Slides
Page 1
Helen Giza CEO & Chair of the Management Board Martin Fischer CFO February 24, 2026 Q4/FY 2025 Earnings Call
Page 2
Safe harbor statement: In this Safe harbor statement, “the Company” and “Fresenius Medical Care” refer to Fresenius Medical Care AG & Co. KGaA, a German partnership limited by shares, prior to its conversion of legal form, and to Fresenius Medical Care AG, a German stock corporation, after its conversion of legal form. This presentation includes certain forward-looking statements within the meaning of Section 27A of the U.S. Securities Act of 1933, as amended, and Section 21E of the U.S. Securities Act of 1934, as amended. Forward-looking statements are inherently subject to risks and uncertainties, many of which cannot be predicted with accuracy or might not even be anticipated. The Company has based these forward-looking statements on current estimates and assumptions which we believe are reasonable and which are made to the best of our knowledge. Actual results could differ materially from those included in the forward-looking statements due to various risk factors and uncertainties, including changes in business, economic or competitive conditions, changes in reimbursement, regulatory compliance issues, regulatory reforms, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, cyber security issues and the availability of financing. Given these uncertainties, readers should not put undue reliance on any forward-looking statements. These and other risks and uncertainties are discussed in detail in the Company’s Annual Report on Form 20-F under the headings “Forward-Looking Statements” and “Risk Factors” and under the headings in that report referred to therein, and in the Company’s other reports filed with the Securities and Exchange Commission (SEC) and the Frankfurt Stock Exchange (Frankfurter Wertpapierbörse). Forward-looking statements represent estimates and assumptions only as of the date that they were made. The information contained in this presentation is subject to change without notice and the company does not undertake any duty to update the forward-looking statements, and the estimates and assumptions associated with them, except to the extent required by applicable law and regulations. If not mentioned differently the term net income refers to the net income attributable to the shareholders of Fresenius Medical Care. Amounts are in Euro if not mentioned otherwise. Implementation of measures as presented herein may be subject to information and consultation procedures with works councils and other employee representative bodies, as per local laws and practice. Consultation procedures may lead to changes on proposed measures.
Page 3
Strategic progress in 2025 Q4 2025 business update Outlook 1 2 3
Page 4
Q4 2024 Conference Call Page 4 2025 | FME Reignite – Next phase of Value Creation Investor Relations Q4/2025 New Value- Based Care segment Soft launch of 5008X U.S. roll-out Select pilot programs in FME clinics to introduce 5008X and prepare for 2026 large-scale launch Step-up in operating income margin Supported by all 3 segments and well within 2025 mid- term target margin band of 10-14% Launched FME Reignite New strategy with ambitious 2030 mid- term aspirations and new capital allocation framework Initiated & Accelerated €1bn share buyback program Reflects strengthened financial profile, further reduced net debt and commitment to returning excess capital to shareholders Accelerated FME25+ program Sustainable savings increased to €804m (plan €750m) by 2025 Further refinement of operating model, enhancing reporting transparency
Page 5
Q4 2024 Conference Call Page 5 2025 | Significant step-up in profitability achieved Investor Relations Q4/2025 Outlook FY 2025 Revenue Positive to a low-single digit percent growth FY 2024 basis: € 19,336 million +5% Operating income +27% Revenue and operating income, as referred to in the outlook, are both on a constant currency basis and excluding special items. Special items will be provided as separate KPI (“Operating income excl. special items”) to capture 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. These items are excluded to ensure comparability of the figures presented with the Company’s financial targets which have been defined excluding special items. See page 29 for reconciliation table for special items. Growth rates as shown above are year-on-year basis . High-teens to high- twenties percent growth FY 2024 basis: € 1,797 million FY 2025: € 19,628 million FY 2025: € 2,212 million
Page 6
Q4 2024 Conference Call Page 6 2025 mid-term financial targets | Committed. Delivered. Investor Relations Q4/2025 2025 mid-term target2 vs. actualsKey financial target Care Delivery target 11-15% Group target 10-14% 7.9% 11.3% Target band of 2.5x-3.0x, lowered from 3.0x-3.5x Operating income margin1 Care Delivery2 Care Enablement2 Group Operating income margin1 Net financial leverage ratio 1 Adjusted operating income margin as defined by the financial outlook for the respective years | 2 2025 mid-term targets as communicated at CMD in April 2023, based on FY 2022 figures as reported in 2023; with Care Delivery still including Value-Based Care, 2025 margin target was of 10-14% | 3 Excluding U.S. federal relief funding and advanced payments under the CARES Act Care Enablement target 8-12% % % 9.5% 13.1% 1.9% 8.1% 3.4³x 2.5x 2022 2025
Page 7
Q4 2024 Conference Call Page 7Investor Relations Q4/2025 2025 target vs. actualsKey strategic initiative Exit international markets with structural challenges ▪ 2025 mid-term target: 19-36 countries (2022: 49) ▪ Current status: 34 countries, thereof 25 core markets Accumulated sustainable savings of € 750 million ▪ 2025 mid-term target of €750 million by 2025 ▪ Exceeded: €804 million Setting again the standard in kidney care in the U.S. ▪ Initiating U.S. rollout of HVHDF-capable 5008X CAREsystem ▪ Leading renal value-based care Portfolio optimization FME25+ transformation program Unlock value as the leading kidney care company 2025 mid-term financial targets | Committed. Delivered.
