Investor Presentation • Feb 20, 2024
Investor Presentation
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Helen Giza CEO & Chair of the Management Board
Martin Fischer CFO
February 20, 2024
Q4 & FY 2023 IR Conference Call

Safe harbor statement: In this Safe harbor statement, "the Company" and "Fresenius Medical Care" refer to Fresenius Medical Care AG & Co. KGaA, a German partnership limited by shares, prior to its conversion of legal form, and to Fresenius Medical Care AG, a German stock corporation, after its conversion of legal form. This presentation includes certain forward-looking statements within the meaning of Section 27A of the U.S. Securities Act of 1933, as amended, and Section 21E of the U.S. Securities Act of 1934, as amended. Forward-looking statements are inherently subject to risks and uncertainties, many of which cannot be predicted with accuracy or might not even be anticipated. The Company has based these forward-looking statements on current estimates and assumptions which we believe are reasonable and which are made to the best of our knowledge. Actual results could differ materially from those included in the forwardlooking statements due to various risk factors and uncertainties, including changes in business, economic or competitive conditions, changes in reimbursement, regulatory compliance issues, regulatory reforms, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, cyber security issues and the availability of financing. Given these uncertainties, readers should not put undue reliance on any forward-looking statements. These and other risks and uncertainties are discussed in detail in the Company's Annual Report on Form 20-F under the headings "Forward-Looking Statements" and "Risk Factors" and under the headings in that report referred to therein, and in the Company's other reports filed with the Securities and Exchange Commission (SEC) and the Frankfurt Stock Exchange (Frankfurter Wertpapierbörse).
Forward-looking statements represent estimates and assumptions only as of the date that they were made. The information contained in this presentation is subject to change without notice and the company does not undertake any duty to update the forward-looking statements, and the estimates and assumptions associated with them, except to the extent required by applicable law and regulations.
If not mentioned differently the term net income after minorities refers to the net income attributable to the shareholders of Fresenius Medical Care. Amounts are in Euro if not mentioned otherwise.
Implementation of measures as presented herein may be subject to information and consultation procedures with works councils and other employee representative bodies, as per local laws and practice. Consultation procedures may lead to changes on proposed measures.

Q4 Business Update 2
Outlook
1
3

Note: Announced divestments partly pending regulatory approval


1 Adjusted for the exit from less profitable acute care contracts

Measures how sufficiently the body is cleansed of waste substances
Measures the share of patients who do not receive dialysis via a dialysis catheter but rather via safer vascular access alternatives that reduce risk of infection and improve outcomes
Measures hemoglobin levels and specific medications given during dialysis to achieve optimum clinical outcomes, such as overall health and well-being


| Q4 2023 | Q3 2023 | |
|---|---|---|
| Quality index | 81% | 81 % |
| Dialysis effectiveness |
94% | 94% |
| Vascular access |
77% | 78% |
| Anemia management |
72% | 72% |
| outlook base1
in € million

Margin in %

1 FY 2023 €1,778 million Operating Income at cc (outlook base); reconciliation table for special items (outlook base), reported growth rates: page 29 | cc = at constant currency

Revenue Low- to mid-single digit percent growth FY 2022 basis: EUR 19.4bn +5% +15% Operating income (outlook base) Between 12 and 14 percent growth FY 2022 basis: EUR 1.54bn FY 2023: EUR 20,464m FY 2023: EUR 1,778m at constant currency
Revenue and operating income, as referred to in the outlook, are both on a constant currency basis and excluding special items. Special items will be provided as separate KPI ("Revenue excluding special items", "Operating income excluding special items") to capture effects that are unusual in nature and have not been foreseeable or not foreseeable in size or impact at the time of providing the outlook. These items are excluded to ensure comparability of the figures presented with the Company's financial targets which have been defined excluding special items. See page 30 for reconciliation table for special items.


