Fresenius Medical Care Ag · XETR:FME
Fresenius Medical Care — Q2 2025 Earnings Presentation
65 slides from Fresenius Medical Care's earnings presentation, September 2025
Slide 1: Fresenius Medical Care AG Investor Presentation Q2 2025
Fresenius Medical Care AG Investor Presentation Q2 2025 September 2025
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: Agenda
1 FME at a glance, markets & growth drivers 2 FME Reignite 3 U.S. HDF opportunity 4 Capital allocation 5 Q2 2025 business update 6 Outlook 2025 & 2030 aspirations
Slide 4: We are the leading kidney care company
FME | We are the leading kidney care company Q4 2024 Conference Call 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 prod
Slide 5: Attractive market positioning in every segment
FME | Attractive market positioning in every segment Q4 2024 Conference Call Care Delivery World’s leading provider of ~300k ~48m ~78% kidney care services Dialysis patients worldwide1 Dialysis treatments of patients highly recommend our service1 in 20241 Value-Based Care #1 in kidney value-based ca
Slide 6: Leveraging the power of vertical integration
FME | Leveraging the power of vertical integration Q4 2024 Conference Call 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 Revenue 2024 Revenue 2024 Patient data and ins
Slide 7: Proven execution | Clear progress against key performance metrics
Proven execution | Clear progress against key performance metricsConference Q4 2024 Call 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% Care Delivery 6.0% 1.9% 2.3
Slide 8: Growth drivers | Attractive underlying business fundamentals intact
Growth drivers | Attractive underlying business fundamentals intactConference Q4 2024 Call 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 mai
Slide 9: Patient inflow | U.S. kidney care patient flow dynamics
Patient inflow | U.S. kidney care patient flow dynamics Q4 2024 Conference Call 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” in
Slide 10: Looking to the future | Accelerating growth
Looking to the future | Accelerating growth Q4 2024 Conference Call +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 Value-based care ~7 Treatment 3.7 Global growth further million milli
Slide 11: Q2 2025 Highlights
Q2 2025 Highlights | Growing patient inflow was offset by higher-than- Q4 2024 Conference Call expected patient outflow Key developments in Q2 2025 Accelerated number of patient referrals and new starts Severe flu season in the U.S. in the first months of the year resulted in − Significantly inc
Slide 12: Agenda
1 FME at a glance, markets & growth drivers 2 FME Reignite 3 U.S. HDF opportunity 4 Capital allocation 5 Q2 2025 business update 6 Outlook 2025 & 2030 aspirations
Slide 13: FME Reignite | Our strategy will Reignite Value Creation
FME Reignite | Our strategy will Reignite Value Creation Q4 2024 Conference Call 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 Investor Presen
Slide 14: Care Delivery | Portfolio positioned for profitable growth
Care Delivery | Portfolio positioned for profitable growth Q4 2024 Conference Call 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. Pro
Slide 15: Care Delivery | Operational efficiency and realized rate
Care Delivery | Enhancing operational efficiency and strengthening Conference Reignite Q4 2024 the CoreCall realized rate to drive robust, sustainable financial performance Productivity and operational Improvements to realized excellence dialysis rates Managing payor and service mix by ensuring in-n
Slide 16: Care Delivery | Right assets in the right markets
Care Delivery | Ensuring we have the right assets in the right Reignite Q4 2024 the Core Conference Call markets to support patients and drive financial performance Strategic divestment to Continued footprint optimization strengthen performance Continuous, systematic review of U.S. dialysis clinic f
