Fresenius Medical Care AG & Co. KGaA

Earnings Release • Sep 29, 2011

Fresenius Medical Care

UniCredit

German Investment Conference 2011,

Munich, September 29, 2011

AGENDA

1 BUSINESS UPDATE & FINANCIALS

2 GROWTH STRATEGY & OUTLOOK

BUSINESS UPDATE & FINANCIALS

World Leader in Dialysis Services¹

We lead in every major market, treating more than 225,909 patients worldwide

North America	FME	139,906
	DaVita	131,000
	Dialysis Clinic Inc.	13,500
Latin America	FME	23,163
	Baxter	8,600
	Diaverum	3,400
EMEA	FME	45,997
	KfH	18,500
	Diaverum	13,900
Asia Pacific	FME	21,3432
	Showai-Kai	5,000
	Zenji-Kai	4,500
		# of patients
1 Based on company statements and estimates 2 Patients including managed clinics (4,500 patients AP)

Market position by major product groups 2010

	Rank 1	Rank 2
Dialyzers	FME	Gambro
Dialysis machines	FME	Gambro
Hemodialysis concentrates	FME	Fuso
Bloodlines	FME	Gambro
Peritoneal dialysis products	Baxter	FME

Q2 | Overview

Strong operating performance

• Excellent International revenue growth of +15% cc
• Excellent Asia Pacific revenue growth of +27% cc
• North America operating margin increased +80 bps (year/year)

\$ in m	Q2 2010	Q2 2011	Growth in %
Net revenue	2,946	3,194	8
Net income attributable to FMC AG & Co. KGaA	248	261	5
Earnings per share	0.83	0.86	4

Q2 | Dialysis Services

Strong global revenue growth

• Excellent organic revenue growth in International + 8%
• Continued impressive same market treatment growth globally + 4%
• North America on target with the "bundle" implementation in the clinics

					Same market
\$ in m	Q2 2010	Q2 2011	Growth in %	Growth in % cc	treatment growth in %
North America	1,817	1,828	1	1	3
International	407	534	31	20	5
Total	2,224	2,362	6	4	4

cc = constant currency

Q2 | Dialysis Products

Global product growth of 7% cc (incl. internal)

• International external product growth of 11% cc
• Asia-Pacific external product growth of 16% cc
• North America external product growth of (5%) impacted by pharma pricing
• External revenue growth in dialysis products of 3%
• Peritoneal dialysis external revenue growth of 18% and internal revenue growth of 53%
• We continue to maintain Venofer market share

\$ in m	Q2 2010	Q2 2011	Growth in %	Growth in % cc
Total product revenue (incl. internal)	983	1,127	15	7
External revenue	722	832	15	7
North America	210	199	(5)	(5)
International	512	629	23	11
cc = constant currency

Q2 | Profit & Loss

\$ in m	Q2 2010	Q2 2011	Growth in %
Net revenue	2,946	3,194	8	5% cc
Operating income (EBIT)	467	510	9
EBIT margin in %	15.8	16.0
Net interest expense	68	75
Income before taxes	399	435	9
Income tax expense	129	149
Tax rate in %	32	34
Non-controlling interest	22	25
Net income attributable to FMC AG & Co. KGaA	248	261	5
cc = constant currency

Q2 | Day Sales Outstanding (DSO)

DSO level in North America up as indicated and expected

• International DSO increased by 5 days compared to Q1 2011 as a result of the economic pressure in some countries
• North America DSO down sequentially by 1 day and further improvement in the course of the year expected

Q2 | Cash Flow

\$ in m	Q2 2010	Q2 2011	Growth in %	Unfavorable DSO development
Operating cash flow	294	311	6	in International Increased inventory levels
% of revenue	10	10
Capital expenditure, net *	(119)	(117)
Free cash flow	175	194	11
Acquisitions and investments, net of divestitures *	(201)	(784)		Acquisition of Euromedics, others
Free cash flow after acquisitions and investments	(26)	(590)

* A reconciliation to the most directly comparable U.S. GAAP financial measures is provided in the attachements

Interest Coverage 2002 - 2010 0 200 400 600 800 1,000 1,200 1,400 1,600 1,800 2,000 2,200 2,400 2,600 0 5 0 100 150 200 250 300 350 400 450 500 4.4 4.7 6.0 7.0 4.9 5.3 6.3 7.5 8.8 8.8 8.8 3 4 5 6 7 8 9 10 EBITDA¹ in \$ m Interest in \$ m EBITDA / Interest Development 2004 2005 2006 PF² 2002 2003 2007 2008 2009 2010 2002 2003 2004 2005 2006 2007 2008 2009 2010 PF² Q1 2011 Q2 2011

