Fresenius Dialysis Company

Fresenius The company that I have chosen to evaluate is Fresenius, a health care company specializing in dialysis equipment and clinics. They are based on Bad Homburg, Germany, which is just outside of Frankfurt. Fresenius is one of the global leaders in this business, and has an extensive network of dialysis clinics in the United States. The dialysis business is driven by age and overall health of individuals in a society. There are a variety of payers, depending on the country.

Most dialysis patients need multiple visits per week to the clinic. This division within the company is Fresenius Medical Care, and accounts for $15.8 billion in revenue and over $1 billion in profits. The company has smaller businesses as well, including Fresensius Kabi, which is IV drugs, clinical nutrition and medical devices. Fresenius Helios operates hospitals, and Fresenius Vamed runs projects and services for hospitals. The location to be analyzed in the American market.

Fresenius is a global company, and its revenues are fairly evenly split between Europe (44%) and North America (40%) but within that the United States is the single largest market for the company. This is a $21 billion industry in the United States. Fresenius is the #2 player in the American market, behind DaVita. Demand in the industry is inelastic -- people who need dialysis need it to survive, and in many cases they are not even the payer.

There is relatively little bargaining power for the payers in the industry, due to the medical need that dialysis patient have for this type of treatment. Because Fresenius uses North America as its reporting unit, it may be difficult to separate out American and Canadian revenues, but based on population it is reasonable that 90% of the total North American market is in the U.S., should estimates be required. There are a number of sources that can be used to gather information.

The overall industry data is culled from a number of different sources. The IBIS World report (2014) provides some basic data -- the full report costs too much money to acquire, but if it could be acquired would be an excellent source of data. This report singles out dialysis centers, whereas Fresenius also makes equipment and sells to third party dialysis centers, hospitals and clinics. While this may make drilling down precise data more difficult, valuable information is still available.

The company's annual report is also a high quality source of information. The company provides financial data and a discussion of the business. There are elements of the annual report that are biased, but in general there is more information about the company in its annual report than anywhere else. There are sometimes academic papers discussing a given industry. Not always, but sometimes, and there are a few on the dialysis business.

These are often found through a Google search or Google Scholar, or an academic database accessible through the library. An example of a paper that can shed some light would be Cutler, Dafny & Ody (2012). Industry reports are often available from industry-specific media as well. Such articles may discuss specific individual companies, or they may discuss the industry in general.

An example of this is Kutscher (2014), which talks about how end stage renal care is 7% of Medicare spending, for just 1% of Medicare patients, and that this is challenging for the payers. As payers adjust, this affects the industry overall, and the firms competing within this industry. Conventional business media will often cover publicly-traded companies, especially large ones like Fresenius that operate in well-covered industries. An example of the insight.