Page 8
Q4 2024 Conference Call Page 8 2025 | Strong cash generation drives capital return to shareholders Investor Relations Q4/2025 Note: All figures FY 2025 | 1 Dividend planned to be proposed to the AGM 2026 Capital allocation Dividend1 €1.49 +3% or 33% of adjusted net income in line with dividend policy of 30-40% Accelerated share buyback €0.6bn Through 2025 - completed first tranche of initial €1bn program Capital return to shareholders Invested €0.9bn in core business for profitable growth Optimized capital structure €2.7bn Operating cash flow Shareholder returns from excess capital
Page 9
Strategic progress in 2025 Q4 2025 business update Outlook 1 2 3
Page 10
Q4 2024 Conference Call Q4 ▪ Strong organic revenue growth¹ of +8.2% driven by Value-Based Care and Care Delivery ▪ Significant operating income² growth of 53% and operating income margin² expansion by 430 bps to 13.9% ▪ FME25+ program savings of €63 million reflect strong momentum in efficiency improvements ▪ Exceptional earnings per share² (EPS) growth of 68%, supported by the accelerated share buyback program ▪ Further reduced net financial leverage ratio of 2.5x; at low end of target corridor 1 Organic growth represents growth in revenue, adjusted for certain reconciling items including revenue from acquisitions, closed or sold operations and differences in dialysis days and presented at constant currency. 2 Adjusted for special items, growth at cc; reconciliation table for special items and currency to reported growth rates: page 28. Page 10 Q4 2025 | Exceptional financial performance capping a milestone year Investor Relations 2025 Q4/2025
Page 11
Q4 2024 Conference Call Page 11 Q4 2025 Highlights | Strong execution accelerates operational improvements Investor Relations Q4/2025 Care Delivery ▪ Same market treatment growth: – U.S. broadly flat – International at +1.7% ▪ Favorable U.S. rate and payor mix development ▪ Positive impact from TDAPA regulation in the U.S. ▪ Preparation of the large-scale commercial launch of 5008X CAREsystem in the U.S. in 2026 Value-Based Care ▪ Positive operating income¹ driven by favorable savings rate, bringing FY2025 to break-even ▪ Increase in number of member months due to further contracting growth ▪ Continued growth of provider network Care Enablement ▪ Overall positive pricing contribution ▪ Negative impacts from volume-based procurement and other regulatory policies in China ▪ Strong FME25+ execution with focus on manufacturing and supply chain footprint optimizations ▪ Preparations well advanced for large- scale launch of 5008X CAREsystem and consumables deliveries in the U.S. 1 Adjusted for special items; Reconciliation table for special items and currency to reported growth rates: page 28.
