Earnings Labs

Fresenius Medical Care AG & Co. KGaA (FMS)

Q4 2017 Earnings Call· Tue, Feb 27, 2018

$22.26

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Transcript

Operator

Operator

Ladies and gentlemen, thank you for standing by. My name is Jasmine, your Chorus Call operator. Welcome and thank you for joining the Fresenius Medical Care Earnings Call on the Fourth Quarter and Full Year 2017. I would now like to turn the conference over to Dominik Heger, Head of Investor Relations. Please go ahead, sir. Dominik Heger - Fresenius Medical Care AG & Co. KGaA: Thank you, Jasmine. We would like to welcome all of you to the Fresenius Medical earnings call for the fiscal year 2017. As always, I'm forced to start out the call by mentioning our cautionary language that is in our Safe Harbor statement, as well as in our presentation and in all the materials that we have distributed earlier today and last night. For further details concerning risks and uncertainties, please refer to these documents, as well as to our SEC filings. This call is limited to 60 minutes. It turned out to be a good approach in our recent calls to limit the number of questions to two. I would like to thank you for the cooperation in the previous calls and it will be great if we could continue with this approach also this time. With us today is Rice Powell, our CEO and Chairman of the Management Board. Rice will give you a business update and go through some of the highlights of the year. Also with us is Mike Brosnan, our Chief Financial Officer, who will give you an update on the financials and also explain the outlook in more detail. I will now hand over to Rice. The floor is yours. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Thank you, Dominik. Good morning, good afternoon, everyone, depending on where you are and what time zone you…

Operator

Operator

Thank you. The first question comes from the line of Thomas Jones of Berenberg. Please go ahead. Thomas M. Jones - Joh. Berenberg, Gossler & Co. KG (United Kingdom): Good afternoon, Rice and Mike. Thanks for taking my questions. The first one I wanted to ask about was the other issue, which seemed to cause some concern this morning and that was around the organic growth rate in the U.S. or the North American Dialysis Care business. It was relatively soft 1.4% in Q4 and has been sort of gradually trending down all year. Given the sort of commercial price renegotiations you made in the last year, one would think the pricing should be fairly visible. So I would just kind of be interested to know what's behind the slowdown in that part of the business and particularly what the outlook might be, whether this is just a kind of one-off reset down and we should be expecting a more normal growth rate in 2018 or there is something else we should be considering. And then the second question, again, one for Rice I'm afraid, sorry, just on the PATIENT Act and kind of what you're hearing in Washington and where you sit on that at the moment and what you think could potentially happen and when in 2018 would be helpful. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Thanks, Tom. Mike, you want to take number one and I'll come back with Tom on PATIENT Act update. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Sure. Tom, I think what you're referring to is more the treatment growth, correct? Thomas M. Jones - Joh. Berenberg, Gossler & Co. KG (United Kingdom): No. It's organic revenue growth in the North American Dialysis Care business. Michael…

Operator

Operator

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

Lisa Clive - Sanford C. Bernstein Ltd.

Analyst

Hi, there. Few questions. First, just on the run rate EBIT for Care Coordination, based on what we saw in Q4, Shiel was in there. I think my best guess is that was something in – the impact of that. I mean, EBIT level was in the 20s. The BPCI catch-up payments maybe could have been north of €10 million. Is it roughly right to think about that in terms of the one-time items in that EBIT figure, in which case still you're at a margin of about 8%, which certainly has been a considerable improvement over last year? Second question, could you just give us an update on the California Union Ballot Initiatives? Are you going to need to spend money on that this year? Is that in your guidance? And then lastly, there's been quite a bit of activity in China in the past 12 months, including the renal hospital you purchased and then actually building a dialysis clinic in December. And just correct me if I'm wrong, but I'm not aware that there is any increase in national reimbursement rates for dialysis. So is this generally that you're finding you can strike deals with local governments to build out facilities in a way that could be sustainable and should we expect a lot more activity on this front in the next few years? Rice Powell - Fresenius Medical Care AG & Co. KGaA: Hey, Lisa. It's Rice. I'll let Mike speak to the run rate in kind of where we're targeting Care Coordination operating margins for 2018, and I'll come back and pick up the ballot initiative in California and talk a little about China. Mike? Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Yeah, thanks. So, Lisa, there's a little bit going on in…

Lisa Clive - Sanford C. Bernstein Ltd.

Analyst

Okay. Can I just ask a follow-up question on that? Because you've had this big shift in reimbursement in vascular access, so I thought that that business was going to tick up nicely into 2018. And then also in ESCO, you massively expanded the program last year and I had assumed you weren't getting paid on those patients yet. So I would assume that that would mean that your U.S. Care Coordination revenue would be up rather nicely on the back of those two things. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Yeah. I think that relative to the ESCOs, the thing I'm talking about with the ESCOs and the BPCI is the big catch-ups we had from the beginning of the program that got booked into fiscal 2017. The underlying organic growth of the ESCOs, we do anticipate will be up nicely. That's why I indicated that when you take out Shiel and you consider the change in the pharmacy, the rest of what's in Care Coordination, which includes vascular and includes these NCP, is showing an improvement in revenues. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Yeah. So, Lisa, we're thinking we're going to be at about 40,000 patients in the ESCOs, just to give you a ballpark of that. But I think Mike's right. I mean there is some moving part here that we'll have to kind of sort through. We just don't have a good visibility on exactly how Parsabiv is going to play and how it's going to move. So we're not hedging this, just we're not sure because it's early on in the process of trying to sort this out. And I don't know if Mike said it or not, but this is the first Part D. This is the first time we've seen something move out of oral into IV into the clinic. We didn't get a lot of great guidance from CMS on this, so we're kind of feeling our way through that one.

