olivLaw · US equity research
Fresenius Medical Care AG FMS
Services-Misc Health & Allied Services, NEC · SIC 8090 · Vertical: Services-Misc Health & Allied Services, NEC (SIC 8090)
Fresenius Medical Care is the world's largest provider of products and services for people with kidney disease, combining medical device manufacturing with clinic-based care. Demand is rising as kidney disease spreads, and the company operates 3,601 dialysis centers as of December 31, 2025. Growing numbers of patients depend on long-term therapy, which makes its business relevant for health systems.
The AI analysis may be outdated: new filings came after its sources (see the «AI analysis» section).
At the close of 04 Nov 2026, Fresenius Medical Care AG (FMS) stock was 23.19 USD (+6.72% on the day), with beta 0.35, 52-week range 20.19–25.70 USD.
Data as of · AI analysis dated · Source: SEC filings and closing prices, computed by olivLaw.
Price history
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Technical reading
- RSI (14)
- 57.6
- strong (55–70)
- Bollinger (20, 2)
- 20.67 – 23.42
- in the upper half of the band · %B 0.92 · band width 12.5%
- SMA 50 / 200
- 22.33 / 22.89
- mixed trend
- MACD (12, 26, 9)
- 0.12 / 0.02
- MACD above signal
Indicators describe past prices; on their own they do not predict direction. On our history the RSI ≤ 40 filter added no return (see the signals methodology).
Performance
| Company | S&P 500 | vs S&P 500 | Vertical median | |
|---|---|---|---|---|
| 1 month | +2.4% | −1.1% | +3.5 pp | — |
| 3 months | −2.9% | −0.5% | −2.5 pp | — |
| 6 months | +10.4% | +4.4% | +6.0 pp | — |
| Year to date | −2.6% | +12.3% | −15.0 pp | — |
| 1 year | −4.5% | +13.5% | −18.1 pp | +17.9% |
| 3 years | +33.0% | +76.4% | −43.4 pp | −12.4% |
| 5 years | −34.7% | +63.7% | −98.3 pp | — |
Price returns, dividends excluded.
Quarterly results
ESEF annual reports carry no quarters: the results are annual (below).
E/P over time
the price (USD) and the reports are in different currencies
E/P = trailing-12-month diluted EPS / price at quarter end. E/P is the inverse of P/E and stays defined when earnings are negative.
Fiscal years
| Fiscal year | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|---|---|---|
| Revenue | 16.5 bn | 17.5 bn | 17.9 bn | 17.6 bn | 19.4 bn | 19.5 bn | 19.3 bn | 19.6 bn |
| Revenue YoY | −7.0% | +5.6% | +2.2% | −1.3% | +10.1% | +0.3% | −0.6% | +1.5% |
| Net income | 2.0 bn | 1.2 bn | 1.2 bn | 969.3 m | 673.4 m | 499.0 m | 537.9 m | 978.4 m |
| Net income YoY | +54.9% | −39.5% | −2.9% | −16.8% | −30.5% | −25.9% | +7.8% | +81.9% |
| Diluted EPS | 6.45 | 3.96 | 3.96 | 3.31 | 2.30 | 1.70 | 1.83 | 3.36 |
| Diluted EPS YoY | +55.0% | −38.6% | 0.0% | −16.4% | −30.5% | −26.1% | +7.6% | +83.6% |
| net % | 12.0% | 6.9% | 6.5% | 5.5% | 3.5% | 2.6% | 2.8% | 5.0% |
