Fresenius Medical Care

Operating performance in 2018 was influenced by special items. We were able to increase the number of dialysis patients treated worldwide, further strengthening our market position.

FMC content

We further increased the number of dialysis patients treated worldwide in 2018.

Fresenius Medical Care is the world’s leading provider of products and services for people with chronic kidney failure. Around 3.4 million patients with this disease worldwide regularly undergo dialysis treatment. When the kidney function of patients with this disease fails, dialysis takes over the vital task of cleansing the blood of toxins and surplus water. ­Fresenius Medical Care offers products and services along the entire dialysis value chain from a single source. We care for more than 333,000 patients in our global network of more than 3,900 dialysis clinics. At the same time, we operate 42 production sites, to provide dialysis products such as dialysis machines, dialyzers, and related dis­posables.

Our strategy is geared towards sustainable growth. We aim to continuously improve the quality of life of patients with kidney disease by offering innovative products and treatment concepts of the highest quality.

Business development

Fresenius Medical Care decreased sales by 7% to €16,547 million in 2018 (currency adjusted: - 2%). Organic sales growth was 4%. The application of IFRS 15 reduced sales by 3%. With the prior-year basis additionally adjusted for divested Care Coordination activities, sales in fiscal year 2018 decreased by 1% (increased by 4% in constant currency).

Health care services sales 1 (dialysis services and Care Coordination) decreased by 2% (increased by 4% in constant currency) to €13,264 million. Sales of health care products (e.g., dia­­ly­sis products) increased by 1% (5% in constant currency) to €3,283 million.

EBIT increased by 29% to €3,038 million (2017: €2,362 million). The increase is mainly attributable to the divested Care Coordination activities. The EBIT margin was 18.4% (2017: 13.3%). EBIT on a comparable basis 1 increased by 6%; the EBIT margin 1, was 14.2% (2017: 13.6%).

Net income 2 increased by 55% (60% in constant currency) to €1,982 million (2017: €1,280 ­million). The adjusted net income 2 increased currency-adjusted by 4%.

Comparable basis net income 1,2 increased by 14% in constant currency.

1On a comparable basis

2Net income attributable to Fresenius Medical Care AG&Co. KGaA

Regional development

Sales by region
€ in millions 2018 2017 Change Currency translation effects % of total Fresenius Medical Care sales
North America 11,570 12,879 - 10% - 4% 70%
Europe / Middle East / Africa 2,587 2,547 2% - 2% 16%
Asia-Pacific 1,689 1,623 4% - 4% 10%
Latin America 686 720 - 5% - 27% 4%
Corporate 15 15 0% 0% 0%
Total 16,547 17,784 - 7% - 5% 100%

North America remained ­Fresenius Medical Care’s largest business region. In 2018, sales 1 decreased by 2% (increased by 2% in constant currency) to €11,570 million, compared to €11,834 million in 2017. EBIT increased by 28% to €2,665 million (2017: €2,086 million), with an EBIT margin of 23.0% (2017: 16.2%). The changes are mainly attributable to the divestiture of Care Coordination activities.

The average revenue per treatment in the United States was US$ 354 in 2018, compared to US$ 342 in 2017. The average cost per treatment in the United States increased from US$ 271 in 2017 to US$ 289 in 2018.

In 2018, the business development outside of North America, in the business segments EMEA (Europe / Middle East / Africa), Asia-Pacific, and Latin America, was impacted by currency translation effects. Sales increased by 1% (8% in constant currency) to €4,962 million (2017: €4,890 million). EBIT decreased by 10% to €731 million (2017: €815 million). The EBIT margin was 14.7% (2017: 16.7%).

1On a comparable basis

Sales by segment 1
€ in millions 2018 2017 Change
North America
    Health care services2 10,725 10,991 - 2%
    Health care products3 845 843 0%
Total 11,570 11,834 - 2%
International4
    Health care services2 2,539 2,496 2%
    Health care products3 2,423 2,394 1%
Total 4,962 4,890 1%
Worldwide
    Health care services2 13,264 13,487 - 2%
    Health care products3, 5 3,283 3,252 1%
Total 16,547 16,739 - 1%
  • 1 On a comparable basis
  • 2 Sales from dialysis services and Care Coordination
  • 3 Sales from dialysis products such as dialysis machines, dialyzers, and related disposables and non-dialysis products
  • 4 International represents the business segments EMEA (Europe / Middle East / Africa), Asia-Pacific, and Latin America
  • 5 Including sales generated by corporate functions of 15 million in 2018 and 15 million in 2017

Acquistions / divestitures

In 2018, Fresenius Medical Care further expanded its clinical network.

With the announced acquisition of NxStage Medical, Inc., a provider of dialysis machines and other products for use in home dialysis and critical care, we intend to broaden the range of therapies. The transaction remains subject to regulatory approvals and other customary closing conditions. Fresenius Medical Care expects the closing of the transaction to occur in early 2019.

As of June 28, 2018, Fresenius Medical Care closed the announced divestiture of Sound Inpatient Physicians Holdings, LLC (Sound) to an investment consortium led by Summit Partners. The divestment of Sound is aligned with ­Fresenius Medical Care’s goal of further sharpening the profile of the company’s Care Coordination portfolio in the United States.

Treatment quality

Again in 2018, physicians and clinical staff in our dialysis clinics offered patients the highest-quality treatment. Please refer to the Non-Financial Report for further details on treatment quality.

Please refer to page 75 f. of the Group Management Report for the 2019 financial outlook of Fresenius Medical Care. For further information, please see Fresenius Medical Care’s Annual Report 2018 or visit the website at www.freseniusmedicalcare.com.

Fresenius Medical Care by region
  North America Europe /
Middle East /
Africa
Latin America Asia-Pacific Total 2018 Change 2018 / 2017
Dialysis clinics (December 31) 2,529 776 229 394 3,928 5%
Dialysis patients (December 31) 204,107 65,061 32,687 31,476 333,331 4%
Treatments 30,843,876 9,731,941 5,080,020 4,371,742 50,027,579 4%