Lisa Clive - Sanford C. Bernstein Ltd.

Analyst

Okay. Did you just say ESCO would get up to 40,000? I thought you were at 25,000 patients when you last gave us a number. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Yeah, we were somewhere around 26,400 I think, and I just talked to William today and we're right at about 40,000.

Lisa Clive - Sanford C. Bernstein Ltd.

Analyst

Oh wow. Okay. Thanks. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Yes. So on the California ballot initiatives, we do think this is real. We're going to have to get ourselves prepared to do some work here. What I would tell you is, as we've costed this out from the FMC standpoint, obviously as a industry we're looking at it and everybody is thinking about what they're going to do. I'm not going to say it's directly in our guidance. But the way we scope it today, we think we've got enough firepower that we could deal with this. If that changes substantially, then we'll come back and let you know, but at this point we think it's a manageable situation for us on the ballot initiative. And you're spot on as far as China. What we're seeing, particularly in the renal hospital and where we built the clinic, we are deep into the interior of China and we're finding that many of these provinces, if you will, or regions have some flexibility to do things differently than maybe what we've seen in Beijing and Shanghai and some of those areas. So we're taking advantage of when the regional health authorities come to us and they want to see if we can work with them, if we can partner in some way, we're taking advantage of those opportunities. But it's not a huge, huge risk, if you will, at this point.

Lisa Clive - Sanford C. Bernstein Ltd.

Analyst

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

Operator

Operator

Next question comes from the line of Hassan Al-Wakeel of Barclays. Please go ahead.

Hassan Al-Wakeel - Barclays Capital Securities Ltd.

Analyst

Thank you for taking my question. I have one. Just in terms of the product business in the U.S., you talk about higher sales of machine and PD products. Do you believe that you're gaining share in this market or do you think that the market is just stronger? Thank you. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Yeah, Hassan, it's Rice. I would tell you, I think it's general market strength. I mean, our shares in the hemo equipment side of the business are pretty consistent. In the PD side of business, and I was looking at our commentary from third quarter, we had a situation late in 2016 going early into 2017 that Baxter had some supply issues. They couldn't get as much product out the door as they needed to. We were constrained. We couldn't help in that matter. So I think what we're seeing is now that everybody's kind of back and we've got capacity and the issues are behind each of us in terms of capacity, I think we're just seeing more people come into the program. And I would say that we feel good about this as we survey patients, Hassan, we are still seeing younger people tell us they'd rather be at home. They'd like to be able to continue managing their lifestyle as they want to do it, not so much as it sometimes gets dictated, if you will, by three times a week in the clinic. So I think PD is growing. I do think there's some catch-up of demand that we couldn't satisfy a year ago.

Hassan Al-Wakeel - Barclays Capital Securities Ltd.

Analyst

Thank you. And so just a follow-up to that, I mean, do you think that we should continue to expect similar run rates into next year? Rice Powell - Fresenius Medical Care AG & Co. KGaA: I don't think PD will run as hot over the full course of this year as it did last year, because I think we've probably caught up to some of that pent-up demand. I think we're still going to see growth, but if I go back to third quarter, I think we had 20% growth in the North American book of business on PD. I think it's similar to that in the fourth quarter, I'd have to check it. So I think it'll slow down some, but we're clearly going to continue to see growth there.

Hassan Al-Wakeel - Barclays Capital Securities Ltd.

Analyst

Excellent. Thank you very much. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: I would just offer as a further commentary, because I've given some indications for services globally and for Care Coordination globally. So I would say that when you look at our products business globally, we'd expect growth to be around the 6% area.

Hassan Al-Wakeel - Barclays Capital Securities Ltd.

Analyst

Thank you. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Yeah.

Operator

Operator

There are no further questions at this time. I hand back to Dominik Heger for closing comments. Dominik Heger - Fresenius Medical Care AG & Co. KGaA: So thank you everyone for participating. I know you had a busy time in the previous weeks with other topics and, I guess, you are happy that two other companies are done now in the reporting side. So thank you for participating and hanging in with us, and looking forward to speak to you in Q1. Thank you. Rice Powell - Fresenius Medical Care AG & Co. KGaA: Take care, folks. Thank you. Michael Brosnan - Fresenius Medical Care AG & Co. KGaA: Thank you.

Operator

Operator

Ladies and gentlemen, the conference is now concluded and you may disconnect your telephone. Thank you for joining and have a pleasant day. Goodbye.