Page 12
Q4 2024 Conference Call Page 12 Q4 2025 | Strong organic revenue and accelerated earnings growth Investor Relations Q4/2025 Revenue | in € million Operating income | in € million -0.3% as reported Q4 2024 Q4 2025 5,085 5,070 +7.1% at cc¹ +8.2% organic2 ▪ Strong organic revenue growth of 8% supported by Value-Based Care and Care Delivery ▪ Care Enablement development negatively impacted by China business ▪ Divestitures realized negatively impacted development by approx. 70 bps 5.1% 11.7%9.6% 13.9% 259 489 705 594 230 Q4 2024 Special items Q4 2024 excl. special items Q4 2025 excl. special items Special items Q4 2025 -111 +52.9% at cc1 ▪ Further accelerated operating income growth¹ supports significant margin expansion to 13.9% ▪ Special items mainly include costs related to FME25+ program, legacy portfolio optimization and effects from Humacyte remeasurements 1 At cc = at constant currency; operating income (growth) excluding special items | Q4 2025 €748 million operating income excl. special items at cc | Reconciliation table for special items and currency to reported growth rates: page 28. 2 Organic growth represents growth in revenue, adjusted for certain reconciling items including revenue from acquisitions, closed or sold operations and differences in dialysis days and presented at constant currency. +44.2% at current rate Margin in %
Page 13
Q4 2024 Conference Call Page 13 Q4 2025 | Significant step up in operating income driven by Care Delivery Investor Relations Q4/2025 9.6% 13.9%Margin in % In € million Q4 2024 operating income Special items Q4 2024 operating income excl. special items Care Delivery Value-Based Care Care Enablement Inter- segment Corporate Fx translation Q4 2025 operating income excl. special items Special items Q4 2025 operating income -7 -43 -111 Reconciliation table for special items and currency to reported growth rates: page 28 259 489 705 594 230 193 37 31 5
Page 14
Q4 2024 Conference Call Page 14 Q4 2025 | Care Delivery delivers highly profitable growth Investor Relations Q4/2025 Margin in % 430 574 255 26 Q4 2024 operating income excl. special items Business growth FME25+ savings Labor / Inflation Fx translation Q4 2025 operating income excl. special items -88 -49 +44.9% at cc1 16.4%+33.7% at current rate12.0% ▪ Business growth supported by positive impacts from TDAPA regulations, positive rate/mix effects as well as the phasing of a consent agreement on certain pharmaceuticals ▪ Higher labor cost including medical benefit costs, partially offset by FME25+ savings 586 551 Q4 2024 Q4 2025 3,571 3,507 2,985 2,956 +5.7% at cc¹ -1.8% as reported U.S. International ▪ U.S. organic growth of 8% driven by positive impacts from TDAPA regulations, favorable rate/mix effects and reduced implicit price concessions ▪ Solid organic growth internationally of 3% ▪ Divestitures negatively impacted growth by approx. 120 bps 1 At cc = at constant currency; operating income (growth) excluding special items | Q4 2025 €623 million operating income excl. special items at cc | Reconciliation table for special items and currency to reported growth rates: page 28 2 Organic growth represents growth in revenue, adjusted for certain reconciling items including revenue from acquisitions, closed or sold operations and differences in dialysis days and presented at constant currency. +7.3% organic2 Revenue | in € million Operating income | in € million
Page 15
Q4 2024 Conference Call Page 15 Q4 2025 | Value-Based Care achieves positive operating income Investor Relations Q4/2025 484 637 Q4 2024 Q4 2025 +42.4% at cc¹ -7 29 Q4 2024 operating income excl. special items 36 Business growth 2 FME25+ savings -1 Inflation -1 Fx translation Q4 2025 operating income excl. special items n.a.1 Margin in % -1.4% 4.5%n.a. at current rate ▪ Business growth mainly driven by improved savings rate ▪ FME25+ savings offset by inflation and foreign exchange impacts ▪ Organic revenue growth driven by further increase in number of member months mainly due to contract expansion +31.6% as reported 1 At cc = at constant currency; operating income (growth) excluding special items | Q4 2025 €30 million operating income excl. special items at cc | Reconciliation table for special items and currency to reported growth rates: page 28 2 Organic growth represents growth in revenue, adjusted for certain reconciling items including revenue from acquisitions, closed or sold operations and differences in dialysis days and presented at constant currency. +42.4% organic2 Revenue | in € million Operating income | in € million
Page 16
