Fresenius Medical Care AG & Co. KGaA

Earnings Release • Nov 5, 2008

Fresenius Medical Care

The World's Leading Renal Therapy Company

Third Quarter / Nine Months 2008 Results Conference Call, November 4, 2008

This presentation includes certain forward-looking statements. 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 competitive conditions, regulatory reforms, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings and the availability of financing. These and other risks and uncertainties are detailed in the Company"s reports filed with the Securities and Exchange Commission and the German Exchange Commission "Deutsche Börse".

1. Business Update

2. Financials and Outlook

3. Q&A Session

Q3 2008 – Strong Quarter

Revenue	\$ 2,713 m	+ 12%
Net income	\$ 206 m	+ 14%
Earnings per share	\$ 0.69	+ 14%

On track to achieve Full Year Guidance

despite:

• Significantly higher Heparin costs in North America
• Volatile currency environment

Total Revenue Increased by 12% to \$ 2,713 m*

* 9% growth at constant currency (cc)

Total Revenue Increased by 10% to \$ 7,890 m*

* 7% growth at constant currency (cc)

Strong Growth of 9% at constant currency

US-\$ in millions	Q3 2007	Q3 2008	Growth	cc
North America	1,494	1,587	6%
International	307	398	30%	20%
Total	1,801	1,985	10%	9%

Good improvements in all metrics

	Total	North America	International
Organic revenue growth	+ 7%	+ 5%	+ 19%
Same market treatment growth	+ 4.8%	+ 3.0%	+ 9.5%
Revenue per treatment		1) \$ 328	\$ 179
Growth		+ 1.8%	+ 8.1% cc
Clinics 2008 YTD	2,349	1,666	683
Growth	+ 6%	+ 5%	+ 8%
De novos Q3 (including managed clinics)	31	21	10
De novos YTD (including managed clinics)	101	62	39

1) including Mexico

Dialysis Services - United States

Revenue per treatment

Overall Strong Quality Performance

	North America		EMEA
% of FME patients	Q3 2007	Q3 2008	Q3 2007	Q3 2008
Kt/V ≥ 1.2	95%	95%	94%	95%
Hemoglobin ≥ 11 g/dl	80%	76%	71%	69%
Hemoglobin = 10-13 g/dl	80%	85%	74%	76%
Albumin ≥ 3.5 g/dl	80%	81%	86%	85%
Phosphate 3.5-5.5 mg/dl	52%	53%	58%	60%
Hospitalization days	11.1 *	10.5 *	7.6	7.8

Reduced hospitalization days reflects our continued commitment for quality improvements

* The hospitalization rates for the US reflects FMS adoption of CMS policy

Quality Outcomes - United States

EPO Utilization

100% = Base Line Index

Data Source: FMC ¹¹ -NA Clinical Data Warehouse and IRIS Data Warehouse - All FME U.S. clinics (including RCG legacy)

Quality Outcomes - United States

Anemia Management

Focuses on quality outcomes for patients in line with K/DOQI guidelines

Data Source: Clinical Performance Management (CPM) Data / Legacy FME U.S. clinics

Q3 2008 Dialysis Products - Global

Excellent External Product Revenue Growth

US-\$ in millions	Q3 2007	Q3 2008	Growth	cc
Total revenue (incl. Internal Revenue)	821	943	15%	10%
External revenue	625	728	16%	11%
North America	167	184	11%	11%
International	458	544	19%	11%

Revenue Run Rate > \$200 m/year External Sales

PhosLo:

• Revenue growth of 62% in Q3
• Prescriptions increase 3% in Q3
• Impact of Generics
• Patient preference
• PhosLo specific phosphorus kinetic modeling (PKM)
• New formulation 2009

Venofer:

• Received FTC Clearance September 2008
• Closed Transaction September 2008
• Proven Superior Safety Profile
• Sales Start in November
• Developing Improved Iron Therapy with American Regent/Galenica

Investing in our Future

Expanding Production Capacities to Meet Customer Demand

U.S.

