Fresenius Medical Care Reports Strong Third Quarter and Nine Months Results; Improved Guidance for 2009
BAD HOMBURG, Germany--(BUSINESS WIRE)--
Fresenius Medical Care AG & Co. KGaA (NYSE: FMS)(FWB: FME):
Summary Third Quarter 2009: Net revenue $ 2,889 million + 6 % Operating income (EBIT) $ 451 million + 7 % Net income attributable to Fresenius Medical Care $ 225 million + 9 % AG & Co. KGaA Earnings per share $ 0.76 + 9 %
Summary First Nine Months 2009: Net revenue $ 8,212 million + 4 % Operating income (EBIT) $ 1,265 million + 2 % Net income attributable to Fresenius Medical Care $ 645 million + 7 % AG & Co. KGaA Earnings per share $ 2.16 + 6 %
Fresenius Medical Care AG & Co. KGaA ("the Company" or "FMC AG & Co. KGaA"), the world's largest provider of dialysis products and services, today announced its results for the third quarter and first nine months of 2009.
Third Quarter 2009:
Revenue
Net revenue for the third quarter of 2009 increased by 6% to $2,889 million (10% at constant currency) compared to the third quarter of 2008. Organic revenue growth worldwide was 8%. Dialysis Services revenue grew by 8% to $2,147 million (10% at constant currency) in the third quarter of 2009. Dialysis Product revenue increased by 2% to $742 million (an increase of 8% at constant currency) in the same period.
North America revenue increased by 10% to $1,950 million. Organic revenue growth was 8%. Dialysis Services revenue grew by 10% to $1,741 million. Average revenue per treatment for the U.S. clinics increased to $348 in the third quarter of 2009 compared to $333 for the same quarter in 2008 and $344 for the second quarter of 2009. This development was mainly based on reimbursement increases and increased utilization of pharmaceuticals. Dialysis Product revenue increased by 14% to $209 million and was led by pharmaceutical sales, especially of the newly licensed intravenous iron products.
International revenue remained nearly unchanged at $939 million, compared to the third quarter of 2008. Based on constant currency, revenue grew by 9%. Organic revenue growth was 7%. Dialysis Services revenue was $406 million, an increase of 2% (+12% at constant currency). Dialysis Product revenue decreased by 2% to $533 million. Product sales grew by 6% based on constant currencies, led by increased pharmaceutical sales and sales of dialyzers.
Earnings
Operating income (EBIT) increased by 7% to $451 million compared to $422 million in the third quarter of 2008, resulting in an operating margin of 15.6%, equal to the operating margin for the third quarter of 2008. Compared to the second quarter of 2009 this represents a 50 basis points improvement. The third quarter operating margin was favorably impacted by an increase in revenue per treatment, an excellent cost management in the U.S. and a decrease in bad debt expenses. The operating margin development was negatively influenced by increased prices for pharmaceuticals, the impact of the launch of a generic version of PhosLo(R) in the U.S. market and unfavorable exchange rate effects in the International segment.
In North America, the operating margin was unchanged at 16.7%, as in the third quarter of 2008. The margin was favorably impacted by an increase in revenue per treatment, including commercial payor revenue, higher utilization of EPO and Medicare reimbursement increases, an excellent cost management in the U.S. and a decrease in bad debt expenses thanks to higher cash collections on receivables. This was offset by cost increases for pharmaceuticals related to both price and utilization, as well as the impact of the launch of a generic version of PhosLo(R) in the U.S. market and increased depreciation expense.
In the International segment, the operating margin increased by 60 basis points to 16.7% due to lower production costs resulting from lower prices for raw material and energy as well as economies of scale and lower bad debt expenses, which was partially offset by unfavorable foreign exchange rate effects.
Net interest expense for the third quarter of 2009 was $75 million compared to $87 million in the same quarter of 2008, mainly due to lower short-term interest rates.
Income tax expense was $131 million for the third quarter of 2009 compared to $120 million in the third quarter of 2008, reflecting effective tax rates of 35.0% and 35.7%, respectively.
Net income attributable to FMC AG & Co. KGaA for the third quarter of 2009 was $225 million, an increase of 9%.