Slide 17: Care Delivery | Volume growth through clinical quality and patient experience
Reignite Care Delivery | Unlocking volume growth through clinical quality Q4 2024 Growth & Conference Call enhancements and best-in-class patient experience Innovation Clinical quality to help patients live Exceptional experience longer and healthier to retain patients Accelerated quality and Seamle
Slide 18: Care Delivery | Strategic growth drivers to accelerate growth
Reignite Care Delivery | Strategic growth drivers to accelerate growth Q4 2024 Growth & Conference Call Innovation Growth acceleration program targets four areas of clinic operations Build a culture to recruit and retain Design and pilot solutions for the future direct patient care staff to alleviat
Slide 19: Value-Based Care | Rapidly evolving market
Value-Based Care | Rapidly evolving market plays an important role Conference in theQ4 2024 Call 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 criti
Slide 20: Value-Based Care | A leading and differentiated player in renal VBC
Value-Based Care | A leading and differentiated player in renal VBC Conference Q4 2024 Call 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 CKCC ma
Slide 21: Value-Based Care | Vertical integration an advantage
Value-Based Care | Vertical integration an advantage and we have enhancedQ4 2024 Conference Call 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
Slide 22: Value-Based Care | Integrated health care of our patients
Reignite Value-Based Care | We take responsibility for the Reignite the Core Q4 2024 Growth & Conference Call 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 patie
Slide 23: Care Enablement | Industry-leading renal MedTech portfolio
Care Enablement | Attractive and industry-leading renal MedTech portfolio Q4 2024 Conference Call 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 m
Slide 24: Care Enablement | Grow our market leader position
Reignite Care Enablement | Grow our market leader position Reignite the Core Q4 2024 Growth & Conference Call and transform kidney care Innovation 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 1
Slide 25: Care Enablement | Commercial excellence and operational efficiency
Care Enablement | Commercial excellence and operational Reignite Q4 2024 the Core Conference Call efficiency to enable robust growth and margin expansion Above-the-market growth, value- Operational excellence based pricing and share gain Geographic expansion in Restructuring of manufacturing profi
Slide 26: Agenda
1 FME at a glance, markets & growth drivers 2 FME Reignite 3 U.S. HDF opportunity 4 Capital allocation 5 Q2 2025 business update 6 Outlook 2025 & 2030 aspirations
Slide 27: U.S. HVHDF opportunity | Addressable market
U.S. HVHDF opportunity | Addressable market Q4 2024 Conference Call 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
Slide 28: U.S. HVHDF opportunity | Transforming the standard of dialysis care
U.S. HVHDF opportunity | Transforming the standard of dialysis care in the Q4 2024 Conference Call U.S. market 5008X launch has potential to improve patient care and accelerate sustainable Care Delivery growth Key benefits to Care Delivery Innovative therapy with potential to improve patient outcome
Slide 29: U.S. HVHDF opportunity | Planned roll-out in FME clinics
U.S. HVHDF opportunity | Planned roll-out in FME clinics Q4 2024 Conference Call 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 HVHD
Slide 30: Agenda
1 FME at a glance, markets & growth drivers 2 FME Reignite 3 U.S. HDF opportunity 4 Capital allocation 5 Q2 2025 business update 6 Outlook 2025 & 2030 aspirations
Slide 31: Capital allocation | Clear set of priorities
Capital allocation | Clear set of priorities focus on shareholder valueConference Q4 2024 Call creation 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
