Earnings Labs

Fresenius Medical Care AG & Co. KGaA (FMS)

Q1 2016 Earnings Call· Tue, May 3, 2016

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Transcript

Operator

Operator

Ladies and gentlemen, thank you for standing by. I am Patrick Wright, your Chorus Call operator. Welcome and thank you for joining the Fresenius Medical Care Earnings Call on the First Quarter 2016. Throughout today's recorded presentation, all participants will be in a listen-only mode. The presentation will be followed by a question-and-answer session. I would now like to turn the conference over to Oliver Maier, Head of Investor Relations. Please go ahead, sir. Oliver Maier - Fresenius Medical Care AG & Co. KGaA: Great. Thank you, Patrick. Much appreciate it. We would like to welcome all of you to the Fresenius Medical Care earnings call for the first quarter of 2016. As always, I would like to start our call by mentioning our cautionary language that is actually in our Safe Harbor statement as well as in our presentations and in all the material that we've provided today. For further details, please refer to these filings, including our SEC filings. With us today is Rice Powell, our CEO and Chairman, and Rice will give you a general business update and go through some of the highlights of the quarter. And also with us is Mike Brosnan, our Chief Financial Officer, who will cover with you the financials and the outlook and a little bit more detail. So, as always, that's the easy part of my end. The floor is yours, Rice. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Thank you, Oliver. Welcome, everyone. I'm delighted that you are joining us today and I appreciate your interest in our company and our first quarter results. I'll begin my prepared remarks on slide number 5. We are off to a good start. We've had a very successful first quarter. Four, five key points that I would like to…

Operator

Operator

Great. Thank you. Ladies and gentlemen, at this time, we will begin the question-and-answer session. And our first question today comes from the line of Tom Jones of Berenberg Bank. Please go ahead. Tom M. Jones - Joh. Berenberg, Gossler & Co. KG (United Kingdom): Good afternoon. I had a couple of questions. The first was just on the transactional currency hit that you took in Q1. I know you mentioned in various different regions that currency was a factor. But in terms of the year-on-year margin decline, how much of that was kind of ongoing currency pressure just related to the overall revenues and the impact that that's having on margins? And how much of it is just the transactional effects related to the balance sheet revaluations of foreign exchange? Basically, I'm just trying to get a feel for how much of the currency impact is a kind of one-off effect in Q1 and how much is going to come through in the following quarters as well. Obviously, all assuming rates held, I am not asking you to make any predictions about which way rates go. My second question, maybe one for Rice. So just wondered if you could give us an update on the BPCI and your early experiences there. And perhaps, within that, segue into what the margin outlook really is for the Care Coordination business for the rest of the year and how you see that developing. Those will be my two questions. I have one quick clarification, but I'll save that for the end. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Okay. I'll grab the first one, Tom. With regard to translation and transaction, as you know, our guidance overall hasn't changed when you look at full year results. But you do…

Operator

Operator

Our next question comes from the line of Michael Jüngling of Morgan Stanley. Please go ahead. Michael K. Jüngling - Morgan Stanley & Co. International Plc: Thank you and good afternoon, everyone. I would like to ask three questions, please. Firstly, on the EMEA and the Asia Pac EBIT margin development for the rest of the year, so if Q1 was a bit softer than I had hoped, and North America better, what is the realistics of trend for those two geographic regions for the remainder of the year? Secondly, on Care Coordination, can you sort of describe a little bit about – a little bit the investments that you're making this year compared to last year, because it seems to me, based on your commentary, it's more so the investments that you're making that is having this fairly flattish margin development? And the final question is on cost savings run rate, what was it at the end of the first quarter, please? Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Great. Let's see, Michael, in terms of trending for the individual regions, we typically don't guide much at that level. Obviously, when you look particularly at Asia Pacific, it's a relatively small region. So fairly small changes in earnings could drive (21:02) changes in the trending. I wouldn't change what I said earlier with regard to FX total company. I think when you look at the individual regions, in Asia, you see a little bit more volatility with regard to the rupee and won with some mitigating effects associated – from the Korean currency. In terms of EMEA, I think it's reasonably stable with the possible exception of the ruble. But what you do have in EMEA in some of the countries is you have customer billings…

Operator

Operator

Our next question comes from the line of Veronika Dubajova. Please go ahead.

