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June 11

June 11, 2024
Miami, USA

Goldman Sachs 45th Annual Global Healthcare Conference

June 11 & 12, 2024

  • Vamed’s operations in Austria to be sold to an Austrian consortium of construction companies, Porr and Strabag.
  • Vamed’s hospital services unit to be transferred to the Fresenius Group. 
  • Vamed's international project business to gradually be scaled back in an orderly manner. Current project contracts are to be fulfilled.  
  • The exit from Vamed, including the announced divestment of the rehabilitation business, is a further milestone on the path to #FutureFresenius and completes the strategic portfolio restructuring.
  • Fresenius has significantly reduced its complexity and underlined its position as a leading therapy-focused company.

Following the announcement of the sale of Vamed’s rehabilitation business, the global healthcare group Fresenius has initiated a structured exit from its Investment Company Vamed. An Austrian consortium of construction companies Porr and Strabag has agreed to acquire Vamed’s activities in its Austrian home market for a total purchase price of 90 million Euros. The transaction includes Vamed’s entities responsible for the technical management of the Vienna General Hospital (AKH Wien), the Austrian project business that is part of Vamed’s Health Tech Engineering segment and shares in several spas throughout Austria. The planned transaction is subject to regulatory approvals and customary conditions.

Vamed’s High-End Services (HES) business unit, which provides services for Fresenius Helios and other hospitals, will be transferred to Fresenius. HES generates around half of its revenue through its provision of services to Helios hospitals. It offers facility and medical technology management for a total of more than 840 hospitals. HES is a stable business with good growth prospects and accounts for around 30% of Vamed's revenue. The profitability of HES is in the mid-single-digit percentage range.

The Health Tech Engineering segment, which is responsible for the international project business and accounts for around 15% of Vamed's revenue, will gradually be scaled back in an orderly manner. The process should largely be completed by 2026. Until then, the business will be reported as a special item outside Fresenius' core business. Current project contracts will be fulfilled. 

The divestments lead to non-cash special items of around € 0.6 billion. Due to the exit from the project business, a high triple-digit-million Euro amount of special items are expected, which are spread over the next few years and mostly cash effective.

As of Q2 2024, Vamed will no longer be a reporting segment of Fresenius. In addition to reducing complexity, this step is expected to improve the Group's profitability by more than 50 basis points. It will also reduce net debt and increase the Group's return on invested capital (ROIC). Last but not least, the transparency and quality of earnings will be significantly enhanced.  

“We have found a holistic and viable solution for the Vamed businesses, creating good prospects for the future. It is the best outcome for patients, for Vamed, and for Fresenius. With the exit from Vamed, our strategic portfolio restructuring has been completed as planned. Fresenius is already a simpler, stronger, and more innovative company due to the consistent implementation of #FutureFresenius. We now have even more opportunities to provide world-class therapies and improve people’s health,” said Fresenius CEO Michael Sen.

Dr. Michael Moser, the member of the Fresenius Management Board among others responsible for the Vamed business, added: “We are pleased that Vamed’s High-End Services business is joining Fresenius. We have found a very good solution for both the rehabilitation business with PAI and the Austrian project business with the Austrian owners Porr and Strabag. This enables us to create long-term growth opportunities. We are now looking for fair solutions for the employees affected by the gradual ramp-down of our project business outside of Austria.” 

After exiting Vamed, Fresenius will consist of the two Operating Companies Fresenius Kabi and Fresenius Helios (each with 100% ownership share) and the Investment Company Fresenius Medical Care (32% ownership share). 
 


This release contains forward-looking statements that are subject to various risks and uncertainties. Future results could differ materially from those described in these forward-looking statements due to certain factors, e.g. changes in business, economic and competitive conditions, regulatory reforms, results of clinical trials, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, the availability of financing and unforeseen impacts of international conflicts. 
Fresenius does not undertake any responsibility to update the forward-looking statements in this release.

  • Excellent start to 2024: Group outlook raised for FY/24 due to the excellent first quarter and a better than originally expected operating performance for the remainder of the financial year 2024: Group organic revenue growth 4 to 7%, EBIT growth in constant currency 6 to 10%.
  • Strategic portfolio measures concluded: Structured exit from Investment Company Vamed initiated.
  • Strong organic growth in Group revenue of 6%1 to € 5.7 billion in Q1/24; Group EBIT increase in constant currency by 15% to € 633 million reflects the excellent performance of Operating Companies and the group-wide cost savings progressing ahead of plan.
  • EPS increases: 11% in constant currency.
  • Strong operating cash flow development at Fresenius Kabi driven by working capital efficiencies; Fresenius Helios expects catch-up of outstanding receivables in Germany in the course of the year.
  • Fresenius Kabi shows excellent organic revenue growth of 9%1 and an improved EBIT margin at 15.1% in particular driven by the positive development of the Biopharma business.
  • Biopharma business picking up: EBIT break-even in Q1/24 driven by licensing business at mAbxience; Tyenne with good progress.
  • Fresenius Helios with solid organic revenue growth of 5%2 and EBIT margin of 11.1%; supported by phasing of energy related government relief funding in Germany and strong operating performance.

 1 Organic growth rate adjusted for the accounting effects related to Argentina hyperinflation.
 2 Organic growth rate adjusted for the divestment of the fertility services group Eugin and the hospital stake in Peru.


If no timeframe is specified, information refers to Q1/2024.

An overview of the results for Q1/2024 - before and after special items – is available on our website.
Following the deconsolidation of Fresenius Medical Care, Group financial figures are presented in accordance with IAS 28 (at equity method) since December 1, 2023. The proportionate share of 32% of Fresenius Medical Care is presented as a separate line in Fresenius Group’s P&L and balance sheet. Dividends received from Fresenius Medical Care will also be reported as a separate line as part of the cash flow statement. Moreover, IAS 28 requires a full purchase price allocation (PPA). The accounting for the PPA is treated as special item. For reasons of simplification and comparability, Fresenius presents net income with and without Fresenius Medical Care`s equity result.

Information on the performance indicators are available on our website at https://www.fresenius.com/alternative-performance-measures.