| Free cash flow | 1.0 bn | 1.4 bn | unavailable | unavailable | unavailable | unavailable | unavailable | unavailable |
Reported results vs expectations
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Balance sheet & financial health
Fiscal year 2025 · 31 Dec 2025
- Cash
- 1.6 bn EUR
- Financial debt
- 7.3 bn EUR
- Net debt
- 5.7 bn EUR
- Equity
- 14.3 bn EUR
- Total assets
- 31.0 bn EUR
- Debt / equity
- 0.51x
- Current ratio
- 1.26x
- ROE
- 6.5%
- ROA
- 3.0%
- FCF margin
- unavailable
Financial statements (source on every figure)
Revenue and net income (EUR)
Margins
Income statement · EUR
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Revenue | 17.9 bn | 17.6 bn | 19.4 bn | 19.5 bn | 19.3 bn | 19.6 bn | SEC (XBRL)· 24 Feb 2026verified |
| Cost of revenue | 12.3 bn | 12.8 bn | 14.5 bn | 14.5 bn | 14.6 bn | 14.6 bn | SEC (XBRL)· 24 Feb 2026verified |
| Gross profit | 5.5 bn | 5.1 bn | 5.3 bn | 4.9 bn ≈ | 4.8 bn ≈ | 5.0 bn ≈ | SEC (XBRL)· 24 Feb 2026derived |
| Research & development | 193.8 m | 220.8 m | 228.6 m | 232.0 m | 183.5 m | 158.0 m | SEC (XBRL)· 24 Feb 2026verified |
| Operating income | 2.3 bn | 1.9 bn | 1.5 bn | 1.4 bn | 1.4 bn | 1.8 bn | SEC (XBRL)· 24 Feb 2026verified |
| Depreciation & amortisation | 1.6 bn | 1.6 bn | 1.7 bn | 1.6 bn | 1.5 bn | 1.5 bn | SEC (XBRL)· 24 Feb 2026verified |
| EBITDA | 3.9 bn ≈ | 3.4 bn ≈ | 3.2 bn ≈ | 3.0 bn ≈ | 2.9 bn ≈ | 3.3 bn ≈ | SEC (XBRL)· 24 Feb 2026derived |
| Interest expense | 410.0 m | 353.6 m | 360.1 m | 424.6 m | 407.0 m | 384.4 m | SEC (XBRL)· 24 Feb 2026verified |
| Pre-tax income | 1.9 bn | 1.6 bn | 1.2 bn | 1.0 bn | 1.1 bn | 1.5 bn | SEC (XBRL)· 24 Feb 2026verified |
| Income tax | 500.6 m | 352.8 m | 325.0 m | 300.6 m | 316.1 m | 321.0 m | SEC (XBRL)· 24 Feb 2026verified |
| Net income | 1.2 bn | 969.3 m | 673.4 m | 499.0 m | 537.9 m | 978.4 m | SEC (XBRL)· 24 Feb 2026verified |
| Diluted EPS | 3.96 | 3.31 | 2.30 | 1.70 | 1.83 | 3.36 | SEC (XBRL)· 24 Feb 2026verified |
≈ computed by olivLaw from the reported lines of the same year: Revenue − Cost of revenue; Operating income + Depreciation & amortisation.
Balance sheet · EUR
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Cash | 1.1 bn | 1.5 bn | 1.3 bn | 1.4 bn | 1.2 bn | 1.6 bn | SEC (XBRL)· 24 Feb 2026verified |
| Inventories | 1.9 bn | 2.0 bn | 2.3 bn | 2.2 bn | 2.1 bn | 2.1 bn | SEC (XBRL)· 24 Feb 2026verified |
| Current assets | 7.3 bn | 8.0 bn | 8.2 bn | 8.7 bn | 7.9 bn | 7.9 bn | SEC (XBRL)· 24 Feb 2026verified |
| Property, plant & equipment, net | 4.1 bn | 4.2 bn | 4.2 bn | 3.8 bn | 3.6 bn | 3.5 bn | SEC (XBRL)· 24 Feb 2026verified |
| Goodwill | 13.0 bn | 14.4 bn | 15.8 bn | 14.7 bn | 15.2 bn | 13.6 bn | SEC (XBRL)· 24 Feb 2026verified |
| Intangibles (excl. goodwill) | 1.4 bn | 1.5 bn | 1.5 bn | 1.4 bn | 1.4 bn | 1.3 bn | SEC (XBRL)· 24 Feb 2026verified |
