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Fresenius Medical Care AG

 

COMPLETE OVERVIEW OF THE FOURTH QUARTER AND FULL YEAR 2025

 

February 24, 2026

 

 

 Investor Relations

phone: +49 6172 609 2525

email: ir@freseniusmedicalcare.com

 

 

Content:

 

Statement of earnings page 2
Segment information page 3
Balance sheet page 4
Cash flow page 5
Revenue development by segment page 6
Key metrics page 7
Reconciliation results excl. special items page 8
Outlook 2026 page 9

 

Disclaimer

 

This release contains forward-looking statements that are subject to various risks and uncertainties. Actual results could differ materially from those described in these forward-looking statements due to various factors, including, but not limited to, changes in business, economic and competitive conditions, legal changes, regulatory approvals, impacts related to COVID-19, results of clinical studies, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, and the availability of financing. These and other risks and uncertainties are detailed in Fresenius Medical Care AG’s reports filed with the U.S. Securities and Exchange Commission. Fresenius Medical Care AG does not undertake any responsibility to update the forward-looking statements in this release.

 

Rounding adjustments applied to individual numbers and percentages may result in these figures differing immaterially from their absolute values. Furthermore, totals and subtotals in tables may differ slightly from unrounded figures due to rounding in accordance with commercial rounding conventions.

 

Copyright by Fresenius Medical Care AG

 

 

 

 

 

 

Statement of earnings

 

   Three months ended December 31,       Twelve months ended December 31,     
in € million, except share data  2025   2024   Change   Change
at cc
   2025   2024   Change   Change
at cc
 
Total revenue   5,070    5,085    -0.3%   7.1%   19,628    19,336    1.5%   5.4%
                                         
Costs of revenue   3,681    3,814    -3.5%   3.9%   14,599    14,579    0.1%   4.1%
Selling, general and administrative expense   785    840    -6.5%   -0.6%   3,033    3,143    -3.5%   -0.2%
Research and development expense   39    50    -22.8%   -20.6%   158    183    -13.9%   -12.6%
Income from equity method investees   (42)   (32)   29.7%   29.9%   (181)   (135)   34.5%   34.5%
Other operating income   (131)   (228)   -42.5%   -40.8%   (528)   (760)   -30.5%   -29.4%
Other operating expense   144    382    -62.3%   -60.5%   720    934    -22.8%   -21.0%
Operating income   594    259    129.4%   143.6%   1,827    1,392    31.2%   35.6%
Operating income excl. special items 1   705    489    44.2%   52.9%   2,212    1,797    23.1%   27.2%
                                         
Interest income   (14)   (21)   -35.8%   -32.4%   (70)   (72)   -2.7%   1.8%
Interest expense   99    101    -2.0%   4.4%   385    407    -5.6%   -2.2%
Interest expense, net   85    80    7.0%   14.1%   315    335    -6.2%   -3.1%
Income before income taxes   509    179    183.9%   201.2%   1,512    1,057    43.1%   47.9%
Income tax expense   106    61    74.5%   81.9%   321    316    1.6%   4.4%
Net income   403    118    240.4%   262.8%   1,191    741    60.8%   66.5%
Net income attributable to noncontrolling interests   76    51    46.3%   56.6%   213    203    4.9%   9.4%
Net income attributable to shareholders of FME AG   327    67    388.9%   420.8%   978    538    81.9%   88.0%
Net income attributable to shareholders of FME AG
excl. special items 1
   412    266    54.9%   63.9%   1,248    903    38.2%   42.6%
                                         
Weighted average number of shares   285,906,303    293,413,449              291,190,575    293,413,449           
                                         
Basic earnings per share  1.14   0.23    401.8%   434.4%  3.36   1.83    83.3%   89.4%
Basic earnings per ADS  0.57   0.11    401.8%   434.4%  1.68   0.92    83.3%   89.4%
                                         