¹ Excluding non-cash charges and excluding restructuring costs, in-process R&D and gain from the sale of dialysis clinics

² Pro Forma incl. Renal Care Group

Pro forma debt maturity profile post-offering 1

¹ Based on utilization of major financing instruments

U.S. Healthcare reform update

Fresenius Medical Care and the entire community appreciate the government's hard work and dedication in this effort

Prospective Payment System (PPS) Rule for Medicare patients

• We have successfully implemented the new reimbursement system
• The agency followed its Congressional mandate and included a 1.8% increase in dialysis reimbursement for 2012

Quality Incentive Program (QIP)

• ESRD Quality Incentive Program is the first federal health care program whose reimbursement is directly tied to quality outcomes and we continue to support the Quality Incentive Program (QIP) since we believe that, by and large, CMS is moving in the right direction (measures for 2012 are good and measures for 2013 and 2014 are proposed only yet)
• We will continue to work with CMS and Congress to ensure that all measures are transparent and consistent with current medical guidelines, and that all incentives are aligned so that patients continue to receive the highest possible care

Debt ceiling negotiations

• We are watching the debt ceiling negotiations very closely, and we have reached out to the Administration and Congress to let them know of the critical importance of raising the debt ceiling for Medicare beneficiaries on dialysis
• In the event the debt ceiling is not raised, the Administration will be faced with the difficult task of determining which programs to fund. Simply put, life sustaining therapies such as dialysis should continue uninterrupted, and we would expect the Administration to prioritize dialysis payments accordingly

· .

Summary

Expansion & Cost Management

North America

• Implementation of the "bundle" for Medicare beneficiaries on target
• Investment in Liberty Dialysis and American Access

International

• Strong expansion of business operations
• Asia-Pacific continues to deliver excellent product growth

2011 Sales and earning outlook confirmed
Another record year to be expected
For 2011 strong revenue growth and further earnings momentum expected 
\$ in m	FY 2011
Net revenue	> 13,000
Net income attributable to FMC AG & Co. KGaA	1,070 – 1,090
Capital expenditure in % of revenue	~ 5%
Acquisitions	~ 1,900
Leverage ratio (Debt/EBITDA ratio)	< 3.0	NEW1
1 Update with publication of 2nd quarter 2011 results

GROWTH STRATEGY & OUTLOOK

© I UniCredit German Investment Conference | September 29, 2011 20

Acquisition of Liberty Dialysis Holdings, Inc.

Strategic rationale

• Transaction includes 100% of Liberty Dialysis (Liberty) and 51% of Renal Advantage (RAI) not owned by Fresenius Medical Care
• Liberty/RAI provide today dialysis to 19,000 patients in ~ 260 clinics
• Liberty/RAI with its involved group of healthcare professionals has excellent quality outcomes with an industry leading percentage of patients with no catheters
• Liberty is largely based on a fast-growing joint venture business model
• Liberty/RAI expand Fresenius Medical Care's presence in 50 Metropolitan Statistical Areas (MSA's) where we are not present today
• The merger allows Fresenius Medical Care to incorporate a geographically more complete network into any shared savings or capitated contracts with federal and state health programs

Acquisition of Liberty Dialysis Holdings, Inc. continued

Financial implications

• The incremental purchase price including assumed debt will be approx. \$1.7 bn excluding the previous investment of approx. \$300 m in Renal Advantage in Q1 2011
• The acquisition would add ~ \$1 bn of revenue
• Merging the operations will provide excellent growth opportunities, no material cost synergies
• The acquisition will be accretive in the first year and funded through cash flow from operations and debt
• On a pro forma basis for calendar year 2012 this transaction combined with our updated 2011 acquisition guidance - will not cause us to exceed 3.0x Debt/EBITDA

Acquisition of Liberty Dialysis Holdings, Inc. continued

Locations of Liberty Dialyis (green) and Renal Advantage (red)

Acquisition of American Access Holdings, LLC

Strategic rationale

• Fresenius Medical Care currently operates 13 ESRD access centers. The acquisition of 28 centers will give Fresenius Medical Care critical mass in North America to ensure that its well positioning for CMS's proposed new quality standards and future reimbursement changes
• Vascular access and its complications are a key challenge for ESRD patients
• Approximately 700,000 access procedures are performed each year for ESRD patients
• About 1/3 of vascular access procedures are performed in outpatient settings

Financial implications

• The purchase price for American Access Care will be \$385 m and add approx. \$175 m incremental annual revenue
• The acquisition is expected to be accretive in the first year

Market Opportunity by Region

Continued Growth Opportunities

CREATING A FUTURE WORTH LIVING. FOR PEOPLE. WORLDWIDE. EVERY DAY.

