ANNUAL REPORT 2023
Operating Companies | Investment Companies | |||||
Fresenius is a global healthcare company. We offer system-critical products and services for therapies for care of critically and chronically ill patients. Fresenius comprises the Operating Companies Fresenius Kabi and Fresenius Helios as well as the Investment Companies Fresenius Vamed and Fresenius Medical Care.
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GROUP IN FIGURES
€ in millions
Revenue and earnings
Revenue 1
EBITDA 1,2
EBIT 1,2
Net income 1,2,3
Depreciation and amortization 1,2
Earnings per share in € 1,2,3
Cash flow and balance sheet
Operating cash flow 1
Free cash flow before acquisitions, dividends and lease liabilities 1
Free cash flow after acquisitions, dividends and lease liabilities 1
Cash conversion rate 1
Total assets
Non-current assets
Equity 4
Equity ratio 4
Net debt 1
Net debt / EBITDA1,2,5
Investments 1,6
Profitability
EBIT margin 1,2
Return on invested capital (ROIC)1,2
Dividend per share in €
Employees (December 31) 1
2023 | 2022 | 2021 | 2020 | 2019 |
22,299 | 21,532 | 19,969 | 18,476 | 17,993 |
3,422 | 3,315 | 3,353 | 3,042 | 3,191 |
2,262 | 2,190 | 2,337 | 2,113 | 2,332 |
1,505 | 1,729 | 1,867 | 1,796 | 1,879 |
1,160 | 1,125 | 1,016 | 929 | 859 |
2.67 | 3.08 | 3.35 | 3.22 | 3.37 |
2,131 | 2,031 | 2,589 | 2,316 | 1,696 |
1,024 | 942 | 1,401 | 986 | 376 |
115 | -318 | 388 | 18 | - 394 |
1.0 | 0.9 | 0.9 | 0.8 | 0.5 |
45,284 | 76,400 | 71,962 | 66,646 | 67,006 |
32,764 | 58,121 | 54,501 | 50,874 | 51,742 |
19,651 | 32,218 | 29,288 | 26,023 | 26,580 |
43% | 42% | 41% | 39% | 40% |
13,268 | 13,316 | 12,650 | 13,021 | 12,980 |
3.76 | 3.80 | 3.64 | 4.12 | 3.93 |
1,346 | 2,015 | 1,635 | 1,841 | 1,664 |
10.1% | 10.2% | 11.7% | 11.4% | 13.0% |
5.2% | 5.6% | 6.2% | 5.9% | 6.7% |
- | 0.92 | 0.92 | 0.88 | 0.84 |
193,865 | 188,876 | 185,827 | 178,140 | 165,834 |
- Prior-yearfigures have been adjusted due to the application of IFRS 5 to the deconsolidated operations of Fresenius Medical Care
- Before special items
- Net income attributable to shareholders of Fresenius SE & Co. KGaA; before special items
- Including noncontrolling interests
- At average exchange rates for both net debt and EBITDA; pro forma closed acquisitions / divestitures, including lease liabilities, including Fresenius Medical Care dividend
- Investments in property, plant and equipment, and intangible assets, acquisitions
For a detailed overview of special items please see the reconciliation tables on pages 64 to 67.
View our interactive tool | 3 |
TARGETS, RESULTS, AND OUTLOOK
TARGETS 2023 1 | RESULTS 2023 | OUTLOOK 2024 | ||||
Fresenius Group | ||||||
Growth in a mid-single-digit | 6% | 3% to 6% | ||||
Revenue growth ex FMC (organic) | percentage range | (base: €21,776 m) | ||||
Broadly flat | 2% | 4% to 8% | ||||
EBIT growth ex FMC (in constant currency) 2 | (base: €2,220 m) | |||||
Liquidity and capital management | ||||||
Cash conversion rate ex FMC | Below 1 | 1 | Around 1 | |||
Net debt / EBITDA ex FMC3 | Below 4.0× | 3.76x | 3.0 to 3.5x |
Capital efficiency
Return on invested capital (ROIC) ex FMC2,4 | Around 5% | 5.2% | Within a range of 5.4% to 6.0% |
- Updated in October 2023
- Before special items
- At average expected exchange rates for both net debt and EBITDA; pro forma closed acquisitions / divestitures; before special items, including lease liabilities
- Pro forma acquisitions
For a detailed overview of special items please see the reconciliation tables on pages 64 to 67.
