Fresenius is focused on developing the critical care markets - this is their new growth strategy. They are the number one or number two player in installed base of dialysis machines around the world. After they acquired Next Stage, they are now neck-and-neck position with Baxter, Gambro, and be very well positioned to help gain market share in the U.S. market. Several years ago they also acquired another, a Germany company called Xenios and acquired a product called the Novalung, and Novalung is an extracorporeal membrane oxygenation-type technology, and it is very good at gas exchange, particularly carbon dioxide exchange. But these ECMO systems that are sold by most of the major cardiac surgery players are gaining rapidly in popularity as a way to help stabilize patients who have very severe respiratory failure (CytoSorb has been estimated to have been used in more than 2,500 ECMO treatments and can do something that the other ECMO systems can't which is reduce the inflammatory mediators that are driving continued lung injury and other organ dysfunction.)
Cytosorb fits with Fresenius' installed base of dialysis machines found throughout Europe and the rest of the world, in NxStage's machines that are a dominant player in the U.S. critical care market, as well as now the machines that they've acquired from Xenios, including the Novalung. It is prudent for Cytosorbents to continue to build on their relationship with Fresenius as the acute care strategy continues to develop, even though the sales impact for now appears to be muted. If an acquisition were to occur, Fresenius would look to take out Cytosorbents for much more than they paid for NxStage which was 5-6x sales as the company continues to move towards break even cash flow (I believe Fresenius paid $2B for NxStage and at the time they were still losing money).
