Annual Report 2025

Change report

Overall business development

The Management Board’s assessment of the effect of general economic developments and those in the healthcare sector for Fresenius as well as business results and significant factors affecting operating performance

Over the course of the year the Fresenius Group increased its consolidated revenue guidance once and its consolidated earnings guidance once, despite the continuing volatility of the overall economic environment. This was particularly affected by inflation-driven increases in material costs, tariffs, staffing shortages, tender business in China, and significant exchange rate effects.

For this reason, the Management Board believes that 2025 was a very successful fiscal year for the Fresenius Group.

Fresenius Kabi achieved organic revenue growth of 7%. EBIT1 increased by 7% (9% in constant currency) to €1,413 million (2024: €1,319 million). The EBIT margin1 was 16.4% (2024: 15.7%).

The organic revenue growth of Fresenius Helios was 7%. EBIT1 increased by 3% (3% in constant currency) to €1,328 million (2024: €1,288 million). The EBIT margin1 was 9.8% (2024: 10.1%).

Following the deconsolidation of Fresenius Medical Care, this former business segment is accounted for using the equity method. The profit attributable to the shareholders of Fresenius SE & Co. KGaA is recognized in a separate line in the income statement. Since fiscal year 2024, it also includes the shares in Aceso Topco 1 S.à r.l., which are also accounted for using the equity method. In fiscal year 2025, the reported income from investments accounted for using the equity method related mainly to Fresenius Medical Care and amounted to €198 million (2024: €38 million).

Comparison of the actual business results with the forecasts

Over the course of the year, Group revenue and earnings1 guidance was increased each once. In total, the Group guidance was raised twice.

The table Achieved group targets 2025 shows how the outlook for the Group and the business segments developed in 2025.

Revenue1 increased organically by 7% in fiscal year 2025 and was thus at the upper end of the guidance adjusted in August 2025 (guidance for 2025: 5–7% growth; previously: 4–6% growth). The increase is driven by the ongoing strong operational performance at Fresenius Kabi and Fresenius Helios.

EBIT1 increased by 6% in constant currency and was therefore in line with the guidance, adjusted in November 2025 (guidance for 2025: 4–8% growth; previously: 3–7% growth). The increase was driven by strong operating performance at Fresenius Kabi, particularly the growth vectors and Fresenius Helios. Continued cost discipline in both Operating Companies also contributed to further earnings improvement.

We invested €1,001 million in property, plant and equipment (2024: €960 million). At 4.4% of Group revenue1, the investments in property, plant and equipment are below the prior-year level of 4.5%, and hence below the expectation (expectation for 2025: around 5%).

The cash conversion rate (CCR) was 1.1 and is therefore above the expectations (expectation for 2025: around 1).

The net financial debt / EBITDA ratio was 2.7×2 (December 31, 2024: 3.0×2) and thus in line with expectations. We had projected that the leverage ratio would be within the self-imposed target corridor of 2.5× to 3.0×2 by the end of 2025.

Group ROIC was 6.6%1,3 (2024: 6.2%1,3) and thus in line with expectations. We had projected a figure of above 6% for fiscal year 2025.

The non-financial performance targets of the Fresenius Group cover the key sustainability topics of medical quality / patient satisfaction and employees and are anchored in the compensation of the Management Board. The following actual figures for fiscal year 2025 were determined as part of the assessment of target achievement for the short-term variable compensation of the Management Board (STI) of Fresenius SE & Co. KGaA.

In the area of medical quality, Fresenius Kabi achieved an Audit & Inspection Score of 0.9 (target value: no more than 2.3), Fresenius Helios Germany achieved an Inpatient Quality Indicator (G-IQI) Score of 91.9% (target value: at least 88%), and Fresenius Helios Spain an Inpatient Quality Indicator (E-IGI) Score of 77.4% (target value: at least 75%). As a result, all divisions met their respective targets for fiscal year 2025.

In the area of employees, the Employee Engagement Index (EEI) of the Fresenius Group was 4.14 in fiscal year 2025 (target value: 4.33).

