Fresenius Medical Care Ag · XETR:FME
Fresenius Medical Care — Investor Day (June 2025)
74 slides from Fresenius Medical Care's investor day presentation, Jun 17, 2025
Slide 1: FME Reignite presentation
FMEReignite presentation London | June 17, 2025 Fresenius Medical Care
Slide 2: Safe harbor statement
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 conve
Slide 3: Helen Giza, CEO and Chair of the Management Board
Helen Giza CEO and Chair of the Management Board Fresenius Medical Care
Slide 4: Our DNA is advancing kidney care
Our DNA is advancing kidney care We are rooted in a long history of innovation and growth 1996 - today 1996 Founding FME (merger of 2025 Fresenius Leading kidney Worldwide 2005 care company 2020 2024 Dialysis and 5008 platform 2006 (~300k patients National Medical launched 2019 FX CorAL FDA Acquisit
Slide 5: We are the leading kidney care company
We are the leading kidney care company Creating a future worth living. For patients. Worldwide. Every day. Care Delivery Value-Based Care Care Enablement We offer a tailored range of products and Dialysis services in our Bundled services We improve patient Dialysis products, services for own dialysi
Slide 6: Positioned to lead: attractive market positioning in every segment
Positioned to lead | Attractive market positioning in every segment Care Delivery World’s leading provider of ~300k ~48m ~78% kidney care services dialysis patients dialysis treatments of patients highly worldwide1 in 20241 recommend our service1 Value-Based Care #1 in kidney value-based care ~$7bn
Slide 7: A cash generative business set for further profitable growth
A cash generative business set for further profitable growth Fresenius Medical Care in FY 2024 Revenue Operating income 19.3 1.4 € billion € billion Free cash flow Leverage 1.7 2.9x € billion Net debt/EBITDA Fresenius Medical Care Capital Markets Day June 2025 Page 7
Slide 8: Proven execution: delivering on commitments of three-year turnaround
Proven execution | Delivering on commitments of three-year turnaround and transformation plan Accelerating momentum during final year of 2025 strategic plan Leadership changes | New MB members (CFO, Structural changes | Simplified and streamlined with Care Delivery, Legal, HR and Compliance) and cha
Slide 9: Proven execution: clear progress against key performance metrics
Proven execution | Clear progress against key performance metrics MARGIN IMPROVEMENT ON TRACK FME25 SAVINGS AHEAD OF PLAN Operating income margin¹ Accumulated FME25 sustainable annual savings in € million 567 9.5% 9.7% 10.2% 9.3% Group 346 7.9% 8.1% 6.0% 2.3% 131 1.9% 2022 2023 2024 2022 2023 2024 D
Slide 10: Franklin W. Maddux, M.D., Global Chief Medical Officer
Franklin W. Maddux, M.D. Global Chief Medical Officer and member of the Management Board Fresenius Medical Care
Slide 11: Attractive underlying business fundamentals intact
Attractive underlying business fundamentals intact Extrapolation from 2020 to 2035 +60% 1/3 +40% +90% Aging global Dialysis Hypertension Diabetes population patients Global population aged 65+1 One out of three people People living with diabetes3 People on maintenance dialysis4 worldwide has hyperte
Slide 12: Limited early identification and management of CKD despite prevalence
Limited early identification and management of CKD despite prevalence 45% of U.S. patients “crash” into dialysis Compared to “optimal” dialysis starts ▪ No prior CKD diagnosis or nephrology care ▪ Placement of permanent vascular access, such as an ▪ Initiation of dialysis via temporary catheter AV f
Slide 13: Patient flow: growth opportunity from new and existing patients
