Fresenius Medical Care AG & Co. KGaA

Earnings Release • Jan 12, 2010

Fresenius Medical Care

The World's Leading Renal Therapy Company

Commerzbank German Investment Seminar

New York, January 12, 2010

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. 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 discussed in detailed in the Company's reports filed with the Securities and Exchange Commission (SEC) and the German Exchange Commission (Deutsche Börse).

1. Business Update

2. Growth Strategy

Third Quarter 2009 - Quality Outcomes

Overall strong quality performance

	North America		EMEA	STATUS
% of FME patients	Q3 2008	Q3 2009	Q3 2008	Q3 2009
Kt/V ≥ 1.2	95%	96%	95%	95%
Hemoglobin = 10-12 g/dl	58%	64%	51%	53%
Hemoglobin = 10-13 g/dl	86%	87%	76%	74%
Albumin ≥ 3.5 g/dl	81%	82%	85%	85%	Improve
Phosphate 3.5-5.5 mg/dl	53%	54%	60%	58%	Improve
Hospitalization days	10.5	* 10.0	* 7.6	7.8

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

Third Quarter 2009 - Highlights

Continued strong organic growth of 8% and improving outcomes

Dialysis Services:

• Continued superior clinical outcomes
• New Therapies patient growth y-o-y
• USA Clinic Nocturnal +39%
• Europe Online Hemodiafiltration +47%

Dialysis Products:

• Highest quality levels across all production plants and product lines
• Renal Pharma revenue on target
• New PD and HD products very well received

Very good third quarter

	Q3 2008	Q3 2009	Growth
Revenue	\$ 2,713 m	\$ 2,889 m	+ 6%
Net income attributable to FME AG & Co. KGaA	\$ 206 m	\$ 225 m	+9%
Earnings per share	\$ 0.69	\$ 0.76	+9%

• Continued strong revenue growth of +10%cc
• Strong sequential EBIT-margin improvement of 50 bps in the third quarter
• Improved net income growth of +9%

Strong performance with ongoing currency headwinds

	9M 2008	9M 2009	Growth
Revenue	\$ 7,890 m	\$ 8,212 m	+ 4%
Net income attributable to FME AG & Co. KGaA	\$ 603 m	\$ 645 m	+ 7%
Earnings per share	\$ 2.03	\$ 2.16	+ 6%

• For the 9M 2009 a total revenue growth of +9%cc and organic growth of +8%

Strong external product growth of 8%cc

US-\$ in millions	Q3 2008	Q3 2009	Growth	cc
Total Revenue (incl. Internal Revenue)	943	988	5%	11%
External Revenue	728	742	2%	8%
North America	184	209	14%
International	544	533	-2%	6%

Very strong revenue growth globally

US-\$ in millions	Q3 2008	Q3 2009	Growth	cc
North America	1,587	1,741	10%
International	398	406	2%	12%
Total	1,985	2,147	8%	10%

Treating more than 192,800 patients in ~ 2,510 clinics

Third Quarter 2009 – Revenue per treatment US

Favorable reimbursement trend

Excellent cash collection in North America

Operating cash flow at 11% of revenue

\$ in millions	9M 2008	9M 2009	Growth
Operating Cash Flow 1)	716	880	23%
1) Capital Expenditures, net	(493)	(388)
Free Cash Flow	223	492 6% of revenue	120%
Acquisitions, net of divestitures1)	(130)	(57)
Free Cash Flow, after acquisitions	93	435 5% of revenue

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

Q3 2009 - Debt and EBITDA Development

* including non-cash charges and in 2006/2007 excluding restructuring costs, in-process R&D and gain from the sale of dialysis clinics. A reconciliation to the most directly comparable US-GAAP financial measure is provided in the attachment.

© 2010 Fresenius Medical Care AG & Co. KGaA 13

US Reimbursement Environment / Legislation

Bundling – 2011

• Final rule anticipated in 1st half of 2010
• Current assessment:
• Insufficient data available to duplicate the CMS analysis
• Some areas would result in reimbursement reductions (e.g. case mix, transition adjustment)
• Part D oral drugs are significantly underfunded as proposed
• Proposed rule does not address coordination of secondary insurance coverage
• FME and the dialysis community are working cooperatively with CMS to address these issues

Healthcare Reform Initiatives

• House and Senate bills passed
• No cuts anticipated for dialysis providers
• Medicare Accountable Care Organization (ACO) and Medicare Special Needs Plans (SNP) reforms remain positive
• Specific issues to be watched

Fiscal Year 2009 – Outlook

Improved guidance for 2009

US-\$ in millions	OLD	Guidance
Net Revenues	> \$ 11,100	~ \$ 11,200
Net Income attributable to FME AG & Co. KGaA	\$ 850 - 890	\$ 865 – 890
Leverage ratio (Debt/EBITDA)	< 2.7	< 2.7
Capital Expenditures	~ \$ 550 - 650	~ \$ 550 - 650
Acquisitions	~ \$ 200 - 300	~ \$ 200 - 250

Superior quality performance in both products and services

Continued expansion of new products and therapies worldwide

Strong sequential EBIT- margin improvement

Very strong Cash Flow development

Continued focus on R&D

Upgraded lower end of earnings guidance

1. Business Update

2. Growth Strategy

The Opportunity for Growth

Global Patients by Region

Source: Company data as of December 2008

Expanded Leading Global Presence

Hemodialysis (HD)

= 90% of all treatments

Peritoneal Dialysis (PD)