Consolidated results for Q1/24 as well as for Q1/24 include special items. These concern: revaluations of biosimilars contingent purchase price liabilities, expenses associated with the Fresenius cost and efficiency program, transaction costs for mAbxience and Ivenix, costs in relation to the change of legal form of Fresenius Medical Care, the transformation of Fresenius Vamed, legacy portfolio adjustments, special items at Fresenius Medical Care, and impact of PPA equity method Fresenius Medical Care. The special items shown within the reconciliation tables are reported in the Corporate/Other segment.

Growth rates of Fresenius Kabi and Fresenius Helios are adjusted. Adjustsments relate to the divestment of the fertility services group Eugin and the hospital stake in Peru at Fresenius Helios and Helios Spain as well as to hyperinflation in Argentina at Fresenius Kabi. Accordingly, growth rates of the Fresenius Group are also adjusted.
Conference call and Audio webcast
As part of the publication of the results for Q1/24, a conference call will be held on May 8, 2024 at 1:30 p.m. CET (7:30 a.m. EST). All investors are cordially invited to follow the conference call in a live audio webcast at https://www.fresenius.com/investors. Following the call, a replay will be available on our website.

 

Michael Sen, CEO of Fresenius: “Fresenius has made an excellent start into the year and our focus on Fresenius Kabi and Fresenius Helios is paying off. We are confident to maintain our growth momentum and raise our outlook for the full year. With the exit from Vamed, our strategic portfolio restructuring is completed as planned. Fresenius is already a simpler, stronger, and more innovative company due to the consistent implementation of #FutureFresenius. We now have even more opportunities to offer world-class therapies and improve people’s health.”

#FutureFresenius: Exit from Investment Company Vamed concludes strategic portfolio measures
The exit from the Investment Company Vamed completes the strategic portfolio restructuring as part of #FutureFresenius. The exit is carried out in three parts: 1) The already announced sale of 67 % of Vamed’s rehabilitation business to the private equity company PAI. Closing of this transaction is expected in the second half of 2024 2) Vamed’s operations in Austria to be sold to an Austrian consortium of the construction companies Porr and Strabag for a total purchase price of €90 million. 3) The Health Tech Engineering (HTE) segment, which is responsible for the international project business and accounts for around 15% of Vamed's revenue, will gradually be scaled back in an orderly manner. The process should largely be completed by 2026. Until then, the business will be reported as a special item outside Fresenius' core business. Current project contracts will be fulfilled.

Vamed’s High-End-Services (HES) which offers services for Fresenius Helios and other hospitals, will be transferred to Fresenius. HES is a stable business with good growth prospects and accounts for around 30% of Vamed's revenues. The profitability of HES is in the mid-single-digit percentage range.

The divestments of the rehabilitation business and the operations in Austria lead to non-cash special items of around €0.6 billion.

Due to the exit from the project business, a high triple-digit-million euro amount of special items are expected, which are spread over the next few years and mostly cash-effective.

As of Q2 2024, Vamed will no longer be a reporting segment of Fresenius. In addition to reducing complexity, this step is expected to improve the Group's profitability by more than 50 basis points. It will also reduce net debt and increase the Group's return on invested capital (ROIC). Last but not least, the transparency and quality of earnings will be significantly enhanced.

After exiting from Vamed, Fresenius will consist of the two Operating Companies Fresenius Kabi and Fresenius Helios (each with 100% ownership share) and the Investment Company Fresenius Medical Care (32% ownership share).

Cost savings program fully on track
The groupwide cost savings program progressed is fully on track. Under the program, Fresenius realized ~€25 million incremental structural cost savings at EBIT level in Q1/24. In the same period, one-time costs of ~€15 million incurred to achieve these savings.

Fresenius expects to achieve annual sustainable cost savings of ~€400 million at EBIT level by 2025. So far, Fresenius reached ~€305 million of cumulative structural cost savings. To reach this target, one-time costs between ~€80 and €100 million are anticipated between 2024 and 2025.

For 2024, total cost savings of ~€330 to €350 million are expected. This corresponds to incremental cost savings of ~€50 to €70 million in 2024 compared to 2023.

The programs continue to target all business segments and the Corporate Center. Key elements include measures to optimize sales and administrative costs, fostering digitalization as well as improve procurement processes.

 

Group sales and earnings development

Group revenue increased by 4% (6% in constant currency) to €5,704 million (Q1/23: €5,546 million). Organic growth was 6%1 driven by an ongoing strong performance of our Operating Companies. Currency translation had a negative effect of 2% on revenue growth.

In Q1/24, revenue of the Operating Companies increased by 5% (7% in constant currency) to €5,216 million (Q1/23: €5,039 million).

Group EBITDA before special items increased by 13% (13% in constant currency) to €924 million (Q1/232: €828 million).

Group EBIT before special items increased by 15% (15% in constant currency) to €633 million (Q1/232: €554 million) mainly driven by the good earnings development at the Operating Companies and the continued progress of the groupwide cost savings program. The EBIT margin before special items was 11.1% (Q1/231: 10.0%). Reported Group EBIT was €559 million (Q1/23: €526 million).

The Operating Companies showed an 9% increase of EBIT before special items (9% in constant currency) to €631 million (Q1/232: €581 million) with an EBIT margin of 12.1% (Q1/232: 11.5%).

1 Organic growth rate adjusted for the divestment of the fertility services group Eugin, the hospital stake in Peru, and accounting effects related to Argentina hyperinflation.
2 Before special items
3 Net income attributable to shareholders of Fresenius SE & Co. KGaA 

 

Group net interest before special items increased to -€115 million (Q1/231: -€87 million) mainly due to financing activities in a higher interest rate environment.

Group tax rate before special items was 24.5% (Q1/231: 24.4%).

Net income1 from deconsolidated Fresenius Medical Care operations before special items increased by 25% (33% in constant currency) to €60 million (Q1/232: €48 million).

Group net income2 before special items increased by 10% (11% in constant currency) to €429 million (Q1/232: €389 million). The increase was driven by the operating strength which outpaces higher interest.

Group net income1 before special items excluding Medical Care increased by 8% (8% in constant currency) to €369 million (Q1/232: €341 million).

