Fresenius Medical Care starts 2025 with strong organic revenue and income growth

Rhea-AI Summary

Fresenius Medical Care (FMS) reported strong Q1 2025 results with 5% organic revenue growth to EUR 4,881 million. The company's operating income grew significantly by 35% to EUR 331 million, while net income more than doubled with a 113% increase to EUR 151 million. Key highlights include:

The FME25 transformation program delivered EUR 68 million in additional savings, with the company confirming its full-year target of EUR 180 million in additional annual savings. Care Delivery segment saw 4% organic growth, while Care Enablement grew 5%. The company maintained stable U.S. same market treatment development despite a severe flu season impact.

The company's net leverage ratio improved to 2.8x from 2.9x in Q4 2024. Fresenius Medical Care confirmed its 2025 outlook, expecting positive low-single-digit revenue growth and operating income growth of high-teens to high-twenties percent.

Positive

• Operating income grew 35% to EUR 331 million, with margin expansion to 6.8%
• Net income more than doubled with 113% growth to EUR 151 million
• FME25 program delivered EUR 68 million in additional savings
• Strong organic revenue growth of 5% across both segments
• Operating cash flow improved by 28% to EUR 163 million
• Net leverage ratio improved to 2.8x from 2.9x in Q4 2024

Negative

• Severe flu season in U.S. led to elevated missed treatments
• Care Delivery International revenue declined 19%
• Portfolio optimization expected to negatively impact full year 2025 Group revenue growth by around 1%
• Higher personnel expenses and inflationary cost increases affected operations

Insights

Healthcare Financial Analyst

Q1 results show remarkable profitability growth with net income up 113%, operating margin expansion to 9.4%, and continued deleveraging despite seasonal challenges.

Fresenius Medical Care has delivered a remarkably strong financial performance in Q1 2025, with reported net income more than doubling (+113%) to EUR 151 million. Even when excluding special items, net income increased by a substantial 31% to EUR 246 million, demonstrating significant underlying improvement. The operating margin expanded to 9.4% (excluding special items) from 8.5% in the prior year period, showing enhanced profitability across the business.

The FME25 transformation program continues to be a key driver of improved performance, delivering EUR 68 million in additional sustainable savings during the quarter. This puts the company on track to achieve its full-year target of approximately EUR 180 million in additional annual savings, bringing the cumulative total to EUR 750 million by year-end 2025.

Balance sheet metrics also improved, with the net leverage ratio decreasing to 2.8x from 2.9x in Q4 2024. While this represents modest deleveraging, the continued trend demonstrates disciplined capital management. Free cash flow turned positive at EUR 21 million, compared to negative EUR 2 million in Q1 2024, indicating improved operational efficiency in cash generation.

Particularly noteworthy is the performance of the Care Enablement segment, which reached its target margin band for the first time with an operating margin of 8.3% (excluding special items), up from 5.9% in the prior year. This significant margin expansion of 240 basis points highlights the success of the segment's transformation initiatives and validates the strategic direction.

The company's confirmation of its full-year 2025 outlook indicates management confidence in sustaining this positive momentum. The projected high-teens to high-twenties percent growth in operating income (excluding special items) would represent a substantial improvement in profitability as the company completes the third and final year of its current strategic plan.

Healthcare Operations Expert

Strong 5% organic growth despite flu season challenges, with accelerating international treatments and successful portfolio optimization driving operational improvements.

Fresenius Medical Care's operational performance demonstrates resilience and improvement despite industry challenges. The company achieved 5% organic revenue growth while maintaining stable U.S. same market treatment development (0% year-over-year) despite headwinds from a severe flu season that drove elevated missed treatments. Meanwhile, international operations showed accelerating momentum with same market treatment growth of 2.5%.

Management's commentary on increased patient referrals continuing from 2024 suggests improving underlying demand trends. This supports their expectation for accelerating U.S. same market treatment growth to above 0.5% for the full year, representing a gradual recovery in their largest market.

The company continues to execute its portfolio optimization strategy, divesting select assets of Spectra Laboratories and clinic operations in Malaysia. While these strategic exits will negatively impact full-year 2025 Group revenue growth by approximately 1%, they allow management to focus resources on core, higher-margin businesses.

