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Fresenius Medical Care AG Investor Presentation FY 2025
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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.
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Q4 2024 Conference Call Page 3 FME | Positioned to drive long-term value creation Investor Presentation FY 2025 2030 industry-leading group margin aspiration 9.3% Mid-teens 2025 2030e Operating income excl. special items Supportive underlying drivers within a growing chronic disease market Highly cash generative business with clear commitment to shareholder returns while maintaining investment grade Differentiated vertically integrated business model with market-leading assets Strong history of innovation and on track to set new standard of care Strategy to reach industry-leading profitability in 2030, with a track record to deliver on targets
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FME at a glance FME segments FY 2025 financials 1 2 3 Outlook4
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Q4 2024 Conference Call Page 5 FME | We are the leading kidney care company Investor Presentation FY 2025 We offer a tailored range of products and services for patients with kidney disease Creating a future worth living. For patients. Worldwide. Every day. Dialysis services in our own dialysis centers as well as home therapy options Bundled services including a range of complementary services, such as vascular access, pharmacy and pharma Care Delivery We improve patient outcomes and lower cost of care Value-Based Care Dialysis products, including digital solutions, technical services and operational management Care Enablement
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Q4 2024 Conference Call Page 6 FME | Market-leading assets with strong and competitive positioning Investor Presentation FY 2025 A leading provider of kidney care services #1 in U.S. renal value-based care #1 Global leading renal MedTech company Value-Based Care Care EnablementCare Delivery ~290k patients, incl. ~205k in U.S. ~3,600 clinics globally ~25 core markets ~€6.8bn in MCUM 2,300+ aligned nephrologists ~160k memberships ~50% patients use FME products 174m dialyzers sold 40% HD market-share Note: MCUM = medical costs under management; HD = hemodialysis | Data as of FY 2025
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Q4 2024 Conference Call Page 7 FME | Leveraging the power of vertical integration Investor Presentation FY 2025 Provide high quality care that improves quality outcomes and reduces costs Care Delivery Care Enablement Support practice management and relationships with partner nephrologists Clinics recognize customer needs to drive innovation in technology Apply innovation in medical technology to drive improved patient outcomes Provide differentiated therapies to clinics Value-Based Care €5.5bn Revenue 2025 €13.7bn Revenue 2025 €2.2bn Revenue 2025 Medical value creation Patient data and insights, future innovation and R&D
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Q4 2024 Conference Call Page 8 Market growth | Attractive underlying business fundamentals intact Investor Presentation FY 2025 Extrapolation from 2020 to 2035 1 United Nations, Department of Economic and Social Affairs, Population Division (2024). World Population Prospects 2024, Online Edition | 2 Age-standardized prevalence of hypertension among adults aged 30–79 years as published in Global report on hypertension 2025: high stakes – turning evidence into action. Geneva: World Health Organization; 2025 | 3 IDF Diabetes Atlas 11th Edition - 2025, adults aged 20-79 living with diabetes | 4 FME 2025 Long Range Patient Projection | All numbers rounded and approximations Aging global population Hypertension +60% Diabetes 1/3 Dialysis patients +90%+40% 0.75 billion 1.2 billion 2035e2020 Global population aged 65+1 People living with diabetes3 People on maintenance dialysis4One out of three people worldwide has hypertension2 500 million 690 million 2035e2020 3.7 million ~7 million 2035e2020
