Fresenius Medical Care AG reported fourth‑quarter 2025 results that surpassed analyst expectations, with revenue of €5,070 million and operating income of €594 million, a 129% year‑over‑year increase. Basic earnings per share rose to €1.14, a beat of €0.04 over the consensus estimate of €1.10, driven largely by disciplined cost control and the continued impact of the FME 25+ transformation program.
Revenue growth was largely flat year‑over‑year, but the company’s three operating segments delivered a mixed picture. Care Delivery generated €3,507 million, a modest decline of 1% from the prior year, while Value‑Based Care revenue surged 32% to €637 million, reflecting the segment’s transition to a pay‑for‑performance model. Care Enablement revenue fell 9% to €1,401 million, a decline driven by regulatory headwinds in China and a shift in reimbursement mix.
The operating income margin expanded to 11.7% from 5.1% in Q4 2024, a 6.6‑percentage‑point lift that the company attributes to the FME 25+ program’s €238 million of additional sustainable savings for 2025. CEO Helen Giza said, “Our operating income margin of 11.3% is well within the mid‑term margin target band we established three years ago for 2025. The Group's step‑up in profitability was the result of solid business growth, accelerated FME25+ efficiency gains, higher‑than‑expected benefits from TDAPA regulation and favorable reimbursement developments, with all segments making meaningful contributions.”
Looking ahead, Fresenius Medical Care guided for flat revenue growth in 2026 and a 3‑7% compound annual growth rate in operating income from 2025 to 2028. Management framed 2026 as a transition year with a “very high base” following 2025's profitability step‑up and with temporary TDAPA benefits beginning to phase out. Giza added, “Looking ahead to 2026, we are set to build on the remarkable transformation of recent years and advance the execution of our FME Reignite strategy. For our patients, we are excited to expand access to high‑volume hemodiafiltration in the U.S. with the large‑scale rollout of our innovative 5008X CAREsystem.”
The market reaction was muted, with a pre‑market decline of 5.61% after the announcement. Investors focused on the flat 2026 outlook and the anticipated transition year, which outweighed the strong Q4 performance and margin expansion. Despite the earnings beat, the company’s forward guidance and the phasing out of TDAPA benefits tempered enthusiasm among investors.
Overall, Fresenius Medical Care’s Q4 2025 results demonstrate the effectiveness of its cost‑saving initiatives and the resilience of its core business segments, while the company signals cautious optimism for 2026 as it navigates regulatory changes and continues to invest in new technology deployments.
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