Investor News Fresenius Medical Care AG & Co. KGaA Investor Relations Else-Kr ner-Str. 1 D-61352 Bad Homburg Contact: Oliver Maier Phone: + 49 6172 609 2601 Fax: + 49 6172 609 2301 E-mail: ir@fmc-ag.com North America: Te

Fresenius Medical Care Reports Strong Third Quarter and Nine

Months Results; Improved Guidance for 2009

Bad Homburg, Germany - Fresenius Medical Care AG & Co. KGaA ("the Company" or "FMC AG & Co. KGaA"), the world's largest provider of dialysis products and services, today announced its results for the third quarter and first nine months of 2009.

Net revenue for the third quarter of 2009 increased by 6% to $2,889 million (10% at constant currency) compared to the third quarter of 2008.Organic revenue growth worldwide was 8%. Dialysis Services revenue grew by 8% to $2,147 million (10% at constant currency) in the third quarter of 2009. Dialysis Product revenue increased by 2% to $742 million (an increase of 8% at constant currency) in the same period.

North America revenue increased by 10% to $1,950 million. Organic revenue growth was 8%. Dialysis Services revenue grew by 10% to $1,741 million. Average revenue per treatment for the U.S. clinics increased

to $348 in the third quarter of 2009 compared to $333 for the same quarter in 2008 and $344 for the second quarter of 2009. This development was mainly based on reimbursement increases and increased utilization of pharmaceuticals.

Dialysis Product revenue increased by 14% to $209 million and was led by pharmaceutical sales, especially of the newly licensed intravenous

International revenue remained nearly unchanged at $939 million, compared to the third quarter of 2008. Based on constant currency, revenue grew by 9%. Organic revenue growth was 7%. Dialysis Services revenue was $406 million, an increase of 2% (+12% at constant currency). Dialysis Product revenue decreased by 2% to $533 million. Product sales grew by 6% based on constant currencies, led by increased pharmaceutical sales and sales of dialyzers.

Operating income (EBIT) increased by 7% to $451 million compared to $422 million

in the third quarter of 2008, resulting in an operating margin of 15.6%, equal

to the operating margin for the third quarter of 2008. Compared to the second

quarter of 2009 this represents a 50 basis points improvement. The third

quarter operating margin was favorably impacted by an increase in revenue per

treatment, an excellent cost management in the U.S. and a decrease in bad debt

expenses. The operating margin development was negatively influenced

by increased prices for pharmaceuticals, the impact of the launch of

a generic version of PhosLo in the U.S. market and unfavorable

exchange rate effects in the International segment.

In North America, the operating margin was unchanged

at 16.7%, as in the third quarter of 2008. The margin was favorably

impacted by an increase in revenue per treatment, including

commercial payor revenue, higher utilization of EPO and Medicare

reimbursement increases, an excellent cost management in the U.S. and

a decrease in bad debt expenses thanks to higher cash collections on

receivables. This was offset by cost increases for pharmaceuticals

related to both price and utilization, as well as the impact of the

launch of a generic version of PhosLo in the U.S. market and increased depreciation expense.

In the International segment, the operating margin increased by 60 basis points to 16.7% due to lower production costs resulting from lower prices for raw material and energy as well as economies of scale and lower bad debt expenses, which was partially offset by unfavorable foreign exchange rate effects.

Net interest expense for the third quarter of 2009 was $75 million compared to $87 million in the same quarter of 2008, mainly due to lower short-term interest rates.

Income tax expense was $131 million for the third quarter of 2009 compared to $120 million in the third quarter of 2008, reflecting effective tax rates of 35.0% and 35.7%, respectively.

Net income attributable to FMC AG & Co. KGaA for the third quarter of 2009 was $225 million, an increase of 9%.