Veronika Dubajova - Goldman Sachs International

Analyst

Good afternoon, gentlemen. Thank you for taking my questions. I'm going to take a stab at Tom's earlier question. I think (26:48) just trying to understand in constant currencies what happen to the international margin year-on-year. And so, maybe as opposed to getting tangled between transactional and translational, can you just give us either quantitatively or qualitatively some color on what actually happen to margins year-on-year in the International business? And if you are happy to go into detail, EMEA, APAC and LatAm, that would be fantastic. But even if not, then if you can just give it to us from a group perspective international, that would be extremely, extremely valuable. My second question is just on the U.S. revenue per treatment which was very solid in Q1. And from memory, I think you have a couple of contracts on the managed care signed that are up for renegotiation this year. And I don't know, Rice, if you can comment on how these discussions are going. And to what extent do you feel that you will or will not be able to replicate the trend on the revenue per treatment as you move into the rest of the year? And my last question is just on Mircera, I think if you can give us an update on what the switch rate was. And apologies if I missed it in the prepared remarks just because I got on there a little too late. Rice Powell - Fresenius Medical Care AG & Co. KGaA: No, Veronika. It's Rice. I actually just realized to myself I didn't talk about Mircera in my prepared remarks. I'm happy to do it. Why don't I take two and three, Mike, and then you want to do one? Michael Brosnan - Fresenius Medical Care AG & Co.…

Veronika Dubajova - Goldman Sachs International

Analyst

I guess, my question is if you strip out that gain from last and the loss from this year, would the margin be comparable higher or lower year-on-year? I guess that's what I'm trying to understand. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Yeah. No, I appreciate that. Let me think about it because I don't think we see this quarter much different than what we did last Q1, that's why I'm just not sure that it helps to give the additional granularity.

Veronika Dubajova - Goldman Sachs International

Analyst

As I said, qualitative commentary, fine. So with striping out the gain and the loss, do you think margins are about unchanged? That's fantastic, and I'm happy to leave it at that. It's just – that's what I'm trying to understand. I think that's what Tom was trying to understand as well. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Okay. Let's keep going and we'll come back after I... Rice Powell - Fresenius Medical Care AG & Co. KGaA: We're pulling through some paper here, but I would say this that, fundamentally, in terms of how the business is working and pricing and things like that, we're not having huge issues. We're in a kind of a stable place short of these things. But I'll let Mike come back to you on that. They're looking at some numbers here now Veronika.

Veronika Dubajova - Goldman Sachs International

Analyst

That's great. And, Rice, any update on the FCPA investigation and progress you're making there? Rice Powell - Fresenius Medical Care AG & Co. KGaA: We are making progress. We continue to – what I would say look at some things, get comfortable, document it, if we need a change of practice or policy, we're doing that. So I think we're still just kind of moving through the process that we need to. I think what sometimes seems to be taking forever, I have to remind people that when you're operating in 120-something, 130-something countries with product in 40 or 50 on the service side, it takes a while as you go through and look at your programs and what you need to do to improve on those sort of things.

Veronika Dubajova - Goldman Sachs International

Analyst

Understood. Thank you so much and, Mike, if you can come back to us, that'd be great.

Operator

Operator

Our next question comes from the line of Chris Cooper of Jefferies. Please go ahead.

Chris Cooper - Jefferies International Ltd.

Analyst

Hi, there. Good afternoon. Thanks for taking my questions. Apologies if I have missed any of these. I joined the call a bit late. Firstly, just on commercial patients, it seems as though, I guess, a message we've seen over the last few quarters is that you've begun to take a bit more share from your key competitor. What have you changed in your approach when you're holding discussions with the private payers? Rice Powell - Fresenius Medical Care AG & Co. KGaA: Yes. And here's what I would say, I think that the improvement that you're seeing is really coming from a couple of places irrespective of whether it's DaVita and (33:20). I think we put ourselves in a much better position to pick up commercial patients have them come into our facilities. I think we've made it easier for people to inquire about where they want to be. I think we're much quicker in our turnaround in accepting those patients. I think there's a fair amount of blocking and tackling or logistics that goes into this more than people might think. When a patient is being discharged from a hospital trying to decide where they want to get their therapy and then calling local clinics to see if they have a spot for them. I think the people that give the better customer service that are more willing and able to talk to those patients on a very timely basis is what really helps you have people move in your clinic. Now, obviously, your relationship with the large payers is important, but it does in many cases come down to a patient-physician-discharge planner relationship, then I think it's where we've gotten better over the previous quarters, and we're continuing to see the benefit of that.

