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Fresenius Medical Care AG & Co. KGaA

Investor Presentation Apr 3, 2014

165_ip_2014-04-03_6b9b3f41-0c1f-46f6-bf56-a7b3edaed854.pdf

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CAPITAL MARKETS DAY Oliver Maier

April 3 2014, New York City

Welcome

to 2014 Capital Markets Day

New York City

09:00 Welcome
Oliver Maier
12:00 Global Manufacturing Operations (GMO)
Kent Wanzek
09:10 Global Overview and Strategy
Rice Powell
12:20 Medical/Care Coordination
Frank Maddux
09:50 Region: North America
Ron Kuerbitz
12:40 Q&A
10:20 Region: Asia Pacific
Roberto Fuste
13:00 Lunch
10:40 Region: EMEA
Rice Powell
13:40 Financials
Mike Brosnan
11:00 Q&A 14:10 Summary
Rice Powell
11:20 Break 14:15 Q&A
11:40 Global R&D (GRD)
Olaf Schermeier
14:30 Finish

Today's Presenters

GLOBAL OVERVIEW & STRATEGY Rice Powell

April 3 2014, New York City

A Fresenius Medical Care Today -
A Global Perspective
B Market Dynamics
C Our Global Strategy

FRESENIUS MEDICAL CARE TODAY

A Global Perspective

Fresenius Medical Care Today

We are the World's Leading Provider of Dialysis Services

North
America
Provider Patients Countries
171,440 2
163,000 1
14,000 1
14,000 1
9,450 1
6,550 1
Europe, Middle East, Africa
Provider Patients Countries
51,540 23
18,500 2
18,500 14
11,500 17
6,900 1
2,750 3
1,650 4
Latin America
Provider Patients Countries
29,270 8
8,750 2
4,250 3
1,650 1
850 1
Asia Pacific
Provider Patients Countries
17,870 12
Zenjin-Kai 6,000 1
5,000 1
4,000 1
2,650 5
1,750 5
300 1

Vertical Integration Enables Extension of Renal Care

MARKET DYNAMICS

Development of Dialysis Patient Numbers

Development of Dialysis Patient Numbers

Innovations Shaping the Future

Global Market Potential (Per Patient/Per Year)

OUR STRATEGY

Driving the Business Forward

Our Vision of Care Coordination

Objectives and Strategy for GEP

OBJECTIVES

  • Identify efficiency potential
  • Enhance overall competitiveness
  • Liberate resources for reinvestment
  • Achieved sustained efficiency gains over multiple years

APPROACH

  • 18 projects active with monthly results review to ensure execution and delivery
  • Owned and led by 2 executives with a dedicated full-time team

2020 Vision

Drivers

2020 Vision

Drivers

  • Compliant, profitable growth
  • Pushing our core beyond 128 countries with products; and >40 countries with dialysis care
  • XXXX Recognize that moving beyond our core brings businesses with different risk and margin profiles
  • % Reimbursement pressure is a fact of life

2020 Vision

  • Focus on quality outcomes through better therapy
  • Sustainable patient growth
  • Strong cash flow generation

\$28.0bn

NORTH AMERICA Ron Kuerbitz

April 3 2014, New York City

A Our Business Today
B Market Dynamics
C Our Strategy & Vision

Our Business Today

Market Dynamics

DEMOGRAPHICS* PAYOR RELATIONSHIPS GROWTH
OPPORTUNITIES
Stable patient growth
>3%
Stable government
reimbursement
37% of US dialysis
market
27.5% of Medicare

population has diabetes

12.7% of Medicare
population has CKD
Stable commecial
reimbursement
Single-digit
rate growth
Targeted
dialysis growth
opportunities
remain
ESRD population
has
multiple co-morbidities
Steady
cash flows
Additional
opportunities
in Care Coordination

Driving the Business Forward

EFFICIENCY

  • Drug
  • Operational
  • Administrative

GROWTH

  • Targeted geographic expansion
  • Improve patient mortality
  • Reduce hospitalization

Poised to Deliver on Our Promise of Care Coordination

CARE COORDINATION
Medicare FFS
(Case Mix Adjusted)
FMCNA Demo % Improvement
One-year Mortality 14.6% 9.3% 36%
Two-year Mortality 26.1% 19.9% 24%
Two-year All-Cause
Hospitalizations
76.1% 60.5% 20%
Two-year CVD
Hospitalizations
75.2% 59.7% 21%
Readmissions 0.71 0.64 10%
Physician Visits 10.57 8.43 20%
SNF Stays 0.6 0.28 53%