| Total assets | 31.7 bn | 34.4 bn | 35.8 bn | 33.9 bn | 33.6 bn | 31.0 bn | SEC (XBRL)· 24 Feb 2026verified |
| Short-term debt | 79.3 m | 1.3 bn | 648.8 m | 456.9 m | 2.1 m | 1.6 bn | SEC (XBRL)· 24 Feb 2026verified |
| Long-term debt | 6.8 bn | 6.6 bn | 7.2 bn | 7.0 bn | 6.3 bn | 5.7 bn | SEC (XBRL)· 24 Feb 2026verified |
| Current liabilities | 6.1 bn | 7.3 bn | 6.5 bn | 6.1 bn | 5.7 bn | 6.2 bn | SEC (XBRL)· 24 Feb 2026verified |
| Total liabilities | 19.4 bn | 20.4 bn | 20.3 bn | 19.1 bn | 17.8 bn | 16.7 bn | SEC (XBRL)· 24 Feb 2026verified |
| Equity | 12.3 bn | 14.0 bn | 15.4 bn | 14.8 bn | 15.8 bn | 14.3 bn | SEC (XBRL)· 24 Feb 2026verified |
| Shares outstanding at year end | 292.9 m | 293.0 m | 293.4 m | 293.4 m | 293.4 m | 279.3 m | SEC (XBRL)· 24 Feb 2026verified |
Cash flow · EUR
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Operating cash flow | 4.2 bn | 2.5 bn | 2.2 bn | 2.6 bn | 2.4 bn | 2.7 bn | SEC (XBRL)· 24 Feb 2026verified |
| Investing cash flow | -1.3 bn | -1.2 bn | -734.7 m | -544.2 m | -84.9 m | -722.5 m | SEC (XBRL)· 24 Feb 2026verified |
| Financing cash flow | -2.7 bn | -1.0 bn | -1.6 bn | -1.9 bn | -2.6 bn | -1.4 bn | SEC (XBRL)· 24 Feb 2026verified |
| Share repurchases | 366.0 m | — | — | — | — | 585.3 m | SEC (XBRL)· 24 Feb 2026verified |
Computed indicators
Growth
Profitability
Returns
Balance sheet
Liquidity
Cash
Efficiency
Market and valuation
1 indicators that do not apply to the sector.
Valuation
olivLaw classification
- score weight coverage: 54.2% of at least 60%
A scoring methodology on indicators and valuation, not investment advice.
Closing price
04 Nov 2026Source: olivLaw, closing series
Market cap: unavailable
Price and reporting are in different currencies; market indicators are unavailable.
Key indicators
Coverage and freshness
Score by group
54% · Insufficient data
Estimated value range
The combined range = the median of the valid methods' low, central and high values; it is not a probability interval and does not cover every result. Envelope of all methods: 16.17 – 91.01 EUR.
Valuation assumptions are editorial choices, not measured; beta is not measured.
Method ranges (EUR per share)
— — Mid · ▏ Price
Valuation methods
- DCF (discounted cash flow)unavailable · the input exists, but its latest figure is far older than the latest reported period: not used
- Peers: EV/EBITDAunavailable · not enough peers
- Peers: P/E49.62 – 91.01 (Mid 72.32)6 companies used · median multiple 21.5x · quartiles 14.8x – 27.1xAGL, DVA, NIVF, PGNY, SHC, VMD
- Dividend discount (DDM)16.17 – 22.05 (Mid 18.65)
Classification (SIC) comparables group by industry code, not by economic activity; the direct group is an editorial selection by activity. Members' multiples are on their own trailing twelve months, at their own latest close.
