This Dialysis Market Leader Has Much to Offer Investors

[okarol]

This Dialysis Market Leader Has Much to Offer Investors


By usman iftikhar | More Articles | Save For Later
September 23, 2013 | Comments (1)

Our sedentary lives, high intake of junk food, stress, smoking, and high consumption of alcohol lead to hypertension,
diabetes, and high blood pressure. Together, these factors often lead to terminal kidney failure, contributing to
the continued growth of the dialysis market. Another key factor granting growth to this market is the rising population.
It is expected that the market will grow at a compound annual growth rate of 7.2% over the four­year period between
2011 to 2015. The number of worldwide dialysis patients reached 2.306 million at the end of 2012, showing a 7% year­
on­year increase with highest change of 9% in Asia Pacific region.
The scenario is expected to largely benefit the world's largest provider of dialysis products and services, Fresenius Medical Care (NYSE: FMS ) , which has bypassed competitors through a recent acquisition.
The company has the largest network of clinics through which it provides dialysis machines, dialyzers, disposable
accessories, and other services in around 40 countries. It is the industry giant with a market share of 33%, followed by
Baxter (NYSE: BAX ) and Gambro.
If we talk about its market position in major products categories, Fresenius had the top ranking in dialyzers, dialysis
machines, concentrates for hemodialysis, and bloodline systems in 2012. In peritoneal dialysis products, however, its
rival Baxter has first ranking, and Fresenius came in second.
Historic performance
Fresenius has shown solid growth over the years. The number of patients treated in 2012 increased by 12% compared to
2011. Revenues reached $13.8 billion in 2012. Revenues from services and products increased by 13% and 1%,
respectively.
The graph below shows that revenues of Fresenius were lower than Baxter's in the last four years, but Fresenius' revenue
growth was better. In 2012, Fresenius' growth was 7.85% as compared to Baxter's 2.14%. Only in 2011 did Baxter show
2.02% better growth than Fresenius, mainly by offering customers the option to replace their COLLEAGUE infusion
pumps or receive monetary consideration. The company implemented this recall at FDA's order.
Source: Morningstar.
Now let's have a look at debt profiles of the two rivals. The debt­to­equity ratio of Fresenius is 0.9, better than Baxter's
1.2. Fresenius' debt­to­EBITDA ratio increased to 2.83 in 2012, as compared to 2.63 in 2011. This was the result of
high investment in the dialysis service business. Its target for 2013 is to keep the debt­to­EBITDA ratio below 3.
Impact of acquisition
Fresenius continues to expand its products and services business through acquisitions. In 2012, acquisitions accounted
for 7% of the company's revenue growth and 5% of its organic growth. Recently, the company has made an agreement
to acquire Rhoen­Klinikum AG, Germany's biggest chain of private hospitals. The transaction will add 43 hospitals and
15 outpatient facilities to Fresenius' portfolio./30/13 This Dialysis MarketLeader Has Much to Offer Investors (FMS)
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Rhoen­Klinikum has shown an excellent performance in the last four years. Its revenues have continuously increased.
Although its revenue growth rate plunged in 2011, it still remained positive. Its total revenues in 2012 were $2.86
billion, equaling around 21% of Fresenius' 2012 revenues.
Source: Company 10­K.
The acquisition will improve earnings from Fresenius' Helios unit, which currently operates 74 hospitals in Germany. It
is expected that the unit's total annual revenues will be $7.34 billion after the acquisition adds 43 new hospitals for a
total of 117. Overall, Rhoen will add $2.67 billion annual revenues and around $334 million in EBITDA of Fresenius.
As Fresenius expands its market share in Germany, Baxteris is also expanding its global market share. Baxter, the
second­largest dialysis market leader, acquired the third­largest dialysis company, Gambro. According to 2012 data,
Baxter and Gambro held market shares of 19% and 12%, respectively. Together, these two entities will have a market
share of 31%, just 2% behind Fresenius (as shown in the graph below). The acquisition will add new products and
therapies to Baxter's portfolio, creating tougher competition for Fresenius.
Source: Company 10­K.
Final thoughts
Fresenius has shown strong growth in the past. Although Baxter (along with Gambro) poses a serious threat to the
company, Fresenius has many positives to help it overcome the threat. The company's revenue growth and debt profile
are better than Baxter's. Moreover, the acquisition of Rhoen­Klinikum will add further growth to the company's portfolio
and EBITDA, giving it an indisputable lead in the German market. The supportive industry trends are also going to
benefit the company. In my opinion, the future is bright for the company's stock.
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usman iftikhar has no position in any stocks mentioned. The Motley Fool has no position in any of the stocks mentioned.
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http://www.fool.com/investing/general/2013/09/23/this-dialysis-market-leader-has-much-to-offer-inve.aspx

[okarol]

My comment on the article:

On September 30, 2013, at 9:31 PM, kidney4jenna wrote:

Just a note about dialysis patients. They aren't all ignorant sloths.

Polycystic kidney disease (PKD) is an inherited condition, affects more than 600,000 Americans and an estimated 12.5 million people worldwide – regardless of sex, age, race or ethnic origin. In fact, PKD affects more people than cystic fibrosis, muscular dystrophy, hemophilia, Down syndrome and sickle cell anemia — combined!

Our daughter's kidney failure is due to a defective bladder. She is on dialysis.

But yes, you are correct, the numbers are growing daily. Only 11% of the people on the organ transplant list get a kidney each year, so the dialysis business will continue to boom.

[Rerun]

But.... if Medicare dumps us... sell your stock!

[okarol]

But.... if Medicare dumps us... sell your stock!