Divestments of non-core and margin dilutive assets as part of ongoing portfolio optimization plan
Announced divestments
Note: Axes are non-linear, indicative only; divestment in Hungary executed as part of FME25 program; divestment of Cura is subject to regulatory approval

| Deleveraging | ▪ Committed to investment grade rating and to manage net financial leverage within self-imposed range of 3.0x to 3.5x. Reduced ratio from 3.4x to 3.2x. ▪ Proceeds from divestments and received Tricare settlement payment used for ongoing deleveraging |
|---|---|
| Shareholder return |
▪ Proposed dividend1 of 1.19 Euro (+6% Y/Y) per share in line with1 the dividend policy |
| Focused investments |
▪ Focus on organic growth in core portfolio ▪ Low priority on M&A activities ▪ Stringent management of capital expenditures ▪ Ambition to double ROIC by 2025 |
1 Pending shareholders' approval on upcoming AGM


Note: CKD = chronic kidney disease; ESRD = end-stage renal disease


A pragmatic, multinational, randomized, controlled trial
Comparison of High-Volume Hemodiafiltration (HVHDF) versus High-Flux Hemodialysis

23% mortality rate reduction
▪ Ambition to double ROIC by 2025

With 100% adoption of HVHDF, mortality can be reduced by approximately (based on 2019 rates):
Critical treatment parameters of CONVINCE matched in daily routine
Survival benefits observed in CONVINCE were confirmed in FME analysis
Note: USRDS = U.S. Renal Data System (2021 USRDS Annual Data Report - 2019 data); NephroCare mortality rates based on internal data; HVHDF = High Volume Hemodiafiltration with convection volume >23L/ treatment 1Zhang Y et al. J Am Soc Nephrol 34: 2023; Poster TH-PO1133


Outlook
1
3


| outlook base1
in € million

Organic growth
Margin in %

▪ Impact from Tricare settlement compensated negative impact from our value-based care business, inflation and higher expenses related to performance-based compensation
1 Q4 2023 €579 million Operating Income at cc (outlook base); reconciliation table for special items (outlook base), reported growth rates: page 28 | cc = at constant currency


Reconciliation table for special items (outlook base): page 28

in € million


1 Q4 2023 €592 million Operating Income at cc (outlook base); reconciliation table for special items (outlook base), reported growth rates: page 28 | cc = at constant currency

in € million


1 Q4 2023 €13 million Operating Income at cc (outlook base); reconciliation table for special items (outlook base), reported growth rates: page 28 | cc = at constant currency

| in € million | Q4 2023 | Q4 2022 | FY 2023 | FY 2022 |
|---|---|---|---|---|
| Operating cash flow | 719 | 600 | 2,629 | 2,167 |
| ▪ Capital expenditures, net |
(239) | (202) | (669) | (687) |
| Free cash flow | 480 | 398 | 1,960 | 1,480 |
| ▪ Free cash flow after investing activities |
623 | 375 | 2,085 | 1,433 |
| Total net debt and lease liabilities | 10,760 | 11,918 |
1 Excl. U.S. federal relief funding and advanced payments under the CARES Act



Q4 Business Update 2
Outlook
1
3


Note: Indicative illustration only; savings and costs split unaudited



in € million; all changes year-over-year

| Revenue (outlook base) |
Low- to mid-single digit percent growth FY 2023 basis: EUR 19.0bn |
Group operating income margin |
|---|---|---|
| Operating income (outlook base) |
Mid- to high-teens percent growth FY 2023 basis: EUR 1.54bn |
10% to 14% by 2025 |
Revenue and operating income, as referred to in the outlook, are both on a constant currency basis, excluding special items, the settlement agreement with the U.S. government in 2023 (Tricare) and major portfolio changes from 2023, namely Argentina and NCP. Special items will be provided as separate KPI ("Revenue excluding special items", "Operating income excluding special items") to capture effects that are unusual in nature and have not been foreseeable or not foreseeable in size or impact at the time of providing the outlook. These items are excluded to ensure comparability of the figures presented with the Company's financial targets which have been defined excluding special items. See page 29 for reconciliation table for special items.



