Revenue and operating income generated in countries outside the eurozone are subject to currency fluctuations. As a significant portion of our operations are derived from our businesses in the U.S., the development of the euro against the U.S. dollar can have a material impact on our results of operations, financial position and net assets and the impacts of foreign currency transaction and translation effects are included in the discussion of our key and secondary performance indicators below.
in € M
Change in % |
|||||
|
2025 |
2024 |
As reported |
Currency translation effects |
Constant Currency1 |
Revenue |
19,628 |
19,336 |
2 |
(3) |
5 |
Costs of revenue |
(14,599) |
(14,579) |
0 |
4 |
4 |
Selling, general and administrative costs |
(3,033) |
(3,143) |
(4) |
4 |
0 |
Research and development |
(158) |
(183) |
(14) |
1 |
(13) |
Income from equity method investees |
181 |
135 |
34 |
1 |
35 |
Other operating income |
528 |
760 |
(31) |
(2) |
(29) |
Other operating expense |
(720) |
(934) |
(23) |
2 |
(21) |
Operating income |
1,827 |
1,392 |
31 |
(5) |
36 |
Operating income margin |
9.3 |
7.2 |
|
|
|
Interest income |
70 |
72 |
(3) |
(5) |
2 |
Interest expense |
(385) |
(407) |
(6) |
4 |
(2) |
Income tax expense |
(321) |
(316) |
2 |
2 |
4 |
Net income |
1,191 |
741 |
61 |
(5) |
66 |
Net income attributable to noncontrolling interests |
(213) |
(203) |
5 |
4 |
9 |
Net income attributable to shareholders of FME AG |
978 |
538 |
82 |
(6) |
88 |
Basic and diluted earnings per share in € |
3.36 |
1.83 |
83 |
(6) |
89 |
1 For further information on Constant Currency, see the chapter "Overview of the Group" section "Performance management system."
Key Performance Indicators
The following discussions include our operating and reportable segments and the measures we use to manage these segments. Due to the change in our operating structure as of June 1, 2025, we have restated the financial information for 2024 for our operating segments in order to conform to the current year’s presentation. For further information, see note 1 and note 29 of the notes to the consolidated financial statements.
in € M, except dialysis treatment, patient and clinic data
Change in % |
|||||||
|
2025 |
2024 |
As reported |
Currency translation effects |
Constant Currency1 |
Organic growth |
Same Market Treatment Growth2 |
Revenue |
19,628 |
19,336 |
2 |
(3) |
5 |
8 |
|
Care Delivery segment |
13,736 |
14,003 |
(2) |
(4) |
2 |
5 |
0.6 |
Thereof: U.S. |
11,507 |
11,526 |
0 |
(4) |
4 |
5 |
0.0 |
Thereof: International |
2,229 |
2,477 |
(10) |
(1) |
(9) |
4 |
2.0 |
Value-Based Care segment |
2,247 |
1,752 |
28 |
(6) |
34 |
34 |
|
Care Enablement segment |
5,476 |
5,557 |
(1) |
(3) |
2 |
2 |
|
Inter-segment eliminations |
(1,831) |
(1,976) |
(7) |
3 |
(4) |
|
|
Thereof: Care Delivery3 |
(497) |
(480) |
4 |
4 |
8 |
|
|
Thereof: Care Enablement3 |
(1,334) |
(1,496) |
(11) |
3 |
(8) |
|
|
Dialysis treatments |
44,746,884 |
47,617,071 |
(6) |
|
|
|
|
Patients |
291,902 |
299,352 |
(2) |
|
|
|
|
Clinics |
3,601 |
3,675 |
(2) |
|
|
|
|
Member Months |
1,788,951 |
1,534,053 |
17 |
|
|
|
|
Membership |
162,697 |
131,750 |
23 |
|
|
|
|
1 For further information on Constant Currency, see the chapter "Overview of the Group" section "Performance management system."
2 Same market treatment growth represents growth, in treatments, adjusted for certain reconciling items including (but not limited to) treatments from acquisitions, closed or sold clinics and differences in dialysis days (Same Market Treatment Growth).
3 Services provided by the Care Delivery segment in the U.S. for patients managed under the Value-Based Care segment are provided at fair market value. We also transfer products from the Care Enablement segment to the Care Delivery segment at fair market value.
Consolidated
Revenue increased as compared to the year ended December 31, 2024, primarily driven by an increase in organic growth in all segments, partially offset by a negative impact from foreign currency translation, the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization) and a decrease in dialysis days.
Care Delivery
The decrease in Care Delivery revenue as compared to the year ended December 31, 2024 was driven by a negative impact from foreign currency translation and the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization), partially offset by an increase in organic growth. Organic growth was supported by favorable Impacts from TDAPA Reimbursement Regulation, reimbursement rate increases, and favorable payor mix effects. As of December 31, 2025, the number of patients treated in dialysis clinics that we own or operate in Care Delivery decreased as compared to December 31, 2024, primarily driven by divestitures in connection with Legacy Portfolio Optimization. Treatments in our Care Delivery segment decreased as compared to the year ended December 31, 2024, mainly due to the effect of closed or sold clinics (primarily related to Legacy Portfolio Optimization) and a decrease in dialysis days, partially offset by Same Market Treatment Growth. During the year ended December 31, 2025, we acquired 6, opened 27, and combined, closed, or sold 107 dialysis clinics.
