2025 SASB Index

Health Care Delivery

(1) 10,768,176 GJ (3 million MWh)
(2) 41%
(3) 18%

For further information on energy management, see chapter "Climate Change"  in our Sustainability Statement.

We report data on waste as well as recycling and treatment methods in the Sustainability Statement.

Note: Reported waste figures do not exclusively cover medical and pharmaceutical waste but encompass all waste generated across our operations. .

For an overview of our waste treatment methods, please see chapter "Resource Use and Circular Economy"  in our Sustainability Statement.

Fresenius Medical Care manages patients’ personal information in full alignment with its Global Privacy Principles. For every processing activity — including collection, access, use, sharing, or transfer of personal data — we carefully assess the scope, purpose, and legal basis to ensure compliance with applicable privacy laws and internal policies.
We are committed to transparency and accountability. Patients, employees, and customers are proactively informed about:
• the types of personal data we process,
• the purposes of processing,
• the legal grounds for processing, and
• their rights under relevant privacy regulations, including the right to access, correct, or update their data.
• other relevant information according to the applicable laws and regulations.
In addition, we employ robust technical and organizational measures to safeguard personal and health information across all digital systems, ensuring confidentiality, integrity, and availability of data in accordance with GDPR, HIPAA, and other applicable standards.

For more information about our policies and practices for protecting patients’ health information, please see the "Protecting Data" chapter in our latest Sustainability statement.

Fresenius Medical Care did not incur monetary losses during the reporting period as a result of legal proceedings associated with data security and privacy, (meaning any adjudicative proceedings before a court, regulator, arbitrator or otherwise).

All relevant legal proceedings and related financial effects are disclosed in our Annual Report – Notes to the Consolidated Financial Statements.

In our dialysis clinics, we treat patients with all kinds of insurance status. In the United States, the insurance mix includes the federal health insurance programs Medicare and Medicaid, as well as private/alternative payors such as commercial insurance and private funds.
For information on our efforts to expand access to high-quality care for more patients, see chapter "Patients" in our Sustainability Statement and the Economic Report.

The United States (US) dialysis services business does not permit controlled substances to be kept or administered in its outpatient dialysis units. Nephrologists and other providers cannot prescribe controlled substances to be administered to patients as part of the dialysis treatment.
Fresenius Rx (located in the US) does not supply controlled substances.
Azura Vascular Care (located in the US) has policies and procedures consistent with all Controlled Substance Regulations found within the Center for Medicare and Medicaid Services (CMS), the Drug Enforcement Administration (DEA), and accrediting bodies. Azura’s internal and external medication management programs are comprehensive in terms of efficiency, meeting regulatory requirements, and keeping patients safe. Azura partners with a pharmacy consulting company to ensure compliant medication management.

In the dialysis services business outside of the US where controlled substances are permitted, prescription is strictly regulated and monitored according to local legislations. Most countries use controlled substances only as emergency treatment. (i.e. no prescription). We have established specific protocols to ensure the safe handling and storage of these medications. In those locations we ensure that the appropriate level staff is trained on the appropriate use, storage, and disposal of controlled substances as required by local/regional laws. Similarly, staff supports patients with substance abuse disorders where required by local/regional laws.

All of FME’s Care Delivery patient facing services businesses (e.g. in the U.S. Fresenius Kidney Care’s in-center, home dialysis, Azura Vascular, FRx as well as Nephrocare in EMEA, and Fresenius Kidney Care in AP) follow the local laws and requirements governing pricing disclosures. The method of communication varies by country and includes written communication, website posting, and in-person consultation, as required.
The US Care Delivery patient facing services business (e.g. Fresenius Kidney Care’s in-center, home dialysis as well as Azura Vascular, FRx) has two approaches. We work with the insurer/payor to understand the patient’s payment responsibility.
For insured patients, the business first submits a claim to the insurance provider.

The insurance provider informs the business about what the patient is responsible for based on their plan. In the case of self-pay patients, the business can provide an estimate of price.
For the patient facing services business outside of the United States (e.g. Nephrocare, Fresenius Kidney Care in AP), the company follows the pricing requirements outlined by the national health system in each country.