Q4 2024 Conference Call Page 16 Q4 2025 | Care Enablement maintains stable operating income margin Investor Relations Q4/2025 Q4 2024 Q4 2025 1,537 1,401 -3.2% at cc¹ 7.7% -8.8% as reported ▪ Revenue development driven by lower volumes and partially offset by continued overall positive pricing ▪ Development negatively impacted by unfavorable business development in China ▪ Business growth driven by unfavorable business development in China and currency transaction effects, partly offset by overall positive pricing ▪ Positive contributions from FME25+ savings compensated inflationary cost increases 118 107 42 Q4 2024 operating income excl. special items Business growth FME25+ savings Inflation Fx translation Q4 2025 operating income excl. special items -31 -18 -4 -5.8% at cc1 7.7% -8.6% at current rate 1 At cc = at constant currency; operating income (growth) excluding special items | Q4 2025 €111 million operating income excl. special items at cc | Reconciliation table for special items and currency to reported growth rates: page 28 2 Organic growth represents growth in revenue, adjusted for certain reconciling items including revenue from acquisitions, closed or sold operations and differences in dialysis days and presented at constant currency. -3.2% organic2 Margin in % Revenue | in € million Operating income | in € million
Page 17
Q4 2024 Conference Call 2022 2023 2024 2025 Key developments Page 17 Q4 2025 | Strong operating cash-flow | low end of leverage target corridor Investor Relations Q4/2025 in € million Q4 2025 Q4 2024 ∆ in % FY 2025 FY 2024 ∆ in % Operating cash flow 1,002 832 20 2,681 2,386 12 ▪ Capital expenditures, net -418 -233 79 -899 -685 31 Free cash flow 584 599 -2 1,782 1,701 5 ▪ Free cash flow after investing activities 583 713 -18 1,958 2,301 -15 Total net debt and lease liabilities 9,196 9,803 -6 9,196 9,803 -6 ▪ In Q4 2025, operating cash flow strongly increased compared to prior year mainly driven by higher net income, improvement in cash collection and prior year phasing of income tax payments ▪ Purchase of production sites in Germany for a total amount of €181 million ▪ Both total debt and lease liabilities (€10.8 billion) as well as total net debt and lease liabilities (€9.2 billion) decreased compared to Q4 2024 ▪ 14.1 million shares or 4.8% of share capital repurchased for €585 million ▪ Net leverage ratio further improved to low end of target corridor 1 Excl. U.S. federal relief funding and advanced payments under the CARES Act Net leverage ratio (Net debt/EBITDA) Previous target corridor 3.0x to 3.5x Target corridor 2.5x to 3.0x 3.2x 2.9x 2.5x 3.41x
Page 18
Q4 2024 Conference Call Page 18 FME25+ | Accelerating and extending sustainable savings until 2027 Investor Relations Q4/2025 G&A = General and Administrative areas | One-time costs to be reported as special items to operating income One-time costs 2026e2025 Sustainable savings Sustainable savings in 2026-2027e ▪ Manufacturing and supply chain optimization ▪ Restructuring of international commercial operations Care Enablement ▪ Further expansion of Global Business Services ▪ Process optimization across all three segments ▪ Procurement optimization G&A areas ~25% ~35% ▪ Supply chain optimization ▪ Clinic footprint optimization ▪ Efficiencies in real estate operations Care Delivery ~40% ~35% ~35% ~30% 2021–2027e in € million +804 +1,200 -793 -350 -1,200 +250 €400m€1,200m Innovative application of technology including AIInnovative application of technology including AI Planned phasing of FME25+ savings +150 -50 2027e
Page 19
Strategic progress in 2025 Q4 2025 business update Outlook 1 2 3
Page 20
Q4 2024 Conference Call Page 20 2026 | Largest product launch in FME history Investor Relations Q4/2025 Around 20% of machines to replace Across 28 states Note: HD = hemodialysis; HHD = home hemodialysis; PD = peritoneal dialysis | Data as of FY 2024 1 Based on CONVINCE study: 4.4% fewer deaths over 2.5 years of therapy with HVHDF, reflecting a 23% lower risk of mortality over the study period Up to 17.3m units of consumables to ship/produce Over 7,200 nurses and technicians to train ~36,000 FME patients to transition to 5008X CAREsystem 2026 will be pivotal transition year to execute large-scale 5008X launch in the U.S. FME U.S. clinic conversion ▪ Large-scale launch of 5008X CAREsystem in FME clinics and transitioning eligible patients to HVHDF treatments is a major undertaking ▪ Replacement should drive in the future – Reduced mortality for patients on HVHDF1 – Operational efficiencies in clinics – Competitive advantage for Care Delivery U.S.
