.2
Fresenius Medical Care AG
COMPLETE OVERVIEW OF THE FIRST QUARTER 2026
May 05, 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 March 31, | ||||||||||||||||
| in € million, except share data, unaudited | 2026 | 2025 | Change | Change at cc | ||||||||||||
| Total revenue | 4,612 | 4,881 | -5.5 | % | 3.1 | % | ||||||||||
| Costs of revenue | 3,433 | 3,697 | -7.2 | % | 1.6 | % | ||||||||||
| Selling, general and administrative expense | 749 | 751 | -0.2 | % | 7.8 | % | ||||||||||
| Research and development expense | 38 | 43 | -11.9 | % | -7.6 | % | ||||||||||
| Income from equity method investees | (41 | ) | (48 | ) | -13.6 | % | -13.6 | % | ||||||||
| Other operating income | (158 | ) | (141 | ) | 12.1 | % | 14.7 | % | ||||||||
| Other operating expense | 305 | 248 | 23.5 | % | 31.8 | % | ||||||||||
| Operating income | 286 | 331 | -13.6 | % | -9.2 | % | ||||||||||
| Operating income excl. special items 1 | 467 | 457 | 2.2 | % | 9.8 | % | ||||||||||
| Interest income | (15 | ) | (15 | ) | -2.4 | % | 1.5 | % | ||||||||
| Interest expense | 94 | 96 | -2.5 | % | 5.2 | % | ||||||||||
| Interest expense, net | 79 | 81 | -2.6 | % | 5.9 | % | ||||||||||
| Income before income taxes | 207 | 250 | -17.2 | % | -14.1 | % | ||||||||||
| Income tax expense | 43 | 61 | -30.0 | % | -28.8 | % | ||||||||||
| Net income | 164 | 189 | -13.1 | % | -9.3 | % | ||||||||||
| Net income attributable to noncontrolling interests | 46 | 38 | 23.0 | % | 36.7 | % | ||||||||||
| Net income attributable to shareholders of FME AG | 118 | 151 | -22.3 | % | -21.0 | % | ||||||||||
| Net income attributable to shareholders of FME AG excl. special items 1 | 251 | 246 | 1.7 | % | 8.5 | % | ||||||||||
| Weighted average number of shares | 275,246,345 | 293,413,449 | ||||||||||||||
| Basic earnings per share | € | 0.43 | € | 0.52 | -17.2 | % | -15.8 | % | ||||||||
| Basic earnings per ADS | € | 0.21 | € | 0.26 | -17.2 | % | -15.8 | % | ||||||||
| Operating income | 286 | 331 | -13.6 | % | -9.2 | % | ||||||||||
| Depreciation, amortization and impairment loss | 463 | 395 | 17.4 | % | 27.9 | % | ||||||||||
| EBITDA | 749 | 726 | 3.2 | % | 10.9 | % | ||||||||||
| In percent of revenue | ||||||||||||||||
| Operating income margin | 6.2 | % | 6.8 | % | ||||||||||||
| Operating income margin excl. special items 1 | 10.1 | % | 9.4 | % | ||||||||||||
