Fresenius Medical Care reports third quarter 2026 performance partially offsetting headwinds and narrowing full year outlook

Care Delivery earnings improved, while China exit costs and inflation weighed on group profitability.

Rhea-AI Summary

Fresenius Medical Care (FMS) narrowed its full-year operating income outlook after third-quarter earnings declined amid regulatory headwinds and higher costs. The company now expects 2026 revenue to be broadly flat and operating income growth between flat and a negative mid-single digit percentage.

Third-quarter revenue rose 1% to EUR 4,937 million, while reported operating income fell 19% to EUR 384 million. Net income attributable to shareholders declined 42% to EUR 160 million. China business changes generated EUR 108 million in one-time costs. Excluding special items, operating income fell 5% to EUR 545 million and basic earnings per share remained flat at EUR 1.11.

Operating cash flow increased 8% to EUR 798 million. The 5008X rollout reached approximately 16% of dialysis machines in U.S. clinics, on track for the company's full-year target of around 20%.

29 points · 0 major

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1 major · 25 points

Hollow bars mark forward-looking points. How the balance works

Positive

• Moderate pointQ3 Care Delivery revenue rose 3% to EUR 3,492 million, with 2% organic growth.
• Moderate pointQ3 Care Enablement revenue increased 7% to EUR 1,451 million, supported by pricing and volumes outside China.
• Moderate pointQ3 Care Delivery operating income rose 18% to EUR 497 million; margin increased to 14.2% from 12.3%.
• Moderate pointQ3 Value-Based Care operating income reached breakeven, versus a EUR 22 million prior-year loss.
• Moderate pointNine-month operating income excluding special items increased 5% to EUR 1,581 million; margin rose to 11.0% from 10.3%.
• Moderate pointNine-month Care Delivery operating income rose 11% to EUR 1,203 million; margin reached 11.7% versus 10.6%.
• Moderate pointNine-month basic EPS excluding special items increased 10% to EUR 3.14.
• Moderate pointNine-month operating cash flow increased 12% to EUR 1,885 million; margin rose to 13.1% from 11.5%.
• Moderate point. Forward-looking: it has not happened yet and may not happen.FME25+ savings are expected at EUR 250 million in 2026 and EUR 1.2 billion by end-2027.
• Moderate pointShare repurchases reached 9.1 million shares for EUR 357 million by September 30, representing 3.4% of issued shares.
• Moderate point. Forward-looking: it has not happened yet and may not happen.The second buyback program targets around EUR 1 billion, excluding ancillary costs, through tranches within 12 months.

18 minor points

• Minor pointQ3 revenue increased 1% to EUR 4,937 million, despite a 1% decline at constant currency.
• Minor pointQ3 U.S. Care Delivery revenue increased 3% to EUR 2,920 million.
• Minor pointQ3 international Care Delivery revenue increased 2% to EUR 572 million, with 6% organic growth.
• Minor pointInternational same-market treatment growth reached 1.4% in Q3 and 1.2% over nine months.
• Minor pointQ3 Care Delivery operating income excluding special items increased 4% to EUR 513 million.
• Minor pointQ3 Value-Based Care operating income excluding special items reached EUR 1 million, versus a EUR 21 million loss.
• Minor pointQ3 Care Enablement operating income excluding special items rose 3% to EUR 106 million; margin fell to 7.3% from 7.6%.
• Minor pointNine-month Care Enablement revenue increased 1% to EUR 4,121 million.
• Minor pointNine-month Care Delivery operating income excluding special items increased 17% to EUR 1,437 million.
• Minor pointNine-month Value-Based Care operating income reached EUR 6 million, versus a EUR 28 million loss.
• Minor pointNine-month Value-Based Care operating income excluding special items reached EUR 27 million, versus a EUR 26 million loss.
• Minor pointNine-month net income excluding special items increased 1% to EUR 844 million.
• Minor pointQ3 operating cash flow increased 8% to EUR 798 million; margin rose to 16.2% from 15.2%.
• Minor pointQ3 free cash flow increased 3% to EUR 564 million; margin reached 11.4% versus 11.3%.
• Minor pointNine-month free cash flow increased 3% to EUR 1,229 million.
• Minor pointFME25+ delivered EUR 74 million in additional sustainable savings during Q3.
• Minor point. Forward-looking: it has not happened yet and may not happen.5008X rollout remains on track for around 20% of U.S. clinic dialysis machines by year-end.
• Minor pointThe U.S. multiFiltratePRO launch followed FDA clearance and approvals of companion solutions Cienby and Calrezdy.