For the US Care Delivery patient facing services business (e.g. Fresenius Kidney Care’s in-center, home dialysis as well as Azura Vascular), the Company sets our pricing and certain pricing information is made publicly available.

For the patient facing services business outside of the United States (e.g. Nephrocare, Fresenius Kidney Care in AP), pricing for services is usually subject to local law and reimbursements.

Pricing transparency requirements in the U.S. are for hospitals and not required for other health facilities.

https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency/hospitals

(a) For the total recordable incident rate, see chapter "Working for Fresenius Medical Care"  in our Sustainability Statement.

(b) We do not report the total recordable incident rate for contract employees. For further information on employee health and safety, see chapter "Working for Fresenius Medical Care"  in our Sustainability Statement.

For 2025, our total voluntary turnover rate is 15.6%, and our total involuntary turnover rate is 5.2%.
The global* voluntary turnover rate for physicians is 5.3% and the involuntary turnover rate is 2.2%.
For non-physician health care practitioners, the voluntary turnover rate is 16.9% and the involuntary turnover rate is 3.8%.

For information on recruitment and retention efforts, see our Sustainability Statement, chapter "Working for Fresenius Medical Care", our global career website, and our employee website. 

For information on nurses training programs, global career paths, and insights into the jobs of our clinical staff, see our Nephrocare website and our corporate website.

1) Fresenius Medical Care takes steps to ensure the continuous operation of our critical healthcare services through providing backup power systems. For our U.S. dialysis clinics, we have placed back-up built-in power generators in areas in the southeast which are most prone to hurricanes. For our EMEA, AP, and some U.S. dialysis, there is a requirement that back up and built-in power generators be available where required by law. Our ambulatory surgery centers, pharmacy, and lab businesses also have facility generators as standard.
Additionally, we strategically place mobile fleets of generators (through vendor relationships) geographically across the U.S. to fill gaps in power generators to ensure continuity that may occur during times of natural disaster or grid failure.
As per our guidelines, these systems are regularly tested and maintained to ensure their readiness in emergency situations, such as natural disasters or grid failures.

2)To allow us to continue treating our patients in extreme conditions, we have developed an emergency response system.
We are actively adapting our business operations to address long-term physical risks such as water stress, drought stress, and heat stress through the development of a forward-looking water strategy. In the long-term, we are also preparing for the impacts of transitioning to a low-carbon economy by further adapting to circular trends through the development of a circular economy strategy.

3)Fresenius Medical Care is committed to ensuring the safety and well-being of our patients, employees, and communities through comprehensive emergency preparedness and response plans These plans are aligned with the regulatory requirements in the jurisdictions where we operate. For instance, for all free-standing Fresenius Medical Care outpatient facilities in the U.S. we comply with the U.S. Centers for Medicare & Medicaid Services (CMS) Emergency Preparedness Final Rule and similar local regulations. For our EMEA dialysis clinics, we have put in place emergency preparedness and response plans where required by law. And for our AP dialysis clinics, we have put in place emergency preparedness and response plans based on operating agreements with the local government. Our emergency plans address key areas such as disaster recovery and continuity of medical supplies and services.
Every Fresenius Kidney Care/NephroCare clinic across the globe annually reviews and updates its emergency plans, conducting drills and exercises to ensure staff are well-prepared to respond to emergencies effectively.
In addition to meeting regulatory standards, we voluntarily implement best practices relevant to outpatient clinical care. Our non-U.S. business built their plans with guidance from frameworks such as the World Health Organization’s Hospital Preparedness for Epidemics, Emergency Response Framework (Edition 2.1), OSHA 1910 Subpart E (Emergency Action Plans), and ISO 45001:2018. Our U.S. dialysis business has dedicated Incident Command Teams that respond to a local disaster when the impact is beyond the ability of the local team to restore operations.
In hospital locations where we provide dialysis as a service, we follow the hospital regulations around emergency preparedness.
Through these efforts, we strive to maintain a high level of readiness and safeguard the continuity of care.