FMCNA Demo improved health outcomes and achieved cost savings of 5.1%

Source: Arbor Research: ESRD Demonstration Disease Management Demonstration Evaluation from 2006-2008, the First Three Years of a Five-Year

Poised to Deliver on Our Promise of Care Coordination

CARE COORDINATION

TECHNOLOGICAL INNOVATION

Poised to Deliver on Our Promise of Care Coordination

CARE COORDINATION

TECHNOLOGICAL INNOVATION

DATA ANALYTICS

High Cost Special Needs Population

Specialized Network Required

Medicare Spending – Dialysis Patients

Per Patient/Year
Inpatient \$
29,706
Dialysis 26,452
Outpatient 8,999
Post-acute
(SNF + Home Health + Hospice) 5,767
Vascular access 1,755
Nephrology 3,110
Other specialists 6,214
Pharmacy 5,270
Total \$
87,273

Source: United States Renal Data Service

Current Fragmented Care Model

Our Vision of Care Coordination: The Renal Care Network

April 3 2014, New York City

A Our Business Today
B Market Dynamics
C Our Strategy
C A Focus on Japan & China

OUR BUSINESS TODAY

Our Business Today

MARKET DYNAMICS

Key Market Trends

Stable HD/PD
Ratio
Increasing
Efforts for
Healthcare
Coverage
ASEAN
Integration
Accelerates
Legal & Political
Constraints for
NephroCare
HD
PD
90%
10%

China
Thailand

Indonesia

Malaysia

Philippines
Adding US\$1.9tn
to
Global Economy
by 2025
Lessening
Increasing
Constraints
Constraints

Taiwan

China

Korea

Japan

Malaysia

Hong Kong

Dialysis Patient Growth by Country 2013 vs. 2012

Public Dialysis Coverage

Full

Partial

None

Geographical Dynamics

1.4 billion
Population
2014
410,230 (+17.5%)
Dialysis Patients
2014
5.2%
Healthcare Spend
as % of GDP
\$59*
Average
Reimbursement
Varies Across
Regions/Cities
Universal Coverage
by 2020
127 million
Population
2014
323,646 (+1.9%)
Dialysis Patients
2014
9.3%
Healthcare Spend
as % of GDP
\$243*
Average
Reimbursement
Reimbursement
Encouraging Higher
Therapies
Stable/Flat Fee
Development
1.2 billion
Population
2014
98,727
(+16.1%)
Dialysis Patients
2014
3.9%
Healthcare Spend
as % of GDP
\$18*
Average
Reimbursement
Not Available for
General Public -
Only
Covers Gov't
Employees & Family
637 million
Population
2014
155,994
(+9.6%)
Dialysis Patients
2014
3.6%
Healthcare Spend
as % of GDP
\$140*
\$0 -
Average
Reimbursement
Vastly Different
Healthcare Systems
& Reimbursement
Across ASEAN
Countries

*Average Reimbursement per Treatment (USD)

Source: 2020 Patient Projection, BAO 2013, U.S. Census Bureau (population estimates)

OUR STRATEGY

Driving the Business Forward

Strategic Alignment

Market Segments & Our Focus

Population (millions)

Providing a Comprehensive & Sustainable Renal Offering

Services Strategic Directions

Geographical Penetration

China Privatization Opportunity

2 Projects Proceeding in Shandong Province

Market Opportunities

Strong Private Investment in Healthcare Clinics

Rapid Growth in Chronic & Acute HD

Enter into PD Market

China Privatization Opportunity

  • Private dialysis care pilot projects in Shandong
  • Establish 35 new NCDCs in 2014 to 135 centers by year end

New Nationwide Distribution Structure

Higher penetration and lower exposure

Strengthening Leadership in Products

  • Continue strong market leadership in dialysis machines and drive high flux single-use dialyzer sales
  • Expand into Tier 2 and Tier 3 cities
  • Prepare to enter PD market in 2015
  • Grow acute business strongly