Negative

• Major point. Forward-looking: it has not happened yet and may not happen.2026 operating income outlook narrowed to flat through negative mid-single digit percentage growth, the prior range's lower half.
• Moderate pointQ3 reported operating income declined 19% to EUR 384 million; margin fell to 7.8% from 9.8%.
• Moderate pointQ3 net income attributable to shareholders declined 42% to EUR 160 million.
• Moderate pointChina business exits generated EUR 108 million in one-time impairment, scrappage and termination costs.
• Moderate pointQ3 Care Enablement recorded an operating loss of EUR 32 million; margin fell to -2.2% from 6.4%.
• Moderate pointQ3 Value-Based Care revenue declined 7% to EUR 537 million, reflecting changed risk contracting.
• Moderate pointU.S. same-market treatment growth was -1.1% in Q3 and -0.8% over nine months.
• Moderate pointNine-month reported operating income declined 8% to EUR 1,136 million; margin fell to 7.9% from 8.5%.
• Moderate pointNine-month Care Enablement operating income declined 43% to EUR 153 million; margin fell to 3.7% from 6.6%.
• Moderate pointNine-month net income attributable to shareholders declined 24% to EUR 496 million.
• Moderate point. Forward-looking: it has not happened yet and may not happen.FME25+ incurred EUR 54 million in Q3 one-time costs; related 2026 costs are expected at EUR 350 million.
• Moderate pointTDAPA reimbursement regulations and increased labor costs offset improvements in Care Delivery.
• Moderate pointAccelerated inflationary cost increases weighed on Care Enablement earnings.

12 minor points

• Minor pointQ3 operating income excluding special items fell 5% to EUR 545 million; margin declined to 11.0% from 11.7%.
• Minor pointQ3 net income excluding special items declined 10% to EUR 291 million.
• Minor pointQ3 basic EPS fell 35% to EUR 0.61.
• Minor pointQ3 Corporate operating loss widened to EUR 35 million from EUR 4 million.
• Minor pointQ3 Corporate operating loss excluding special items reached EUR 29 million, versus a EUR 3 million gain.
• Minor pointNine-month group revenue declined 1% to EUR 14,409 million, despite 2% growth at constant currency.
• Minor pointNine-month Value-Based Care revenue declined 3% to EUR 1,563 million, despite 1% growth at constant currency.
• Minor pointNine-month Care Enablement operating income excluding special items declined 2% to EUR 329 million.
• Minor pointNine-month Corporate operating loss widened to EUR 119 million from EUR 78 million.
• Minor pointNine-month Corporate operating loss excluding special items widened to EUR 105 million from EUR 9 million.
• Minor pointNine-month basic EPS declined 17% to EUR 1.84.
• Minor pointPortfolio divestitures reduced group revenue development by 30 basis points in Q3 and 40 basis points over nine months.

Key Figures

Revenue: EUR 4,937 million; +1% year over year Operating income: EUR 384 million; -19% year over year Operating income excluding special items: EUR 545 million; -5% year over year +5 more

Revenue

EUR 4,937 million; +1% year over year

Q3 2026 reported

Operating income

EUR 384 million; -19% year over year

Q3 2026 reported

Operating income excluding special items

EUR 545 million; -5% year over year

Q3 2026

Net income

EUR 160 million; -42% year over year

Q3 2026 reported

Basic EPS

EUR 0.61; -35% year over year

Q3 2026 reported

Revenue outlook

Broadly flat

2026 compared with prior year

Operating income outlook

Flat to a negative mid-single-digit percent growth rate

2026 compared with prior year; outlook narrowed

China strategy refinement costs

EUR 108 million

One-time costs treated as a special item

Historical Context

1 past event · Latest: Sep 25

1 event

1. Sep 25

   China strategy refinement

   24h Move

   +1.5%

   Company disclosed China peritoneal-dialysis exit and expected about €110 million in one-time costs.

24h Move is the share-price change in the day after each event; other market factors may also have contributed.

Key Terms

acute kidney injury, continuous kidney replacement therapy, regional citrate anticoagulation, peritoneal dialysis, +1 more

5 terms

acute kidney injury medical

"for critically ill patients with acute kidney injury (AKI)"

A sudden decline in how well the kidneys remove waste and balance fluids, often developing over hours or days; think of it like an engine that abruptly loses power and can’t filter efficiently. It matters to investors because it can drive higher medical costs, alter clinical trial results, trigger regulatory scrutiny, lead to drug label changes or recalls, and affect revenue and liability for healthcare and life sciences companies.

continuous kidney replacement therapy medical

"continuous kidney replacement therapy (CKRT) system in the U.S."

