Operator
Operator
Good day and welcome to the Fresenius Medical Care earnings release of first quarter 2010 results conference call. At this time, I’d like to hand the conference over Mr. Oliver Maier. Please go ahead, sir.
Fresenius Medical Care AG & Co. KGaA (FMS)
Q1 2010 Earnings Call· Tue, May 4, 2010
$22.22
-1.24%
Same-Day
-3.36%
1 Week
-8.13%
1 Month
-3.78%
vs S&P
+5.33%
Operator
Operator
Good day and welcome to the Fresenius Medical Care earnings release of first quarter 2010 results conference call. At this time, I’d like to hand the conference over Mr. Oliver Maier. Please go ahead, sir.
Oliver Maier
Management
Thank you so much Marian. Good afternoon and good morning, everybody. I would like to welcome you to our first quarter results conference call. I’m joined today by Ben Lipps, our Chairman and CEO and Ben will address our strategic priorities and give you a general business update. Our Chief Financial Officer, Mike Brosnan will then discusses our first quarter results in greater detail and addresses our growth outlook for the full-year. We will use slides for the presentation today, which has been posted on our website and link that will sent to you separately by e-mail. I would like to remind to you that our comments today will be gathering to our Safe Harbor statement, which means to the course of our presentation today, we make certain forward-looking statements and actual results could vary materially. We will use non-GAAP financial measures to help you understand our underlying business performance although the measures reconciliations are provided in our investor news. So with that, I would like to turn the call over to Ben. Ben, the floor is yours.
Ben Lipps
Chairman
Thank you, Oliver. Ladies and gentlemen, a very warm welcome like to extend that to our Board members, our employees and associates around the world and those who are joining us on the Internet. As Oliver said, I'll cover basically the business update and Mike will cover the financials, and then we'll open it for questions-and-answers. Turning now to page four, before I start, I’d like to say we’re pleased with the good start to the year. It was a very good quarter. We’re on track for achieving our targets, our guidance for the year and I’d like to also emphasis that we continued to have excellent quality in both our products and our services and I’d like to thank the Board and all of our employees for their extra effort and making sure that we continue to provide the best quality products and services for use on the patients with dialysis. Now as I moving into some numbers, we’ve recorded revenues of $2.8 billion for the first quarter that was a constant currency growth of 10% excellent constant currency growth, 13% actual currency and an 8% organic. We’re pleased with that as continued for the last few quarter. I’d also like to say that we had, as Mike will show you very strong underlying operating performance that we were able to digest currency devaluation in Venezuela and still end up with a 7% increase in net income. So all-in-all, we’re quite pleased with the start to the year. Turning now to page five, let’s look at the revenue by region. We saw excellent revenue growth in all the regions, North America turned in $1.96 billion at a very strong revenue growth at 10% in an actual, organic of 8% that continues to the excellent track record that we saw…
Mike Brosnan
Chief Financial Officer
Thank you, Ben. I’d like to extend miles well to the call today, our employees, our management, our supervisory board and interested investors. I will start on slide 15 and walk you through in a little bit more detail of the operating results for the first quarter of 2010. As Ben has already commented, our revenues were $2.9 billion, up 13% in terms of actual currencies. We had about a 6% depreciation of the dollar in the quarter-over-quarter. So the constant currency growth is still double-digit at 10% and the organic growth as Ben has commented was 8%. All of this result in very strong top line performance for the company for the first quarter of this year. The top line performance translated to additional operating income of $423 million or 7% growth year-over-year. The operating margins did decline, when you look at quarter-over-quarter and I’ll talk about that in more detail in my next slide, but operating margins for the first quarter were 14.7% compared to 15.5% last year. Two comments I’ll make, the first is that you recall in the year end analyst discussion, and then I guided you with regard to our performance in 2010 that we did have a devaluation of the currency in Venezuelan Bolivar and that would take place with regard to its onetime effect in the first quarter of 2010. So consistent with that guidance, we’re seeing that effect in the first quarter. A net accounts in the quarter were about 50 basis points and what you will also seen in the year-over-year is that we did have some adjustments to our inventory carrying values in the prior year and the combined effect of those two items account for about a 130 basis points swing between 2009 and 2010. Interest expense continues to…
Oliver Maier
Management
Great, thank you Mike, thank you, Ben for the update and the presentation and the details. Marian, I think we can now open up the phone lines for the questions.