Earnings per share (EPS) for the third quarter of 2009 rose by 9% to $0.76 per ordinary share compared to $0.69 for the third quarter of 2008. The weighted average number of shares outstanding for the third quarter of 2009 was approximately 298.3 million shares compared to 297.2 million shares for the third quarter of 2008. The increase in shares outstanding resulted from stock option exercises in the past twelve months.
Cash Flow
In the third quarter of 2009, the Company generated $443 million in cash from operations, an increase of 41% compared to the third quarter of 2008 and representing approximately 15% of revenue. The cash flow performance was positively influenced by increased earnings and a favorable development of the Days Sales Outstanding.
A total of $139 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions was $304 million compared to $155 million in the third quarter of 2008. A total of $26 million in cash was used for acquisitions net of divestitures. Free Cash Flow after acquisitions and divestitures was $278 million compared to $116 million in the third quarter of last year.
Nine Months Ended September 30, 2009:
Revenue and Earnings
Net revenue was $8,212 million, up 4% from the first nine months of 2008. At constant currency, net revenue rose 9%. Organic growth was 8% in the first nine months of 2009.
Operating income (EBIT) increased by 2% to $1,265 million compared to $1,240 million in the first nine months of 2008, resulting in an operating margin of 15.4% compared to 15.7% for the first nine months of 2008. This development was mainly due to higher personnel expenses, price increases for pharmaceuticals including Heparin as well as the impact of the launch of a generic version of PhosLo(R) in the U.S. market. These effects were partially offset by a strong performance of the dialysis product business, increased commercial payor revenue as well as the effect of cost control measures.
Net interest expense for the first nine months of 2009 was $225 million compared to $252 million in the same period of 2008, mainly due to lower short-term interest rates.
Income tax expense was $345 million in the first nine months of 2009 compared to $357 million in the same period in 2008, reflecting effective tax rates of 33.2% and 36.1%, respectively. Tax expense was positively impacted by a non-recurring revaluation of a tax claim recorded in the second quarter of 2009.
For the first nine months of 2009, net income attributable to FMC AG & Co. KGaA was $645 million, up 7% from the first nine months of 2008.
Earnings per ordinary share rose by 6% to $2.16. The weighted average number of shares outstanding during the first nine months of 2009 was approximately 298.0 million.
Cash Flow
Cash from operations during the first nine months of 2009 was $880 million compared to $716 million for the same period in 2008, representing approximately 11% of revenue. The cash flow generation benefited from increased earnings and the favorable development of the Days Sales Outstanding.
A total of $388 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions for the first nine months of 2009 was $492 million compared to $223 million in the same period in 2008. A total of $57 million in cash was used for acquisitions net of divestitures. Free Cash Flow after acquisitions and divestitures was $435 million compared to $93 million in the first nine months of last year.
Please refer to the attachments for a complete overview on the third quarter and first nine months of 2009 and the reconciliation of non-GAAP financial measures included in this release to the most comparable GAAP financial measures.
Patients - Clinics - Treatments
As of September 30, 2009, Fresenius Medical Care treated 192,804 patients worldwide, which represents a 6% increase compared to the same period last year. North America provided dialysis treatments for 130,522 patients, an increase of 4%. Including 31 clinics managed by Fresenius Medical Care North America, the number of patients in North America was 132,158. The International segment served 62,282 patients, an increase of 10% over last year.
As of September 30, 2009, the Company operated a total of 2,509 clinics worldwide. This is comprised of 1,749 clinics in North America (1,780 including managed clinics), an increase of 5%, and 760 clinics in the International segment, an increase of 11%.
Fresenius Medical Care delivered approximately 21.84 million dialysis treatments worldwide during the first nine months of 2009. This represents an increase of 6% year over year. North America accounted for 14.75 million treatments, an increase of 4%, and the International segment delivered 7.09 million treatments, an increase of 10% over last year.
Employees
As of September 30, 2009, Fresenius Medical Care had 67,245 employees (full-time equivalents) worldwide compared to 63,990 employees as of September 30, 2008. This increase of over 3,200 employees is due to the overall growth in the Company's business.
