Fresenius Medical Care AG 6-K, filed Nov 2, 2021
Fresenius Medical Care AG (FMS)
About this 6-K
Fresenius Medical Care AG filed this 6-K on November 2, 2021.
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 6-K
REPORT OF FOREIGN PRIVATE ISSUER
Pursuant to Rule 13a-16 or 15d-16 of the
Securities Exchange Act of 1934
For the month of November 2021
Commission file number: 001-32749
FRESENIUS MEDICAL CARE AG & Co. KGaA
(Translation of registrant's name into English)
Else-Kröner Strasse 1
61346 Bad Homburg
Germany
(Address of principal executive offices)
Indicate by check mark whether the registrant files or will file annual reports under cover of Form 20-F or Form 40-F.
Form 20-F x Form 40-F ¨
Indicate by check mark if the registrant is submitting the Form 6-K in paper as permitted by Regulation S-T Rule 101(b)(1): ¨
Indicate by check mark if the registrant is submitting the Form 6-K in paper as permitted by Regulation S-T Rule 101(b)(7): ¨
On November 2, 2021, Fresenius Medical Care AG & Co. KGaA (the “Company”) issued a Press Release announcing its third quarter results for the period ending September 30, 2021. A copy of the Press Release is furnished as Exhibit 99.1 and the corresponding financial figures as Exhibit 99.2.
The attached Press Release contains non-GAAP financial measures. For purposes of Regulation G, a non-GAAP financial measure is a numerical measure of a company’s performance, financial position, or cash flows that either excludes or includes amounts that are not normally excluded or included in the most directly comparable measure calculated and presented in accordance with generally accepted accounting principles. To supplement our third quarter 2021 consolidated financial results presented in accordance with International Financial Reporting Standards, or IFRS, we have used non-GAAP financial measures, including (a) EBITDA, or operating income excluding interest, taxes, depreciation and amortization, (b) free cash flow, (c) net leverage ratio (ratio of net debt to adjusted EBITDA) and (d) results presented in constant currency. These non-GAAP measures are provided to enhance the user’s overall understanding of our current financial performance and our prospects for the future. In addition, because we have historically reported certain non-GAAP financial measures in our financial results, we believe the inclusion of these non-IFRS financial measures provides consistency and comparability in our financial reporting to prior periods for which these non-GAAP financial measures were previously reported. These non-GAAP financial measures should not be used as a substitute for or be considered superior to GAAP financial measures. Reconciliation of the non-GAAP financial measures EBITDA, Adjusted EBITDA, Net Leverage Ratio and Free Cash Flow to the most comparable IFRS financial measures are included in the attached Financial Statements. As the reconciliation of amounts stated in Constant Currency is inherent in the disclosure included in the Press Release, we believe that a separate reconciliation would not provide any additional benefit.
The Exhibits attached hereto, shall not be deemed “filed” for purposes of Section 18 of the Securities and Exchange Act of 1934 (the “Exchange Act”) or otherwise subject to the liabilities of that section, nor shall they be deemed incorporated by reference in any filing under the Securities Act of 1933 or the Exchange Act, regardless of any general incorporation language in such filing.
EXHIBITS
The following exhibits are being furnished with this Report:
| Exhibit 99.1 | Press release issued on November 2, 2021. |
| Exhibit 99.2 | Complete overview of the third quarter 2021 and first nine months 2021. |
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
DATE: November 2, 2021
| Fresenius Medical Care AG & Co. KGaA, | |||
| a partnership limited by shares, represented by: | |||
fresenius medical care management ag, its | |||
| General Partner | |||
| By: | /s/ Rice Powell | ||
| Name: | Rice Powell | ||
| Title: | Chief Executive Officer and Chairman of the Management Board of the General Partner | ||
| By: | /s/ Helen Giza | ||
| Name: | Helen Giza | ||
| Title: | Chief Financial Officer and Member of the Management Board of the General Partner | ||
Exhibit 99.1
| Press Release | Media contact Matthias Link T +49 6172 609-2872 matthias.link@fmc-ag.com
Contact for analysts and investors Dr. Dominik Heger T +49 6172 609-2601 dominik.heger@fmc-ag.com
www.freseniusmedicalcare.com |
November 2, 2021
Fresenius Medical Care confirms outlook for 2021 while considering the continued negative impact of COVID-19
| - | Stronger than projected headwind from COVID-19 effects with significantly increased patient excess mortality due to global spread of Delta variant |
| - | Organic growth continued with 1% |
| - | Financial targets for FY 2021 confirmed, expectation to reach lower end of the guidance ranges for revenue and net income |
| - | FME25 transformation update to achieve EUR 500 million savings by 2025 |
Rice Powell, Chief Executive Officer of Fresenius Medical Care, said: “The COVID-19 pandemic is an unprecedented situation for all of us and still costs many lives day by day. The existence of the Delta variant has caused excess mortality among our patients to rise again in the third quarter. This means that we must absorb a sizably larger COVID-19 effect on our business than we projected at the beginning of the year and, at the same time, manage through an increasingly inflationary cost environment. Against this backdrop, we now expect to reach the lower end of our guidance ranges for both revenue and net income.”
