Fresenius Kabi is launching its first biosimilar in Germany following the European Commission (EC) granting marketing authorization for IDACIO® for all indications of the reference medicine in the areas of rheumatology, gastroenterology and dermatology.

Fresenius Kabi is launching its first biosimilar in Germany following the European Commission (EC) granting marketing authorization for IDACIO® for all indications of the reference medicine in the areas of rheumatology, gastroenterology and dermatology.

• Fresenius Kabi with continued good growth in Q1/19
• Helios Germany stabilized; Helios Spain with continued dynamic growth
• Fresenius Medical Care with strong financial performance supported by agreements that materialized earlier than planned
• Growth investments on track
• Group guidance confirmed despite expected earnings dilution from NxStage

¹ Adjusted for IFRS 16 effect
² Q1/18 adjusted for divestitures of Care Coordination activities at FMC
³ Net income attributable to shareholders of Fresenius SE & Co. KGaA

Stephan Sturm, CEO of Fresenius, said: “We have made a successful start into 2019. All four Fresenius business segments have developed in line with our expectations, putting us well on course to meet our targets for the year. High-quality, yet affordable healthcare for ever more patients worldwide is our commitment. Consistent organic growth and major investments into key growth areas continue to reinforce our delivery of that commitment. Those strong foundations will also ensure the long-term success of our business.”

Group guidance for 2019 confirmed
After closing the NxStage acquisition on February 21, the related sales and earnings contributions are now included in the Group guidance. Despite the expected earnings dilution from NxStage, Fresenius confirms its FY/19 guidance. Fresenius projects sales growth¹ of 3% to 6% in constant currency. Net income^2,3 growth is expected to be ~0% in constant currency.
Including the NxStage acquisition which is increasing the net debt/EBITDA ratio in 2019 by ~30 basis points and excluding IFRS 16, Fresenius now expects year-end 2019 net debt/EBITDA ratio  to be at the upper-end of the original self-imposed target corridor of 2.5 to 3.0x.
Due to the adoption of the IFRS 16 accounting standard (“IFRS 16 effect”), Fresenius increases its self-imposed target corridor of 2.5x to 3.0x net debt/EBITDA to 3.0x to 3.5x.

¹ On a comparable basis: FY/18 base: €33,009 million; FY/18 adjusted for divestitures of Care Coordination activities at FMC (H1/18); FY/19: adjusted for IFRS 16 effect
² Net income attributable to shareholders of Fresenius SE & Co. KGaA
³ On a comparable basis: FY/18 base: €1,872 million; FY/18 before special items and adjusted for divestitures of Care Coordination activities at FMC (H1/18); FY/19: before special items (transaction-related expenses, expenses associated with the cost optimization program at FMC, revaluations of biosimilars contingent liabilities); adjusted for IFRS 16 effect
⁴ Both net debt and EBITDA calculated at expected annual average exchange rates; excluding further potential acquisitions

5% sales growth¹ in constant currency
Group sales were €8,495 million including an IFRS 16 effect of -€22 million. Group sales1 on a comparable basis increased by 8% (5% in constant currency) to €8,517 million (Q1/18: €7,870 million). Organic sales growth was 5%. Acquisitions/divestitures contributed net 0% to growth. Positive currency translation effects of 3% were mainly driven by the appreciation of the U.S. dollar against the euro.

Group sales by region:

¹ On a comparable basis: Q1/18 adjusted for divestitures of Care Coordination activities at FMC; Q1/19 adjusted for IFRS 16 effect

Net income^1,2 growth flat in constant currency
Group EBITDA before special items was €1,701 million including an IFRS 16 effect of €220 million. Group EBITDA² on a comparable basis increased by 6% (3% in constant currency) to €1,481 million (Q1/18: €1,394 million).

Group EBIT before special items was €1,130 million including an IFRS 16 effect of €19 million. Group EBIT² on a comparable basis increased by 6% (2% in constant currency) to €1,111 million (Q1/18: €1,050 million). The EBIT margin² on a comparable basis was 13.0% (Q1/18: 13.3%). Reported Group EBIT  was €1,115 million.

Group net interest before special items was -€181 million including an IFRS 16 effect of -€48 million. On a comparable basis, net interest² improved to -€133 million (Q1/18: -€139 million) mainly due to lower rates for refinancing activities. Reported Group net interest was -€184 million.

Group tax rate before special items and adopting IFRS 16 was 23.3%. Group tax rate² on a comparable basis was 23.4% (Q1/18: 20.9%). The prior-year was positively influenced by one-time effects related to the adoption of the U.S. tax reform.

Noncontrolling interest before special items was €271 million including an IFRS 16 effect of €13 million. Noncontrolling interest² on a comparable basis was €284 million (Q1/18: €270 million), of which 94% was attributable to the noncontrolling interest in Fresenius Medical Care.

Group net income¹ before special items was €457 million including an IFRS 16 effect of -€8 million. Group net income^1,2 on a comparable basis increased by 3% (0% in constant currency) to €465 million (Q1/18: €451million). Reported Group net income^1,3 was €453 million.
Earnings per share¹ before special items was €0.82 including an IFRS 16 effect of -€0.02.

Earnings per share¹ before special items was €0.82 including an IFRS 16 effect of -€0.02. Earnings per share^1,2 on a comparable basis increased by 3% (0% in constant currency) to €0.84 (Q1/18: €0.81). Reported Earnings per share^1,3 was €0.81.

¹ Net income attributable to shareholders of Fresenius SE & Co. KGaA
² On a comparable basis: Q1/19 before special items and adjusted for IFRS 16 effect; Q1/18 adjusted for divestitures of Care Coordination activities at FMC
³ After special items and including IFRS 16 effect

Continued investment in growth
2019 is an investment year for the Fresenius Group. Fresenius is making good progress in all of its investment initiatives to secure long-term sustainable growth. Spending on property, plant and equipment was €441 million (Q1/18: €380 million), primarily for the modernization and expansion of dialysis clinics, production facilities as well as hospitals and day clinics. This corresponds to 5% of sales.

Total acquisition spending was €1,923 million (Q1/18: €192 million), mainly for the acquisition of NxStage.

Cash flow development
Group operating cash flow was €289 million including an IFRS 16 effect of €171 million. On a comparable basis, Group operating cash flow was €118 million (Q1/18: €236 million) with a margin of 1.4% (Q1/18: 2.9%). After a strong Q4/18, operating cash flow was impacted by working capital changes at Fresenius Kabi, for example by some phasing of payments and stockbuild to prepare for a possible Brexit. Moreover, as in previous years’ first quarters, operating cash flow was influenced by the seasonality in invoicing at Fresenius Medical Care North America. Fresenius does not expect these temporary effects to have a significant impact on FY/19 cash flow.

