Amendment No. 4 to Agreement No. 200600447 Sample Contracts

AMENDMENT NO. 4 TO AGREEMENT NO. 200600447 BETWEEN AMGEN USA INC. AND FRESENIUS MEDICAL CARE HOLDINGS, INC.
Amendment No. 4 to Agreement No. 200600447 • August 2nd, 2007 • Fresenius Medical Care AG & Co. KGaA • Services-misc health & allied services, nec

This Amendment No. 4 (“Amendment No. 4”) to Agreement No. 200600447 (the “Agreement”) is being entered into by and among Amgen USA Inc. (“Amgen”), a wholly-owned subsidiary of Amgen Inc.; Amgen Inc.; and Fresenius Medical Care Holdings, Inc. (“FMCH”) (Amgen and FMCH each a “Party” and together, the “Parties”). This Amendment No. 4 shall be effective on July 1, 2007.

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