You should read the following discussion and analysis of the results of operations of the Company and its subsidiaries in conjunction with our historical consolidated financial statements and related notes contained elsewhere in this report. Some of the statements contained below, including those concerning future revenue, costs, and capital expenditures, and possible changes in our industry, competition, and financial condition include forward-looking statements. We made these forward-looking statements based on the expectations and beliefs of management concerning future events which may affect us, but we cannot assure that such events will occur or that the results will be as anticipated. Because such statements involve risks and uncertainties, actual results may differ materially from the results which the forward-looking statements express or imply. Such statements include the matters and are subject to the uncertainties that we described in the discussion in this report entitled “Introduction - Forward-looking statements.” See also Item 3.D, “Key Information – Risk factors.” Our business is also subject to other risks and uncertainties that we describe from time to time in our public filings. Developments in any of these areas could cause our results to differ materially from the results that we or others have projected or may project. Our reported financial condition and results of operations are sensitive to accounting methods, assumptions, and estimates that are the basis for our financial statements. For information about our discretionary accounting policies and estimations, see note 2 of the notes to our consolidated financial statements included in this report. The critical accounting policies, judgments made in the creation and application of these policies, and sensitivities of reported results to changes in accounting policies, assumptions, and estimates are factors to be considered along with our financial statements and the discussion below in III. Results of operations, financial position and net assets - “Results of operations.” I. Performance management system The Management Board oversees our Company by setting strategic and operational targets and measuring various financial key performance indicators used for internal management determined in euro based upon IFRS Accounting Standards and other measures, as described below. The key performance indicators used for internal management are identical in the individual operating segments. Each operating segment is evaluated based on target figures that reflect the revenue and expenses they control. For a discussion of items that we believe are within or are outside of operating segment control, see “II. Financial condition and results of operations — Company Structure,” below). Certain of the following financial measures and other financial information as well as discussions and analyses set out in this report include measures that are not defined by IFRS Accounting Standards (Non-IFRS Measures). We believe this information, along with comparable IFRS Accounting Standards financial measurements, is useful to our investors as it provides a basis for assessing our performance, payment obligations related to performance-based compensation, our compliance with covenants, and enhanced transparency and comparability of our results. Non-IFRS financial measures should not be viewed or interpreted as a substitute for financial information presented in accordance with IFRS Accounting Standards. Our presentation of some financial measures used in this report such as changes in revenue, operating income, and net income attributable to shareholders of FME AG (or net income) includes the impact of translating local currencies to our reporting currency for financial reporting purposes. We calculate and present these financial measures using both IFRS Accounting Standards and at constant exchange rates to show changes in these metrics and other items without giving effect to period-to-period currency fluctuations. Under IFRS Accounting Standards, amounts received in local (non-euro) currency are translated into euro at the average exchange rate for the period presented. Once we translate the local currency for the constant currency, we then calculate the change, as a percentage, of the current period calculated using the prior period exchange rates versus the prior period. This resulting percentage is a Non-IFRS Measure referring to a change as a percentage at constant currency. These currency-adjusted financial measures are identifiable by the designated terms “Constant Exchange Rates” or “Constant Currency.” The primary key performance indicators are presented both in accordance with IFRS Accounting Standards and at Constant Currency. Each of these indicators presented at Constant Currency is considered a non-IFRS measure. For the purposes of management compensation, these metrics are also benchmarked at the underlying exchange rates used in the calculation of our incentive compensation targets. 68 Table of Contents We believe that the measures at Constant Currency are useful to investors, lenders, and other creditors because such information enables them to gauge the impact of currency fluctuations on our revenue, operating income, net income attributable to shareholders of FME AG, and other items from period to period. In addition, under our long-term incentive plans, we measure the attainment of certain predetermined financial targets for revenue growth and net income growth in Constant Currency. However, we limit our use of Constant Currency period-over-period changes to a measure for the impact of currency fluctuations on the translation of local currency into euro. We do not evaluate our results and performance without considering both: (1) period-over-period changes in revenue, operating income, net income attributable to shareholders of FME AG, and other items prepared in accordance with IFRS Accounting Standards, and (2) Constant Currency changes in revenue, operating income, net income attributable to shareholders of FME AG, and other items. We caution the readers of this report not to consider these measures in isolation, but to review them in conjunction with changes in revenue, operating income, net income attributable to shareholders of FME AG, and other items prepared in accordance with IFRS Accounting Standards. We present the growth rate derived from non-IFRS measures next to the growth rate derived from IFRS Accounting Standards measures such as revenue, operating