Reported Group net income2 decreased to €278 million (Q1/232: €346 million).
Negative effects from the Purchase Price Allocation (PPA) and other negative special items at Fresenius Medical Care as well as the Vamed transformation had a negative impact on the Group net income income1.

Earnings per share2 before special items increased by 10% (11% in constant currency) to €0.76 (Q1/232: €0.69). Reported earnings per share2 were €0.49 (Q1/23: €0.61).

1 Before special items
2 Net income attributable to shareholders of Fresenius SE & Co. KGaA
For a detailed overview of special items please see the reconciliation tables at Financial Results.

 

Group Cash flow development
Group operating cash flow was €2 million (Q1/23: €32 million). The first quarter is usually the softest in the course of the year. In Q1/24 the soft operating cash flow was mainly driven by temporarily higher working capital, in particular due to nursing budget related receivables built ups at Helios Germany. Group operating cash flow margin was 0.0% (Q1/23: 0.6%). Free cash flow before acquisitions, dividends and lease liabilities decreased to -€194 million (Q1/23: -€180 million). Free cash flow after acquisitions, dividends and lease liabilities improved to -€103 million (Q1/23: -€258 million).

Fresenius Kabi’s operating cash flow increased to €157 million (Q1/23: €21 million) with a margin of 7.7% (Q1/23: 1.1%) mainly driven by an improved working capital management.

Fresenius Helios’ operating cash flow decreased to -€117 million (Q1/23: €108 million) and was impacted by higher working capital in particular driven by temporary nursing budget related receivables built-ups at Helios Germany. The operating cash flow margin was -3.7% (Q1/23: 3.5%).

Fresenius Vamed’s operating cash flow improved to -€10 million (Q1/23: -€68 million) with a margin of -1.8% (Q1/23: -11.7%).

The cash conversion rate (CCR), which is defined as the ratio of adjusted free cash flow1 to EBIT before special items was 1.0 in Q1/24 (LTM) (Q1/23: 0.9 LTM). This positive development is due to the increased cash flow focus across the Group.

1 Cash flow before acquisitions and dividends; before interest, tax, and special items

 

Group leverage
Group debt decreased by 8% (8% in constant currency) to €14,504 million (Dec. 31, 2023: € 15,830 million) mainly related to the repayment of debt. Group net debt increased by 2% (2% in constant currency) to € 13,485 million (Dec. 31, 2023: € 13,268 million) which is mainly related to the cash flow development at Fresenius Helios, particularly driven by temporary receivables built ups related to the nursing budget at Helios in Germany.

As of March 31, 2024, the net debt/EBITDA ratio was 3.75x1,2 (Dec. 31, 2023: 3.76x1,2), a further reduction compared to Q4/23 and mainly driven by the good EBITDA development. Compared to Q1/23 (3.96x1,2) this is a 21 bps reduction.

Fresenius expects the net debt/EBITDA3 ratio to be within the self-imposed corridor of 3.0 to 3.5x by the end of 2024. This is expected to be driven by reducing net debt and by the operational performance at the Operating Companies.

ROIC increased to 5.5% in Q1/24 (Q1/23: 5.2%) mainly due to the EBIT improvement. The Operating Companies improved ROIC to 5.8% (Q1/23: 5.5%).

1 At average exchange rates for both net debt and EBITDA; pro forma closed acquisitions/divestitures, including lease liabilities, including Fresenius Medical Care dividend
2 Before special items
3 At expected average exchange rates for both net debt and EBITDA; pro forma closed acquisitions/divestitures; excluding further potential acquisitions/divestitures; before special items; including lease liabilities, including Fresenius Medical Care dividend

For a detailed overview of special items please see the reconciliation tables at Financial Results.

 

Operating Company Fresenius Kabi

Revenue increased by 9% in constant currency (3% reported) to €2,051 million (Q1/23: €1,991 million). The reported revenue growth is mainly driven by negative currency translation effects related to the US dollar and the hyperinflation in Argentina. Organic growth was 9%1. This strong performance was driven in particular by the Biopharma business as well as by Nutrition.

Revenue of the Growth Vectors (MedTech, Nutrition and Biopharma) increased by 4% (14% in constant currency) to €1,089 million (Q1/23: €1,051 million). Organic growth was outstanding at 13%. In Nutrition, organic growth of 8% benefited from the good development in the US and was driven by many other international markets. Whereas China continued to be impacted by indirect effects of the government’s countrywide anti-corruption campaign and direct effects of the soft economy. Biopharma showed excellent organic growth of 117% driven by successful product launches in Europe and the US, as well as licensing agreements. MedTech showed organic growth of 1% given the high prior-year level.

1 Organic growth rate adjusted for accounting effects related to Argentina hyperinflation.
2 Before special items

Growth rates adjusted for Argentina hyperinflation.

 

Revenue in the Pharma (IV Drugs & Fluids) business increased by 2% (4% in constant currency; organic growth: 5%) and amounted to €962 million (Q1/23: €940 million). The solid organic growth was mainly driven by the positive development across many regions including the US.

EBIT1 of Fresenius Kabi increased by 7% (8% in constant currency) to €310 million (Q1/23: €289 million) mainly due to the good revenue development, the EBIT break-even result of the Biopharma business, and ongoing progress of the cost saving initiatives. EBIT margin1 was 15.1% (Q1/23: 14.5%) and thus within the structural EBIT margin band.

EBIT1 of the Growth Vectors increased by 29% (constant currency: 17%) to €124 million (Q1/23: €96 million) due to the EBIT break-even result of the Biopharma business and the good revenue development. EBIT1 margin was 11.4% (Q1/23: 9.2%).

EBIT1 in the Pharma business increased 4% (constant currency: 6%) to €206 million (Q1/23: €197 million) due to the very well-progressing cost saving initiatives and the good revenue development. EBIT1 margin was 21.4% (Q1/23: 21.0%).

1 Before special items

Growth rates adjusted for Argentina hyperinflation.

For a detailed overview of special items please see the reconciliation tables at Financial Results.

 

 

Operating Company Fresenius Helios

Revenue increased by 6% (5% in constant currency) to €3,184 million (Q1/23: €3,066 million). Organic growth was 5%.