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Key figures (IFRS)
| Q3 2021 EUR m | Q3 2020 EUR m | Growth yoy |
Growth yoy, cc |
9M 2021 EUR m | 9M 2020 EUR m | Growth yoy |
Growth yoy, cc |
||||||||||||||||||||||||||
| Revenue | 4,441 | 4,414 | +1 | % | +1 | % | 12,972 | 13,459 | -4 | % | +2 | % | |||||||||||||||||||||
Operating income | 505 | 632 | -20 |
%
| -19 |
% | 1,403 | 1,843 | -24 |
% | -20 |
%
| |||||||||||||||||||||
| excl. special items1 | 510 | 632 | -19 | % | -19 | % | 1,417 | 1,843 | -23 | % | -19 | % | |||||||||||||||||||||
Net income2 excl. special items1 | 273 277 | 354 354 | -23 -22 |
% % | -22 -21 |
% % | 741 751 | 987 987 | -25 -24 |
% % | -21 -20 |
% % | |||||||||||||||||||||
Basic EPS (EUR) excl. special items1 | 0.93 0.94 | 1.21 1.21 | -23 -22 |
% % | -22 -21 |
% % | 2.53 2.56 | 3.35 3.35 | -25 -24 |
% % | -21 -20 |
% % | |||||||||||||||||||||
cc = at constant currency, EPS = earnings per share
Spread of Delta variant caused resurgence of excess mortality
As a result of the global spread of the Delta variant, COVID-19-related incremental excess mortality3 among Fresenius Medical Care’s patients has increased again to around 2,700 in the third quarter of 2021 (Q1 2021: ~3,200; Q2 2021: ~1,900). Thus, excess mortality amounted to approximately 11,500 patients in the past 12 months (as of September 30, 2021) and approximately 18,200 since the start of the pandemic.
The increase in excess mortality in the third quarter has led to a more negative impact on Fresenius Medical Care’s growth compared to the second quarter. The overall adverse effect of accumulated COVID-19-related excess mortality on organic growth in the Health Care Services business amounted to around 390 basis points in the third quarter and 330 basis points in the first nine months of 2021.
At the end of the third quarter, approximately 78% of Fresenius Medical Care’s patients in the U.S. had received at least one dose of COVID-19 vaccine. Also on a global basis, approximately 78% of Fresenius Medical Care’s patients have received at least one vaccination.
1 Costs related to the FME25 program
2 Net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA
3 Historical excess mortality updated for late entries
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Outlook
When giving guidance in February 2021, Fresenius Medical Care assumed an accumulation of COVID-19-related excess mortality in the first half and a return to normal mortality patterns in the second half of the year. The continued and increasing presence of COVID-19 has led to a significant increase in excess mortality in the third quarter which was not included in the Company’s outlook for 2021. Due to decreasing infection rates since the end of the third quarter, the Company is now projecting excess mortality to decline in the fourth quarter.
Based on Fresenius Medical Care’s current projections, the Company confirms its outlook for revenue to grow at a low- to mid-single digit percentage rate and net income to decline at a high-teens to mid-twenties percentage rate against the 2020 base and is now expecting to be at the lower end of these guidance ranges.4
Revenue and earnings development affected by COVID-19 pandemic
Revenue in the third quarter increased by 1% to EUR 4,441 million (+1% at constant currency, +1% organic).