Debt/EBITDA Ratio
The ratio of debt to Earnings before Interest, Taxes, Depreciation and Amortization (EBITDA) decreased from 2.71 at the end of the third quarter of 2008 to 2.62 at the end of the third quarter of 2009. At the end of 2008, the debt/EBITDA ratio was 2.69.
Rating
In the third quarter of 2009, Standard & Poor's Rating Services continued to rate the Company's corporate credit as 'BB' with a 'stable' outlook. Moody's also affirmed its rating of the Company's corporate credit as 'Ba1' with a 'stable' outlook. As in the previous quarter, Fitch rates the Company's corporate credit as 'BB' while revising its outlook from 'negative' to 'stable'. For further information on Fresenius Medical Care's credit ratings, maturity profiles and credit instruments, please visit our website at www.fmc-ag.com / Investor Relations / Credit Relations.
Outlook for 2009
For the full year of 2009, the Company now expects to achieve revenue of around $11.2 billion (previously $11.1 billion), an increase of around 8% in constant currency.
Net income attributable to FMC AG & Co. KGaA is now expected to be between $865 million and $890 million in 2009. Previously the Company expected the net income to be in the range of $850 million and $890 million for the full year 2009.
In addition, the Company expects to spend $550 to $650 million on capital expenditures and $200 to $250 million (previously $200 to $300 million) on acquisitions. The projected debt/EBITDA ratio has been retained unchanged at below 2.7.
Ben Lipps, Chief Executive Officer of Fresenius Medical Care, said: "We are very pleased with our results in the third quarter of 2009, which reflects an excellent performance by all regions. While we maintained our increased commitment to research and development, our sustained high organic growth globally and good cost containment accounted for this overall successful operating performance. The free cash flow for the third quarter exceeded our expectations and resulted from excellent cash collections in North America. Our strong performance in the quarter provides the basis for us to improve our guidance for the full year 2009."
Conference Call
Fresenius Medical Care will hold a conference call to discuss the results of the third quarter and the first nine months of 2009 on Tuesday, November 03, 2009, at 3:30 pm CET / 9:30 am EST. The Company invites investors to listen to the live webcast of the call at the Company's website www.fmc-ag.com in the "Investor Relations" section. A replay will be available shortly after the call.
Fresenius Medical Care is the world's largest integrated provider of products and services for individuals undergoing dialysis because of chronic kidney failure, a condition that affects more than 1,770,000 individuals worldwide. Through its network of 2,509 dialysis clinics in North America, Europe, Latin America, Asia-Pacific and Africa, Fresenius Medical Care provides dialysis treatment to 192,804 patients around the globe. Fresenius Medical Care is also the world's leading provider of dialysis products such as hemodialysis machines, dialyzers and related disposable products. Fresenius Medical Care is listed on the Frankfurt Stock Exchange (FME, FME3) and the New York Stock Exchange (FMS, FMS/P).
For more information about Fresenius Medical Care, visit the Company's website at www.fmc-ag.com.
This release contains forward-looking statements that are subject to various risks and uncertainties. Actual results could differ materially from those described in these forward-looking statements due to certain factors, including changes in business, economic and 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 Fresenius Medical Care AG & Co. KGaA's reports filed with the U.S. Securities and Exchange Commission. Fresenius Medical Care AG & Co. KGaA does not undertake any responsibility to update the forward-looking statements in this release.
