Fresenius Medical Care AG & Co. KGaA

Investor Presentation • Nov 2, 2023

Q3 2023 Conference Call November 2, 2023

Helen Giza, CEO & Chair of the Management Board Martin Fischer, CFO

Safe harbor statement: 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 forward-looking 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 Fresenius Medical Care AG & Co. KGaA's (FMC AG & Co. KGaA) 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 FMC AG & Co. KGaA'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 AG & Co. KGaA. 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.

Executing on our strategic plan

Unlock value as the leading kidney care company
-------------------------------------------------	--

Structure	Simplified governance	Global operating model with two segments	Financial reporting with enhanced transparency
Capital allocation	Disciplined financial policy	ROIC improvement focus
Operational efficiencies &		FME25
turnaround drivers
Portfolio optimization	Care Delivery		Care Enablement

GLP-1 medications' assumed effects on the kidney disease population

Overall, GLP-1 medications are expected to have a balanced impact on ESRD patient volumes

Expected long-term impact

• GLP-1 help control T2D with proven benefits for cardiovascular health
• More CKD patients surviving to progress toward ESRD and healthier ESRD patients to dialyze longer
• GLP-1 assumed to have a positive impact on slowing the progression of kidney disease
• Impact will be driven by many factors including adoption rate, long term adherence, side effects and comorbidities
• Effects as well as side effects still evolving and may take many years to develop

ESRD patients with significant comorbidity burden

Note: Assessment based on limited available information; GLP-1 = Glucose-like peptide 1 receptor agonist; T2D = Type 2 diabetes; CKD = chronic kidney disease; ESRD = end-stage renal disease

Continuous monitoring of clinical performance to enhance care

Quality index components

Dialysis effectiveness

Measures how sufficiently the body is cleansed of waste substances

Vascular access

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

Anemia management

Measures hemoglobin levels and specific medications given during dialysis to achieve optimum clinical outcomes, such as overall health and well-being

	Q3 2023	Q2 2023
Quality index	81%	81 %
Dialysis effectiveness	94%	94%
Vascular

access

Anemia

management 71% 72%

78% 78%

Execution against strategic plan

Q3 Business Update

Q3 2023 | Earnings outlook raised

• Continued solid organic growth driven by both operating segments, sequentially stable same market treatment growth in the U.S.
• Successful execution on turnaround plan driving productivity improvements in Care Delivery and pricing in Care Enablement
• FME25 savings fully on track
• Continued execution on portfolio optimization plan
• FY 2023 earnings outlook raised
• Final ESRD PPS rate in line with expectations
• CMS star rating | FME outpaces industry for 3-/4-/5-star clinics

2023

Q3 2023 | Organic growth momentum continues

in € million

Organic growth

• in Care Delivery driven by price including hyperinflation
• in Care Enablement driven by both volume and price

Operating income | guidance base Revenue ¹ | guidance base¹

Negative impacts from inflation and lower income from a nonrecurring consent payment on certain pharmaceuticals

1: Q3 2023 €451 million Operating Income at cc (guidance base); reconciliation table for special items (guidance base), reported growth rates: page 22 | cc = at constant currency

Q3 2023 | Operating margin further improving

Reconciliation table for special items (guidance base): page 22

Q3 2023 | Key developments in Care Delivery

• Organic revenue growth supported by InterWell Health, reimbursement rate and mix
• Positive U.S. same market treatment growth when adjusted for exits from less profitable acute care contracts
• CD International revenue growth driven by hyperinflation while negatively impacted by exchange rate effects
• Positive earnings development supported by business growth, productivity-driven lower personnel expenses and FME25 savings
• InterWell Health earnings contribution positive but with lower-thanexpected CKCC contributions
• Execution on portfolio optimization | agreement to divest NCP

Q3 2023 | Care Delivery earnings driven by improved productivity

1: Q3 2023 €432 million Operating Income at cc (guidance base); reconciliation table for special items (guidance base), reported growth rates: page 22 | cc = at constant currency

Q3 2023 | Key developments in Care Enablement

• Revenue development driven by
• negative impact from foreign currency translation
• higher sales of in-center disposables, machines for chronic treatment and home hemodialysis products
• positive impact from pricing measures
• Earnings improved year-over-year driven by
• increased volumes, prices and FME25 savings, offsetting cost inflation
• negative impact from currency transaction effects
• Continued execution of FME25 transformation and turnaround measures