| EBITDA margin | 16.2 | % | 14.9 | % | ||||||||||||
| EBITDA margin excl. special items 1 | 17.9 | % | 17.3 | % | ||||||||||||
1 For a reconciliation of special items, please refer to the table on page 8.
| Statement of earnings | page 2 of 9 | May 5, 2026 |
Segment information
| Three months ended March 31, | ||||||||||||||||
| unaudited | 2026 | 2025 | Change | Change at cc | ||||||||||||
| Total | ||||||||||||||||
| Revenue in € million | 4,612 | 4,881 | -5.5 | % | 3.1 | % | ||||||||||
| Operating income in € million | 286 | 331 | -13.6 | % | -9.2 | % | ||||||||||
| Operating income in € million excl. special items 1 | 467 | 457 | 2.2 | % | 9.8 | % | ||||||||||
| Operating income margin | 6.2 | % | 6.8 | % | ||||||||||||
| Operating income margin excl. special items 1 | 10.1 | % | 9.4 | % | ||||||||||||
| Days sales outstanding (DSO) 2 | 65 | 67 | ||||||||||||||
| Employees (headcount) | 108,165 | 112,035 | ||||||||||||||
| Care Delivery segment | ||||||||||||||||
| Revenue in € million | 3,294 | 3,447 | -4.4 | % | 5.0 | % | ||||||||||
| Operating income in € million | 271 | 320 | -15.3 | % | -3.0 | % | ||||||||||
| Operating income in € million excl. special items 1 | 398 | 356 | 11.6 | % | 26.4 | % | ||||||||||
| Operating income margin | 8.2 | % | 9.3 | % | ||||||||||||
| Operating income margin excl. special items 1 | 12.1 | % | 10.3 | % | ||||||||||||
| Days sales outstanding (DSO) 2 | 65 | 64 | ||||||||||||||
| Value-Based Care segment | ||||||||||||||||
| Revenue in € million | 490 | 529 | -7.4 | % | 3.0 | % | ||||||||||
| Operating income in € million | (11 | ) | 3 | n.a. | n.a. | |||||||||||
| Operating income in € million excl. special items 1 | 9 | 4 | 113.5 | % | 137.4 | % | ||||||||||
| Operating income margin | -2.3 | % | 0.6 | % | ||||||||||||
| Operating income margin excl. special items 1 | 1.8 | % | 0.8 | % | ||||||||||||
| Days sales outstanding (DSO) 2 | 32 | 36 | ||||||||||||||
| Care Enablement segment | ||||||||||||||||
| Revenue in € million | 1,299 | 1,367 | -5.0 | % | 1.1 | % | ||||||||||
| Operating income in € million | 87 | 94 | -7.5 | % | -8.7 | % | ||||||||||
| Operating income in € million excl. special items 1 | 113 | 114 | -1.0 | % | 0.1 | % | ||||||||||
| Operating income margin | 6.7 | % | 6.9 | % | ||||||||||||
| Operating income margin excl. special items 1 | 8.7 | % | 8.3 | % | ||||||||||||
| Days sales outstanding (DSO) 2 | 83 | 91 | ||||||||||||||
| Inter-segment eliminations 3 | ||||||||||||||||
| Revenue in € million | (471 | ) | (462 | ) | 1.9 | % | 11.7 | % | ||||||||
| Operating income in € million | (21 | ) | (5 | ) | 303.5 | % | 348.6 | % | ||||||||
| Operating income in € million excl. special items 1 | (21 | ) | (5 | ) | 303.5 | % | 348.6 | % | ||||||||
| Corporate | ||||||||||||||||
| Operating income in € million | (40 | ) | (81 | ) | -50.8 | % | -26.4 | % | ||||||||
| Operating income in € million excl. special items 1 | (32 | ) | (12 | ) | 150.0 | % | 297.5 | % | ||||||||
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 information | page 3 of 9 | May 5, 2026 |
Balance sheet
| March 31, | December 31, | |||||||
| in € million, except for net leverage ratio, unaudited | 2026 | 2025 | ||||||
| Assets | ||||||||
| Cash and cash equivalents | 1,239 | 1,599 | ||||||
| Trade accounts and other receivables from unrelated parties | 3,582 | 3,142 | ||||||
| Inventories | 2,303 | 2,141 | ||||||