Page 21
Q4 2024 Conference Call Page 21 FY 2026 | Outlook & margin assumptions Investor Relations Q4/2025 Revenue and operating income, as referred to in the outlook, are both on a constant currency basis and excluding special items. Special items will be provided as separate KPI (“Operating income excl. special items”) to capture 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. These items are excluded to ensure comparability of the figures presented with the Company’s financial targets which have been defined excluding special items. The outlook assumes current laws/policies/regulations and tariffs. See page 29 for reconciliation table for special items. Growth rates as shown above are year-on-year basis Revenue growth Operating income growth Between positive and negative mid-single digit percent FY 2025 basis: € 2,212 million Broadly flat FY 2025 basis: € 19,628 million FY 2026 Revenue and operating income Implied Group operating income margin 10.5 – 12.0 percent
Page 22
Q4 2024 Conference Call Page 22 FY 2026 | Outlook assumptions Investor Relations Q4/2025 Care Delivery − Normal flu season with same market treatment growth in the U.S. broadly flat and in International with solid growth − Moderate reimbursement rate increases and lower contribution from TDAPA regulation Value-Based Care − Around € 300 million lower due to changed contracting approach Care Enablement − Solid organic volume growth with moderately negative impacts from regulatory policy changes in China Other drivers − Portfolio optimization (realized in 2025 and 2026) negatively impacts growth by around 0.3% − Currency assumptions based on EUR/USD 1.18 Revenue assumptions Operating income assumptions in € million Operating income drivers Special items − FME25+ costs around € 350 million − Legacy Portfolio Optimization costs of around € 50 million Revenue base − FY 2025 revenue of € 19,628 million Operating income base − FY 2025 operating income excluding special items of € 2,212 million Inflation (labor & cost) Regulatory effects2 Business growth1 200-300 150-200 Incremental FME25+ savings 250 250-350 Strategic investments3 100-150 The outlook assumes current laws/policies/regulations and tariffs. 1 Excl. regulatory effects and strategic investments | 2 Incl. phosphate binders, expiry of extended tax subsidies for ACA | 3 Incl. 5008X rollout costs (OPEX), IT platform investments (in Corporate line) Headwind Tailwind
Page 23
Q4 2024 Conference Call Page 23 Aspirations | Industry-leading growth and margins Investor Relations Q4/2025 Revenue and operating income, as referred to in the outlook, are both on a constant currency basis and excluding special items. Special items will be provided as separate KPI (“Operating income excl. special items”) to capture 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. These items are excluded to ensure comparability of the figures presented with the Company’s financial targets which have been defined excluding special items. The outlook assumes current laws/policies/regulations and tariffs. See page 29 for reconciliation table for special items. Revenue growth CAGR Operating income margin in % 2030 Aspirations 2028 Aspirations Operating income growth CAGR 2025-2030 2025-2028 3 to 7 percent Care Enablement | mid-single digit percent Excluding Value-Based Care Value-Based Care | Low-single digit Care Enablement | Mid-teens Care Delivery | low- to mid-single digit percent Group | Mid-teens Care Delivery | Mid-teens
Page 24
Your questions are welcome
Page 25
Appendix
Page 26
Q4 2024 Conference Call Page 26 Q4 2025 | Profit and Loss Investor Relations Q4/2025 Q4 2025 € million Q4 2024 € million Growth in % Growth in % cc Revenue 5,070 5,085 0 7 Operating income 594 259 129 144 Operating income margin in % 11.7 5.1 Operating income excl. special items 705 489 44 53 Operating income margin excl. special items in % 13.9 9.6 Net interest expense 85 80 7 14 Income before taxes 509 179 184 201 Income tax expense 106 61 75 82 Tax rate in % 20.9 34.1 Non-controlling interest 76 51 46 57 Net income¹ 327 67 389 421 Net income excl. special items¹ 412 266 55 64 1 Attributable to shareholders of FME AG; reconciliation table for special items and currency to reported growth rates: page 28
Page 27
