Fresenius Medical Care AG & Co. KGaA

Earnings Release • Aug 23, 2011

Fresenius Medical Care

Deutsche Bank Corporate Conference Tokyo, August 22 – 23, 2011

AGENDA

• 1 BUSINESS UPDATE
• 2 FINANCIALS & OUTLOOK
• 3 GROWTH STRATEGY
• 4 SPECIAL: ASIA-PACIFIC
• 5 BACKUP

Q2 2011 BUSINESS UPDATE

© I Tokyo I August 22 – 23, 2011 3

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 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

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

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

Q2 2011 FINANCIALS & OUTLOOK

© I Tokyo I August 22 – 23, 2011 10

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

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

GROWTH STRATEGY

© I Tokyo I August 22 – 23, 2011 15

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

World Leader in Dialysis Services¹

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

North America	FME	139,906
	DaVita	125,000
	Dialysis Clinic Inc.	13,500
Latin America	FME	23,163
	Baxter	8,400
	Diaverum	3,500
EMEA	FME	45,997
	KfH	18,500
	Diaverum	13,000
Asia Pacific	FME	21,3432
	Showai-Kai	7,200
	Zenji-Kai	4,200
		# of patients
1 Based on company statements and estimates 2 Patients including managed clinics

¹ Clinics including managed clinics

2020: Estimates suggest an increase to nearly 4 million dialysis patients North America ~5% Europe ~4% Latin America ~7% Asia-Pacific ~10% Worldwide ~6% Development of Dialysis Patient Population 8,000 80,000 200,000 500,000 900,000 1,500,000 2,500,000 3,500,000

Market Opportunity by Region

SPECIAL: ASIA-PACIFIC

© I Tokyo I August 22 – 23, 2011 22

Asia-Pacific: market environment

6.1%

ESRD Dialysis HD PD TX

• Significant and sustained growth of ESRD patients, particularly in emerging markets
• Dialysis will remain predominantly HD
• Developed and developing economies challenged with aging populations and diabetes epidemic
• Intensifying competition will put pressure on ASP and costs
• Options/sources for increased funding will come with increased economic prosperity

0%

Total Asia Pacific AGR at 9% (which is 50% higher than World AGR)

Asia-Pacific: Strategic drivers

Operations

• Leading and strong local teams
• Organizational development
• Legal
• Risk management
• Sourcing
• Business development
• Internal audit
• Management reporting
• Production
• R&D

Products

• New key products
• FX dialyzers
• 5008S
• BCM
• Dialysis chairs
• Water technology
• Bloodlines
• Regional production
• FX dialyzers
• Bloodlines / AV needles
• Concentrates
• PD

Services

• Entry to new dialysis care markets
• Korea
• Malaysia
• Philippines
• China
• Thailand
• New services / drugs
• FIDN
• RDI

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

Thank you very much for your attention!

BACKUP

© I Tokyo I August 22 – 23, 2011 31

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

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)

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
H1 2010	H1 2011	Growth in %	Growth in % cc	growth in %
3,578	3,610	1	1	3
817	1,037	27	20	5
4,395	4,647	6	5	4

cc = constant currency

Q2 | Dialysis Services revenue per treatment

355 348 356 348 340 350 360 2010 2011 in \$ Q1 Q2 Q1 Q2 (2%)

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

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

• The agency followed its Congressional mandate and included a 1.8% increase in dialysis reimbursement for 2012
• The agency has taken into account the actual number of dialysis facilities that participate in the new payment system and eliminated the 3.1% transition adjustment for 2012

Quality Incentive Program (QIP)

We continue to support the Quality Incentive Program (QIP) and believe that, by and large, CMS is moving in the right direction

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

Acquisition of American Access Holdings, LLC continued

21,000 patients dialyzed in FMC-NA centers within AAC service area 35,000 vascular access procedures within AAC service area

AAC Acquired Locations-RED PINS Current FME Locations-GREEN PINS

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 | Total Debt/EBITDA

Ratio slightly up based on recently announced acquisitions

• FY 2011 target of < 3.0
• Total debt of \$ 7,114 m and annualized EBITDA of \$ 2,567 m *

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

Q2 2010	Q2 2011	Growth in %	Growth in % cc
			11
(81)	(100)
512	629	23	11
390	394	1	1
(180)	(195)
210	199	(5)	(5)
983	1,127	15	7
(261)	(295)
722	832	15	7
Q2 2010	Q2 2011
(121)	(121)
2	4
(119)	(117)
	593	729	23

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

Deutsche Bank Corporate Conference Tokyo, August 22 – 23, 2011