Health Care Services revenue in the third quarter increased by 1% to EUR 3,530 million (+2% at constant currency, +1% organic). Organic growth was achieved despite the adverse effects of the COVID-19 pandemic and a lower reimbursement for calcimimetics.
Health Care Products revenue was stable and amounted to EUR 911 million (-1% at constant currency, 0% organic). Lower sales of in-center disposables and peritoneal dialysis products were offset by positive exchange rate effects and higher sales of machines for chronic treatment.
In the first nine months, revenue declined by 4% to EUR 12,972 million (+2% at constant currency, +1% organic). Health Care Services revenue decreased by 4% to EUR 10,255 million (+2% at constant currency, +1% organic); Health Care Products revenue declined by 1% to EUR 2,717 million (+2% at constant currency, +2% organic).
4 These targets are based on the 2020 results excluding the impairment of goodwill and trade names in the Latin America Segment of EUR 195 million. They are inclusive of anticipated COVID-19 effects, in constant currency and exclude special items. Special items include costs related to FME25 and other effects that are unusual in nature and have not been foreseeable or not foreseeable in size or impact at the time of giving guidance.
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Operating income decreased by 20% to EUR 505 million in the third quarter (-19% at constant currency), resulting in a margin of 11.4% (Q3 2020: 14.3%). Operating income excluding special items declined by 19% to EUR 510 million (-19% at constant currency), resulting in a margin of 11.5% (Q3 2020: 14.3%). The decline was mainly due to adverse COVID-19-related effects, inflationary materials cost increases and higher labor costs. These effects were slightly mitigated by an improved U.S. payor mix, in particular due to an increased number of patients with Medicare Advantage coverage.
Operating income for the first nine months decreased by 24% to EUR 1,403 million (-20% at constant currency), resulting in a margin of 10.8% (9M 2020: 13.7%). Operating income excluding special items declined by 23% to EUR 1,417 million (-19% at constant currency), resulting in a margin of 10.9% (9M 2020: 13.7%).
Net income2 decreased by 23% to EUR 273 million in the third quarter (-22% at constant currency) mainly due to the explained effects on operating income and a higher tax rate. Net income excluding special items declined by 22% to EUR 277 million (-21% at constant currency).
In the first nine months, net income decreased by 25% to EUR 741 million (-21% at constant currency). Net income excluding special items declined by 24% to EUR 751 million (-20% at constant currency).
Basic earnings per share (EPS) decreased by 23% to EUR 0.93 (-22% at constant currency) in the third quarter. EPS excluding special items declined by 22% to EUR 0.94 (-21% at constant currency).
In the first nine months, EPS decreased by 25% to EUR 2.53 (-21% at constant currency). EPS excluding special items declined by 24% to EUR 2.56 (-20% at constant currency).
Cash flow development
In the third quarter, Fresenius Medical Care generated EUR 692 million of operating cash flow (Q3 2020: EUR 746 million), resulting in a margin of 15.6% (Q3 2020: 16.9%). The decrease was mainly due to continued recoupment of the U.S. federal government’s payments in the second quarter of 2020 under the CARES Act. In the first nine months, operating cash flow amounted to EUR 1,820 million (9M 2020: EUR 3,649 million), resulting in a margin of 14.0% (9M 2020: 27.1%).
Fresenius Medical Care generated EUR 511 million of free cash flow5 (Q3 2020: EUR 507 million) in the third quarter, resulting in a margin of 11.5% (Q3 2020: 11.5%). In the first nine months, Free cash flow amounted to EUR 1,259 million (9M 2020: EUR 2,913 million), resulting in a margin of 9.7% (9M 2020: 21.6%).
5 Net cash provided by / used in operating activities, after capital expenditures, before acquisitions, investments, and dividends
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Regional developments
In North America, revenue was stable and amounted to EUR 3,080 million in the third quarter (+1% at constant currency, +1% organic). The low growth was mainly due to the adverse COVID-19 impact on both the Health Care Services and Health Care Products businesses along with associated downstream and negative exchange rate effects. These effects were partially offset by contributions from acquisitions. In the first nine months, revenue decreased by 6% to EUR 8,931 million (0% at constant currency, 0% organic).