| Q4 2023 € million |
Q4 2022 € million |
Growth in % |
Growth in % cc |
|
|---|---|---|---|---|
| Revenue | 4,988 | 4,997 | 0 | 7 |
| Operating income | 428 | 352 | 22 | 27 |
| Operating income margin in % | 8.6 | 7.0 | ||
| Operating income excl. special items & PRF | 555 | 489 | 14 | 18 |
| Operating income margin in % excl. special items & PRF | 11.1 | 9.8 | ||
| Operating income excl. special items & PRF at cc (outlook base)1 | 579 | 489 | 18 | |
| Operating income margin in % excl. special items & PRF at cc | 10.8 | 9.8 | ||
| Net interest expense | 85 | 75 | 12 | 15 |
| Income before taxes | 343 | 277 | 24 | 31 |
| Income tax expense | 86 | 83 | 4 | 13 |
| Tax rate in % | 25.2 | 30.0 | ||
| Non-controlling interest | 69 | 55 | 25 | 31 |
| Net income | 188 | 139 | 35 | 41 |
| Net income excl. special items & PRF | 259 | 248 | 4 | 8 |
1: Reconciliation table for special items (outlook base), reported growth rates: page 28 | cc = at constant currency

| FY 2023 € million |
FY 2022 € million |
Growth in % |
Growth in % cc |
|
|---|---|---|---|---|
| Revenue | 19,454 | 19,398 | 0 | 5 |
| Operating income | 1,369 | 1,512 | -9 | -7 |
| Operating income margin in % | 7.0 | 7.8 | ||
| Operating income excl. special items & PRF | 1,741 | 1,540 | 13 | 15 |
| Operating income margin in % excl. special items & PRF | 8.9 | 7.9 | ||
| Operating income excl. special items & PRF in cc (outlook base)1 | 1,778 | 1,540 | 15 | |
| Operating income margin in % excl. special items & PRF in cc | 8.7 | 7.9 | ||
| Net interest expense | 336 | 292 | 15 | 16 |
| Income before taxes | 1,033 | 1,220 | -15 | -13 |
| Income tax expense | 301 | 325 | -8 | -5 |
| Tax rate in % | 29.1 | 26.7 | ||
| Non-controlling interest | 233 | 222 | 6 | 8 |
| Net income | 499 | 673 | -26 | -24 |
| Net income excl. special items & PRF | 756 | 729 | 4 | 6 |
1: Reconciliation table for special items (outlook base), reported growth rates: page 29 | cc = at constant currency

| € million | FY 2022 | Q1 2022 | Q2 2022 | Q3 2022 | Q4 2022 |
|---|---|---|---|---|---|
| Revenue | 19,398 | 4,548 | 4,757 | 5,096 | 4,997 |
| Operating income | 1,540 | 390 | 284 | 377 | 489 |
Reconciliation of non-IFRS financial measures to the most directly comparable IFRS financial measures for comparison with outlook
| Group | Care Delivery | Care Enablement | Corporate | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| € million | Q4 2023 | Q4 2022 | Growth rate |
Q4 2023 | Q4 2022 | Growth rate |
Q4 2023 | Q4 2022 | Growth rate |
Q4 2023 | Q4 2022 |
| Operating Income | 428 | 352 | 22% | 515 | 456 | 13% | -42 | -62 | -32% | -44 | -44 |
| FME25 program | 52 | 95 | 25 | 63 | 27 | 32 | -- | -- | |||
| Ukraine war | -- | 25 | -- | -2 | -- | 27 | -- | -- | |||
| Humacyte investment remeasurement |
1 | 24 | -- | -- | -- | -- | 1 | 24 | |||
| Hyperinflation Turkiye | -- | -1 | -- | -1 | 0 | 0 | -- | -- | |||
| Legacy portfolio optimization | 57 | -- | 32 | -- | 25 | -- | 0 | -- | |||
| Legal form conversion costs | 17 | -- | -- | -- | -- | -- | 17 | -- | |||
| Net gain related to Interwell Health | -- | 0 | -- | 0 | -- | -- | -- | -- | |||
| U.S. Provider Relief Funding | -- | -6 | -- | -6 | -- | -- | -- | -- | |||
| Operating income excl. special items and PRF |
555 | 489 | 14% | 572 | 510 | 12% | 10 | -3 | n.a. | -26 | -20 |
| Foreign currency translation | 24 | -- | -- | 20 | -- | -- | 3 | -- | -- | 1 | -- |
| Operating income excl. special items and PRF in cc |
579 | 489 | 18% | 592 | 510 | 16% | 13 | -3 | n.a. | -25 | -20 |
Inter-segment elimination effect on operating income: €-1m in Q4 2023, €2m in Q4 2022 | cc = at constant currency