Revenue of Helios Germany increased by 4% (in constant currency: 4%) to €1,903 million (Q1/23: €1,828 million), mainly driven by solid admissions numbers and favourable price effects. Organic growth was 4%.

Revenue of Helios Spain increased by 10% (8% in constant currency) to €1,281 million (Q1/23: €1,170 million) driven by ongoing strong activity levels and positive price effects. Organic growth was 7%1. The clinics in Latin America also showed a good performance.

EBIT2 of Fresenius Helios increased by 14% (14% in constant currency) to €353 million (Q1/23: €311 million) with an EBIT margin2 of 11.1% (Q1/23: 10.1%).

EBIT of Helios Germany increased by 32% to €205 million (Q1/23: €155 million) with an EBIT margin of 10.8% (Q1/23: 8.5%) in particular driven by the phasing of the Government relief funding for higher energy costs as well as the good revenue development and the progressing cost savings program.

1 Before special items

Growth rates adjusted for the divestment of the fertility services group Eugin and the hospital stake in Peru

For a detailed overview of special items please see the reconciliation tables at Financial Results.

 

EBIT1 of Helios Spain decreased by 6% (7% in constant currency) to €149 million (Q1/23: €157 million). EBIT1 was impacted by the phasing due to the calendar variation related to the Easter week and related lower activities and mix effects as well as a high prior-year level. Despite the Easter effect, the EBIT margin1 was 11.6% (Q1/23: 13.4%).

As part of the portfolio optimization, the sale of the fertility services group Eugin was completed on January 31, 2024. The divestment of the majority stake in the hospital Clínica Ricardo Palma hospital in Lima, Peru, was completed on April 23, 2024. The sale marks Fresenius’ exit from the Peruvian hospital market.

 

Fresenius Vamed
Further progress was made in Q1/24 with the far-reaching restructuring program to increase Fresenius Vamed’s profitability which was initiated in 2023.

Revenue from continued business was €514 million in Q1/24. Organic growth of the continued business increased 1% driven by the positive development of the Services business offsetting the negative effects of the Project business. Total revenue of Fresenius Vamed was €561 million (Q1/23: €583 million) and declined by 4% (-4% in constant currency).

EBIT1 was at €2 million in Q1/24 (Q1/231: -€27 million), thus showing a significant year-over-year improvement and making it the third consecutive quarter of positive EBIT. The EBIT margin1 in Q1/24 was 0.4% (Q1/231: -4.6%).

The ongoing transformation resulted in negative special items of €47 million in Q1/24 mainly related to cessation of activities, asset re-evaluations and restructuring costs resulting in write-downs and provisions. The negative special items were predominantly booked as non-cash items.

1 Before special items

Growth rates adjusted for the divestment of the fertility services group Eugin and the hospital stake in Peru

 

Group and segment outlook for 20241
Fresenius raises its outlook for FY/24 based on the excellent first quarter and improved prospects for the ramainder of the year.

For 2024, Group organic revenue growth2 is now expected to grow between 4% to 7% (previous: 3% to 6%). Group constant currency EBIT3,4 is expected to grow in the rage of 6% to 10% (previous: 4% to 8%).

Fresenius Kabi now expects organic revenue growth in a mid-to high-single-digit percentage range in 2024 (previous: mid-single-digit percentage range). The EBIT margin4 is now expected to be in a range of 15% to 16% (previously: around 15%) (structural margin band: 14% to 17%).

Fresenius Helios expects organic revenue to grow in a low to mid-single digit percentage range in 2024. The EBIT margin4 is expected to be within the structural margin band of 9% to 11%.

The adjustment of the Group outlook also reflects the fact that the forecast is now given without Fresenius Vamed, i.e. exclusively for the Operating Companies Fresenius Kabi and Fresenius Helios. Following the announcement of the planned divestment of Fresenius Vamed's rehabilitation business, Fresenius has initiated its structured exit from its Investment Company Fresenius Vamed.

1 For the prior-year basis please see table “Basis for Guidance for 2024”
2 2023 base: €20,307 million
3 2023 base: €2,266 million
4 Before special items

 

Basis for Guidance for 2024

 

 

 

This release contains forward-looking statements that are subject to various risks and uncertainties. Future results could differ materially from those described in these forward-looking statements due to certain factors, e.g. changes in business, economic and competitive conditions, regulatory reforms, results of clinical trials, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, the availability of financing and unforeseen impacts of international conflicts. Fresenius does not undertake any responsibility to update the forward-looking statements in this release.

  • Vamed’s operations in Austria to be sold to an Austrian consortium of construction companies, Porr and Strabag.
  • Vamed’s hospital services unit to be transferred to the Fresenius Group.
  • Vamed's international project business to gradually be scaled back in an orderly manner. Current project contracts are to be fulfilled.  
  • The exit from Vamed, including the announced divestment of the rehabilitation business, is a further milestone on the path to #FutureFresenius and completes the strategic portfolio restructuring.
  • Fresenius has significantly reduced its complexity and underlined its position as a leading therapy-focused company.


Following the announcement of the sale of Vamed’s rehabilitation business, the global healthcare group Fresenius has initiated a structured exit from its Investment Company Vamed. An Austrian consortium of construction companies Porr and Strabag has agreed to acquire Vamed’s activities in its Austrian home market for a total purchase price of 90 million Euros. The transaction includes Vamed’s entities responsible for the technical management of the Vienna General Hospital (AKH Wien), the Austrian project business that is part of Vamed’s Health Tech Engineering segment and shares in several spas throughout Austria. The planned transaction is subject to regulatory approvals and customary conditions.

Vamed’s High-End Services (HES) business unit, which provides services for Fresenius Helios and other hospitals, will be transferred to Fresenius. HES generates around half of its revenue through its provision of services to Helios hospitals. It offers facility and medical technology management for a total of more than 840 hospitals. HES is a stable business with good growth prospects and accounts for around 30% of Vamed's revenue. The profitability of HES is in the mid-single-digit percentage range.

The Health Tech Engineering segment, which is responsible for the international project business and accounts for around 15% of Vamed's revenue, will gradually be scaled back in an orderly manner. The process should largely be completed by 2026. Until then, the business will be reported as a special item outside Fresenius' core business. Current project contracts will be fulfilled.