income, net income attributable to shareholders of FME AG, and other items. As the reconciliation is inherent in the disclosure included within “Results of operations, financial position and net assets,” below, we believe that a separate reconciliation would not provide any additional benefit. Financial performance indicators Primary key performance indicators Revenue and revenue growth We use revenue and revenue growth as key performance indicators as we believe that the key to continue growing our revenue is to attract new patients and increase the number of treatments performed each year. The number of treatments performed each year is therefore an indicator of both the absolute amount of revenue as well as continued revenue growth. For further information regarding revenue recognition and measurement, refer to note 1 k) of the notes to the consolidated financial statements included in this report. Revenue and revenue growth are also benchmarked based on movement at Constant Exchange Rates (Non-IFRS Measures). Operating income Operating income is the most appropriate measure for evaluating the profitability of the operating segments and therefore is also a key performance indicator. Operating income is also benchmarked based on movement at Constant Exchange Rates (Non-IFRS Measure). Secondary financial performance indicators Return on invested capital (ROIC) (Non-IFRS Measure) ROIC is the ratio of operating income, for the last twelve months, after tax (net operating profit after tax or NOPAT) to the average invested capital of the last five quarter closing dates, including adjustments for acquisitions and divestitures made during the last twelve months with a purchase price above a €50 M threshold, consistent with the respective adjustments made in the determination of adjusted EBITDA (earnings before interest, taxes, depreciation, and amortization) below (see “Net leverage ratio (Non-IFRS Measure)”). ROIC expresses how efficiently we allocate the capital under our control or how well we employ our capital with regard to investment projects. For further adjustments to ROIC used in the calculation of Management Board compensation, see Item 6.B, “Directors, senior management and employees — Compensation,” below. The following tables show the reconciliation of average invested capital to total assets, which we believe to be the most directly comparable IFRS Accounting Standards financial measure, and how ROIC is calculated: 69 Table of Contents ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Reconciliation of average invested capital and ROIC (Non-IFRS Measure, unadjusted) in € M, except where otherwise specified ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ September 30, ​ June 30, ​ March 31, ​ December 31, 2025 ​ ​ ​ 2025 ​ ​ ​ 2025 ​ ​ ​ 2025 ​ ​ ​ 2025 ​ ​ ​ 2024 Total assets ​ 31,002 ​ 30,887 ​ 31,291 32,735 33,567 Plus: Cumulative goodwill amortization and impairment loss ​ 379 ​ 380 ​ 465 494 504 Minus: Cash and cash equivalents(1) ​ (1,599) ​ (1,256) ​ (1,720) (1,079) (1,185) Minus: Deferred tax assets(1) ​ (237) ​ (231) ​ (232) (225) (230) Minus: Accounts payable to unrelated parties(1) ​ (738) ​ (726) ​ (687) (771) (906) Minus: Accounts payable to related parties ​ (85) ​ (92) ​ (48) (106) (55) Minus: Provisions and other current liabilities(2) ​ (2,699) ​ (3,235) ​ (2,496) (2,637) (2,803) Minus: Income tax liabilities(1) ​ (248) ​ (256) ​ (247) (238) (222) Invested capital ​ 25,775 ​ 25,471 ​ 26,326 28,173 28,670 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average invested capital as of December 31, 2025 26,883 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Operating income 1,827 ​ ​ ​ ​ Income tax expense(3) (451) ​ ​ ​ ​ NOPAT 1,376 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Adjustments to average invested capital and ROIC in € M, except where otherwise specified ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ September 30, ​ June 30, ​ March 31, ​ December 31, 2025 ​ ​ ​ 2025 ​ ​ ​ 2025(4) ​ ​ ​ 2025(4) ​ ​ ​ 2025(4) ​ ​ ​ 2024(4) Total assets ​ — ​ — ​ (56) (58) (57) Plus: Cumulative goodwill amortization and impairment loss ​ — ​ — ​ (76) ​ (78) ​ (76) Minus: Cash and cash equivalents ​ — ​ — ​ 4 ​ 5 ​ 4 Minus: Deferred tax assets ​ — ​ — ​ — ​ — ​ — Minus: Accounts payable to unrelated parties ​ — ​ — ​ 1 ​ 1 ​ 2 Minus: Accounts payable to related parties ​ — ​ — ​ — — — Minus: Provisions and other current liabilities (2) ​ — ​ — ​ 12 13 12 Minus: Income tax liabilities ​ — ​ — ​ 2 2 2 Invested capital ​ — ​ — ​ (113) (115) (113) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Adjustment to average invested capital as of December 31, 2025 (68) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Adjustment to operating income(4) (35) ​ ​ ​ ​ Adjustment to income tax expense(4) ​ 9 ​ ​ ​ ​ ​ ​ ​ ​ Adjustment to NOPAT (26) ​ ​ ​ ​ ​ 70 Table of Contents ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Reconciliation of average invested capital and ROIC (Non-IFRS Measure) in € M, except where otherwise specified ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ September 30, ​ June 30, ​ March 31, ​ December 31, 2025 ​ ​ ​ 2025 ​ ​ ​ 2025(4) ​ ​ ​ 2025(4) ​ ​ ​ 2025(4) ​ ​ ​ 2024(4) Total assets ​ 31,002 ​ 30,887 ​ 31,235 32,677 33,510 Plus: Cumulative goodwill amortization and impairment loss ​ 379 ​ 380 ​ 389 416 428 Minus: Cash and cash equivalents(1) ​ (1,599) ​ (1,256) ​ (1,716) (1,074) (1,181) Minus: Deferred tax assets(1) ​ (237) ​ (231) ​ (232) (225) (230) Minus: Accounts payable to unrelated parties(1) ​ (738) ​ (726) ​ (686) (770) (904) Minus: Accounts payable to related parties ​ (85) ​ (92) ​ (48) (106) (55) Minus: Provisions and other current liabilities(2) ​ (2,699) ​ (3,235) ​ (2,484) (2,624) (2,791) Minus: Income tax liabilities(1) ​ (248) ​ (256) ​ (245) (236) (220) Invested capital ​ 25,775 ​ 25,471 ​ 26,213 28,058 28,557 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average invested capital as of December 31, 2025 ​ 26,815 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Operating income(4) 1,792 ​ ​ ​ ​ Income tax expense(3), (4) (442) ​ ​ ​ ​ NOPAT 1,350 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ROIC in % 5.0 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Reconciliation of average invested capital and ROIC (Non-IFRS Measure, unadjusted) in € M, except where otherwise specified ​ ​ December 31, ​ September 30, ​ June 30, ​ March 31, ​ December 31, 2024 ​ ​ ​ 2024 ​ ​ ​ 2024 ​ ​ ​ 2024 ​ ​ ​ 2024 ​ ​ ​ 2023 