| € million | FY 2022 | Q1 2022 | Q2 2022 | Q3 2022 | Q4 2022 |
|---|---|---|---|---|---|
| Revenue | 19,398 | 4,548 | 4,757 | 5,096 | 4,997 |
| Operating income | 1,540 | 390 | 284 | 377 | 489 |
Reconciliation of non-IFRS financial measures to the most directly comparable IFRS financial measures for comparison with outlook
| Group | Care Delivery | Care Enablement | Corporate | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| € million | FY 2023 | FY 2022 |
Growth rate |
FY 2023 | FY 2022 | Growth rate |
FY 2023 | FY 2022 | Growth rate |
FY 2023 | FY 2022 | |
| Operating Income | 1,369 | 1,512 | -9% | 1,516 | 1,686 | -10% | -67 | -30 | 123% | -67 | -144 | |
| FME25 program | 153 | 204 | 75 | 118 | 78 | 86 | 0 | -- | ||||
| Ukraine war | -- | 49 | -- | 9 | -- | 40 | -- | -- | ||||
| Humacyte investment remeasurement |
-15 | 103 | -- | -- | -- | -- | -15 | 103 | ||||
| Hyperinflation Turkiye | -- | 5 | -- | -2 | -- | 7 | -- | -- | ||||
| Legacy portfolio optimization | 204 | -- | 96 | -- | 108 | -- | -- | -- | ||||
| Legal form conversion costs | 30 | -- | -- | -- | -- | -- | 30 | -- | ||||
| Net gain related to Interwell Health | -- | -56 | -- | -56 | -- | -- | -- | -- | ||||
| U.S. Provider Relief Funding | -- | -277 | -- | -277 | -- | -- | -- | -- | ||||
| Operating income excl. special items and PRF |
1,741 | 1,540 | 13% | 1,687 | 1,478 | 14% | 119 | 103 | 16% | -52 | -41 | |
| Foreign currency translation | 37 | -- | -- | 35 | -- | -- | 5 | -- | -- | -3 | -- | |
| Operating income excl. special items and PRF in cc |
1, 778 | 1,540 | 15% | 1,722 | 1,478 | 16% | 124 | 103 | 19% | -55 | -41 |
Inter-segment elimination effect on operating income: €-13m in FY 2023, €0m in FY 2022 | cc = at constant currency

