General and mid-term outlook

The outlook for the Fresenius Group for the coming years continues to be positive. We are continuously striving to optimize our costs, to adjust our capacities so as to be able to treat patients and supply customers reliably, and to improve our product mix. We expect these efforts to improve our earnings. In addition, good growth opportunities for Fresenius are above all presented by the following factors:

  • The sustained growth of the markets in which we operate: Fresenius sees very good opportunities to profit from the considerable health care needs due to aging populations and technical advances, but driven also by the still insufficient access to health care in the developing and emerging countries. There are above-average and sustained growth opportunities for us not only in the markets of Asia and Latin America, but also in Eastern Europe. Appropriate reimbursement structures and efficient health care systems will evolve over time in these countries as economic conditions improve. We will strengthen our local business activities in these regions and successively introduce further products from our portfolio to these markets.
  • The development of innovative products and therapies: these will create the potential to further expand our market position in the regions. In addition to innovation, best-in-class quality, reliability, and convenience of our products and therapies are key to being able to exploit opportunities for expansion. Although the research is still in its infancy, the development of portable artificial kidneys is conceivable in the long term at Fresenius Medical Care, for instance.
  • The expansion of our regional presence: the fast-growing markets in Asia-Pacific and Latin America especially offer further potential for increasing our market shares. China, for instance, which has the world’s biggest population, offers excellent growth opportunities not only in clinical nutrition and infusion therapies for Fresenius Kabi, which already holds a leading market position in China, but also for Fresenius Medical Care in dialysis.

    We also plan to successively roll out products and therapies from our existing portfolio in countries where we do not yet offer a comprehensive range. The acquisition of APP Pharmaceuticals in the Fresenius Kabi business segment, for instance, will enable us to introduce infusion and nutrition therapy products to the US market and also APP Pharmaceutical’s products through Fresenius’ international marketing and sales network in future.
  • The broadening of our services business: Fresenius Helios has concrete opportunities in the German hospital market to profit from the further privatization of public hospitals. Changes in the law could present new opportunities, for instance, for Fresenius Medical Care. Since Japan is one of the world’s biggest dialysis markets, changes in the framework conditions for the operation of dialysis clinics for private commercial enterprises there could open up new revenue potential for Fresenius Medical Care.
  • Selective acquisitions: besides good organic growth, we will continue to utilize opportunities to grow by making small and mid-sized acquisitions that extend our product portfolio and strengthen our regional presence.

We are also exploiting any opportunities for tapping potential within our operations for cost management and efficiency and profitability enhancement measures. These include plans for a further optimized procurement process and cost-efficient production.

Acquisitions, primarily the acquisition of APP Pharmaceuticals, have led to appreciably higher Group debt with a corresponding impact on net interest. Our goal is therefore to further improve the Group’s leverage ratios. As of December 31, 2009, the net debt / EBITDA ratio was 3.0. We expect to achieve < 3.0 by the end of 2010. This forecast takes account of all events known at the time the annual financial statements were prepared that could influence our operating performance in 2010 and beyond. Significant risks are discussed in the Risk Report. As in the past, we will do our utmost to achieve and – if possible – exceed our targets.

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