Fresenius Medical Care AG & Co. KGaA (FMS) reported first‑quarter 2026 results that showed revenue of €4,612 million, a 6 % decline year‑over‑year but a 3 % increase at constant currency, and operating income of €286 million, down 14 % from the same quarter last year. Adjusted earnings per share rose to €0.91, a 10 % increase from the €0.84 reported in Q1 2025, and a significant beat over the consensus estimate of $0.57 (≈€0.54). Operating income excluding special items climbed 2 % to €467 million, lifting the adjusted operating margin to 10.1 % from 9.4 % a year earlier. The company also accelerated its share‑buyback program, repurchasing 23.3 million shares for €941 million as of March 31 2026, and completed a total of 24.8 million shares by April 30 2026.
Revenue fell 6 % largely because of adverse currency movements and the divestiture of legacy assets, which offset gains in core dialysis services. Care Delivery, the company’s largest segment, posted strong operating income growth driven by positive TDAPA effects, while Care Enablement and Value‑Based Care delivered mixed results. The mix shift toward higher‑margin services helped lift the adjusted operating margin, but the overall revenue decline pressured the headline operating income.
Adjusted operating income rose 2 % to €467 million, reflecting disciplined cost management and a favorable mix of services. The 10.1 % adjusted margin, up from 9.4 % a year earlier, indicates that the company is successfully leveraging its FME25+ transformation program to improve profitability even as revenue contracts. The 14 % drop in headline operating income is largely attributable to the revenue decline and the impact of one‑time special items that were excluded in the adjusted figure.
Adjusted EPS of €0.91 beat the consensus estimate of $0.57 (≈€0.54) by €0.34, a 60 % over‑performance. The beat was driven by strong cost control, a favorable service mix, and the continued momentum of the FME Reignite strategy, which has delivered savings and improved operating leverage. “Fresenius Medical Care delivered continued operational and financial progress in the first quarter, with organic revenue growth, improved profitability and adjusted EPS growth. Operating income growth was in line with our planned phasing,” said CEO Helen Giza.
The accelerated share‑buyback program reflects management’s confidence in the company’s long‑term value creation. “We are pleased with the speed of the rollout of our innovative 5008X CAREsystem, now available in around 100 clinics and with more than 100,000 treatments performed,” added Giza. The program’s completion of 24.8 million shares by April 30 2026 demonstrates a commitment to returning capital to shareholders while maintaining a strong balance sheet.
Fresenius Medical Care reaffirmed its 2026 outlook, maintaining guidance for group operating income and margins despite regulatory headwinds. The company highlighted ongoing challenges from currency fluctuations, pricing pressure in China, and regulatory scrutiny, while underscoring tailwinds from positive TDAPA effects, the FME25+ savings program, and the expanding 5008X CAREsystem rollout. “Through focused execution of our FME Reignite strategy, we remain on track to maintain Group operating income at a consistent high level while overcoming significant regulatory headwinds. We confirm our outlook for 2026 and are firmly committed to creating long‑term value for our shareholders,” Giza said.
Market reaction to the results was negative, with shares falling between 5 % and 7 % in pre‑market trading. Investors focused on the revenue miss and the impact of currency headwinds, even as the adjusted EPS beat expectations and the company reiterated its confidence in the 2026 guidance.
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