A continuous kidney replacement therapy (CKRT or CRRT) is a form of dialysis used in critically ill patients that runs continuously over many hours or days to remove waste products, balance electrolytes, and remove excess fluid. It is delivered by a bedside pump and filter connected to a large-bore venous catheter and typically operates more slowly and gently than intermittent hemodialysis, making it suitable for patients with unstable blood pressure; common modes include convective, diffusive, or combined clearance methods and anticoagulation is often required to keep the filter working.

regional citrate anticoagulation medical

"for regional citrate anticoagulation using the Ci-Ca Protocol"

A method of preventing blood clotting in an extracorporeal circuit (such as during dialysis or continuous kidney replacement therapy) by adding citrate to the blood as it leaves the patient. Citrate binds ionized calcium, which is required for clotting, so the blood stays anticoagulated inside the circuit; before the blood returns to the patient, calcium is replaced by a separate infusion so systemic clotting function is preserved. The technique reduces the need for whole‑body anticoagulants but requires monitoring of ionized calcium and acid–base status because citrate can accumulate, especially in patients with severe liver dysfunction.

peritoneal dialysis medical

"exited its peritoneal dialysis (PD) business"

Peritoneal dialysis is a kidney replacement treatment that uses the lining of the abdomen as a natural filter: a sterile fluid is put into the belly, left to absorb waste and excess fluid, then drained away, and the cycle repeats. It matters to investors because it drives demand for machines, disposable solutions and training services, affects healthcare costs and reimbursement trends, and can shift patient care from hospitals to home, altering market opportunities.

impairment charges financial

"primarily attributable to impairment charges, scrappage and termination costs"

Impairment charges are one-time accounting write-downs taken when a company decides an asset — like a factory, brand, patent, or investment — is worth less than it was recorded for. Like marking down the price of a damaged item on a store shelf, they reduce reported profits and the asset’s book value; investors watch them because they can signal lasting business problems or change future earnings and balance-sheet strength.

AI-generated analysis. How Rhea-AI works. Not financial advice.

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• Stable organic revenue¹ development driven by growth in Care Delivery and Care Enablement, offset by the expected decline in profit-neutral Value-Based Care
• Operating income² decreased by 6%, due to regulatory and inflation headwinds
• Reported operating income decreased by 19% and reported net income³ decreased by 42%, mainly due to one-time costs related to the China strategy refinement
• Earnings per share² (EPS) remained stable supported by the share buyback program
• 348 U.S. clinics representing 16% of our U.S. dialysis machines converted to the 5008X CAREsystem™ with 1.3 million treatments⁴
• FY 2026 outlook – revenue outlook broadly flat, operating income outlook narrowed to between flat and a negative mid-single digit percent growth rate

BAD HOMBURG, Germany, Nov. 3, 2026 /PRNewswire/ -- "Three weeks into my role as CEO, I am energized by the opportunities ahead. As a global leader in kidney care, Fresenius Medical Care combines exceptional capabilities with unparalleled reach. Following the structural changes of recent years, many parts of our business are still at an early stage of development. This creates a compelling opportunity to deliver transformational improvements in performance, not simply the incremental gains typically associated with more mature businesses. We are muted in our assessment of performance and endeavor to improve the current trajectory over time," said Shervin J. Korangy, new Chief Executive Officer and Chair of the Management Board of Fresenius Medical Care. "With the FME25+ transformation, the company has built a solid foundation to continue to profitably grow and create value for all stakeholders. My focus will be on identifying opportunities to accelerate innovation, expand access to care, improve outcomes and drive long-term profitable growth."

Martin Fischer, Chief Financial Officer of Fresenius Medical Care outlined, "Fresenius Medical Care delivered a quarter of broadly stable revenue and resilient earnings development, as continued underlying performance improvements counter the expected negative effects from TDAPA regulations and increased inflation headwinds. Care Delivery further increased operating income², driven by continued underlying operating income² improvement of 21% excluding the negative TDAPA effects. The U.S. rollout of our innovative 5008X CAREsystem is progressing on plan, now available in 348 U.S. clinics, having performed 1.3 million treatments. The ongoing experience with the HvHDF modality in our clinics is exciting and clinical observations are consistently tracking very well compared with real-world data outside the U.S., which show to significantly improve patient outcomes."

