Fresenius Medical Care AG & Co. KGaA

Earnings Release • Oct 2, 2008

Fresenius Medical Care

The World's Leading Renal Therapy Company

DZ Bank AG – German Healthcare Conference Zurich, October 2, 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. Midterm Strategy

4. Attachments

Q2 2008 – Strong Quarter

Revenue	\$ 2,665 m	+ 11%
Net income	\$ 211 m	+ 18%
Earnings per share	\$ 0.71	+ 18%

On track to achieve Full Year Guidance

despite:

• EPO reimbursement below previous year
• Heparin costs in North America significantly higher in the second half of 2008

Total Revenue Increased by 11% to \$ 2,665 m *

Accelerated International Growth of 19% cc

US-\$ in millions	Q2 2007	Q2 2008	Growth	cc
North America	1,499	1,533	2%
Adjusted for the sale of the perfusion business International	296	391	3% 32%	19%
Total	1,796	1,924	7%	5%
Adjusted for the sale of the perfusion business			8%	6%

Strong Organic Revenue growth and improving Revenue per Treatment

Q2 2008	Total	North America	International
Organic revenue growth	+ 5%	+ 3%	+ 19%
Same market treatment growth	+ 4.2%	+ 2.8%	+ 7.9%
Revenue per treatment		1) \$ 323	\$ 183
Growth		-0.1%	+ 10.3% cc
Clinics Q2 2008	2,318	1,647	671
Growth	+ 5%	+ 4%	+ 7%
De novos Q2 (including managed clinics)	26	12	14

1) including Mexico

cc = constant currency

Epo Utilization and Dialysis Reimbursement developing as Expected

Overall Strong Quality Performance Except for Hemoglobin

	North America			EMEA
% of FME patients	Q2 2007	Q2 2008	Q2 2007	Q2 2008
Kt/V ≥ 1.2	94%	95%	94%	95%
Hemoglobin ≥ 11 g/dl	81%	73%	72%	69%
Albumin ≥ 3.5 g/dl	79%	80%	86%	85%
Phosphate 3.5-5.5 mg/dl	52%	55%	57%	60%
Hospitalization days	* 11.2	* 10.5	7.9	8.0

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

Quality Outcomes - United States

EPO Utilization

Quality Outcomes - United States

Anemia Management

Excellent External Product Revenue Growth

US-\$ in millions	Q2 2007	Q2 2008	Growth	cc
Total revenue (incl. Internal Revenue)	799	953	19%	10%
External revenue	609	741	22%	12%
North America	161	182	13%	13%
International	448	559	25%	11%

U.S. Legislative Update

Medicare Bill was passed on July 14, 2008

Key Dialysis components included are:

• Composite rate increase of 1% per annum in 2009 and 2010
• New law mandates a bundled payment rate at 98% of total nonbundled expenditures starting in 2011
• Providers may elect to voluntarily phase in over 3 years
• Permanent market basket increase beginning in 2012, estimated approximately 2% per year
• Extends authority for Medicare Advantage Special Needs Plan (MA-SNP) through 2011
• Delays moratorium on new MA-SNP to 2010

Fresenius Medical Care – North America

Health Plan 2nd year results

Focusing on further improving patient therapy and expanding market opportunities globally

• Exclusive 10 year U.S. manufacturing and distribution sublicense agreement for Venofer® and next generation I.V. Iron product for dialysis stage V
• Venofer® is the leading I.V. Iron product worldwide

o Total U.S. I.V. Iron purchases are ~ \$500 million (Venofer® accounts for 55%)

Transaction is subject to FTC – HSR clearance

Focusing on further improving patient therapy and expanding market opportunity in Europe and Latin America

• Exclusive agreement with Galenica to commercialize I.V. Iron products Venofer® and Ferinject® for dialysis stage V patients
• Total market for I.V. Iron in Europe, Middle East, Africa, and Latin America was more than \$120 million in 2007
• o Commercialization expected to become effective no later than January 1, 2009
• o Expected 2010 annual sales to be about \$50 million

Highlights Q2

North Europe (EU)  America Asia-Pacific (AP)  -	 Continued revenue growth momentum in products of 13%  Bundle reimbursement in 2011 with automatic update  Anemia Management developing as expected  Add IV Iron to the Renal Pharma Portfolio
Europe	 Revenue growth momentum continued of 13%cc  Continued strong growth in Eastern Europe +17%  Same market treatment growth of 9%  Very strong growth in the Acute Renal Business
Asia - Pacific	 Strong same market treatment growth of 6%  Impressive revenue growth in China of 42%cc  Continued impressive revenue growth of 38% cc (excl. Japan)  Launch of new high performance dialyzer FX-S

1. Business Update

2. Financials and Outlook

3. Midterm Strategy

4. Attachments

Profit & Loss

US-\$ in millions	Q2 2007	Q2 2008	Growth
Net revenue	2,404	2,665	* 11%
Operating income (EBIT)	391	429	10%
EBIT margin in %	16.3	16.1
Interest expense, net	92	82
Income before income tax	299	347	16%
Income Tax expense	113	129
Tax rate	38.0%	37.2%
Minority interest	7	7
Net income	179	211	18%

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

Q2 2007	Q2 2008	Growth
225	209	(7%)
(130)	(179)
95	30	(69%)
2	(58)
97	(28)
		8% of revenue

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.