Given the effects described above in combination with increasing investments, free cash flow before acquisitions and dividends adjusted for IFRS 16 was -€339 million (Q1/18: - €155 million). Free cash flow after acquisitions and dividends adjusted for IFRS 16 was -€2,282 million (Q1/18: -€389 million). The IFRS 16 effect amounts to €171 million respectively. Correspondingly, cash flow from financing activities declined by €171 million.

Solid balance sheet structure
The Group’s total assets were €64,985 million including an IFRS 16 effect of €5,669 million. Adjusted for IFRS 16, Group total assets¹ increased by 5% (3% in constant currency) to €59,316 million (Dec. 31, 2018: €56,703 million). Current assets¹ grew by 1% (0% in constant currency) to €14,958 million (Dec. 31, 2018: €14,790 million). Non-current assets¹ increased by 6% (5% in constant currency) to €44,358 million (Dec. 31, 2018: € 41,913 million).

Total shareholders’ equity was €25,830 million including an IFRS 16 effect of -€167 million. Adjusted for IFRS 16, total shareholders’ equity¹ increased by 4% (2% in constant currency) to €25,997 million (Dec. 31, 2018: €25,008 million). The equity ratio was 39.7%. Adjusted for IFRS 16, the equity ratio was 43.8% (Dec. 31, 2018: 44.1%).

Group debt was €26,378 million including an IFRS 16 effect of €5,836 million. Adjusted for IFRS 16, Group debt¹  increased by 8% to €20,542 million (8% in constant currency) (Dec. 31, 2018: € 18,984 million). Group net debt was €24,835 million including an IFRS 16 effect of €5,836 million. Adjusted for IFRS 16, Group net debt¹ increased by 17% (16% in constant currency) to € 18,999 million (Dec. 31, 2018: € 16,275 million) mainly due to the acquisition of NxStage by Fresenius Medical Care and the negative free cash flow.

As of March 31, 2019, the net debt/EBITDA ratio increased to 3.09^1,2,3 (December 31, 2018: 2.712,3). Excluding the acquisition of NxStage the net debt/EBITDA ratio was 2.83^1,2,3 as of March 31, 2019. Including the IFRS 16 effect, the reported net debt/EBITDA ratio increased to 3.53^2,3.

¹ Adjusted for IFRS 16 effect
² At LTM average exchange rates for both net debt and EBITDA; pro forma closed acquisitions/divestitures
³ Before special items

Increased number of employees
As of March 31, 2019, the number of employees was 283,795 (Dec. 31, 2018: 276,750).

Business Segments

Fresenius Medical Care (Figures according to Fresenius Medical Care Investor News)
Fresenius Medical Care is the world's largest provider of products and services for individuals with renal diseases. As of March 31, 2019, Fresenius Medical Care was treating 336,716 patients in 3,971 dialysis clinics. Along with its core business, the company provides related medical services in the field of Care Coordination.

 

• 6% sales^1,2  growth in constant currency
• Earnings supported by agreements that materialized earlier than planned
• Outlook confirmed

Adjusted for the Q1/18 contribution from the divested Care Coordination activities, the effect of the adoption of the IFRS 16 accounting standard (“IFRS 16 effect”) and the contribution from NxStage, sales increased by 11% (6% at constant currency) to €4,125 million (Q1/18: €3,725 million). Organic sales growth was 6%. Positive currency translation effects of 5% were mainly related to the appreciation of the U.S. dollar against the euro.

Health Care Services sales^1,2 increased by 12% (6% at constant currency) to €3,316 million (Q1/18: €2,958 million). Health Care Products sales^1,2 increased by 5% (4% at constant currency) to €809 million (Q1/18: €767 million).

In North America, sales^1,2 increased by 14% (5% in constant currency) to €2,879 million (Q1/18: €2,523 million). Health Care Services sales^1,2 increased by 14% (6% in constant currency) to €2,679 million (Q1/18: €2,339 million).

¹ On an adjusted basis: before expenses associated with the cost optimization program, the IFRS 16 effect, excluding effects from NxStage transaction
² Q1/18 adjusted for divestitures of Care Coordination activities
³ Net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA

Sales² outside North America increased by 4% (6% in constant currency) to €1,246 million (Q1/18: €1,202 million). Health Care Services sales² increased by 3% (8% in constant currency) to €637 million (Q1/18: €619 million). Health Care Product sales² adjusted increased by 4% (5% in constant currency) to €609 million (Q1/18: €583 million).

Fresenius Medical Care’s EBIT³ increased by 9% (4% in constant currency) to €551 million (Q1/18: €506 million). The EBIT margin3 decreased to 13.4% (Q1/18: 13.6%).

Net income^1,3 increased by 8% (3% in constant currency) to €318 million (Q1/18: €296 million).

Operating cash flow was €76 million (Q1/18: -€45 million) with a margin of 1.8% (Q1/18: -1.1%). The increase was mainly driven by the adoption of the IFRS 16 accounting standard leading to a reclassification of the repayment portion of rent to financing activities (€141 million). Adjusted for the IFRS 16 effect, operating cash flow was -€65 million.

For FY/19, Fresenius Medical Care expects adjusted sales to grow by 3% to 7% ,6 in constant currency. Net income1 is expected to develop in the range of -2% to +2% ,7 in constant currency.

For further information, please see Fresenius Medical Care’s Investor News at www.freseniusmedicalcare.com.

¹ Net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA
² Q1/18 adjusted for divestitures of Care Coordination activities; Q1/19 adjusted for IFRS 16 effects, excluding effects from NxStage transaction
³ Q1/18 before special items and after adjustments; Q1/19 before special items (before transaction-related expenses, expenses associated with the cost optimization program), adjusted for IFRS 16 effect, excluding effects from NxStage transaction
⁴ Before special items (operating cash flow after special items)
⁵ Adjusted for IFRS 16 effect
⁶ FY/18 base: €16,026 million
⁷ FY/18 base: €1,341 million

Fresenius Kabi
Fresenius Kabi offers intravenously administered generic drugs, clinical nutrition and infusion therapies for seriously and chronically ill patients in the hospital and outpatient environments. The company is also a leading supplier of medical devices and transfusion technology products. In the biosimilars business, Fresenius Kabi develops products with a focus on oncology and autoimmune diseases.

 

• 4% organic sales growth and 7% EBIT¹ growth in constant currency
• High prior-year base impacts organic sales growth in North America
• FY/19 outlook confirmed

Sales increased by 6% (4% in constant currency) to €1,701 million (Q1/18: €1,603 million). Organic sales growth was 4%. Positive currency translation effects of 2% were mainly related to the appreciation of the U.S. dollar against the euro.

Sales in Europe grew by 3% (organic growth: 3%) to €573 million (Q1/18: €557 million). Sales in North America increased by 5% (decreased organically by 2% from a high prior-year basis) to €623 million (Q1/18: €591 million). Sales in Asia-Pacific increased by 13% (organic growth: 11%) to €341 million (Q1/18: €301 million). Sales in Latin America/Africa increased by 6% (organic growth: 18%) to €164 million (Q1/18: €154 million).