Earnings per share (EPS) for the third quarter of 2009 rose by 9% to $0.76 per ordinary share compared to $0.69 for the third quarter of 2008. The weighted average number of shares outstanding for the third quarter of 2009 was approximately 298.3 million shares compared to 297.2 million shares for the third quarter of 2008. The increase in shares outstanding resulted from stock option exercises in the past twelve months.

In the third quarter of 2009, the Company generated $443 million in cash from operations, an increase of 41% compared to the third quarter of 2008 and representing approximately 15% of revenue. The cash flow performance was positively influenced by increased earnings and a favorable development of the Days Sales Outstanding.

A total of $139 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions was $304 million compared to $155 million in the third quarter of 2008. A total of $26 million in cash was used for acquisitions net of divestitures. Free Cash Flow after acquisitions and divestitures was $278 million compared to $116 million in the third quarter of last year.

Nine Months Ended September 30, 2009:

Revenue and Earnings

Net revenue was $8,212 million, up 4% from the first nine months of 2008. At constant currency, net revenue rose 9%. Organic growth was 8% in the first nine months of 2009.

Operating income (EBIT) increased by 2% to $1,265 million compared to

$1,240 million in the first nine months of 2008, resulting in an

operating margin of 15.4% compared to 15.7% for the first nine months

of 2008. This development was mainly due to higher personnel

expenses, price increases for pharmaceuticals including Heparin as

well as the impact of the launch of a generic version of PhosLo in

the U.S. market. These effects were partially offset by a strong

performance of the dialysis product business, increased commercial

payor revenue as well as the effect of cost control measures.

Net interest expense for the first nine months of 2009 was $225 million compared to $252 million in the same period of 2008, mainly due to lower short-term interest rates.

Income tax expense was $345 million in the first nine months of 2009 compared to $357 million in the same period in 2008, reflecting effective tax rates of 33.2% and 36.1%, respectively. Tax expense was positively impacted by a non-recurring revaluation of a tax claim recorded in the second quarter of 2009.

For the first nine months of 2009, net income attributable to FMC AG & Co. KGaA was $645 million, up 7% from the first nine months of 2008.

Earnings per ordinary share rose by 6% to $2.16. The weighted average number of shares outstanding during the first nine months of 2009 was approximately 298.0 million.

Cash from operations during the first nine months of 2009 was $880 million compared to $716 million for the same period in 2008, representing approximately 11% of revenue. The cash flow generation benefited from the favorable development of the Days Sales Outstanding.

A total of $388 million was spent for capital expenditures, net of disposals. Free Cash Flow before acquisitions for the first nine months of 2009 was $492 million compared to $223 million in the same period in 2008. A total of $57 million in cash was used for acquisitions net of divestitures. Free Cash Flow after acquisitions and divestitures was $435 million compared to $93 million in the first nine months of last

Please refer to the attachments for a complete overview on the third quarter and first nine months of 2009 and the reconciliation of non-GAAP financial measures included in this release to the most comparable GAAP financial measures.

Patients - Clinics - Treatments

As of September 30, 2009, Fresenius Medical Care treated 192,804 patients worldwide, which represents a 6% increase compared to the same period last year. North America provided dialysis treatments for 130,522 patients, an increase of 4%. Including 31 clinics managed by Fresenius Medical Care North America, the number of patients in North America was 132,158. The International segment served 62,282 patients, an increase of 10% over last

As of September 30, 2009, the Company operated a total of 2,509 clinics worldwide. This is comprised of 1,749 clinics in North America (1,780 including managed clinics), an increase of 5%, and 760 clinics in the International segment, an increase of 11%.

Fresenius Medical Care delivered approximately 21.84 million dialysis treatments worldwide during the first nine months of 2009. This represents an increase of 6% year over year. North America accounted for 14.75 million treatments, an increase of 4%, and the International segment delivered 7.09 million treatments, an increase of 10% over last year.

As of September 30, 2009, Fresenius Medical Care had 67,245 employees (full-time equivalents) worldwide compared to 63,990 employees as of September 30, 2008. This increase of over 3,200 employees is due to the overall growth in the Company's business.