The divestments lead to non-cash special items of around € 0.6 billion. Due to the exit from the project business, higher three-digit-million special items are expected, which are spread over the next few years and mostly cash relevant.

As of Q2 2024, Vamed will no longer be a reporting segment of Fresenius. In addition to reducing complexity, this step will improve the Group's profitability by more than 50 basis points. It will also reduce net debt and increase the Group's return on invested capital (ROIC). Last but not least, the transparency and quality of earnings will be significantly enhanced.  

“We have found a holistic and viable solution for the Vamed businesses, creating good prospects for the future. It is the best outcome for patients, for Vamed, and for Fresenius. With the exit from Vamed, our strategic portfolio restructuring has been completed as planned. Fresenius is already a simpler, stronger, and more innovative company due to the consistent implementation of #FutureFresenius. We now have even more opportunities to provide world-class therapies and improve people’s health,” said Fresenius CEO Michael Sen.

Dr. Michael Moser, the member of the Fresenius Management Board among others responsible for the Vamed business, added: “We are pleased that Vamed’s High-End Services business is joining Fresenius. We have found a very good solution for both the rehabilitation business with PAI and the Austrian project business with the Austrian owners Porr and Strabag. This enables us to create long-term growth opportunities. We are now looking for fair solutions for the employees affected by the gradual ramp-down of our project business outside of Austria.”

After exiting Vamed, Fresenius will consist of the two Operating Companies Fresenius Kabi and Fresenius Helios (each with 100% ownership share) and the Investment Company Fresenius Medical Care (32% ownership share).

 

This release contains forward-looking statements that are subject to various risks and uncertainties. Future results could differ materially from those described in these forward-looking statements due to certain factors, e.g. changes in business, economic and competitive conditions, regulatory reforms, results of clinical trials, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, the availability of financing and unforeseen impacts of international conflicts.
Fresenius does not undertake any responsibility to update the forward-looking statements in this release.

  • Excellent start to 2024 – Due to the excellent first quarter Group outlook raised for FY/24: Group organic revenue growth 4-7% and EBIT growth in constant currency 6-10% expected. 
  • Strategic portfolio measures concluded: Structured exit from Investment Company Vamed initiated.
  • Strong organic growth in Group revenue of 6%1 to € 5.7 billion in Q1/24; Group EBIT increase in constant currency by 15% to € 633 million reflects the excellent performance of Operating Companies and the group-wide cost savings progressing ahead of plan.
  • EPS increases: 11% in constant currency.
  • Strong operating cash flow development at Fresenius Kabi driven by working capital efficiencies; Fresenius Helios expects catch-up of outstanding receivables in Germany in the course of the year.
  • Fresenius Kabi shows excellent organic revenue growth of 9%2  and an improved EBIT margin at 15.1% in particular driven by the positive development of the Biopharma business.
  • Biopharma business picking up: EBIT break-even in Q1/24.
  • Fresenius Helios with solid organic revenue growth of 5%3 and EBIT margin of 11.1%; supported by phasing of energy related government relief funding in Germany and strong operating performance.

If no timeframe is specified, information refers to Q1/2024.

Michael Sen, CEO of Fresenius: “Fresenius has had an excellent start into the year, showing that our focus on Fresenius Kabi and Fresenius Helios is increasingly paying off. We are confident that we can maintain our growth momentum and are raising our outlook for the full year accordingly. With the exit from Vamed, our strategic portfolio restructuring has been completed as planned. Fresenius is already a simpler, stronger, and more innovative company due to the consistent implementation of #FutureFresenius. We now have even more opportunities to offer world-class therapies and improve people’s health.”

Organic growth rate adjusted for the divestment of the fertility services group Eugin, the hospital stake in Peru, and accounting effects related to Argentina hyperinflation
Organic growth rate adjusted for the accounting effects related to Argentina hyperinflation
Organic growth rate adjusted for the divestment of the fertility services group Eugin and the hospital stake in Peru.

An overview of the results for Q1/2024 - before and after special items – is available on our website.

Following the deconsolidation of Fresenius Medical Care, Group financial figures are presented in accordance with IAS 28 (at equity method) since December 1, 2023. The proportionate share of 32% of Fresenius Medical Care is presented as a separate line in Fresenius Group’s P&L and balance sheet. Dividends received from Fresenius Medical Care will also be reported as a separate line as part of the cash flow statement. Moreover, IAS 28 requires a full purchase price allocation (PPA). The accounting for the PPA is treated as special item. For reasons of simplification and comparability, Fresenius presents net income with and without Fresenius Medical Care`s equity result.

Information on the performance indicators are available on our website at https://www.fresenius.com/alternative-performance-measures

Consolidated results for Q1/24 as well as for Q1/24 include special items. These concern: revaluations of biosimilars contingent purchase price liabilities, expenses associated with the Fresenius cost and efficiency program, transaction costs for mAbxience and Ivenix, costs in relation to the change of legal form of Fresenius Medical Care, the transformation of Fresenius Vamed, legacy portfolio adjustments, special items at Fresenius Medical Care, and expenses PPA equity method Fresenius Medical Care. The special items shown within the reconciliation tables are reported in the Corporate/Other segment.

Analyst conference call and Audio webcast 
As part of the publication of the results for Q1/24, an analyst  conference call will be held on May 8, 2024 at 1:30 p.m. CET (7:30 a.m. EST). All investors are cordially invited to follow the conference call in a live audio webcast at https://www.fresenius.com/investors. Following the call, a replay will be available on our website.


Group sales and earnings development
Group revenue increased by 4% (6% in constant currency) to €5,704 million (Q1/23: €5,546 million). Organic growth was 6%1 driven by an ongoing strong performance of our Operating Companies. Currency translation had a negative effect of 2% on revenue growth. 

In Q1/24, revenue of the Operating Companies increased by 5% (7% in constant currency) to €5,216 million (Q1/23: €5,039 million). 

Group EBITDA before special items increased by 13% (13% in constant currency) to €924 million (Q1/232: €828 million). 