Operating income in North America decreased by 13% to EUR 446 million in the third quarter (-13% at constant currency), resulting in a margin of 14.5% (Q3 2020: 16.8%). The decline was mainly due to the adverse impact of COVID-19, including a high prior-year base mainly driven by government relief funding, as well as inflationary cost increases. This was partially offset by an improved U.S. payor mix, in particular due to an increased number of patients with Medicare Advantage coverage. In the first nine months, operating income declined by 22% to EUR 1,242 million (-17% at constant currency), resulting in a margin of 13.9% (9M 2020: 16.7%).
Revenue in the EMEA region decreased by 2% to EUR 671 million in the third quarter (-2% at constant currency, -2% organic). The decrease was mainly due to adverse COVID-19-related impacts in Health Care Services as well as lower sales of in-center disposables and peritoneal dialysis products, partially offset by higher sales of products for acute care treatment and machines for chronic treatment. In the first nine months, revenue declined by 1% to EUR 2,033 million (+1% at constant currency, 0% organic).
Operating income in EMEA decreased by 21% to EUR 79 million in the third quarter (-21% at constant currency), resulting in a margin of 11.7% (Q3 2020: 14.6%). The decline was mainly due to inflationary cost increases, adverse COVID-19-related effects, an unfavorable mix in the Products business and timing of export sales. This was partially offset by favorable transactional exchange rate effects and an increase in reimbursement rates in certain countries. In the first nine months, operating income decreased by 17% to EUR 232 million (-16% at constant currency), resulting in a margin of 11.4% (9M 2020: 13.6%).
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In Asia-Pacific, revenue increased by 4% to EUR 501 million in the third quarter (+3% at constant currency, +2% organic). This was mainly driven by organic growth in Health Care Services, including a recovery in elective procedures, as well as positive exchange rate effects, contributions from acquisitions and higher sales of machines for chronic treatment, partially offset by lower sales of in-center disposables. In the first nine months, revenue grew by 6% to EUR 1,458 million (+8% at constant currency, +8% organic).
Operating income decreased by 11% to EUR 86 million in the third quarter (-10% at constant currency), resulting in a margin of 17.2% (Q3 2020: 20.0%). The decline was mainly due to adverse COVID-19-related effects and inflationary cost increases, partially offset by business growth including the above-mentioned effect from the recovery of elective procedures. In the first nine months, operating income grew by 8% to EUR 256 million (+10% at constant currency), resulting in a margin of 17.5% (9M 2020: 17.2%).
Despite a significant headwind from exchange rates and the adverse impact of COVID-19, Latin America revenue increased by 5% to EUR 178 million in the third quarter (+13% at constant currency, +12% organic). This was mainly driven by organic growth in the Services business, contributions from acquisitions and higher sales of in-center disposables. In the first nine months, revenue was stable and amounted to EUR 508 million (+16% at constant currency, +14% organic).
Operating income in Latin America decreased by 61% to EUR 4 million in the third quarter (-62% at constant currency), resulting in a margin of 2.4% (Q3: 2020: 6.6%). The decline was due to inflationary cost increases and adverse COVID-19 effects. In the first nine months, operating income declined by 53% to EUR 14 million (-54% at constant currency), resulting in a margin of 2.7% (9M 2020: 5.7%).
Patients, clinics and employees
As of September 30, 2021, Fresenius Medical Care treated 344,872 patients in 4,151 dialysis clinics worldwide. At the end of the third quarter, the Company had 123,528 employees (full-time equivalents) worldwide, compared to 126,463 employees as of September 30, 2020.
FME25 Update
For the update on the FME25 transformation program, a separate press release is issued.
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Conference call
Fresenius Medical Care will host a two-hour conference call to discuss the results of the third quarter and first nine months of 2021 on November 2, 2021 at 3:30 p.m. CET / 10:30 a.m. EDT. Please note that this will be an extended call, as the Company will additionally provide an update on the FME25 transformation program. Details will be available on the Fresenius Medical Care website www.freseniusmedicalcare.com in the “Investors” section. A replay will be available shortly after the call.
Please refer to our statement of earnings included at the end of this news and to the attachments as separate PDF files for a complete overview of the results of the third quarter and first nine months of 2021. Our 6-K disclosure provides more details.