Fresenius Three Months Ended Nine Months Ended Medical Care Statement of September 30, September 30, Earnings (in US-$ thousands, % % except share 2009 2008 Change 2009 2008 Change and per share data) (unaudited) Net revenue Dialysis Care 2,146,349 1,984,938 8.1% 6,123,774 5,753,484 6.4% Dialysis 742,320 728,327 1.9% 2,088,274 2,136,801 -2.3% Products Total net 2,888,669 2,713,265 6.5% 8,212,048 7,890,285 4.1% revenue Cost of 1,910,168 1,803,886 5.9% 5,439,530 5,201,721 4.6% revenue Gross profit 978,501 909,379 7.6% 2,772,518 2,688,564 3.1% Selling, general and 504,520 466,983 8.0% 1,443,206 1,388,680 3.9% administrative Research and 22,656 20,206 12.1% 64,508 59,978 7.6% development Operating 451,325 422,190 6.9% 1,264,804 1,239,906 2.0% income (EBIT) Interest (4,624) (6,467) -28.5% (16,797) (19,266) -12.8% income Interest 79,769 93,516 -14.7% 241,466 271,275 -11.0% expense Interest 75,145 87,049 -13.7% 224,669 252,009 -10.8% expense, net Income before 376,180 335,141 12.2% 1,040,135 987,897 5.3% taxes Income tax 131,687 119,492 10.2% 345,436 356,513 -3.1% expense1) Net income 244,493 215,649 13.4% 694,699 631,384 10.0% Less: Net income attributable 19,193 9,314 106.1% 50,180 28,088 78.7% to Noncontrolling interest1) Net income attributable 225,300 206,335 9.2% 644,519 603,296 6.8% to FMC AG & Co. KGaA Operating 451,325 422,190 6.9% 1,264,804 1,239,906 2.0% income (EBIT) Depreciation and 118,291 107,897 9.6% 334,133 306,761 8.9% amortization EBITDA 569,616 530,087 7.5% 1,598,937 1,546,667 3.4% Total bad debt 50,189 56,274 159,078 157,922 expenses Earnings per $0.76 $0.69 8.8% $2.16 $2.03 6.4% ordinary share Earnings per $0.76 $0.69 8.8% $2.16 $2.03 6.4% ordinary ADS Weighted average number of shares Ordinary 294,443,038 293,417,973 294,181,563 293,030,503 shares Preference 3,857,335 3,802,913 3,832,367 3,790,298 shares Percentages of revenue Cost of 66.1% 66.5% 66.2% 65.9% revenue Gross profit 33.9% 33.5% 33.8% 34.1% Selling, general and 17.5% 17.2% 17.6% 17.6% administrative Research and 0.8% 0.7% 0.8% 0.8% development Operating 15.6% 15.6% 15.4% 15.7% income (EBIT) Interest 2.6% 3.2% 2.7% 3.2% expense, net Income before 13.0% 12.4% 12.7% 12.5% taxes Income tax 4.6% 4.4% 4.2% 4.5% expense Net income attributable to 0.7% 0.3% 0.6% 0.4% Noncontrolling interest Net income attributable 7.8% 7.6% 7.8% 7.6% to FMC AG & Co. KGaA EBITDA 19.7% 19.5% 19.5% 19.6% 1) Due to the adoption of the new accounting rule ASC 810 (US GAAP), tax expenses related to minority interests of partnerships were reclassified to noncontrolling interest. The effect is neutral to net income attributable to FMC AG & Co. KGaA. The previous year's periods have been adjusted accordingly.
Fresenius Medical Care Three Months Ended Nine Months Ended Segment and Other September 30, September 30, Information (in US-$ million) 2009 2008 % Change 2009 2008 % Change (unaudited) Net revenue North America 1,950 1,771 10.1% 5,600 5,153 8.7% International 939 942 -0.3% 2,612 2,737 -4.6% Total net revenue 2,889 2,713 6.5% 8,212 7,890 4.1% Operating income (EBIT) North America 325 296 9.8% 894 858 4.2% International 156 152 3.0% 457 462 -1.1% Corporate (30) (26) 16.7% (86) (80) 7.3% Total operating income 451 422 6.9% 1,265 1,240 2.0% (EBIT) Operating income in percentage of revenue North America 16.7% 16.7% 16.0% 16.7% International 16.7% 16.1% 17.5% 16.9% Total 15.6% 15.6% 15.4% 15.7% Employees Full-time equivalents 67,245 63,990
Fresenius Medical Care Reconciliation of non US-GAAP financial measures to the most directly Three Months Ended Nine Months Ended comparable US-GAAP financial measures September 30, September 30, (in US-$ million) 2009 2008 2009 2008 (unaudited) Segment information North America Net revenue 1,950 1,771 Costs of revenue and research and 1,309 1,187 development Selling, general and administrative 316 288 Costs of revenue and operating expenses 1,625 1,475 Operating income (EBIT) 325 296 Percent of revenue 16.7% 16.7% Dialysis Products revenue incl. and excl. internal sales North America Dialysis Products revenue incl. 376 321 internal sales less internal sales (167) (137) Dialysis Products external sales 209 184 International Dialysis Products revenue incl. 613 622 internal sales less internal sales (80) (78) Dialysis Products external sales 533 544 Reconciliation of cash flow from operating activities to EBITDA1) Total EBITDA 1,599 1,547 Interest expense, net (225) (252) Income tax expense (345) (357) Change in working capital and other non (149) (222) cash items Net cash provided by operating 880 716 activities Annualized EBITDA Operating income (EBIT) last twelve 1,697 1,668 months Depreciation and amortization last 443 410 twelve months Non cash charges 48 44 Annualized EBITDA 2,188 2,122 1) EBITDA is the basis for determining compliance with certain covenants in Fresenius Medical Care's long-term debt instruments.
