Operations and Business Environment - Fresenius Medical Care

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02. 1 Our Fiscal year 60 Dialysis Provider Business In the last year, the majority of all hemodialysis patients were treated in around 25,000 dialysis centers worldwide, yielding an average of some 55 patients per center. Clear differences exist in the organizational structures of dialysis center operations, depending on whether a country’s health system is predominantly private or public. There are about 5,000 dialysis centers in both the U.S. and in the European Union. Whereas less than 1% of these dialysis centers are publicly operated in the U.S., the share in the EU is about 60 %. In Japan, however, private nephrologists play a key role, running about 80 % of all facilities. However, the last few years have seen a significant increase in the number of company-owned clinics in Eastern Europe, possibly reflecting the fact that private companies are more efficient when it comes to modernization and capacity extension than the respective government bodies. Dialysis Clinic Operators 2006 Number of patients treated The acquisition of Renal Care Group further strengthened Fresenius Medical Care’s position as the market leader in dialysis care in the U.S. Fresenius Medical Care now commands a U.S. market share of about 34 % and treats significantly more patients there than its closest competitor DaVita. Fresenius Medical Care and DaVita together provide dialysis care to approximately twothirds of all dialysis patients in the U.S. The dialysis market outside the U.S. is much more fragmented. Here Fresenius Medical Care is also the largest dialysis provider and market leader, with 46,000 patients in over 25 countries, thus ranking as the thirdlargest global dialysis company, even if the North American dialysis business is not included in the calculation. U.S. European Union Japan Worldwide 1% 71% 28 % 60 % 15 % 25 % 20 % 80 % 36 % 24 % 40 % Public sector Private individuals Private companies Dialysis Clinic Operators in Eastern Europe Number of patients treated 2006 2000 61% 19 % 20 % 75 % 8 % 17 % Public sector Private individuals Private companies Fresenius Medical Care 2006
As in previous years, many healthcare systems continued to face increasing cost pressure in order to reduce welfare system expenditure while simultaneously striving to improve treatment standards for patients. Under these conditions, reliable product supply, patient education, quality and innovative approaches toward optimizing patient care constitute key success factors for market participants. A vertically integrated dialysis provider like Fresenius Medical Care, offering not only the entire product spectrum in the dialysis sector but also high-quality treatment in dialysis clinics worldwide, has excellent opportunities to continually expand its position in the current and future dialysis market. In 2006, Fresenius Medical Care continued to uphold its clear leadership as the largest private provider of dialysis care worldwide, treating more than 163,500 dialysis patients in more than 2,100 clinics. Dialysis reimbursement schemes differ from country to country, and also vary within the countries. Among the factors determining reimbursement are the type of treatment provided, the type of the care provider and regulatory issues. The establishment of reimbursement structures based on treatment quality remains a focus of discussions. The goal of this reimbursement method is to uphold the treatment quality while maintaining the current level of costs for the treatment of a dialysis patient. Fresenius Medical Care has been active in numerous countries with differing healthcare systems and reimbursement schemes for many years now. Our international experience puts us in a position to offer support to national health systems in their endeavors to customize structures, adapt our business according to local needs and regulations, and to act profitable in different healthcare environments. 61 Top 5 Dialysis Providers Worldwide 2006 Number of patients treated Fresenius Medical Care 163,517 DaVita 103,000 Kuratorium für Dialyse 17,400 Dialysis Clinic International 13,000 Gambro International 12,000 l Fresenius Medical Care 2006 Number of patients treated by region U.S. European Union Other regions 34 % 66 % 7 % 93 % 3 % 97 % Fresenius Medical Care Other providers Fresenius Medical Care 2006
Page 1 and 2: 02. 1-6 With more than 56,000 emplo
Page 3 and 4: Our Fiscal year 02. 1 02. 1 Operati
Page 5 and 6: Path 2: Acquisitions. We intend to
Page 7 and 8: In addition, our development depart
Page 9 and 10: on the basis of growing clinical ex
Page 11 and 12: Asia While Japan’s gross domestic
Page 13: dialysis and about 165,000 receive
Page 17 and 18: Dialysis machines constitute anothe
Page 19 and 20: Comparison of the Actual Business R
Page 21 and 22: The Management’s General Assessme
Page 23 and 24: In terms of dialysis products, we w
Page 25 and 26: Europe, including the Middle East a
Page 27 and 28: egarding stock options and the incr
Page 29 and 30: Financing Detailed information on f
Page 31 and 32: of existing production facilities i
Page 33 and 34: The Group has no significant accrua
Page 35 and 36: is among our most important goals.
Page 37 and 38: departments enter into outline cont
Page 39 and 40: Quality and Environmental Managemen
Page 41 and 42: Clinical Databases Clinical databas
Page 43 and 44: In addition, we received regulatory
Page 45 and 46: combines RCG’s industry-leading s
Page 47 and 48: - In April 2006, new guidelines wer
Page 49 and 50: titative appraisals of the likeliho
Page 51 and 52: Risks in the Healthcare Industry Ri
Page 53 and 54: possibility of default. Please see
Page 55 and 56: to page 95 of the Consolidated Fina
Page 57 and 58: 02. 6 Outlook Business Policy Frese
Page 59 and 60: dialysis will remain the treatment
Page 61 and 62: Employees At this point, Fresenius

Operations and Business Environment - Fresenius Medical Care

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