Total assets 33,567 32,511 33,896 34,336 33,930 Plus: Cumulative goodwill amortization and impairment loss 504 519 565 519 629 Minus: Cash and cash equivalents(1) (1,185) (1,387) (1,112) (1,192) (1,427) Minus: Deferred tax assets(1) (230) (296) (281) (279) (292) Minus: Accounts payable to unrelated parties(1) (906) (779) (793) (748) (775) Minus: Accounts payable to related parties (55) (73) (100) (110) (123) Minus: Provisions and other current liabilities(2) (2,803) (2,671) (3,062) (3,026) (2,936) Minus: Income tax liabilities(1) (222) (227) (189) (280) (231) Invested capital 28,670 27,597 28,924 29,220 28,775 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average invested capital as of December 31, 2024 28,637 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Operating income 1,392 ​ ​ ​ ​ Income tax expense(3) (502) ​ ​ ​ ​ NOPAT 890 ​ ​ ​ ​ ​ 71 Table of Contents ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Adjustments to average invested capital and ROIC in € M, except where otherwise specified ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ September 30, ​ June 30, ​ March 31, ​ December 31, 2024 ​ ​ ​ 2024 ​ ​ ​ 2024(4) ​ ​ ​ 2024(4) ​ ​ ​ 2024(4) ​ ​ ​ 2023(4) Total assets — (38) (47) (622) (709) Plus: Cumulative goodwill amortization and impairment loss — (2) (2) (50) (84) Minus: Cash and cash equivalents — 3 5 24 35 Minus: Deferred tax assets — 2 2 3 10 Minus: Accounts payable to unrelated parties — 2 2 13 12 Minus: Accounts payable to related parties — — — 1 1 Minus: Provisions and other current liabilities(2) — 8 7 29 39 Minus: Income tax liabilities — — — 1 3 Invested capital — (25) (33) (601) (693) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Adjustment to average invested capital as of December 31, 2024 (270) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Adjustment to operating income(4) 139 ​ ​ ​ ​ Adjustment to income tax expense(4) (50) ​ ​ ​ ​ Adjustment to NOPAT 89 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Reconciliation of average invested capital and ROIC (Non-IFRS Measure) in € M, except where otherwise specified ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ September 30, ​ June 30, ​ March 31, ​ December 31, 2024 ​ ​ ​ 2024 ​ ​ ​ 2024(4) ​ ​ ​ 2024(4) ​ ​ ​ 2024(4) ​ ​ ​ 2023(4) Total assets 33,567 32,473 33,849 ​ 33,714 ​ 33,221 Plus: Cumulative goodwill amortization and impairment loss 504 517 563 ​ 469 ​ 545 Minus: Cash and cash equivalents(1) (1,185) (1,384) (1,107) ​ (1,168) ​ (1,392) Minus: Deferred tax assets(1) (230) (294) (279) ​ (276) ​ (282) Minus: Accounts payable to unrelated parties(1) (906) (777) (791) ​ (735) ​ (763) Minus: Accounts payable to related parties (55) (73) (100) ​ (109) ​ (122) Minus: Provisions and other current liabilities(2) (2,803) (2,663) (3,055) ​ (2,997) ​ (2,897) Minus: Income tax liabilities(1) (222) (227) (189) ​ (279) ​ (228) Invested capital 28,670 27,572 28,891 ​ 28,619 ​ 28,082 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Average invested capital as of December 31, 2024 28,367 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Operating income(4) 1,531 ​ ​ ​ ​ Income tax expense(3), (4) (552) ​ ​ ​ ​ NOPAT 979 ​ ​ ​ ​ ROIC in % 3.5 ​ ​ ​ ​ ​ (1) Includes amounts related to assets, and associated liabilities, classified as held for sale (see note 4 of the notes to the consolidated financial statements included in this report). (2) Including non-current provisions, non-current labor expenses, and variable payments outstanding for acquisitions and excluding pension liabilities and noncontrolling interests subject to put provisions. (3) Adjusted for noncontrolling partnership interests. (4) Including adjustments for acquisitions and divestitures made during the last twelve months with a purchase price above a €50 M threshold. Operating income margin Operating income margin represents the ratio of operating income to revenue. We believe operating income margin shows the profitability of each of our operating segments and our company on a consolidated basis. 72 Table of Contents Net income and net income growth As net income represents the profitability of our business after all costs including operating costs, interest income and expense, taxes, and the impacts of noncontrolling interests in our subsidiaries, this metric shows our profit for the period after taking into account all aspects of our business. On a consolidated level, we also use percentage growth in net income (net income attributable to shareholders of FME AG) at Constant Currency as an additional performance indicator used for internal management. Net income and net income growth are also benchmarked based on movement at Constant Exchange Rates (Non-IFRS Measures). Basic earnings per share growth Percentage growth in basic earnings per share at Constant Currency (Non-IFRS Measure) is a performance indicator used to evaluate our profitability. This indicator helps to manage our overall performance. Basic earnings per share is calculated by dividing net income attributable to shareholders by the weighted-average number of outstanding shares over the course of the year. Net cash provided by (used in) operating activities in % of revenue Our consolidated statement of cash flows indicates how we generated and used cash and cash equivalents. In conjunction with our other primary financial statements, it provides information that helps us evaluate changes to our net assets and our financial structure (including liquidity and solvency). Net cash provided by (used in) operating activities is applied to assess whether a business can internally generate the cash required to make the necessary replacement and expansion of investments. This indicator is impacted by the profitability of our business and the development of working capital, mainly receivables. Net cash provided by (used in) operating activities in percent of revenue shows the percentage of our revenue that is available in terms of financial resources. This measure is an indicator of our operating financial strength. Free cash flow in % of revenue (Non-IFRS Measure) Free cash flow (which we define as net cash provided by (used in) operating activities after capital expenditures, before acquisitions and investments) refers to the cash flow we have at our disposal, including cash flows that may be restricted for other uses. This indicator shows the percentage of revenue available for acquisitions and investments, dividends to shareholders, debt servicing, reductions in debt financing, and for