Fresenius Medical Care September 30, December 31, Balance Sheet (unaudited) (audited) (in US-$ million) 2009 2008 Assets Current assets 4,726 4,212 Intangible assets 8,281 8,156 Other non-current assets 2,690 2,552 Total assets 15,697 14,920 Liabilities and equity Current liabilities 2,642 3,145 Long-term liabilities 6,341 5,652 Total equity 6,714 6,123 Total liabilities and equity 15,697 14,920 Equity/assets ratio: 43% 41% Debt Short-term borrowings 312 684 Short-term borrowings from related parties 43 1 Current portion of long-term debt and capital 160 455 lease obligations Long-term debt and capital lease obligations, 4,561 3,957 less current portion Trust Preferred Securities 663 641 Total debt 5,739 5,738
Fresenius Medical Care Cash Flow Statement Nine Months Ended September 30, 2009 2008 (in US-$ million) (unaudited) Operating activities Net income 695 631 Depreciation / amortization 334 307 Change in working capital and other non cash items (149) (222) Cash Flow from operating activities 880 716 Investing activities Purchases of property, plant and equipment (398) (502) Proceeds from sale of property, plant and equipment 10 9 Capital expenditures, net (388) (493) Free Cash Flow 492 223 Acquisitions and investments, net of cash acquired and net purchases of intangible assets (109) (176) Proceeds from divestitures 52 46 Acquisitions, net of divestitures (57) (130) Free Cash Flow after investing activities 435 93 Financing activities Change in accounts receivable securitization program (335) 452 Change in intercompany debt (68) (1) Change in other debt 212 310 Redemption of Trust Preferred Securities - (678) Proceeds from exercise of stock options 26 38 Distributions to noncontrolling interest (48) (27) Contributions from noncontrolling interest 8 - Dividends paid (232) (252) Cash Flow from financing activities (437) (158) Effects of exchange rates on cash 4 - Net increase (decrease) in cash 2 (65) Cash at beginning of period 222 245 Cash at end of period 224 180
Fresenius Medical Care Quarterly Performance Scorecard - Revenue Three months ended September 30, 2009 cc 2008 cc (in US-$ thousands, except per-treatment revenue) North America Net revenue 1,949,384 1,770,820 Growth year-over-year 10.1% 6.6% Dialysis Care 1,740,040 1,586,594 Growth year-over-year 9.7% 6.2% U.S. per treatment 348 333 Per treatment 342 328 Sequential growth 1.2% 1.7% Growth year-over-year 4.1% 1.8% Dialysis Products incl. internal sales 375,788 320,908 Growth year-over-year 17.1% 8.1% External sales 209,343 184,226 Growth year-over-year 13.6% 10.5% International Net revenue 939,115 942,278 Growth year-over-year -0.3% 8.6% 23.1% 14.4% Dialysis Care 406,309 398,345 Growth year-over-year 2.0% 12.2% 29.8% 20.1% Per treatment 167 184 179 166 Sequential growth 5.2% -2.1% Growth year-over-year -6.4% 2.9% 16.8% 8.1% Dialysis Products incl. internal sales 612,631 622,010 Growth year-over-year -1.5% 7.2% 18.7% 10.3% External sales 532,806 543,933 Growth year-over-year -2.0% 5.9% 18.6% 10.5% cc = at constant exchange rates