EBIT¹ increased by 13% (7% in constant currency) to €303 million (Q1/18: €268 million) with an EBIT margin1 of 17.8% (Q1/18: 16.7%).

Net income^1,2 increased by 19% (12% in constant currency) to €203 million (Q1/18: €170 million).

Operating cash flow³ was €132 million (Q1/18: €226 million). After a strong Q4/18, operating cash flow was impacted by working capital changes, for example by some phasing of payments and stockbuild to prepare for a possible Brexit. The cash flow margin was 7.8% (Q1/18: 14.1%).

Fresenius Kabi confirms its outlook for FY/19 and expects organic sales growth⁴ of 3% to 6% and EBIT growth⁵ in constant currency of 3% to 6%.

¹ On a comparable basis: before special items and adjusted for IFRS 16 effect
² Net income attributable to shareholders of Fresenius SE & Co. KGaA
³ Adjusted for IFRS 16 effect, before special items (operating cash flow after special items)
⁴ On a comparable basis: FY/18 base: €6,544 million; FY/19 before special items (acquisition-related expenses, revaluations of biosimilars contingent liabilities) and adjusted for IFRS 16 effect
⁵ On a comparable basis: FY/18 base: €1,139 million; FY/18 before special items; FY/19 before special items (acquisition-related expenses, revaluations of biosimilars contingent liabilities) and adjusted for IFRS 16 effect.

Fresenius Helios
Fresenius Helios is Europe's leading private hospital operator. The company comprises Helios Germany and Helios Spain (Quirónsalud). Helios Germany operates 86 hospitals, ~125 outpatient centers and treats approximately 5.3 million patients annually. Quirónsalud operates 47 hospitals, 56 outpatient centers and around 300 occupational risk prevention centers, and treats approximately 13.3 million patients annually.

 

• 4% organic sales growth
• Helios Germany stabilized; Helios Spain with continued dynamic growth
• FY/19 outlook confirmed

Sales decreased by 1% (increased by 4%¹; organic growth: 4%) to €2,311 million (Q1/18: €2,331 million).

Sales of Helios Germany decreased by 6% (increased by 1%¹; organic growth: 2%) to €1,485 million (Q1/18: €1,574 million). Sales were impacted by a decline in admissions in Germany, partially due to the transfer of the post-acute care business from Helios to Vamed, a shortage of nurses at selected intensive care units and a less pronounced flu season. The admission decline was more than compensated by positive price effects.

Helios Spain increased sales by 9% (organic growth: 9%) to €826 million (Q1/18: €757 million), mainly driven by the private sector. The occupational risk prevention business also had a valuable contribution. Performance in Q1/18 was impacted by the Easter holidays.

¹ Adjusted for the post-acute care business transferred to Fresenius Vamed as of July 1, 2018
² Adjusted for IFRS 16 effect
³ Net income attributable to shareholders of Fresenius SE & Co. KGaA

EBIT¹ of Fresenius Helios decreased by 4% (-3%²) to €266 million (Q1/18: €278 million) with an EBIT margin of 11.5% (Q1/18: 11.9%).

EBIT¹ of Helios Germany decreased by 16% (-14%²) to €149 million (Q1/18: €177 million). The EBIT margin improved sequentially by 50 bps to 10.0% (Q4/18: 9.5%). The development of Helios Germany is impacted by the admissions decline and the investments for preparatory structural measures.

EBIT¹ of Helios Spain increased by 16% to €119 million (Q1/18: €103 million), mainly due to the strong operating performance with an EBIT margin of 14.4% (Q1/18: 13.6%).

Net income^1,3  decreased by 8% to €176 million (Q1/18: €191 million).
Operating cash flow¹ was €91 million (Q1/18: €97 million) with a margin of 3.9% (Q1/18: 4.2%). The decrease is mainly attributable to the increase in days sales outstanding (DSO).

Fresenius Helios confirms its outlook for FY/19 and expects organic sales growth of 2% to 5% and an EBIT¹ growth of -5% to -2%.

¹ Adjusted for IFRS 16 effect
² Adjusted for the post-acute care business transferred to Fresenius Vamed as of July 1, 2018
³ Net income attributable to shareholders of Fresenius SE & Co. KGaA

Fresenius Vamed
Fresenius Vamed manages projects and provides services for hospitals and other health care facilities worldwide and is a leading post-acute care provider in Central Europe. The portfolio ranges along the entire value chain: from project development, planning, and turnkey construction, via maintenance and technical management to total operational management.

• Excellent organic sales growth of 31%
• Order backlog at all-time high ‒ strong foundation for future growth
• FY/19 outlook confirmed

Sales increased by 77% (33%¹) to €440 million (Q1/18: €249 million). Organic sales growth was 31%, acquisitions contributed 2% to growth. Both the project and the service business showed strong momentum. Sales of the project business increased by 17% to €108 million (Q1/18: €92 million). Sales in the service business grew by 111% (41%¹) to €332 million (Q1/18: €157 million), supported by an intensified collaboration with Fresenius Helios.

In Q1/19, EBIT² increased by 83% (83%² in constant currency) to €11 million (Q1/18: €6 million) with an EBIT margin of 2.5% (Q1/18: 2.4%). EBIT² additionally adjusted for the acquisition of the German post-acute care business was €7 million with an EBIT margin of 2.1%.

Net income^2,3 increased by 50% to €6 million (Q1/18: €4 million).

Order intake increased by 47% to €383 million (Q1/18: €260 million). As of March 31, 2019, order backlog reached a new all-time high of €2,698 million (Dec 31, 2018: €2,420 million).

Operating cash flow² increased by 45% to €-23 million (Q1/18: €-42 million) with a margin of -5.2% (Q1/18: -16.9%).

Fresenius Vamed confirms its outlook for FY/19 and expects organic sales growth of ~10% and EBIT growth² of 15% to 20%.

¹ Adjusted for German post-acute care business acquired from Fresenius Helios as of July 1, 2018
2 Adjusted for IFRS 16 effect
³ Net income attributable to shareholders of VAMED AG

Conference Call
As part of the publication of the results for the first quarter 2019, a conference call will be held on May 2, 2019 at 1:30 p.m. CET (7:30 a.m. EST). You are cordially invited to follow the conference call in a live broadcast over the Internet at www.fresenius.com/media-calendar. Following the call, a replay will be available on our website.

For a detailed overview of special items and adjustments please see the reconciliation tables on pages 19-22 of the PDF file.

For additional information on the performance indicators used please refer to our website www.fresenius.com/alternative-performance-measures.