TARGETS, RESULTS, AND OUTLOOK
TARGETS 2023 1 | RESULTS 2023 | OUTLOOK 2024 | |||||
Operating and Investment Companies | |||||||
Fresenius Kabi | |||||||
Mid-single- | Mid-single-digit | ||||||
Revenue growth | 7% | percentage growth | |||||
(organic) | digit percentage growth | (base: €8,009 m) | |||||
Around 14% | Around 15% | ||||||
(structural margin band: | |||||||
(structural margin band: | 14.3% | 14% to 17%; | |||||
EBIT margin 2 | of 14% - 17%) | base: €1,145 m) | |||||
Fresenius Helios | |||||||
Mid-single-digit | Low-to-mid-single-digit | ||||||
Revenue growth | 5% | percentage growth | |||||
(organic) | percentage growth | (base: €11,952 m) | |||||
Within structural | Within the structural | ||||||
EBIT margin band | 10 .0% | margin band of 9% to 11% | |||||
EBIT margin 2 | of 9% - 11% | (base: €1,190 m) | |||||
Fresenius Vamed | |||||||
Low-to-mid-single-digit | Mid-single-digit | ||||||
Revenue growth | 1% | percentage growth | |||||
(organic) | percentage growth | (base: €2,201 m) | |||||
Clearly below structural | 1% to 2%-points below the | ||||||
EBIT margin band | -0.7% | structural margin band | |||||
EBIT margin 2 | of 4% - 6% | of 4% to 6% (base: -€16 m) |
- Updated in October 2023
- Before special items
For a detailed overview of special items please see the reconciliation tables on pages 64 to 67.
Group Management Report | Group Non-Financial Report | Corporate Governance | Consolidated financial statements | Further information |
TABLE OF CONTENTS
- Management Board
- Report of the Supervisory Board
- Fresenius share
- Group Management Report
-
Fundamental information about the Group
26 The Group's business model
31 Strategy and goals
36 Corporate performance criteria
42 Research and development
48 Employees
49 Change to the Supervisory Board
49 Change to the Management Board
50 Procurement
50 Quality management
50 Responsibility, environmental management, and sustainabil- ity
51 Economic report
51 Macroeconomic conditions
51 Healthcare industry
56 Overall business development
59 Results of operations, financial position, assets and liabilities
79 Overall assessment of the business situation
79 Outlook
79 General and mid-term outlook
80 Healthcare sector and markets
84 Group revenue and earnings
84 Revenue and earnings by business segment
85 Expenses
85 Tax rate
85 Cost and efficiency program
85 Liquidity and capital management
86 Investments
86 Capital structure
86 Dividend
86 Non-financial targets
87 | Opportunities and risk report | 204 | Corporate Governance | 360 | Responsibility statement | |||
87 | Opportunities management | 205 | Corporate Governance Declaration | |||||
87 | Significant characteristics of | 220 | Further information on | |||||
the Fresenius risk manage- | Corporate Governance | 361 | Auditor's report | |||||
ment system and entire inter- | 222 | Compensation report | ||||||
nal control system | ||||||||
91 Assessment of the overall risk | 369 | Further information | ||||||
situation | 261 | Consolidated financial statements | 370 | Boards | ||||
91 Risks affecting the one-year | 262 | Consolidated statement of income | 370 | Supervisory Board | ||||
forecast period | 263 | Consolidated statement of | Fresenius SE & Co. KGaA | |||||
92 | Risk areas | comprehensive income | 372 | Management Board | ||||
264 | Consolidated statement | Fresenius Management SE | ||||||
of financial position | 373 | Supervisory Board | ||||||
102 | Separate | 265 | Consolidated statement | Fresenius Management SE | ||||
Group Non-Financial Report | of cash flows | 374 | Glossary | |||||
103 | Strategy and management | 267 | Consolidated statement | 379 | Imprint | |||
116 | Well-being of the patient | of changes in equity | 380 | Financial Calendar | ||||
132 | Innovation | 269 | Consolidated segment reporting | 380 | Fresenius share / ADR | |||
137 | Digital transformation | 380 | Contact | |||||
142 | Cybersecurity | |||||||
146 | Employees | 271 | Notes | |||||
157 | Occupational health and safety | 272 | General notes | |||||
164 | Diversity and equal opportunities | 295 | Notes on the consolidated | |||||
169 | Compliance and Integrity | statement of income | ||||||
184 | Environment | 302 Notes on the consolidated | ||||||
194 | Further key figures | statement of financial | ||||||
199 | Report profile | position | ||||||
201 | Independent practitioner's report | 327 | Other notes |
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Group Management Report | Group Non-Financial Report | Corporate Governance | Consolidated financial statements | Further information |
Letter to our shareholders | Management Board | Report of the Supervisory Board | Fresenius share
TO OUR SHAREHOLDERS
- Management Board
- Report of the Supervisory Board
- Fresenius share
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LETTER TO
OUR SHAREHOLDERS
Dear Shareholders,
The healthcare industry is not only of fundamental importance to people's well-being, but also a highly attractive economic sector: nowhere are more investments currently being made. Healthcare is the most exciting field of activity right now for future technologies like artificial intelligence (AI) and robotics.
Fresenius is at the heart of healthcare and will continue to draw on these developments in the future to further strengthen its position as a leading therapy-focused company. In the 2023 fiscal year, we achieved important milestones and shall maintain the high pace of implementation in the coming years.
Michael Sen | 8 |
Chairman of the Management Board |
Group Management Report | Group Non-Financial Report | Corporate Governance | Consolidated financial statements | Further information |
Letter to our shareholders | Management Board | Report of the Supervisory Board | Fresenius share
The healthcare industry offers tremendous opportunities. It is growing structurally, yet at the same time facing the challenge of having to use resources more efficiently.