Slide 32: Capital allocation | New regular share buyback program
Capital allocation | New regular share buyback program Q4 2024 Conference Call 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 can
Slide 33: Optimal capital structure | Building on sound financing strategy
Optimal capital structure | Building on sound and proven financing Conference strategy Q4 2024 Call Diversified financing mix1 Prudent financial policy Other2 1% Schuldschein Loans 2% Sufficient liquidity reserve Undrawn ESG-linked Revolver Credit Facility of €2.0bn USD Bonds 23% Committed bilat
Slide 34: Agenda
1 FME at a glance, markets & growth drivers 2 FME Reignite 3 U.S. HDF opportunity 4 Capital allocation 5 Q2 2025 business update 6 Outlook 2025 & 2030 aspirations
Slide 35: Q2 2025 | Key developments at Group level
Q2 2025 | Key developments at Group level Q4 2024 Conference Call Q2 Strong organic revenue growth1 of 7% supported by all operating segments FME25+ savings of EUR 58 million contributed to earnings Operating income2 grew by 13% at constant currency, further driving margin expansion Operatin
Slide 36: Q2 2025 | Strong organic revenue growth and double-digit operating income growth
Q2 2025 | Strong organic revenue growth and double-digit operatingConference income Q4 2024 Call growth Revenue | in € million Operating income | in € million Margin in % +5.0% at cc¹ 8.9% 9.1% 9.9% 8.9% 4,766 +6.7% organic2 4,792 +0.5% as reported +12.9% at cc1 476 425 11 436 425 +9.2% -51 at curre
Slide 37: Q2 2025 | Group Operating income and margin bridge
Q2 2025 | Group Operating income and margin bridge Q4 2024 Conference Call Margin in % 9.1% 9.9% In € million 54 476 20 -1 -14 425 11 436 -16 425 -3 -51 Q2 2024 Special items Q2 2024 Care Value-Based Care Inter- Corporate Fx Q2 2025 Special items Q2 2025 operating operating Delivery Care Enablement
Slide 38: Q2 2025 | Care Delivery operating income and margin improvement
Q2 2025 | Care Delivery operating income and margin improvement Conference despiteQ4 2024 Call flat U.S. volumes Revenue | in € million Operating income | in € million Margin in % 10.9% -0.3% 11.2% +1.3% at cc¹ at current rate 3,481 +3.6% organic2 3,381 -2.9% as reported +5.3% at cc1 76 25 379 378 2
Slide 39: Q2 2025 | Value-Based Care revenue growth driven by member months
Q2 2025 | Value-Based Care revenue growth driven by member months Q4 2024 Conference Call Revenue | in € million Operating income | in € million Margin in % +28.4% at cc¹ 506 -44.4% +28.4% organic2 +22.0% as reported -1.5% at current rate -1.7% 415 -43.2% at cc1 -6 -3 1 -1 0 -9 Q2 2024 Business FME2
Slide 40: Q2 2025 | Care Enablement operating income and margin significantly up
Q2 2025 | Care Enablement operating income and margin significantly upQ4 2024 Conference Call Revenue | in € million Operating income | in € million Margin in % 4.9% +75.7% 8.7% +3.4% at cc¹ at current rate 1,363 +3.4% organic2 1,348 -1.1% as reported +79.4% at cc1 34 117 37 -17 -3 66 Q2 2024 Q2 202
Slide 41: Q2 2025 | Strong cash flow development and improved leverage ratio
Q2 2025 | Strong cash flow development and improved leverage ratio Q4 2024 Conference Call in € million Q2 2025 Q2 2024 ∆ in % H1 2025 H1 2024 ∆ in % Key developments Operating cash flow 775 442 75 938 570 65 Operating cash flow improved Capital expenditures, net -147 -153 -4 -289 -283 2 strongl
Slide 42: Agenda
1 FME at a glance, markets & growth drivers 2 FME Reignite 3 U.S. HDF opportunity 4 Capital allocation 5 Q2 2025 business update 6 Outlook 2025 & 2030 aspirations
Slide 43: FME25+ | Sustainable savings of €1.05bn until 2027
FME25+ | Sustainable savings of €1.05bn until 2027 through operational Q4 2024 Conference Call efficiencies to drive sustainable earnings growth 2021–2027e FME25+ sustainable savings 2026-2027e €1,050m €300m Planned phasing of FME25+ in € million Care Delivery Supply chain optimization 2025e 2026–