U.S. Mexico

Mexico

L' Arbresle France

Germany

Germany

Italy

China

Buzen Japan

Inukai Japan

Expand International Dialysis Service Network

• Participate in profitable and fast growing countries like:
• Poland, Romania, Czech, UK and Russia
• Chile, Colombia
• Taiwan and Korea

Investing in our Future

Regenerative Renal Therapy – Improving Peritoneal Dialysis

Highlights Q3

cc= constant currency y-o-y = year over year

Financials and Outlook

Profit & Loss

US-\$ in millions	Q3 2007	Q3 2008	Growth
Net revenue	2,426	2,713	* 12%
Operating income (EBIT)	397	422	6%
EBIT margin in %	16.4	15.6
Interest expense, net	95	87
Income before income tax	302	335	11%
Income Tax expense	115	123
Tax rate	38.0%	36.6%
Minority interest	6	6
Net income	181	206	14%

* 9% growth at constant currency, 8% organic growth

Profit & Loss

US-\$ in millions	9M 2007	9M 2008	Growth
Net revenue	7,151	7,890	* 10%
Operating income (EBIT)	1,152	1,240	8%
EBIT margin in %	16.1	15.7
Interest expense, net	281	252
Income before income tax	871	988	13%
Income Tax expense	331	366
Tax rate	38.0%	37.0%
Minority interest	20	19
Net income	520	603	16%

* 7% growth at constant currency, 7% organic growth

Continued Solid Performance in All Segments

in %

Days Sales Outstanding (DSO)

Stable within narrow range

US-\$ in millions	Q3 2007	Q3 2008	Growth
1) Net cash provided by operating activities	382	315 12% of revenue	(18%)
1) Capital expenditures (net)	(122)	(160)
Free Cash Flow	260	155	(41%)
Acquisitions, net of divestitures1)	(25)	(39)
Free Cash Flow after acquisitions	235	116

1) A reconciliation to the most directly comparable US-GAAP financial measure is provided in the attachment.

US-\$ in millions	9M 2007	9M 2008	Growth
1) Net cash provided by operating activities	890	716 9% of revenue	(20%)
1) Capital expenditures (net)	(359)	(493)
Free Cash Flow	531	223	(58%)
Acquisitions, net of divestitures1)	(115)	(130)
Free Cash Flow after acquisitions	416	93

1) A reconciliation to the most directly comparable US-GAAP financial measure is provided in the attachment.

Debt and EBITDA Development

• including non-cash charges

pf = pro forma excluding restructuring costs, in-process R&D and gain from the sale of dialysis clinics LTM = last twelve months cl = closing RCG A reconciliation to the most directly comparable US-GAAP financial measure is provided in the attachment.

Weakness in the Euro and some other currencies present challenges for reported results

• Largest translation exposure in Euro/US\$
• Weakness in some other currencies, but low exposure
• Speed of weakening limits short term mitigating measures
• Offsetting impact of transaction exposure more limited than usual

However:

• Underlying business is strong and on target
• Exchange rates developing favorably in some key markets
• Strong US\$ favorable for Euro valuation

Euro has weakened versus the US\$ in a very short time period

Relative performance YTD

Solid Financial Position

Liquidity secured through medium and long term financing:

• Strong Bank Group
• No near term Re-financing
• Accounts/Receivable Facility Renewed in October
• Nearly \$900 million un-utilized lines
• Attractive spreads locked in before the "crisis"

Financial Cushion (as of Sept 30, 2008)

\$ in millions	Facility	1) Utilization	Cushion
Credit Agreement	4,095	3,443	652
Trust Preferred Securities	654	654	0
Bond 2007 – 2017	500	500	0
Notes (Schuldscheindarlehen)	286	286	0
EIB Facility	316	178	0
Other bank facilities	503	274	229
Subtotal	6,354	5,335	881
Accounts Receivable Program
2) North America	620	537	0
TOTAL	6,974	5,872	881

1 ) Utilization may differ from Balance Sheet debt due to off-balance sheet items (e.g. letters of credit and guarantees)

2 ) \$ 650 million facility amount (since Oct. 2008 \$550 million), limit represents maximum amount of eligible receivables

Current Debt Maturity

Oct 27, 2008		Amount	"07	'08	'09	'10	'11	Year '12	'13	'14	'15	'16	'17
	in million
Accounts Receivable Facility	\$	550
Credit Agreement Rev./TLA	\$	1,521
Credit Agreement TLB	\$	1,574
Senior Notes 2007-2017	\$	500
Trust Preferred Securities IV	\$	225
Trust Preferred Securities V	€	300
Notes (Schuldscheindarlehen)	€	200

Outlook 2008 -	Confirmed

US-\$ in millions Guidance

Net Revenues	> \$ 10,400
Net Income	\$ 805 - 825

Leverage ratio (Debt/EBITDA)	< 2.8
Capital Expenditure	~ \$ 650 - 750
Acquisitions	~ \$ 150 - 250

Thank You for your interest in Fresenius Medical Care !