Achieved Group targets 2025

 

 

Guidance 2025, published February 2025

 

Guidance adjustment / update, published May 2025

 

Guidance adjustment / update, published August 2025

 

Guidance adjustment / update, published November 2025

 

Achieved in 2025

Group1

 

 

 

 

 

 

 

 

 

 

Revenue (growth, organic)

 

4–6% growth

 

Confirmed

 

5–7% growth

 

Confirmed

 

7%

EBIT (growth, in constant currency)

 

3–7% growth

 

Confirmed

 

Confirmed

 

4–8% growth

 

6%

Operating Companies

 

 

 

 

 

 

 

 

 

 

Fresenius Kabi1

 

 

 

 

 

 

 

 

 

 

Revenue (growth, organic)

 

Mid-to-high-single-digit percentage growth

 

Confirmed

 

Confirmed

 

Confirmed

 

7%

EBIT margin

 

16–16.5% (structural margin band of 16–18%)

 

Confirmed

 

Confirmed

 

Confirmed

 

16.4%

Fresenius Helios1

 

 

 

 

 

 

 

 

 

 

Revenue (growth, organic)

 

Mid-single-digit percentage growth

 

Confirmed

 

Confirmed

 

Confirmed

 

7%

EBIT margin

 

Around 10% (structural margin band of 10–12%)

 

Confirmed

 

Confirmed

 

Confirmed

 

9.8%

1

Before special items

Organic growth rate adjusted for accounting effects related to Argentina hyperinflation.

For a detailed overview of special items please see section Reconciliation Fresenius Group.

1 Before special items

2 At average exchange rates for both net debt and EBITDA; pro forma closed acquisitions / divestitures, before special items, including lease liabilities, including Fresenius Medical Care dividend, net debt adjusted for the valuation effect of the exchangeable bond

3 Pro forma acquisitions

Organic growth rate adjusted for accounting effects related to Argentina hyperinflation.

For a detailed overview of special items please see section Reconciliation Fresenius Group.

Audit & Inspection Score
The Audit & Inspection Score at Fresenius Kabi is based on the number of critical and serious non-conformances from regulatory GMP inspections and the number of serious non-conformances from TÜV ISO 9001 audits in relation to the total number of inspections and audits performed. The score shows how many deviations were identified on average during the inspections and audits considered.
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Cash Conversion Rate (CCR)
The cash conversion rate is defined as the ratio of adjusted free cash flow (cash flow before acquisitions and dividends; before interest, tax and special items) to operating income (EBIT) before special items. This allows us to assess our ability to generate cash and amongst others, also to pay dividends.
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Constant currencies
Constant currencies for income and expenses are calculated using prior-year average rates; constant currencies for assets and liabilities are calculated using the mid-closing rate on the date of the respective statement of financial position.
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EBITDA (Earnings before Interest, Taxes, Depreciation and Amortization)
EBITDA is calculated from EBIT by adding depreciations recognized in income and deducting write-ups recognized in income, both on intangible assets as well as property, plant and equipment.
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Employee Engagement Index (EEI)
The Employee Engagement Index measures how positively employees identify with their employer, how committed they feel, and how engaged they are at work. The key figure can be reported in relation to a business segment or for the entire Group.
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Inpatient Quality Indicator
The Inpatient Quality Indicator at Fresenius Helios comprises the measurement of a set of standardized German inpatient quality indicators (G-IQI). These are based on routinely collected hospital billing data from hospital information systems. The number of indicators achieved compared to the total number of indicators is calculated to measure the overall success rate. There is individual target setting and measurement of target achievement in the two Helios segments Helios Germany and Helios Spain. Subsequently, target achievement is consolidated at Helios company level with equal weighting (50% each) for Executive Board compensation.
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ROIC (Return on Invested Capital)
Calculated by: (EBIT - taxes) / Invested capital.
Invested capital = total assets + accumulated amortization of goodwill - deferred tax assets - cash and cash equivalents - trade accounts payable - accruals (without pension accruals) - other liabilities not bearing interest.
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