Services Strategic Directions

Geographical Penetration

Japan Deregulation would provide opportunity

Market Opportunities

2nd Largest Dialysis Patient Population in AP

Reimbursement Encouraging Higher Therapies

Deregulation of Healthcare Services Business

Continue Successful Strategic Alliance with Nikkiso

  • 5.4% dialyzers market share*
  • 3.0m dialyzers sales target in 2014
  • Launched CorDiax in Q1 2014

Services Strategic Directions

Geographical Penetration

China Privatization Opportunity

2 Projects Proceeding in Shandong Province

Services Expansion

Vascular Access Care

1st Center in Taiwan; Expansion Underway Across Region

Japan Deregulation would provide opportunity

Diabetes Care Implementation in Progress

Expansion in India

2 Dialysis Care JVs in Place; A 3rd JV to Set Up 3 Clinics Underway

Polyclinics / Labs

De Novo Growth 22 Clinics and 35 NCDCs in 2014

FIDN as Differentiator for Renal Specialized Staff

Currently in Philippines, Singapore, Malaysia; New Programs to Start in Taiwan, China, India in 2014

Product Strategic Directions

Country-Affordable Solutions

Machines / Dialyzers

Basic machine & economical disposables

Concentrates

Localization via production set-up / acquisitions / OEMs

Expansion of Local Portfolio

Needles

Global sourcing & enter new markets

Acute Expansion to new markets

Bloodlines In-sourcing

PD Basic PD China, Malaysia

Renal Pharma

Local portfolios with registrations / new products Channel management agreement with Vifor Pharma

Care Coordination Asia Pacific

April 3 2014, New York City

Dominik Wehner, Chief Executive Officer, EMEA

A Our Business Today
B Market Dynamics
C Our Strategy
D A Focus on some EMEA countries

Our Business Today

MARKET DYNAMICS

Patient Growth EMEA

Dialysis Base Reimbursement

OUR STRATEGY

Driving the Business Forward

EMEA Strategy

EMEA Strategy

Operational

Administrative

A FOCUS ON…..

Spain, France and Turkey

Spain: Start of Comprehensive Price in Two Regions

Murcia 1st Comprehensive Contract Awarded

Catalonia Change to Comprehensive Contract for the Region

  • 62 NephroCare clinics
  • 5,220 patients
  • >820,000 treatments p.a.
  • ~\$198 reimbursement
  • 23% market share
  • 39% share of private market

  • 186 HD-patients

  • ~\$210 reimbursement, incl. supplement for HDF-therapy
  • 1,230 HD-patients
  • ~\$240 reimbursement, incl. supplement for HDF-therapy

France: Inclusion of EPO in HD Reimbursement

Inclusion of EPO into Dialysis Reimbursement as of March 1, 2014

  • Inclusion of EPO into Dialysis Reimbursement
  • Implementation of anemia-monitoring tools to improve and optimize achievement of hemoglobin targets

Turkey: Reimbursement Management in Challenging Environment – Increase by 7% Achieved in 2014

  • >57,000 patients in 852 Dialysis centers
  • 7,000 HD patients in 52 FME clinics
  • No major reimbursement increase since 2005 despite high inflation levels

Continuous negotiations with Health Insurance and Government

  • 5 centers closed, 6 centers merged, 4 centers acquired and merged with 4 existing centers
  • More closures/divestures planned
  • Discussion with MOH and Health Insurance about additional payment on quality

Q&A

MORNING BREAK 11:20 – 11:40

GLOBAL R&D (GRD) Olaf Schermeier

April 3 2014, New York City

A Global R&D Vision
B Our Strategy
C A Focus on Innovation

Global R&D Mission

1st choice in product innovation and quality,

leveraging our vertical integration and adding value through our products and therapy improvements

OUR STRATEGY

Driving the Business Forward

Our Strategy

INNOVATION

A Focus in our Business

Manual Workflow Nurses and Technicians using standard equipment

Optimized Workflow using automation technologies

Dedicated New Machine Platforms Targeted to the Needs of Developing Markets

Innovation on Dialyzers and Bloodlines to Reduce Drug Utilization

Modified Fiber Stopped @ 21hr 29min

Arterial Venous

Traditional Fiber Clot @ 3hr 51min

Arterial Venous

Dedicated New Platforms Targeted to the Needs of Home HD Patients

April 3 2014, New York City

A Our Global Manufacturing Operations Network
B Our Capabilities
C Our Strategy -
Adding Value