repurchasing shares. For a reconciliation of cash flow performance indicators for the years ended 2025, 2024, and 2023, which reconciles free cash flow and free cash flow in percent of revenue to Net cash provided by (used in) operating activities and Net cash provided by (used in) operating activities in percent of revenue, see “Item 5. Operating and financial review and prospects — IV. Financial position — Sources of liquidity.” Capital expenditures We manage our investments using a detailed coordination and evaluation process. The Management Board sets our complete investment budget and targets. Before realizing specific investment projects or acquisitions, our internal Acquisition & Investment Committee examines, based on certain thresholds, the individual projects and measures considering the expected return on investment and potential yield. Investment projects are evaluated using common methods such as net present value, internal interest rate methods, and return on invested capital. We utilize this evaluation methodology to ensure that we only make and implement investments and acquisitions that increase shareholder value. Capital expenditures for property, plant, and equipment and capitalized development costs is an indicator used for internal management. The measure influences the capital invested for replacement and expansion. Net leverage ratio (Non-IFRS Measure) The net leverage ratio is a performance indicator used for capital management. To determine the net leverage ratio, debt and lease liabilities less cash and cash equivalents (net debt) is compared to adjusted EBITDA, which we define as EBITDA adjusted for: ● the effects of acquisitions and divestitures made during the year with a purchase price above a €50 M threshold as defined in our Syndicated Credit Facility (See note 17 of the notes to the consolidated financial statements included in this report), ● non-cash charges, 73 Table of Contents ● impairment loss (including any impairment losses associated with the FME25+ Program and Legacy Portfolio Optimization, as defined below), and ● special items, including: i. costs related to our FME25+ Program, ii. the impact from the remeasurement of our investment in Humacyte, Inc. and receivables related to a royalty stream that we are entitled to base on sales made by Humacyte, Inc. in the U.S. (Humacyte Remeasurements), iii. certain costs associated with the Conversion, primarily related to the requisite relabeling of our products, transaction costs (such as costs for external advisors and conducting an extraordinary general meeting) and costs related to the establishment of dedicated administrative functions required to manage certain services which have historically been administered at the Fresenius SE group level and paid by the Company through corporate charges (Legal Form Conversion Costs), and iv. costs incurred in relation to strategic divestitures identified during our Legacy Portfolio Optimization review. For further information regarding these costs during the years ended December 31, 2025, 2024, and 2023, see notes 4 and 5 e) of the notes to the consolidated financial statements included in this report). The ratio is an indicator of the length of time the Company needs to service the net debt out of its own resources. We believe that the net leverage ratio provides alternative information that management believes to be useful in assessing our ability to meet our payment obligations in addition to considering the absolute amount of our debt. We have a strong market position in a growing, global, and mainly non-cyclical market. Furthermore, most of our customers have a high credit rating as the dialysis industry is characterized by stable and sustained cash flows. We believe this enables us to work with a reasonable proportion of debt. Adjusted EBITDA, a non-IFRS Measure, is used in our capital management and is also relevant in major financing instruments, including the Syndicated Credit Facility. You should not consider adjusted EBITDA to be an alternative to net earnings determined in accordance with IFRS Accounting Standards or to cash flow from operating, investing, or financing activities. In addition, not all funds depicted by adjusted EBITDA are available for management’s discretionary use. For example, a substantial portion of such funds are subject to contractual restrictions and functional requirements to fund debt service, capital expenditures, and other commitments as described in more detail elsewhere in this report. For our self-set target range for the net leverage ratio and a reconciliation of adjusted EBITDA and net leverage ratio as of December 31, 2025 and 2024, see “Item 5. Operating and financial review and prospects — IV. Financial position — Financing strategy.” Business metrics for Value-Based Care The metrics outlined below represent performance indicators utilized by management to evaluate the Value-Based Care operating segment. Value and risk-based care programs include shared risk arrangements in which private payors or government programs share the savings or losses from reductions or increases in the overall medical spend of a population under management assuming that certain quality thresholds are also met. Full risk arrangements include capitated arrangements and shared saving arrangements in which private payors credit us periodic, fixed payments based on expected medical expenses of such members. Since capitation arrangements often can be recognized as premium revenue and the full medical premium for ESRD beneficiaries generally is very large, capitation programs can drive significant revenue and, when costs are effectively managed, profit opportunities; however, these programs also carry significant costs and potential risk of loss due to the full-risk nature of these arrangements. See “Item 4B, “Information on the Company — Business Overview — Regulatory and Legal Matters — Reimbursement — Executive order-based models.” Our financial performance in this segment is directly linked to our ability to manage a defined scope of medical costs within specific parameters for clinical outcomes. Due to the time required for CMS and private payors to review data for programs, we utilize estimates in order to report certain metrics on a timely basis. The key metrics currently used to evaluate performance in the Value-Based Care operating segment include member months under medical cost management (Member Months) and membership. 