Operator
Operator
Thank you. (Operator Instructions) The first question from Lisa Clive from Sanford Bernstein; please go ahead. Lisa Clive – Sanford Bernstein: Ben a few questions, first looking at your revenue procurement development in the US and I understand the decline is less than it looks at first glance, but could you just discuss some of the reasons so that whether it’s mainly drug utilization or whether there’s been any shift in payment rates from private payers. Second on bundled pricing and preparing for that, could you discuss the timing of spending on that will cost the front loaded. Should we expect that over the next six months, or will at also run into 2011? Then lastly, could you discuss your negotiation with private payers? I understand you do want to try and get us many of them on a bundled basis, and maybe just a bit on timing and your progress there?
Ben Lipps
Chairman
Lisa, this is Ben. I’ll take part of that basically, the question you had about commercial mix. We’ve essentially continued to see that increase over the last 12 months and we’ve continued with that for the quarter-over-quarter although we don’t look at it that closely quarter-over-quarter, but we’re still doing very well in that area. As far as -- dollar change difference is so many little things, I’ll let Mike do that in a minute. The second thing I want to talk about was the private payers, we don't comment on the percentage of private payers that are bundled, of course as I think both ourselves and some of the other providers have indicated that was the desire on the part of the payers and we’ve certainly commented that. So we probably won’t comment on how much, but it's clearly significant and it will probably grows a bundle comes in. Now as far as the playing out the cost and the timing, I think everybody in the industry is saying two to four quarters, but we don't really know what we’re dealing with yet. So we can’t give you a firm number on that. We’re all sitting here with punches of plans in mind, but it makes those sense to start execute until we see the final rate come out and that we expect that towards the end of June. So at this point, I think we’re all implemented over some time period, but exactly what it will flush, we won’t know that could we see the final rate and we’ll certainly comment on that on our second quarter call. At this point, Mike, do you want to comment on what ends up to a dollar or how you look at that, I don't think we --
Mike Brosnan
Chief Financial Officer
I’m happy to make that comment and Lisa, what I would say is that the guidance we provided at year end was 2% to 4% increase of the average revenue per treatment for 2009 that the midpoint of that range would put us for 2010, more or less flat we have the fourth quarter of 2009. So I think we're on track. I think we’re continuing to see the positive signs that we look for both year-over-year and sequentially with regard to pair mix in particular and commercial rate improvement. The only comment I’d make in terms of the dollar in change is that such a small number when you’re dealing with year end versus Q1 and all the true-ups that take place at the conclusion of the fiscal year that we think our performance is on track with our guidance.
Operator
Operator
Next question comes from Kevin Ellich from RBC Capital Markets.
Kevin Ellich - RBC Capital Markets
Analyst · RBC Capital Markets
Ben, I just wanted to go back to slide eight. The slide that shows your strategic initiatives or Nocturnal clinic balances and online HDF, the outcomes was fantastic. Just wondering what the likelihood that any of these alternative treatment options could be more traction and eventually become the standard or covered?
Ben Lipps
Chairman
Let's take the Clinic Nocturnal. Basically, we see opportunities to go to about 15% in terms of if you just look at the capacity and that probably will cover a significant portion of population. The online HDF basically be the time, there’s in the four hour range and so it essentially can actually replace dialysis. It could be a 101 replacement and of course that could be a long term, some combination of those two in the US. So I think that these are not something we’re doing just research, we feel that application over the next five years to actually change the therapy.
Kevin Ellich - RBC Capital Markets
Analyst · RBC Capital Markets
Then we’ve see a little M&A activity in the US, I think DC. I was referring by a small private balances change. Just wondering if that consolidation as the many leverage with you, how do you view that and I guess what is your outlook on the acquisition market in the US now?
Ben Lipps
Chairman
I think as mentioned last call, we’re really pleased with the essentially market situation in the US. There’s the number of independent providers that were very interested and helping them when the bundle comes along and so we’re not at this point in any major acquisition program in the US and I don't think we will be, but at the same time, I think if there are some consolidation among the SDOs as they recall or they call themselves, I don't think that really impacts the market. I believe that basically most of my customers as we understand the bundle, we and I think DaVita will work with them to be in the ACO program or basically whatever we can do with the innovation department. So I think in some ways it really as a decision they’re making for their own financial reasons, but it doesn't change the market.
Kevin Ellich - RBC Capital Markets
Analyst · RBC Capital Markets
Then just wondering if you have any updated thoughts on bundling, Ben your competitor DaVita on their call can sounded a little bit more positive on what to you expect in the final bundling? I was just wondering, what you’re feeling and also the timing?