Our Business Today

FMCNA Supply Chain

  • 14 Distribution Centers
  • 47 Cross Docks
  • 450 Trucks
  • \$12m TruBlu Revenues
  • \$3m Savings Raw Materials on TruBlu fleet

\$989m PPE (Net Book Value)

• CapEx 4-6% of Product Sales (External + Internal)

Strategic Procurement

  • \$1.1bn purchased raw materials and components
  • 70% long-term supply agreements

\$2.3bn Production Value

13,700 Employees

  • 12,700 Operations
  • ~15% of Production Value
  • 1,000 Supply Chain

40 Production Sites in 20 Countries

2013 Numbers

  • 1 Dialyzers 112m

  • 1 Hemodialysis Machines 48,500

  • 1 Bloodlines 175m

  • 1 Concentrates 30%

  • 2 Peritoneal Dialysis 25%

  • 24/7 or 24/6 in most facilities

Our Capabilities

Our Strategy - Adding Value

Leading. Quality. Value. Solutions.

MEDICAL/CARE COORDINATION Franklin W. Maddux, MD FACP

April 3 2014, New York City

A Our Approach
B Our Strategy
C A Focus on Innovation

Our Approach to Value Based Care Models

Enterprise Segments

Products & Therapy Assets

Chronic Disease Care Provider Network Assets

Care Coordination & Performance Risk Assets

Aligning Resources to Coordinate Care Throughout the Health Value Chain

Business Asset Types Per Enterprise Segment

Accessing the Patient Where They Receive Care

Chronic Disease Care is Distinctive: Best Example is Renal Disease Care

Clinical Healthcare Segments

Chronic Disease Care Characteristics

  • Goal is Crisis Avoidance
  • Evidence-Based Care Exists
  • Standardized Protocols
  • Intensive Measurement
  • Trends to Predict Problems
  • Frequent Patient Contact & Education
  • Efficient Care Yields Better Outcomes

Evolution of Our Ability to Influence Outcomes

Renal Patient Outcomes: Impact of Adjacent Illnesses

Only 30% of hard outcomes in renal disease patients controlled by dialysis treatment parameters

Outcomes driven by associated illnesses and the management of multiple conditions

2004

Organized Care for Renal Disease

HOW IT WORKS?

Anemia Management

Sequencing the Anemia Management Medication Portfolio in the Coming Years

2013 2018

Short Acting ESA Agents

Long Acting ESA Agents

HIF Inhibitors - Novel Agents

Modeling Erythropoiesis in ESRD Patients

Mathematical Modeling of the ESRD Patient Physiology

$$
\frac{\partial}{\partial t}\int_{\gamma}^{\gamma+\Delta\gamma}\int_{\mu}^{\mu+\Delta\mu}P(t,\xi,\zeta)d\xi d\zeta=2(\text{rate entering iron class }\gamma\text{ from class }2\gamma)
$$

Algorithms

  • V5
  • Current CMAB computerized algorithm
  • 65000 patients
  • B
  • Pilot with Basal EPO on hold, 25% reduction
  • 4630 patients
  • C
  • Pilot with basal EPO on hold, 50% reduction
  • 3213 patients
  • A
  • Alternate CMAB A like Arizona
  • 5700 patients
  • Other
  • Hawaii, Kaiser, other individual algorithms, residual V4 (<15,000)
  • 52000 patients

$$
= 2 \int_{\gamma}^{\gamma + \Delta \gamma} \int_{\mu}^{\mu + \Delta \mu} \beta P(t, \xi, 2\zeta) d\xi d\zeta
$$

\n
$$
- \int_{\gamma}^{\gamma + \Delta \gamma} \int_{\mu}^{\mu + \Delta \mu} \beta P(t, \xi, \zeta) d\xi d\zeta
$$

\n
$$
- \int_{\gamma}^{\gamma + \Delta \gamma} \int_{\mu}^{\mu + \Delta \mu} \delta P(t, \xi, \zeta) d\xi d\zeta
$$

\n
$$
+ \int_{\gamma}^{\gamma + \Delta \gamma} \rho P(t, \mu, \zeta) d\zeta - \int_{\gamma}^{\gamma + \Delta \gamma} \rho P(t, \mu + \Delta \mu, \zeta) d\zeta
$$

\n
$$
+ \int_{\mu}^{\mu + \Delta \mu} h P(t, \xi, \gamma) d\xi - \int_{\mu}^{\mu + \Delta \mu} h P(t, \xi, \gamma + \Delta \gamma) d\xi,
$$

Dustin Kapraun, Peter Kotanko, Franz Kappel and Doris Furtinger

HOW IT WORKS?