Chris Cooper - Jefferies International Ltd.

Analyst

Great. Thank you. Second one, please. Just on the margin progress that you've made during the quarter, clearly, you're continuing to make that progress on the cost per treatment, but it jumped out at me that the year-on-year improvement is actually slowing despite the amount of patients from Mircera coming in well ahead of your own expectations. I just wondered whether you're seeing a bit more personnel cost growth there as you were last quarter or whether there's something else going on as well? Rice Powell - Fresenius Medical Care AG & Co. KGaA: No, that's a good question, Chris. I think what you have to remember is, as you look at sequential quarter; simply, we have higher personnel expenses in the beginning of the year. We've talked about that before in other calls. And also, we talked about we had an extra pay period in the first quarter in North America which impacts that as well, when you think about clinic staff that generate part of that cost per treatment. Year-over-year, it's a very good story. So, sequentially, I think it's just a matter of we're in the first quarter where we have higher personnel expenses is really the effect you're seeing. But if you go back and look year-over-year, I think we've announced $7, I think. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Yeah, exactly, Rice. And we also have two fewer days in Q1 versus Q4, which we'll also look... Rice Powell - Fresenius Medical Care AG & Co. KGaA: Yeah, that's right, correct. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: ...at cost differential. So, okay, yeah, coming back to Veronika, and as you know, because we've had these discussions in the past, I don't want to make the call all about foreign exchange, but I think, qualitatively, I indicated earlier that we felt that the underlying operations of the international regions was doing quite well once you took out the currency effects. And I'd repeat that, in response to your question, it's helpful, I think you could look – when you're looking at the International business, currency probably had a 200-basis-point depreciating effect on the operating performance for International. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Chris, we don't want to cut you off, but please any other questions?

Chris Cooper - Jefferies International Ltd.

Analyst

No, that's very helpful. Thanks for your help. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: You bet. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Thank you.

Operator

Operator

Our next question comes from the line of David Adlington of JP Morgan. Please go ahead.

David James Adlington - JPMorgan Securities Plc

Analyst

Hi, guys. Thanks for the question. Maybe in slightly different way, obviously, very good progress on your North American dialysis margins, and so maybe if you can give an update in terms of the progression through the year and just how those margins might develop given where you are with Mircera and the GEP, just wondered how we might be thinking about margin progression quarter by quarter through the year. Rice Powell - Fresenius Medical Care AG & Co. KGaA: You want to flip the coin, Mike, or you want to take that? Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Yeah, no, I gave some indication last call. So I think what we had said was that we would anticipate a slight decrease in cost per treatment year-over-year 2016 over 2015, so I think we would stick with that. Obviously, you'd see a benefit in Q1, but then, as Mircera annualizes out, I think you'll see a mitigation of that. So, full year, I think you'll see a slight decline in cost per treatment.

David James Adlington - JPMorgan Securities Plc

Analyst

Okay. Fair enough. Thank you. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Sure.

Operator

Operator

Next question comes from the line of Lisa Clive of Bernstein. Please go ahead.

Lisa Bedell Clive - Sanford C. Bernstein Ltd.

Analyst

Good afternoon. Two questions within the Care Coordination division. First, could you just provide an update on ESCO? Rice, your comments about CMS potentially allowing a few extra sites was interesting. Could you maybe comment on how many incremental patients you could potentially add there if that does happen? And then second, my understanding following your December Care Coordination Meet the Management event was that there's also a lot of activity going on with your plans to launch a Medicare Advantage plan, I guess, a special needs plan specifically. Did that indeed launch at the beginning of this year? How should we think about that opportunity over the next 12 months and beyond and how is the recruitment going so far? Rice Powell - Fresenius Medical Care AG & Co. KGaA: Sure, Lisa. So, on the ESCO, literally, that news that CMS is considering a couple more locations is kind of hot off the press, and we really have not sat and talked about would we, and if yes, where, how many. So we may have some more color for you on that next quarter, but I don't have much more than that right now. What I can tell you is that, if you look at the 8,000 patients that we told you we were planning for the ESCO back when we saw you in November, December, we are pretty much right at that number, just a little shy of that number, because we've had some people wash in and out. So I think we're seeing some stability on that case. And on the C-SNPs, yes, we're moving forward there as we had planned to, and I don't have an exact number for you at the moment as to where that is, I'll have to look and see if I've got it written down somewhere. But it is in place. We're moving forward as we had planned to do. So I think we're making good progress on all of those fronts. I just don't know enough about the ESCO to give you any more color than that at the moment.