Patient flow | Growth opportunity from caring for new and existing patients Reducing outflows an important volume component Every market has a unique pattern of inflows and outflows OUTFLOW Low Stable with low churn Ideal growth zone Low inflow Inflow > Outflow Low outflow INFLOW Low High At risk St
Slide 14: Modeling U.S. kidney care patient flow dynamics
Modeling U.S. kidney care patient flow dynamics FME population impact model Initiation of dialysis Mortality CKD Dialysis Population 550,000 200 ~127,000/year 17% annual Population density (k) 40 Population density (k) 30 100 20 10 0 0 0 20 40 60 80 100 0 20 40 60 80 100 Age Age Pre-emptive Transpla
Slide 15: Modeling patient flow dynamics: patient inflow
Modeling U.S. kidney care patient flow dynamics | Patient inflow Scale of U.S. CKD/ESRD patient Complex U.S. patient population population (in million) ▪ 10-12 co-morbidities on average 10.5 – Hypertension (31%) – Diabetes (44%) – Glomerular diseases (6%) ▪ ~45% of patients “crash” into dialysis ▪ C
Slide 16: Modeling patient flow dynamics: ESRD patient outflow
Modeling U.S. kidney care patient flow dynamics | ESRD patient outflow Opportunity to reduce outflow and improve patient number growth U.S. patient outflow – baseline average Mortality ▪ Opportunity to improve through – High-volume HDF treatments Mortality Mortality 17% – Optimal dialysis starts – O
Slide 17: Key variables of CKD and ESRD population dynamics
Key variables of CKD and ESRD population dynamics Obesity trends and GLP-1A medications SGLT2i medication effects Relationship between CKD survival and future ESRD population trends High-volume hemodiafiltration (HVHDF) Other factors ▪ Value-based care ▪ COVID pandemic endemic Fresenius Medical Care
Slide 18: Current and future obesity trends in the U.S.
Current and future obesity trends in the U.S. Rates of obesity and severe obesity increasing1 Men Women 50% ▪ U.S. 1990-2021 | Obesity increased 158% Overweight in male and 186% in female adolescents² 40% ▪ U.S. 2050 (est.): 43 million children and 210 30% million adults with obesity² ▪ Higher perce
Slide 19: GLP-1A effects on CKD and ESRD populations
GLP-1A effects on CKD and ESRD populations GLP-1A not a cure for diabetes or GLP-1A effects on CKD/ESRD growth advanced CKD1 trends Decline in kidney function ▪ Introduced into high/growing obesity rate environment Difference in mean annual decline, 1.16 ml/min/1.73 m2 ▪ Implies maximum ACE-inhibito
Slide 20: SGLT2i demonstrates reduced CV mortality in CKD and ESRD populations
SGLT2i demonstrates reduced cardiovascular (CV) mortality in CKD and ESRD populations Time scales of SGLT2i-medicated delays of kidney disease progression in clinical studies Delayed CKD progression ≠ cure Dapagliflozin Empagliflozin Canagliflozin ▪ Evidence for reduction in CV mortality (Farxiga®)
Slide 21: How CONVINCE informs impact of HVHDF on patient survival
How CONVINCE informs impact of high-volume hemodiafiltration (HVHDF) on patient survival Quantified results from CONVINCE1 Novel treatment modality with many benefits Average extended life expectancy Improved Decreased ▪ Switching from high-flux HD to HVHDF results in average patient intradialytic r
Slide 22: Modest attenuations in CV mortality could lead to substantial ESRD growth
Modest attenuations in cardiovascular (CV) mortality could lead to substantial growth in ESRD population CKD 200 Dialysis 40 Population Population density (k) density (k) 30 100 20 10 0 0 0 20 40 60 80 100 0 20 40 60 80 100 Age Age Small improvement in survival in totalCV mortality CKD Stage 3 would
Slide 23: Looking to the future. Accelerating growth.
