07.22.21
Rank: #18 (Last year: #18)
$6.22 Billion ($44.55 Billion)
Prior Fiscal: $5.50 Billion
Percentage Change: +13.1%
No. of Employees: 125,364 (total)
Global Headquarters: Bad Homburg, Germany
KEY EXECUTIVES:
Rice Powell, CEO and Management Board Chairman, Fresenius Medical Care AG & Co.
Helen Giza, CFO, Fresenius Medical Care AG & Co.
Franklin W. Maddux, M.D., Global Chief Medical Officer, Fresenius Medical Care AG & Co.
Dr. Olaf Schermeier, CEO for Global R&D, Fresenius Medical Care AG & Co.
Kent Wanzek, CEO, Global Manufacturing, Quality and Supply, Fresenius Medical Care AG & Co.
Bill Valle, CEO, Fresenius Medical Care North America
Mike Asselta, President, Fresenius Kidney Care
Mark Costanzo, President, Fresenius Renal Therapies Group
David Pollack, President, Integrated Care Group
Joe Turk, President, Home and Critical Care Therapies
Dennis Braun, CFO, Fresenius Medical Care North America
Brian Gauger, Chief Development Officer, Fresenius Medical Care North America
Rob Kossmann, M.D., Chief Medical Officer, Fresenius Medical Care North America
Anvil Nelson Jr. refuses to be defined by his illness.
The 64-year-old entrepreneur lost his first kidney in 2003 and surrendered his second to cancer 14 years later, but neither forfeiture has dramatically changed his modus vivendi. If anything, the losses have made Nelson more determined than ever to live his life as fully and normally as possible.
And he’s managed to do just that.
Besides running his own chemical manufacturing firm (QVS Inc.) two hours away from his Nashville, Tenn., home, Nelson is a board member of both the city’s Rescue Mission, a Christian charity organization, and the Tennessee Kidney Foundation.
In addition, Nelson maintains a leadership role at his church—a position he’s held for more than 20 years—and officiates at college and state-level track and field competitions. He also spends as much time as he can with his wife and two children, who live nearby.
“I have a pretty busy life,” he said with a chuckle. “My family actually thinks I’m too busy.”
Maybe so, but Nelson still makes time for life-sustaining weekly hemodialysis treatments, which he schedules around work, family and community obligations. Nelson initially underwent treatment at a dialysis center (after recovering from cancer surgery), but found it too time-consuming and exhausting.
“It was very rigorous, because you had to schedule it and stay there for a few hours,” he recounted in a patient story posted online. “I booked my treatments for 5 a.m. on Mondays, Wednesdays, and Fridays, so I could use the rest of the day, but that meant getting up around 4 o’clock in the morning to drive there. After getting treatment, you need time to recover. Often, I couldn’t even manage to drive to work in Chattanooga on Mondays after dialysis because I had to rest. I wanted to keep on living my life and not be tied to a center. That’s why I initially considered peritoneal dialysis as it was the only way I could continue working as usual.”
Nelson eventually found a better way, though: Home hemodialysis, courtesy of a portable system from Fresenius Medical Care. Cleared by the U.S. Food and Drug Administration in August 2017, the NxStage System One is a portable hemodialysis solution cleared for home daytime or nocturnal use. The easily transportable machine features a uniquely designed volumetric balancing system that provides scaleless fluid accuracy and reduces waste bag disposal noise. NxStage allows patients to individualize their own therapy based on their conditions and needs (continuous renal replacement therapy, intermittent hemodialysis, sustained low-energy dialysis, prolonged intermittent renal replacement therapy, ultra filtration, or therapeutic plasma exchange).
Additionally, the NxStage System comes with an app for the electronic collection and transmission of treatment information. The app has automated flowsheets to simplify data tracking and recording.
Notifications provide reminders or support for operational issues; pop-up notifications help patients troubleshoot problems when alarms go off, according to Fresenius. User guides, instructions, and a keyword search tool are other features designed to streamline overall operations and debugging.
“It gives me a lot of flexibility,” Nelson said of the NxStage System. I usually choose to do treatment in the afternoon or early evening after work. That means I don’t have to dress up and leave the house. I don’t want to make it sound too rosy, but home dialysis is a great opportunity. I can really get on with my life, run my business, and even travel.”
