Fresenius Medical Care delivers strong organic revenue growth and double-digit operating income growth in the second quarter of 2025
Strong organic revenue growth1 of 7% driven by all operating segments
Stable U.S. same market treatment development driven by accelerating patient inflow
FME25+ savings of EUR 58 million contributed to earnings
Operating income2 grew by 13% at constant currency, further driving margin expansion
Stable reported operating income and 20% increase in reported net income3
Operating cash flow improved strongly by 75%, net leverage ratio improved to 2.7x
FY 2025 outlook confirmed
First tranche of announced share buyback to be initiated in August
BAD HOMBURG, Germany, Aug. 5, 2025 /PRNewswire/ -- "In the second quarter of 2025, we further improved our operational performance as strong organic revenue growth and double-digit operating income growth put us fully on track to deliver our full year 2025 financial outlook", said Helen Giza, Chief Executive Officer of Fresenius Medical Care AG. "Organic revenue growth of 7% was supported by all operating segments. The overall phasing of earnings in the first half of the year developed in line with our planning. Strong profitability gains in Care Enablement led to double-digit operating income growth. Care Delivery also drove improvements in operating income and margin, despite flat U.S. volume development. We remain encouraged by the strong and accelerating momentum in patient referrals that continued in the second quarter. However, this positive development in patient inflow was offset by higher-than-expected patient outflow driven by continued elevated mortality and a greater number of missed treatments following the severe flu season in the first months of the year. In the second half of the year, we expect to realize further significant operational and financial improvements." Giza added: "Reflecting our confidence and the strong cash generation, we are about to initiate the first tranche of the announced share buyback in August."
Key figures Q2 and H1 2025 (unaudited)
Q2 2025
Q2 2024
Growth
Growth
H1 2025
H1 2024
Growth
Growth
EUR m
EUR m
yoy
yoy, cc
EUR m
EUR m
yoy
yoy, cc
Revenue
4,792
4,766
1 %
5 %
9,673
9,491
2 %
3 %
Operating income
425
425
0 %
3 %
757
671
13 %
13 %
excl. special items2
476
436
9 %
13 %
933
838
11 %
12 %
Net income3
225
187
20 %
23 %
376
258
46 %
46 %
excl. special items2
268
212
26 %
30 %
514
400
28 %
29 %
Basic EPS (EUR)
0.77
0.64
20 %
23 %
1.28
0.88
46 %
46 %
excl. special items2
0.91
0.72
26 %
30 %
1.75
1.36
28 %
29 %
yoy = year-on-year, cc = at constant currency, EPS = earnings per share
Strategic execution on track
Fresenius Medical Care, the world's leading provider of products and services for individuals with renal disease, maintained strong focus on the execution of its strategic plan. During the second quarter of 2025, the FME25+ transformation program continued its positive momentum, delivering EUR 58 million additional sustainable savings while related one-time costs, treated as special items, amounted to EUR 53 million. The Company confirms its full year FME25+ target of around EUR 180 million additional annual savings, totaling to EUR 1,050 million by year end 2027. The Company assumes related one-time costs of EUR 100 million to 150 million in 2025 and EUR 1,000 million to 1,050 million for the total program.
The Company continues the execution of its portfolio optimization plan to exit non-core and margin-dilutive assets. Special items associated with portfolio optimization amounted to negative EUR 6 million in the second quarter.
All transactions that were realized as part of Fresenius Medical Care's portfolio optimization plan in 2024 are estimated to negatively impact full year 2025 Group revenue growth by around one percent. Related costs will be treated as special items in operating income.
As part of the new capital allocation framework, as presented at its recent Capital Markets Day, Fresenius Medical Care commits to return excess capital to shareholders. The Company announced an initial share buyback of EUR 1 billion within two years. The Company intends to initiate the first tranche of the program in August.
Organic revenue growth1 across all segments
In the second quarter 2025, Group revenue increased by 1% (+5% at constant currency, +7% organic1) to EUR 4,792 million. Divestitures realized as part of the portfolio optimization plan affected the revenue development by -110 basis points.
Care Delivery revenue decreased by 3% (+1% at constant currency, +4% organic1) to EUR 3,381 million. Divestitures realized as part of the portfolio optimization plan affected the revenue development by -190 basis points.