Operating income   594    259    129.4%   143.6%   1,827    1,392    31.2%   35.6%
Depreciation, amortization and impairment loss   373    477    -21.7%   -16.4%   1,500    1,743    -13.9%   -10.9%
EBITDA   967    736    31.5%   39.9%   3,327    3,135    6.2%   9.8%
                                         
In percent of revenue                                        
Operating income margin   11.7%   5.1%             9.3%   7.2%          
Operating income margin excl. special items 1   13.9%   9.6%             11.3%   9.3%          
EBITDA margin   19.1%   14.5%             17.0%   16.2%          
EBITDA margin excl. special items 1   21.2%   17.4%             18.8%   17.3%          

 

1 For a reconciliation of special items, please refer to the table on page 8.

 

Statement of earnings page 2 of 9 February 24, 2026

 

 

 

 

 

Segment information

 

   Three months ended December 31,       Twelve months ended December 31,     
   2025   2024   Change   Change
at cc
   2025   2024   Change   Change
at cc
 
Total                                        
Revenue in € million   5,070    5,085    -0.3%   7.1%   19,628    19,336    1.5%   5.4%
Operating income in € million   594    259    129.4%   143.6%   1,827    1,392    31.2%   35.6%
Operating income in € million excl. special items 1   705    489    44.2%   52.9%   2,212    1,797    23.1%   27.2%
Operating income margin   11.7%   5.1%             9.3%   7.2%          
Operating income margin excl. special items 1   13.9%   9.6%             11.3%   9.3%          
                                         
Days sales outstanding (DSO) 2                       59    63           
Employees (headcount)                       109,698    111,513           
                                         
Care Delivery segment                                        
Revenue in € million   3,507    3,571    -1.8%   5.7%   13,736    14,003    -1.9%   1.8%
Operating income in € million   528    260    103.3%   121.9%   1,614    1,218    32.5%   39.6%
Operating income in € million excl. special items 1   574    430    33.7%   44.9%   1,801    1,593    13.0%   18.5%
Operating income margin   15.1%   7.3%             11.8%   8.7%          
Operating income margin excl. special items 1   16.4%   12.0%             13.1%   11.4%          
                                         
Days sales outstanding (DSO) 2                       54    56           
                                         
Value-Based Care segment                                        
Revenue in € million   637    484    31.6%   42.4%   2,247    1,752    28.2%   33.9%
Operating income in € million   29    (7)   n.a.    n.a.    1    (28)   n.a.    n.a. 
Operating income in € million excl. special items 1   29    (7)   n.a.    n.a.    3    (28)   n.a.    n.a. 
Operating income margin   4.5%   -1.4%             0.1%   -1.6%          
Operating income margin excl. special items 1   4.5%   -1.4%             0.1%   -1.6%          
                                         
Days sales outstanding (DSO) 2                       33    33           
                                         
Care Enablement segment                                        
Revenue in € million   1,401    1,537    -8.8%   -3.2%   5,476    5,557    -1.4%   2.2%
Operating income in € million   56    71    -21.0%   -20.3%   326    267    22.0%   22.8%
Operating income in € million excl. special items 1   107    118    -8.6%   -5.8%   442    336    31.5%   33.3%
Operating income margin   4.0%   4.6%             6.0%   4.8%          
Operating income margin excl. special items 1   7.7%   7.7%             8.1%   6.0%          
                                         
Days sales outstanding (DSO) 2                       86    95           
                                         
Inter-segment eliminations 3                                        
Revenue in € million   (475)   (507)   -6.3%   0.3%   (1,831)   (1,976)   -7.3%   -3.9%
Operating income in € million   22    (8)   n.a    n.a    5    (17)   n.a.    n.a. 
Operating income in € million excl. special items 1   22    (8)   n.a.    n.a.    4    (24)   n.a.    n.a. 
                                         
Corporate                                        
Operating income in € million   (41)   (57)   -27.9%   -3.9%   (119)   (48)   148.4%   206.2%
Operating income in € million excl. special items 1   (27)   (44)   -37.2%   -11.5%   (38)   (80)   -54.3%   -27.4%

 

1 For a reconciliation of special items, please refer to the table on page 8.

2 Includes receivables related to assets held for sale.

3 Services provided by the Care Delivery segment in the U.S. for patients managed under the Value-Based Care segment are provided at fair market value. The Company also transfers products from the Care Enablement segment to the Care Delivery segment at fair market value. The associated internal revenues and expenses and all other consolidation of transactions are included within “Inter-segment eliminations”.