Fresenius Medical Care is the world's leading provider of products and services for individuals with renal diseases of which around 3.7 million patients worldwide regularly undergo dialysis treatment. Through its network of 4,151 dialysis clinics, Fresenius Medical Care provides dialysis treatments for approximately 345,000 patients around the globe. Fresenius Medical Care is also the leading provider of dialysis products such as dialysis machines or dialyzers. Along with its core business, the Renal Care Continuum, the Company focuses on expanding in complementary areas and in the field of critical care. Fresenius Medical Care is listed on the Frankfurt Stock Exchange (FME) and on the New York Stock Exchange (FMS).
For more information visit the Company’s website at www.freseniusmedicalcare.com.
Disclaimer:
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 various factors, including, but not limited to, changes in business, economic and competitive conditions, legal changes, regulatory approvals, impacts related to the COVID-19 pandemic, results of clinical studies, 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.
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Exhibit 99.2
| Content: Statement of earnings page 2 Segment information page 3 Balance sheet page 4 Cash flow page 5 Revenue development page 6 Key metrics page 7 Quality data page 8 page 9 Outlook 2021 page 10 Disclaimer Fresenius Medical Care AG & Co. KGaA November 2, 2021 COMPLETE OVERVIEW OF THE THIRD QUARTER 2021 Investor Relations AND FIRST NINE MONTHS 2021 email: ir@fmc-ag.com phone: +49 6172 609 2525 Reconciliation results excl. special items 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. Copyright by Fresenius Medical Care AG & Co. KGaA |
| Statement of earnings in € million, except share data, unaudited 2021 2020 Change Change at cc 2021 2020 Change Change at cc Health Care Services 3,530 3,499 0.9% 1.7% 10,255 10,708 -4.2% 1.6% Health Care Products 911 915 -0.3% -0.7% 2,717 2,751 -1.3% 1.7% Total revenue 4,441 4,414 0.6% 1.2% 12,972 13,459 -3.6% 1.6% Costs of revenue 3,174 3,055 3.9% 4.6% 9,214 9,295 -0.9% 4.6% Gross profit 1,267 1,359 -6.8% -6.1% 3,758 4,164 -9.7% -5.3% Selling, general and administrative 731 706 3.5% 3.8% 2,273 2,228 2.0% 6.8% Research and development 52 45 16.6% 16.9% 153 141 8.3% 11.2% Income from equity method investees (21) (24) -13.0% -13.6% (71) (48) 46.9% 47.4% Operating income 505 632 -20.1% -19.4% 1,403 1,843 -23.9% -19.8% Operating income margin 11.4% 14.3% 10.8% 13.7% Interest income (16) (8) 107.0% 111.7% (45) (27) 63.1% 71.0% Interest expense 84 96 -11.8% -11.5% 259 311 -17.0% -12.8% Interest expense, net 68 88 -22.0% -22.1% 214 284 -24.7% -20.9% Income before taxes 437 544 -19.8% -19.0% 1,189 1,559 -23.7% -19.6% Income tax expense 105 124 -15.6% -14.6% 274 362 -24.3% -20.2% Net income 332 420 -21.1% -20.3% 915 1,197 -23.5% -19.4% Net income attributable to noncontrolling interests 59 66 -12.2% -11.9% 174 210 -16.7% -11.5% Net income attributable to shareholders of FMC-AG & Co. KGaA 273 354 -22.8% -21.9% 741 987 -25.0% -21.1% Operating income 505 632 -20.1% -19.4% 1,403 1,843 -23.9% -19.8% Depreciation, amortization and impairment loss 402 393 2.5% 2.9% 1,187 1,204 -1.4% 3.5% EBITDA 907 1,025 -11.4% -10.9% 2,590 3,047 -15.0% -10.6% EBITDA margin 20.4% 23.2% 20.0% 22.6% Weighted average number of shares 292,986,093 292,817,296 292,926,425 294,458,296 Basic earnings per share €0.93 €1.21 -22.8% -21.9% €2.53 €3.35 -24.6% -20.7% Basic earnings per ADS €0.47 €0.60 -22.8% -21.9% €1.26 €1.68 -24.6% -20.7% Three months ended September 30, Nine months ended September 30, Statement of earnings page 2 of 10 November 2, 2021 |