• Underlying business developed as expected
• Earnings supported by agreements that materialized earlier than planned 
• Cost optimization program initiated
• Integration of NxStage successfully started
• Non-prosecution agreement concluded with U.S. government
• Outlook confirmed

The outlook provided by Fresenius Medical Care refers to adjusted revenue and adjusted net income².

¹ For a detailed reconciliation, please refer to the table in the PDF
² Net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA

“In the first quarter we achieved healthy organic growth across all regions,” said Rice Powell, Chief Executive Officer of Fresenius Medical Care. “All of our major initiatives are underway. We have completed the acquisition of NxStage, and started its integration process as well as an expansion of the infrastructure necessary for home dialysis. We are very well positioned to reach the investment milestones set for 2019, and to meet our full-year targets.” 

Investment year underway
Fresenius Medical Care continues its investments in the USA to increase the number of treatments being carried out in a home setting. Investments in training facilities, education and distribution infrastructure are a part of the initiative. 

Expanding the production facilities in China is underway to cover for the growing product demand in the country with the most dialysis patients worldwide. Fresenius Medical Care´s development of its footprint in the services business is also progressing including the acquisition of selected hospitals to support renal care and the construction of clinics. 

The investments of around EUR 100 million in 2019 as part of the Cost Optimization Program include as a major part the optimization of the US services footprint. The corresponding investments will ramp-up throughout the remainder of the year. 

Key financials developed in line with expectations
Revenue in the first quarter 2019 increased by 4% to EUR 4,133 million (-1% at constant currency). Adjusted for the Q1 2018 revenue contribution from Sound Inpatient Physicians (“Sound”, divested effective end of Q2 2018) as well as the impact from the IFRS 16 implementation and the revenue contribution from NxStage following the closing, revenue increased by 11% (+6% at constant currency). Health Care Services revenue increased by 3% to EUR 3,317 million (-2% at constant currency). The decrease at constant currency was largely due to decreases attributable to prior year activities associated with Sound as well as the effect of closed or sold clinics and a decrease in dialysis days, partially offset by growth in same market treatments, increases in organic revenue per treatment and contributions from acquisitions. Health Care Products revenue increased by 6% to EUR 816 million (+4% at constant currency), mainly driven by higher sales of home hemodialysis products, largely as a result of the NxStage acquisition, dialyzers, products for acute care treatments, solutions and concentrates, and bloodlines, partially offset by lower sales of machines as a result of changes in the accounting treatment of sale-leaseback transactions related to the IFRS 16 implementation. 

Total EBIT increased by 8% and reached EUR 537 million (+3% at constant currency), resulting in an operating margin of 13.0% (+50 basis points). On an adjusted basis, EBIT increased by 9% (+4% at constant currency). The adjusted EBIT margin decreased from 13.6% to 13.4% (-20 basis points). 

Net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA decreased by 3% to EUR 271 million (-6% at constant currency). On an adjusted basis, net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA increased by 8% (+3% at constant currency).

Earnings growth in the first quarter was supported by agreements that have been realized earlier in the year than planned. In North America the annual positive impact from income attributable to a consent agreement on certain pharmaceuticals supported the earnings growth. In EMEA earnings growth was supported by the reduction of a contingent consideration liability related to Xenios, which was under discussion at the time the outlook for 2019 was issued.  

Based on the number of approximately 306.7 million shares (weighted average number of shares outstanding), basic earnings per share (EPS) decreased by 3% to EUR 0.88 (-7% at constant currency). On an adjusted basis, basic EPS amounted to EUR 1.04, representing an increase of 8% (+3% at constant currency).

Healthy organic growth across all regions 
North America revenue, which represents 70% of total revenue, increased by 4% to EUR 2,887 million (-4% at constant currency). Organic growth in North America was 6%. Health Care Services revenue increased by 3% to EUR 2,680 million (-4% at constant currency). On an adjusted basis, Health Care Services revenue increased by 14% (+6% at constant currency), driven by a 14% increase of Dialysis Care revenue to EUR 2,372 million (+6% at constant currency). The positive development at constant currency was mainly driven by increases in organic revenue per treatment, growth in same market treatments and contributions from acquisitions, partially offset by the impact of one less dialysis day. Same-market treatment growth in the US was 3.7%, a sequential improvement of 40 basis points. Care Coordination revenue decreased by 40% to EUR 308 million (-45% at constant currency), mainly due to the divestiture of Sound. On an adjusted basis, Care Coordination revenue increased by 17% to EUR 308 million (+8% at constant currency), mainly driven by increased member months for health plan services and increased volumes for vascular services.

As of the end of March 2019, the company was treating 205,775 patients (+4%) at its 2,559 clinics (+6%) in North America. Dialysis treatments increased by 3%.

In the U.S., the average revenue per treatment increased by USD 7 to USD 355 (+2%). The increase was mainly driven by higher utilization of calcimimetics and an increase in the ESRD PPS base rate, partially offset by lower revenue from commercial payors.

Cost per treatment in the U.S., adjusted for the implementation of IFRS 16, increased from USD 289 to USD 301 (+4%). This increase was largely driven by higher utilization of calcimimetics and higher personnel expense.
Health Care Products revenue increased by 12% to EUR 207 million (+4% at constant currency) due to higher sales of home hemodialysis products, products for acute care, and bloodlines, all largely as a result of the NxStage acquisition, partially offset by lower sales of machines as a result of changes in the accounting treatment of sale-leaseback transactions related to the IFRS 16 implementation.

Total EBIT of the North America segment increased by 3% to EUR 372 million (-4% at constant currency), resulting in an EBIT margin of 12.9% compared to 13.1% in the first quarter 2018. The EBIT margin decrease was mainly driven by higher personnel expense, the integration of and operational costs associated with NxStage and an unfavourable impact from legal settlements, partially offset by the positive impact from income attributable to a consent agreement on certain pharmaceuticals, increases in the Care Coordination margin, a favourable effect from the IFRS 16 implementation and a favourable impact from manufacturing. On an adjusted basis, EBIT increased by 5% (-1% at constant currency). The adjusted EBIT margin was 13.6% compared to 14.7% in the first quarter 2018. 

EMEA revenue increased by 3% to EUR 653 million (+4% at constant currency), driven by a positive business development in both Health Care Services and Health Care Products. Organic growth was 4%. Health Care Services revenue increased by 3% to EUR 324 million (+5% at constant currency), resulting from growth in same market treatments, contributions from acquisitions and increases in organic revenue per treatment, partially offset by the impact of one less dialysis day. Health Care Products revenue increased by 2% to EUR 329 million (+3% at constant currency). Dialysis Product revenue increased by 3% (+3% at constant currency) mainly due to higher sales of machines and dialyzers, hemodialysis solutions and concentrates as well as renal pharmaceuticals, partially offset by lower sales of products for acute care treatments. Non-Dialysis Products revenue decreased by 3% to EUR 19 million (-3% at constant currency). 