Already on the rise in 2019, home dialysis became considerably more prevalent last year during the global pandemic. Fresenius Medical Care—one of the top two U.S. dialysis providers—reported a 25 percent boost in home dialysis training sessions during Q1 2020 and a 14 percent gain in home treatments last year vs. 2019. Before the coronavirus emerged, the company served more than 25,000 dialysis patients at home and reported record growth of its in-home program (expanding at nine times the rate of its in-center dialysis offerings).
“The pandemic and the requirement for social distancing, and at times, isolation, have highlighted the advantages of dialysis at home,” Jeffrey Hymes, M.D., chief medical officer for Fresenius Kidney Care (part of Fresenius Medical Care North America), told Renal & Urology News last April. “We expect the increased interest in home dialysis will continue even after the acute crisis passes and help expand the strong growth in home dialysis we have experienced over the past year.”
Helping to foster that growth was a federal push two summers ago to reduce end stage renal disease spending by 2025 and mounting clinical evidence of home treatment benefits (lower costs, less time-consuming, fewer deaths). Meanwhile, dialysis providers such as Fresenius Medical, Outset Medical Inc., and DaVita Kidney Care began preparing for the shift to home dialysis by modifying their product portfolios through innovation and/or acquisition.
Fresenius chose the latter path, purchasing Boston-based NxStage Medical Inc. for $2 billion in a deal that extended the company’s reach beyond the clinic. Finalized in February 2019, the purchase instantly augmented Fresenius’ product lineup with portable dialysis machines (like Nelson’s NxStage System One) for home or clinical use. The investment was a sound one, as NxStage generated $300 million in sales for its parent firm in 2019, according to Fresenius financial reports.
Last spring, Fresenius integrated the NxStage portfolio in Europe, the Middle East, and Africa, where about 7 percent of patients purify their blood at home.
Besides the NxStage Medical purchase, Fresenius also has bolstered its home dialysis prowess via remote patient monitoring and telehealth technology. In July 2019, for example, Fresenius invested in Denver-based BioIntelliSense, developer of a medical-grade data services platform for continuous health monitoring, predictive analytics, and algorithmic clinical insights. Three months later, the company launched a connected health platform (TheHub) designed to help patients, caregivers, and providers better collaborate and monitor treatments.
In addition, Fresenius has created a new global medical office to spearhead its R&D and share best practices throughout its dialysis clinics.
“...we continue to make good progress with our expansion of home dialysis,” Fresenius Management Board Chairman Stephan Sturm told shareholders in a letter within the company’s 2020 annual report. “We have now successfully completed the integration of the NxStage portfolio in the Europe, Middle East, and Africa region. This will enable us to offer even more patients a greater choice of treatment methods, especially treatment in their home environment. Already in the United States, 14 percent of the dialysis treatments we provide are performed in patients’ homes. Dialysis at home offers many advantages and demand is rising steadily in many regions. The pandemic has further strengthened this trend.”
The trend helped boost sales last year, but not by much. Fresenius Group revenue rose 2 percent to 36.3 billion euros, driven in part by increases in three of its four business segments. Fresenius Medical Care and Fresenius Kabi proceeds improved 2 percent and 1 percent respectively, with health care product revenue within the Medical Care division swelling 4 percent to 3.74 billion euros. However, Fresenius Helios’ 6 percent gain was obliterated by an equivalent decrease in Fresenius Vamed sales.
Group gross profit was flat at 10.31 billion euros, and net income fell 7 percent to 2.82 billion euros, according to the company’s annual report. Earnings per (ordinary) share slipped 4 percent to 3.22 euros.
“Earnings declined for the first time in many years, 3 percent in constant currency,” Sturm noted in his shareholder letter. “Under the circumstances, it was a successful business year, though not a year of dynamic growth. It was certainly not the kind of year that people have come to expect from us nor was it what we expected early last year, before the coronavirus struck.”