A demographic shift is taking place: in many regions of the world, the population is aging and the number of people with chronic diseases is increasing. The importance of health equity - that is to say, fair, affordable, and high- quality healthcare for all people - is rightly growing. Health awareness has improved among many people, too.
At the same time, great progress has been made in rec- ognizing, treating, and curing diseases that were until recently considered incurable. This is thanks to disruptive changes such as cell and gene research in biology, technological advances in AI and robotics, and ever greater quantities of usable data.
We have realigned our company to the #FutureFresenius strategy and are now focusing on simplifying the structure, sharpening our focus, and enhancing performance. Fresenius previously had a complex corporate structure. In today's fast-paced world, we must be faster and more focused. Only by improving Fresenius can we fulfil our mission and thus improve people's health.
Humans and machines for optimal therapy: robot-assisted surgery enables greater precision and therefore a faster recovery.
Simplified structure
We have reduced complexity and created transparency and flexibility. Fresenius completed the deconsolidation of Fresenius Medical Care (FMC) at the end of November 2023. This historic step offers both companies tremendous advantages: decisions are now made faster and more effi- ciently. The management teams can concentrate on their respective core business. Capital allocation has improved. FMC is no longer part of the fully consolidated subsidiaries of Fresenius. The latter continues to hold a 32 percent stake in of FMC's share capital however and therefore has a vested interest in its value-preserving development.
- Great progress has been made in recognizing, treating, and curing diseases that were until recently considered incurable. «
Sharper focus
We are now concentrating on our operating companies Fresenius Helios and Fresenius Kabi. Both businesses afford attractive market positions and good growth oppor- tunities. We manage FMC and the hospital and healthcare provider Fresenius Vamed as investment companies. At the same time, we are divesting ourselves of businesses for which we are no longer the "best owner." We have sold our hospital business in Peru and the Eugin chain of fertility clinics, for example.
With Fresenius Helios in Germany and Quirónsalud in Spain, Fresenius is Europe's leading private hospital operator and treats around 26 million patients every year. Two things that makes us proud: in 2023, Newsweek magazine voted five Quirónsalud clinics among the world's best specialized hospitals. And Wirtschaftswoche business magazine named Fresenius Helios the top healthcare provider in Germany in the "Regional clinic/hospital groups" category.
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Group Management Report | Group Non-Financial Report | Corporate Governance | Consolidated financial statements | Further information |
Letter to our shareholders | Management Board | Report of the Supervisory Board | Fresenius share
A few examples of innovations:
- At Quirónsalud, digital solutions already support a large part of the patient journey. The Casiopea platform developed in-house is used to assign patients to the right location and to initiate the correct course of treat- ment before a patient has even visited the doctor or clinic. Overall, the outcome is better coordinated pro- cesses, more pleasant treatment paths, and more suc- cessful therapies.
- AI applications and digital solutions are also increasingly being integrated into everyday clinical practice at our Fresenius Helios facilities in Germany. Thanks to AI, for
example in the analysis of radiological images or use of robots during minimally invasive procedures, diagnoses and medical interventions are becoming more precise and efficient. This is good for both the medical quality and the company's economic success.
Fresenius Kabi is successfully implementing the Vision 2026 strategy. The generics we produce save healthcare systems around the world substantial sums of money and make high-quality medicines available to a growing number of people. Seventy percent of the intravenous drugs we deliver to the USA are on the list of essential medicines of the U.S. Food and Drug Administration (FDA). With our portfolio and pipeline of biosimilars, new treatment options with affordable medicines and medical products are constantly becoming available - in 40 countries worldwide already.
- Fresenius is at the heart of health- care and will continue to draw on these developments in the future to further strengthen its position as a leading therapy-focused company. «
Biosimilars are follow-on versions of biopharmaceuticals, that is to say, biotechnological drugs that are authorized after the patent period of the original active ingredient has expired. They are used to treat autoimmune diseases
or cancer.
Biosimilars from Fresenius Kabi allow more people access to state-of-the-art therapies.
Some highlights at Fresenius Kabi:
- In 2023, we among others achieved two milestones with our biosimilars: with the launch of Tyenne®, which is used to treat inflammatory and autoimmune diseases, a biosimilar with the active ingredient tocilizumab is now available in the EU for the first time. And in the USA, we significantly expanded the treatment options for patients with autoimmune diseases and cancer through the market launches of the two biosimilars Idacio® and Stimufend®.
- In terms of medical technology, we offer state-of-the-art infusion pump technology with the Ivenix® infusion sys- tem. In the USA, we have signed a multi-year agreement with the renowned U.S. hospital group, the Mayo Clinic, for the supply and service of 10,000 Ivenix® large-volume infusion pumps for its hospitals and clinics.
- Fresubin® PLANT-BASED Drink, a vegan alternative, complements our extensive range of clinical nutrition and meets the growing demand for plant-based alternatives.
Enhanced performance
With the implementation of our strategy at the start of the year, we also established our Fresenius Financial Frame- work. The main new feature is a focus on returns through clearly defined EBIT margin bands for the business segments and capital returns at Group level.
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Fresenius SE & Co. KGaA published this content on 14 March 2024 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 14 March 2024 12:33:09 UTC.