EBIT increased by 26% to EUR 138 million (+27% at constant currency). Consequently, the EBIT margin was 21.1%, an increase from 17.1% in the first quarter 2018, mainly driven by a reduction of a contingent consideration liability related to Xenios, partially offset by higher bad debt expense, higher rent expense, and the impact from one less dialysis day. 
As of the end of March 2019, the company was treating 65,833 patients (+4%) at its 782 clinics (+4%) in the EMEA region. Dialysis treatments increased by 4%.

Asia-Pacific revenue increased by 9% to EUR 428 million (+6% at constant currency), driven by a positive business development in both Health Care Services and Health Care Products. Organic growth was 6%. Health Care Services revenue increased by 8% to EUR 199 million (+4% at constant currency). Dialysis Care revenue increased by 7% to EUR 147 million (+1% at constant currency), mainly as a result of growth in same market treatments and contributions from acquisitions, partially offset by missing contributions from closed or sold clinics, a decrease in organic revenue per treatment and a decrease in dialysis days. Care Coordination revenue increased by 14% to EUR 52 million (+12% at constant currency), driven by contributions from acquisitions and organic revenue growth. Health Care Products revenue grew by 10% to EUR 229 million (+8% at constant currency), mainly driven by increased sales of dialyzers and machines.

EBIT increased by 28% to EUR 95 million (+25% at constant currency). The resulting EBIT margin was 22.1% (Q1 2018: 19.0%), mainly driven by favorable foreign currency transaction effects and a positive impact from business growth. 

As of the end of March 2019, the company was treating 31,674 patients (+5%) at its 398 clinics in the Asia-Pacific region (+3%). Dialysis treatments increased by 4%.

Latin America delivered revenue of EUR 161 million, a decrease of 5%, but a significant increase of 14% at constant currency. Organic growth was 13%. Health Care Services revenue decreased by 5% to EUR 114 million (+20% at constant currency). The increase at constant currency was mainly a result of increases in organic revenue per treatment and contributions from acquisitions. Health Care Products revenue decreased by 5% to EUR 47 million (+1% at constant currency).

EBIT decreased by 19% to EUR 11 million (-24% at constant currency). The resulting EBIT margin was 7.1% (Q1 2018: 8.3%). The decline was mainly driven by hyperinflation in Argentina. 

As of the end of March 2019, the company was treating 33,434 patients (+6%) at its 232 clinics in Latin America (+0%). Dialysis treatments increased by 4%.

Net interest expense increased in the first quarter by 30% to EUR 108 million (+24% at constant currency). The increase was primarily due to the IFRS 16 implementation and the acquisition of NxStage, partially offset by the replacement of high interest bearing senior notes repaid in 2018 by debt instruments at lower interest rates and interest income from the investment of the Sound proceeds. Income tax expense increased by 20% to EUR 101 million for the first quarter of 2019, which translates into an effective tax rate of 23.5% (Q1 2018: 20.3%). The increase was largely driven by the prior year impact in 2018 caused by favorable implications of the US tax reform.

Cash flow in line with expectations 
The company generated EUR 76 million of operating cash flow (Q1 2018: EUR -45 million). The increase was largely driven by the IFRS 16 implementation leading to a reclassification of the repayment portion of rent to financing activities. The number of days sales outstanding (DSOs) increased to 83 days as compared to 75 days at December 31, 2018. Free cash flow (net cash used in operating activities, after capital expenditures, before acquisitions and investments) amounted to EUR -123 million (Q1 2018: EUR -263 million). Free cash flow was -3.0% of revenue (Q1 2018: -6.6%).

Outlook confirmed^3,4
For 2019, Fresenius Medical Care expects adjusted revenue to grow between 3% and 7% and adjusted net income⁴ to develop in the range of -2% to 2%. 

For 2020, Fresenius Medical Care expects adjusted revenue as well as adjusted net income2 to grow at a mid to high single digit rate.

In order to make the business performance in the respective periods comparable these targets as well as the 2018 base are and will be adjusted for items such as: FCPA Related Charges, the IFRS 16 implementation, the contributions from Sound in the first half year of 2018, the gain (loss) related to divestitures of Care Coordination activities and expenses for the implementation of the cost optimization program. All effects from the acquisition of NxStage Medical Inc. are excluded from the targets for 2019 and 2020.

3 Numbers at constant currency
4 Reported revenue 2018 of EUR 16,547 million adjusted for Sound H1 2018; reported net income 2018 of EUR 1,982 million adjusted for Sound H1 2018, the gain (loss) related to divestitures of Care Coordination activities and the 2018 FCPA related charge 

NxStage Update
The table below shows the previously communicated estimated effects of the NxStage acquisition on Fresenius Medical Care´s outlook for 2019 and 2020. The numbers exclude effects from the IFRS 16 implementation and integration costs of approximately EUR 50 to 75 million over the three years following the closing of the transaction. The company assumes the full year effect of incremental intangible assets amortization to be in the range of EUR 70 to 80 million for the first two years, then drop to EUR 45 to 55 million thereafter. The company will update estimates after a detailed assessment, if required.

2019 estimates cover the period starting on February 21, 2019 (closing date) until year-end 2019.

Fast implementation of the share buy-back program 
In March 2019 Fresenius Medical Care started the first phase of its announced share buy-back program. The first phase runs from March 12, 2019 to May 10, 2019. It allows for a maximum of 6,000,000 shares to be repurchased. Until March 31, 2019, Fresenius Medical Care repurchased 1,629,240 shares, for an average stock price of EUR 69.86.

Non-prosecution agreement concluded with U.S. government
In March 2019, Fresenius Medical Care entered into a Non-Prosecution Agreement with the U.S. Department of Justice and a separate agreement with the Securities and Exchange Commission to resolve matters governed by the U.S. Foreign Corrupt Practices Act (FCPA). In 2012, the Company had voluntarily notified the U.S. government about internal investigations into conduct in countries outside the U.S. that might violate the FCPA.

Number of employees increased
As of March 31, 2019, Fresenius Medical Care had 118,308 employees (full-time equivalents) worldwide, compared to 114,831 employees at the end of March 2018. This increase of 3% was mainly attributable to the NxStage acquisition.

Conference call
Fresenius Medical Care will host a conference call to discuss the results of the first quarter today at 3:30 p.m. CEDT / 9:30 a.m. EDT. Details will be available on the company’s website www.freseniusmedicalcare.com in the “Investors/Events” section. A replay will be available shortly after the call.

Please refer to the PDF for a complete overview of the results for the first quarter 2019.