Expectations aside, Fresenius weathered the pandemic with relatively minor damage thanks to a diversified portfolio that shielded the firm from the financial repercussions of repeated lockdowns and social distancing. Fresenius also benefited from surging demand for its critical care devices (it increased production of those products at the pandemic’s height) and home hemodialysis services (household treatments skyrocketed 41 percent in North America during Q2 2020).
Yet Fresenius couldn’t fully insulate itself from COVID-19’s fallout. Its Kabi and Helios segments—the latter, Europe’s largest hospital operator—fell victim to the postponement/cancellation of elective surgeries, while waning interest in rehabilitation services and health tourism, and fewer dollars for capital projects handicapped Vamed’s sales. Dialysis products and services took a substantial hit in Q4 2020 as the virus claimed a significant number of chronic kidney disease patients during its second lap around the world.
During COVID-19’s initial run, Fresenius gained U.S. Food and Drug Administration clearance for the Novalung extracorporeal membrane oxygenation (ECMO) system, used to treat acute respiratory or cardiopulmonary failure. Novalung was the first ECMO system to be cleared for more than six hours of use as extracorporeal life support, according to Fresenius Medical Care North America (FMCNA).
The Novalung System is indicated for long-term respiratory/cardiopulmonary support; it provides assisted extracorporeal circulation and physiologic gas exchange (oxygenation and CO2 removal) of blood in adults suffering from acute respiratory failure or acute cardiopulmonary failure.
The therapy is designed for use in clinical care settings such as intensive care units, operating rooms, cardiac catheterization labs, and emergency departments, for patients where other available treatment options have failed and continued clinical deterioration is expected, or the risk of death is imminent. These may include:
“Novalung is a critical leap forward in providing heart and lung support therapy for a longer duration than ever available before,” Mark Costanzo, president of FMCNA’s Renal Therapies Group, said upon the product’s clearance in February 2020. “We’ve applied our leadership and technical expertise in renal medical devices to elevate standards for acute respiratory and cardiopulmonary failure treatments and technologies. We’re proud to broaden our care offerings to provide new therapies for patients with acute cardiopulmonary conditions.”
$6.22 Billion ($44.55 Billion)
Prior Fiscal: $5.50 Billion
Percentage Change: +13.1%
No. of Employees: 125,364 (total)
Global Headquarters: Bad Homburg, Germany
KEY EXECUTIVES:
Rice Powell, CEO and Management Board Chairman, Fresenius Medical Care AG & Co.
Helen Giza, CFO, Fresenius Medical Care AG & Co.
Franklin W. Maddux, M.D., Global Chief Medical Officer, Fresenius Medical Care AG & Co.
Dr. Olaf Schermeier, CEO for Global R&D, Fresenius Medical Care AG & Co.
Kent Wanzek, CEO, Global Manufacturing, Quality and Supply, Fresenius Medical Care AG & Co.
Bill Valle, CEO, Fresenius Medical Care North America
Mike Asselta, President, Fresenius Kidney Care
Mark Costanzo, President, Fresenius Renal Therapies Group
David Pollack, President, Integrated Care Group
Joe Turk, President, Home and Critical Care Therapies
Dennis Braun, CFO, Fresenius Medical Care North America
Brian Gauger, Chief Development Officer, Fresenius Medical Care North America
Rob Kossmann, M.D., Chief Medical Officer, Fresenius Medical Care North America
Anvil Nelson Jr. refuses to be defined by his illness.
The 64-year-old entrepreneur lost his first kidney in 2003 and surrendered his second to cancer 14 years later, but neither forfeiture has dramatically changed his modus vivendi. If anything, the losses have made Nelson more determined than ever to live his life as fully and normally as possible.
And he’s managed to do just that.
Besides running his own chemical manufacturing firm (QVS Inc.) two hours away from his Nashville, Tenn., home, Nelson is a board member of both the city’s Rescue Mission, a Christian charity organization, and the Tennessee Kidney Foundation.
In addition, Nelson maintains a leadership role at his church—a position he’s held for more than 20 years—and officiates at college and state-level track and field competitions. He also spends as much time as he can with his wife and two children, who live nearby.
“I have a pretty busy life,” he said with a chuckle. “My family actually thinks I’m too busy.”