Slide 44: Outlook 2025 | Strong earnings growth
Outlook 2025 | Strong earnings growth Q4 2024 Conference Call FY 2025 Revenue & Operating Income Positive to a low-single digit Revenue percent growth FY 2024 basis: EUR 19,336 million Implied Group operating income margin around 11% to 12% High-teens to high-twenties Operating percent growth income
Slide 45: 2030 Aspirations | Advancing to industry-leading margins
2030 Aspirations | Advancing to industry-leading margins Q4 2024 Conference Call Operating income1 margin aspirations by 2030 Assumptions to margin aspirations 2024 2030e Patient number growth of 4-5% globally and of 2 plus % in the U.S. (2025-2035 CAGR) Fresenius 9.3% Mid-teens Medical Care Mod
Slide 46: Outlook 2025 and 2030 Aspirations | Revenue-relevant assumptions by segment
Outlook 2025 and 2030 Aspirations | Revenue-relevant assumptionsConference by Q4 2024Call segment Outlook 2025 2030 Aspirations FME Group Positive to a low-single digit percent growth at cc Broadly stable currency exchange rates Portfolio optimization: (realized in 2024) negative impact of aro
Slide 47: Appendix
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Slide 48: H1 2025 | Strong organic revenue growth and double-digit operating income growth
H1 2025 | Strong organic revenue growth and double-digit operatingConference income Q4 2024 Call growth Revenue | in € million Operating income | in € million Margin in % +3.1% at cc¹ 7.1% 8.8% 9.6% 7.8% 9,491 +6.1% organic2 9,673 +1.9% as reported +11.9% at cc1 933 167 838 757 671 +11.2% at current
Slide 49: H1 2025 | Group Operating income and margin bridge
H1 2025 | Group Operating income and margin bridge Q4 2024 Conference Call Margin in % 8.8% 9.6% In € million 91 933 37 -5 -2 167 838 -6 -20 757 671 -176 H1 2024 Special items H1 2024 Care Value-Based Care Inter- Corporate Fx H1 2025 Special items H1 2025 operating operating Delivery Care Enablement
Slide 50: H1 2025 | Care Delivery improved operating income and margin
H1 2025 | Care Delivery improved operating income and margin despite Q4 2024 Conference Call flat U.S. volumes Revenue | in € million Operating income | in € million Margin in % 10.1% +4.1% 10.7% -1.1% at cc¹ at current rate 6,962 +2.8% organic2 6,828 -1.9% as reported +5.2% at cc1 120 55 704 734 5,
Slide 51: H1 2025 | Value-Based Care revenue growth driven by member months
H1 2025 | Value-Based Care revenue growth driven by member months Q4 2024 Conference Call Revenue | in € million Operating income | in € million Margin in % 1.8% -0.5% +24.7% at cc¹ +24.7% organic2 1,035 +23.5% as reported 838 15 -18 1 -3 0 -5 H1 2024 Business FME25+ Inflation Fx translation H1 2025
Slide 52: H1 2025 | Care Enablement operating income and margin significantly up
H1 2025 | Care Enablement operating income and margin significantly upQ4 2024 Conference Call Revenue | in € million Operating income | in € million Margin in % 5.4% +62.1% 8.5% +4.1% at cc¹ at current rate 2,660 +4.1% organic2 2,715 +2.0% as reported +63.0% at cc1 70 231 56 -35 -2 142 H1 2024 H1 20
Slide 53: Q2 2025 | Profit and Loss
Q2 2025 | Profit and Loss Q4 2024 Conference Call Q2 2025 Q2 2024 Growth Growth € million € million in % in % cc Revenue 4,792 4,766 1 5 Operating income 425 425 0 3 Operating income margin in % 8.9 8.9 Operating income excl. special items 476 436 9 13 Operating income margin excl. special items in
Slide 54: H1 2025 | Profit and Loss
H1 2025 | Profit and Loss Q4 2024 Conference Call H1 2025 H1 2024 Growth Growth € million € million in % in % cc Revenue 9,673 9,491 2 3 Operating income 757 671 13 13 Operating income margin in % 7.8 7.1 Operating income excl. special items 933 838 11 12 Operating income margin excl. special items
Slide 55: Q2 2025 | 2024 base for 2025 targets, reconciliation adjustments
