Fresenius Posts Adjusted Operating Income of 545 Million Euros and Lowers Upper End of 2026 Outlook
Key Facts
Fresenius Medical Care said on Nov. 3, 2026, that operating income excluding special items was 545 million euros in the third quarter, down 5% from a year earlier but above Vara Research’s consensus of 518 million euros, according to Reuters. By contrast, reported operating income fell 19% to 384 million euros, the company said. Net income attributable to shareholders was 160 million euros, down 42% year on year. Net income excluding special items fell 10% to 291 million euros. Adjusted basic earnings per share were unchanged at 1.11 euros, while basic earnings per share fell 35% to 0.61 euros. The company did not cite a comparison between adjusted earnings per share and analyst estimates.
Group revenue was 4.937 billion euros, up 1% from the third quarter of 2025, when it was 4.885 billion euros. Revenue fell 1% excluding the effect of foreign exchange rates, while organic growth was just 0.1%, the company said. In the first nine months of 2026, revenue fell 1% to 14.409 billion euros on a reported basis. It rose 2% at constant currency and 3% organically over the same period. Performance varied by business: Care Delivery revenue rose 3% to 3.492 billion euros, and Care Enablement revenue increased 7% to 1.451 billion euros. By contrast, Value-Based Care revenue fell 7% to 537 million euros.
The company attributed pressure on profitability to regulatory and inflationary headwinds and cited one-time costs of 108 million euros in China linked to a refinement of its commercial strategy. The costs mainly included asset impairments, inventory disposals and termination costs. It said the reset involved stopping local production and sales of the 4008A device and exiting the peritoneal dialysis business, while meeting existing commitments. The company included the costs of these steps among special items in the Care Enablement segment. Those items are reflected in the gap between the 19% fall in reported operating income and the 5% decline excluding special items. At group level, adjusted operating income exceeded Vara’s estimates but remained below the year-earlier level.
In Care Delivery, operating income excluding special items rose 4% to 513 million euros, the company said. Management attributed the improvement to pricing and savings, which partly offset pressure from TDAPA rules and higher labor costs. It said the segment’s underlying operating income improved 21% after excluding the negative impact of TDAPA rules. But treatment activity in the U.S. market itself fell 1.1% in the third quarter, according to Reuters. The decline accelerated from 0.4% in the first quarter and 0.9% in the second. As an indicator of operational expansion, the company said 348 U.S. clinics, representing 16% of its dialysis machines in the United States, had switched to the 5008X CAREsystem as of Sept. 30, with 1.3 million treatments performed.
Despite the decline in net income, free cash flow rose 3% to 564 million euros in the third quarter, compared with 550 million euros in the year-earlier period. In the first nine months of 2026, free cash flow increased 3% to 1.229 billion euros, the company said. The company also lowered the upper end of its annual operating income outlook. It now expects operating income in 2026 to range from flat to a mid-single-digit decline, compared with its previous range of a mid-single-digit decline to mid-single-digit growth. It kept its 2026 revenue outlook at broadly stable growth. The chief executive said the narrower range reflected operating income performance in the first nine months and expected headwinds in the fourth quarter, adding that the outlook was now in the lower half of the previous range.
New Chief Executive Shervin Korangy said parts of the company’s business were still at an early stage of development following structural changes in recent years. Management, he added, “is cautious in its assessment of performance and seeks to improve the current trajectory over time.” He said the foundations of the FME25+ transformation had been laid to support profitable growth and create value for stakeholders. In market data cited by EL7, FMS closed at 22.61 on Nov. 2, 2026, with no price currency specified in the record. The timing of updated guidance remains tied to fourth-quarter performance, which management said it expects to face headwinds.