 

cc = constant currency. Changes in revenue, operating income and net income attributable to shareholders of FME AG include the impact of changes in foreign currency exchange rates. We calculate and present these financial measures using both IFRS Accounting Standards and at constant exchange rates to show changes in these metrics and other items without giving effect to period-to-period currency fluctuations. Under IFRS Accounting Standards, amounts received in local (non-euro) currency are translated into euro at the average exchange rate for the period presented. Once we translate the local currency for the constant currency, we then calculate the change, as a percentage, of the current period using the prior period exchange rates versus the prior period. The single quarter results are calculated as the variance between the current year-to-date results less the preceding quarter’s year-to-date which makes the single quarter subject to further foreign exchange fluctuation. This resulting percentage is a non-IFRS measure referring to a change as a percentage at constant currency. These currency-adjusted financial measures are identifiable by the designated term "Constant Currency".

 

Segment informationpage 3 of 9 February 24, 2026

 

 

 

 

 

Balance sheet

 

   December 31,   December 31, 
in € million, except for net leverage ratio  2025   2024 
Assets          
Cash and cash equivalents   1,599    1,180 
Trade accounts and other receivables from unrelated parties   3,142    3,367 
Inventories   2,141    2,068 
Other current assets   1,016    1,308 
Goodwill and intangible assets   14,826    16,541 
Right-of-use assets   3,014    3,612 
Other non-current assets   5,264    5,491 
Total assets   31,002    33,567 
           
Liabilities and equity          
Accounts payable to unrelated parties   738    904 
Other current liabilities   5,507    4,756 
Non-current liabilities   10,474    12,138 
Total equity   14,283    15,769 
Total liabilities and equity   31,002    33,567 
           
Equity/assets ratio   46%   47%
           
Debt and lease liabilities          
Short-term debt from unrelated parties   17    2 
Current portion of long-term debt   1,596    575 
Current portion of lease liabilities from unrelated parties   577    616 
Current portion of lease liabilities from related parties   7    25 
Long-term debt, less current portion   5,692    6,261 
Lease liabilities from unrelated parties, less current portion   2,895    3,412 
Lease liabilities from related parties, less current portion   11    88 
Debt and lease liabilities included within liabilities directly associated with assets held for sale       9 
Total debt and lease liabilities   10,795    10,988 
Minus: Cash and cash equivalents1   (1,599)   (1,185)
Total net debt and lease liabilities   9,196    9,803 
           
Reconciliation of adjusted EBITDA and net leverage ratio to the most directly comparable IFRS Accounting Standards financial measure          
Net income   1,191    741 
Income tax expense   321    316 
Interest income   (70)   (72)
Interest expense   385    407 
Depreciation and amortization   1,463    1,536 
Adjustments2   447    450 
Adjusted EBITDA   3,737    3,378 
           
Net leverage ratio   2.5    2.9 

 

1 Includes cash and cash equivalents included within assets held for sale.

2 Acquisitions and divestitures made for the last twelve months with a purchase price above a €50 M threshold as defined in the Syndicated Credit Facility (2025: €1 M; 2024: -€23 M), non-cash charges, primarily related to pension expense (2025: €47 M; 2024: €52 M), impairment loss (2025: €37 M; 2024: €207 M), and special items, including costs related to the FME25+ Program (2025: €185 M; 2024: €164 M), Legacy Portfolio Optimization (2025: €83 M; 2024: €113 M), Legal Form Conversion Costs (2025: €4 M; 2024: €9 M), and Humacyte Remeasurements (2025: €90 M; 2024: -€72 M).