Q2 2025 | 2024 base for 2025 targets, reconciliation adjustments Q4 2024 Conference Call Reconciliation of non-IFRS financial measures to the most directly comparable IFRS financial measures for comparison with outlook Inter-segment Group Care Delivery Value-Based Care Care Enablement Corporate elim
Slide 56: H1 2025 | 2024 base for 2025 targets, reconciliation adjustments
H1 2025 | 2024 base for 2025 targets, reconciliation adjustments Q4 2024 Conference Call Reconciliation of non-IFRS financial measures to the most directly comparable IFRS financial measures for comparison with outlook Inter-segment Group Care Delivery Value-Based Care Care Enablement Corporate elim
Slide 57: Debt
Debt Q4 2024 Conference Call Q2 2025 FY 2024 FY 2023 € million € million € million Debt Short-term debt from unrelated parties 24 2 457 + Current portion of long-term debt 990 575 487 + Current portion of lease liabilities from unrelated parties 564 616 593 + Current portion of lease liabilities fro
Slide 58: EBITDA
EBITDA Q4 2024 Conference Call Reconciliation of adjusted EBITDA and net leverage ratio to the most directly comparable IFRS financial measures LTM Q2 2025 FY 2024 FY 2023 € million € million € million Net income 844 741 732 + Income tax expense 317 316 301 − Interest income -75 -72 -88 + Interest e
Slide 59: Return on Invested Capital (ROIC)
Return on Invested Capital (ROIC) Q4 2024 Conference Call 12.4% 8.6% 7.8% 8.0% 8.0% 7.1% 6.6% 6.1% 5.1% 4.5% 5.0% adj. 5.8% 3.9% 4.9% 3.6% 3.9% rep. 3.3% 3.5% 2.8% 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Q2 2025 For the years 2015-17 ROIC as reported within the Form 20-F. ROIC adjusted
Slide 60: Exchange rates, U.S. dialysis days per quarter, definitions
Exchange rates, U.S. dialysis days per quarter, definitions Q4 2024 Conference Call Exchange rates U.S. dialysis days per quarter Q1 Q2 Q3 Q4 Full year H1 2025 FY 2024 FY 2023 2025 76 78 79 79 312 €:USD Period end 1.172 1.039 1.105 2024 77 78 79 80 314 Average 1.092 1.082 1.081 2023 77 78 79 79 313
Slide 61: Key metrics for Care Delivery and Value-Based Care
Key metrics for Care Delivery and Value-Based Care Q4 2024 Conference Call Care Delivery as of June 30, 2025 as of June 30, 2024 Patients Treatments Clinics Patients Treatments Clinics United States 206,259 15,327,129 2,627 206,306 15,412,884 2,628 Growth in % 0 -1 0 International 94,080 6,987,137 1
Slide 62: Continuous monitoring of clinical performance to enhance care
Continuous monitoring of clinical performance to enhance care Q4 2024 Conference Call Quality index components Dialysis effectiveness Measures how sufficiently the body is cleansed of waste substances Vascular access Quality index Measures the share of patients who do not receive dialysis via a dial
Slide 63: Segment information for FY 2021, 2022, 2023 and 2024
Segment information for FY 2021, 2022, 2023 and 2024 Q4 2024 Conference Call € million; % change year-over-year FY 2024 Growth Growth at cc Organic growth FY 2023 FY 2022 FY 2021 Total Revenue 19,336 -1 0 4 19,454 19,398 17,619 Operating income 1,392 2 3 1,369 1,512 1,852 Operating income excl. spec
Slide 64: Conferences & Roadshows | IR event calendar
IR event calendar Q4 2024 Conference Call Date Event Reporting August 5, 2025 Report on Q2 2025: Earnings Release and Conference Call November 4, 2025 Report on Q3 2025: Earnings Release and Conference Call February 24, 2026 Report on Q4/FY 2025: Earnings Release and Conference Call August 6, 2025 Q
Slide 65: Fresenius Medical Care AG Investor Relations
Dr. Dominik K. Heger Ilia Kuerten Fresenius Medical Care AG Investor Relations Head of Investor Relations, Vice President Else-Kröner-Str. 1 Strategic Development & Investor Relations Communications | EVP 61352 Bad Homburg v. d. H. Germany ir@FreseniusMedicalCare.com +49(0) 6172-609-2525 +49(0) 61
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