Q4 2024 Conference Call Page 27 FY 2025 | Profit and Loss Investor Relations Q4/2025 FY 2025 € million FY 2024 € million Growth in % Growth in % cc Revenue 19,628 19,336 2 5 Operating income 1,827 1,392 31 36 Operating income margin in % 9.3 7.2 Operating income excl. special items 2,212 1,797 23 27 Operating income margin excl. special items in % 11.3 9.3 Net interest expense 315 335 -6 -3 Income before taxes 1,512 1,057 43 48 Income tax expense 321 316 2 4 Tax rate in % 21.2 29.9 Non-controlling interest 213 203 5 9 Net income¹ 978 538 82 88 Net income excl. special items¹ 1,248 903 38 43 1 Attributable to shareholders of FME AG; reconciliation table for special items and currency to reported growth rates: page 29
Page 28
Q4 2024 Conference Call Reconciliation of non-IFRS financial measures to the most directly comparable IFRS financial measures for comparison with outlook Page 28 Q4 2025 | Reconciliation adjustments Investor Relations Q4/2025 Group Care Delivery Value-Based Care Care Enablement Corporate Inter-segment eliminations € million Q4 2025 Q4 2024 in % Q4 2025 Q4 2024 in % Q4 2025 Q4 2024 in % Q4 2025 Q4 2024 in % Q4 2025 Q4 2024 Q4 2025 Q4 2024 Revenue 5,070 5.085 0 3,507 3,571 -2 637 484 32 1,401 1,537 -9 -- -- -475 -507 Operating Income 594 259 129 528 260 103 29 -7 n.a. 56 71 -21 -41 -57 22 -8 FME25+ program 73 73 26 29 0 -- 47 42 0 2 -- -- Humacyte remeasurements 18 7 -- -- -- -- 4 0 14 7 -- -- Legacy portfolio optimization 18 146 20 141 -- -- 0 5 -2 0 0 0 Legal form conversion costs 2 4 -- -- -- -- -- 0 2 4 -- -- Sum of special items 111 230 46 170- 0 -- 51 47 14 13 0 0 Operating income excl. special items 705 489 44 574 430 34 29 -7 n.a. 107 118 -9 -27 -44 22 -8 Foreign currency translation 43 49 1 4 -12 1 Operating income excl. Special items at cc 748 623 30 111 -39 23
Page 29
Q4 2024 Conference Call Reconciliation of non-IFRS financial measures to the most directly comparable IFRS financial measures for comparison with outlook Page 29 FY 2025 | Reconciliation adjustments and 2025 base for 2026 outlook Investor Relations Q4/2025 Group Care Delivery Value-Based Care Care Enablement Corporate Inter-segment eliminations € million FY 2025 FY 2024 in % FY 2025 FY 2024 in % FY 2025 FY 2024 in % FY 2025 FY 2024 in % FY 2025 FY 2024 FY 2025 FY 2024 Revenue 19,628 19,336 2 13,736 14,003 -2 2,247 1,752 28 5,476 5,557 -1 -- -- -1,831 -1,976 Operating Income 1,827 1,392 31 1,614 1,218 33 1 -28 n.a. 326 267 22 -119 -48 5 -17 FME25+ program 194 180 89 74 2 -- 103 104 0 2 -- -- Humacyte remeasurements 90 -72 -- -- -- -- 13 -28 77 -44 -- -- Legacy portfolio optimization 97 288 98 301 -- -- 0 -7 0 1 -1 -7 Legal form conversion costs 4 9 -- -- -- -- -- 0 4 9 -- -- Sum of special items 385 405 187 375 2 -- 116 69 81 -32 -1 -7 Operating income excl. special items 2,212 1,797 23 1,801 1,593 13 3 -28 n.a. 442 336 32 -38 -80 4 -24 Foreign currency translation 73 88 0 6 -21 0 Operating income excl. Special items at cc 2,285 1,889 3 448 -59 4
Page 30
Q4 2024 Conference Call Page 30 Debt Investor Relations Q4/2025 FY 2025 € million FY 2024 € million FY 2023 € million Debt Short-term debt from unrelated parties 17 2 457 + Current portion of long-term debt 1,596 575 487 + Current portion of lease liabilities from unrelated parties 577 616 593 + Current portion of lease liabilities from related parties 7 25 24 + Long-term debt, less current portion 5,692 6,261 6,960 + Lease liabilities from unrelated parties, less current portion 2,895 3,412 3,419 + Lease liabilities from related parties, less current portion 11 88 110 + Debt and lease liabilities included within liabilities directly associated with assets held for sale -- 9 137 Total debt and lease liabilities 10,795 10,988 12,187 − Cash and cash equivalents1 -1,599 -1,185 -1,427 Total net debt and lease liabilities 9,196 9,803 10,760 1 Includes cash and cash equivalents included within assets held for sale
Page 31
Q4 2024 Conference Call Reconciliation of adjusted EBITDA and net leverage ratio to the most directly comparable IFRS financial measures Page 31 EBITDA Investor Relations Q4/2025 FY 2025 € million FY 2024 € million FY 2023 € million Net income 1,191 741 732 + Income tax expense 321 316 301 − Interest income -70 -72 -88 + Interest expense 385 407 424 + Depreciation and amortization 1,463 1,536 1,613 + Adjustments1 447 450 409 Adjusted EBITDA 3,737 3,378 3,391 Net leverage ratio (Net debt/EBITDA) 2.5 2.9 3.2 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 (2025: 1 M; 2024: -€23 M), non-cash charges, primarily related to pension expense (2025: €47 M; 2024: €52 M), impairment loss (2025: €37 M; 2024: €207 M), and special items, including costs related to the FME25+ Program (2025: €185 M; 2024: €164 M), Legacy Portfolio Optimization (2025: €83 M; 2024: €113 M), Legal Form Conversion Costs (2025: €4 M; 2024: €9 M), and Humacyte Remeasurements (2025: €90 M; 2024: -€72 M).