Assumptions (illustrative, editorial)
- Risk-free rate
- 3.0%
- Equity risk premium
- 5.5%
- Beta (default)
- 1.00
- Cost of equity
- 8.5%
- Terminal growth
- 2.0%
Factor scorecard
Insufficient data
Minimum-evidence gate: score weight coverage: 54.2% of at least 60%
| Factor | Value | Score | Weight used |
|---|---|---|---|
| ROIC · Quality | 7.1% | 39 (on a fixed band) | 19% |
| Net margin · Quality | 5.0% | 50 (vs peers) | 12% |
| FCF conversion · Quality | unavailable | unavailable | — |
| Revenue CAGR 3Y · Growth | 0.4% | 3 (on a fixed band) | 15% |
| EPS CAGR 3Y · Growth | 13.5% | 90 (on a fixed band) | 15% |
| Net debt / EBITDA · Balance sheet | 1.7x | 65 (on a fixed band) | 19% |
| Interest coverage · Balance sheet | 4.8x | 50 (on a fixed band) | 12% |
| Current ratio · Balance sheet | 1.3x | 39 (on a fixed band) | 8% |
| P/E (TTM) · Valuation | unavailable | unavailable | — |
| EV/EBITDA · Valuation | unavailable | unavailable | — |
| FCF yield · Valuation | unavailable | unavailable | — |
| Shareholder yield (distributions) · Returns | unavailable | unavailable | — |
| Payout ratio (FCF) · Returns | unavailable | unavailable | — |
Factors without a value were dropped; the remaining weights were renormalised.
Score groups
- Balance sheet55/100 · 3/3 factors with a value
- Growth47/100 · 2/2 factors with a value
- Quality43/100 · 2/3 factors with a value
- Returns· partialunavailable · 0/2 factors with a value
- Valuation· partialunavailable · 0/3 factors with a value
A «partial» group is computed from under half of its weight or from one factor: it is not a full assessment of the group.
Memo
FRESENIUS MEDICAL CARE AG (FMS). Latest full fiscal year: 2025; data up to 2025-12-31.
Figures computed from the financial statements: revenue 19.6 bn EUR in 2025; YoY growth 1.5%; net margin 5.0%; ROE 7.0%; net debt/EBITDA 1.7x.
The estimated value range is 32.89–56.53 EUR per share (median of 2 methods, agreement: low); assumptions are illustrative. The range is the median of the methods' low, central and high values, not a probability interval.
Insufficient data for a verdict (score weight coverage: 54.2% of at least 60%).
Text generated deterministically from the figures shown; no language model. Not investment advice.
What supports the thesis
- EPS CAGR 3Y: 13.5%
What contradicts it
- Revenue CAGR 3Y: 0.4%
- The valuation methods diverge
Not assessed (insufficient data or a ratio without meaning): FCF conversion, P/E (TTM), EV/EBITDA, FCF yield, Shareholder yield (distributions), Payout ratio (FCF).
Versus the vertical median
Services-Misc Health & Allied Services, NEC (SIC 8090) · same industry (4-digit SIC) · compared with 10 companies
Multiples and returns vs the median
Price rebased to 100 (monthly, 5 years)
Companies in the vertical
| Market cap | P/E | ROE | Net margin | Revenue YoY | 1A / 3A | |
|---|---|---|---|---|---|---|
| DVADavita Inc. | 12.1 bn | 14.2 | — | 6.5% | +6.5% | +61% / +90% |
| FMSFresenius Medical Care AG | 6.5 bn | 6.9 | 7.0% | 5.0% | +1.5% | −5% / +33% |
| SHCSotera Health Company | 4.7 bn | 27.3 | 27.0% | 14.1% | +5.7% | −6% / +20% |
| PGNYProgyny, Inc. | 2.3 bn | 32.7 | 16.2% | 6.0% | +10.4% | +14% / −12% |
| AGLagilon health, inc. | 1.6 bn | 16.5 | -29.7% | -1.5% | −2.1% | +491% / −64% |
| VMDViemed Healthcare, Inc. | 383.1 m | 26.5 | 11.0% | 5.0% | +20.5% | +46% / +30% |
| CCELCryo-Cell International, Inc. | 40.9 m | — | — | -6.2% | −1.3% | +18% / −5% |
| BRTXBiorestorative Therapies, Inc. | 38.5 m | — | -241.1% | -3,089.6% | −10.3% | +40% / −21% |
| MGRXMangoceuticals, Inc. | 4.5 m | — | -95.1% | -4,791.3% | −26.0% | −81% / −98% |
| NIVFNewgenivf Group Limited | 166.5 k | 0.2 | 77.2% | 209.0% | −13.0% | −100% / −100% |
| MCTACharming Medical Limited | — | — | -0.9% | -0.5% | −22.7% | unavailable / unavailable |
1- and 3-year price returns: for FMS from daily closes (the same as the performance table), for the other companies from month-end closes.
olivLaw engine forecast
The world engine ran after the company's latest material disclosure. Probabilities are of TOUCHING a level within the horizon (not closing there) and sit next to the random walk (p_rw), the no-information benchmark.