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

1. Business Update

2. Financials and Outlook

3. Midterm Strategy

4. Attachments

Expanded Global Presence Last 12 Months

* including clinics where FME has an interest of at least 10%

Dialysis Services Worldwide - Patients

Source: Company data

where FME has an interest of at least 10%

Global Patients by Region

2007

Sustainable Patient Growth of ~ 6% p.a.

~ 2 million patients expected by 2010

~ 4 million patients expected by 2025

Dialysis Products Worldwide

• We clearly gained market share in HD
• Produced 75 Million Dialyzers in 2007
• Produced the Company's 500 Millionth Dialyzer
• RSI Acquisition to set standards in future technologies

Source: 2007 Company data / internal estimates

New Products 2008/2009

Market Opportunity

2010 Revenue Target

Sustainable Growth of Earnings After Tax – Low to Mid-Teens per year

Our Growth Drivers

Targeted Revenue Growth in 2008 >7%

Thank You for your interest in Fresenius Medical Care !

1. Business Update

2. Financials and Outlook

3. Midterm Strategy

4. Attachments

H1 2008	Clinic	Patients	Treatments (in million)
Total	2,318	179,340	13.61
Growth	+ 5%	+ 4%	+ 5%
North America	1,647	123,784	9.39
Growth	+ 4%	+ 3%	+ 3%
International	671	55,556	4.22
Growth	+ 7%	+ 8%	+ 8%
Europe	382	28,799	2.17
Latin America	175	18,404	1.41
Asia-Pacific	114	8,353	0.64

Total Revenue Increased 10% to \$ 5,177 m *

Accelerated Growth Internationally of 16% cc

US-\$ in millions	H1 2007	H1 2008	Growth	cc
North America	2,983	3,028	2%
Adjusted for the sale of the perfusion business			3%
International	573	741	29%	16%
Total	3,556	3,769	6%	4%
Adjusted for the sale of the perfusion business			7%	5%

Excellent External Product Revenue Growth

US-\$ in millions	H1 2007	H1 2008	Growth	cc
Total revenue (incl. Internal Revenue)	1,539	1,822	18%	10%
External revenue	1,169	1,408	20%	11%
North America	314	354	13%	13%
International	855	1,054	23%	10%

US-\$ in millions	H1 2007	H1 2008	Growth
1) Net cash provided by operating activities	508	401 8% of revenue	(21%)
1) Capital expenditures (net)	(237)	(332)
Free Cash Flow	271	69	(75%)
Acquisitions, net of divestitures1)	(90)	(92)
Free Cash Flow after acquisitions	181	(23)

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

Profit & Loss

US-\$ in millions	H1 2007	H1 2008	Growth
Net revenue	4,725	5,177	* 10%
Operating income (EBIT)	756	818	8%
EBIT margin in %	16.0	15.8
Interest expense, net	187	165
Income before income tax	569	653	15%
Income Tax expense	216	243
Tax rate	38.0%	37.2%
Minority interest	14	13
Net income	339	397	17%

* 6% growth at constant currency, 6% organic growth

Continued Solid Performance in All Segments

in %

Days Sales Outstanding (DSO)

Overall Slightly Increasing since Beginning of the Year

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

All numbers are in US-\$ millions
External Revenue	Q2 2008	Q2 2007	growth	cc
International product revenue	638	508	+ 26%	+ 12%
- Internal revenue	(79)	(61)
= External revenue	559	447	+ 25%	+ 11%
North America product revenue	315	291	+ 8%
- Internal revenue	(133)	(130)
= External revenue	182	161	+ 13%
TOTAL product revenue	953	799	+ 19%	+ 10%
- Internal revenue	(212)	(191)
= External revenue	741	608	+ 22%	+ 12%

Capital expenditure (net)	H1 2008	H1 2007	Q2 2008	Q2 2007
Purchase of property, plant and equipment	343	249	184	133
- Proceeds from sale of property, plant and equipment	(11)	(12)	(5)	(3)
= Capital expenditure (net)	332	237	179	130

Reconciliation of non US-GAAP financial measures to the most directly comparable US-GAAP financial measure
All numbers are in US-\$ millions
Debt	Q2 2008	FY 2007	FY 2006	FY 2005	FY 2004
Short term borrowings	734	217	331	151	419
+ Short term borrowings from related parties	181	2	5	19	6
+ Current portion of long-term debt and capital lease obligations	151	85	160	126	230
+ Current portion of Trust Preferred Securities	-	670
+ Long-term debt and capital lease obligations, less current portion	4,183	4,004	3,829	707	545
+ Trust Preferred Securities (net of current portion)	696	664	1,254	1,188	1,279
= Total debt	5,945	5,642	5,579	2,191	2,479
EBITDA	Q2 2008	FY 2007	FY 2006 (pro forma)	FY 2005	FY 2004
Last twelve months operating income (EBIT)	1,642	1,580	1,367	939	852
+ Last twelve months depreciation and amortization	392	363	326	251	233
+ Non-cash charges	42	41	35	14	13
= EBITDA (annualized)	2,076	1,984	1,728	1,204	1,098
Cash Flow		H1 2008	H1 2007	Q2 2008	Q2 2007
Acquisitions and investments and net purchases of intangible assets		(133)	(117)	(60)	(26)
Proceeds from divestitures		41	27	2	28
Acquisitions, net of divestitures		(92)	(90)	(58)	2

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

November 4th, 2008 Report Q3/9M 2008

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