Maybe so, but Nelson still makes time for life-sustaining weekly hemodialysis treatments, which he schedules around work, family and community obligations. Nelson initially underwent treatment at a dialysis center (after recovering from cancer surgery), but found it too time-consuming and exhausting.
“It was very rigorous, because you had to schedule it and stay there for a few hours,” he recounted in a patient story posted online. “I booked my treatments for 5 a.m. on Mondays, Wednesdays, and Fridays, so I could use the rest of the day, but that meant getting up around 4 o’clock in the morning to drive there. After getting treatment, you need time to recover. Often, I couldn’t even manage to drive to work in Chattanooga on Mondays after dialysis because I had to rest. I wanted to keep on living my life and not be tied to a center. That’s why I initially considered peritoneal dialysis as it was the only way I could continue working as usual.”
Nelson eventually found a better way, though: Home hemodialysis, courtesy of a portable system from Fresenius Medical Care. Cleared by the U.S. Food and Drug Administration in August 2017, the NxStage System One is a portable hemodialysis solution cleared for home daytime or nocturnal use. The easily transportable machine features a uniquely designed volumetric balancing system that provides scaleless fluid accuracy and reduces waste bag disposal noise. NxStage allows patients to individualize their own therapy based on their conditions and needs (continuous renal replacement therapy, intermittent hemodialysis, sustained low-energy dialysis, prolonged intermittent renal replacement therapy, ultra filtration, or therapeutic plasma exchange).
Additionally, the NxStage System comes with an app for the electronic collection and transmission of treatment information. The app has automated flowsheets to simplify data tracking and recording.
Notifications provide reminders or support for operational issues; pop-up notifications help patients troubleshoot problems when alarms go off, according to Fresenius. User guides, instructions, and a keyword search tool are other features designed to streamline overall operations and debugging.
“It gives me a lot of flexibility,” Nelson said of the NxStage System. I usually choose to do treatment in the afternoon or early evening after work. That means I don’t have to dress up and leave the house. I don’t want to make it sound too rosy, but home dialysis is a great opportunity. I can really get on with my life, run my business, and even travel.”
Already on the rise in 2019, home dialysis became considerably more prevalent last year during the global pandemic. Fresenius Medical Care—one of the top two U.S. dialysis providers—reported a 25 percent boost in home dialysis training sessions during Q1 2020 and a 14 percent gain in home treatments last year vs. 2019. Before the coronavirus emerged, the company served more than 25,000 dialysis patients at home and reported record growth of its in-home program (expanding at nine times the rate of its in-center dialysis offerings).
“The pandemic and the requirement for social distancing, and at times, isolation, have highlighted the advantages of dialysis at home,” Jeffrey Hymes, M.D., chief medical officer for Fresenius Kidney Care (part of Fresenius Medical Care North America), told Renal & Urology News last April. “We expect the increased interest in home dialysis will continue even after the acute crisis passes and help expand the strong growth in home dialysis we have experienced over the past year.”
Helping to foster that growth was a federal push two summers ago to reduce end stage renal disease spending by 2025 and mounting clinical evidence of home treatment benefits (lower costs, less time-consuming, fewer deaths). Meanwhile, dialysis providers such as Fresenius Medical, Outset Medical Inc., and DaVita Kidney Care began preparing for the shift to home dialysis by modifying their product portfolios through innovation and/or acquisition.
Fresenius chose the latter path, purchasing Boston-based NxStage Medical Inc. for $2 billion in a deal that extended the company’s reach beyond the clinic. Finalized in February 2019, the purchase instantly augmented Fresenius’ product lineup with portable dialysis machines (like Nelson’s NxStage System One) for home or clinical use. The investment was a sound one, as NxStage generated $300 million in sales for its parent firm in 2019, according to Fresenius financial reports.
Last spring, Fresenius integrated the NxStage portfolio in Europe, the Middle East, and Africa, where about 7 percent of patients purify their blood at home.