Shervin J. Korangy concluded, "Based on the operating income development in the first nine months and the anticipated headwinds in the fourth quarter we narrowed our outlook for 2026 to the lower half of our outlook range."

Key figures Q3 and 9M 2026 (unaudited)
	Q3 2026	Q3 2025	Growth	Growth	9M 2026	9M 2025	Growth	Growth
	EUR m	EUR m	yoy	yoy, cc	EUR m	EUR m	yoy	yoy, cc
Revenue	4,937	4,885	1 %	-1 %	14,409	14,558	-1 %	2 %
Operating income	384	477	-19 %	-19 %	1,136	1,233	-8 %	-5 %
excl. special items2	545	574	-5 %	-6 %	1,581	1,507	5 %	8 %
Net income3	160	275	-42 %	-41 %	496	651	-24 %	-21 %
excl. special items2	291	322	-10 %	-10 %	844	836	1 %	4 %
Basic EPS (EUR)	0.61	0.94	-35 %	-34 %	1.84	2.22	-17 %	-14 %
excl. special items2	1.11	1.10	0 %	0 %	3.14	2.85	10 %	13 %

yoy = year-on-year, cc = at constant currency, EPS = earnings per share

Strategic progress
Fresenius Medical Care, the world's leading provider of products and services for individuals with renal disease, continues to focus on execution to improve core operations and to drive profitable growth.

The large-scale U.S. commercial rollout of the innovative 5008X CAREsystem is progressing as planned. Since its launch in early 2026, approximately 16% of dialysis machines in Fresenius Medical Care's U.S. clinics have been replaced, keeping the company on track to reach its full-year target of around 20%. As adoption expands, treatments performed with the system have risen to 1.3 million, including more than 500,000 HDF treatments and more than 300,000 HvHDF treatments. Early observations are directionally better than previously published real-world data associating HvHDF with fewer hospitalizations, fewer missed treatments, and improved survival compared with conventional hemodialysis. At ASN Kidney Week in Denver, Colorado, we presented updates demonstrating the ability to achieve HvHDF for U.S. patients, with typical treatment times, blood and dialysate flows during therapy and look forward to presenting data in publications and congresses specifically around patient experience, hospitalizations, and survival through 2027.

In October, Fresenius Medical Care launched the multiFiltratePRO™ system in the U.S. for critically ill patients with acute kidney injury (AKI). The system continuously cleans the blood, removing waste and extra fluid when a patient's kidneys can no longer do this on their own. multiFiltratePRO is the first FDA-cleared continuous kidney replacement therapy (CKRT) system in the U.S. for regional citrate anticoagulation using the Ci-Ca Protocol. The system brings important treatment steps together in one place, helping make a complex therapy easier for healthcare professionals to manage so they can focus on patient care.

The launch followed FDA clearance of multiFiltratePRO and approval of Cienby™, a sodium citrate solution, and Calrezdy™, a calcium chloride solution. Together, these advances reflect Fresenius Medical Care's longstanding experience in developing and bringing complex kidney therapies to patients around the world.

In China, the company refined its commercial strategy by discontinuing production and sales of the 4008A hemodialysis system locally and exited its peritoneal dialysis (PD) business while maintaining existing obligations in the market. The resulting one-time costs of EUR 108 million are primarily attributable to impairment charges, scrappage and termination costs, treated as a special item in Care Enablement.

During the third quarter of 2026, the FME25+ transformation program delivered EUR 74 million additional sustainable savings while related one-time costs, treated as special items amounted to EUR 54 million. The company expects EUR 250 million savings and EUR 350 million related one-time costs in 2026. FME25+ savings are expected to total EUR 1.2 billion by the end of 2027.

As part of the capital allocation framework, share buyback programs complement shareholder returns through dividends. On May 26, a second program for a total volume of around EUR 1 billion (excluding ancillary costs) was announced and is being executed in tranches within 12 months. The first tranche was initiated on May 28 and is planned to end by December 15, 2026. As of September 30, 9.1 million shares or 3.4% of total shares issued have been repurchased for a total investment of EUR 357 million.

Organic revenue growth in Care Delivery and Care Enablement
In the third quarter of 2026, Group revenue increased by 1% compared to prior year (-1% at constant currency, +0.1% organic¹) to EUR 4,937 million. Divestitures realized as part of the portfolio optimization plan negatively affected the revenue development by 30 basis points.

Care Delivery revenue increased by 3% (+1% at constant currency, +2% organic¹) to EUR 3,492 million. Divestitures realized as part of the portfolio optimization plan negatively affected the revenue development by 40 basis points.