Lisa Bedell Clive - Sanford C. Bernstein Ltd.

Analyst

Okay. Thanks. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Sure.

Operator

Operator

And our next question comes from the line of (39:55) Please go ahead.

Unknown Speaker

Analyst

Hello (39:59) Rice Powell - Fresenius Medical Care AG & Co. KGaA: Hi (40:00)

Unknown Speaker

Analyst

Hey. Just two questions basically. One on the Renal Vifor joint venture whether maybe you can give us an update on Velphoro here, and also maybe the broader pipeline opportunities you would see there midterm? Second question, more broader-based, big picture on innovation in general, although related to product. Would you see from your own 650 guys in R&D something major coming up, where we should pay strong attention, and vice versa, would you see any disruptive technology maybe out there in the market coming from competition? Thank you. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Hey, (40:41), it's Rice. I would tell you that Velphoro continues to move well in the U.S. We continue to see good progression of a number of scripts that are being written. We're fighting the fight that you have to fight with the pharmacy benefit managers to get on their formularies and hopefully get one of the top one or two positions, and we're making progress there. I happened to listen to the (41:07) call last week and they're just not getting the traction yet that they thought they would. So I think that's inuring to our benefit on the Velphoro side. When you look at the pipeline for the joint venture, as you probably well know, we've got a number of activities that we've gone into in terms of licensing and looking at new product opportunities. We've got a couple of different binders that we're looking at. Most of this is ex-U.S. because, as you find many times, start-up companies with new and novel drugs want to try to commercialize the U.S. but they tend to license out in the rest of the world because they need the licensee stream in order to continue their R&D or their clinical work.…

Unknown Speaker

Analyst

Good. Thank you. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Sure.

Operator

Operator

Our next question comes from the line of Gary Lieberman of Wells Fargo. Please go ahead.

Gary Lieberman - Wells Fargo Securities LLC

Analyst

Good afternoon. Thanks for taking the question. I was hoping you could talk a little bit more about your experience with the BPCI and how it's proceeding versus your initial expectation. There has been some discussion by participants about CMS's lack of ability to get timely data to participants, which is maybe stymied it a little bit. So would be interested to hear your experience. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Hey, Gary, it's Rice. I'd say that's a true statement. I think we are feeling that the data flows a little better now than it was three, four, or five, six months ago. But part of why we've been very descriptive about having some sense of BPCI in the back half of this year is because that data flow has got to get – just continue to get better and we've got to be able to analyze it and react to it. So, I would say a little better. But still more work to be done and that's why we just continue to say it's going to be latter part of the year before we can really make some sense of that is probably the best way I can comment.

Gary Lieberman - Wells Fargo Securities LLC

Analyst

And then in terms of your thoughts on growth in Care Coordination either organically or through acquisition, has your experience with the BPCI or just changes in supply-demand for different types of providers changed and what's your thinking there? Rice Powell - Fresenius Medical Care AG & Co. KGaA: Well, I would say when we consider BPCI we sort of – we're still of the opinion back half of the year data flow has got to get better. We signed up for the DRGs, if you will, that we're going to maintain. I think that's still steady as she goes. We're still in play there. When I take a step back and look at Care Coordination in a bigger sense, we're still looking at opportunities. We're still pursuing some things like our polyclinics in Germany that continues to progress. I think we're up to about 30 of those in over 46 locations or 47 locations where we're doing dialysis and cardiology, things like that. So I think we continue to look at that. We continue to think there are opportunities that are out there. And we're screening things as we go forward, Gary.

Gary Lieberman - Wells Fargo Securities LLC

Analyst

Okay, great. Thanks very much. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Sure.