The engine has no published run for this company yet.
Valuation scenarios (editable assumptions)
Illustrative scenarios
Scenarios are not available. input data missing
AI analysis
AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.
Possibly outdated: the newest document it read is from 24 Feb 2026; since then the company filed 6-K (03 Nov 2026), 6-K (07 Oct 2026), 6-K (25 Sept 2026), 6-K (27 Aug 2026), 6-K (04 Aug 2026).
In brief
Fresenius Medical Care is the world's largest provider of products and services for people with kidney disease, combining medical device manufacturing with clinic-based care. Demand is rising as kidney disease spreads, and the company operates 3,601 dialysis centers as of December 31, 2025 1. Growing numbers of patients depend on long-term therapy, which makes its business relevant for health systems.
SWOT
Strengths
- The company has the largest dialysis clinic network in the world and strong vertical integration between manufacturing and services 1.
- Its presence in more than 140 countries and its ability to support home and hospital treatment give operational flexibility 1.
- The Value-Based Care segment, strengthened through Interwell Health, offers a differentiated performance-based care model 1.
Weaknesses
- Profitability is modest, and adjusted ROIC for 2025 remains at a low level 1.
- A significant part of revenue depends on U.S. government reimbursement, which is generally lower than private payment 1.
- The company has had to divest several non-core activities, which points to difficulties in sustaining some markets 1.
Opportunities
Risks
- Dependence on U.S. regulationhigh
The company operates in a heavily regulated sector, and legislative changes could directly affect revenue and profitability 1.
- Changes to Medicare and Medicaid reimbursementhigh
Government tariffs are generally lower than private ones, and reduced funding could affect the revenue mix 1.
- Shift in patient coveragemedium
The expiry of ACA enhanced subsidies could move patients from private insurance toward Medicare and Medicaid, which pay lower rates 1.
- Pressure from insurersmedium
Consolidation among insurers and pharmacy benefit managers could limit the company's ability to negotiate favorable rates 1.
- Litigation and compliancemedium
Failure to meet billing and reporting rules could lead to exclusion from government programs or to litigation 1.
Investment thesis
What would need to be true (bull case)
- Demand for dialysis keeps rising with the spread of kidney disease, supporting long-term revenue 1.
- The company is a global leader in its field with an unusually integrated link between manufacturing and services 1.
- Growth in Value-Based Care could create revenue sources more stable than per-procedure reimbursement 1.
What would break the thesis
What to watch
- Development of Medicare and Medicaid reimbursement and the effects of OBBBA2026
- Results of the Value-Based Care segment after the higher ownership stakeQ1 2027
- Share of patients treated at home, especially in the U.S.next 10-K
- Pace of growth in the number of dialysis patients worldwide2027
Products, market & competition
AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.
Possibly outdated: the newest document it read is from 24 Feb 2026; since then the company filed 6-K (03 Nov 2026), 6-K (07 Oct 2026), 6-K (25 Sept 2026), 6-K (27 Aug 2026), 6-K (04 Aug 2026).
The business
The company presents itself as a vertically integrated medical technology and healthcare service provider that develops, manufactures and distributes devices, systems, products and medicines for kidney care in more than 140 countries 1. Its activity is organized into three segments: Care Delivery, Value-Based Care and Care Enablement 1. At the end of 2025 it served 291,902 dialysis patients in its clinic network 1.
The core market is dialysis, the treatment that replaces kidney function in chronic kidney failure. In-center hemodialysis is the most common form, used by 89% of dialysis patients worldwide in 2025 1. The company says a substantial part of its revenue comes from services, with a large share tied to Medicare and private reimbursement 1.