Group EBIT before special items increased by 15% (15% in constant currency) to €633 million (Q1/232: €554 million) mainly driven by the good earnings development at the Operating Companies and the continued progress of the groupwide cost savings program. The EBIT margin before special items was 11.1% (Q1/231: 10.0%). Reported Group EBIT was €559 million (Q1/23: €526 million).  

The Operating Companies showed an 9% increase of EBIT before special items (9% in constant currency) to €631 million (Q1/232: €581 million) with an EBIT margin of 12.1% (Q1/232: 11.5%). 

Group net interest before special items increased to -€115 million (Q1/232: -€87 million) mainly due to financing activities in a higher interest rate environment.

Group tax rate before special items was 24.5% (Q1/232: 24.4%). 

Net income2 from deconsolidated Fresenius Medical Care operations before special items increased by 25% (33% in constant currency) to €60 million (Q1/232: €48 million). 

Group net income3 before special items increased by 10% (11% in constant currency) to €429 million (Q1/231: €389 million). The increase was driven by the operating strength which outpaces higher interest. 

Organic growth rate adjusted for the divestment of the fertility services group Eugin, the hospital stake in Peru, and accounting effects related to Argentina hyperinflation.
Before special items
Net income attributable to shareholders of Fresenius SE & Co. KGaA.

Group net income1 before special items excluding Medical Care increased by 8% (8% in constant currency) to €369 million (Q1/232: €341 million).

Reported Group net income1 decreased to €278 million (Q1/231: €346 million) Negative effects from the Purchase Price Allocation (PPA) and other negative special items at Fresenius Medical Care as well as the Vamed transformation had a negative impact on the Group net income income1

Earnings per share1 before special items increased by 10% (11% in constant currency) to €0.76 (Q1/232: €0.69). Reported earnings per share1 were €0.49 (Q1/23: €0.61). 

Group Cash flow development 
Group operating cash flow was €2 million (Q1/23: €32 million). The first quarter is usually the softest in the course of the year. In Q1/24 the soft operating cash flow was mainly driven by temporarily higher working capital, in particular due to nursing budget related receivables built ups at Helios Germany. Group operating cash flow margin was 0.0% (Q1/23: 0.6%). Free cash flow before acquisitions, dividends and lease liabilities decreased to -€194 million (Q1/23: -€180 million). Free cash flow after acquisitions, dividends and lease liabilities improved to -€103 million (Q1/23: -€258 million). 

Fresenius Kabi’s operating cash flow increased to €157 million (Q1/23: €21 million) with a margin of 7.7% (Q1/23: 1.1%) mainly driven by an improved working capital management. 

Fresenius Helios’ operating cash flow decreased to -€117 million (Q1/23: €108 million) and was impacted by higher working capital in particular driven by temporary nursing budget related receivables built-ups at Helios Germany. The operating cash flow margin was -3.7% (Q1/23: 3.5%). 

Fresenius Vamed’s operating cash flow improved to -€10 million (Q1/23: -€68 million) with a margin of -1.8% (Q1/23: -11.7%).

Before special items
For a detailed overview of special items please see the reconciliation tables at Financial Results | FSE (fresenius.com)

The cash conversion rate (CCR), which is defined as the ratio of adjusted free cash flow1 to EBIT before special items was 1.0 in Q1/24 (LTM) (Q1/23: 0.9 LTM). This positive development is due to the increased cash flow focus across the Group.

Group leverage 
Group debt decreased by 8% (8% in constant currency) to €14,504 million 
(Dec. 31, 2023: € 15,830 million) mainly related to the repayment of debt. Group net debt increased by 2% (2% in constant currency) to € 13,485 million (Dec. 31, 2023: € 13,268 million) which is mainly related to the cash flow development at Fresenius Helios, particularly driven by temporary receivables built ups related to the nursing budget at Helios in Germany.

As of March 31, 2024, the net debt/EBITDA ratio was 3.75x2,3 (Dec. 31, 2023: 3.76x3,4), a further reduction compared to Q4/23 and mainly driven by the good EBITDA development. Compared to Q1/23 (3.96x2,3,4) this is a 21 bps reduction.

Fresenius expects the net debt/EBITDA4 ratio to be within the self-imposed corridor of 3.0 to 3.5x by the end of 2024. This is expected to be driven by reducing net debt and by the operational performance at the Operating Companies. 

ROIC increased to 5.5% in Q1/24 (Q1/23: 5.2%) mainly due to the EBIT improvement. The Operating Companies improved ROIC to 5.8% (Q1/23: 5.5%). 

Cash flow before acquisitions and dividends; before interest, tax, and special items
At average exchange rates for both net debt and EBITDA; pro forma closed acquisitions/divestitures, including lease liabilities, including Fresenius Medical Care dividend
Before special items
At expected average exchange rates for both net debt and EBITDA; pro forma closed acquisitions/divestitures; excluding further potential acquisitions/divestitures; before special items; including lease liabilities, including Fresenius Medical Care dividend

For a detailed overview of special items please see the reconciliation tables at Financial Results | FSE (fresenius.com)

Cost savings program fully on track 
The groupwide cost savings program progressed is fully on track. Under the program, Fresenius realized ~€25 million incremental structural cost savings at EBIT level in Q1/24. In the same period, one-time costs of ~€15 million incurred to achieve these savings. 

Fresenius expects to achieve annual sustainable cost savings of ~€400 million at EBIT level by 2025. So far, Fresenius reached ~€305 million of cumulative structural cost savings. To reach this target, one-time costs between ~€80 and €100 million are anticipated between 2024 and 2025. 

For 2024, total cost savings of ~€330 to €350 million are expected. This corresponds to incremental cost savings of ~€50 to €70 million in 2024 compared to 2023. 

The programs continue to target all business segments and the Corporate Center. Key elements include measures to optimize sales and administrative costs, fostering digitalization as well as improve procurement processes.

Operating Company Fresenius Kabi 
Revenue increased by 9% in constant currency (3% reported) to €2,051 million (Q1/23: €1,991 million). The reported revenue growth is mainly driven by negative currency translation effects related to the US dollar and the hyperinflation in Argentina. Organic growth was 9%1. This strong performance was driven in particular by the Biopharma business as well as by Nutrition. 