| FY 2023 € million |
FY 2022 € million |
FY 2021 € million |
|
|---|---|---|---|
| Debt | |||
| Short-term debt from unrelated parties | 457 | 644 | 1,178 |
| + Short-term debt from related parties |
- | 4 | 78 |
| + Current portion of long-term debt |
487 | 694 | 668 |
| + Current portion of lease liabilities from unrelated parties |
593 | 650 | 640 |
| + Current portion of lease liabilities from related parties |
24 | 24 | 21 |
| + Long-term debt, less current portion |
6,960 | 7,171 | 6,647 |
| + Lease liabilities from unrelated parties, less current portion |
3,419 | 3,875 | 3,990 |
| + Lease liabilities from related parties, less current portion |
110 | 130 | 98 |
| + Debt and lease liabilities included within liabilities directly associated with assets held for sale |
137 | - | - |
| Total debt and lease liabilities | 12,187 | 13,192 | 13,320 |
| − Cash and cash equivalents |
-1,427 | -1,274 | -1,482 |
| Total net debt and lease liabilities | 10,760 | 11,918 | 11,838 |
Includes cash and cash equivalents included within assets held for sale.
| FY 2023 € million |
FY 2022 € million |
FY 2021 € million |
|
|---|---|---|---|
| Net income | 732 | 895 | 1,219 |
| + Income tax expense |
301 | 325 | 353 |
| − Interest income |
-88 | -68 | -73 |
| + Interest expense |
424 | 360 | 353 |
| + Depreciation and amortization |
1,613 | 1,718 | 1,586 |
| Adjustments1 + |
409 | 320 | 125 |
| Adjusted EBITDA | 3,391 | 3,550 | 3,563 |
| Net leverage ratio (Net debt/EBITDA) | 3.2 | 3.4 | 3.3 |
1 Adjustments: Acquisitions and divestitures made for the last twelve months with a purchase price above a €50 M threshold as defined in the Syndicated Credit Facility (2023: -€35 M; 2022: -€22 M), non-cash charges, primarily related to pension expense (2023: €56 M; 2022: €54 M), impairment loss (2023: €139 M; 2022: €120 M) and special items, including costs related to the FME25 Program (2023: €106 M; 2022: €155 M), Legal Form Conversion Costs (2023: €30 M), Legacy Portfolio Optimization (2023: €128 M), Humacyte Investment Remeasurement (2023: -€15 M; 2022: €103 M), Net Gain Related to InterWell Health (2022: -€114 M), Hyperinflation in Turkiye (2022: €5 M) and the Impacts Related to the War in Ukraine (2022: €19 M).



| FY 2023 | FY 2022 | FY 2021 | ||
|---|---|---|---|---|
| €:USD | Period end | 1.105 | 1.067 | 1.133 |
| Average | 1.081 | 1.053 | 1.183 | |
| €:CNY | Period end | 7.851 | 7.358 | 7.195 |
| Average | 7.660 | 7.079 | 7.628 | |
| €:RUB | Period end | 100.215 | 78.138 | 85.300 |
| Average | 92.461 | 73.365 | 87.153 | |
| €:ARS | Period end | 894.735 | 189.201 | 116.780 |
| Average | 315.018 | 137.041 | 112.522 | |
| €:BRL | Period end | 5.362 | 5.639 | 6.310 |
| Average | 5.401 | 5.440 | 6.378 | |
| €:TRL | Period end | 32.653 | 19.965 | 15.234 |
| Average | 25.760 | 17.409 | 10.512 |
| Q1 | Q2 | Q3 | Q4 | Full year | |
|---|---|---|---|---|---|
| 2023 | 77 | 78 | 79 | 78 | 312 |
| 2022 | 77 | 78 | 79 | 79 | 313 |
| 2021 | 77 | 78 | 79 | 79 | 313 |
| cc | At constant currency |
|---|---|
| HD | Hemodialysis |
| PD | Peritoneal dialysis |
| Net income | Net income attributable to shareholders of FME |
| LTM | Last-Twelve-Months |

| as of December 31, 2023 | as of December 31, 2022 | |||||
|---|---|---|---|---|---|---|
| Patients | Treatments | Clinics | Patients | Treatments | Clinics | |
| United States | 205,308 | 31,210,375 | 2,615 | 206,033 | 31,361,555 | 2,671 |
| Growth in % | 0 | 0 | -2 | 0 | -2 | 0 |
| International | 127,240 | 20,444,165 | 1,310 | 138,654 | 20,948,576 | 1,445 |
| Growth in % | -8 | -2 | -9 | -1 | 0 | -3 |
| Total | 332,548 | 51,654,540 | 3,925 | 344,687 | 52,310,131 | 4,116 |
| Growth in % | -4 | -1 | -5 | 0 | -1 | -1 |