= 10% of all the treatments

Produced more than 80.000.000 Dialyzers in 2008

Source: Company data as of December 2008

Dialysis Services Worldwide - Patients

Source: Company data as of December 2008 (except FME, based on Q3/2009)

Fresenius Medical Care – North America

Health Plan 2nd year results

Our Growth Opportunities

1. Increased Product Market Share

2. Reimbursement Based on Quality

3. Expansion of Dialysis Network

4. Renal Pharma – Enhanced Therapy

5. New Clinical Services / Comprehensive Bundle

Fresenius Medical Care

The World's Leading Renal Therapy Company

Commerzbank German Investment Seminar

New York, January 12, 2010

9M 2009	Clinic	Patients	Treatments (in million)
Total	2,509	192,804	21.8
Growth	+ 7%	+ 6%	+ 6%
North America	1,749	130,522	14.8
Growth	+ 5%	+ 4%	+ 4%
International	760	62,282	7.1
Growth	+ 11%	+ 10%	+ 10%
Europe	427	31,431	3.6
Latin America	193	20,834	2.4
Asia-Pacific	140	10,017	1.1

Excellent performance in all key metrics

Q3 2009	Total	North America	International
Organic revenue growth	+ 8%	+ 8%	+ 9%
Same market treatment growth	+ 4%	+ 4%	+ 4%
Revenue per treatment		1) \$ 342	\$ 167
Growth		+ 4%	+ 3%cc
Number of clinics	2,509	1,749	760
Growth	+ 7%	+ 5%	+ 11%
De novos (including managed clinics)	23	18	5

1) including Mexico

cc = constant currency

\$ in millions	Q3 2008	Q3 2009	Growth
Net revenue	2,713	2,889	* 6%
Operating income (EBIT)	422	451	7%
EBIT margin in %	15.6	15.6
Interest expense, net	87	75
Income before income tax	335	376	12%
Income Tax expense	120	131
Tax rate	36%	35%
Non controlling interest	9	20
Net income attributable to FME AG & Co. KGaA	206	225	9%

* 10% growth at constant currency, 8% organic growth

\$ in millions	9M 2008	9M 2009	Growth
Net revenue	7,890	8,212	* 4%
Operating income (EBIT)	1,240	1,265	2%
EBIT margin in %	15.7	15.4
Interest expense, net	252	225
Income before income tax	988	1,040	5%
Income Tax expense	357	345
Tax rate	36%	33%
Non controlling interest	28	50
Net income attributable to FME AG & Co. KGaA	603	645	7%

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

Operating Margin Development

Operating cash flow at 15% of revenue

\$ in millions	Q3 2008	Q3 2009	Growth
Operating Cash Flow 1)	315	443	41%
1) Capital Expenditures, net	(160)	(139)
Free Cash Flow	155	304 11% of revenue	97%
Acquisitions, net of divestitures1)	(39)	(26)
Free Cash Flow, after acquisitions	116	278 10% of revenue

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

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

All numbers are in \$ millions

Debt	Q3 2009	FY 2008	FY 2007	FY 2006	FY 2005
Short term borrowings (incl. A/R program)	312	684	217	331	151
+ Short term borrowings from related parties	43	1	2	5	19
+ Current portion of long-term debt and capital lease obligations	160	455	85	160	126
+ Current portion of Trust Preferred Securities		0	670
+ Long-term debt and capital lease obligations, less current portion	4,561	3,957	4,004	3,829	707
+ Trust Preferred Securities (net of current portion)	663	641	664	1,254	1,188
= Total debt	5,739	5,738	5,642	5,579	2,191

EBITDA	Q3 2009	Q3 2008	FY 2008	1) FY 2007	FY 2006 (pro forma)	FY 2005
Last twelve months operating income (EBIT)	1,697	1,668	1,672	1,580	1,367	939
+ Last twelve months depreciation and amortization	443	410	416	363	326	251
+ Non-cash charges	48	44	44	41	35	14
= EBITDA (annualized)	2,188	2,122	2,132	1,984	1,728	1,204

Attachment II

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

All numbers are in \$ millions

External Revenue	Q3 2009	Q3 2008	growth	cc
International product revenue	613	622	- 2%	+ 7%
- Internal revenue	(80)	(78)
= External revenue	533	544	- 2%	+ 6%
North America product revenue	376	321	+ 17%
- Internal revenue	(167)	(137)
= External revenue	209	184	+ 14%
TOTAL product revenue	988	943	+ 5%	+ 11%
- Internal revenue	(246)	(215)
= External revenue	742	728	+ 2%	+ 8%
Capital expenditure (net)	9M 2009	9M 2008	Q3 2009	Q3 2008
Purchase of property, plant and equipment	(398)	(502)	(145)	(160)
- Proceeds from sale of property, plant and equipment	10	9	6	(0)
= Capital expenditure (net)	(388)	(493)	(139)	(160)
Cash Flow	9M 2009	9M 2008	Q3 2009	Q3 2008
Acquisitions and Investment and net purchases of intangible assets	(109)	(176)	(27)	(44)
Proceeds from divestitures	52	46	1	5
Acquisitions, net of divestitures	(57)	(130)	(26)	(39)

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

Gerrit Jost Tel.: +49-(0)6172-609-5216 Fax.: +49-(0)6172-609-2301 Email: gerrit.jost@fmc-ag.com

Terry L. Morris Tel.: +1-800-948-2538 Fax.: +1-615-345-5605 Email: terry.morris@fmc-na.com Ordinary shares WKN 578 580 ISIN DE0005785802 SEDOL1 5129074 DE

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