Operator

Operator

Our next question is a follow-up question from the line of Michael Jüngling of Morgan Stanley. Please go ahead. Michael K. Jüngling - Morgan Stanley & Co. International Plc: Thank you. Two more, please. Firstly, on the earnings growth guidance for this year, given what you've delivered in Q1 and also the FX, is it fair to assume that it's more likely that you'll be coming out towards the bottom end of the range rather than the high end of the range of 15% to 20%? And then secondly, on the income from equity accountees, sort of a really strong Q1, Mike, could you give some guidance as to what that number may look like for the full year? Is – i.e., for Q1, the run rate for the full year or did something a little bit more unusual happen? Thank you. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Okay. Sure, Michael. Not ready to call the number within the range, too early in the year. So I'll stick with the range. Relative to equity method investees, I think what you're seeing coming through in the quarter is the change we've made with regard to the pharmaceutical, so I think that probably will kind of fluctuate more or less around that level for the balance of the year. Michael K. Jüngling - Morgan Stanley & Co. International Plc: Great. And that was all. Thank you. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Okay. Thanks. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Thanks, Michael.

Operator

Operator

Our next question is also a follow-up question from Lisa Clive of Bernstein. Please go ahead.

Lisa Bedell Clive - Sanford C. Bernstein Ltd.

Analyst

Hi. I have actually somewhat similar to the prior question. If we just think through the – specifically the margins as we go through the year, some of these items may be back-end-loaded. I mean, the global efficiency program continues to deliver and I guess that sort of incrementally increases quarter-on-quarter. Perhaps there's some incremental savings from Mircera towards the back half of the year versus what you got in Q1. GranuFlo cost, I don't know how much those roll off in the second half of the year once the settlement happens. Could you may be just talk through some of the items that potentially help that margin trajectory and help get to that 15% to 20% growth? Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Lisa, I think big picture, when we talked about 15% to 20% even going back to the beginning of 2015, we were talking in terms of the investments we were making in the retrospective shared savings program, the ESCOs, the BPCI. I think with what we've said about BPCI potentially getting to an inflection point in the back half of this year, that should be a contributor. Wrapping up the GranuFlo and moderating a bit in terms of legal expense should be a contributor there assuming everything works smoothly through the August settlement, the inking of the deal, if you will. And GDP, you mentioned, this is the third year and we should get towards sustained savings rate this year. And then more generally, we talked about the fact that, for the last several years, we were kind of managing three issues globally, GranuFlo being one, the FDA being the second and the compliance work being the third. We had wrapped up two of the three of those with the GranuFlo settlement and we were optimistic that we could get to a resolution on the third this year. So I think those are kind of those elements. I don't want to understate what we think is the strong operating performance of the core business both in terms of North America which is clearly evident, and the international businesses which operationally I said were actually doing very well and are masked somewhat by the FX that we've been talking about. I mentioned those things but I don't do it in the context of ignoring the fact that we're seeing good fundamental operating growth in the businesses around the world.

Lisa Bedell Clive - Sanford C. Bernstein Ltd.

Analyst

Understood. Thanks very much.

Operator

Operator

And our next question is also a follow-up question from the line of Gary Lieberman of Wells Fargo. Please go ahead.

Gary Lieberman - Wells Fargo Securities LLC

Analyst

Thanks. I just wanted to follow up on one of the questions that you just answered. Mike, I think you mentioned that there was a change regarding how you're booking pharma in the equity income. Is there any more detail you could provide us there? Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: No, it wasn't a change, Michael, it was just – obviously the joint venture earnings come in through the income and equity investees line. So to the extent of which you have a change, you've got some additional earnings coming to the company through that line as a consequence of the Pharma JV. So there's no change. It's just...

Gary Lieberman - Wells Fargo Securities LLC

Analyst

Got it. So it's just increased sales of Mircera essentially then? Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Yeah. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Or any number, though, that run through that line, Gary, that's it. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Because that is a significant contributor. Yeah, exactly.

Gary Lieberman - Wells Fargo Securities LLC

Analyst

Okay. Got it, thanks. Oliver Maier - Fresenius Medical Care AG & Co. KGaA: Hey, Patrick, I don't see any more questions actually. Do you have any more questions actually in the pipeline?

Operator

Operator

There are no further questions from the phone lines. Oliver Maier - Fresenius Medical Care AG & Co. KGaA: Okay. Great. Thank you so much. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Thanks, everyone. Thank you. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Thanks for your interest. Thank you. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Take care. Bye-bye

Operator

Operator

Ladies and gentlemen, the conference is now concluded and you may disconnect your phone. Thank you joining and have a pleasant day. Good-bye.