| Segment information unaudited 2021 2020 Change Change at cc 2021 2020 Change Change at cc Total Revenue in € million 4,441 4,414 0.6% 1.2% 12,972 13,459 -3.6% 1.6% Operating income in € million 505 632 -20.1% -19.4% 1,403 1,843 -23.9% -19.8% Operating income margin 11.4% 14.3% 10.8% 13.7% Days sales outstanding (DSO) 59 51 Employees (full-time equivalents) 123,528 126,463 North America Revenue in € million 3,080 3,069 0.3% 0.9% 8,931 9,495 -5.9% 0.0% Operating income in € million 446 514 -13.3% -12.5% 1,242 1,587 -21.7% -16.8% Operating income margin 14.5% 16.8% 13.9% 16.7% Days sales outstanding (DSO) 38 26 EMEA Revenue in € million 671 682 -1.6% -1.7% 2,033 2,048 -0.7% 0.6% Operating income in € million 79 99 -20.8% -20.7% 232 278 -16.6% -16.3% Operating income margin 11.7% 14.6% 11.4% 13.6% Days sales outstanding (DSO) 89 91 Asia-Pacific Revenue in € million 501 484 3.6% 2.8% 1,458 1,377 5.9% 7.8% Operating income in € million 86 97 -11.0% -10.2% 256 237 7.9% 10.4% Operating income margin 17.2% 20.0% 17.5% 17.2% Days sales outstanding (DSO) 104 114 Latin America Revenue in € million 178 170 4.6% 13.2% 508 508 0.0% 15.6% Operating income in € million 4 11 -61.1% -61.9% 14 29 -53.1% -54.1% Operating income margin 2.4% 6.6% 2.7% 5.7% Days sales outstanding (DSO) 143 138 Corporate Revenue in € million 11 9 35.1% 33.6% 42 31 32.4% 38.1% Operating income in € million (110) (89) 22.9% 23.2% (341) (288) 18.0% 21.4% Three months ended September 30, Nine months ended September 30, Segment information page 3 of 10 November 2, 2021 |
| Balance sheet in € million, except for net leverage ratio, unaudited September 30 December 31 2021 2020 Assets Current assets 7,999 7,275 Goodwill and intangible assets 15,320 14,340 Right of use assets 4,238 4,130 Other non-current assets 6,274 5,944 Total assets 33,831 31,689 Liabilities and equity Current liabilities 7,492 6,160 Non-current liabilities 12,893 13,198 Total equity 13,446 12,331 Total liabilities and equity 33,831 31,689 Equity/assets ratio 40 % 39 % Debt and lease liabilities Short-term debt from unrelated parties 1,324 63 Short-term debt from related parties 39 17 Current portion of long-term debt 652 1,008 Current portion of lease liabilities from unrelated parties 621 588 Current portion of lease liabilities from related parties 21 21 Long-term debt, less current portion 6,571 6,800 Lease liabilities from unrelated parties, less current portion 3,895 3,764 Lease liabilities from related parties, less current portion 104 119 Total debt and lease liabilities 13,227 12,380 Minus: Cash and cash equivalents (1,562) (1,082) Total net debt and lease liabilities 11,665 11,298 Reconciliation of annualized adjusted EBITDA and net leverage ratio to the most directly comparable IFRS financial measures Net income 1,154 1,435 Income tax expense 413 501 Interest income (59) (42) Interest expense 357 410 Depreciation and amortization 1,557 1,587 Adjustments 1 292 249 Annualized adjusted EBITDA 3,714 4,140 Net leverage ratio 3.1 2.7 1 Acquisitions and divestitures made for the last twelve months with a purchase price above a €50 M threshold as defined in the Syndicated Credit Facility (2021: €18 M), non-cash charges, primarily related to pension expense (2021: €49 M; 2020: €50 M), impairment loss (2021: €211 M; 2020: €199 M) and costs related to the FME25 program (2021: €14 M). Balance sheet page 4 of 10 November 2, 2021 |