Revenue of the Growth Vectors (MedTech, Nutrition and Biopharma) increased by 4% (14% in constant currency) to €1,089 million (Q1/23: €1,051 million). Organic growth was outstanding at 13%. In Nutrition, organic growth of 8% benefited from the good development in the US and was driven by many other international markets. Whereas China continued to be impacted by indirect effects of the government’s countrywide anti-corruption campaign and direct effects of the soft economy. Biopharma showed excellent organic growth of 117% driven by successful product launches in Europe and the US, as well as licensing agreements. MedTech showed organic growth of 1% given the high prior-year level. 

Revenue in the Pharma (IV Drugs & Fluids) business increased by 2% (4% in constant currency; organic growth: 5%) and amounted to €962 million (Q1/23: €940 million). The solid organic growth was mainly driven by the positive development across many regions including the US.

Organic growth rate adjusted for accounting effects related to Argentina hyperinflation.

EBIT1 of Fresenius Kabi increased by 7% (8% in constant currency) to €310 million (Q1/23: €289 million) mainly due to the good revenue development, the EBIT break-even result of the Biopharma business, and ongoing progress of the cost saving initiatives. EBIT margin1 was 15.1% (Q1/23: 14.5%) and thus within the structural EBIT margin band. 

EBIT1 of the Growth Vectors increased by 29% (constant currency: 17%) to €124 million (Q1/23: €96 million) due to the EBIT break-even result of the Biopharma business and the good revenue development. EBIT1 margin was 11.4% (Q1/23: 9.2%). 

EBIT1 in the Pharma business increased 4% (constant currency: 6%) to €206 million (Q1/23: €197 million) due to the very well-progressing cost saving initiatives and the good revenue development. EBIT1 margin was 21.4% (Q1/23: 21.0%). 

Operating Company Fresenius Helios
Revenue increased by 6% (5% in constant currency) to €3,184 million (Q1/23: €3,066 million). Organic growth was 5%. 

Revenue of Helios Germany increased by 4% (in constant currency: 4%) to €1,903 million (Q1/23: €1,828 million), mainly driven by solid admissions numbers and favourable price effects. Organic growth was 4%.

Revenue of Helios Spain increased by 10% (8% in constant currency) to €1,281 million (Q1/23: €1,170 million) driven by ongoing strong activity levels and positive price effects. Organic growth was 7%2. The clinics in Latin America also showed a good performance. 

Before special items
Growth rates adjusted for Argentina hyperinflation

For a detailed overview of special items please see the reconciliation tables at Financial Results | FSE (fresenius.com)
EBIT1 of Fresenius Helios increased by 14% (14% in constant currency) to €353 million (Q1/23: €311 million) with an EBIT margin2 of 11.1% (Q1/23: 10.1%). 

EBIT of Helios Germany increased by 32% to €205 million (Q1/23: €155 million) with an EBIT margin of 10.8% (Q1/23: 8.5%) in particular driven by the phasing of the Government relief funding for higher energy costs as well as the good revenue development and the progressing cost savings program.

EBIT1 of Helios Spain decreased by 6% (7% in constant currency) to €149 million (Q1/23: €157 million). EBIT1 was impacted by the phasing due to the calendar variation related to the Easter week and related lower activities and mix effects as well as a high prior-year level. Despite the Easter effect, the EBIT margin1 was 11.6% (Q1/23: 13.4%).

As part of the portfolio optimization, the sale of the fertility services group Eugin was completed on January 31, 2024. The divestment of the majority stake in the hospital Clínica Ricardo Palma hospital in Lima, Peru, was completed on April 23, 2024. The sale marks Fresenius’ exit from the Peruvian hospital market.

Fresenius Vamed 
Further progress was made in Q1/24 with the far-reaching restructuring program to increase Fresenius Vamed’s profitability which was initiated in 2023. 

Revenue from continued business was €514 million in Q1/24. Organic growth of the continued business increased 1% driven by the positive development of the Services business offsetting the negative effects of the Project business. Total revenue of Fresenius Vamed was €561 million (Q1/23: €583 million) and declined by 4% (-4% in constant currency). 

EBIT2 was at €2 million in Q1/24 (Q1/232: -€27 million), thus showing a significant year-over-year improvement and making it the third consecutive quarter of positive EBIT. The EBIT margin2 in Q1/24 was 0.4% (Q1/232: -4.6%).

Growth rates adjusted for the divestment of the fertility services group Eugin and the hospital stake in Peru.

For a detailed overview of special items please see the reconciliation tables at Financial Results | FSE (fresenius.com)
Before special items

The ongoing transformation resulted in negative special items of €47 million in Q1/24 mainly related to cessation of activities, asset re-evaluations and restructuring costs resulting in write-downs and provisions. The negative special items were predominantly booked as non-cash items. 

Following the exit from Vamed, the company will no longer be a reporting segment of Fresenius as of Q2 2024.

Group and segment outlook for 20241 
Fresenius raises its outlook for FY/24 based on the excellent first quarter and improved prospects for the ramainder of the year.

For 2024, Group organic revenue2 is now expected to grow between 4% to 7% (previous: 3% to 6%). Group constant currency EBIT1,3  is expected to grow in the rage of 6% to 10% (previous: 4% to 8%). 

Fresenius Kabi now expects organic revenue growth in a mid-to high-single-digit percentage range in 2024 (previous: mid-single-digit percentage range). The EBIT margin1 is now expected to be in a range of 15% to 16% (previously: around 15%) (structural margin band: 14% to 17%). 

Fresenius Helios expects organic revenue to grow in a low to mid-single digit percentage range in 2024. The EBIT margin1 is expected to be within the structural margin band of 9% to 11%. 

The adjustment of the Group outlook also reflects the fact that the outlook is now provided without Fresenius Vamed, i.e. only for the Operating Companies Fresenius Kabi and Fresenius Helios. Following the announcement of the planned sale of Fresenius Vamed's rehabilitation business, Fresenius has initiated its structured exit from its Investment Company Fresenius Vamed.