 

Balance sheet page 4 of 9 February 24, 2026

 

 

 

 

 

Cash flow statement

 

   Three months ended December 31,   Twelve months ended December 31, 
in € million  2025   2024   2025   2024 
Operating activities                    
Net income   403    118    1,191    741 
Depreciation, amortization and impairment loss   373    477    1,500    1,743 
Change in trade accounts and other receivables from unrelated parties   98    30    (76)   (198)
Change in inventories   (59)   96    (249)   108 
Change in other working capital and non-cash items   187    111    315    (8)
Net cash provided by (used in) operating activities   1,002    832    2,681    2,386 
In percent of revenue   19.8%   16.4%   13.7%   12.3%
                     
Investing activities                    
Purchases of property, plant and equipment and capitalized development costs   (423)   (241)   (915)   (699)
Proceeds from sale of property, plant and equipment   5    8    16    14 
Capital expenditures, net   (418)   (233)   (899)   (685)
                     
Free cash flow   584    599    1,782    1,701 
In percent of revenue   11.5%   11.8%   9.1%   8.8%
                     
Acquisitions and investments, net of cash acquired, and purchases of intangible assets   (3)   (5)   (22)   (23)
Investments in debt securities   (62)   (17)   (87)   (82)
Proceeds from divestitures, net of cash disposed   38    128    202    630 
Proceeds from sale of debt securities   26    8    83    75 
Free cash flow after investing activities   583    713    1,958    2,301 

 

Cash flowpage 5 of 9 February 24, 2026

 

 

 

 

 

Revenue development by segment

 

in € million  2025   2024   Change   Change
at cc
   Organic
growth
  

Same market
treatment

growth1

 
Three months ended December 31,                              
Total revenue   5,070    5,085    -0.3%   7.1%   8.2%     
                               
Care Delivery segment   3,507    3,571    -1.8%   5.7%   7.3%   0.3%
Thereof: U.S.   2,956    2,985    -0.9%   7.7%   8.0%   -0.2%
Thereof: International   551    586    -6.1%   -4.4%   3.4%   1.7%
                               
Value-Based Care segment   637    484    31.6%   42.4%   42.4%     
                               
Care Enablement segment   1,401    1,537    -8.8%   -3.2%   -3.2%     
                               
Inter-segment eliminations   (475)   (507)   -6.3%   0.3%          
Thereof: Care Delivery segment   (133)   (110)   21.1%   31.4%          
Thereof: Care Enablement segment   (342)   (397)   -13.8%   -8.2%          
                               
Twelve months ended December 31,                              
Total revenue   19,628    19,336    1.5%   5.4%   7.6%     
                               
Care Delivery segment   13,736    14,003    -1.9%   1.8%   4.7%   0.6%
Thereof: U.S.   11,507    11,526    -0.2%   4.2%   4.7%   0.0%
Thereof: International   2,229    2,477    -10.0%   -9.3%   4.4%   2.0%
                               
Value-Based Care segment   2,247    1,752    28.2%   33.9%   33.9%     
                               
Care Enablement segment   5,476    5,557    -1.4%   2.2%   2.2%     
                               
Inter-segment eliminations   (1,831)   (1,976)   -7.3%   -3.9%          
Thereof: Care Delivery segment   (497)   (480)   3.6%   8.1%          
Thereof: Care Enablement segment   (1,334)   (1,496)   -10.8%   -7.8%          

 

1 Same market treatment growth = organic growth less price effects.

 

Revenue development by segment page 6 of 9 February 24, 2026

 

 

 

 

 

Key metrics

 

   Twelve months ended December 31, 2025 
   Clinics     Patients   Treatments 
   2025   2024   Change     2025     2024   Change   2025   2024   Change 
Care Delivery segment   3,601   3,675   -2%   291,902     299,352   -2%  44,746,884   47,617,071   -6%
Thereof: U.S.   2,622   2,624   0%   205,483     206,436   0%  31,069,465   31,213,447   0%
Thereof: International   979   1,051   -7%   86,419     92,916   -7%  13,677,419   16,403,624   -17%

 