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Q4 2024 Conference Call 329 349 423 416 586 2022 2023 2024 2025 Share buyback Dividend Page 9 FME | Proven execution and clear progress in key performance metrics Investor Presentation FY 2025 1 Adjusted operating income margin as defined by the financial outlook for the respective years; corresponding definitions and reconciliation tables provided in our full year 2025 earnings results documents; in 2025 excluding Value-Based Care | 2 Dividend planned to be proposed to the AGM 2026 (based on reduced shares outstanding due to share buyback program initiated i n August 2025) | 3 Excluding U.S. federal relief funding and advanced payments under the CARES Act | 4 Former target band of 3.0x to 3.5x lowered at CMD June 2025 Accumulated FME25+ sustainable annual savings in € million 131 346 567 804 2022 2023 2024 2025 FME25+ SAVINGS ACCELERATED Net financial leverage ratio (net debt/EBITDA) at year end 2022 2023 2024 2025 3.4³x 3.2x 2.9x NET LEVERAGE RATIO IMPROVED Operating income margin¹ MARGIN TARGETS ACHIEVED 7.9% 8.1% 9.3% 11.3%9.5% 9.7% 10.2% 13.1% 1.9% 2.3% 6.0% 8.1% 2022 2023 2024 2025 Group Care Delivery Care Enablement Target band⁴: 2.5x to 3.0x INCREASED SHAREHOLDER RETURNS 2.5x 2 Shareholder returns in € million 1.12 1.44 1.491.19 Dividend per share in € 1,002
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Q4 2024 Conference Call Page 10 FME Reignite | Our strategy will Reignite Value Creation Investor Presentation FY 2025 Reignite Growth & Innovation Reignite Value Creation€ Reignite our Culture Reignite the Core Strengthen core operations Drive profitable growth and innovation Develop together and strengthen our culture
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Q4 2024 Conference Call Page 11 U.S. HVHDF | Game changer to transform the standard of care and leverage FME’s vertical integration Investor Presentation FY 2025 Production capacity Annual 5008X production capacity of Care Enablement Planned rollout Planned 5008X penetration in Care Delivery clinics Addressable market Clinical benefit Improved mortality rates following HVHDF penetration Survival benefits in CONVINCE emerge after 3 months 4.4% fewer deaths over 2.5 years of therapy with HVHDF, reflecting a 23% lower risk of mortality over the CONVINCE study period Around 15,000 Up to 20,000 Up to 20,000 Market rollout from a position of strength 90% machine market share o Total U.S. in-center HD machines ~160k o Current installed base of 2008 machines ~145k 66% of external disposable market share of 2008 machines’ installed base Aspiration to achieve 100% consumables market share for 5008X by 2030 2026e 2027e 2028e 2029e 2030e 100% 30% - 50% 50% - 70% 70% - 90% ~20% 2026e 2027e 2028-2030e per year Note: HD = hemodialysis; HVHDF = high volume hemodiafiltration
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Q4 2024 Conference Call Page 12 FME25+ | Accelerating and extending sustainable savings until 2027 Investor Presentation FY 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
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Q4 2024 Conference Call Page 13 Capital allocation | Clear set of priorities focus on shareholder value creation Investor Presentation FY 2025 1 Net income attributable to shareholders of the FME AG Invest in core business for profitable growth Optimize capital structure Return of excess capital to shareholders >€2.5bn Operating cash flow, annually in 2025-2030e Strong cash generation to further increase over time Operating cash flow of 13-15% of revenue in 2025-2030e Invest in core business for profitable growth Capex of €0.8bn to €1.0bn p.a. in 2025-2030e Optimize capital structure Strong balance sheet, financial flexibility and commitment to a sustainable Investment Grade rating Self-imposed target band: net leverage of 2.5x to 3.0x Return of excess capital to shareholders Dividend policy: 30% to 40% payout ratio of adjusted net income1 Share buybacks: complement dividends as instrument to return excess capital. Cash generation Capital allocation
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FME at a glance FME segments FY 2025 financials 1 2 3 Outlook4