For the prior-year basis please see table “Basis for Guidance for 2024” 
2023 base: €20,307 million
2023 base: €2,266 million

 

This release contains forward-looking statements that are subject to various risks and uncertainties. Future results could differ materially from those described in these forward-looking statements due to certain factors, e.g. changes in business, economic and competitive conditions, regulatory reforms, results of clinical trials, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, the availability of financing and unforeseen impacts of international conflicts. 
Fresenius does not undertake any responsibility to update the forward-looking statements in this release.

Contact

Timo Lindemann

T +49 (0) 6172 608-7939
timo.lindemann@fresenius.com

  • PAI Partners ("PAI") to acquire controlling majority of 67 percent, Fresenius to retain 33 percent to participate in future upsides
  • Fresenius continues to drive its portfolio optimization – further momentum in #FutureFresenius
  • Sharpened focus on Operating Companies Fresenius Helios and Fresenius Kabi to drive growth
  • Closing expected in the second half of the year

 

The global healthcare group Fresenius is continuing to drive its portfolio optimization. The company has reached an agreement with PAI for the sale of the majority of Vamed’s rehabilitation business. Upon completion of the transaction, PAI will become the majority owner of the new company with 67 percent, while Fresenius will retain 33 percent. The rehabilitation business comprises 67 facilities with 9,100 beds and around 9,500 employees (FTE) across Germany, Austria, Switzerland, the Czech Republic, and the UK. It has an enterprise value of €853 million. In 2023, it generated revenues of approximately €1 billion and was profitable. Closing is expected in the second half of 2024, subject to regulatory approval and the customary closing conditions. Approval of the transaction by a Vamed General Meeting where Fresenius holds a requisite 77 percent majority is expected shortly. The transaction follows last year’s announcement to focus on the Operating Companies Fresenius Kabi and Fresenius Helios.

“Building on the encouraging momentum of #FutureFresenius, the divestment is another milestone in our portfolio optimization. The rehabilitation franchise is a perfect fit for the new owner and will ensure the continuity of the business. For Fresenius it will reduce complexity and free up management capacity to further focus on our core and driving growth. Our full dedication at Fresenius is to advancing patient care globally,” said Michael Sen, CEO of Fresenius.

The rehabilitation business is Vamed’s largest business unit and offers a comprehensive range of healthcare services outside of Fresenius’ core focus areas. The business has strong competitive positions, but significant capex and management focus is required to realize its full value potential. As a stand-alone business and benefitting from PAI’s vast expertise in managing complex assets, the new company will be well positioned to meet the needs of its patients even better.

PAI is an international private equity firm that invests in market-leading companies globally. It has an extensive investment track record in the healthcare sector including DomusVi, a leading player in the European residential elderly care sector.

The announced transaction is integral to the ongoing realignment of Fresenius Vamed’s distinct businesses. Fresenius initiated an in-depth analysis of Vamed’s business model, its governance and relevant processes in 2023. At the same time, a comprehensive and far-reaching restructuring program was initiated with the clear goal of increasing Vamed’s profitability.

UBS is acting as financial advisor and Latham & Watkins is serving as legal advisor to Fresenius.

This release contains forward-looking statements that are subject to various risks and uncertainties. Future results could differ materially from those described in these forward-looking statements due to certain factors, e.g. changes in business, economic and competitive conditions, regulatory reforms, results of clinical trials, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, the availability of financing and unforeseen impacts of international conflicts.
Fresenius does not undertake any responsibility to update the forward-looking statements in this release.

  • PAI Partners ("PAI") to acquire controlling majority of 67 percent, Fresenius to retain 33 percent to participate in future upsides
  • Fresenius continues to drive its portfolio optimization – further momentum in #FutureFresenius
  • Sharpened focus on Operating Companies Fresenius Helios and Fresenius Kabi to drive growth
  • Closing expected in the second half of the year

The global healthcare group Fresenius is continuing to drive its portfolio optimization. The company has reached an agreement with PAI for the sale of the majority of Vamed’s rehabilitation business. Upon completion of the transaction, PAI will become the majority owner of the new company with 67 percent, while Fresenius will retain 33 percent. The rehabilitation business comprises 67 facilities with 9,100 beds and around 9,500 employees (FTE) across Germany, Austria, Switzerland, the Czech Republic, and the UK. It has an enterprise value of €853 million. In 2023, it generated revenues of approximately €1 billion and was profitable. Closing is expected in the second half of 2024, subject to regulatory approval and the customary closing conditions. Approval of the transaction by a Vamed General Meeting where Fresenius holds a requisite 77 percent majority is expected shortly. The transaction follows last year’s announcement to focus on the Operating Companies Fresenius Kabi and Fresenius Helios.

“Building on the encouraging momentum of #FutureFresenius, the divestment is another milestone in our portfolio optimization. The rehabilitation franchise is a perfect fit for the new owner and will ensure the continuity of the business. For Fresenius it will reduce complexity and free up management capacity to further focus on our core and driving growth. Our full dedication at Fresenius is to advancing patient care globally,” said Michael Sen, CEO of Fresenius.

The rehabilitation business is Vamed’s largest business unit and offers a comprehensive range of healthcare services outside of Fresenius’ core focus areas. The business has strong competitive positions, but significant capex and management focus is required to realize its full value potential. As a stand-alone business and benefitting from PAI’s vast expertise in managing complex assets, the new company will be well positioned to meet the needs of its patients even better. 

PAI is an international private equity firm that invests in market-leading companies globally. It has an extensive investment track record in the healthcare sector including DomusVi, a leading player in the European residential elderly care sector. 

The announced transaction is integral to the ongoing realignment of Fresenius Vamed’s distinct businesses. Fresenius initiated an in-depth analysis of Vamed’s business model, its governance and relevant processes in 2023. At the same time, a comprehensive and far-reaching restructuring program was initiated with the clear goal of increasing Vamed’s profitability. 

UBS is acting as financial advisor and Latham & Watkins is serving as legal advisor to Fresenius.
 

This release contains forward-looking statements that are subject to various risks and uncertainties. Future results could differ materially from those described in these forward-looking statements due to certain factors, e.g. changes in business, economic and competitive conditions, regulatory reforms, results of clinical trials, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, the availability of financing and unforeseen impacts of international conflicts. Fresenius does not undertake any responsibility to update the forward-looking statements in this release.
 

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