    Twelve months ended December 31, 2025 
    Member Months   Membership 
  2025     2024   Change   2025   2024   Change 
Value-Based Care segment                              
Total U.S.  1,788,951     1,534,053    17%   162,697    131,750    23%

 

Key metricspage 7 of 9 February 24, 2026

 

 

 

 

 

Reconciliation of non-IFRS financial measures to the most directly comparable IFRS Accounting Standards financial measures for comparability with the Company´s outlook

 

       Special items                       Special items                 
                                       Results                                     
               Legal       Interwell
Health
   Sum  Results
2025
       2025
excl.
               Legal        Sum    Results
2024
   Change   Change
excl.
 
in € million, except share data  Results
2025
   FME25+
Program1
   Legacy
Portfolio
Optimization2
   Form
Conversion
Costs
   Humacyte
Remeasurements
   Deferred
Tax
Reversal3
   of
special
items
   excl.
special
items
   Currency
translation
effects
   special
items at
cc
   Results
2024
   FME25+
Program1
   Legacy
Portfolio
Optimiza
tion2
   Form
Conversion
Costs
   Humacyte
Remeasurements
   of
special
items
   excl.
special
items
   excl.
special
items
   special
items at
cc
 
Three months ended December 31,                                                                            
Total revenue   5,070                            5,070    374    5,444    5,085                        5,085    -0.3%   7.1%
Care Delivery segment   3,507                            3,507    268    3,775    3,571                        3,571    -1.8%   5.7%
Thereof: U.S.   2,956                            2,956    258    3,214    2,985                        2,985    -0.9%   7.7%
Thereof: International   551                            551    10    561    586                        586    -6.1%   -4.4%
Value-Based Care segment   637                            637    52    689    484                        484    31.6%   42.4%
Care Enablement segment   1,401                            1,401    87    1,488    1,537                        1,537    -8.8%   -3.2%
Inter-segment eliminations   (475)                           (475)   (33)   (508)   (507)                       (507)   -6.3%   0.3%
                                                                                                
EBITDA   967    69    18    2    18        107    1,074    67    1,141    736    68    69    4    7    148    884    21.5%   29.1%
                                                                                                
Total operating income   594    73    18    2    18        111    705    43    748    259    73    146    4    7    230    489    44.2%   52.9%
Care Delivery segment   528    26    20                46    574    49    623    260    29    141            170    430    33.7%   44.9%
Value-Based Care segment   29    0                    0    29    1    30    (7)                       (7)   n.a.    n.a. 
Care Enablement segment   56    47    0        4        51    107    4    111    71    42    5    0    0    47    118    -8.6%   -5.8%
Inter-segment eliminations   22        0                0    22    1    23    (8)       0            0    (8)   n.a.    n.a. 
Corporate   (41)   0    (2)   2    14        14    (27)   (12)   (39)   (57)   2    0    4    7    13    (44)   -37.2%   -11.5%
                                                                                                
Interest expense, net   85                            85    6    91    80                        80    7.0%   14.1%
                                                                                                
Income tax expense   106    19    2    1    4    0    26    132    9    141    61    20    16    1    2    39    100    32.9%   40.3%
                                                                                                
Net income attributable to noncontrolling
interests
   76                            76    4    80    51        (8)           (8)   43    73.7%   85.9%
                                                                                                
Net income4   327    54    16    1    14    0    85    412    24    436    67    53    138    3    5    199    266    54.9%   63.9%
                                                                                                
Basic earnings per share  1.14   0.19   0.06   0.00   0.05   0.00   0.30   1.44   0.08   1.52   0.23   0.18   0.47   0.01   0.02   0.68   0.91    59.0%   68.2%
                                                                                                