Thank you very much for your attention!

H1 | Overview

Good start into 2011 despite U.S. Medicare reimbursement reform and confirming full year guidance by targeting another record year 2011

• Strong underlying operating performance
• Revenue growth of 5% at constant currency
• Organic revenue growth of 3%
• confirming full year 2011 sales and earnings guidance

\$ in m	H1 2010	H1 2011	Growth in %
Net Revenue	5,828	6,230	7
Net income attributable to FMC AG & Co. KGaA	459	481	5
Earnings per share	1.53	1.59	4

H1 | Dialysis Services

Excellent International revenue growth

• Excellent International organic revenue growth in International + 9%
• Europe revenue growth of +20% (+14%cc)
• Asia-Pacific revenue growth of +61% (+49%cc)

					Same market treatment
\$ in m	H1 2010	H1 2011	Growth in %	Growth in % cc	growth in %
North America	3,578	3,610	1	1	3
International	817	1,037	27	20	5
Total	4,395	4,647	6	5	4

cc = constant currency

H1 | Dialysis Products

Global product growth of 7% cc (incl. internal)

• External product growth in International of 9% cc
• Asia-Pacific external product growth of 17% cc
• North America external product growth of (3%) impacted by pharma pricing
• Peritoneal dialysis external revenue growth of 19%

\$ in m	H1 2010	H1 2011	Growth in %	Growth in % cc
Total product revenue (incl. internal)	1,940	2,151	11	7
External revenue	1,433	1,584	10	6
North America	408	395	(3)	(3)
International	1,025	1,181	15	9
cc = constant currency

H1 | Profit & Loss

\$ in m	H1 2010	H1 2011	Growth in %
Net revenue	5,828	6,230	7	5% cc
Operating income (EBIT)	892	955	7
EBIT margin in %	15.3	15.3
Net interest expense	135	146
Income before taxes	757	809	7
Income tax expense	257	273
Tax rate in %	34	34
Non-controlling interest	41	55
Net income attributable to FMC AG & Co. KGaA	459	481	5
cc = constant currency

H1 | Cash Flow

\$ in m	H1 2010	H1 2011	Growth in %
Operating cash flow	643	487	(24)	Unfavorable DSO development and higher inventory levels
% of revenue	11	8		Expect to be in the targeted range of 10% for FY 2011
Capital expenditure, net *	(218)	(231)
Free cash flow	425	256	(40)
Acquisitions and investments, net of divestitures *	(283)	(1,122)		Acquisition of Euromedics, investment in Renal Advantage, others
Free cash flow after acquisitions and investments	142	(866)

* A reconciliation to the most directly comparable U.S. GAAP financial measures is provided in the attachements

Q2 | Dialysis Services | Quality outcomes

Excellent quality improvement programs	U. S.		EMEA		Asia-Pacific
% of patients	Q2 2010	Q2 2011	Q2 2010	Q2 2011	Q2 2010	Q2 2011
Kt/V ≥ 1.2	97	97	95	96	96	97
No catheter (all patients)	74	77	81	81	97	94
No catheter (>90 days)	n/a	80	85	85	97	95
Hemoglobin = 10 – 12 g/dl	68	75	55	56	60	61
Albumin ≥ 3.5 g/dl*	81	84	87	89	89	87
Phosphate ≤ 5.5 mg/dl	61	63	76	76	71	71
Calcium 8.4 – 10.2 mg/dl	79	79	76	77	74	75
Hospitalization days, per patient	9.9	9.8	9.1	9.6	4.8	5.2

* In the U.S. the albumin results are calculated with the BCG-method (bromcresol green)

Q2 | Dialysis Services revenue per treatment

2010 2011 in \$ Q1 Q2 Q1 Q2 (2%)

Q2 | Dialysis Services clinic network status

Impressive International expansion

	Clinics	De novo	Acquired
	as of June 30, 2011	as of H1 2011	as of H1 2011
Total	2,838	29	77
Growth vs. June 30, 2010	+ 10%
North America	1,826	19	2
Growth vs. June 30, 2010	+ 2%
International	1,012	10	75
Europe	569	7	68
Latin America	200	3	5
Asia-Pacific	243	-	2
Growth vs. June 30, 2010	+ 26%
cc = constant currency

