Fresenius Medical Care (FME) Q3 2026 earnings summary

Executive summary

• Q3 revenue was €4,937m, up 1% reported, down 1% at constant currency and up 0.1% organically; adjusted operating income fell 5% reported and 6% at constant currency.

• Reported operating income declined 19% to €384m and shareholder net income fell 42% to €160m, with China strategy and other special-item costs affecting results.

• FY2026 revenue outlook remained broadly flat; operating income guidance narrowed to flat through negative mid-single-digit growth at constant currency, excluding special items.

Financial highlights

• Q3 adjusted operating income was €545m versus €574m, with an 11.0% margin versus 11.7%; reported operating margin was 7.8% versus 9.8%.

• Q3 adjusted net income attributable to shareholders was €291m versus €322m; 9M reported net income was €496m, while adjusted net income was €844m versus €836m.

• 9M revenue was €14,409m, down 1% reported and up 2% at constant currency; adjusted operating income was €1,581m, up 5% reported and 8% at constant currency.

• Q3 operating cash flow rose 8% to €798m and free cash flow increased 3% to €564m; 9M operating cash flow was €1,885m and free cash flow €1,229m.

• Q3 special items totaled €161m for operating income and €131m for shareholder net income; China strategy refinement costs were €108m.

Outlook and guidance

• FY2026 revenue is expected to remain broadly flat and operating income to range from flat to negative mid-single-digit growth, at constant currency and excluding special items.

• FY2026 TDAPA headwind is expected at €50m; Q4 headwind is estimated at €140m after a Q3 headwind slightly above €60m.

• FY2027 TDAPA-related and base-business pressures are expected to create a €300m–€350m operating income headwind versus 2026; detailed guidance is due in February.

• FY2026 inflation headwinds are expected to exceed the previously stated €300m upper end; FME25+ savings remain on track at €250m for the year.

• FME25+ is expected to deliver €250m of savings and €350m of related one-time costs in 2026; cumulative savings target is €1.2bn by end-2027.