Fresenius Medical Care Quarterly Performance Scorecard - Dialysis Care Volume Three months ended September 30, 2009 2008 North America Number of treatments 5,060,911 4,829,339 Treatments per day 64,062 61,131 Per day sequential growth 1.0% 0.5% Per day year-over-year growth 4.8% 3.2% Same market growth year-over-year 3.6% 3.0% International Number of treatments 2,427,410 2,226,681 Same market growth year-over-year 4.5% 9.5% Fresenius Medical Care Quarterly Performance Scorecard - Expenses Three months ended September 30, 2009 2008 North America Costs of revenue and operating expenses Percent of revenue 83.3% 83.3% Selling, general and administrative Percent of revenue 16.2% 16.3% Bad debt expenses Percent of revenue 2.5% 2.9% Dialysis Care operating expenses/Treatment (in US-$) 283 274 Sequential growth -0.6% 1.6% Growth year-over-year 3.3% 2.1% Total Group Costs of revenue and operating expenses Percent of revenue 84.4% 84.4% Selling, general and administrative Percent of revenue 17.5% 17.2% Effective tax rate 35.0% 35.7%
Fresenius Medical Care Quarterly Performance Scorecard - Cash Flow/Investing Activities Three months ended September 30, 2009 2008 (in US-$ thousands, except number of de novos) Total Group Operating Cash Flow 443,168 314,512 Percent of revenue 15.3% 11.6% Free Cash Flow before acquisitions 304,345 154,670 Percent of revenue 10.5% 5.7% Acquisitions and investments, net of divestitures 26,742 39,034 Capital expenditures, net 138,823 159,842 Percent of revenue 4.8% 5.9% Maintenance 52,136 63,818 Percent of revenue 1.8% 2.4% Growth 86,687 96,024 Percent of revenue 3.0% 3.5% Number of de novos 23 29 North America 18 19 International 5 10 Fresenius Medical Care Quarterly Performance Scorecard - Balance Sheet Three months ended September 30, 2009 2008 Total Group Debt (in US-$ million) 5,739 5,748 Debt/EBITDA 2.6 2.7 North America Days sales outstanding 55 60 International Days sales outstanding 112 108
Fresenius Medical Care
Quarterly Performance Scorecard
Three months ended September 30, 2009 2008
Clinical Performance
North America (U.S.)
Single Pool Kt/v > 1.2 96% 95%
Hemoglobin = 10-12g/dl 64% 58%
Hemoglobin = 10-13g/dl 87% 86%
Albumin >= 3.5 g/dl 1) 82% 81%
Phosphate 3.5-5.5mg/dl 54% 53%
Hospitalization Days per patient 2)
10.0 10.5
(12 months ending September 30)
Demographics
North America (U.S.)
Average age (in years) 62 62
Average time on dialysis (in years) 3.6 3.6
Average body weight (in kg) 80 79
Prevalence of diabetes 54% 53%
1) International standard BCR CRM470
2) Hospitalization data for 2009 includes legacy RCG facilities
Fresenius Medical Care
Quarterly Performance Scorecard
Three months ended September 30, 2009 2008
Clinical Performance
Europe, Middle East and Africa
Single Pool Kt/v > 1.2 95% 95%
Hemoglobin = 10-12g/dl 53% 51%
Hemoglobin = 10-13g/dl 74% 76%
Albumin >= 3.5 g/dl 1) 85% 85%
Phosphate 3.5-5.5mg/dl 58% 60%
Hospitalization Days per patient
7.8 7.6
(12 months ending September 30)
Demographics
Europe, Middle East and Africa
Average age (in years) 64 63
Average time on dialysis (in years) 4.8 4.6
Average body weight (in kg) 70 69
Prevalence of diabetes 28% 28%
1)International standard BCR CRM470
Source: Fresenius Medical Care AG & Co. KGaA
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