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

External Revenue Q2 (excl. \$4 m Corporate)	Q2 2010	Q2 2011	Growth in %	Growth in % cc
International product revenue	593	729	23	11
- Internal revenue	(81)	(100)
= International external revenue	512	629	23	11
North America product revenue	390	394	1	1
- Internal revenue	(180)	(195)
= North America external revenue	210	199	(5)	(5)
Total product revenue	983	1,127	15	7
- Internal revenue	(261)	(295)
Total external revenue	722	832	15	7
Capital expenditure, net	Q2 2010	Q2 2011
Purchase of property, plant and equipment	(121)	(121)
- Proceeds from sale of property, plant and equipment	2	4
= Capital expenditure, net	(119)	(117)

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

External Revenue H1 (excl. \$4 m Corporate)	H1 2010	H1 2011	Growth in %	Growth in % cc
International product revenue	1,185	1,372	16	9
- Internal revenue	(160)	(191)
= International external revenue	1,025	1,181	15	9
North America product revenue	755	771	2	2
- Internal revenue	(347)	(376)
= North America external revenue	408	395	(3)	(3)
Total product revenue	1,940	2,151	11	7
- Internal revenue	(507)	(567)
Total external revenue	1,433	1,584	10	6
Capital expenditure, net	H1 2010	H1 2011
Purchase of property, plant and equipment	(227)	(238)
- Proceeds from sale of property, plant and equipment	9	7
= Capital expenditure, net	(218)	(231)

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

Cash Flow	H1 2010	H1 2011	Q2 2010	Q2 2011
Acquisitions, investments and net purchases of	(291)	(1,122)	(207)	(784)
intangible assets
+ Proceeds from divestitures	8	-	6	-
= Acquisitions and investments, net of divestitures	(283)	(1,122)	(201)	(784)

Patients, treatments, clinics – Q2 2011	Clinics	Patients	Treatments in million
North America	1,826	139,906	10.62
Growth in %	2	4	4
International	1,012	86,003	5.94
Growth in %	26	28	18
Europe	569	45,997	2.92
Latin America	200	23,163	1.78
Asia-Pacific	243	16,843	1.24
TOTAL	2,838	225,909	16.56
Growth in %	10	12	9

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

Debt	Q2 2011	FY2010	FY 2009	FY 2008	FY 2007	FY 2006
Short term borrowings (incl. A/R program)	761	671	316	684	217	331
+ Short term borrowing from related parties	161	10	10	1	2	5
+ Current portion of long-term debt and capital lease obligations	231	264	158	455	85	160
+ Current portion of trust preferred securities	-	625	-	-	670	-
+ Long-term debt and capital lease obligations less current portion	5,961	4,310	4,428	3,957	4,004	3,829
+ Trust preferred securities less current portion	-	-	656	641	664	1,254
TOTAL debt	7,114	5,880	5,568	5,738	5,642	5,579
EBITDA	Q2 2011	FY2010	FY 2009	FY 2008	FY 2007	FY 2006
Last twelve month operating income (EBIT)	1,987	1,924	1,756	1,672	1,580	1,367
+ Last twelve month depreciation and amortization	530	503	457	416	363	326
+ Non-cash charges	50	45	50	44	41	35
EBITDA (annualized)	2,567	2,472	2,263	2,132	1,984	1,728
Total Debt / EBITDA	2.77	2.38	2.46	2.69	2.84	3.23

Contacts

Fresenius Medical Care

Investor Relations Else-Kröner-Str. 1

61352 Bad Homburg v.d.H.

Ticker:	FME or FMS (NYSE)
WKN:	578 580
ISIN:	DE00057858002

• Oliver Maier Head of Investor Relations and Corporate Communications Tel: +49 (0) 6172 – 609 – 2601 Email: Oliver.Maier@fmc-ag.com
• Gerrit Jost Tel: +49 (0) 6172 – 609 – 5216 Email: Gerrit.Jost@fmc-ag.com
• Terry Morris Tel: +1 800 – 948 – 2538 Email: Terry.Morris@fmc-na.com

	Financial Calendar*
--	---------------------	--	--	--

Fresenius Medical Care

• 02.11.2011 Report on 1st 3 rd quarter 2011
• 21.02.2012 Report on Fiscal Year 2011
• 03.05.2012 Report on 1st quarter 2012
• 10.05.2012 Annual General Meeting, Frankfurt/Main
• 01.08.2012 Report on 1st half 2012
• 31.10.2012 Report on 1st 3 rd quarter 2012

* Please notice that these dates might be subject to change

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 detail in Fresenius Medical Care AG & Co. KGaA's (FMC AG & Co. KGaA) reports filed with the Securities and Exchange Commission (SEC) and the German Exchange Commission (Deutsche Börse).

Fresenius Medical Care

UniCredit

German Investment Conference 2011,

Munich, September 29, 2011