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Q4 2024 Conference Call Page 15 FME segments | Aligned for value creation Investor Presentation FY 2025 Care Delivery Value-Based Care Care Enablement Productivity and operational excellence Improvements to realized dialysis rates Continued footprint optimization Clinical quality to help patients live longer and healthier; HVHDF Exceptional experience to retain patients Taking responsibility for the integrated health care of our patients Creating mutual value between FME and VBC through key quality and outcomes initiatives Drive profitable growth and innovation Commercial excellence and operational efficiency to enable robust growth and margin expansion Above-the-market growth, value- based pricing and share gain Operational excellence 5008X roll-out in the U.S. Focused R&D program driving innovation Advancing to industry- leading margins Progressing on a path to profitable growth Accelerating profitable growth 2030
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Q4 2024 Conference Call Page 16 Care Delivery | We are the world’s leading provider of dialysis services Investor Presentation FY 2025 Around 290,000 Patients worldwide Around 3,600 Dialysis centers Treated Around 37% of all dialysis patients in the U.S. Around 45m Dialysis treatments in 2025 79% of patients would highly recommend our service 65% of dialysis centers rated 3 stars or better by CMS¹ Note: HD = hemodialysis; HHD = home hemodialysis; PD = peritoneal dialysis | Data as of FY 2025 1 As of FY 2024
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Q4 2024 Conference Call Page 17 Care Delivery | Portfolio positioned for profitable growth Investor Presentation FY 2025 Dialysis clinic network treating ~205k patients in ~2,600 clinics across the U.S. Provides outpatient vascular care services to individuals requiring dialysis access Produces and distributes drugs and pharmaceuticals, including Vifor JV Provides dialysis medications, delivered to dialysis centers or to patients at home Care Delivery revenue Care Delivery U.S. Care Delivery International U.S. Int’l 84% 16% €13.7bn FY 2025 Provides dialysis therapy in 34 markets Primarily in EMEA and APAC regions
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Q4 2024 Conference Call Page 18 Care Delivery | Largest product launch in FME history Investor Presentation FY 2025 Around 20% of machines to replace Across 28 states Note: HVHDF = high volume hemodiafiltration 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 HVHDF 1 – Operational efficiencies in clinics – Competitive advantage for Care Delivery U.S.
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Q4 2024 Conference Call Page 19 Patient numbers | Accelerating growth Investor Presentation FY 2025 HVHDF Dialysis patients +90% People on maintenance dialysis 3.7 million ~7 million 2035e2020 Global +4-5% Treatment growth further accelerated by additional benefits from HVHDF and value-based care Value-based care Meds improving CKD/ESRD survival Preventive health, AI, diagnostics Personalized medicine U.S. +2% plus U.S. treatment yield Source: FME 2025 Long Range Patient Projection Medical trends and how we are participating 2025-2035e CAGR Patient number growth
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Q4 2024 Conference Call Page 20 Patient inflow | U.S. kidney care patient flow dynamics Investor Presentation FY 2025 10-12 co-morbidities on average – Hypertension (31%) – Diabetes (44%) – Glomerular diseases (6%) ~45% of patients “crash” into dialysis Cardiovascular events primary cause of CKD Stage 3 patients not surviving to CKD Stage 4 and ESRD – Small improvement in survival in total CKD Stage 3 would lead to double the at-risk ESRD population Complex U.S. patient population Scale of U.S. CKD/ESRD patient population (in million) Note: ESRD = End-Stage Renal Disease 10.5 1.08 0.55 CKD Stage 3a/3b CKD Stages 4/5 ESRD
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Q4 2024 Conference Call Page 21 Value-Based Care | Leading renal value-based care in the U.S. Investor Presentation FY 2025 Around 160,000 Memberships Around 1.8m Member months All 10 of top 10 highest scoring kidney contracting entities in CKCC program1 2,300+ Aligned nephrologists in provider network #1 Renal value-based care in the U.S. Note: Data as of FY 2025 | CKCC = Comprehensive Kidney Care Contracting program, a value-based care program of the Centers for Medicare & Medicaid Services (CMS) Innovation Center 1 Announced in October 2024 Around €6.8bn Medical cost under management