Looking to the future. Accelerating growth. +90% Dialysis 2025-2035e CAGR Medical trends and how we patients are participating HVHDF People on maintenance Patient number U.S. treatment yield dialysis growth Treatment Value-based care 3.7 ~7 Global growth further million million +4-5% accelerated by
Slide 24: Helen Giza, CEO and Chair of the Management Board
Helen Giza CEO and Chair of the Management Board Fresenius Medical Care
Slide 25: We lead kidney care through exceptional patient care and innovation
We lead kidney care through exceptional patient care and innovation Fresenius Medical Care
Slide 26: Our strategy will Reignite Value Creation
Our strategy will Reignite Value Creation Reignite Reignite Reignite the Core Growth & Innovation our Culture Drive profitable Develop together and Strengthen core growth and strengthen our operations innovation culture € Reignite Value Creation Fresenius Medical Care Capital Markets Day June 2025 P
Slide 27: Our strategy: Reignite the Core
Our strategy | Reignite the Core Be operationally excellent – with our core assets Reignite the Core Drive scalable, high-quality care to further enhance patient health Strengthen core Standardize and improve our operations to operations increase efficiency and margins Make focused investments in te
Slide 28: Our strategy: Reignite Growth and Innovation
Our strategy | Reignite Growth and Innovation Further enhance clinical outcomes and patient safety Reignite Growth & Innovation Increase R&D efficiency by developing a global product platform and products Launch HVHDF in the U.S. to set a new standard of care Drive profitable growth Leverage leading
Slide 29: Our strategy: Reignite our Culture
Our strategy | Reignite our Culture Become the employer of choice in healthcare Reignite our Culture Attract, retain and engage the best talent with a passion to make an impact Develop together and strengthen our culture Foster a culture of care and living our core values We Care, We Connect, We Com
Slide 30: We Care, We Connect, We Commit
Reignite Develop together and strengthen our culture Culture We Care We Connect We Commit deeply for our patients, our with employees, patients, to delivering industry-leading people, and for creating a customers and communities to outcomes, meeting the highest healthier, more sustainable set the st
Slide 31: Leveraging the power of vertical integration
Reignite FME | Leveraging the power of vertical integration Introduction of Value-Based Care as a separate segment Clinics recognize Care Care Provide customer needs to drive Delivery Enablement differentiated innovation in technology therapies to clinics €14.0bn Medical value creation €5.6bn Revenu
Slide 32: Our Ambition
Our Ambition Deliver both industry-leading outcomes and margins with above-market growth Fresenius Medical Care
Slide 33: Care Delivery
Care Delivery Reignite Reignite Reignite the Core Growth & Innovation our Culture Strengthen core Drive profitable Develop together operations growth and and strengthen our innovation culture € Reignite Value Creation Capital Markets Day June 2025 Page 33
Slide 34: Enhancing operational efficiency and strengthening realized rate
Reignite Enhancing operational efficiency and strengthening realized rate the Core to drive robust, sustainable financial performance Productivity and operational Improvements to realized excellence dialysis rates Managing payor and service mix by ensuring in-network access for patients Further stan
Slide 35: Care Delivery portfolio positioned for profitable growth
Reignite Care Delivery portfolio positioned for profitable growth the Core Care Delivery U.S. Care Delivery International Dialysis clinic network treating ▪ Provides dialysis therapy in ~25 core markets >200k patients in >2,600 clinics ▪ Primarily in EMEA and APAC regions across the U.S. Provides ou
Slide 36: Ensuring the right assets in the right markets
Reignite Ensuring we have the right assets in the right markets to support the Core patients and drive financial performance Strategic divestment to Continued footprint optimization strengthen performance Continuous, systematic review of U.S. dialysis clinic footprint Execution of select assets of S
Slide 37: Unlocking volume growth through clinical quality and patient experience