In Care Delivery U.S., revenue increased by 3% (+1% at constant currency, +1% organic¹) to EUR 2,920 million. Favorable rate effects were offset by the TDAPA reimbursement regulations headwind as expected. U.S. same market treatment growth came in at -1.1%.

In Care Delivery International, revenue increased by 2% (+3% at constant currency, +6% organic¹) to EUR 572 million, driven by positive organic growth¹. International same market treatment growth amounted to 1.4%.

Value-Based Care revenue declined by 7% (-9% at constant currency, -9% organic¹) to EUR 537 million. The development in the quarter was driven by the changed risk contracting for one of the contracts, partially offset by positive effects from payor premium rates and prior-year phasing of CKCC reporting from CMS.

Care Enablement revenue increased by 7% (+5% at constant currency, +5% organic¹) to EUR 1,451 million. Positive pricing globally and positive volume development outside China were mainly driven by the sales of 5008X CAREsystem.

Within Inter-segment eliminations⁵, revenue for services provided and products transferred between the operating segments at fair market value came in at negative EUR 543 million.

In the first nine months of 2026, Group revenue decreased by 1% (+2% at constant currency, +3% organic¹) to EUR 14,409 million. Currency effects negatively impacted revenue development in all three operating segments. Divestitures realized as part of the portfolio optimization plan negatively impacted the revenue development by 40 basis points. Care Delivery revenue remained flat (+4% at constant currency, +5% organic¹) at EUR 10,264 million, with Care Delivery U.S. flat (+4% at constant currency, +5 organic¹) at EUR 8,582 million and Care Delivery International flat (+2% at constant currency, +7% organic¹) at EUR 1,682 million. Divestitures realized as part of the portfolio optimization plan negatively affected the revenue development of Care Delivery by 70 basis points and the revenue development of Care Delivery International by 3,900 basis points. U.S. same market treatment growth came in at -0.8% while international same market treatment growth amounted to 1.2%. Value-Based Care revenue decreased by 3% (+1% at constant currency, +1% organic¹) to EUR 1,563 million. Care Enablement revenue increased by 1% (+3% at constant currency, +3% organic¹) to EUR 4,121 million. Inter-segment eliminations came in at negative EUR 1,539 million.

Earnings development in line with planned full-year phasing
In the third quarter of 2026, Group operating income declined by 19% (-19% at constant currency) to EUR 384 million, resulting in a margin of 7.8% (Q3 2025: 9.8%). Operating income excluding special items declined by 5% (-6% at constant currency) to EUR 545 million, resulting in a margin² of 11.0% (Q3 2025: 11.7%).

Operating income in Care Delivery increased by 18% (+17% at constant currency) to EUR 497 million, resulting in a margin of 14.2% (Q3 2025: 12.3%). Operating income excluding special items increased by 4% (+2% at constant currency) to EUR 513 million, resulting in a margin² of 14.7% (Q3 2025: 14.5%). Compared to previous year, the improvement was driven by positive rate effects, as well as savings from the FME25+ program, offsetting negative impacts from TDAPA reimbursement regulations and increased labor costs.

Operating income in Value-Based Care improved to a breakeven in the quarter from a loss of EUR 22 million in the prior year, resulting in a margin of 0.0% (Q3 2025: -3.8%) Operating income excluding special items improved to EUR 1 million compared to a loss of EUR 21 million in the prior year, resulting in a margin² of 0.1% (Q3 2025: -3.7%) and reflecting the quarterly earnings volatility, which is inherent to the business model. The improvement was driven by the prior-year phasing of CKCC reporting by CMS, an enhanced savings rate and positive contributions from the FME25+ program.

Operating income in Care Enablement resulted in a loss of EUR 32 million and a margin of -2.2% (Q3 2025: 6.4%) mainly due to one-time costs related to the China strategy refinement. Operating income excluding special items increased by 3% (+4% at constant currency) to EUR 106 million, resulting in a margin² of 7.3% (Q3 2025: 7.6%). Compared to the previous year's quarter, increased sales of the 5008X CAREsystem, the FME25+ program as well as positive price globally and volume effects outside China contributed positively. This was offset mainly by accelerated inflationary cost increases.

Operating income for Corporate amounted to a loss of EUR 35 million (Q3 2025: loss of EUR 4 million). Operating income excluding special items amounted to a loss of EUR 29 million (Q3 2025: gain of EUR 3 million). The development was mainly driven by the planned costs for strategic IT platform investments, while the impact from virtual power purchase agreements was positive.