| € million; % change year-over-year | FY 2023 | Growth | Growth at cc |
Organic growth |
FY 2022 | Growth | Growth at cc |
Organic growth |
FY 2021 |
|---|---|---|---|---|---|---|---|---|---|
| Total | |||||||||
| Revenue | 19,454 | 0 | 5 | 4 | 19,398 | 10 | 2 | 2 | 17,619 |
| Operating income | 1,369 | -9 | -7 | 1,512 | -18 | -25 | 1,852 | ||
| Operating income margin in % | 7.0 | 7.8 | 10.5 | ||||||
| Operating income excl. special items | 1,741 | 13 | 15 | 1,540 | -20 | -26 | 1,915 | ||
| Operating income margin in % excl. special items | 8.9 | 7.9 | 10.9 | ||||||
| Care Delivery segment | |||||||||
| Revenue | 15,578 | 0 | 5 | 3 | 15,593 | 11 | 2 | 1 | 14,031 |
| Operating income | 1,516 | -10 | -8 | 1,686 | 3 | -8 | 1,643 | ||
| Operating income margin in % | 9.7 | 10.8 | 11.7 | ||||||
| Operating income excl. special items | 1,687 | 14 | 16 | 1,478 | -13 | n.a. | 1,693 | ||
| Operating income margin in % excl. special items | 10.8 | 9.5 | 12.1 | ||||||
| Care Enablement segment | |||||||||
| Revenue | 5,345 | 0 | 5 | 4 | 5,353 | 5 | 0 | 0 | 5,086 |
| Operating income | -67 | 123 | 123 | -30 | -- | -- | 315 | ||
| Operating income margin in % | -1.2 | -0.6 | 6.2 | ||||||
| Operating income excl. special items | 119 | 15 | 19 | 103 | -68 | n.a. | 327 | ||
| Operating income margin in % excl. special items | 2.2 | 1.9 | 6.4 | ||||||
| Inter-segment elimination | |||||||||
| Revenue | -1,469 | -5 | 0 | -1,548 | 3 | -4 | -1,498 | ||
| Operating income | -13 | -- | -- | 0 | -- | -- | 7 | ||
| Corporate | |||||||||
| Operating income | -67 | -54 | -52 | -144 | 29 | 14 | -113 | ||
| Operating income excl. special items | -52 | 26 | 33 | -41 | -63 | n.a. | -112 |
Note: cc = constant currency; n. a. = not available

| Date | Event | ||||||
|---|---|---|---|---|---|---|---|
| g n rti M & G o A p e R |
February 20, 2024 May 7, 2024 May 16, 2024 July 30, 2024 November 5, 2024 |
Report on 4th quarter 2023: Earnings Release and Conference Call Report on 1st quarter 2024: Earnings Release and Conference Call Annual General Meeting 2024, Frankfurt Report on 2nd quarter 2024: Earnings Release and Conference Call Report on 3rd quarter 2024: Earnings Release and Conference Call |
|||||
| s s e w c o n h e & s r e d nf a o o R C |
February 21-22, 2024 February 21, 2024 February 26, 2024 February 27, 2024 March 11, 2024 March 12-13, 2024 March 26, 2024 March 27, 2024 April 3-4, 2024 |
FY 2023 CEO & CFO Roadshow, London Sellside Analyst Reception, London Morgan Stanley European MedTech & Life Sciences Conference, London UBS European Healthcare Conference, London U.S. investor clinic visit, Miami Barclays Global Healthcare Conference 2024, Miami BNPP Exane Healthcare Conference, Virtual Société Générale Flagship ESG Conference, Paris CEO U.S. Roadshow, Boston and NYC |
Dates and/or participation might be subject to change

Fresenius Medical Care AG Investor Relations Else-Kröner-Str. 1 61352 Bad Homburg v. d. H. Germany
Ticker: FME or FMS (NYSE/ADR)
WKN: 578 580
ISIN: DE00057858002
CUSIP (ADR): 358029106
Head of Investor Relations and Head of Investor Relations, Strategic Development & Communications | EVP
+49(0) 6172-609-2525
dominik.heger@ freseniusmedicalcare.com
Vice President Investor Relations
+49(0) 6172-268 5966
ilia.kuerten@ freseniusmedicalcare.com
Senior Director Investor Relations
+1 860-609-2394
alicia.cahill@ freseniusmedicalcare.com

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