Fresenius Medical Care (FME) Q1 2026 earnings summary

Executive summary

• Organic revenue grew 3.9%; adjusted operating income rose 10% at constant currency and adjusted margin expanded to 10.1%.

• Reported operating income fell 14% and net income attributable to shareholders fell 22%, reflecting special items including FME25+ costs.

• FY 2026 outlook was reaffirmed; FME25+ savings, U.S. clinic optimization and the 5008X CAREsystem rollout progressed.

Financial highlights

• Revenue was €4,612m, down 5.5% reported, up 3.1% at constant currency and 3.9% organically.

• Reported operating income was €286m, down 14%; excluding special items, it was €467m and grew 10% at constant currency.

• Net income attributable to shareholders was €118m, down 22%; adjusted attributable net income was €251m.

• Operating cash flow rose 39% to €227m; free cash flow increased 94% to €40m.

• Special items totaled €181m, including €166m for FME25+; reported operating margin was 6.2% versus 6.8% a year earlier.

Outlook and guidance

• FY 2026 revenue is expected to be broadly flat at constant currency; operating income is expected within a positive-to-negative mid-single-digit growth range, excluding special items.

• The outlook implies a 10.5%–12.0% operating margin; positive earnings growth is expected in H1, with TDAPA headwinds weighing on H2 comparisons.

• 2026 capital expenditures are expected at €0.8bn–€1.0bn, including investment in 5008X rollout, production facilities and R&D.

• FME25+ savings are expected to reach €250m in 2026, alongside €350m of related one-time costs; the program targets €1.2bn cumulative savings by end-2027.