Q3 2023 | Care Enablement earnings driven by growth and savings

in € million

Operating income | guidance base Revenue ¹ | guidance base¹

1: Q3 2023 €24 million Operating Income at cc (guidance base); reconciliation table for special items (guidance base), reported growth rates: page 22 | cc = at constant currency

Q3 2023 | Strong cash flow development

in € million	Q3 2023	Q3 2022
Operating cash flow	760	658
 Capital expenditures, net	(134)	(157)
Free cash flow	626	501
 Free cash flow after investing activities	609	557

Net leverage ratio (Net debt/EBITDA)

1 Excl. U.S. federal relief funding and advanced payments under the CARES Act

Key developments

• Operating cash flow improved mainly due positive working capital contribution resulting from recoupment of COVID-19 related relief funding in 2022
• Free cash flow conversion accelerated in line with operating cash flow
• €650m Euro bond, maturing in Nov. 2023, successfully refinanced by mix of longterm bank loans, cash and short-term debt

Outlook | Earnings guidance upgraded

FY 2023

Revenue [%] Low- to mid-single digit percentage growth

FY 2022 basis: EUR 19.4bn

Operating income [%] Low-single digit percentage growth

Prev.: flat to low-single digit percentage decline

FY 2022 basis: EUR 1.54bn

Further outlook

By 2025 an improved operating income margin of 10 to 14% is targeted

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 giving guidance. 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 22 for reconciliation table for special items.

Your questions are welcome.

Q3 2023

Appendix

Q3 2023

Q3 2023 | Profit and Loss

	Q3 2023 € million	Q3 2022 € million	Growth in %	Growth in % cc
Revenue	4,936	5,096	(3)	7
Operating income	324	472	(31)	(28)
Operating income margin in %	6.6	9.3
Operating income excl. special items & PRF	431	377	14	20
Operating income margin in % excl. special items & PRF	8.7	7.4
Operating income excl. special items & PRF in cc (guidance base)1	451	377		20
Operating income margin in % excl. special items & PRF in cc	8.3	7.4
Net interest expense	89	76	16	19
Income before taxes	235	396	(40)	(37)
Income tax expense	88	112	(21)	(18)
Tax rate in %	37.6	28.4
Non-controlling interest	63	54	19	27
Net income	84	230	(63)	(61)
Net income excl. special items & PRF	168	168	0	5

1: Reconciliation table for special items (guidance base), reported growth rates: page 22 | cc = at constant currency

9M 2023 | Profit and Loss

	9M 2023 € million	9M 2022 € million	Growth in %	Growth in % cc
Revenue	14,466	14,401	0	5
Operating income	942	1,160	(19)	(18)
Operating income margin in %	6.5	8.1
Operating income excl. special items & PRF	1,186	1,052	13	14
Operating income margin in % excl. special items & PRF	8.2	7.3
Operating income excl. special items & PRF in cc (guidance base)1	1,200	1,052		14
Operating income margin in % excl. special items & PRF in cc	7.9	7.3
Net interest expense	252	217	16	16
Income before taxes	690	943	(27)	(26)
Income tax expense	214	242	(11)	(11)
Tax rate in %	31.0	25.7
Non-controlling interest	165	166	(1)	1
Net income	311	535	(42)	(41)
Net income excl. special items & PRF	497	481	3	5

1: Reconciliation table for special items (guidance base), reported growth rates: page 23 | cc = at constant currency

2022 base for 2023 targets, reconciliation adjustments

in € 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 guidance (€ million)

	Group			Care Delivery				Care Enablement			Corporate
	Q3 2023	Q3 2022	Growth rate	Q3 2023	Q3 2022	Growth rate	Q3 2023	Q3 2022	Growth rate	Q3 2023	Q3 2022
Operating Income	324	472	-31%	332	500	-34%	(1)	(26)	-95%	(8)	(7)
FME25 program	49	53		25	20		23	33		1	--
Ukraine war	--	--		--	1		--	(1)		--	--
Humacyte investment remeasurement	(1)	1		--	--		--	--		(1)	1
Hyperinflation Turkiye	--	--		--	(1)		--	1		--	--
Legacy portfolio optimization	53	--		53	--		--	--		--	--
Legal form conversion costs	6	--		--	--		--	--		6	--
Net gain related to Interwell Health	--	(56)		--	(56)		--	--		--	--
U.S. Provider Relief Funding	--	(93)		--	(93)		--	--		--	--
Operating income excl. special items and PRF	431	377	14%	410	371	11%	22	7	197%	(2)	(6)
Foreign currency translation	20	--	--	22	--	--	2	--	--	(4)	--
Operating income excl. special items and PRF in cc	451	377	20%	432	371	17%	24	7	217%	(6)	(6)