74 Table of Contents These metrics are intended for discussion and internal evaluation purposes and may be further refined or expanded in future reporting periods. Because these measures are not derived from financial measures, they do not constitute measures determined in accordance with IFRS Accounting Standards or non-IFRS financial measures, and accordingly, are not reconciled to IFRS Accounting Standards metrics. Member Months Member Months is calculated by multiplying the number of members included in value-based reimbursement programs by the corresponding number of months these members participate in those programs. Under certain value-based care programs, we assume both the risk associated with generating savings and the risk related to the total cost of care for attributed patients. The financial results are recorded in earnings as our performance is determined. A change in patient membership may indicate future earnings or losses as our performance is determined through these managed care programs. Membership Membership refers to the total number of individuals who are enrolled in a plan or program for which they receive care under a value-based care model. The metric represents the population of patients whose health outcomes, utilization of services and cost of care are measured under value-based care programs and, we believe, is an indicator of the revenue generated. II. Financial condition and results of operations Overview We are the world’s leading provider of products and services for individuals with renal diseases, based on publicly reported revenue. We provide dialysis and related services for individuals with renal diseases, including through value and risk-based care programs, as well as other healthcare services. We also develop, manufacture, and distribute a wide variety of healthcare products. Our healthcare products include hemodialysis machines, peritoneal dialysis cyclers, dialyzers, peritoneal dialysis solutions, hemodialysis concentrates, solutions and granulates, bloodlines, renal pharmaceuticals, systems for water treatment, as well as acute cardiopulmonary and apheresis products. We supply dialysis clinics we own, operate, or manage with a broad range of products and also sell dialysis products to other dialysis service providers. Our other healthcare services include pharmacy services, vascular specialty services, ambulatory surgery center services, and physician nephrology practice management. Dialysis patient growth results from factors such as: ● aging populations and increased life expectancies; ● shortage of donor organs for kidney transplants; ● increasing incidence of kidney disease; ● better treatment and survival of patients with diabetes, hypertension, and other illnesses, which frequently lead to the onset of CKD; ● improvements in treatment quality, new pharmaceuticals, and product technologies, which prolong patient life; and ● improving standards of living in developing countries, which make life-saving dialysis treatment available. 75 Table of Contents We are also engaged in different areas of healthcare product therapy research. As a global company delivering healthcare services and products, we face the challenge of addressing the needs of a wide variety of stakeholders, such as patients, customers, payors, regulators, and legislators in many different economic environments and healthcare systems. In general, government-funded programs (in some countries in coordination with private insurers) pay for certain healthcare items and services provided to their citizens. Not all healthcare systems provide payment for dialysis treatment. Therefore, the reimbursement systems and ancillary services utilization environment in various countries significantly influence our business. Company structure For a description of our structure, especially as it relates to our operating segments, see “Certain defined terms,” above, as well as note 29 of the notes to the consolidated financial statements included in this report. Significant U.S. reimbursement, legislative matters, and other Medicare payment arrangements A significant portion of healthcare services we provide is paid for by governmental institutions. For the year ended December 31, 2025, approximately 16% of our consolidated revenue was attributable to U.S. federally-funded healthcare benefit programs, such as Medicare and Medicaid, under which reimbursement rates are set by CMS. Legislative or regulatory changes could affect reimbursement rates for a significant portion of the services we provide. The stability of reimbursement in the U.S. has been affected by the ESRD PPS and the U.S. federal government across the board spending cuts in payments to Medicare providers commonly referred to as “U.S. Sequestration.” Presently, there is considerable uncertainty regarding possible future additional changes in healthcare regulation, including the regulation of reimbursement for dialysis services. As a consequence of the pressure to decrease healthcare costs, government reimbursement rate increases in the U.S. have historically been limited and are expected to continue in this fashion. However, any significant decreases in reimbursement under Medicare, Medicaid, Medicare Advantage plans, or from commercial insurance (which could result from changes in legislation, regulation, or other federal pressure on insurers to decrease rates), or in patient access to commercial insurance (as the result, e.g., of the termination of enhanced premium tax credits that expired at the end of 2025), or Medicare Advantage plans could have material adverse effects on our healthcare services business and, because the demand for dialysis products is similarly affected by reimbursement and coverage rates, on our products business. To the extent that increases in operating costs that are affected by inflation, such as labor and supply costs, are not fully reflected in a compensating increase in reimbursement rates, our business and results of operations would be adversely affected. For additional information regarding reimbursement and other regulatory matters, including the Marietta decision and impacts from OBBBA, as well as a description of the other Medicare programs, initiatives, and arrangements that we participate (or have participated) in, each with specific reimbursement models, see Item 3.D, “Key information — Risk factors,” Item 4.B, “Information on the Company — B. Business Overview — Regulatory and Legal Matters — Health care Reform” and “— Reimbursement,” above. III. Results of operations, financial position and net assets Highlights The following items represent notable impacts or trends in our business and/or industry for the year ended December 31, 2025: Legacy Portfolio Optimization and FME25+ Program We continue to review our business portfolio, specifically with a view to exiting unsustainable markets and divesting non-core businesses and the cessation of certain R&D programs to enable more focused capital allocation towards areas in our core business that are expected to have higher profitable growth. During the year ended December 31, 2025, the impacts from Legacy Portfolio Optimization mainly related to the completed divestitures in Brazil, Malaysia, and Kazakhstan as well as the select assets of our wholly owned Spectra Laboratories, and impairment losses primarily related to right-of-use assets as described in notes 4 and 5 e) of the notes to the consolidated financial statements included in this report. 