| Cash flow statement in € million, unaudited 2021 2020 2021 2020 Operating activities Net income 332 420 915 1,197 Depreciation / amortization / impairment loss 402 393 1,187 1,204 Change in working capital and other non-cash items (42) (67) (282) 1,248 Net cash provided by (used in) operating activities 692 746 1,820 3,649 In percent of revenue 15.6% 16.9% 14.0% 27.1% Investing activities Purchases of property, plant and equipment and capitalized development costs (194) (245) (588) (746) Proceeds from sale of property, plant and equipment 13 6 27 10 Capital expenditures, net (181) (239) (561) (736) Free cash flow 511 507 1,259 2,913 In percent of revenue 11.5% 11.5% 9.7% 21.6% Acquisitions and investments, net of cash acquired, and purchases of intangible assets (142) (76) (270) (155) Investments in debt securities 0 (2) (63) (30) Proceeds from divestitures 0 14 3 13 Proceeds from sale of debt securities 22 15 118 27 Free cash flow after investing activities 391 458 1,047 2,768 Cash flow page 5 of 10 November 2, 2021 Nine months ended September 30, Three months ended September 30, Cash flow page 5 of 10 November 2, 2021 |
| Revenue development in € million, unaudited 2021 2020 Change Change at cc Organic growth Three months ended September 30, Total revenue 4,441 4,414 0.6% 1.2% 0.9% Health Care Services 3,530 3,499 0.9% 1.7% 1.2% -2.4% Health Care Products 911 915 -0.3% -0.7% -0.4% North America 3,080 3,069 0.3% 0.9% 0.5% Health Care Services 2,810 2,801 0.3% 0.9% 0.4% -1.7% 2 Health Care Products 270 268 0.6% 1.1% 1.2% EMEA 671 682 -1.6% -1.7% -1.6% Health Care Services 346 346 0.0% -0.3% 0.1% -4.0% Health Care Products 325 336 -3.4% -3.2% -3.2% Asia-Pacific 501 484 3.6% 2.8% 2.3% Health Care Services 239 227 5.3% 6.9% 5.8% 3.4% Health Care Products 262 257 2.0% -0.8% -0.7% Latin America 178 170 4.6% 13.2% 12.2% Health Care Services 126 120 5.0% 16.2% 12.9% -5.2% Health Care Products 52 50 3.5% 6.0% 10.5% Corporate 11 9 35.1% 33.6% Health Care Services 9 5 53.1% 50.6% Health Care Products 2 4 5.7% 5.7% Nine months ended September 30, Total revenue 12,972 13,459 -3.6% 1.6% 1.2% Health Care Services 10,255 10,708 -4.2% 1.6% 1.0% -1.9% Health Care Products 2,717 2,751 -1.3% 1.7% 1.8% North America 8,931 9,495 -5.9% 0.0% -0.4% Health Care Services 8,148 8,660 -5.9% 0.0% -0.4% -2.0% 2 Health Care Products 783 835 -6.2% -0.3% -0.3% EMEA 2,033 2,048 -0.7% 0.6% 0.5% Health Care Services 1,020 1,028 -0.7% 0.7% 0.2% -3.5% Health Care Products 1,013 1,020 -0.7% 0.5% 0.7% Asia-Pacific 1,458 1,377 5.9% 7.8% 7.7% Health Care Services 694 641 8.3% 11.9% 11.5% 5.5% Health Care Products 764 736 3.8% 4.3% 4.4% Latin America 508 508 0.0% 15.6% 13.8% Health Care Services 364 360 1.1% 18.6% 16.2% -1.0% Health Care Products 144 148 -2.5% 8.1% 8.4% Corporate 42 31 32.4% 38.1% Health Care Services 29 19 52.7% 62.0% Health Care Products 13 12 0.9% 1.0% Same market treatment growth1 2 U.S. (excl. Mexico), same market treatment growth North America: -2.2% for the three months and -2.5% for the nine months ended September 30, 2021. 1 same market treatment growth = organic growth less price effects Revenue development page 6 of 10 November 2, 2021 |
| Key metrics Dialysis Care Services unaudited Clinics Growth in % De novos Patients Growth in % Treatments Growth in % Total 4,151 2% 61 344,872 -1% 39,510,028 -1% North America 2,683 2% 28 209,651 -1% 24,158,943 -2% EMEA 816 1% 17 65,336 -3% 7,384,018 -4% Asia-Pacific 406 2% 13 33,434 2% 3,559,846 3% Latin America 246 -2% 3 36,451 -2% 4,407,221 1% Nine months ended September 30, 2021 Key metrics page 7 of 10 November 2, 2021 |