The company has reshaped its portfolio in recent years by divesting non-core activities, including clinics in Brazil, Kazakhstan and Malaysia sold in 2025 1. At the same time it has expanded Value-Based Care, aiming to improve care for patients with chronic kidney disease 1. This focus on core activities is described as part of a portfolio optimization plan 1.
Segments
Care Delivery
The Care Delivery segment covers the global network of dialysis clinics and services for the complex care needs of people with kidney disease 1. The company runs 3,601 clinics across this segment, with the U.S. clinics serving most of its patients 1.
Market context
The number of people needing dialysis is growing by 4% to 5% a year worldwide and is expected to reach about 7 million by 2035 1. In acute kidney replacement therapy the company holds a market share of about 30% 1.
The market is heavily regulated, and revenue depends largely on U.S. government reimbursement, which does not always keep pace with cost increases 1. A shift of patients toward public programs or different insurance could change the revenue mix, so market developments depend on health policy in each country 1.
Trends
- Rising kidney disease burdentailwind
Obesity, diabetes and hypertension are driving a rise in kidney disease, and the number of patients needing dialysis or transplant keeps growing 1. If this trend continues, demand for the company's services could remain high 1.
- Shift to home dialysismixed
Home-based treatment, especially peritoneal dialysis, is growing in some markets, notably in the U.S., where a share of patients are treated at home 1. The company supports this shift with materials, training and clinical monitoring 1.
- U.S. reimbursement changesheadwind
The 2025 legislation, including OBBBA, limits Medicaid funding and ACA exchange coverage, which could move patients toward programs with lower rates 1. Such changes could affect revenue in the Care Delivery segment directly 1.
- Cost pressure on health systemsheadwind
Public health systems are seeking to reduce costs, which can pressure tariffs and reimbursement conditions for dialysis 1. Consolidation among insurers and pharmacy benefit managers could reduce the company's bargaining power 1.
Competitive position
The company presents itself as the world's largest provider of products and services for kidney patients, and its clinic network is the largest globally 1. Competition comes from other dialysis service providers and from device and kidney-technology makers, although the source does not name competitors of comparable scale 1.
In Value-Based Care the company competes with other providers of performance-based care models, while in manufacturing it faces firms offering hemodialysis and peritoneal dialysis technology 1. Its advantage rests on vertical integration of production and services 1.
- Other dialysis service providers
Competitors in the clinic and dialysis services segment, not named individually in the source 1.
- Dialysis device manufacturers
Competitors in hemodialysis equipment and consumables, without explicit names in the source 1.
- Performance-based care model providers
Competitors in Value-Based Care, described generically in the source 1.
- Acute kidney replacement therapy providers
Competitors in the acute kidney replacement market, where the company holds about 30% share 1.
Links, dependencies and risks
Who the company is tied to, from its own SEC filings (customers, suppliers, production, partners, competitors, countries, regulation), from the 5 %+ holders' statements (13D/13G) and from what other companies say about it. Click a node for its evidence; on a listed company the graph moves to it.
Loading the links…
News & filings
In the press
No news in our archive over the last 180 days.
SEC filings
- Current report (foreign issuer)03 Nov 2026
- Current report (foreign issuer)03 Nov 2026
- Current report (foreign issuer)07 Oct 2026
- Current report (foreign issuer)25 Sept 2026
- Current report (foreign issuer)27 Aug 2026
- Current report (foreign issuer)04 Aug 2026
- Current report (foreign issuer)03 Aug 2026
- Current report (foreign issuer)03 Aug 2026
- Current report (foreign issuer)03 Aug 2026
- Current report (foreign issuer)29 Jul 2026
Sources
- [1] Form 20-F, fiscal year ended 2025-12-31 · SEC / Fresenius Medical Care AG · 24 Feb 2026
Figures computed by olivLaw from SEC filings and closing prices; the qualitative analysis is AI-generated from cited sources. Not investment advice.