76 Table of Contents On June 17, 2025, we launched our new strategy, FME Reignite, announcing our increased profitability aspirations for 2030 and a new capital allocation framework to enhance value creation. Included within the announcement was the expansion of the transformation of our operating structure into a significantly simplified structure embodying a more centralized approach and steps to achieve cost savings, originally named FME25 Program, by two years. The total program with its extension was renamed the FME25+ Program. We continue to target sustainable savings, including operational efficiencies, under our FME25+ Program, which was based on the successful implementation of the original FME25 Program. The FME25 Program introduced Care Enablement - the consolidation of our previously decentralized healthcare products business (including research and development, manufacturing, supply chain and commercial operations as well as supporting functions, such as regulatory and quality management) under a global MedTech umbrella, and Care Delivery, combining our global healthcare services businesses. These two operating segments were further expanded to include Value-Based Care under FME Reignite. The majority of the costs and recurring savings are included in costs of revenue and selling, general and administrative expense within our consolidated statements of income. The following table shows the overall impact from Legacy Portfolio Optimization on our operating income as well as the costs and recurring savings associated with the FME25+ Program for the years ended December 31, 2025, 2024, and 2023: ​ ​ ​ ​ ​ ​ ​ Legacy Portfolio Optimization and FME25+ Program impacts on operating income in € M ​ ​ For the year ended December 31, ​ ​ ​ 2025 ​ ​ 2024 ​ ​ 2023 Legacy Portfolio Optimization (97) (288) (204) FME25+ Program ​ ​ ​ Costs (194) (180) (153) Recurring savings 804 567 346 ​ In the discussion of our results below, the effects of the costs and savings related to the FME25+ Program are presented on a net basis. ​ Settlement of Interwell Health put options During the second quarter of 2025, the Company entered into an agreement with shareholders of Interwell Health (our value and risk-based care subsidiary) to accelerate the settlement of put options held by non-physician investors originally granted as part of the 2022 merger of Cricket Health, InterWell Health LLC and Fresenius Health Partners, Inc. that created Interwell Health (the 2022 Interwell Health Transaction). The settlement in the amount of $362 M (€312 M) for this transaction occurred during September 2025 and represented a transaction with noncontrolling interests without loss of control. The settlement also resulted in the derecognition of certain deferred tax liabilities initially established in connection with the 2022 Interwell Health Transaction (Interwell Health Deferred Tax Reversal). For further information, see “Net cash provided by (used in) financing activities” below and note 26 of the notes to the consolidated financial statements included in this report. Purchase of production sites Effective December 31, 2025, pursuant to an agreement signed on October 17, 2025, Fresenius Medical Care Deutschland GmbH purchased the Company’s production sites in Schweinfurt and St. Wendel, Germany, which were previously leased from Fresenius SE and certain of its affiliates (collectively, Fresenius SE Companies), for a total transaction cost of €181 M (including a purchase price paid to Fresenius SE Companies in the amount of €171 M). For further information, see note 6 of the notes to the consolidated financial statements included in this report. Share buyback We launched our €1 BN share buyback program (excluding ancillary transaction costs) in two tranches to be completed within two years by August 10, 2027. Under the first tranche, shares were to be acquired up to a maximum of €600 M including any true-ups over a period ending latest April 30, 2026. The first tranche was initiated on August 11, 2025 and completed ahead of schedule on December 29, 2025, under which 14,124,564 shares were repurchased for €586 M (including true-ups). On January 9, 2026, we announced that we would accelerate our share buyback program and start the repurchase of the second tranche. Under the second tranche, we plan to repurchase a total amount of around €414 M from January 12 to May 8, 2026. The share buyback program is expected to be completed significantly earlier than originally planned, in less than a year. As of December 31, 2025, 14,124,564 shares have been repurchased resulting in cash outflows of €585 M. For further information, see note 20 of the notes to the consolidated financial statements included in this report. 