Group and segment outlook 2026

Trends towards a changing geopolitical order have been observable and are still continuing since the beginning of the 2025 fiscal year. The potential implications of this for customs duties, taxes, regulation, administration and political decision-making, for example, may have direct and indirect negative effects on the industry environment and the business activities of the Fresenius Group, although these cannot be estimated at present.

Fresenius will continue to closely monitor the potential impact of increased volatility and reduced visibility on its business and balance sheet.

Guidance for Fiscal Year 2026¹ raised

All of these assumptions are subject to considerable uncertainty. Assumptions to guidance: The company acknowledges that the prevailing trends of fast-moving macroeconomic and geopolitical environment continue, resulting in increased volatility and a higher level of operational uncertainty. The guidance does not take into account potential extreme scenarios that could affect the company, its peers, and the healthcare sector as a whole. 

Indications

#CommittedToLife: the health and well-being of patients is Fresenius’ top priority. For more than 100 years, we have been combining cutting-edge technology with a focus on patients, paving the way for the therapies of the future. We save and improve lives and health. We provide access to affordable and innovative medical products and clinical care of the highest quality.

Fresenius businesses geared towards driving forces in healthcare

The global healthcare sector is growing and changing rapidly in response to critical challenges driven by demographic shifts, technological advancements and evolving patient needs. These secular growth drivers are here to stay:

• Ageing global population: The world’s population is aging significantly, increasing demand for healthcare services.
• Higher prevalence of chronic diseases: Chronic conditions are driving higher healthcare spending worldwide.
• Growing healthcare spending: Across geographies, healthcare spending as a share of GDP continues to rise. In the U.S., for example, spending approached nearing $5 trillion in 2023 based on CMS data. At +7.5%, this is the biggest increase in decades!
• Technological advancements: Digital solutions and AI will play an increasingly role in quality and productivity.
• Demand for highly-skilled workforce: Attracting top talent is essential to stay at the forefront of innovative healthcare.

Fresenius is part of the solution: We are a relevant, system-critical healthcare company combining innovative medicine, advanced medical technology, and the highest quality in clinical care to shape next-level therapies.

The healthcare sector is one of the world’s largest industries, offering exceptional growth opportunities. We geared our businesses towards these driving forces and are committed to staying at the forefront, ensuring our businesses remain system-relevant and future-ready.

 

Strong balance across system-critical businesses

Our unique strengths lie in our positioning: we cover the entire patient journey with a broad portfolio range – right at the critical spots in care – capable of advancing therapies on many levels. With Fresenius Kabi and Fresenius Helios, we address, lead and meet evolving patient needs across three therapy platforms: 

• (Bio)Pharma including clinical nutrition: This includes our broad range of essential IV Generics and IV Fluids, Enteral and Parenteral Clinical Nutrition, and our fast-growing Biosimilars business.
• MedTech: We are addressing cutting-edge technology in Transfusion & Cell Therapies and the Infusion & Nutrition Systems space.
• Care Provision: This is where we provide high-quality and innovative treatments through our market-leading networks of hospitals and outpatient facilities in Germany and Spain – treating 26 million patients every year!

With this strategy, we address the driving forces in healthcare that will change the pattern of growth. All business at Fresenius Kabi and Fresenius Helios have leading market positions in attractive markets and grow meaningfully organically. We are part of the solution of innovative healthcare and future therapies: 

• Health Equity: Providing affordable and accessible products and services
• Integrated therapies: Driving multimodal therapies across three platforms
• Digital solutions and AI: Enhancing clinical outcomes, quality and productivity
• Human touch: From cutting-edge technology to human-to-human care 
   

#FutureFresenius is clearly paying off

Since launching #FutureFresenius in October 2022, we have driven structural productivity and improved returns, creating a simpler, more focused, and stronger healthcare company – delivering clear impact for all stakeholders! Key milestones include deconsolidating Fresenius Medical Care, concluding several important strategic portfolio measures, and exiting Vamed.

In 2025, we kicked-off the next phase of #FutureFresenius - Rejuvenate – taking our performance to the next level! In this phase we focus on:

• Upgrading our core businesses by doing what we are doing  – even  better! Through patient care, customer service, better processes and operations, we’re creating value day by day!
   
• And scaling our three therapy platforms:
  • specialized (Bio)Pharma
  • targeted MedTech
  • holistic Care Provision 

This means bringing new products and innovations to the market, focusing on the needs of patients and customers. We are investing in AI and digital transformation to enhance clinical decision-making, streamline workflows, and improve patient experiences. These next-generation capabilities will strengthen our leadership in medical quality and innovation.

 

 

Overview #FutureFresenius strategy: 

• RESET: First we simplified our group structure, optimized our financial management system, and created change momentum across the organization.
• REVITALIZE: We then geared up for continuous portfolio optimization and the pursuit of growth verticals.
• REJUVENATE: We are now driving platform-driven growth through product launches and add-ons, and creating value from investments.
• REIMAGINE: Our further enhanced capabilities will allow us to actively shape the future of healthcare!

 

Corporate governance covers all aspects connected with the management, supervision and transparency of companies. Key elements of good corporate governance are efficient company management, the protection of shareholders' interests and transparent corporate communication.

We place great importance on open communication and strive to create an environment in which all individuals can openly raise concerns about potential human rights violations. This includes employees (including those of suppliers and service providers), suppliers, customers, patients, residents living near our sites, or other parties concerned and their representatives.Concerns regarding potential human rights violations can be raised without fear of discrimination, disadvantages, or retaliation. To support this, we have established appropriate systems and procedures for reporting misconduct.

Process for handling and investigating reports

The following graphic illustrates the steps for processing reports, starting from the acknowledgment of receipt to the feedback provided to the reporter, using the example of two fictional protagonists: Kate and Aditi.