U.S.
In the U.S., revenue remained stable as an increase in organic growth was offset by a negative impact from foreign currency translation and a decrease in dialysis days. Organic growth in the U.S. was supported by favorable Impacts from TDAPA Reimbursement Regulation, reimbursement rate increases, and favorable payor mix effects. In the U.S., the number of patients we treated in dialysis clinics that we own or operate remained relatively stable at 205,483 patients (December 31, 2024: 206,436). Treatments remained relatively stable at 31,069,465 for the year ended December 31, 2025 as compared to 31,213,447 for the year ended December 31, 2024. We owned or operated 2,622 dialysis clinics in the U.S. at December 31, 2025 as compared to 2,624 dialysis clinics at December 31, 2024. During the year ended December 31, 2025, we acquired 2, opened 15, and combined, closed, or sold 19 dialysis clinics.
International
In International, the decrease in revenue was driven by the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization) and a negative impact from foreign currency translation, partially offset by an increase in organic growth. There were 86,419 patients treated in dialysis clinics that we own or operate in International, a decrease of 7% (December 31, 2024: 92,916) primarily driven by divestitures in connection with Legacy Portfolio Optimization. Treatments in International decreased by 17% to 13,677,419 for the year ended December 31, 2025 as compared to 16,403,624 for the year ended December 31, 2024, driven by the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization), partially offset by Same Market Treatment Growth. We owned or operated 979 dialysis clinics in International at December 31, 2025 as compared to 1,051 dialysis clinics at December 31, 2024. During the year ended December 31, 2025, we acquired 4, opened 12 and combined, closed, or sold 88 dialysis clinics.
Value-Based Care
Value-Based Care revenue increased as compared to the year ended December 31, 2024, primarily due to an increase in organic growth, driven by an increase in Member Months mainly due to contract expansion, partially offset by a negative impact from foreign currency translation.
Care Enablement
Care Enablement revenue decreased as compared to the year ended December 31, 2024, primarily driven by a negative impact from foreign currency translation, partially offset by higher revenues related to critical care products (including products for acute care treatment and acute cardiopulmonary products), machines for chronic treatment, home hemodialysis products, and peritoneal dialysis products. Apart from the negative foreign currency translation impact, the development of revenue was driven by volume increases and positive pricing momentum despite a negative impact from volume-based procurement and other regulatory policies in China.
in € M
Change in % |
|||||
|
2025 |
2024 |
As reported |
Currency translation effects |
Constant Currency1 |
Operating income (loss) |
1,827 |
1,392 |
31 |
(5) |
36 |
Care Delivery segment |
1,614 |
1,218 |
33 |
(7) |
40 |
Value-Based Care segment |
1 |
(28) |
n.a. |
|
n.a. |
Care Enablement segment |
326 |
267 |
22 |
(1) |
23 |
Inter-segment eliminations |
5 |
(17) |
n.a. |
|
n.a. |
Corporate |
(119) |
(48) |
148 |
(58) |
206 |
Operating income (loss) margin |
9.3 |
7.2 |
|
|
|
Care Delivery segment |
11.8 |
8.7 |
|
|
|
Value-Based Care segment |
0.1 |
(1.6) |
|
|
|
Care Enablement segment |
6.0 |
4.8 |
|
|
|
1 For further information on Constant Currency, see the chapter "Overview of the Group" section "Performance management system."
Consolidated
The increase in our operating income was largely driven by a positive impact from business growth (across all operating segments), net savings associated with the FME25+ Program, and reduced expenses from Legacy Portfolio Optimization, partially offset by higher personnel expense (including elevated medical benefit costs), a negative impact from Humacyte Remeasurements, inflationary cost increases, a negative impact from foreign currency translation, and an unfavorable impact from foreign currency transaction effects.
Care Delivery
Care Delivery operating income increased primarily as a result of a favorable impact from business growth (driven by favorable Impacts from TDAPA Reimbursement Regulation, reimbursement rate increases, and favorable payor mix effects), reduced expenses from Legacy Portfolio Optimization, and net savings associated with the FME25+ Program, partially offset by higher personnel expense (including elevated medical benefit costs), a negative impact from foreign currency translation, and inflationary cost increases.
Value-Based Care
For the year ended December 31, 2025, Value-Based Care recorded operating income as compared to an operating loss for the year ended December 31, 2024, mainly driven by a favorable savings rate for certain contracts, partially offset by an unfavorable effect from CKCC programs.
Care Enablement
Care Enablement operating income increased primarily due to net savings from the FME25+ Program and a favorable impact from business growth (driven by higher volumes and positive pricing developments, despite volume-based procurement and other regulatory policies in China). The increase in operating income was partially offset by inflationary cost increases, a negative impact from the remeasurement of receivables related to a royalty stream that we are entitled to base on sales made by Humacyte, Inc. in the U.S., and an unfavorable impact from foreign currency transaction effects.