In Care Delivery U.S., revenue decreased by 2% (+3% at constant currency, +3% organic1) to EUR 2,817 million. Reimbursement rate increases and a favorable payor mix development had a positive impact while exchange rates developed unfavorably. The severe flu season in the U.S. in the first months of the year resulted in significantly increased mortality compared to the elevated mortality level in the prior year. This impacted the treatment numbers in the second quarter and for the remainder of the year. The effect was partially offset in the second quarter by an accelerated number of patient new starts. Therefore, U.S. same market treatment growth came in flat year-on-year.
In Care Delivery International, revenue decreased by 8% (-8% at constant currency, +5% organic1) to EUR 564 million. The effect of closed or sold operations, mainly related to portfolio optimization, were partially offset by organic growth1. Same market treatment growth amounted to +1.7%.
Fresenius Medical Care now reports Value-Based Care, previously part of Care Delivery, as a standalone segment. The new segmentation reflects the growing importance of this business and the Company's clear commitment towards enhancing financial reporting transparency. Value-Based Care revenue grew by 22% (+28% at constant currency, +28% organic1) to EUR 506 million, mainly driven by significantly higher number of member months due to contract expansion, while exchange rates developed unfavorably.
Care Enablement revenue declined by 1% (+3% at constant currency, +3% organic1) to EUR 1,348 million. Volume growth and continued positive pricing momentum was offset by unfavorable exchange rate effects.
Within Inter-segment eliminations4, revenue for services provided and products transferred between the operating segments at fair market value came in 10% below prior year at negative EUR 443 million (-6% at constant currency). In line with the new segment reporting, services provided by the Care Delivery segment for patients managed under the Value-Based Care segment are now being included within inter-segment eliminations.
In the first half 2025, Group revenue increased by 2% (+3% at constant currency, +6% organic¹) to EUR 9,673 million. Divestitures realized as part of the portfolio optimization plan impacted the revenue development by ‑190 basis points. Care Delivery revenue decreased by 2% (-1% at constant currency, +3% organic1) to EUR 6,828 million, with Care Delivery U.S. growing by 1% (+2% at constant currency, +2% organic1) to EUR 5,709 million and Care Delivery International decreasing by 14% (-14% at constant currency, +5% organic1) to EUR 1,119 million. Divestitures realized as part of the portfolio optimization plan affected the revenue development of Care Delivery by -300 basis points and the revenue development of Care Delivery International by -1,600 basis points. U.S. same market treatment growth came in flat while International same market treatment growth improved to 2.1%. Value-Based Care revenue increased by 24% (+25% at constant currency, +25% organic1) to EUR 1,035 million. Care Enablement revenue increased by 2% (+4% at constant currency, +4% organic1) to EUR 2,715 million. Inter-segment eliminations decreased by 7% (-6% at constant currency) to a deduction of EUR 905 million.
Double-digit operating income growth and further margin expansion
In the second quarter 2025, Group Operating income remained stable (+3% at constant currency) at EUR 425 million, resulting in a margin of 8.9% (Q2 2024: 8.9%). Operating income excluding special items increased by 9% (+13% at constant currency) to EUR 476 million, resulting in a margin2 of 9.9% (Q2 2024: 9.1%). Divestitures realized during the second quarter were neutral on operating income margin development.
Operating income in Care Delivery increased by 3% (+9% at constant currency) to EUR 346 million, resulting in a margin of 10.2% (Q2 2024: 9.6%). Operating income excluding special items came in flat (+5% at constant currency) at EUR 378 million, resulting in a margin2 of 11.2% (Q2 2024: 10.9%). Compared to previous year, operating income development was driven by positive price effects, the impact from phosphate binders, and savings from the FME25+ program. The development was negatively impacted by higher personnel expenses due to planned merit increases and unfavorable medical benefit costs as well as other inflationary cost increases.
Operating income in Value-Based Care amounted to a loss of EUR 9 million, compared to a loss of EUR 6 million in the prior year, resulting in a margin of -1.7% (Q2 2024: -1.5%). Identically, operating income excluding special items amounted to a loss of EUR 9 million, compared to a loss of EUR 6 million in the prior year, resulting in a margin2 of -1.7% (Q2 2024: -1.5%). The development was mainly driven by an unfavorable savings rate and inflation, while the effect from an increase in member months contributed positively.
Operating income in Care Enablement increased by 36% (+39% at constant currency) to EUR 89 million, resulting in a margin of 6.6% (Q2 2024: 4.8%). Operating income excluding special items significantly increased by 76% (+79% at constant currency) to EUR 117 million, resulting in a margin2 of 8.7% (Q2 2024: 4.9%). The improvement compared to the previous year's quarter was mainly driven by globally higher volumes and positive ...