Help us do the right thing!

Have you noticed something that does not seem right? Or have you been affected yourself? Then speak up. Our video explains how to submit a report, why reporting concerns matters, and what happens after a report is received.  

Reports received with human rights relevance in the reporting year 2025

The metrics describe the reports received through our reporting systems in the reporting year that were related to human rights – broken down into those affected in our own operations and those in our value chain. Of the 24 (2024: 28) reports received, 1 (2024: 4) proved to be a human rights violation. No report was related to a severe human rights incident in the upstream or downstream value chain or in Fresenius’ own operations. 

Consideration of the interests of affected stakeholders

At Fresenius, we place great importance on appropriately considering the perspectives of reporters and potentially affected stakeholders. All reports are reviewed transparently, fairly, and carefully by specially trained personnel. Our aim is to ensure that concerns are taken seriously and addressed in line with applicable legal and internal requirements. We consider all relevant information and perspectives to support balanced and appropriate decisions. We also use feedback from affected stakeholders to assess the acceptance and effectiveness of our process and to continuously improve our procedures.

Review and further development of our systems and procedures

The results of our risk analysis and the findings on potential target groups of our systems and procedures for reporting misconduct are incorporated into the further development of our grievance mechanism and the processing of respective reports. Based on our findings, we review the effectiveness of the procedure on an annual basis, or more frequently if required. Where necessary, we make appropriate adjustments.  

Human rights risks can change over time. We therefore conduct annual and event-related risk analyses in case of substantiated knowledge in our own business locations and at our direct and indirect suppliers. As part of this regular process, we aim to identify human rights risks and impacts in accordance with the requirements of applicable legislation.

Process for identifying and assessing human rights risks

Our approach to identifying and assessing human rights risks is based on three phases: risk identification, risk analysis, and risk assessment and prioritization. The process is illustrated below using the fictional protagonist John.*

*The persons and stories depicted in these images are purely fictional. Any resemblance to actual persons is purely coincidental and unintentional.

How we evaluate and prioritize human rights risks

To assess and prioritize risks, we evaluate both the potential impact on affected individuals and the likelihood of a risk occurring. The results are visualized in a 4x4 risk matrix. The potential impact ranges from “low” to “severe” and is assessed based on four criteria: scale, scope, possibility for remediation, and company involvement. Likelihood ranges from “unlikely” to “almost certain” and is assessed based on process evaluations, comparable cases, and contextual factors that may increase the probability of a risk materializing. 

Results of the risk assessments

We carry out regular risk assessments of human rights topics within our own operations and throughout our value chain in line with applicable international and national requirements. As part of this process, we identify areas that we consider to be of particular relevance based on the potential severity of impacts and our ability to influence them. 

Prioritized risks for own operations

Based on our risk assessments, we have identified the following operational-level risks across specific entities and countries:

• Occupational health and safety
• Discrimination and unequal treatment
• Freedom of association
• Working hours and rest periods  

Prioritized risks for our value chain 

Based on our risk assessments, we have identified the following specific operational-level risks among direct suppliers:

• Compensation and wages
• Freedom of association
• Environmental pollution and waste

Based on the information currently available to us, we have not identified any prioritized risks among indirect suppliers. Further information on our preventive and remedial activities, as well as their implementation, is available here and in our Sustainability Statement.

S&P Global Ratings (S&P), a globally recognized credit rating agency today revised its credit outlook for Fresenius SE from stable to positive. The rating was affirmed at BBB. As part of its evaluation, S&P acknowledged the significant progress highlighting Fresenius’ strong operating performance, particularly within its growth vectors, ongoing cost base improvements, as well as a further reduction in the Company’s leverage. S&P also highlighted the sharpened and simplified portfolio, underscoring the Company’s resilience in the current operating environment.

“The revised outlook is another proof point that #FutureFresenius is paying off. It confirms our focus on long-term profitable growth and balance sheet strength, while at the same time preparing the business for future growth. Based on the strength of our operating businesses and the strong cash flow generation, we have significantly deleveraged the Company over the past years and expect to stay well within our self-imposed target leverage range,” says Fresenius CFO Sara Hennicken.

Fresenius is rated investment grade by the three leading credit rating agencies S&P Global Ratings (BBB/positive), Moody’s (Baa3/stable) and Fitch (BBB-/stable). The company is committed to its investment grade rating and to its self-imposed target leverage range of 2.5 to 3.0x net debt/EBITDA¹, which forms part of its capital allocation framework.

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

S&P Global Ratings (S&P), a globally recognized credit rating agency today revised its credit outlook for Fresenius SE from stable to positive. The rating was affirmed at BBB. As part of its evaluation, S&P acknowledged the significant progress highlighting Fresenius’ strong operating performance, particularly within its growth vectors, ongoing cost base improvements, as well as a further reduction in the Company’s leverage. S&P also highlighted the sharpened and simplified portfolio, underscoring the Company’s resilience in the current operating environment.

“The revised outlook is another proof point that #FutureFresenius is paying off. It confirms our focus on long-term profitable growth and balance sheet strength, while at the same time preparing the business for future growth. Based on the strength of our operating businesses and the strong cash flow generation, we have significantly deleveraged the Company over the past years and expect to stay well within our self-imposed target leverage range,” says Fresenius CFO Sara Hennicken.

Fresenius is rated investment grade by the three leading credit rating agencies S&P Global Ratings (BBB/positive), Moody’s (Baa3/stable) and Fitch (BBB-/stable). The company is committed to its investment grade rating and to its self-imposed target leverage range of 2.5 to 3.0x net debt/EBITDA¹, which forms part of its capital allocation framework.

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