Fresenius Medical Care (NYSE: FMS) Q1 profit dips as cash flow rises
Rhea-AI Filing Summary
Fresenius Medical Care reported Q1 2026 revenue of €4.61 billion, down 5.5% year on year, mainly due to currency effects, while organic growth was positive. Reported operating income fell 13.6% to €286 million, but excluding special items it rose 2.2% to €467 million, lifting the adjusted margin to 10.1%.
Net income attributable to shareholders declined 22.3% to €118 million, yet excluding special items it increased 1.7% to €251 million; adjusted basic EPS rose 8.5% to €0.91. Operating cash flow grew 39% to €227 million and free cash flow nearly doubled to €40 million.
The FME25+ transformation delivered €50 million additional quarterly savings, with related special items of €166 million in Q1 and a targeted €1.2 billion savings by end of 2027. The company completed a €1.0 billion buyback of 24.8 million shares, about 8.5% of share capital, and ended the quarter with a net leverage ratio of 2.6x. Management confirmed the 2026 outlook for broadly flat revenue and operating income growth within a mid-single-digit range at constant currency, excluding special items.
Positive
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Negative
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Insights
Underlying profitability and cash flow improved despite restructuring drag.
Fresenius Medical Care shows a mixed Q1 2026 picture. Revenue declined 5.5% to €4.61 billion, but grew 3.9% organically as all operating segments contributed when currency effects are removed.
Reported operating income dropped to €286 million, yet excluding €181 million in special items from the FME25+ program, portfolio optimization and Humacyte remeasurements, operating income rose 2.2% to €467 million, with the adjusted margin improving to 10.1%. Adjusted EPS increased 8.5% to €0.91, indicating better underlying economics.
Cash generation strengthened, with operating cash flow up 39% to €227 million and free cash flow up 94% to €40 million. Net leverage remained around the lower end of the 2.5x–3.0x target band at 2.6x. Management reaffirmed 2026 guidance for broadly flat revenue and operating income growth between positive and negative mid-single digits, at constant currency and excluding special items, so subsequent quarterly results in 2026 will show how consistently they deliver on this path.
Large buyback completed, while leverage and restructuring remain controlled.
The company executed a sizable capital return, completing a €1.0 billion share buyback program of 24.8 million shares, about 8.5% of share capital, in less than one year instead of the originally planned two years.
At the same time, FME25+ restructuring weighed on reported earnings, with €166 million of special items in Q1 and expected €350 million related one-time costs in 2026, against targeted annual savings of €250 million that year and €1.2 billion by end of 2027. Despite these investments, total net debt and lease liabilities were €9.79 billion and the net leverage ratio stood at 2.6x, within the stated 2.5x–3.0x corridor. Future disclosures will show how quickly restructuring savings offset the ongoing special items and capital returns.
Key Figures
Key Terms
FME25+ Program financial
TDAPA reimbursement regulations financial
net leverage ratio financial
constant currency financial
Value-Based Care segment financial
EBITDA financial
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SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 6-K
REPORT OF FOREIGN PRIVATE ISSUER
Pursuant to Rule 13a-16 or 15d-16 of the
Securities Exchange Act of 1934
For the month of May 2026
Commission file number: 001-32749
FRESENIUS MEDICAL CARE AG
(Translation of registrant's name into English)
Else-Kröner Strasse 1
61346 Bad Homburg
Germany
(Address of principal executive offices)
Indicate by check mark whether the registrant files or will file annual reports under cover of Form 20-F or Form 40-F.
Form 20-F x Form 40-F ¨
On May 5, 2026, Fresenius Medical Care AG (the “Company”) issued a Press Release announcing its first quarter results for the period ending March 31, 2026. A copy of the Press Release is furnished as Exhibit 99.1 and the corresponding financial figures as Exhibit 99.2.