Inter-segment elimination effect on operating income: €1m in Q3 2023, €5m in Q3 2022 | cc = at constant currency

2022 base for 2023 targets, reconciliation adjustments

in € 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 guidance (€ million)

	Group			Care Delivery				Care Enablement			Corporate
	9M 2023	9M 2022	Growth rate	9M 2023	9M 2022	Growth rate	9M 2023	9M 2022	Growth rate	9M 2023	9M 2022
Operating Income	942	1,160	-19%	1,001	1,230	-19%	(24)	33	n.a.	(23)	(101)
FME25 program	100	109		50	55		51	54		(1)	--
Ukraine war	--	24		--	11		--	13		--	--
Humacyte investment remeasurement	(16)	79		--	--		--	--		(16)	79
Hyperinflation Turkiye	--	6		--	(1)		--	7		--	--
Legacy portfolio optimization	147	--		64	--		83	--		13	--
Legal form conversion costs	13	--		--	--		--	--			--
Net gain related to Interwell Health	--	(56)		--	(56)		--	--		--	--
U.S. Provider Relief Funding	--	(270)		--	(270)		--	--		--	--
Operating income excl. special items and PRF	1,186	1,052	13%	1,115	969	15%	110	107	3%	(27)	(22)
Foreign currency translation	14	--	--	15	--	--	0	--	--	(2)	--
Operating income excl. special items and PRF in cc	1,200	1,052	14%	1,130	969	17%	110	107	3%	(29)	(22)

Inter-segment elimination effect on operating income: €-12m in 9M 2023, €-2m in 9M 2022 | cc = at constant currency

Debt

Reconciliation of non-IFRS financial measures to most directly comparable IFRS financial measures

	Q3 2023 € million	FY 2022 € million	FY 2021 € million
Debt
Short-term debt from unrelated parties	547	665	1,178
+ Short-term debt from related parties	3	4	78
+ Current portion of long-term debt	707	694	668
+ Current portion of long-term lease liabilities from unrelated parties	627	650	640
+ Current portion of long-term lease liabilities from related parties	24	24	21
+ Long-term debt, less current portion	7,264	7,171	6,647
+ Long-term lease liabilities from unrelated parties, less current portion	3,687	3,875	3,990
+ Long-term lease liabilities from related parties, less current portion	116	130	98
+ Debt and lease liabilities included within liabilities directly associated with assets held for sale	31	-	-
Total debt and lease liabilities	13,006	13,213	13,320
− Cash and cash equivalents	(1,574)	(1,274)	(1,482)
Total net debt and lease liabilities	11,432	11,939	11,838

Includes cash and cash equivalents included within assets held for sale.

Reconciliation of annualized adjusted EBITDA and net leverage ratio to the most directly comparable IFRS financial measures

	LTM Q3 2023 € million	FY 2022 € million	FY 2021 € million
Net income	670	895	1,219
+ Income tax expense	297	325	353
− Interest income	(86)	(68)	(73)
+ Interest expense	413	360	353
+ Depreciation and amortization	1,651	1,718	1,586
Adjustments1 +	434	320	125
Adjusted EBITDA (annualized)	3,379	3,550	3,563
Net leverage ratio (Net debt/EBITDA)	3.4	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 (2022: -€22 M), non-cash charges, primarily related to pension expense (2023: €50 M; 2022: €54 M), impairment loss (2023: €170 M; 2022: €120 M) and special items, including costs related to the FME25 Program (2023: €128 M; 2022: €155 M), Legal Form Conversion Costs (2023: €13 M), Legacy Portfolio Optimization (2023: €71 M), Net Gain Related to InterWell Health (2023: -€1 M; 2022: -€114 M), Humacyte Investment Remeasurement (2023: €7 M; 2022: €103 M), Hyperinflation in Turkiye (2023: -€1 M; 2022: €5 M) and the Impacts Related to the War in Ukraine (2023: -€3 M; 2022: €19 M).