Reignite Unlocking volume growth through clinical quality enhancements Growth & and best-in-class patient experience Innovation Clinical quality to help patients live Exceptional experience longer and healthier to retain patients Accelerated quality and Seamless patient patient safety initiatives ac
Slide 38: Care Delivery: advancing to industry-leading margins by 2030
Reignite Care Delivery | Advancing to industry-leading margins by 2030 Value € Creation Path to mid-teens operating income margin aspiration Mid-teens 11.4% (Increasing inflow) Increasing patient new starts (Reducing outflow) Patient quality and safety, retention (Reducing outflow) U.S. HVHDF rollou
Slide 39: Value-Based Care
Value-Based Care Reignite Reignite Reignite the Core Growth & Innovation our Culture Strengthen core Drive profitable Develop together operations growth and and strengthen our innovation culture € Reignite Value Creation Capital Markets Day June 2025 Page 39
Slide 40: Rapidly evolving VBC market plays important role
Rapidly evolving VBC market plays an important role in the industry and our future Renal VBC is a large and growing market Currently poised for stability and growth phase CKD 4-5 MCUM1 ESRD2 MCUM1 ▪ Value-based kidney care 11% 12% Emergence recognized as a critical 2010 - 2018 opportunity for payors
Slide 41: Interwell Health is the leading, differentiated player in renal VBC
FME’s Value-Based Care company Interwell Health is the leading, differentiated player in renal VBC Three unique sources of differentiation 2024 Business at a glance Connectivity to FME 25% 82% 82% of ESRD patients have access to an FME $7bn Subcap dialysis clinic 49% Medical Shared risk costs under
Slide 42: Strong reputation for high quality and clinical results
We have established a strong reputation for high quality and meaningful clinical results for patients 2.5x optimal start rates compared to national averages improving patient survival on dialysis 80% of FME KCEs qualified as high performers in the Kidney Care Choices Program 80% of gross savings in
Slide 43: Vertical integration creates an advantage for VBC
Our vertical integration creates an advantage for this growing business and we are lending greater visibility into performance Benefits of vertical integration Visible value creation VBC creates value for FME Initiating new reporting segment to ▪ VBC directly improves outcomes and survival for dialy
Slide 44: Value-Based Care: responsibility for integrated health care of patients
Reignite Reignite Value-Based Care | We take responsibility for the the Core Growth & integrated health care of our patients Innovation Creating mutual value between Drive profitable growth and FME and VBC through key quality innovation and outcomes initiatives Focus on patient engagement to Optimal
Slide 45: Value-Based Care: path to profitable growth
Reignite Value-Based Care | Path to profitable growth Value € Creation Path to low single digit operating income margin aspiration Low Low single single digit digit Shifting contract mix towards more profitable segments Reducing medical cost (e.g. enhancing patient engagement) Cost efficiencies / sy
Slide 46: Care Enablement
Care Enablement Reignite Reignite Reignite the Core Growth & Innovation our Culture Strengthen core Drive profitable Develop together operations growth and and strengthen our innovation culture € Reignite Value Creation Capital Markets Day June 2025 Page 46
Slide 47: Commercial excellence and operational efficiency in Care Enablement
Reignite Commercial excellence and operational efficiency will enable the Core robust growth and margin expansion in Care Enablement Above-the-market growth, value- Operational excellence based pricing and share gain Geographic expansion in Restructuring of manufacturing profitable markets footprin
Slide 48: Attractive, industry-leading renal MedTech portfolio
Reignite Attractive, industry-leading renal MedTech portfolio the Core Care Enablement ▪ €5.6bn FY 2024 revenue, across three verticals: In-Center EMEA Home U.S. APAC Critical Care ▪ Globally, and in each region, in- center represents the majority of revenues ▪ In-center mix, broadly LatAm – 25% mac
Slide 49: Leveraging global market share to drive pricing and contracting