Page 32
Q4 2024 Conference Call Page 32 Return on Invested Capital (ROIC) Investor Relations Q4/2025 ▪ ROIC in 2020 excl. the impact of the Latin America impairment (special item) and in 2021 excluding FME25+ (special item) ▪ ROIC for 2020 and 2021 was 7.5% and 5.5% excl. IFRS 16 and excl. Latin America impairment in 2020 ▪ ROIC in 2022 adjusted for the effects of the FME25+ program, the Humacyte Investment Remeasurement, the net gain related to InterWell Health, the effects of hyperinflation in Turkiye and impacts related to the war in Ukraine ▪ ROIC in 2023-2024 adjusted for the effects of the FME25+ program, Legal Form Conversion costs, Legacy Portfolio Optimization and Humacyte Remeasurements ▪ ROIC in 2025 adjusted for the effects of the FME25+ program, Legal Form Conversion costs, Legacy Portfolio Optimization, Humacyte Remeasurements and Interwell Health Deferred Tax Reversal 2020 2021 2022 2023 2024 2025 5.8% 6.6% 4.9% 5.1% 3.3% 3.9% 2.8% 3.6% 3.5% 4.5% 5.0% rep. 6.1% adj.
Page 33
Q4 2024 Conference Call Page 33 Exchange rates, U.S. dialysis days per quarter, definition Investor Relations Q4/2025 FY 2025 FY 2024 FY 2023 €:USD Period end 1.175 1.039 1.105 Average 1.130 1.082 1.081 €:CNY Period end 8.226 7.583 7.851 Average 8.118 7.788 7.660 €:RUB Period end 93.980 115.968 100.215 Average 94.429 100.458 92.461 Exchange rates Q1 Q2 Q3 Q4 Full year 2025 76 78 79 80 313 2024 77 78 79 80 314 2023 77 78 79 79 313 U.S. dialysis days per quarter Definitions cc at constant currency HD Hemodialysis PD Peritoneal dialysis Net income Net income attributable to shareholders of FME LTM Last-Twelve-Months
Page 34
Q4 2024 Conference Call Page 34 Key metrics for Care Delivery and Value-Based Care Investor Relations Q4/2025 Care Delivery as of December 31, 2025 as of December 31, 2024 Patients Treatments Clinics Patients Treatments Clinics United States 205,483 31,069,465 2,622 206,436 31,213,447 2,624 Growth in % 0 0 0 International 86,419 13,677,419 979 92,916 16,403,624 1,051 Growth in % -7 -17 -7 Total 291,902 44,746,884 3,601 299,352 47,617,071 3,675 Growth in % -2 -6 -2 Value-Based Care as of December 31, 2025 as of December 31, 2024 Member Months Membership Member Months Membership United States 1,788,951 162,697 1,534,053 131,750 Growth in % 17 23
Page 35
Q4 2024 Conference Call Page 35 Continuous monitoring of clinical performance to enhance care Investor Relations Q4/2025 Quality index components Quality index Global indicator for patient well-being and treatment success Dialysis effectiveness Measures how sufficiently the body is cleansed of waste substances Vascular access Measures the share of patients who do not receive dialysis via a dialysis catheter but rather via safer vascular access alternatives that reduce risk of infection and improve outcomes Anemia management Measures hemoglobin levels and specific medications given during dialysis to achieve optimum clinical outcomes, such as overall health and well-being Q4 2025 Q4 2024 Quality index 80% 80% Dialysis effectiveness 93% 93% Vascular access 75% 77% Anemia management 71% 71%
Page 36