In the first nine months of 2026, Group operating income decreased by 8% (-5% at constant currency) to EUR 1,136 million, resulting in a margin of 7.9% (9M 2025: 8.5%). Operating income excluding special items increased by 5% (+8% at constant currency) to EUR 1,581 million, resulting in a margin² of 11.0% (9M 2025: 10.3%). In Care Delivery, operating income increased by 11% (+16% at constant currency) to EUR 1,203 million, resulting in a margin of 11.7% (9M 2025: 10.6%). Operating income excluding special items increased by 17% (+23% at constant currency) to EUR 1,437 million, resulting in a margin² of 14.0% (9M 2025: 12.0%). In Value-Based Care operating income improved to EUR 6 million compared to a loss of EUR 28 million in the prior year, resulting in a margin of 0.4% (9M 2025: -1.7%). Operating income excluding special items improved to EUR 27 million compared to a loss of EUR 26 million in the prior year, resulting in a margin² of 1.7% (9M 2025: -1.6%). In Care Enablement, operating income declined by 43% (-42% at constant currency) to EUR 153 million, resulting in a margin of 3.7% (9M 2025: 6.6%). Operating income excluding special items declined by 2% (flat at constant currency) to EUR 329 million, resulting in a margin² of 8.0% (9M 2025: 8.2%). Operating income for Corporate amounted to a loss of EUR 119 million (9M 2025: loss of EUR 78 million). Operating income excluding special items amounted to a loss of EUR 105 million (9M 2025: loss of EUR 9 million).

Net income³ decreased by 42% compared to prior year (-41% at constant currency) to EUR 160 million in the third quarter of 2026. Net income excluding special items decreased by 10% (-10% at constant currency) to EUR 291 million.

In the first nine months of 2026, net income³ decreased by 24% (-21% at constant currency) to EUR 496 million. Net income excluding special items increased by 1% (+4% at constant currency) to EUR 844 million.

Basic earnings per share (EPS) decreased by 35% compared to prior year (-34% at constant currency) to EUR 0.61 in the third quarter of 2026, based on 262,951,005 shares. Basic EPS excluding special items remained flat (flat at constant currency) at EUR 1.11.

In the first nine months of 2026, basic EPS decreased by 17% (-14% at constant currency) to EUR 1.84, based on 268,833,509 shares. Basic EPS excluding special items increased by 10% (+13% at constant currency) to EUR 3.14.

Strong operating cash flow, net leverage ratio stable around lower end of target corridor
In the third quarter of 2026, operating cash flow increased by 8% to EUR 798 million (Q3 2025: EUR 742 million), resulting in a margin of 16.2% (Q3 2025: 15.2%). In the first nine months of 2026, operating cash flow improved by 12% to EUR 1,885 million (9M 2025: EUR 1,679 million). The related margin came in at 13.1% (9M 2025: 11.5%). Both developments were mainly driven by favorable working capital development.

Free cash flow⁶ increased by 3% to EUR 564 million in the third quarter of 2026 (Q3 2025: EUR 550 million), resulting in a margin of 11.4% (Q3 2025: 11.3%). In the first nine months of 2026, Fresenius Medical Care increased free cash flow by 3% to EUR 1,229 million (9M 2025: EUR 1,199 million), resulting in a margin of 8.5% (9M 2025: 8.2%).

Total net debt and lease liabilities increased by 6% to EUR 9,787 million (Q3 2025: EUR 9,218 million). The net leverage ratio (net debt/EBITDA) remained stable at 2.6x in Q3 2026 (Q2 2026: 2.6x) and continues to be around the lower end of our 2.5x to 3.0x target band.

Patients, clinics and employees
As of September 30, 2026, Fresenius Medical Care treated 289,014 patients in 3,512 dialysis clinics worldwide and had 106,291 employees globally.

Outlook 2026 narrowed
Fresenius Medical Care continues to expect revenue growth¹ to be broadly flat in 2026 compared to prior year. The company narrows its outlook for operating income² and now expects operating income² growth to be between flat and a negative mid-single digit percent growth rate compared to prior year.

The expected growth rates for 2026 are at constant currency and excluding special items in operating income. The 2025 basis for the revenue outlook is EUR 19,628 million and for the operating income outlook is EUR 2,212 million.

Investor conference call
Fresenius Medical Care will host a conference call for analysts and investors to discuss the results of the third quarter, on November 3, 2026, at 2:00 p.m. CET / 8:00 a.m. ET. Details are available on the Fresenius Medical Care website in the "Investors" section. A replay and a transcript will be available shortly after the call.