Fluid Management Strategies

    1. Targeting the Correct Dry Weight
    1. Avoiding Sodium Loading During Dialysis
    1. Avoiding Missed & Shortened Treatments

Crit-Line

Crit-Line Initial Results: Four Months of Follow Up

HOW IT WORKS?

Maintaining Nutritional Competence

Why is Nutrition So Important?

A Novel Nutritional Competence Indicator – The Z Score

The Trajectory of the Z Score Change Helps Predict Outcomes

The Impact of Readmission on Nutritional Competence

PREDICTIVE ANALYTICS

Predictive Analytics – The Process

Patient Cohorts

Data Sources

Example Predictive Models

Complex Mathematical Models

Random Forest

Measuring Successful Models

Applying Interventions Selectively

LUNCH 13:00 – 13:40

This Afternoon's Agenda

13:40 Financials -
Mike Brosnan
14:10 Summary -
Rice Powell
14:15 Q&A

April 3 2014, New York City

A Global Efficiency Program
B Financial Outlook
C Capital Allocation
D Summary

GLOBAL EFFICIENCY PROGRAM

Driving the Business Forward

Top Five Projects with High Savings Potential

Efficiency Scope: Break Out of Savings Run-Rate

  • Positive NPV
  • Savings to Cost 3x
  • Project EPS Accretion >10%

FINANCIAL OUTLOOK

Driving the Business Forward

Revenue and Revenue Growth: Breakdown 2020

Revenue and Revenue Growth: Breakdown 2020

Financial Targets: Revenue

(Average Annual, Constant Currency)

2015 -
2020
Volume/
Patient
Price/
Mix
Market Share/
Acquisitions
Total
Growth
Products 3-4% ±2% 1-2% 4-7%
Services 5-6% ±1% 1-2% 6-8%
Care
Coordination
>10%

Total Revenue Growth Rate (p.a.) ~10%

Financial Targets: Net Income and EPS

2015 - 2020

Net Income Growth Rate (p.a.) High Single Digit

EPS Growth Rate (p.a.) High Single Digit

CAPITAL ALLOCATION

Capital Allocation Framework

Capital Allocation 2014 - 2020

Financial Targets: Cash Flow from Operations and CapEx

Major Debt Portfolio and Maturities

(as of December 31, 2013)

Debt Maturity Profile

(as of December 31, 2013)

Business Model Supports Leverage

2000-2013

Leverage as Funded Debt to EBITDA

2014–2020

  • Leverage Ratio
  • Opportunities in Leveraged Finance
  • Opportunities in Debt Capital Markets
  • 50-60 Basis Points Increase Pro Forma

Return on Invested Capital

2000-2013

2014–2020

  • Continued Value Accretive Growth
  • From 2014 Onward Improvement Expected
  • Increase by >100 Basis Points over the Period

Page 20

SUMMARY

Growth In Services, in Products and in Care Coordination
Efficiency Identified areas with efficiency potential to be incorporated
under the Global Efficiency Program
(GEP)
Shareholder
Value
Sustainable Increase in EPS
Reliable Dividend

April 3 2014, New York City

Q&A

Thank you 2014 Capital Markets Day

New York City

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. The Company has based these forward-looking statements on its views with respect to future events an financial performance. 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. Given these uncertainties, readers should not put undue reliance on any forward-looking statements. 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).

Forward-looking statements represent estimates and assumptions only as of the date that they were made. The information contained in this presentation is subject to change without notice and the company does not undertake any duty to update the forward-looking statements, and the estimates and assumptions associated with them, except to the extent required by applicable law and regulations.

If not mentioned differently the term net income after minorities refers to the net income attributable to the shareholders of Fresenius Medical Care AG Co. KGaA independent of being the reported or the adjusted number. Numbers mentioned are in US-\$.

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