| Quality data1 in % of patients Q3 2021 Q3 2020 Q3 2021 Q3 2020 Q3 2021 Q3 2020 Q3 2021 Q3 2020 Kt/V ≥ 1.2 97 97 93 93 94 91 94 94 Hemoglobin = 10-12 g/dl 71 71 81 82 48 46 51 52 Calcium = 8.4-10.2 mg/dl 83 80 80 77 74 74 70 71 Albumin ≥ 3.5 g/dl1) 81 79 89 90 90 89 88 90 Phosphate ≤ 5.5 mg/dl 57 58 78 79 76 75 67 64 Patients without catheter (after 90 days) 78 80 77 77 78 78 80 81 in days Days in hospital per patient year 9.8 9.6 7.9 7.2 4.0 4.0 4.2 3.1 1 Definitions cf. Annual Report 2020, Section "Non-Financial Group Report" EMEA North America Asia-Pacific Latin America Quality data page 8 of 10 November 2, 2021 |
| in € million, except share data, unaudited Results 2021 FME25 program Results 2021 excl. special items Results 2020 Change Change at cc Three months ended September 30, Total revenue 4,441 4,441 4,414 0.6% 1.2% EBITDA 907 5 912 1,025 -10.9% -10.4% Total operating income 505 5 510 632 -19.3% -18.6% North America 446 446 514 -13.3% -12.5% EMEA 79 79 99 -20.8% -20.7% Asia-Pacific 86 86 97 -11.0% -10.2% Latin America 4 4 11 -61.1% -61.9% Corporate (110) 5 (105) (89) 17.1% 17.4% Interest expense, net 68 68 88 -22.0% -22.1% Income tax expense 105 1 106 124 -14.4% -13.5% Net income attributable to noncontrolling interests 59 59 66 -12.2% -11.9% Net income1 273 4 277 354 -21.7% -20.8% Basic earnings per share €0.93 €0.01 €0.94 €1.21 -21.7% -20.8% Nine months ended September 30, Total revenue 12,972 12,972 13,459 -3.6% 1.6% EBITDA 2,590 14 2,604 3,047 -14.6% -10.2% Total operating income 1,403 14 1,417 1,843 -23.1% -19.1% North America 1,242 1,242 1,587 -21.7% -16.8% EMEA 232 232 278 -16.6% -16.3% Asia-Pacific 256 256 237 7.9% 10.4% Latin America 14 14 29 -53.1% -54.1% Corporate (341) 14 (327) (288) 13.2% 16.6% Interest expense, net 214 214 284 -24.7% -20.9% Income tax expense 274 4 278 362 -23.2% -19.2% Net income attributable to noncontrolling interests 174 174 210 -16.7% -11.5% Net income1 741 10 751 987 -24.0% -20.1% Basic earnings per share €2.53 €0.03 €2.56 €3.35 -23.6% -19.7% 1 Attributable to shareholders of FMC-AG & Co. KGaA Reconciliation of non-IFRS financial measures to the most directly comparable IFRS financial measures Results excl. special items Reconciliation results excl. special items page 9 of 10 November 2, 2021 |
| Outlook 2021 Spalte1 Results 2020 Outlook 2021 (at Constant Currency, except for ROIC) Revenue1 €17,859 M growth: low to mid single digit percentage rate Revenue growth at Constant Currency1 growth: low to mid single digit percentage rate Operating income1 €2,499 M decline: mid teens to low twenties percentage rate Net income1, 2 €1,359 M decline: high teens to mid twenties percentage rate Net income2 growth at Constant Currency1 decline: high teens to mid twenties percentage rate ROIC1,3 6.6% ≥ 5.0% 1 Outlook 2021 is inclusive of anticipated COVID-19 effects and excl. special items. Special items include costs related to the FME25 program and effects that are unusual in nature and have not been foreseeable or not foreseeable in size or impact at the time of giving guidance. The growth rates are based on the results 2020 excl. the Impairment Charge of goodwill and trade names in the Latin America Segment of €195 M. 3 Results 2020: excl. Impairment Charge. 2 Net income attributable to shareholders of FMC-AG & Co. KGaA. Outlook 2021 page 10 of 10 November 2, 2021 |