Please refer to our statement of earnings included at the end of this press release and to the attachments as separate PDF files for a complete overview of the results of the third quarter of 2026. Our form 6-K disclosure provides more details.

About Fresenius Medical Care:
Fresenius Medical Care is the world's leading provider of products and services for individuals with renal diseases of which around 4.5 million patients worldwide regularly undergo dialysis treatment. Through its network of 3,512 dialysis clinics, Fresenius Medical Care provides dialysis treatments for approx. 290,000 patients around the globe. Fresenius Medical Care is also the leading provider of dialysis products such as dialysis machines or dialyzers. Fresenius Medical Care is listed on the Frankfurt Stock Exchange (FME) and on the New York Stock Exchange (FMS).

For more information visit the company's website at www.freseniusmedicalcare.com.

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, 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's reports filed with the U.S. Securities and Exchange Commission. Fresenius Medical Care does not undertake any responsibility to update the forward-looking statements in this release.

The CONVINCE study was exclusively supported by the European Commission Research & Innovation, Horizon 2020, Call H2020-SC1-2016-2017 under the topic SC1-PM-10-2017: Comparing the effectiveness of existing healthcare interventions in the adult population (grant no 754803).

1	At constant currency, adjusted for certain reconciling items including revenue from acquisitions, closed or sold operations and differences in dialysis days
2	Adjusted for special items; growth rate at constant currency (if not stated otherwise); for further details please see the reconciliation attached to the press release
3	Net income attributable to shareholders of Fresenius Medical Care AG
4	Data as of Sep 30, 2026
5	The company transfers products from the Care Enablement segment to the Care Delivery segment at fair market value. Services provided by the Care Delivery segment for patients managed under the Value-Based Care segment are also provided at fair market value. The associated internal revenues and expenses and all other consolidation of transactions are included within "Inter-segment eliminations".
6	Net cash provided by / used in operating activities, after capital expenditures, before acquisitions, investments, and dividends

Media contact
Christine Peters
T +49 160 60 66 770
Christine.Peters@FreseniusMedicalCare.com

Contact for analysts and investors
Dr. Dominik Heger
T +49 6172 609 2525
Dominik.Heger@FreseniusMedicalCare.com

 

Statement of earnings
	Three months ended September 30,
in € million, except share data, unaudited	2026	2025	Change	Change at cc
Revenue	4,937	4,885	1.1 %	-0.5 %
Costs of revenue	3,661	3,643	0.5 %	-1.2 %
Selling, general and administrative expense	744	705	5.4 %	3.6 %
Research and development expense	41	38	9.7 %	8.4 %
(Income) loss from equity method investees	(18)	(47)	-61.1 %	-61.1 %
Other operating income	(116)	(56)	107.5 %	105.0 %
Other operating expense	241	125	92.2 %	87.2 %
Operating income	384	477	-19.4 %	-18.9 %
Operating income excl. special items1	545	574	-5.1 %	-5.7 %
Interest expense, net	81	74	10.2 %	7.5 %
Income before taxes	303	403	-24.8 %	-23.8 %
Income tax expense	78	75	3.5 %	6.1 %
Net income	225	328	-31.3 %	-30.6 %
Net income attributable to noncontrolling interests	65	53	23.7 %	21.7 %
Net income2	160	275	-41.9 %	-40.6 %
Net income2 excl. special items1	291	322	-9.6 %	-10.0 %
Weighted average number of shares	262,951,005	292,101,583
Basic earnings per share	€0.61	€0.94	-35.4 %	-34.1 %
Basic earnings per share excl. special items1	€1.11	€1.10	0.4 %	0.0 %
In percent of revenue
Operating income margin	7.8 %	9.8 %
Operating income margin excl. special items1	11.0 %	11.7 %

1 For a reconciliation of special items, please refer to the table at the end of the press release.
2 Attributable to shareholders of FME AG.