Return on Invested Capital (ROIC) continued to be impacted by lower earnings

• Long-term value creation based on accretive acquisitions and organic growth
• 2020 negative impact from Latin America impairment
• 2021 negative impact from FME25
• 2022 negative impact from FME25 and the Humacyte investment remeasurement

• 2023 with effects from FME25 and Legacy Portfolio Optimization

• For the years 2015-17 ROIC as reported within the Form 20-F.

• ROIC adjusted in 2018 for the divestiture of Care Coordination activities, FCPA-related charge, U.S. Ballot Initiatives, U.S. tax reform / including these effects, ROIC for FY 2018 was 12.4%
• ROIC adjusted in 2019 for the effects of IFRS 16, NxStage, FCPA, Cost optimization costs, divestiture of Care Coordination activities / including these effects, ROIC for FY 2019 was 6.8% (excl. IFRS 16)
• ROIC in 2020 excl. the impact of the Latin America impairment (special item) and in 2021 excluding FME25 (special item)
• ROIC for 2020 and 2021 was 7.5% and 5.5% excl. IFRS 16 and excl. Latin America impairment in 2020
• ROIC in 2022 adjusted for the effects of the FME25 program, the Humacyte Investment Remeasurement, the net gain related to InterWell Health, the effects of hyperinflation in Turkiye and impacts related to the war in Ukraine
• ROIC in 2023 adjusted for the effects of the FME25 program, Legal Form Conversion Costs, Legacy Portfolio Optimization and Humacyte Investment Remeasurement

Exchange rates, U.S. dialysis days per quarter, definitions

Exchange rates

		9M 2023	FY 2022	FY 2021
€:USD	Period end	1.059	1.067	1.133
	Average	1.083	1.053	1.183
€:CNY	Period end	7.735	7.358	7.195
	Average	7.624	7.079	7.628
€:RUB	Period end	103.184	78.138	85.300
	Average	90.025	73.365	87.153
€:ARS	Period end	370.355	189.201	116.780
	Average	267.155	137.041	112.522
€:BRL	Period end	5.307	5.639	6.310
	Average	5.425	5.440	6.378
€:TRL	Period end	29.051	19.965	15.234
	Average	24.149	17.409	10.512

U.S. dialysis days per quarter

	Q1	Q2	Q3	Q4	Full year
2023	77	78	79	79	313
2022	77	78	79	79	313
2021	77	78	79	79	313
2020	77	78	79	79	313
2019	76	78	79	80	313

Definitions

HD Hemodialysis
PD Peritoneal dialysis
Net income Net income attributable to shareholders of FME
LTM Last-Twelve-Months

Patients, treatments, clinics

	as of September 30, 2023			as of September 30, 2022
	Patients	Treatments	Clinics	Patients	Treatments	Clinics
United States	205,887	23,380,747	2,617	205,985	23,491,632	2,687
Growth in %	0	0	(3)	0	(3)	1
International	135,906	15,426,432	1,397	138,608	15,660,512	1,466
Growth in %	(2)	(1)	(5)	0	2	(1)
Total	341,793	38,807,179	4,014	344,593	39,152,144	4,153
Growth in %	(1)	(1)	(3)	0	(1)	0

Financial calendar

	Date	Event
M G A	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 Report on 2nd quarter 2024: Earnings Release and Conference Call Report on 3rd quarter 2024: Earnings Release and Conference Call
s w o h s d a o R	November 3, 2023 November 7-9, 2023 November 8, 2023 November 13, 2023 November 14, 2023 November 29, 2023 December 5, 2023 December 5-6, 2023 December 13, 2023	Roadshow in London, Goldman Sachs Roadshow in U.S. West Coast / Canada, ODDO Societe Generale European ESG Conference, Paris Roadshow in Edinburgh, Barclays UBS Flagship European Conference, London Societe Generale The Premium Review Conference, Paris Bank of America Home Care Conference, virtual Berenberg European Conference, Pennyhill Roadshow in Tokyo, Societe Generale

Dates and/or participation might be subject to change

Conferences

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Reportin g

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FME 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

Ilia Kuerten

Vice President Investor Relations

+49(0) 6172-609-96253 ilia.kuerten@fmc-ag.com

Alicia Cahill

Director Investor Relations

+1 860-609-2394 alicia.cahill@fmc-ag.com