 1,867 | -7% | -12% |
| 1 Net income attributable to shareholders of Fresenius SE & Co. KGaA | ||||
Reconciliation business segments
Fresenius Medical Care
Download(XLS, 36 KB)| € in millions | 2022 | 2021 | Growth rate | Growth rate in constant currency |
|---|---|---|---|---|
| Revenue reported | 19,398 | 17,619 | 10% | 2% |
| EBIT reported (after special items) | 1,512 | 1,852 | -18% | -25% |
| Costs related to FME25 program | 204 | 63 | ||
| Impacts related to the war in Ukraine | 49 | - | ||
| Hyperinflation Turkey | 5 | - | ||
| Remeasurement Humacyte investment | 103 | - | ||
| Net Gain related to InterWell Health | -56 | - | ||
| EBIT (before special items) | 1,817 | 1,915 | -5% | -13% |
| Net income reported (after special items)1 | 673 | 969 | -31% | -37% |
| Costs related to FME25 program | 149 | 49 | ||
| Impacts related to the war in Ukraine | 47 | - | ||
| Hyperinflation Turkey | 5 | - | ||
| Remeasurement Humacyte investment | 76 | - | ||
| Net Gain related to InterWell Health | -37 | - | ||
| Net income (before special items)1 | 913 | 1,018 | -10% | -17% |
| 1 Net income attributable to Fresenius Medical Care AG & Co. KGaA | ||||
Fresenius Kabi
Download(XLS, 35 KB)| € in millions | 2022 | 2021 | Growth rate | Growth rate in constant currency |
|---|---|---|---|---|
| Revenue reported | 7,850 | 7,193 | 9% | 4% |
| Revaluations of biosimilars contingent purchase price liabilities | 23 | -49 | ||
| Expenses associated with the Fresenius cost and efficiency program | 195 | 58 | ||
| Impacts related to the war in Ukraine | 15 | - | ||
| Transaction costs mAbxience, Ivenix | 40 | - | ||
| Hyperinflation Turkey | 7 | - | ||
| EBIT (before special items) | 1,080 | 1,153 | -6% | -14% |
Fresenius Helios
Download(XLS, 35 KB)| € in millions | 2022 | 2021 | Growth rate | Growth rate in constant currency |
|---|---|---|---|---|
| Revenue reported | 11,716 | 10,891 | 8% | 7% |
| Expenses associated with the Fresenius cost and efficiency program | 0 | 10 | ||
| EBIT (before special items) | 1,185 | 1,127 | 5% | 5% |
Fresenius Vamed
Download(XLS, 35 KB)| € in millions | 2022 | 2021 | Growth rate | Growth rate in constant currency |
|---|---|---|---|---|
| Revenue reported | 2,359 | 2,297 | 3% | 2% |
| Expenses associated with the Fresenius cost and efficiency program | 4 | 0 | ||
| Impacts related to the war in Ukraine | 22 | - | ||
| EBIT (before special items) | 20 | 101 | -80% | -81% |