• Fresenius Kabi with continued good growth in Q1/19
• Helios Germany stabilized; Helios Spain with continued dynamic growth
• Fresenius Medical Care with strong financial performance supported by agreements that materialized earlier than planned
• Growth investments on track
• Group guidance confirmed despite expected earnings dilution from NxStage

 

 

¹ Adjusted for IFRS 16 effect
² Q1/18 adjusted for divestitures of Care Coordination activities at FMC
³ Net income attributable to shareholders of Fresenius SE & Co. KGaA

 

Group guidance for 2019 confirmed
After closing the NxStage acquisition on February 21, the related sales and earnings contributions are now included in the Group guidance. Despite the expected earnings dilution from NxStage, Fresenius confirms its FY/19 guidance. Fresenius projects sales growth¹ of 3% to 6% in constant currency. Net income^2,3 growth is expected to be ~0% in constant currency.
Including the NxStage acquisition which is increasing the net debt/EBITDA ratio in 2019 by ~30 basis points and excluding IFRS 16, Fresenius now expects year-end 2019 net debt/EBITDA ratio  to be at the upper-end of the original self-imposed target corridor of 2.5 to 3.0x.
Due to the adoption of the IFRS 16 accounting standard (“IFRS 16 effect”), Fresenius increases its self-imposed target corridor of 2.5x to 3.0x net debt/EBITDA to 3.0x to 3.5x.

¹ On a comparable basis: FY/18 base: €33,009 million; FY/18 adjusted for divestitures of Care Coordination activities at FMC (H1/18); FY/19: adjusted for IFRS 16 effect
² Net income attributable to shareholders of Fresenius SE & Co. KGaA
³ On a comparable basis: FY/18 base: €1,872 million; FY/18 before special items and adjusted for divestitures of Care Coordination activities at FMC (H1/18); FY/19: before special items (transaction-related expenses, expenses associated with the cost optimization program at FMC, revaluations of biosimilars contingent liabilities); adjusted for IFRS 16 effect
⁴ Both net debt and EBITDA calculated at expected annual average exchange rates; excluding further potential acquisitions

For a detailed overview of special items and adjustments please see the reconciliation tables on pages 19-22 of the PDF file.

 

5% sales growth¹ in constant currency
Group sales were €8,495 million including an IFRS 16 effect of -€22 million. Group sales1 on a comparable basis increased by 8% (5% in constant currency) to €8,517 million (Q1/18: €7,870 million). Organic sales growth was 5%. Acquisitions/divestitures contributed net 0% to growth. Positive currency translation effects of 3% were mainly driven by the appreciation of the U.S. dollar against the euro.

Group sales by region:

 

 

¹ On a comparable basis: Q1/18 adjusted for divestitures of Care Coordination activities at FMC; Q1/19 adjusted for IFRS 16 effect

For a detailed overview of special items and adjustments please see the reconciliation tables on pages 19-22 of the PDF file.

 

Net income^1,2 growth flat in constant currency
Group EBITDA before special items was €1,701 million including an IFRS 16 effect of €220 million. Group EBITDA² on a comparable basis increased by 6% (3% in constant currency) to €1,481 million (Q1/18: €1,394 million).

Group EBIT before special items was €1,130 million including an IFRS 16 effect of €19 million. Group EBIT² on a comparable basis increased by 6% (2% in constant currency) to €1,111 million (Q1/18: €1,050 million). The EBIT margin² on a comparable basis was 13.0% (Q1/18: 13.3%). Reported Group EBIT  was €1,115 million.

Group net interest before special items was -€181 million including an IFRS 16 effect of -€48 million. On a comparable basis, net interest² improved to -€133 million (Q1/18: -€139 million) mainly due to lower rates for refinancing activities. Reported Group net interest was -€184 million.

Group tax rate before special items and adopting IFRS 16 was 23.3%. Group tax rate² on a comparable basis was 23.4% (Q1/18: 20.9%). The prior-year was positively influenced by one-time effects related to the adoption of the U.S. tax reform.

Noncontrolling interest before special items was €271 million including an IFRS 16 effect of €13 million. Noncontrolling interest² on a comparable basis was €284 million (Q1/18: €270 million), of which 94% was attributable to the noncontrolling interest in Fresenius Medical Care.

Group net income¹ before special items was €457 million including an IFRS 16 effect of -€8 million. Group net income^1,2 on a comparable basis increased by 3% (0% in constant currency) to €465 million (Q1/18: €451million). Reported Group net income^1,3 was €453 million.
Earnings per share¹ before special items was €0.82 including an IFRS 16 effect of -€0.02.

Earnings per share¹ before special items was €0.82 including an IFRS 16 effect of -€0.02. Earnings per share^1,2 on a comparable basis increased by 3% (0% in constant currency) to €0.84 (Q1/18: €0.81). Reported Earnings per share^1,3 was €0.81.

 

¹ Net income attributable to shareholders of Fresenius SE & Co. KGaA
² On a comparable basis: Q1/19 before special items and adjusted for IFRS 16 effect; Q1/18 adjusted for divestitures of Care Coordination activities at FMC
³ After special items and including IFRS 16 effect

For a detailed overview of special items and adjustments please see the reconciliation tables on pages 19-22 of the PDF file.

 

Continued investment in growth
2019 is an investment year for the Fresenius Group. Fresenius is making good progress in all of its investment initiatives to secure long-term sustainable growth. Spending on property, plant and equipment was €441 million (Q1/18: €380 million), primarily for the modernization and expansion of dialysis clinics, production facilities as well as hospitals and day clinics. This corresponds to 5% of sales.

Total acquisition spending was €1,923 million (Q1/18: €192 million), mainly for the acquisition of NxStage.

 

Cash flow development
Group operating cash flow was €289 million including an IFRS 16 effect of €171 million. On a comparable basis, Group operating cash flow was €118 million (Q1/18: €236 million) with a margin of 1.4% (Q1/18: 2.9%). After a strong Q4/18, operating cash flow was impacted by working capital changes at Fresenius Kabi, for example by some phasing of payments and stockbuild to prepare for a possible Brexit. Moreover, as in previous years’ first quarters, operating cash flow was influenced by the seasonality in invoicing at Fresenius Medical Care North America. Fresenius does not expect these temporary effects to have a significant impact on FY/19 cash flow.

Given the effects described above in combination with increasing investments, free cash flow before acquisitions and dividends adjusted for IFRS 16 was -€339 million (Q1/18: - €155 million). Free cash flow after acquisitions and dividends adjusted for IFRS 16 was -€2,282 million (Q1/18: -€389 million). The IFRS 16 effect amounts to €171 million respectively. Correspondingly, cash flow from financing activities declined by €171 million.

Solid balance sheet structure
The Group’s total assets were €64,985 million including an IFRS 16 effect of €5,669 million. Adjusted for IFRS 16, Group total assets¹ increased by 5% (3% in constant currency) to €59,316 million (Dec. 31, 2018: €56,703 million). Current assets¹ grew by 1% (0% in constant currency) to €14,958 million (Dec. 31, 2018: €14,790 million). Non-current assets¹ increased by 6% (5% in constant currency) to €44,358 million (Dec. 31, 2018: € 41,913 million).