Reignite Leveraging attractive global market share to continue to drive the Core pricing and contracting excellence FY 2024 | Market share distribution In-center HD products Home products (PD & HHD) Critical care FME 40% Competitor 1 62% Competitor 1 37% Competitor 1 10% FME 26% FME 30% All other Co
Slide 50: Grow our market leader position and transform kidney care
Reignite Grow our market leader position and transform kidney care Growth & Innovation In-Center Home Critical Care Drive market to outcome- Drive growth of Home HD Achieve market leadership improving therapies with expansion of premium Grow PD share in profitable product portfolio in Introduce digi
Slide 51: Care Enablement: accelerating profitable growth to 2030
Reignite Care Enablement | Accelerating profitable growth to 2030 Value € Creation Path to mid-teens operating income margin aspiration Mid-teens 6.0% Pricing excellence and market share expansion U.S. HVHDF (5008X) rollout Focused R&D program | Innovation FME25+ Operational and process efficiencies
Slide 52: Strategy in action: U.S. HVHDF roll-out
Strategy in action U.S. HVHDF roll-out Reignite Reignite Reignite the Core Growth & Innovation our Culture Strengthen core Drive profitable Develop together operations growth and and strengthen our innovation culture € Reignite Value Creation Capital Markets Day June 2025 Page 52
Slide 53: U.S. HVHDF roll-out: game changer to transform standard of care
U.S. HVHDF roll-out | Game changer to transform the standard of care in the U.S. and leverage FME’s vertical integration Potential to improve Streamlining clinic operations Accelerating FME’s thousands of patient lives to drive highest quality care performance ▪ Better outcomes for patients – 23% ▪
Slide 54: U.S. HVHDF roll-out: strategic approach to stakeholders
U.S. HVHDF roll-out | Strategic approach to benefit stakeholders across renal community Preparation for commercial launch with comprehensive consideration across all key stakeholders Dialysis patients Engagement with and education for dialysis patients on HVHDF benefits, quality of life improvement,
Slide 55: U.S. HVHDF roll-out: Care Enablement
U.S. HVHDF roll-out | Care Enablement Annual 5008X U.S. addressable market production capacity 90% machine market share Up to 20,000 ▪ Total U.S. in-center HD machines ~160k ▪ Current installed base of 2008T ~145k Around 15,000 66% of external disposable market share of 2008T installed base Aspirati
Slide 56: U.S. HVHDF roll-out: Care Delivery
U.S. HVHDF roll-out | Care Delivery Improved mortality rates following HVHDF Planned 5008X penetration in FME clinics penetration ▪ Survival benefits in CONVINCE emerge after 3 months 2026e 15% - 30% ▪ 4.4% fewer deaths over 2.5 years of therapy with HVHDF, reflecting a 23% lower risk of mortality o
Slide 57: How our strategy enables Value Creation
How our strategy enables Value Creation Reignite Reignite Reignite the Core Growth & Innovation our Culture Strengthen core Drive profitable Develop together operations growth and and strengthen our innovation culture € Reignite Value Creation Capital Markets Day June 2025 Page 57
Slide 58: Advancing to industry-leading margins
Reignite Advancing to industry-leading margins Value € Creation 2030 segment margin aspirations1 2030 group margin aspiration1 2024 2030e Care Delivery 11.4% Mid-teens Mid-teens Care Enablement 6.0% Mid-teens 9.3% Value-Based Low single -1.6% 2024 2030e Care digit 1 Assuming no major disruptions as
Slide 59: Strong cash generation to drive enhanced shareholder returns
Reignite Strong cash generation to drive enhanced shareholder returns Value € Creation New capital allocation framework Invest in core business for profitable growth New dividend policy 30% to 40% Shareholder payout ratio of adjusted net income >€2.5bn returns from excess cash Operating cash flow, a
Slide 60: Martin Fischer, CFO
Martin Fischer CFO and member of the Management Board Fresenius Medical Care
Slide 61: Financial profile: strong track record of delivered improvements since 2022
Financial profile | Strong track record of delivered improvements since 2022 Transparency & Focus Global segments CD and CE started in January 2023 Strongly enhanced internal data availability and reporting Profitability Capital allocation FME25 savings target expanded twice Strict financial policy