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Q4 2024 Conference Call Page 22 Value-Based Care | A leading and differentiated player in renal VBC Investor Presentation FY 2025 Connectivity to FME 85% of ESRD patients have access to an FME dialysis clinic Leading provider network 2,300+ aligned nephrologists, growing from 1,600 in 2022 Unique Acumen EHR technology Nephrology-specific electronic health record used by 62% of aligned providers¹ 85% 1 Providers defined as Physicians and Advanced Practice Providers | 2 Medicare Advantage | 3 Includes revenue from Acumen Three unique sources of differentiation Business at a glance ESRD CKD 30% 31% 39% Subcap Shared risk CKCC 97% MA² CKCC Other³ ~€6.8bn Medical costs under management 2025 24% 1% 2% ~160k Memberships €2.2bn Revenue 76%
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Q4 2024 Conference Call Page 23 Value-Based Care | Vertical integration as an advantage and enhanced visibility into performance Investor Presentation FY 2025 VBC directly improves outcomes and survival for dialysis patients, a key growth driver for FME Benefits other parts of FME: a lever for driving HVHDF adoption in the U.S. Anchors our participation in a ‘must play’ space through a leading asset poised for growth Initiating new reporting segment to increase financial reporting transparency Creating greater insight into drivers of growing part of FME VBC creates value for FME FME creates value for VBC FME gives VBC access to patients and clinics to accelerate growth FME best practices and resources support VBC in its growth Benefits of vertical integration Visible value creation
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Q4 2024 Conference Call Page 24 Value-Based Care | Rapidly evolving market plays an important role in the industry and our future Investor Presentation FY 2025 ESRD patients in VBC programs 2019 - 2023 1 MCUM = medical costs under management as of 2023; Kidney VBC companies include VBCs focusing on renal care (e.g. Evergreen Nephrology, Monogram Health, Somatus). Hospital Accountable Care Organizations (ACOs) include hospitals that are implementing VBC programs through CMS and directly contracting with health plans. | 2 Includes ESRD patients on dialysis. Sources: USRDS, CMS, NAACOS, Pitchbook, FME estimates Renal VBC is a large and growing market Currently poised for stability and growth phase 25% CAGR 11% 34%55% $18bn FME VBC Other Kidney VBC Hospital ACO CKD 4-5 MCUM1 12% 47% 41% $38bn ESRD2 MCUM1 Emergence 2010 - 2018 Rapid acceleration and innovation 2019 - 2024 Stability and growth 2025+ Value-based kidney care recognized as a critical opportunity for payors, including U.S. government Renal services industry has attracted an inflow of well-funded new entrants: $2bn+ in industry investments Growth expectations are normalizing Industry focusing on scaling proven models and phasing out unviable ones
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Q4 2024 Conference Call Page 25 Care Enablement | We are the market leading renal Medtech company Investor Presentation FY 2025 Around 40% share in hemodialysis product market Around 56,000 machines installed in 2025 171m dialyzers sold in 2025 Around 50% of all dialysis patients use our products Global #1 In-center HD machines Global #1 Home HD machines Global #2 PD machines Note: HD = hemodialysis; PD = peritoneal dialysis | Data as of FY 2025
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Q4 2024 Conference Call Page 26 Care Enablement | Attractive and industry-leading renal MedTech portfolio Investor Presentation FY 2025 Diverse, international footprint with U.S. representing around one-third of total revenues APAC EMEA €5.5bn FY 2025 revenue, across three verticals: In-Center Home Critical Care Globally, and in each region, in-center represents the majority of revenues In-center mix by revenue, broadly – 25% machines – 75% consumables Care Enablement LatAm U.S.