The attached Press Release contains non-GAAP financial measures. For purposes of Regulation G, a non-GAAP financial measure is a numerical measure of a company’s performance, financial position, or cash flows that either excludes or includes amounts that are not normally excluded or included in the most directly comparable measure calculated and presented in accordance with generally accepted accounting principles. To supplement our first quarter 2026 consolidated financial results presented in accordance with International Financial Reporting Standards, or IFRS, we have used non-GAAP financial measures, including (a) EBITDA, or operating income excluding interest, taxes, depreciation and amortization, (b) free cash flow, (c) net leverage ratio (ratio of net debt to adjusted EBITDA) and (d) results presented in constant currency and as adjusted for special items identified in the Press Release and associated tables. These non-GAAP measures are provided to enhance the user’s overall understanding of our current financial performance and our prospects for the future. In addition, because we have historically reported certain non-GAAP financial measures in our financial results, we believe the inclusion of these non-IFRS financial measures provides consistency and comparability in our financial reporting to prior periods for which these non-GAAP financial measures were previously reported. These non-GAAP financial measures should not be used as a substitute for or be considered superior to GAAP financial measures. Reconciliation of the non-GAAP financial measures to the most comparable IFRS financial measures are included in the attached Financial Statements. As the reconciliation of amounts stated in Constant Currency is inherent in the disclosure included in the Press Release, we believe that a separate reconciliation would not provide any additional benefit.
The Exhibits attached hereto, shall not be deemed “filed” for purposes of Section 18 of the Securities and Exchange Act of 1934 (the “Exchange Act”) or otherwise subject to the liabilities of that section, nor shall they be deemed incorporated by reference in any filing under the Securities Act of 1933 or the Exchange Act, regardless of any general incorporation language in such filing.
EXHIBITS
The following exhibits are being furnished with this Report:
| Exhibit 99.1 | Press release issued on May 5, 2026. |
| Exhibit 99.2 | Complete overview of the first quarter 2026. |
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
DATE: May 5, 2026
| Fresenius Medical Care AG | ||||
| By: | /s/ Helen Giza | |||
| Name: | Helen Giza | |||
| Title: | Chief Executive Officer and Chair of the Management Board | |||
| By: | /s/ Martin Fischer | |||
| Name: | Martin Fischer | |||
| Title: | Chief Financial Officer and member of the Management Board |
Exhibit 99.1
| Press Release | 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
www.freseniusmedicalcare.com |
Fresenius Medical Care delivers strong operating income growth in Q1 2026 while advancing the U.S. rollout of 5008X CAREsystems at speed
| · | Organic revenue growth1 of 4% with growth in all operating segments |
| · | Operating income2 grew 10%, resulting in further margin expansion to 10.1% |
| · | FME25+ transformation program related one-time costs mainly drove reported operating income decline of 14% and reported net income3 decrease of 22% |
| · | Earnings per share2 (EPS) increased by 16%, supported by the share buyback program |
| · | FY 2026 outlook confirmed |
Bad Homburg, Germany (May 5, 2026) – “Fresenius Medical Care delivered continued operational and financial progress in the first quarter, with organic revenue growth, improved profitability and adjusted EPS growth. Operating income growth was in line with our planned phasing,” said Helen Giza, Chief Executive Officer of Fresenius Medical Care. “Care Delivery posted strong operating income growth supported by positive TDAPA effects. Excluding positive TDAPA effects, underlying Care Delivery operating income2 improved by 6%. We are pleased with the speed of the rollout of our innovative 5008X CAREsystem, now available in around 100 clinics and with more than 100,000 treatments performed.” Giza continued, “Through focused execution of our FME Reignite strategy, we remain on track to maintain Group operating income at a consistent high level while overcoming significant regulatory headwinds. We confirm our outlook for 2026 and are firmly committed to creating long-term value for our shareholders.”
| 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 |
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Key figures Q1 2026 (unaudited)
| Q1 2026 | Q1 2025 | Growth | Growth | |||||||||||||
| EUR m | EUR m | yoy | yoy, cc | |||||||||||||
| Revenue | 4,612 | 4,881 | -6 | % | +3 | % | ||||||||||
| Operating income | 286 | 331 | -14 | % | -9 | % | ||||||||||
| excl. special items2 | 467 | 457 | +2 | % | +10 | % | ||||||||||
| Net income3 | 118 | 151 | -22 | % | -21 | % | ||||||||||
| excl. special items2 | 251 | 246 | +2 | % | +9 | % | ||||||||||
| Basic EPS (EUR) | 0.43 | 0.52 | -17 | % | -16 | % | ||||||||||
| excl. special items2 | 0.91 | 0.84 | +8 | % | +16 | % | ||||||||||
yoy = year-on-year, cc = at constant currency, EPS = earnings per share
Progress on FME Reignite
Fresenius Medical Care, the world’s leading provider of products and services for individuals with renal disease, successfully advances the next phase of value creation with its FME Reignite strategy. The strategy focuses on strengthening core operations, driving profitable growth and innovation, and advancing the company culture.