Both operating segments demonstrated improved performance. Care Delivery maintained its prior year margin level despite one fewer dialysis day and the negative impact from the flu season. Care Enablement executed strongly against its transformation plan with 5% organic revenue growth across all geographical regions and continued positive pricing momentum.

The business serves approximately 299,000 patients across 3,674 dialysis clinics worldwide, with a workforce that grew slightly to 112,035 employees. This measured expansion supports operational improvements while maintaining cost discipline. The overall operational metrics suggest Fresenius Medical Care is successfully balancing growth initiatives with efficiency improvements as it executes the final year of its current strategic plan.

• Strong organic revenue growth¹ of 5% driven by Care Enablement and Care Delivery
• Stable U.S. same market treatment development despite impact from a severe flu season
• FME25 savings of EUR 68 million contributed to earnings
• Operating income² grew 11% at constant currency resulting in margin expansion
• Reported operating income grew by 35% and reported net income³ by 113%
• Net leverage ratio further improved to 2.8x and FY 2025 outlook confirmed

BAD HOMBURG, Germany, May 6, 2025 /PRNewswire/ -- "The results of the first quarter of 2025 once again demonstrate our continuous operational and financial progress as we are executing the third and last year of our current strategic plan," said Helen Giza, Chief Executive Officer of Fresenius Medical Care. "Revenue of both segments grew organically, and the phasing of the operating income development was in-line with our expectations. Care Enablement executed strongly against its transformation plan and further expanded its operating income margin, reaching its target margin band for the first time. Care Delivery maintained prior year´s margin level despite one dialysis day less and the negative impact from a severe flu season. Continuing last year´s positive momentum, patient referrals further increased. We therefore expect accelerating same market treatment growth in the U.S. to above 0.5% for the full year, after a stable development in Q1. We also continue to expect operational and financial improvements in both segments during the year, translating into significant earnings and margin growth. We therefore confirm our financial outlook for the full year 2025."

Key figures Q1 2025 (unaudited)

	Q1 2025 EUR m	Q1 2024 EUR m	Growth yoy	Growth yoy, cc
Revenue	4,881	4,725	3 %	1 %
Operating income	331	246	35 %	32 %
excl. special items2	457	403	13 %	11 %
Net income3	151	71	113 %	109 %
excl. special items2	246	188	31 %	29 %
Basic EPS (EUR)	0.52	0.24	113 %	109 %
excl. special items2 (EUR)	0.84	0.64	31 %	29 %
yoy = year-on-year, cc = at constant currency, EPS = earnings per share

Execution momentum underpins a good start to fiscal 2025

Fresenius Medical Care, the world's leading provider of products and services for individuals with renal disease, has made a good start to the third year of its strategic plan. During the first quarter, the FME25 transformation program continued its positive momentum, delivering EUR 68 million additional sustainable savings while related one-time costs, treated as special items, amounted to EUR 28 million. The Company confirms its full year target of around EUR 180 million additional annual savings, totaling to EUR 750 million by year end 2025.

Fresenius Medical Care continues the execution of its portfolio optimization plan to exit non-core and margin-dilutive assets. Announced divestments include select assets of Spectra Laboratories, our U.S. laboratory testing services business, as well as our clinic operations in Malaysia. Special items associated with portfolio optimization amounted to negative EUR 24 million in the first quarter.

All transactions that were realized as part of the Company's portfolio optimization plan in 2024 are estimated to negatively impact full year 2025 Group revenue growth by around one percent. Related cost will be treated as special items in operating income.

Strong organic revenue growth¹ in both segments

In the first quarter 2025, Group revenue increased by 3% (+1% at constant currency, +5% organic¹) to EUR 4,881 million. Divestitures realized as part of the portfolio optimization plan affected the revenue development by -260 basis points.

Care Delivery revenue increased by 2% (-1% at constant currency, +4% organic¹) to EUR 3,857 million. Divestitures realized as part of the portfolio optimization plan affected the revenue development by -370 basis points.

In Care Delivery U.S., revenue increased by 6% (+3% at constant currency, +4% organic¹) to EUR 3,302 million. A growing value-based care business, reimbursement rate increases, and a favorable payor mix as well as exchange rate effects had a positive impact, compensating a decrease in dialysis days. A severe flu season in the U.S. drove elevated missed treatments. U.S. same market treatment growth came in flat year-on-year.