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Q4 2024 Conference Call Market share distribution¹ Page 27 Care Enablement | Growing our market leader position and transform kidney care Investor Presentation FY 2025 40% 10% 8% 7% FME Competitor 1 Competitor 2 Competitor 3 62% 26% Competitor 1 FME All other competitors 37% 30% 5% 4% Competitor 1 FME Competitor 2 Competitor 3 In-center HD products Home products (PD & HHD) Critical care Drive market to outcome-improving therapies Introduce digitally-connected ecosystem based on new technology platform Drive growth of Home HD Grow PD share in profitable markets, while improving economics Redefine the market in introducing point-of-care fluid generation in PD Achieve market leadership with expansion of premium product portfolio in Americas and APAC Expand ICU portfolio <3% each 1 As of FY 2024
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FME at a glance FME segments FY 2025 financials 1 2 3 Outlook4
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Q4 2024 Conference Call FY Strong organic revenue growth¹ of +7.6% driven by all operating segments Significant operating income² growth of 27% and operating income margin² step up to 11.3% FME25+ program savings of €238 million reflect strong momentum in efficiency improvements Exceptional earnings per share² (EPS) growth of 44%, 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 45 Page 29 FY 2025 | A milestone year marked by outstanding profitability gains Investor Presentation 2025 FY 2025
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Q4 2024 Conference Call Page 30 2025 | Strong cash generation drives capital return to shareholders Investor Presentation FY 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
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Q4 2024 Conference Call Page 31 2025 | Strong organic growth and step-up in profitability achieved Investor Presentation FY 2025 +1.5% as reported FY 2024 FY 2025 19,336 19,628 +5.4% at cc¹ +7.6% organic2 Strong organic revenue growth of 8% supported by all operating segments Divestitures negatively impacted development by approx. 130 bps 7.2% 9.3%9.3% 11.3% 405 FY 2024 Special items FY 2024 excl. special items FY 2025 excl. special items Special items FY 2025 -3851,392 1,797 2,212 1,827 +27.2% at cc1 Operating income¹ growth of 27% reached top end of financial outlook, supported by all operating segments, resulting in a significant margin step up to 11.3% 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 | FY 2025 €2,285 million operating income excl. special items at cc | Reconciliation table for special items and currency to reported growth rates: page 45 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 +23.1% at current rate Margin in % Operating income | in € millionRevenue | in € million
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Q4 2024 Conference Call Page 32 FY 2025 | Significant operating income growth driven by all segments Investor Presentation FY 2025 9.3% 11.3%Margin in % In € million 405 296 31 112 28 21 FY 2024 operating income Special items FY 2024 operating income excl. special items Care Delivery Value-Based Care Care Enablement Inter- segment Corporate Fx translation FY 2025 operating income excl. special items Special items FY 2025 operating income -73 -385 1,392 1,797 2,212 1,827 Reconciliation table for special items and currency to reported growth rates: page 45
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Q4 2024 Conference Call Page 33 2025 | Care Delivery delivers highly profitable growth Investor Presentation FY 2025 Margin in % 482 113 FY 2024 operating income excl. special items Business growth FME25+ savings Labor / Inflation Fx translation FY 2025 operating income excl. special items -299 -88 1,593 1,801 +18.5% at cc1 13.1%+13.0% at current rate11.4% Business growth supported by favorable impacts from TDAPA regulations and positive rate/mix effects Higher labor, including medical benefit costs and inflationary cost increases were partially offset by FME25+ savings 11,526 2,477 FY 2024 11,507 2,229 FY 2025 14,003 13,736 +1.8% at cc¹ -1.9% as reported U.S. International U.S. organic growth of 5% driven by positive impacts from TDAPA regulations and favorable rate/mix effects Strong organic growth internationally of 4% Divestitures negatively impacted growth by approx. 210 bps 1 At cc = at constant currency; operating income (growth) excluding special items | FY 2025 €1,889 million operating income excl. special items at cc | Reconciliation table for special items and currency to reported growth rates: page 45 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 +4.7% organic2 Operating income | in € millionRevenue | in € million
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Q4 2024 Conference Call Page 34 2025 | Value-Based Care achieves positive operating income Investor Presentation FY 2025 FY 2024 FY 2025 1,752 2,247 +33.9% at cc¹ -28 3 FY 2024 operating income excl. special items 30 Business growth 5 FME25+ savings -4 Inflation 0 Fx translation FY 2025 operating income excl. special items n.a. at cc1 -1.6% +0.1%n.a.% at current rate Positive operating income Business growth mainly driven by a favorable savings rate, partially offset by an unfavorable effect from CKCC programs FME25+ savings offset inflation impacts Organic revenue growth driven by increase in number of member months mainly due to contract expansion +28.2% as reported 1 At cc = at constant currency; operating income (growth) excluding special items | FY 2025 €3 million operating income excl. special items at cc | Reconciliation table for special items and currency to reported growth rates: page 45 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 +33.9% organic2 Operating income | in € millionRevenue | in € million Margin in %