During the first quarter, the FME25+ transformation program delivered EUR 50 million additional sustainable savings. Fresenius Medical Care started the optimization of its U.S. dialysis clinic footprint by exiting 64 of up to 100 selected clinics. The company expects to retain the majority of its dialysis patients in neighboring clinics. FME25+ one-time costs, driven mainly by clinic closures cost, were treated as special items and amounted to EUR 166 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, shareholder returns through dividends are complemented by share buybacks. Through an initial share buyback program of EUR 1.0 billion, 24.8 million shares or 8.5% of share capital were bought back in a significantly accelerated way. On April 30, the program was successfully completed in less than one year instead of within two years, as originally announced. As of March 31, 23.3 million shares or 7.9% of total share capital have been repurchased for a total investment amount of EUR 941 million.
Solid organic revenue growth driven by all operating segments
In the first quarter 2026, Group revenue decreased by 6% compared to prior year (+3% at constant currency, +4% organic1) to EUR 4,612 million. Significant currency effects negatively impacted revenue development in all three operating segments. Divestitures realized as part of the portfolio optimization plan negatively affected the revenue development by 50 basis points.
Care Delivery revenue decreased by 4% (+5% at constant currency, +6% organic1) to EUR 3,294 million. Divestitures realized as part of the portfolio optimization plan negatively affected the revenue development by 80 basis points.
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In Care Delivery U.S., revenue decreased by 4% (+6% at constant currency, +7% organic1) to EUR 2,765 million. TDAPA reimbursement regulations as well as favorable rate and payor mix effects had a positive impact while exchange rates developed unfavorably. U.S. same market treatment growth came in at -0.4%.
In Care Delivery International, revenue decreased by 5% (-2% at constant currency, +3% organic1) to EUR 529 million. The effects of closed or sold operations, mainly related to portfolio optimization, and unfavorable exchange rates were partially offset by positive organic growth1. International same market treatment growth amounted to 1.3%.
Value-Based Care revenue decreased by 7% (+3% at constant currency, +3% organic1) to EUR 490 million. The development in the quarter was driven by higher number of member months and positive effects from premium rates, offset by the changed risk contracting for one of the contracts and negative exchange rate effects.
Care Enablement revenue decreased by 5% (+1% at constant currency, +1% organic1) to EUR 1,299 million. Unfavorable exchange rate effects as well as lower volumes, driven by negative impacts from volume-based procurement and stricter tender requirements in China, were partly offset by positive pricing and volume development outside China, mainly driven by the sales of 5008X CAREsystems.
Within Inter-segment eliminations4, revenue for services provided and products transferred between the operating segments at fair market value came in at negative EUR 471 million.
Continued earnings growth and margin expansion
In the first quarter 2026, Group operating income decreased by 14% (-9% at constant currency) to EUR 286 million, resulting in a margin of 6.2% (Q1 2025: 6.8%). Operating income excluding special items increased by 2% (+10% at constant currency) to EUR 467 million, resulting in a margin2 of 10.1% (Q1 2025: 9.4%).
Operating income in Care Delivery decreased by 15% (-3% at constant currency) to EUR 271 million, resulting in a margin of 8.2% (Q1 2025: 9.3%). Operating income excluding special items increased by 12% (+26% at constant currency) to EUR 398 million, resulting in a margin2 of 12.1% (Q1 2025: 10.3%). Compared to previous year, operating income development was driven by positive impact from TDAPA reimbursement regulations as well as positive rate and payor mix effects. The development was negatively impacted by higher personnel expenses.
Operating income in Value-Based Care amounted to a loss of EUR 11 million, compared to a profit of EUR 3 million in the prior year, resulting in a margin of -2.3% (Q1 2025: 0.6%) Operating income excluding special items more than doubled with an increase of 113% (+137% at constant currency) to EUR 9 million, resulting in a margin2 of 1.8% (Q1 2025: 0.8%). The improvement was driven by an enhanced savings rate and positive contributions from the FME25+ program.
| 4 | 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”. |
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Operating income in Care Enablement decreased by 7% (-9% at constant currency) to EUR 87 million, resulting in a margin of 6.7% (Q1 2025: 6.9%). Operating income excluding special items decreased by 1% (stable at constant currency) to EUR 113 million, resulting in a margin2 of 8.7% (Q1 2025: 8.3%). Compared to the previous year’s quarter, positive contributions from FME25+ program, the sales of 5008X CAREsystems as well as positive price and volume effects outside China contributed positively. This was offset mainly by unfavorable currency transaction as well as negative volume and price effects in China.