| Other current assets | 984 | 1,016 | ||||||
| Goodwill and intangible assets | 15,103 | 14,826 | ||||||
| Right-of-use assets | 2,935 | 3,014 | ||||||
| Other non-current assets | 5,322 | 5,264 | ||||||
| Total assets | 31,468 | 31,002 | ||||||
| Liabilities and equity | ||||||||
| Accounts payable to unrelated parties | 771 | 738 | ||||||
| Other current liabilities | 5,959 | 5,507 | ||||||
| Non-current liabilities | 10,533 | 10,474 | ||||||
| Total equity | 14,205 | 14,283 | ||||||
| Total liabilities and equity | 31,468 | 31,002 | ||||||
| Equity/assets ratio | 45 | % | 46 | % | ||||
| Debt and lease liabilities | ||||||||
| Short-term debt | 1,796 | 1,613 | ||||||
| Long-term debt, less current portion | 5,741 | 5,692 | ||||||
| Current portion of lease liabilities | 593 | 584 | ||||||
| Lease liabilities, less current portion | 2,899 | 2,906 | ||||||
| Total debt and lease liabilities | 11,029 | 10,795 | ||||||
| Minus: Cash and cash equivalents | (1,239 | ) | (1,599 | ) | ||||
| Total net debt and lease liabilities | 9,790 | 9,196 | ||||||
| Reconciliation of annualized adjusted EBITDA and net leverage ratio to the most directly comparable IFRS Accounting Standards financial measure | ||||||||
| Net income | 1,166 | 1,191 | ||||||
| Income tax expense | 303 | 321 | ||||||
| Interest income | (69 | ) | (70 | ) | ||||
| Interest expense | 382 | 385 | ||||||
| Depreciation and amortization | 1,435 | 1,463 | ||||||
| Adjustments 1 | 495 | 447 | ||||||
| Annualized adjusted EBITDA | 3,712 | 3,737 | ||||||
| Net leverage ratio | 2.6 | 2.5 | ||||||
1 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 (2026: -€2 M; 2025: €1 M), non-cash charges, primarily related to pension expense (2026: €45 M; 2025: €47 M), impairment loss (2026: €134M; 2025: €37 M), and special items, including costs related to the FME25+ Program (2026: €218 M; 2025: €185 M), Legacy Portfolio Optimization (2026: €78 M; 2025: €83 M), Legal Form Conversion Costs (2026: €3 M; 2025: €4 M), and Humacyte Remeasurements (2026: €19 M; 2025: €90 M).
| Balance sheet | page 4 of 9 | May 5, 2026 |
Cash flow statement
| Three months ended March 31, | ||||||||
| in € million, unaudited | 2026 | 2025 | ||||||
| Operating activities | ||||||||
| Net income | 164 | 189 | ||||||
| Depreciation, amortization and impairment loss | 463 | 395 | ||||||
| Change in trade accounts and other receivables from unrelated parties | (386 | ) | (307 | ) | ||||
| Change in inventories | (147 | ) | (71 | ) | ||||
| Change in other working capital and non-cash items | 133 | (43 | ) | |||||
| Net cash provided by (used in) operating activities | 227 | 163 | ||||||
| In percent of revenue | 4.9 | % | 3.3 | % | ||||
| Investing activities | ||||||||
| Purchases of property, plant and equipment and capitalized development costs | (190 | ) | (146 | ) | ||||
| Proceeds from sale of property, plant and equipment | 3 | 4 | ||||||
| Capital expenditures, net | (187 | ) | (142 | ) | ||||
| Free cash flow | 40 | 21 | ||||||
| In percent of revenue | 0.9 | % | 0.4 | % | ||||
| Acquisitions and investments, net of cash acquired, and purchases of intangible assets | (5 | ) | (6 | ) | ||||
| Investments in debt securities | 0 | (12 | ) | |||||
| Proceeds from divestitures, net of cash disposed | 2 | 19 | ||||||
| Proceeds from sale of debt securities | 21 | 33 | ||||||