Ben Lipps
Chairman
I think I can tell you what the consensus at least I’m hearing on the timing, but I certainly can’t tell you what’s in it. I think everybody is actually speculated this thing pretty widely. It’s our view that people are focusing; CMS is focusing at the end of June or at least this quarter and so, I know that all of the industry and everyone has conveyed what the CMS in terms of the worries that we have and they’ve been very receptive in terms of meeting with it so. I think media’s optimism is warranted, but I don’t think either one of us who really know what’s the bundle is going to be until they finally put up the rig. So at this point, we’re optimistic, but because of the discussion, but at this point, I don’t know anything more than I did six months ago.
Kevin Ellich - RBC Capital Markets
Analyst · RBC Capital Markets
Last question, EPO utilization, I’m wondering, if you guys could gives us that and then you made a comment about increased utilization of Pharma, was there anything unusual there, can you get more color as to what the increased utilization was?
Ben Lipps
Chairman
Yes, if you look at year-over-year, I mentioned that it’s really been pretty flat for the last three quarters, two quarters, but essentially, what we’ve seen over the year is that we’ve seen an increase in EPO. We’ve seen an increase in iron, and a little bit of vitamin B. So it’s pretty much the same three drugs that we dealt with. We pretty well leveled off I think on the EPO and essentially we’ve also seen an increase in essentially the Medicare payment, and if you look at it, it’s potentially those with EPO being the least of the amount. Those really iron and vitamin B.
Operator
Operator
Next question comes from Ilan Chaitowitz from Redburn Partners.
Ilan Chaitowitz - Redburn Partners
Analyst · Redburn Partners
This is Ilan from Redburn in London. First, I was mentioning happy birthday to Oliver; and then just the three questions. Firstly, with regard to interestingly slide on page 11, what does that actually means in terms of the 12% cost reductions, would that mean from how many EBIT per patients perspective in terms of those that are enrolled in the accountable came out of, just a bit of clarity on that one. Secondly, with regard to the corporate cost, if you could talked about a little bit with regard to Q1, those grew substantially higher than the revenues, and I was wondering what we should think about for the full-year. With regard to the US acquisitions, you mentioned that 2010 and 2011 could see your acquisition plans pick up a bit. Are you seeing a big wall of cash with regard to interest in the sector now, or is it just pieced of million times of the acquisitions that have been announced so far this year?
Ben Lipps
Chairman
Well, let me take the last one. I don’t know that I can speak for the acquires that have acquired in the US I think there is a desire to get to a certain size in preparation for the bundle. So I think that consolidation was primarily that any acquisitions, I think we did about 30 million in the quarter, Mike in the US and those were usually small acquisitions it really fit into a our networks or our physician networks; and that’s essentially what we have planned for the year. So I don’t see that we’ll participate in much more than that. We do have a number of international opportunities, which we obviously are looking at and so, we still think we’ll spend the $400 million this year. Corporate cost, I’ll leave to Mike and as part of the EBIT, we saved you about 12% of this cost in our demo, but again it was a demo and it cost us probably closer to 7% to 8% of revenue to do that essentially to save the 12%. So by March, you’re looking somewhere in the 5% EBIT margin that this was really we’re looking at, this is the pilot for CMS and yes it would be attractive possibly if it rolled out across a broader base, but the pilot will probably be essentially neutral, but it won’t be a major generator of income, but we think it’s the right direction for the industry to go.
Operator
Operator
Next question come from Martin Wales from UBS.
Martin Wales - UBS
Analyst · UBS
Two questions, first could you just elaborate on hospitalization days gone up internationally, you talked about expansion, and you’d say a bit more. Secondly, I think successfully rolled out better there in 90% that your internal operations, you talk a bit about the funds externally and also I note from your 20-F. You talk about actually payments to originator on the basis of on the annual estimated use, sales of license, could you have to keep any price rises and in a sense how that agreement works in the lot of the 20-F commentary.
Ben Lipps
Chairman
Martin, this is Ben. As I mentioned, as you looking into the future, if we’re going to do any optimization of anemia management, I will feel you need to have a proven safe to iron drug and so that’s the case then it would be acceptable for us to have at least the physicians with clinic expected at the 90% level that we’re proud that we got there. Now as far as the contract is basically has some revenue over 10 year commitments to it and essentially we’re on track for those and so that -- you think of another distributor or a distributor plus we have the right manufacture, if we need to put a various cost issues that they develop in future. So form that standpoint, I hope that answers your question on the iron. As for as the acquisitions you never telegraphed in ahead of time, but I was only trying to telegraph that we’re not in the U.S, we’re certainly not -- we’re looking at small acquisitions in the US. Internationally, it basically just depends on the opportunity and the pricing and last year pricing wasn’t attractive and if it becomes attractive this year will be active. We didn’t answer the question on corporate cost. I’d like to turn that to Mike.