Slide 62: FME 2030: advancing to industry-leading margins
FME 2030 | Advancing to industry-leading margins Operating income1 margin aspirations by 2030 Assumptions to margin aspirations 2024 2030e ▪ Patient number growth of 4-5% p.a. globally and of 2 plus % in the U.S. Fresenius 9.3% Mid-teens Medical Care ▪ Moderate reimbursement rate increases and conti
Slide 63: Reporting transparency: Care Delivery and Value-Based Care as separate segments
Reporting transparency | Care Delivery and Value-Based Care as separate segments going forward Revenue Operating income Highlights in € million; organic growth1 in % in € million; excluding special items, growth in % at cc 20231 2024 20231 2024 2030e Care Care Delivery Delivery Margin Aspiration ▪ O
Slide 64: Extending FME25+: additional €300m savings until 2027
Extending FME25+ | Additional €300m savings until 2027 through operational efficiencies to drive sustainable earnings growth 2021-2027e FME25+ additional savings until 2027e €1,050m €300m Planned phasing of FME25+ in € million Care Delivery ▪ Supply chain optimization 2025e 2026–2027e ~20% ~40% ▪ Cl
Slide 65: Reignite Value Creation: priorities focus on shareholder value
Reignite Value Creation | Clear set of priorities focus on shareholder value generation Invest in core business Cash generation for profitable growth Strong cash generation to further increase over time Operating cash flow of 13-15% of revenue in 2025-2030e Capital allocation Return of >€2.5bn exces
Slide 66: Reignite Core: capex of €0.8 to €1bn annually
Reignite Core | Capex of €0.8 to €1bn annually for sustainable profitable growth Capex development ▪ Capex focused on organic growth of core Net Capex for PP&E % of revenues business 6.4% 5.8% 4.7% 3.5% 3.4% 3.5% 4-5% ▪ Capture growth opportunities, invest in further target enhance quality levels, p
Slide 67: Optimal capital structure: financial leverage refined to 2.5x to 3.0x
Optimal capital structure | Financial leverage refined to 2.5x to 3.0x Net financial leverage ratio ▪ Successful deleveraging in the past quarters on 4.0 Ratio of net debt to EBITDA the back of improving operating income and proceeds from portfolio optimization 3.5 3.4x ▪ New self-imposed target ban
Slide 68: Optimal capital structure: sound and proven financing strategy
Optimal capital structure | Building on sound and proven financing strategy Updated, further balanced maturity profile1 Strong access to debt capital market in € million ▪ In line with our business profile, targeting both 2,000 EUR and USD bond markets is a cornerstone for our financing strategy 1,6
Slide 69: Attractive new dividend policy
Reignite Value Creation | Attractive new dividend policy Dividend development Dividend to be based on payout ratio of 30% to 40% of net income1 excluding Dividend payout ratio (based on net income1 excl. special items) special items 23% 24% 27% 30% 28% 29% 39% 36% 46% 47% ▪ Long-term track record of
Slide 70: New regular share buyback program
Reignite Value Creation | New regular share buyback program Focus on attractive shareholder return and Initial share buyback program of €1bn value creation within two years ▪ Intention to acquire own shares on the stock Share buybacks to complement new dividend exchange and to cancel them policy as
Slide 71: Future financial profile
Future financial profile | Investment in profitable growth, optimized capital structure and return of excess capital to shareholders Transparency & Focus Further increase through additional VBC segment as of Q2 2025 reporting Further enhancing internal data availability and reporting Profitability C
Slide 72: Helen Giza, CEO and Chair of the Management Board
Helen Giza CEO and Chair of the Management Board Fresenius Medical Care
Slide 73: 2030 Aspiration
Reignite the Core Reignite Growth & Innovation Reignite our Culture 2030 Aspiration Mid-teens percent operating income margin Reignite Value Creation 30-40% dividend payout plus share buyback program
Slide 74: Contacts
Contacts Fresenius Medical Care AG Investor Relations Else-Kröner-Str. 1 61352 Bad Homburg v. d. H. Germany Dr. Dominik Heger Ilia Kuerten Alicia Cahill ir@FreseniusMedicalCare.com Head of Investor Relations Vice President Senior Director and Investor Relations Investor Relations Ticker: Head of I