Medical Equipment and Supplies

No fatalities have been reported in which a causal relationship with our products has been definitively established. 

It is essential that our products and services are effective, reliable, and associated with minimal risk to patients. Robust standards for the planning, conduct, and monitoring of clinical studies underpin the quality and safety of our products.
In 2025, we completed our first comprehensive Portfolio Sustainability Assessment, a systematic review of environmental and significant social performance of our products and services. The annual assessment is designed to enhance transparency around the sustainability of our portfolio by considering social, environmental and economic criteria. It can be used to create a foundation for portfolio decisions that systematically factor in our sustainability impact.

The product assessment integrates relevant criteria, including circular economy principles and material use for our products and packaging. Through simplified life cycle assessments (screening-LCAs), we measure and compare the environmental impacts of our products, covering factors such as critical materials, energy consumption, and end-of-life pathways. Currently, screening LCAs are conducted for a majority of our current medical device product lines. We have conducted detailed comparative LCAs for selected disposable products to validate findings and guide material and process improvements

Globally, we donate dialysis machines and medical supplies to organizations that require support. In 2025 we donated approximately 1.9 metric tons of devices and equipment reflecting a total value of around 12, 700 €. We also donated approximately 3.94 metric tons of supplies reflecting a total value of around 1,240,000 €. Most of the products/supplies donated reflect a partnership FME started with an organization called Supporting Initiatives to Redistribute Unused Medicine (SIRUM), where we donated unused, unexpired, non-controlled, and non-refrigerated medications. SIRUM will take our donations and redistribute to people in need through community clinics and charitable pharmacies in the United States.

In the U.S., we return and reuse shipping materials (including ice packs, Styrofoam cooler, and cardboard boxes) that transport the erythropoiesis-stimulating agent (ESA) Mircera. 44,938 shippers were returned and passed inspection for reuse, which results in savings of 592.9 metric tons.
Through a program with Lexmark, our locations in the U.S. returned around 6,300 printer cartridges with a total weight of 9.6 metric tons. 

We also continued our program for reusing blue drums that are used to deliver acid concentrate to clinics in the U.S. In 2025, we reused more than 900 metric tons of drums. The drums are collected at care centers. They then go through a cleaning process at the production site making them suitable for reuse.

Fresenius Medical Care in the U.S. recycled around 2,900 machines (including mixers, 2008K, 2008T, K2, K@Home) from its FKC clinics recovering selected materials. In the U.S. we returned around 5,500 IVUS catheters to NEScientific for repurposing.

Responsible sourcing of mineral raw materials remains a key part of our commitment to sustainable procurement. We acknowledge that mineral extraction, especially in high-risk regions, may be associated with poor labor practices and human rights violations. We adhere to Section 1502 of the U.S. Dodd-Frank Wall Street Reform and Consumer Protection Act, which addresses the use of “conflict minerals”. Our approach is guided by the OECD Due Diligence Guidance for Responsible Supply Chains of Minerals from Conflict-Affected and High-Risk Areas, as outlined in our Conflict Minerals Policy.

We publish an annual conflict minerals report. Suppliers found to be non-compliant with our Conflict Minerals Policy are subject to review for ongoing business engagement. We actively encourage our suppliers to foster similar standards and promote transparency within their own supply chains.

We had no monetary losses associated with formal legal proceedings associated with bribery or corruption in 2024. All relevant legal proceedings and related financial effects are disclosed in our Annual Report – Notes to the consolidated financial statements.

As a healthcare company, we interact with external (third-party) healthcare professionals (HCPs) and patient organizations. The responsibility for patient treatment lies with HCPs who must be able to make independent clinical decisions. Our global HCP Policy governs interactions with third-party HCPs and establishes safeguards. The policy is overseen by the Compliance department and is available to all employees.
Our Code of Ethics and Business Conduct covers general compliance concepts and standards, including the expectation that all employees perform their duties in accordance with the Company’s purpose, global values, policy, the Code of Ethics and Business Conduct  and the law. The general principles in the Code of Ethics and Business Conduct are supported by policies that address specific situations in accordance with all applicable local laws, including interactions with health care professionals.