Mike Brosnan
Chief Financial Officer
Ben, it’s too quick for me. So I wanted to answer your question with regard to the corporate cost increase and in the statistical structure looking at the corporate cost to $34 million includes the R&D spending that we’re directing on a global basis and that represented even though R&D costs in total did not change year-over-year, they’re relatively flat at the $23 million were that’s being spend did shift slightly. So $6 million of that roughly $10 million change relates to an increase in corporate R&D spend with the regions reducing there slightly. So that R&D spending was lap year. The balance is relatively small changes probably the biggest effect, which is be the affective foreign change for cost including Europe converted to dollars. With respect to the hospitalization data, would you repeat that questions.
Martin Wales - UBS
Analyst · UBS
You made a brief comment that the hospitalization days gone up internationally and you tried to the expansion to the reason and not talked about eight days being --?
Ben Lipps
Chairman
What I said the hospitalization days internationally is in the target range of the 8% to 9%. My comment was on the mortality increase or decrease, we saw 270 basis point decrease in mortality in the international, which is really quite significant large in the reason that happens is as we have been expanding and picking up clinics that basically, I’d say they have different procedures and we do in terms of quality. We get a very similarly an improvement in the quality and the mortality that’s the point I was making was 270 basis point improvement in mortality is really driven by us improving the clinics that we purchased.
Martin Wales - UBS
Analyst · UBS
I’m sorry if you just comeback briefly to my first quarter, or my question on Venofer, my question is assuming that you put the price for Venofer or you get key -- extra because 20-F quite the payments still on the originated based upon annul estimated units of sale high volume?
Operator
Operator
Next question comes from Julie Simmonds from Piper Jaffray.
Julie Simmonds - Piper Jaffray
Analyst · Piper Jaffray
I just wanted a little bit one clinic (Inaudible) as to what the plans are to role that pilot out into more of your clinics and how complicated that is a pressure?
Ben Lipps
Chairman
We are up over 200 clinics and we will be expanding it this year, again, I am not sure exactly what the plans are, but it’s been growing at about 20% to 30% year. We have a lot of interest on the part of patients. It certainly is a rounding issue in terms of physicians rounding it on that particular shift and so we are working on some idea there to make it really easier for the physicians also. But when they see the outcomes that their patients have, they’ve been very supporting. So, I think the most you would have envisioned though would be about a 15% because that’s about all the clinic utilization of that we have available in that night shift. But we’ll continue and then once we see the bundle and what’s included in terms of quality activities or the quality metrics then we’ll make more decision how quickly you’ll remove it forward.
Operator
Operator
Next question comes from Tom Jones from Berenberg Bank.
Tom Jones - Berenberg Bank
Analyst · Berenberg Bank
I’ve got a couple of questions if I may. First just to clarify something, on your slide like the classical term bundling you included the compensate rate cost in Part B in your bundle, but you’ve missed out for Part D drugs cost, is that just a graphical misrepresentation or do you know something about Part D drugs in the bundle that we’ve done?
Ben Lipps
Chairman
Trying to be neutral. Again at this point in time the thinking is that it will go in at later point when everybody understands the economics, but that was just basically the way the slides looked two years ago and I kept it the same way. No messages one way the other.
Tom Jones - Berenberg Bank
Analyst · Berenberg Bank
The more important questions, I was wondering, you got a plenty of price and volume detail in relations to service businesses, but wonder if you might be able to do the same on the product side internationally and in the US. The second question, your competitor from California may move now to Denver, may quite a bit of that discussion about those exposure to the VA and some potential rate changes there, I just wondered if you can make a few qualitative if not quantitative comments in that regards. And then lastly just a very general question, your operating level, your debt leverage is getting down now to level, which don’t look a little bit inefficient, I was just wondering, how quality programs have, but just wondering how much lower yield you comfortably let that go before you start to think about doing everything to keep the debt-to-EBITDA in that sort of 2.5 to 3 times range, well, there might be?
Ben Lipps
Chairman
Okay, that one I’d give to Mike, let me try to knock off the others too, like you say, it’s not a bigger problem we have. The prices, I am not sure if I can answer that intelligently for you because remember we have a whole family products and when we bring out a new product we try to get an improvement in price because clearly it’s got improved features. So, generally in this industry it’s one because of the cost cutting changes now one that we would every year increase prices. So, it’s really driven by new product introduction. So, I think net-net we policy see on average very little price increase in any of our products in the dialysis products area. So, you can really care on much there. We do make up in manufacturing volume or manufacturing efficiencies where it comes from. As far as the VA, I got to give you my perspective on it, and it’s probably not totally satisfying, but over the years we’ve looked at the VA as another commercial customer okay and really in many ways they are so you negotiate with the commercial customer and you get a balance between quality and price and so I see most of the discussion around going to Medicare rates that’s pretty difficult considering the Medicare want to bundle and so on so fourth. So the way we look at it is that we have as we look at our guidance, I think Mike and I had talked with guys the 2% to 4% increase year-over-year in terms of our revenue per treatment. We just say that okay what ever happens we commit to that and we’re essentially just another commercial entities that will blend in with the other commercial entities some ups and down, but that’s all, that’s where we are handling at this point time. I don’t know any other way that Tom just thinks about it okay.