 

Statement of earnings
	Nine months ended September 30,
in € million, except share data, unaudited	2026	2025	Change	Change at cc
Revenue	14,409	14,558	-1.0 %	2.0 %
Costs of revenue	10,645	10,917	-2.5 %	0.6 %
Selling, general and administrative expense	2,229	2,248	-0.9 %	1.7 %
Research and development expense	119	119	0.0 %	1.5 %
(Income) loss from equity method investees	(18)	(140)	-87.0 %	-86.9 %
Other operating income	(395)	(397)	-0.6 %	0.1 %
Other operating expense	693	578	20.3 %	22.0 %
Operating income	1,136	1,233	-7.9 %	-4.5 %
Operating income excl. special items1	1,581	1,507	5.0 %	8.2 %
Interest expense, net	243	229	5.9 %	8.5 %
Income before taxes	893	1,004	-11.0 %	-7.5 %
Income tax expense	210	215	-1.9 %	2.0 %
Net income	683	789	-13.5 %	-10.1 %
Net income attributable to noncontrolling interests	187	138	35.6 %	40.8 %
Net income2	496	651	-23.9 %	-20.9 %
Net income2 excl. special items1	844	836	1.0 %	4.1 %
Weighted average number of shares	268,833,509	292,971,355
Basic earnings per share	€1.84	€2.22	-17.1 %	-13.8 %
Basic earnings per share excl. special items1	€3.14	€2.85	10.1 %	13.4 %
In percent of revenue
Operating income margin	7.9 %	8.5 %
Operating income margin excl. special items1	11.0 %	10.3 %

1 For a reconciliation of special items, please refer to the table at the end of the press release.
2 Attributable to shareholders of FME AG.

 

Reconciliation of non-IFRS financial measures to the most directly comparable IFRS Accounting Standards financial measures for comparability with the Company´s outlook
	Three months ended September 30,		Nine months ended September 30,
in € million, unaudited	2026	2025	2026	2025
Operating performance excl. special items
These items are excluded to ensure comparability of the figures presented with the Company's financial targets which have been defined excluding special items.
Revenue	4,937	4,885	14,409	14,558
Operating income	384	477	1,136	1,233
FME25+ Program	54	41	262	122
Legacy Portfolio Optimization1	98	50	107	79
Legal Form Conversion Costs	—	0	—	2
Humacyte Remeasurements	9	6	5	71
Tavneos Impacts2	—	—	71	—
Sum of special items	161	97	445	274
Operating income excl. special items	545	574	1,581	1,507
Net income3	160	275	496	651
FME25+ Program	40	30	195	90
Legacy Portfolio Optimization1	85	47	82	76
Legal Form Conversion Costs	—	0	—	1
Humacyte Remeasurements	6	5	4	53
Interwell Health Deferred Tax Reversal	—	(35)	—	(35)
Tavneos Impacts2	—	—	67	—
Sum of special items	131	47	348	185
Net income3 excl. special items	291	322	844	836

1 2026: mainly related to the China strategy refinement which primarily resulted in impairment of capitalized development costs, termination costs, accelerated depreciation of a production line, as well as inventory and fixed asset write-offs; 2025: mainly related to the divestitures in Brazil, Malaysia, and Kazakhstan as well as the select assets of FME AG's wholly owned Spectra Laboratories, and impairment loss primarily related to right-of-use assets.
2 The impacts from the revocation of the TAVNEOS® marketing authorization which led primarily to an impairment of intangible assets recorded by Vifor Fresenius Medical Care Renal Pharma Ltd., resulting in a negative impact on FME AG's income (loss) from equity method investees.
3 Attributable to shareholders of FME AG.

 

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SOURCE Fresenius Medical Care Holdings, Inc.

FAQ

AI-generated questions and answers. How Rhea-AI works. Not financial advice.

What is Fresenius Medical Care's revised 2026 outlook?

Fresenius Medical Care expects broadly flat revenue and operating income growth between flat and a negative mid-single digit percentage. The operating income outlook is now in the lower half of the previous range, reflecting earnings development over the first nine months and anticipated fourth-quarter headwinds.

What were Fresenius Medical Care's third-quarter 2026 earnings?

Third-quarter reported operating income declined 19% to EUR 384 million, while net income attributable to shareholders fell 42% to EUR 160 million. Basic earnings per share fell 35% to EUR 0.61. Excluding special items, basic earnings per share remained flat at EUR 1.11.

Which businesses did Fresenius Medical Care exit in China?

Fresenius Medical Care discontinued local production and sales of the 4008A hemodialysis system and exited its peritoneal dialysis business in China, while maintaining existing market obligations. The changes generated EUR 108 million in one-time costs, primarily impairment charges, scrappage and termination costs.

When does Fresenius Medical Care's current share buyback tranche end?

The first tranche of Fresenius Medical Care's second buyback program is planned to end by December 15, 2026. It began on May 28. The overall program has a volume of around EUR 1 billion, excluding ancillary costs, and is being executed in tranches within 12 months.