The ratio of debt to Earnings before Interest, Taxes, Depreciation and Amortization (EBITDA) decreased from 2.71 at the end of the third quarter of 2008 to 2.62 at the end of the third quarter of 2009. At the end of 2008, the debt/EBITDA ratio was 2.69.

In the third quarter of 2009, Standard & Poor's Rating Services continued to rate the Company's corporate credit as BB' with a stable' outlook. Moody's also affirmed its rating of the Company's corporate credit as Ba1' with a stable' outlook. As in the previous quarter, Fitch rates the Company's corporate credit as BB' while revising its outlook from

negative' to stable'. For further information on Fresenius Medical Care's credit ratings, maturity profiles and credit instruments, please visit our website at www.fmc-ag.com / Investor Relations / Credit Relations.

For the full year of 2009, the Company now expects to achieve revenue of around $11.2 billion (previously $11.1 billion), an increase of around 8% in constant currency.

Net income attributable to FMC

AG & Co. KGaA is now

expected to be between $865 million and $890 million in 2009. Previously the Company

expected the net income to be in the range of $850 million and $890 million for

In addition, the Company expects to spend $550 to $650 million on capital expenditures and $200 to $250 million (previously $200 to $300 million) on acquisitions. The projected debt/EBITDA ratio has been retained unchanged at below 2.7.

Ben Lipps, Chief Executive Officer of

Fresenius Medical Care, said: "We are very pleased with our

results in the third quarter of 2009, which reflects an excellent

performance by all regions. While we maintained our increased

commitment to research and development, our sustained high organic

growth globally and good cost containment accounted for this overall

successful operating performance. The free cash flow for the third

quarter exceeded our expectations and resulted from excellent cash

collections in North America. Our strong performance in the quarter

provides the basis for us to improve our guidance for the full year

Fresenius Medical Care will hold a conference call to discuss the results of the third quarter and the first nine months of 2009 on Tuesday, November 03, 2009, at 3:30 pm CET / 9:30 am EST. The Company invites investors to listen to the live webcast of the call at the Company's website www.fmc-ag.com in the "Investor Relations" section. A replay will be available shortly after the call.

Fresenius Medical Care is the world's largest integrated provider of products and services for individuals undergoing dialysis because of chronic kidney failure, a condition that affects more than 1,770,000 individuals worldwide. Through its network of 2,509 dialysis clinics in North America, Europe, Latin America, Asia-Pacific and Africa, Fresenius Medical Care provides dialysis treatment to 192,804 patients around the globe. Fresenius Medical Care is also the

world's leading provider of dialysis products such as hemodialysis machines, dialyzers and related disposable products. Fresenius Medical Care is listed on the Frankfurt Stock Exchange (FME, FME3) and the New York Stock Exchange (FMS, FMS/P).

For more information about Fresenius Medical Care visit the Company's website at www.fmc-ag.com.

This release contains forward-looking statements that are subject to various risks and uncertainties. Actual results could differ materially from those described in these forward-looking statements due to certain factors, including changes in business, economic and competitive conditions, regulatory reforms, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, and the availability of financing. These and other risks and

uncertainties are detailed in Fresenius Medical Care AG & Co. KGaA's reports filed with the U.S. Securities and Exchange Commission. Fresenius Medical Care AG & Co. KGaA does not undertake any responsibility to update the forward-looking statements in this release.

1) Due to the adoption of the new accounting rule ASC 810 (US GAAP), tax expenses related to minority interests of partnerships were reclassified to noncontrolling interest. The effect is neutral to net income attributable to FMC AG & Co. KGaA. The previous year's periods have been adjusted accordingly.

1) EBITDA is the basis for determining compliance with certain covenants in Fresenius Medical Care's long-term debt instruments.

cc = at constant exchange rates

1) International standard BCR CRM470