| Free cash flow after investing activities | 58 | 55 | ||||||
| Cash flow | page 5 of 9 | May 5, 2026 |
Revenue development by segment
| in € million, unaudited | 2026 | 2025 | Change | Change at cc | Organic growth | Same market treatment growth 1 | ||||||||||||||||||
| Three months ended March 31, | ||||||||||||||||||||||||
| Total revenue | 4,612 | 4,881 | -5.5 | % | 3.1 | % | 3.9 | % | ||||||||||||||||
| Care Delivery segment | 3,294 | 3,447 | -4.4 | % | 5.0 | % | 6.1 | % | 0.1 | % | ||||||||||||||
| Thereof: U.S. | 2,765 | 2,892 | -4.4 | % | 6.4 | % | 6.7 | % | -0.4 | % | ||||||||||||||
| Thereof: International | 529 | 555 | -5.0 | % | -2.1 | % | 3.3 | % | 1.3 | % | ||||||||||||||
| Value-Based Care segment | 490 | 529 | -7.4 | % | 3.0 | % | 3.0 | % | ||||||||||||||||
| Care Enablement segment | 1,299 | 1,367 | -5.0 | % | 1.1 | % | 1.1 | % | ||||||||||||||||
| Inter-segment eliminations | (471 | ) | (462 | ) | 1.9 | % | 11.7 | % | ||||||||||||||||
| Thereof: Care Delivery segment | (121 | ) | (119 | ) | 1.5 | % | 12.9 | % | ||||||||||||||||
| Thereof: Care Enablement segment | (350 | ) | (343 | ) | 2.1 | % | 11.3 | % | ||||||||||||||||
1 Same market treatment growth = organic growth less price effects
| Revenue development by segment | page 6 of 9 | May 5, 2026 |
Key metrics
| Three months ended March 31, | |||||||||||||||||||||||||||
| unaudited | 2026 | 2025 | Change | 2026 | 2025 | Change | 2026 | 2025 | Change | ||||||||||||||||||
| Clinics | Patients | Treatments | |||||||||||||||||||||||||
| Care Delivery segment | 3,539 | 3,674 | -4 | % | 289,923 | 299,358 | -3 | % | 10,672,063 | 11,007,408 | -3 | % | |||||||||||||||
| Thereof: U.S. | 2,562 | 2,623 | -2 | % | 203,930 | 205,662 | -1 | % | 7,505,920 | 7,548,182 | -1 | % | |||||||||||||||
| Thereof: International | 977 | 1,051 | -7 | % | 85,993 | 93,696 | -8 | % | 3,166,143 | 3,459,226 | -8 | % | |||||||||||||||
| Three months ended March 31, | |||||||||||||||||||||
| unaudited | 2026 | 2025 | Change | 2026 | 2025 | Change | |||||||||||||||
| Member Months | Membership | ||||||||||||||||||||
| Value-Based Care segment | |||||||||||||||||||||
| Total U.S. | 460,809 | 438,187 | 5 | % | 156,541 | 148,415 | 5 | % | |||||||||||||
| Key metrics | page 7 of 9 | May 5, 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 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| in
€ million, except share data, unaudited |
Results
2026 | FME25+ Program | Legacy Portfolio Optimiza- tion1 | Humacyte Remeasure- ments | Sum of special items | Results
2026 excl. special items | Currency translation effects | Results
2026 excl. special items at cc | Results
2025 | FME25+
Program | Legacy Portfolio Optimiza- tion1 | Legal Form Conversion Costs | Humacyte Remeasure- ments | Sum
of special items | Results 2025 excl. special items | Change
excl. special items | Change
excl. special items at cc | ||||||||||||||||||||||||||||||||||||||||||||||||