In Care Delivery International, revenue declined by 19% (-19% at constant currency, +5% organic¹) to EUR 555 million. The effect of closed or sold operations, mainly related to Legacy Portfolio Optimization, as well as a decrease in dialysis days were partially offset by organic growth¹. Same market treatment growth accelerated to 2.5%.

Care Enablement revenue grew by 5% (+5% at constant currency, +5% organic¹) to EUR 1,367 million, mainly driven by volume growth in all our geographical regions and continued positive pricing momentum. Volume-based procurement in China developed in line with expectations and was supportive of volume growth, yet a headwind to price development.

Within Inter-segment eliminations⁴, revenue for products transferred between the operating segments at fair market value came in 5% below prior year at negative EUR 343 million (-7% at constant currency).

Significant operating income growth

Operating income significantly increased by 35% (+32% at constant currency) to EUR 331 million, resulting in a margin of 6.8% (Q1 2024: 5.2%). Operating income excluding special items increased by 13% (+11% at constant currency) to EUR 457 million, resulting in a margin² of 9.4% (Q1 2024: 8.5%).

Operating income in Care Delivery increased by 71% (+64% at constant currency), resulting in a margin of 8.4% (Q1 2024: 5.0%). Operating income excluding special items increased by 4% (flat at constant currency), resulting in a margin² of 9.3% (Q1 2024: 9.2%). Compared to previous year, operating income development was driven by the impact from phosphate binders, positive price effects and savings associated with the FME25 program. The development was negatively impacted by higher personnel expenses, that developed in line with expectations, less positive contribution from the value-based care business, a negative impact from treatment volumes as well as inflationary cost increases.

Operating income in Care Enablement increased by 34% (+33% at constant currency), resulting in a margin of 6.9% (Q1 2024: 5.4%). Operating income excluding special items increased by 50% (+49% at constant currency), resulting in a margin² of 8.3% (Q1 2024: 5.9%). The improvement compared to the previous year's quarter was mainly driven by savings from the FME25 program and globally positive volume and pricing developments. These positive effects were partially offset by inflationary cost increases that developed in line with expectations.

Operating income for Corporate amounted to EUR -81 million (Q1 2024: EUR -14 million). Humacyte remeasurements, that are treated as special items in the Corporate line, amounted to EUR -67 million and virtual power purchase agreements contributed EUR 3 million. Operating income excluding special items amounted to EUR -12 million (Q1 2024: EUR -18 million).

Net income³ more than doubled (+113%) to EUR 151 million (+109% at constant currency). Net income excluding special items increased by 31% (+29% at constant currency) to EUR 246 million.

Basic earnings per share (EPS) more than doubled (+113%) to EUR 0.52 (+109% at constant currency). EPS excluding special items increased by 31% (+29% at constant currency) to EUR 0.84.

Continued strong cash flow development and further improved net leverage ratio

In the first quarter, Fresenius Medical Care improved operating cash flow by 28% to EUR 163 million (Q1 2024: EUR 127 million), resulting in a margin of 3.3% (Q1 2024: 2.7%). The operating cash flow development was driven by the seasonality of invoicing, in line with expectations.

Free cash flow⁵ increased to EUR 21 million in the first quarter (Q1 2024: EUR -2 million).

Total net debt and lease liabilities were further reduced to EUR 9,753 million (Q4 2024: EUR 9,803 million). The net leverage ratio (net debt/EBITDA) slightly improved from 2.9x in Q4 2024 to 2.8x in Q1 2025.

Patients, clinics and employees

As of March 31, 2025, Fresenius Medical Care treated 299,358 patients in 3,674 dialysis clinics worldwide and had 112,035 employees (headcount) globally, compared to 111,513 employees as of December 31, 2024.

Outlook 2025 confirmed

Fresenius Medical Care confirms its outlook for fiscal 2025 and expects revenue growth to be positive to a low-single digit percent rate compared to prior year. The Company expects operating income excluding special items to grow by a high-teens to high-twenties percent rate compared to prior year.

The expected growth rates for 2025 are at constant currency, excluding special items in operating income. The 2024 basis for the revenue outlook is EUR 19,336 million and for the operating income outlook is EUR 1,797 million.