Operating income for Corporate amounted to a loss of EUR 40 million (Q1 2025: loss of EUR 81 million). Operating income excluding special items amounted to a loss of EUR 32 million (Q1 2025: loss of EUR 12 million). This development was mainly driven by the planned cost of the strategic IT platform investments.
Net income3 decreased by 22% compared to prior year (-21% at constant currency) to EUR 118 million in the first quarter 2026. Net income excluding special items increased by 2% (+9% at constant currency) to EUR 251 million.
Basic earnings per share (EPS) decreased by 17% compared to prior year (-16% at constant currency) to EUR 0.43 in the first quarter 2026, based on 275,246,345 shares. Basic EPS excluding special items increased by 8% (+16% at constant currency) to EUR 0.91.
Significantly improved cash flow, net leverage ratio around lower end of target corridor
In the first quarter 2026, operating cash flow significantly increased by 39% to EUR 227 million (Q1 2025: EUR 163 million), resulting in a margin of 4.9% (Q1 2025: 3.3%). The operating cash flow development was mainly driven by favorable working capital development despite seasonality in invoicing.
Free cash flow5 increased by 94% to EUR 40 million in the first quarter 2026 (Q1 2025: EUR 21 million), resulting in a margin of 0.9% (Q1 2025: 0.4%).
Total net debt and lease liabilities slightly increased to EUR 9,790 million (Q1 2025: EUR 9,753 million). The net leverage ratio (net debt/EBITDA) came in at 2.6x in Q1 2026 (Q4 2025: 2.5x) and continues to be around the lower end of our 2.5x to 3.0x target band.
Patients, clinics and employees
As of March 31, 2026, Fresenius Medical Care treated 289,923 patients in 3,539 dialysis clinics worldwide and had 108,165 employees globally.
Outlook 2026 confirmed
In 2026, Fresenius Medical Care expects revenue growth to be broadly flat compared to prior year. The company expects operating income to remain on a consistent level, with a range between a positive and negative mid-single digit percent growth rate compared to prior year.
5 Net cash provided by / used in operating activities, after capital expenditures, before acquisitions, investments, and dividends
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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 first quarter today, May 5, 2026, 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 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 3,539 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.
Page 5/7
Statement of earnings
| Three months ended March 31, | Change | |||||||||||||||
| in € million, except share data, unaudited | 2026 | 2025 | Change | at cc | ||||||||||||
| 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 items1 | 467 | 457 | 2.2 | % | 9.8 | % | ||||||||||
| Interest expense, net | 79 | 81 | -2.6 | % | 5.9 | % | ||||||||||
| Income before 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 income2 | 118 | 151 | -22.3 | % | -21.0 | % | ||||||||||
| Net income2 excl. special items1 | 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 share excl. special items1 | € | 0.91 | € | 0.84 | 8.5 | % | 15.7 | % | ||||||||
| In percent of revenue | ||||||||||||||||
| Operating income margin | 6.2 | % | 6.8 | % | ||||||||||||
| Operating income margin excl. special items1 | 10.1 | % | 9.4 | % | ||||||||||||
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.
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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 | 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 | 4,612 | 4,881 | ||||||
| Operating income | 286 | 331 | ||||||
| FME25+ Program | 166 | 28 | ||||||
| Legacy Portfolio Optimization1 | 12 | 24 | ||||||
| Legal Form Conversion Costs | — | 0 | ||||||
| Humacyte Remeasurements | 3 | 74 | ||||||
| Sum of special items | 181 | 126 | ||||||
| Operating income excl. special items | 467 | 457 | ||||||
| Net income2 | 118 | 151 | ||||||
| FME25+ Program | 124 | 20 | ||||||
| Legacy Portfolio Optimization1 | 7 | 20 | ||||||
| Legal Form Conversion Costs | — | 0 | ||||||
| Humacyte Remeasurements | 2 | 55 | ||||||
| Sum of special items | 133 | 95 | ||||||
| Net income2 excl. special items | 251 | 246 | ||||||
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.
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Exhibit 99.2
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 |