Tom Jones - Berenberg Bank
Analyst · Berenberg Bank
Okay, I’ll get some (Inaudible) and on the leverage question?
Ben Lipps
Chairman
On the leverage I appreciate it’s a nice problem to have the cash flows are good, the debt is coming down, an anticipation that I indicated in the year-end call that we do not have as corporate objective to become investment grade and we doubled our guidance from our historical spend in terms of acquisitions. So I think that we have a lot of refinancing plans for the back half of the year and as I indicated, we’re very confident that will go off while as they, but in the interim it make some sense for us to or probably keep our cash balances a little bit higher than we historically have and, for the right opportunity, we’re having very strong balance sheet.
Tom Jones - Berenberg Bank
Analyst · Berenberg Bank
Do you think I mean, over the last sort of 12 to 24 months, specifically you’ve been quite thinking about what you buy. Do you think that going forward you might just sort of maybe low at threshold a little bit, or just maybe buy some slightly less profitable growth? Even if it is still generating positive return on capital for the spread on your cost of capital, do you think you’ll be willing to see that spread now are slightly, or you will sort of revaluing for historically or is that not some you think about.
Mike Brosnan
Chief Financial Officer
One of things I’ve commented on in the past is that, relative to the $400 million we on spending that we thought that would be roughly 50/50 US and international. So I wouldn’t say that will be less picky, but I would say we feel we have a lots of opportunities on a global basis to buy interesting properties at the right multiples. So if we think it what we want we may shift a little bit in terms of the mix of acquisition spend relative to the US market versus some of the other markets we’ve indicated, we’re interested in Eastern Europe and Asia.
Operator
Operator
Your next question comes from Andreas Dirnagl from Stephens.
Andreas Dirnagl - Stephens
Analyst · Stephens
Tom took most of my questions I’m just left the pass the couple of the answers you’ve already given. Ben in response to the question on the commercial mix, you said that you’re still seeing improvement there, when you say that, are you speaking about the revenue impact, or volume or both?
Ben Lipps
Chairman
I’m really looking at the patients or treatments, okay, mix of treatment this is the way we monitor that.
Andreas Dirnagl - Stephens
Analyst · Stephens
Then just to be clear with the response to Tom’s question, I gather you’re saying in effect what everyone seems to be hearing which is that your current expectation would be that the Part D the oral drugs are probably going to be postponed from at least the initial bundle, correct?
Mike Brosnan
Chief Financial Officer
Andreas, this is Mike Brosnan. I just wanted to supplement, Ben’s comment a little bit. I can imagine where the questions coming from, not, exactly. When we referred a mix, we’re indicating that a larger percentage of our patients are coming from commercial, but we talk to it in the context of rate volume because, those patients are paying higher rates, so it’s both volume and rate.
Andreas Dirnagl - Stephens
Analyst · Stephens
Then just on the oral drugs?
Ben Lipps
Chairman
I think, again I listen to the same discussion that you probably listen to him, and it seems like, if the payment was appropriate then clearly it would go in, we probably could do the things with it. However, establishing, what is the appropriate payment may take a pilot and so that’s why I’m saying that I’m hearing more discussion it will go in the later date than I’m hearing that will go in now, but really that’s nothing more than discussion, I really don’t know and we’re prepared whatever is the light approach that CMS takes, we will essentially work with them and accommodate whatever reports they take. I could nothing to say, they whatever go in the bundle, it just a matter of timing.
Operator
Operator
We will now take a follow-up question from Kevin Ellich from RBC Capital Markets. Please go ahead, your line is now open. It seems he has stepped away from the telephone. That concludes today’s question-and-answer session. I’d like to hand the call back over to your host for any additional or closing remarks.
Ben Lipps
Chairman
Okay. Thank you very much for your interest in joining us today. We look forward to seeing you on one of the road shows. Thanks.
Oliver Maier
Management
Thank you very much everybody.
Operator
Operator
Thank you. That will conclude today’s conference call. Thanks for participation ladies and gentlemen, you man now disconnect.