Q4 2024 Conference Call Page 36 Segment information of past five years Investor Relations Q4/2025 € million; % change year-over-year FY 2025 Growth Growth at cc Organic growth FY 2024 FY 2023 FY 2022 FY 2021 Total Revenue 19,628 2 5 8 19,336 19,454 19,398 17,619 Operating income 1,827 31 36 1,392 1,369 1,512 1,852 Operating income excl. special items 2,212 23 27 1,797 1,5601 1,540 1,915 Operating income margin in % excl. special items 11.3 9.3 8.11 7.9 10.9 Care Delivery segment2 Revenue 13,736 -2 2 5 14,003 14,749 15,593 14,031 Operating income 1,614 33 40 1,218 1,612 1,686 1,643 Operating income excl. special items 1,801 13 19 1,593 1,5971 1,478 1,693 Operating income margin in % excl. special items 13.1 11.4 11.01 9.5 12.1 Value-Based Care segment Revenue 2,247 28 34 34 1,752 1,277 Operating income 1 n.a. n.a. -28 -96 Operating income excl. special items 3 n.a. n.a. -28 -961 Operating income margin in % excl. special items 0.1 -1.6 -7.51 Care Enablement segment Revenue 5,476 -1 2 2 5,557 5,345 5,353 5,086 Operating income 326 22 23 267 -67 -30 315 Operating income excl. special items 442 32 33 336 1221 103 327 Operating income margin in % excl. special items 8.1 6.0 2.31 1.9 6.4 Inter-segment elimination2 Revenue -1,831 -7 -4 -1,976 -1,917 -1,548 -1,498 Operating income 5 n.a. n.a. -17 -13 0 7 Operating income excl. special items 4 n.a. n.a. -24 -131 Corporate Operating income -119 148 206 -48 -67 -144 -113 Operating income excl. special items -38 -54 -27 -80 -501 -41 -112 1) 2023: excluding the Tricare settlement; New VBC Segmentation applicable from FY 2023; cc = constant currency; n.a. = not applicable; FY 2021 and FY 2022 as published on Feb 22, 2023 2) Care Delivery excl. Value-Based Care in 2025, 2024 and 2023; Care Delivery incl. Value-Based Care in 2022 and 2021
Page 37
Q4 2024 Conference Call Page 37 IR event calendar Investor Relations Q4/2025 Dates and/or participation might be subject to change February 24 Virtual Report on Q4/FY 2025: Earnings Release and Conference Call 25 London C-Level Q4/FY 2025 Roadshow 27 Frankfurt C-Level Q4/FY 2025 Roadshow 02 London Morgan Stanley European Healthcare Conference 03 London UBS European Healthcare Conference 05 Boston C-Level Roadshow 10–11 Miami Barclays Global Healthcare Conference 19 Paris Bernstein European Sustainability Conference 24 London BNP Paribas Healthcare Conference with C-Level 25 Paris C-Level Roadshow March April 14–15 Hong Kong HSBC Global Investment Summit May 05 Virtual Report on Q1 2026: Earnings Release and Conference Call 14 Las Vegas Bank of America Global Healthcare Conference 21 Frankfurt Annual General Meeting 06 London C-Level Q1 2026 Roadshow 26 Frankfurt dbAccess European Champions Conference with C-Level June 03 New York Jefferies Global Healthcare Conference 02 Paris BNPP Exane CEO Conference with C-Level 09 Miami Goldman Healthcare Conference with C-Level 11 London Citi European Healthcare CEO Conference with C-Level 18 London JP Morgan European Healthcare Conference Reporting & AGM C-Level Investor Relations 29 Virtual Barclays Conversations in European Healthcare with C-Level
Page 38
Ilia Kuerten Vice President Investor Relations +49(0) 6172-268 5966 Ilia.Kuerten@ FreseniusMedicalCare.com Alicia Cahill Senior Director Investor Relations +1 860-609-2394 Alicia.Cahill@ FreseniusMedicalCare.com Dr. Dominik Heger Global Head of Investor Relations, Market & Competition, Sustainability | EVP +49(0) 6172-2685-822 Dominik.Heger@ FreseniusMedicalCare.com Gari Hoto Senior Manager Investor Relations +49(0) 6172-268-6078 Garikai.Hoto@ FreseniusMedicalCare.com Fresenius Medical Care AG Investor Relations Else-Kröner-Str. 1 61352 Bad Homburg v. d. H. Germany ir@FreseniusMedicalCare.com Ticker: FME and FMS (NYSE/ADR) WKN: 578 580 ISIN: DE00057858002 CUSIP (ADR): 358029106