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Q4 2024 Conference Call Page 35 2025 | Care Enablement further improved operating income margin Investor Presentation FY 2025 FY 2024 FY 2025 5,557 5,476 +2.2% at cc¹ 8.1% -1.4% as reported Organic growth driven by volume growth and continued overall positive pricing, despite negative impacts from volume-based procurement and other regulatory policies in China Business growth supported by volume growth and overall positive pricing Positive contributions from FME25+ savings overcompensated for inflationary cost increases 336 442 37 148 FY 2024 operating income excl. special items Business growth FME25+ savings Inflation Fx translation FY 2025 operating income excl. special items -73 -6 +33.3% at cc1 6.0% +31.5% at current rate 1 At cc = at constant currency; operating income (growth) excluding special items | FY 2025 €448 million operating income excl. special items at cc | Reconciliation table for special items and currency to reported growth rates: page 45 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 +2.2% organic2 Operating income | in € millionRevenue | in € million Margin in %
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Q4 2024 Conference Call Key developments Page 36 FY 2025 | Strong operating cash-flow | low end of leverage target corridor Investor Presentation FY 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 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 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 FY 2024 Through 2025, 14.1 million shares or 4.8% of share capital repurchased for €585 million; second tranche of around EUR 414m started on Jan 12 and planned to end by May 8, 2026 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 2022 2023 2024 2025
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Q4 2024 Conference Call Diversified financing mix1, 2 Prudent financial policy1 Page 37 Optimal capital structure | Building on sound and proven financing strategy Investor Presentation FY 2025 Well-balanced maturity profile1, 3 Sufficient liquidity reserve Undrawn ESG-linked Revolver Credit Facility of €2.0bn Committed bilateral credit lines of ~€510m, supplemented by further uncommitted facilities (~€800m) and Commercial Paper program of €1.5bn (fully unutilized as of December 31, 2025) Sound financing strategy Commitment to investment grade ratings Conservative fix/floating mix of ~75%/25%4 Balanced currency mix of ~54%5 US-Dollar and ~46% Euro Proactive refinancing strategy of upcoming maturities Proven long-term track record within bank and capital markets Large and strong banking group Proven ability to access US-Dollar (incl. 144A) and Euro bond markets Share of fixed rate6: 75% Average maturity6: 3.5 years Average interest6: 2.7% 1 As of December 31, 2025 | 2 Does not include debt and lease liabilities included within liabilities directly associated with assets held for sale | 3 Based on utilization of major financing instruments, excl. Commercial Paper and other cash management lines | 4 Calculations based on total financial debt, excluding Lease & Purchase Money Obligations | 5 Including ~4% other currencies Lease Obligations 32% USD Bonds 24% EUR Bonds 41% Schuldschein Loans 2%Other 1²% €10.8bn 800 750 600 500 1,250 500 723 426 1,404 25 200 0 400 800 1,200 1,600 2026 2027 2028 2029 2030 2031 2032 EUR Bonds USD Bonds Schuldschein Loans
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FME at a glance FME segments FY 2025 financials 1 2 3 Outlook4
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Q4 2024 Conference Call Page 39 FY 2026 | Outlook & margin assumptions Investor Presentation FY 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 45 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
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Q4 2024 Conference Call Page 40 FY 2026 | Outlook assumptions Investor Presentation FY 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
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Q4 2024 Conference Call Page 41 Aspirations | Industry-leading growth and margins Investor Presentation FY 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 45 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
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Appendix
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Q4 2024 Conference Call Page 43 Continuous monitoring of clinical performance to enhance care Investor Presentation FY 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%
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Q4 2024 Conference Call Page 44 FY 2025 | Profit and Loss Investor Presentation FY 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 45
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Q4 2024 Conference Call Reconciliation of non-IFRS financial measures to the most directly comparable IFRS financial measures for comparison with outlook Page 45 FY 2025 | Reconciliation adjustments and 2025 base for 2026 outlook Investor Presentation FY 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
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Q4 2024 Conference Call Page 46 Return on Invested Capital (ROIC) Investor Presentation FY 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.
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Q4 2024 Conference Call Page 47 FME | Segment information of past five years Investor Presentation FY 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
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Q4 2024 Conference Call Page 48 FME | Investor Relations event calendar Investor Presentation FY 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
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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