Twelve months ended December 31,                                                                                               
Total revenue   19,628                            19,628    758    20,386    19,336                        19,336    1.5%   5.4%
Care Delivery segment   13,736                            13,736    522    14,258    14,003                        14,003    -1.9%   1.8%
Thereof: U.S.   11,507                            11,507    505    12,012    11,526                        11,526    -0.2%   4.2%
Thereof: International   2,229                            2,229    17    2,246    2,477                        2,477    -10.0%   -9.3%
Value-Based Care segment   2,247                            2,247    99    2,346    1,752                        1,752    28.2%   33.9%
Care Enablement segment   5,476                            5,476    205    5,681    5,557                        5,557    -1.4%   2.2%
Inter-segment eliminations   (1,831)                           (1,831)   (68)   (1,899)   (1,976)                       (1,976)   -7.3%   -3.9%
                                                                                                
EBITDA   3,327    185    83    4    90        362    3,689    124    3,813    3,135    164    113    9    (72)   214    3,349    10.2%   13.9%
                                                                                                
Total operating income   1,827    194    97    4    90        385    2,212    73    2,285    1,392    180    288    9    (72)   405    1,797    23.1%   27.2%
Care Delivery segment   1,614    89    98                187    1,801    88    1,889    1,218    74    301            375    1,593    13.0%   18.5%
Value-Based Care segment   1    2                    2    3    0    3    (28)                       (28)   n.a.    n.a. 
Care Enablement segment   326    103    0        13        116    442    6    448    267    104    (7)   0    (28)   69    336    31.5%   33.3%
Inter-segment eliminations   5        (1)               (1)   4    0    4    (17)       (7)           (7)   (24)   n.a.    n.a. 
Corporate   (119)   0    0    4    77        81    (38)   (21)   (59)   (48)   2    1    9    (44)   (32)   (80)   -54.3%   -27.4%
                                                                                                
Interest expense, net   315                            315    10    325    335                        335    -6.2%   -3.1%
                                                                                                
Income tax expense   321    51    6    1    23    34    115    436    14    450    316    50    14    2    (18)   48    364    20.1%   23.8%
                                                                                                
Net income attributable to noncontrolling
interests
   213                            213    10    223    203        (8)           (8)   195    9.2%   13.9%
                                                                                                
Net income4   978    143    91    3    67    (34)   270    1,248    39    1,287    538    130    282    7    (54)   365    903    38.2%   42.6%
                                                                                                
Basic earnings per share  3.36   0.49   0.31   0.01   0.23   (0.12)  0.92   4.28   0.14   4.42   1.83   0.44   0.97   0.02   (0.18)  1.25   3.08    39.3%   43.7%

 

1 The FME25 Program was expanded by two years, the overall savings target increased and renamed to the FME25+ Program.

2 2025: mainly related to the completed divestitures in Brazil, Malaysia, and Kazakhstan as well as the select assets of FME AG’s wholly owned Spectra Laboratories, and impairment losses primarily related to right-of-use assets; 2024: mainly comprise gains and losses from divestitures, impairment losses resulting from the measurement of assets held for sale or from write-downs of related non-current assets.

3 Derecognition of certain deferred tax liabilities initially established in connection with the 2022 Interwell Health Transaction as a result of the settlement of Interwell Health put options.

4 Attributable to shareholders of FME AG.

 

Reconciliation results excl. special itemspage 8 of 9 February 24, 2026

 

 

 

 

 

Outlook 2026

 

  

Outlook 2026

(at Constant Currency)

  Results 2025 
Revenue growth1  Broadly flat    €19,628 M 
Operating income growth1  Between positive and negative mid-single digit percent    €2,212 M 

 

1 Outlook 2026 is based on the assumptions outlined in the earnings release for the fourth quarter and full year of 2025 and excludes special items. Special items include the costs related to the FME25+ Program, the impacts from Legacy Portfolio Optimization and the Humacyte Remeasurements and other effects that are unusual in nature and have not been foreseeable or not foreseeable in size or impact at the time of providing the outlook. The outlook assumes current laws, policies, regulations, and tariffs. The growth rates are based on the results 2025 excluding the costs related to the FME25+ Program (€194 M for operating income), the impacts from Legacy Portfolio Optimization (€97 M for operating income), the Legal Form Conversion Costs (€4 M for operating income) and the Humacyte Remeasurements (€90 M for operating income).

 

Outlook 2026page 9 of 9 February 24, 2026