Besides the NxStage Medical purchase, Fresenius also has bolstered its home dialysis prowess via remote patient monitoring and telehealth technology. In July 2019, for example, Fresenius invested in Denver-based BioIntelliSense, developer of a medical-grade data services platform for continuous health monitoring, predictive analytics, and algorithmic clinical insights. Three months later, the company launched a connected health platform (TheHub) designed to help patients, caregivers, and providers better collaborate and monitor treatments.
In addition, Fresenius has created a new global medical office to spearhead its R&D and share best practices throughout its dialysis clinics.
“...we continue to make good progress with our expansion of home dialysis,” Fresenius Management Board Chairman Stephan Sturm told shareholders in a letter within the company’s 2020 annual report. “We have now successfully completed the integration of the NxStage portfolio in the Europe, Middle East, and Africa region. This will enable us to offer even more patients a greater choice of treatment methods, especially treatment in their home environment. Already in the United States, 14 percent of the dialysis treatments we provide are performed in patients’ homes. Dialysis at home offers many advantages and demand is rising steadily in many regions. The pandemic has further strengthened this trend.”
The trend helped boost sales last year, but not by much. Fresenius Group revenue rose 2 percent to 36.3 billion euros, driven in part by increases in three of its four business segments. Fresenius Medical Care and Fresenius Kabi proceeds improved 2 percent and 1 percent respectively, with health care product revenue within the Medical Care division swelling 4 percent to 3.74 billion euros. However, Fresenius Helios’ 6 percent gain was obliterated by an equivalent decrease in Fresenius Vamed sales.
Group gross profit was flat at 10.31 billion euros, and net income fell 7 percent to 2.82 billion euros, according to the company’s annual report. Earnings per (ordinary) share slipped 4 percent to 3.22 euros.
“Earnings declined for the first time in many years, 3 percent in constant currency,” Sturm noted in his shareholder letter. “Under the circumstances, it was a successful business year, though not a year of dynamic growth. It was certainly not the kind of year that people have come to expect from us nor was it what we expected early last year, before the coronavirus struck.”
Expectations aside, Fresenius weathered the pandemic with relatively minor damage thanks to a diversified portfolio that shielded the firm from the financial repercussions of repeated lockdowns and social distancing. Fresenius also benefited from surging demand for its critical care devices (it increased production of those products at the pandemic’s height) and home hemodialysis services (household treatments skyrocketed 41 percent in North America during Q2 2020).
Yet Fresenius couldn’t fully insulate itself from COVID-19’s fallout. Its Kabi and Helios segments—the latter, Europe’s largest hospital operator—fell victim to the postponement/cancellation of elective surgeries, while waning interest in rehabilitation services and health tourism, and fewer dollars for capital projects handicapped Vamed’s sales. Dialysis products and services took a substantial hit in Q4 2020 as the virus claimed a significant number of chronic kidney disease patients during its second lap around the world.
During COVID-19’s initial run, Fresenius gained U.S. Food and Drug Administration clearance for the Novalung extracorporeal membrane oxygenation (ECMO) system, used to treat acute respiratory or cardiopulmonary failure. Novalung was the first ECMO system to be cleared for more than six hours of use as extracorporeal life support, according to Fresenius Medical Care North America (FMCNA).
The Novalung System is indicated for long-term respiratory/cardiopulmonary support; it provides assisted extracorporeal circulation and physiologic gas exchange (oxygenation and CO2 removal) of blood in adults suffering from acute respiratory failure or acute cardiopulmonary failure.
The therapy is designed for use in clinical care settings such as intensive care units, operating rooms, cardiac catheterization labs, and emergency departments, for patients where other available treatment options have failed and continued clinical deterioration is expected, or the risk of death is imminent. These may include:
- Failure to wean from cardiopulmonary bypass following cardiac surgery in adult patients; or
- ECMO-assisted cardiopulmonary resuscitation in adults.
“Novalung is a critical leap forward in providing heart and lung support therapy for a longer duration than ever available before,” Mark Costanzo, president of FMCNA’s Renal Therapies Group, said upon the product’s clearance in February 2020. “We’ve applied our leadership and technical expertise in renal medical devices to elevate standards for acute respiratory and cardiopulmonary failure treatments and technologies. We’re proud to broaden our care offerings to provide new therapies for patients with acute cardiopulmonary conditions.”