Fresenius Medical Care

The World's Leading Renal Therapy Company

Third Quarter / Nine Months 2008 Results Conference Call, November 4, 2008

9m 2008	Clinic *	Patients *	Treatments (in million)
Total	2,349	181,937	20.67
Growth	+ 6%	+ 6%	+ 5%
North America	1,666	125,356	14.22
Growth	+ 5%	+ 4%	+ 4%
International	683	56,581	6.44
Growth	+ 8%	+ 10%	+ 9%
Europe	389	28,941	3.30
Latin America	177	19,042	2.16
Asia-Pacific	117	8,598	0.98

* Data per Sept. 30, 2008

Continued Strong Growth Internationally of 17% cc

US-\$ in millions	9M 2007	9M 2008	Growth	cc
North America	4,476	4,615	3%
International	881	1,138	29%	17%
Total	5,357	5,753	7%	5%

9M 2008 Dialysis Products - Global

Excellent External Product Revenue Growth

US-\$ in millions	9M 2007	9M 2008	Growth	cc
Total revenue (incl. Internal Revenue)	2,360	2,765	17%	10%
External revenue	1,794	2,137	19%	11%
North America	481	538	12%	12%
International	1,313	1,598	22%	10%

Reconciliation of non US-GAAP financial measures to the most directly comparable US-GAAP financial measure

All numbers are in US-\$ millions
External Revenue	Q3 2008	Q3 2007	Growth	cc
International product revenue	622	524	+ 19%	+ 10%
- Internal revenue	(78)	(66)
= External revenue	544	458	+ 19%	+ 11%
North America product revenue	320	297	+ 8%
- Internal revenue	(136)	(130)
= External revenue	184	167	+ 11%
TOTAL product revenue	943	821	+ 15%	+ 10%
- Internal revenue	(215)	(196)
= External revenue	728	625	+ 16%	+ 11%

Capital expenditure (net)	9M 2008	9M 2007	Q3 2008	Q3 2007
Purchase of property, plant and equipment	502	381	160	132
- Proceeds from sale of property, plant and equipment	(9)	(22)	(0)	(10)
= Capital expenditure (net)	493	359	160	122

Reconciliation of non US-GAAP financial measures to the most directly comparable US-GAAP financial measure
All numbers are in US-\$ millions
Debt	Q3 2008	FY 2007	FY 2006	FY 2005	FY 2004
Short term borrowings	686	217	331	151	419
+ Short term borrowings from related parties	1	2	5	19	6
+ Current portion of long-term debt and capital lease obligations	437	85	160	126	230
+ Current portion of Trust Preferred Securities	-	670
+ Long-term debt and capital lease obligations, less current portion	3,972	4,004	3,829	707	545
+ Trust Preferred Securities (net of current portion)	652	664	1,254	1,188	1,279
= Total debt	5,748	5,642	5,579	2,191	2,479
EBITDA	Q3 2008	FY 2007	FY 2006 (pro forma)	FY 2005	FY 2004
Last twelve months operating income (EBIT)	1,668	1,580	1,367	939	852
+ Last twelve months depreciation and amortization	410	363	326	251	233
+ Non-cash charges	44	41	35	14	13
= EBITDA (annualized)	2,122	1,984	1,728	1,204	1,098
Cash Flow		9M 2008	9M 2007	Q3 2008	Q3 2007
Acquisitions and investments and net purchases of intangible assets		(176)	(144)	(44)	(27)
Proceeds from divestitures		46	29	5	2
Acquisitions, net of divestitures		(130)	(115)	(39)	(25)

Contacts

Fresenius Medical Care AG & Co. KGaA Investor Relations Else-Kröner-Str. 1 61352 Bad Homburg v.d.H.

Oliver Maier Head of Investor Relations & Corporate Communications Tel.: +49-(0)6172-609-2601 Fax.: +49-(0)6172-609-2301 Email: oliver.maier@fmc-ag.com

Terry L. Morris Tel.: +1-800-948-2538 Fax.: +1-615-345-5605 Email: terry.morris@fmc-na.com

Gerrit Jost Tel.: +49-(0)6172-609-5216 Fax.: +49-(0)6172-609-2301 Email: gerrit.jost@fmc-ag.com Ordinary shares WKN 578 580 ISIN DE0005785802 SEDOL1 5129074 DE

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