Total shareholders’ equity was €25,830 million including an IFRS 16 effect of -€167 million. Adjusted for IFRS 16, total shareholders’ equity¹ increased by 4% (2% in constant currency) to €25,997 million (Dec. 31, 2018: €25,008 million). The equity ratio was 39.7%. Adjusted for IFRS 16, the equity ratio was 43.8% (Dec. 31, 2018: 44.1%).

Group debt was €26,378 million including an IFRS 16 effect of €5,836 million. Adjusted for IFRS 16, Group debt¹  increased by 8% to €20,542 million (8% in constant currency) (Dec. 31, 2018: € 18,984 million). Group net debt was €24,835 million including an IFRS 16 effect of €5,836 million. Adjusted for IFRS 16, Group net debt¹ increased by 17% (16% in constant currency) to € 18,999 million (Dec. 31, 2018: € 16,275 million) mainly due to the acquisition of NxStage by Fresenius Medical Care and the negative free cash flow.

As of March 31, 2019, the net debt/EBITDA ratio increased to 3.09^1,2,3 (December 31, 2018: 2.712,3). Excluding the acquisition of NxStage the net debt/EBITDA ratio was 2.83^1,2,3 as of March 31, 2019. Including the IFRS 16 effect, the reported net debt/EBITDA ratio increased to 3.53^2,3.

 

¹ Adjusted for IFRS 16 effect
² At LTM average exchange rates for both net debt and EBITDA; pro forma closed acquisitions/divestitures
³ Before special items

For a detailed overview of special items and adjustments please see the reconciliation tables on pages 19-22 of the PDF file.

 

Business Segments

Fresenius Medical Care (Figures according to Fresenius Medical Care Investor News)
Fresenius Medical Care is the world's largest provider of products and services for individuals with renal diseases. As of March 31, 2019, Fresenius Medical Care was treating 336,716 patients in 3,971 dialysis clinics. Along with its core business, the company provides related medical services in the field of Care Coordination.

 

• 6% sales^1,2  growth in constant currency
• Earnings supported by agreements that materialized earlier than planned
• Outlook confirmed

Adjusted for the Q1/18 contribution from the divested Care Coordination activities, the effect of the adoption of the IFRS 16 accounting standard (“IFRS 16 effect”) and the contribution from NxStage, sales increased by 11% (6% at constant currency) to €4,125 million (Q1/18: €3,725 million). Organic sales growth was 6%. Positive currency translation effects of 5% were mainly related to the appreciation of the U.S. dollar against the euro.

Health Care Services sales^1,2 increased by 12% (6% at constant currency) to €3,316 million (Q1/18: €2,958 million). Health Care Products sales^1,2 increased by 5% (4% at constant currency) to €809 million (Q1/18: €767 million).

In North America, sales^1,2 increased by 14% (5% in constant currency) to €2,879 million (Q1/18: €2,523 million). Health Care Services sales^1,2 increased by 14% (6% in constant currency) to €2,679 million (Q1/18: €2,339 million).

 

¹ On an adjusted basis: before expenses associated with the cost optimization program, the IFRS 16 effect, excluding effects from NxStage transaction
² Q1/18 adjusted for divestitures of Care Coordination activities
³ Net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA

For a detailed overview of special items and adjustments please see the reconciliation tables on pages 19-22 of the PDF file.

 

Sales² outside North America increased by 4% (6% in constant currency) to €1,246 million (Q1/18: €1,202 million). Health Care Services sales² increased by 3% (8% in constant currency) to €637 million (Q1/18: €619 million). Health Care Product sales² adjusted increased by 4% (5% in constant currency) to €609 million (Q1/18: €583 million).
Fresenius Medical Care’s EBIT³ increased by 9% (4% in constant currency) to €551 million (Q1/18: €506 million). The EBIT margin³ decreased to 13.4% (Q1/18: 13.6%).

Net income^1,3 increased by 8% (3% in constant currency) to €318 million (Q1/18: €296 million).

Operating cash flow was €76 million (Q1/18: -€45 million) with a margin of 1.8% (Q1/18: -1.1%). The increase was mainly driven by the adoption of the IFRS 16 accounting standard leading to a reclassification of the repayment portion of rent to financing activities (€141 million). Adjusted for the IFRS 16 effect, operating cash flow was -€65 million.

For FY/19, Fresenius Medical Care expects adjusted sales to grow by 3% to 7%^2,6 in constant currency. Net income1 is expected to develop in the range of -2% to +2%^3,7 in constant currency.

 

For further information, please see Fresenius Medical Care’s Investor News at www.freseniusmedicalcare.com.

 

¹ Net income attributable to shareholders of Fresenius Medical Care AG & Co. KGaA
² Q1/18 adjusted for divestitures of Care Coordination activities; Q1/19 adjusted for IFRS 16 effects, excluding effects from NxStage transaction
³ Q1/18 before special items and after adjustments; Q1/19 before special items (before transaction-related expenses, expenses associated with the cost optimization program), adjusted for IFRS 16 effect, excluding effects from NxStage transaction
⁴ Before special items (operating cash flow after special items)
⁵ Adjusted for IFRS 16 effect
⁶ FY/18 base: €16,026 million
⁷ FY/18 base: €1,341 million

For a detailed overview of special items and adjustments please see the reconciliation tables on pages 19-22 of the PDF file.

 

Fresenius Kabi
Fresenius Kabi offers intravenously administered generic drugs, clinical nutrition and infusion therapies for seriously and chronically ill patients in the hospital and outpatient environments. The company is also a leading supplier of medical devices and transfusion technology products. In the biosimilars business, Fresenius Kabi develops products with a focus on oncology and autoimmune diseases.

 

• 4% organic sales growth and 7% EBIT¹ growth in constant currency
• High prior-year base impacts organic sales growth in North America
• FY/19 outlook confirmed

Sales increased by 6% (4% in constant currency) to €1,701 million (Q1/18: €1,603 million). Organic sales growth was 4%. Positive currency translation effects of 2% were mainly related to the appreciation of the U.S. dollar against the euro.

Sales in Europe grew by 3% (organic growth: 3%) to €573 million (Q1/18: €557 million). Sales in North America increased by 5% (decreased organically by 2% from a high prior-year basis) to €623 million (Q1/18: €591 million). Sales in Asia-Pacific increased by 13% (organic growth: 11%) to €341 million (Q1/18: €301 million). Sales in Latin America/Africa increased by 6% (organic growth: 18%) to €164 million (Q1/18: €154 million).

EBIT¹ increased by 13% (7% in constant currency) to €303 million (Q1/18: €268 million) with an EBIT margin1 of 17.8% (Q1/18: 16.7%).

Net income^1,2 increased by 19% (12% in constant currency) to €203 million (Q1/18: €170 million).