____________________
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.
3	Net income attributable to shareholders of Fresenius Medical Care AG.
4	The company transfers products between segments at fair market value. The associated internal revenues and expenses and all other consolidation of transactions are included within "Inter-segment eliminations".
5	Net cash provided by / used in operating activities, after capital expenditures, before acquisitions, investments, and dividends

Investor conference call

Fresenius Medical Care will host a conference call for analysts and investors to discuss the results of the first quarter 2025 today, May 6, 2025, at 2:00 p.m. CEST / 8:00 a.m. EDT. 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 first quarter 2025. 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 4.2 million patients worldwide regularly undergo dialysis treatment. Through its network of 3,674 dialysis clinics, Fresenius Medical Care provides dialysis treatments for approx. 299,000 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.

Statement of earnings
	Three months ended March 31,
in € million, except share data, unaudited	2025	2024	Change	Change  at cc
Revenue	4,881	4,725	3.3 %	1.2 %
Costs of revenue	3,697	3,551	4.1 %	2.0 %
Selling, general and administrative expense	751	776	-3.2 %	-4.9 %
Research and development expense	43	48	-9.0 %	-10.1 %
Income from equity method investees	(48)	(29)	65.8 %	65.9 %
Other operating income	(141)	(113)	24.5 %	24.1 %
Other operating expense	248	246	0.4 %	-0.4 %
Operating income	331	246	34.7 %	31.6 %
Operating income excl. special items1	457	403	13.4 %	10.9 %
Interest expense, net	81	88	-8.4 %	-11.1 %
Income before taxes	250	158	58.8 %	55.5 %
Income tax expense	61	40	54.5 %	51.6 %
Net income	189	118	60.3 %	56.8 %
Net income attributable to noncontrolling interests	38	47	-18.9 %	-21.2 %
Net income2	151	71	113.1 %	108.8 %
Net income2 excl. special items1	246	188	31.3 %	28.6 %
Weighted average number of shares	293,413,449	293,413,449
Basic earnings per share	€0.52	€0.24	113.1 %	108.8 %
Basic earnings per share excl. special items1	€0.84	€0.64	31.3 %	28.6 %
In percent of revenue
Operating income margin	6.8 %	5.2 %
Operating income margin excl. special items1	9.4 %	8.5 %
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 March 31,
in € million, unaudited	2025	2024
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	4,881	4,725
Operating income	331	246
FME25 Program	28	28
Legacy Portfolio Optimization1	24	143
Legal Form Conversion Costs	0	1
Humacyte Remeasurements	74	(15)
Sum of special items	126	157
Operating income excl. special items	457	403
Net income2	151	71
FME25 Program	20	20
Legacy Portfolio Optimization1	20	107
Legal Form Conversion Costs	0	1
Humacyte Remeasurements	55	(11)
Sum of special items	95	117
Net income2 excl. special items	246	188
1 2025: mainly comprise severance payments and the impairment of goodwill resulting from the measurement of assets held for sale; 2024: mainly comprise the impairment of intangible and tangible assets resulting from the measurement of assets held for sale as well as losses from divestitures.
2 Attributable to shareholders of FME AG.

 

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 2601
dominik.heger@freseniusmedicalcare.com 

www.freseniusmedicalcare.com

 

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SOURCE Fresenius Medical Care Holdings, Inc.

FAQ

What were Fresenius Medical Care's (FMS) key financial results in Q1 2025?

FMS reported EUR 4,881 million in revenue (+5% organic growth), EUR 331 million operating income (+35%), and EUR 151 million net income (+113%). Operating cash flow improved 28% to EUR 163 million.

How much did FMS's FME25 transformation program save in Q1 2025?

The FME25 program delivered EUR 68 million in additional sustainable savings in Q1 2025, with a full-year target of EUR 180 million in additional annual savings.

What is Fresenius Medical Care's (FMS) outlook for 2025?

FMS expects positive low-single-digit revenue growth and operating income growth of high-teens to high-twenties percent for fiscal 2025.

How did FMS's U.S. operations perform in Q1 2025?

Care Delivery U.S. revenue increased 6% to EUR 3,302 million, with flat same market treatment growth due to impacts from a severe flu season and decreased dialysis days.

What was FMS's net leverage ratio in Q1 2025?

The net leverage ratio improved to 2.8x in Q1 2025, down from 2.9x in Q4 2024.