Fresenius Medical Care Achieves Strong Start to 2025 with Solid Organic Growth and Improved Profitability Across Segments
Fresenius Medical Care, the world’s leading provider of products and services for individuals with chronic kidney failure, began 2025 with a strong operational and financial performance. The company reported solid organic revenue growth and a significant year-over-year increase in operating income in the first quarter, marking continued momentum in executing its FME25 transformation strategy—the final year of its current three-year strategic plan.
Helen Giza, Chief Executive Officer of Fresenius Medical Care, expressed confidence in the company’s trajectory: “The results of the first quarter of 2025 once again demonstrate our continuous operational and financial progress as we are executing the third and last year of our current strategic plan. Revenue of both segments grew organically, and the phasing of the operating income development was in line with our expectations.”
Giza also emphasized the performance of the company’s two core business segments, Care Delivery and Care Enablement. “Care Enablement executed strongly against its transformation plan and further expanded its operating income margin, reaching its target margin band for the first time. Care Delivery maintained the prior year’s margin level despite one dialysis day less and the negative impact from a severe flu season.”
Encouragingly, the company also observed increased patient referrals during the quarter, continuing a positive trend from 2024. Fresenius Medical Care expects this trend to support accelerating same-market treatment growth in the U.S. to more than 0.5% for the full year, following a stable development in the first quarter.
“We also continue to expect operational and financial improvements in both segments during the year, translating into significant earnings and margin growth. We therefore confirm our financial outlook for the full year 2025,” Giza added.
Advancing Strategic Execution: FME25 Delivers Sustainable Savings
Fresenius Medical Care’s FME25 transformation program remained a central pillar of its operational success. During the first quarter of 2025, the initiative delivered EUR 68 million in additional sustainable savings, aligning with management expectations. While the program incurred EUR 28 million in one-time special item costs, the company remains on track to achieve its full-year target of approximately EUR 180 million in additional annual savings. This would bring the cumulative savings to EUR 750 million by the end of 2025.
As part of its broader strategic roadmap, Fresenius Medical Care also continues to optimize its business portfolio. The company is actively divesting from non-core and margin-dilutive assets to streamline operations and focus on its most profitable business areas. Recent divestments include select assets of Spectra Laboratories, a U.S.-based laboratory testing services provider, and the company’s dialysis clinic operations in Malaysia.
Portfolio-related special items totaled EUR -24 million in Q1 2025. The full-year impact of completed divestitures from 2024 is expected to reduce 2025 revenue growth by approximately 1%, though these costs will be recognized as special items in the company’s operating income.
Broad-Based Organic Revenue Growth Across Segments
Fresenius Medical Care delivered strong top-line performance in the first quarter, with Group revenue reaching EUR 4,881 million—up 3% year-over-year, or 5% on an organic basis. At constant currency, revenue increased 1%. The divestments made as part of the portfolio optimization plan negatively affected reported revenue by approximately 260 basis points.
The Care Delivery segment, which includes dialysis treatment services, posted revenue of EUR 3,857 million—up 2% from the prior year. Adjusted for constant currency, revenue declined slightly (-1%), but organic growth stood at 4%. Portfolio divestitures had a 370 basis point negative impact on reported results.
In the U.S., Care Delivery revenue rose by 6% (+3% at constant currency, +4% organic) to EUR 3,302 million. Key drivers included continued expansion of the company’s value-based care business, increased reimbursement rates, and a favorable payor mix. Foreign exchange tailwinds also contributed positively, partially offsetting a decline in dialysis treatment days caused by a severe flu season. As a result, same-market treatment volume in the U.S. remained flat compared to the previous year.
International Care Delivery revenue declined sharply by 19% (-19% at constant currency), falling to EUR 555 million. However, on an organic basis, the segment grew 5%. The steep decline was primarily due to the closure or sale of underperforming operations as part of the company’s ongoing Legacy Portfolio Optimization. Despite these headwinds, same-market treatment growth outside the U.S. accelerated to 2.5%.
The Care Enablement segment, responsible for manufacturing and distributing dialysis products, reported revenue growth of 5% across all measures (reported, constant currency, and organic), reaching EUR 1,367 million. Growth was driven by strong global product demand, favorable pricing, and positive volume trends. Notably, volume-based procurement in China aligned with expectations—supportive of overall growth but weighing on pricing levels.
Revenue within Inter-segment eliminations, reflecting internal product transfers at market value, declined by 5% year-over-year to EUR -343 million (-7% at constant currency).
Margin Expansion and Significant Operating Income Gains
Operating income increased significantly in the first quarter, rising 35% year-over-year (+32% at constant currency) to EUR 331 million. This corresponds to an operating margin of 6.8%, up from 5.2% in Q1 2024. Excluding special items, operating income climbed 13% (+11% at constant currency) to EUR 457 million, representing a margin of 9.4%—up from 8.5% in the previous year.
The Care Delivery segment recorded a 71% jump in operating income (+64% at constant currency), reaching a margin of 8.4%, compared to 5.0% in Q1 2024. Excluding special items, operating income rose 4% (flat at constant currency), with a margin of 9.3%. These results reflect the impact of phosphate binder income, pricing improvements, and FME25-driven cost savings. Higher personnel expenses and inflationary cost pressures weighed on margins, as did reduced treatment volumes and lower contributions from value-based care services.
Operating income for the Care Enablement segment also rose sharply, increasing 34% (+33% at constant currency) to yield a margin of 6.9%—up from 5.4% a year ago. Excluding special items, operating income surged 50% (+49% at constant currency), with a margin of 8.3%. Growth was supported by improved global pricing, higher product volumes, and transformation program savings, which more than offset inflationary headwinds.
In contrast, the Corporate segment posted an operating loss of EUR -81 million, compared to EUR -14 million in Q1 2024. This included EUR -67 million related to Humacyte remeasurements and a EUR 3 million contribution from virtual power purchase agreements. Excluding special items, the operating loss narrowed to EUR -12 million, compared to EUR -18 million in the prior year.
Net Income and EPS More Than Double
Fresenius Medical Care achieved a notable improvement in bottom-line performance. Net income more than doubled year-over-year, rising 113% to EUR 151 million (+109% at constant currency). When excluding special items, net income rose by 31% (+29% at constant currency) to EUR 246 million.
Basic earnings per share (EPS) mirrored these gains, doubling to EUR 0.52 (+109% at constant currency). EPS excluding special items increased by 31% (+29% at constant currency) to EUR 0.84.
Strong Cash Flow and Continued Deleveraging
The company reported a 28% increase in operating cash flow for the quarter, reaching EUR 163 million, equivalent to a margin of 3.3%. This improvement was attributed to seasonal billing cycles and aligned with management expectations. Free cash flow also turned positive, totaling EUR 21 million, up from a negative EUR 2 million in Q1 2024.
Fresenius Medical Care continued to strengthen its balance sheet. Total net debt and lease liabilities declined to EUR 9,753 million, down from EUR 9,803 million at year-end 2024. The net leverage ratio (net debt/EBITDA) improved slightly to 2.8x from 2.9x in the previous quarter.
Operational Footprint and Workforce
As of March 31, 2025, Fresenius Medical Care operated 3,674 dialysis clinics worldwide, serving 299,358 patients. The company employed 112,035 people globally, up from 111,513 at the end of 2024.
With its strategic transformation efforts gaining traction and a clear roadmap for operational and financial improvement, Fresenius Medical Care remains on track to achieve its 2025 targets. The company’s consistent performance in the first quarter underscores its resilience and commitment to delivering long-term value to patients, stakeholders, and shareholders alike.