Operating cash flow³ was €132 million (Q1/18: €226 million). After a strong Q4/18, operating cash flow was impacted by working capital changes, for example by some phasing of payments and stockbuild to prepare for a possible Brexit. The cash flow margin was 7.8% (Q1/18: 14.1%).

Fresenius Kabi confirms its outlook for FY/19 and expects organic sales growth⁴ of 3% to 6% and EBIT growth⁵ in constant currency of 3% to 6%.

 

¹ On a comparable basis: before special items and adjusted for IFRS 16 effect
² Net income attributable to shareholders of Fresenius SE & Co. KGaA
³ Adjusted for IFRS 16 effect, before special items (operating cash flow after special items)
⁴ On a comparable basis: FY/18 base: €6,544 million; FY/19 before special items (acquisition-related expenses, revaluations of biosimilars contingent liabilities) and adjusted for IFRS 16 effect
⁵ On a comparable basis: FY/18 base: €1,139 million; FY/18 before special items; FY/19 before special items (acquisition-related expenses, revaluations of biosimilars contingent liabilities) and adjusted for IFRS 16 effect.

For a detailed overview of special items and adjustments please see the reconciliation tables on pages 19-22 of the PDF file.

 

 

 

Fresenius Helios
Fresenius Helios is Europe's leading private hospital operator. The company comprises Helios Germany and Helios Spain (Quirónsalud). Helios Germany operates 86 hospitals, ~125 outpatient centers and treats approximately 5.3 million patients annually. Quirónsalud operates 47 hospitals, 56 outpatient centers and around 300 occupational risk prevention centers, and treats approximately 13.3 million patients annually.

 

• 4% organic sales growth
• Helios Germany stabilized; Helios Spain with continued dynamic growth
• FY/19 outlook confirmed

Sales decreased by 1% (increased by 4%¹; organic growth: 4%) to €2,311 million (Q1/18: €2,331 million).

Sales of Helios Germany decreased by 6% (increased by 1%¹; organic growth: 2%) to €1,485 million (Q1/18: €1,574 million). Sales were impacted by a decline in admissions in Germany, partially due to the transfer of the post-acute care business from Helios to Vamed, a shortage of nurses at selected intensive care units and a less pronounced flu season. The admission decline was more than compensated by positive price effects.

Helios Spain increased sales by 9% (organic growth: 9%) to €826 million (Q1/18: €757 million), mainly driven by the private sector. The occupational risk prevention business also had a valuable contribution. Performance in Q1/18 was impacted by the Easter holidays.

 

¹ Adjusted for the post-acute care business transferred to Fresenius Vamed as of July 1, 2018
² Adjusted for IFRS 16 effect
³ Net income attributable to shareholders of Fresenius SE & Co. KGaA

For a detailed overview of special items and adjustments please see the reconciliation tables on pages 19-22 of the PDF file.

 

EBIT¹ of Fresenius Helios decreased by 4% (-3%²) to €266 million (Q1/18: €278 million) with an EBIT margin of 11.5% (Q1/18: 11.9%).

EBIT¹ of Helios Germany decreased by 16% (-14%²) to €149 million (Q1/18: €177 million). The EBIT margin improved sequentially by 50 bps to 10.0% (Q4/18: 9.5%). The development of Helios Germany is impacted by the admissions decline and the investments for preparatory structural measures.

EBIT¹ of Helios Spain increased by 16% to €119 million (Q1/18: €103 million), mainly due to the strong operating performance with an EBIT margin of 14.4% (Q1/18: 13.6%).

Net income^1,3  decreased by 8% to €176 million (Q1/18: €191 million).
Operating cash flow¹ was €91 million (Q1/18: €97 million) with a margin of 3.9% (Q1/18: 4.2%). The decrease is mainly attributable to the increase in days sales outstanding (DSO).

Fresenius Helios confirms its outlook for FY/19 and expects organic sales growth of 2% to 5% and an EBIT¹ growth of -5% to -2%.

 

 

¹ Adjusted for IFRS 16 effect
² Adjusted for the post-acute care business transferred to Fresenius Vamed as of July 1, 2018
³ Net income attributable to shareholders of Fresenius SE & Co. KGaA

For a detailed overview of special items and adjustments please see the reconciliation tables on pages 19-22 of the PDF file.

 

Fresenius Vamed
Fresenius Vamed manages projects and provides services for hospitals and other health care facilities worldwide and is a leading post-acute care provider in Central Europe. The portfolio ranges along the entire value chain: from project development, planning, and turnkey construction, via maintenance and technical management to total operational management.

 

• Excellent organic sales growth of 31%
• Order backlog at all-time high ‒ strong foundation for future growth
• FY/19 outlook confirmed

Sales increased by 77% (33%¹) to €440 million (Q1/18: €249 million). Organic sales growth was 31%, acquisitions contributed 2% to growth. Both the project and the service business showed strong momentum. Sales of the project business increased by 17% to €108 million (Q1/18: €92 million). Sales in the service business grew by 111% (41%¹) to €332 million (Q1/18: €157 million), supported by an intensified collaboration with Fresenius Helios.

In Q1/19, EBIT² increased by 83% (83%² in constant currency) to €11 million (Q1/18: €6 million) with an EBIT margin of 2.5% (Q1/18: 2.4%). EBIT² additionally adjusted for the acquisition of the German post-acute care business was €7 million with an EBIT margin of 2.1%.

Net income^2,3 increased by 50% to €6 million (Q1/18: €4 million).

Order intake increased by 47% to €383 million (Q1/18: €260 million). As of March 31, 2019, order backlog reached a new all-time high of €2,698 million (Dec 31, 2018: €2,420 million).

Operating cash flow² increased by 45% to €-23 million (Q1/18: €-42 million) with a margin of -5.2% (Q1/18: -16.9%).

Fresenius Vamed confirms its outlook for FY/19 and expects organic sales growth of ~10% and EBIT growth²  of 15% to 20%.

 

¹ Adjusted for German post-acute care business acquired from Fresenius Helios as of July 1, 2018
2 Adjusted for IFRS 16 effect
³ Net income attributable to shareholders of VAMED AG

For a detailed overview of special items and adjustments please see the reconciliation tables on pages 19-22 of the PDF file.

 

Conference Call
As part of the publication of the results for the first quarter 2019, a conference call will be held on May 2, 2019 at 1:30 p.m. CET (7:30 a.m. EST). All investors are cordially invited to follow the conference call in a live broadcast over the Internet at www.fresenius.com/investors. Following the call, a replay will be available on our website.

 

For additional information on the performance indicators used please refer to our website www.fresenius.com/alternative-performance-measures.

Glycopyrrolate is now available in the company’s Simplist™ ready-to-administer prefilled syringes, expanding the company´s analgesia and anesthesia portfolio. It is the first FDA-approved manufacturer-supplied ready-to-administer prefilled syringe for this medication in the U.S.