| Three months ended March 31, | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Total revenue | 4,612 | — | — | — | — | 4,612 | 419 | 5,031 | 4,881 | — | — | — | — | — | 4,881 | -5.5 | % | 3.1 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Care Delivery segment | 3,294 | — | — | — | — | 3,294 | 325 | 3,619 | 3,447 | — | — | — | — | — | 3,447 | -4.4 | % | 5.0 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Thereof: U.S. | 2,765 | — | — | — | — | 2,765 | 310 | 3,075 | 2,892 | — | — | — | — | — | 2,892 | -4.4 | % | 6.4 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Thereof: International | 529 | — | — | — | — | 529 | 15 | 544 | 555 | — | — | — | — | — | 555 | -5.0 | % | -2.1 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Value-Based Care segment | 490 | — | — | — | — | 490 | 55 | 545 | 529 | — | — | — | — | — | 529 | -7.4 | % | 3.0 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Care Enablement segment | 1,299 | — | — | — | — | 1,299 | 83 | 1,382 | 1,367 | — | — | — | — | — | 1,367 | -5.0 | % | 1.1 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Inter-segment eliminations | (471 | ) | — | — | — | — | (471 | ) | (44 | ) | (515 | ) | (462 | ) | — | — | — | — | — | (462 | ) | 1.9 | % | 11.7 | % | ||||||||||||||||||||||||||||||||||||||||
| EBITDA | 749 | 60 | 12 | 3 | 75 | 824 | 64 | 888 | 726 | 28 | 17 | 0 | 74 | 119 | 845 | -2.5 | % | 5.1 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Total operating income | 286 | 166 | 12 | 3 | 181 | 467 | 34 | 501 | 331 | 28 | 24 | 0 | 74 | 126 | 457 | 2.2 | % | 9.8 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Care Delivery segment | 271 | 118 | 9 | — | 127 | 398 | 52 | 450 | 320 | 14 | 22 | — | — | 36 | 356 | 11.6 | % | 26.4 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Value-Based Care segment | (11 | ) | 20 | — | — | 20 | 9 | 1 | 10 | 3 | 1 | — | — | — | 1 | 4 | 113.5 | % | 137.4 | % | |||||||||||||||||||||||||||||||||||||||||||||
| Care Enablement segment | 87 | 28 | 1 | (3 | ) | 26 | 113 | 1 | 114 | 94 | 11 | 2 | — | 7 | 20 | 114 | -1.0 | % | 0.1 | % | |||||||||||||||||||||||||||||||||||||||||||||
| Inter-segment eliminations | (21 | ) | — | — | — | — | (21 | ) | (3 | ) | (24 | ) | (5 | ) | — | — | — | — | — | (5 | ) | 303.5 | % | 348.6 | % | ||||||||||||||||||||||||||||||||||||||||
| Corporate | (40 | ) | 0 | 2 | 6 | 8 | (32 | ) | (17 | ) | (49 | ) | (81 | ) | 2 | — | 0 | 67 | 69 | (12 | ) | 150.0 | % | 297.5 | % | ||||||||||||||||||||||||||||||||||||||||
| Interest expense, net | 79 | — | — | — | — | 79 | 6 | 85 | 81 | — | — | — | — | — | 81 | -2.6 | % | 5.9 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Income tax expense | 43 | 42 | 5 | 1 | 48 | 91 | 5 | 96 | 61 | 8 | 4 | 0 | 19 | 31 | 92 | -0.9 | % | 5.4 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Net income attributable to noncontrolling interests | 46 | — | — | — | — | 46 | 7 | 53 | 38 | — | — | — | — | — | 38 | 23.0 | % | 36.7 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Net income2 | 118 | 124 | 7 | 2 | 133 | 251 | 16 | 267 | 151 | 20 | 20 | 0 | 55 | 95 | 246 | 1.7 | % | 8.5 | % | ||||||||||||||||||||||||||||||||||||||||||||||
| Basic earnings per share | € | 0.43 | € | 0.45 | € | 0.02 | € | 0.01 | € | 0.48 | € | 0.91 | € | 0.06 | € | 0.97 | € | 0.52 | € | 0.07 | € | 0.07 | € | 0.00 | € | 0.18 | € | 0.32 | € | 0.84 | 8.5 | % | 15.7 | % | |||||||||||||||||||||||||||||||
1 2026: mainly related to costs associated with the 2025 divestiture of select assets of the Company’s wholly owned Spectra Laboratories; 2025: mainly comprises severance payments and the impairment of goodwill resulting from the measurement of assets held for sale.
2 Attributable to shareholders of FME AG.
| Reconciliation results excl. special items | page 8 of 9 | May 5, 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 2026 | page 9 of 9 | May 5, 2026 |