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Fresenius is a leading healthcare firm, operating out of Bad Homburg, Germany. Fresenius has carefully cultivated a network of outpatient kidney dialysis centres serving more than 345,000 patients to date. Fresenius was established in 1912 but merged with W.R. Grace’s National Medical Care in 1996 to establish Fresenius Medical Care. Since then, Fresenius has not only developed a strong market share of the dialysis marketplace in Germany but also in the United States. It has a North American base in Massachusetts, which has enabled it to secure a 38% market share stateside.

Fresenius has multiple sites producing its treatments for end-stage renal disease (ESRD), including locations in Japan, Germany and the US. The company’s growth has been underpinned by the acquisition of several companies. Its first acquisition of Liberty Dialysis Holding, costing $1.5 billion, added a further 201 clinics under the Fresenius umbrella. Its most recent acquisition was another ambitious move – a $2 billion buyout of NxStage, an American producer of in-home dialysis devices.

The Fresenius share price has yielded considerable returns for long-term investors since its public listing on the Frankfurt Stock Exchange. All-time returns to January 2023 would equate to a 1,605% yield, but it could have been substantially bigger than this. In May 2017, the Fresenius share price peaked at around €80 having been as low as €4.49 in January 1996.

The Fresenius share price took a turn for the worse as the company entered the new millennium. Having reached an all-time high of €13.39 in November 2000, Fresenius (FREG.DE) stock tumbled in the subsequent years. This was likely due to the bursting of the dot-com bubble, which affected most equities, and the fall-out of the company’s $468m financial penalty for billing for unnecessary medical tests.

Fresenius shares then experienced multiple bullish periods, beginning in the mid-2000s, when it peaked at €21.02 in April 2007. Following the global financial crash, the Fresenius share price experienced its biggest surge in the early-to-mid 2010s. The acquisition of Liberty Dialysis Holding was the catalyst for a five-year-long bullish trend, peaking at €67.94 in November 2015. All-time highs of €79.49 were achieved in May 2017.

There are several other publicly listed healthcare giants that could be deemed competitors of Fresenius. Community Health is one of the leading counterparts in the healthcare industry. This Fortune 500 firm is now America’s number one provider of general healthcare services, including acute care facilities. It has active healthcare delivery systems in no less than 47 markets.

Denver-based DaVita is another notable competitor for Fresenius, particularly in the North American market. DaVita is another company focused squarely on kidney care, with dialysis and other relevant lab-based services and diagnostics.

Deerfield-based Baxter International is another long-time provider of critical care and renal support, operating since 1931. Fresenius has one of the largest workforces in the renal care sector, with both Community Health Systems and Baxter International having employee bases one-sixth of the size of Fresenius.