77 Table of Contents Other Trends Recent changes in global trade policy, including new tariffs on most products imported into the U.S. and the possibility of additional trade restrictions, have created increased uncertainty and potential risk within the healthcare industry and to our business operations and financial performance. While we have implemented measures to mitigate these risks, we may see further increased costs for supplies depending on the nature and scope of these shifts on the affected goods and materials we use. In addition to tariffs, additional macroeconomic factors continue to present challenges as inflation remains elevated, which contributes to higher labor and production costs, as well as ongoing disruptions of global supply chains and new or potential export/import restrictions across key markets. Resulting cost increases have and could continue to adversely impact our financial condition and results of operations, especially if we are unable to absorb these costs through increased reimbursement (which is largely dependent on government action and contractual terms) and increased prices for our products or offset them through supply chain adjustments, product redesign (which could require regulatory approvals), or other operational efficiencies. We are closely monitoring these developments and identifying additional strategies to mitigate potential financial and operational impacts and have experienced a limited impact in 2025. However, given the continuously changing nature of these challenges and their broader economic implications, we cannot accurately predict the full extent of their impact on our business in the medium to long-term. Additionally, for the year ended December 31, 2025, the euro to U.S. dollar exchange rate experienced moderate volatility, with the euro generally strengthening against the U.S. dollar. Influences on currency markets via geopolitical developments such as the changes in trade policy noted above and corrective actions taken by central banks may cause such exchange rate developments to differ significantly in the future. As described in Item 4.B, “Information on the Company — B. Business Overview — Regulatory and Legal Matters — Health care Reform” and “— Reimbursement,” above, we are facing regulatory challenges that we assume will impact earnings development in future quarters. In the U.S., the elimination of the ACA premium tax credits (absent any future extension) and certain Medicaid-related provisions of the OBBBA are anticipated to adversely affect reimbursement levels and patient volumes. Additionally, certain pharmaceutical products are reimbursed under TDAPA, which provides for separate payment under the ESRD PPS for a limited transitional period. Upon expiration of the applicable TDAPA period, reimbursement for these pharmaceutical products transitions to either a post-TDAPA add-on under the ESRD PPS for dialysis drugs or biologicals for which there is an existing functional category or via a modification to the ESRD PPS rate, if applicable, after CMS undertakes additional rulemaking for dialysis drugs or biologicals for which there is not an existing functional category. The impacts from such changes in reimbursement on our results of operations, financial position, and net assets are described in the following discussions as “Impacts from TDAPA Reimbursement Regulation.” These U.S. regulatory impacts, together with other evolving global regulatory and reimbursement developments such as volume-based procurement and other regulatory policies in China, could continue to place pressure on our business in future periods and result in a negative impact on our revenues and operating income. On July 11, 2025, the German legislature approved an investment program for economic growth which increases depreciation for machinery and equipment used in the calculation of income tax as well as implemented a gradual reduction of the corporate tax rate from 15% to 10% from 2028 until 2032. We do not expect a material impact on our business, financial position and results of operations as a result of the new regulation. The following sections summarize our consolidated results of operations, financial position and net assets as well as key performance indicators by reporting segment, as well as Corporate, for the periods indicated. We prepared the information consistent with the manner in which management internally disaggregates financial information to assist in making operating decisions and evaluating management performance. Results of operations Revenue and operating income generated in countries outside the eurozone are subject to currency fluctuations. As a significant portion of our operations are derived from our businesses in the U.S., the development of the euro against the U.S. dollar can have a material impact on our results of operations, financial position and net assets and the impacts of foreign currency transaction and translation effects are included in the discussion of our key and secondary performance indicators below. 78 Table of Contents Year ended December 31, 2025 compared to year ended December 31, 2024 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Results of operations in € M ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Change in % ​ ​ ​ ​ ​ ​ ​ ​ Currency ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ translation ​ Constant ​ ​ ​ ​ 2025 ​ ​ ​ 2024 ​ ​ ​ As reported ​ ​ ​ effects ​ ​ ​ Currency(1) Revenue ​ 19,628 ​ 19,336 ​ 2 ​ (3) ​ 5 Costs of revenue ​ (14,599) ​ (14,579) ​ 0 ​ 4 ​ 4 Selling, general and administrative costs ​ (3,033) ​ (3,143) ​ (4) ​ 4 ​ 0 Research and development ​ (158) ​ (183) ​ (14) ​ 1 ​ (13) Income from equity method investees ​ 181 ​ 135 ​ 34 1 ​ 35 Other operating income ​ 528 ​ 760 ​ (31) ​ (2) ​ (29) Other operating expense ​ (720) ​ (934) ​ (23) 2 ​ (21) Operating income ​ 1,827 ​ 1,392 ​ 31 ​ (5) ​ 36 Operating income margin ​ 9.3 ​ 7.2 ​ ​ ​ ​ ​ Interest income ​ 70 ​ 72 ​ (3) ​ (5) ​ 2 Interest expense ​ (385) ​ (407) ​ (6) 4 ​ (2) Income tax expense ​ (321) ​ (316) ​ 2 ​ 2 ​ 4 Net income ​ 1,191 ​ 741 ​ 61 ​ (5) ​ 66 Net income attributable to noncontrolling interests ​ (213) ​ (203) ​ 5 ​ 4 ​ 9 Net income attributable to shareholders of FME AG ​ 978 ​ 538 ​ 82 ​ (6) ​ 88 Basic and diluted earnings per share in € 3.36 1.83 ​ 83 ​ (6) ​ 89 (1) For further information on Constant Exchange Rates, see “I. Performance management system” above. Key Performance Indicators The following discussions include our operating and reportable segments and the measures we use to manage these segments. Due to the change in our operating structure as of June 1, 2025, we have restated the financial information for 2024 for our operating segments in order to conform to the current year’s presentation. For further information, see note 1 and note 29 of the notes to the consolidated financial statements included in this report. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue ​ ​ ​ ​ in € M, except dialysis treatment, patient and clinic data ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Change in % ​ ​ ​ ​ ​ ​ ​ ​ Currency ​ ​ ​ ​ ​ Same Market ​ ​ ​ ​ ​ ​ ​ ​ translation ​ Constant ​ Organic ​ Treatment ​ ​ ​ ​ 2025 ​ ​ ​ 2024 ​ ​ ​ As reported ​ ​ ​ effects ​ ​ ​ Currency(1) ​ ​ ​ growth ​ ​ ​ Growth(2) Revenue ​ 19,628 ​ 19,336 ​ 2 ​ (3) ​ 5 ​ 8 ​ ​ Care Delivery segment ​ 13,736 ​ 14,003 ​ (2) ​ (4) ​ 2 ​ 5 ​ 0.6 Thereof: U.S. ​ 11,507 ​ 11,526 ​ 0 ​ (4) ​ 4 ​ 5 ​ 0.0 Thereof: International ​ 2,229 ​ 2,477 ​ (10) ​ (1) ​ (9) ​ 4 ​ 2.0 Value-Based Care segment ​ 2,247 ​ 1,752 ​ 28 ​ (6) ​ 34 ​ 34 ​ ​ Care Enablement segment ​ 5,476 ​ 5,557 ​ (1) ​ (3) ​ 2 ​ 2 ​ ​ Inter-segment eliminations ​ (1,831) ​ (1,976) ​ (7) ​ 3 ​ (4) ​ ​ ​ ​ Thereof: Care Delivery (3) ​ (497) ​ (480) ​ 4 ​ 4 ​ 8 ​ ​ ​ ​ Thereof: Care Enablement (3) ​ (1,334) ​ (1,496) ​ (11) ​ 3 ​ (8) ​ ​ ​ ​ Dialysis treatments ​ 44,746,884 ​ 47,617,071 ​ (6) ​ ​ ​ ​ ​ ​ ​ ​ Patients ​ 291,902 ​ 299,352 ​ (2) ​ ​ ​ ​ ​ ​ ​ ​ Clinics ​ 3,601 ​ 3,675 ​ (2) ​ ​ ​ ​ ​ ​ ​ ​ Member Months ​ 1,788,951 ​ 1,534,053 ​ 17 ​ ​ ​ ​ ​ ​ ​ ​ Membership ​ 162,697 ​ 131,750 ​ 23 ​ ​ ​ ​ ​ ​ ​ ​ (1) For further information on Constant Exchange Rates, see “I. Performance management system” above. (2) Same market treatment growth represents growth in treatments, adjusted for certain reconciling items including (but not limited to) treatments from acquisitions, closed or sold clinics and differences in dialysis days (Same Market Treatment Growth). (3) Services provided by the Care Delivery segment in the U.S. for patients managed under the Value-Based Care segment are provided at fair market value. We also transfer products from the Care Enablement segment to the Care Delivery segment at fair market value. 79 Table of Contents Consolidated Revenue increased as compared to the year ended December 31, 2024, primarily driven by an increase in organic growth in all segments, partially offset by a negative impact from foreign currency translation, the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization) and a decrease in dialysis days. Care Delivery The decrease in Care Delivery revenue as compared to the year ended December 31, 2024 was driven by a negative impact from foreign currency translation and the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization), partially offset by an increase in organic growth. Organic growth was supported by favorable Impacts from TDAPA Reimbursement Regulation, reimbursement rate increases, and favorable payor mix effects. As of December 31, 2025, the number of patients treated in dialysis clinics that we own or operate in Care Delivery decreased as compared to December 31, 2024, primarily driven by divestitures in connection with Legacy Portfolio Optimization. Treatments in our Care Delivery segment decreased as compared to the year ended December 31, 2024, mainly due to the effect of closed or sold clinics (primarily related to Legacy Portfolio Optimization) and a decrease in dialysis days, partially offset by Same Market Treatment Growth. During the year ended December 31, 2025, we acquired 6, opened 27, and combined, closed, or sold 107 dialysis clinics. U.S. In the U.S., revenue remained stable as an increase in organic growth was offset by a negative impact from foreign currency translation and a decrease in dialysis days. Organic growth in the U.S. was supported by favorable Impacts from TDAPA Reimbursement Regulation, reimbursement rate increases, and favorable payor mix effects. In the U.S., the number of patients we treated in dialysis clinics that we own or operate remained relatively stable at 205,483 patients (December 31, 2024: 206,436). Treatments remained relatively stable at 31,069,465 for the year ended December 31, 2025 as compared to 31,213,447 for the year ended December 31, 2024. We owned or operated 2,622 dialysis clinics in the U.S. at December 31, 2025 as compared to 2,624 dialysis clinics at December 31, 2024. During the year ended December 31, 2025, we acquired 2, opened 15 and combined, closed, or sold 19 dialysis clinics. International In International, the decrease in revenue was driven by the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization) and a negative impact from foreign currency translation, partially offset by an increase in organic growth. There were 86,419 patients treated in dialysis clinics that we own or operate in International, a decrease of 7% (December 31, 2024: 92,916) primarily driven by divestitures in connection with Legacy Portfolio Optimization. Treatments in International decreased by 17% to 13,677,419 for the year ended December 31, 2025 as compared to 16,403,624 for the year ended December 31, 2024, driven by the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization), partially offset by Same Market Treatment Growth. We owned or operated 979 dialysis clinics in International at December 31, 2025 as compared to 1,051 dialysis clinics at December 31, 2024. During the year ended December 31, 2025, we acquired 4, opened 12 and combined, closed, or sold 88 dialysis clinics. Value-Based Care Value-Based Care revenue increased as compared to the year ended December 31, 2024, primarily due to an increase in organic growth, driven by an increase in Member Months mainly due to contract expansion, partially offset by a negative impact from foreign currency translation. 80 Table of Contents Care Enablement Care Enablement revenue decreased as compared to the year ended December 31, 2024, primarily driven by a negative impact from foreign currency translation, partially offset by higher revenues related to critical care products (including products for acute care treatment and acute cardiopulmonary products), machines for chronic treatment, home hemodialysis products, and peritoneal dialysis products. Apart from the negative foreign currency translation impact, the development of revenue was driven by volume increases and positive pricing momentum despite a negative impact from volume-based procurement and other regulatory policies in China. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Operating income (loss) in € M ​ ​ ​ ​ ​ ​ Change in % ​ ​ ​ ​ ​ ​ ​ ​ Currency ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ translation ​ Constant ​ ​ ​ 2025 ​ ​ 2024 ​ ​ As reported ​ ​ effects ​ ​ Currency(1) Operating income (loss) 1,827 1,392 31 (5) 36 Care Delivery segment 1,614 1,218 33 (7) 40 Value-Based Care segment 1 (28) n.a. ​ n.a. Care Enablement segment 326 267 22 (1) 23 Inter-segment eliminations 5 (17) n.a. ​ n.a. Corporate (119) (48) 148 (58) 206 Operating income (loss) margin 9.3 7.2 ​ ​ ​ Care Delivery segment 11.8 8.7 ​ ​ ​ Value-Based Care segment 0.1 (1.6) ​ ​ ​ Care Enablement segment 6.0 4.8 ​ ​ ​ (1)For further information on Constant Exchange Rates, see “I. Performance management system” above. Consolidated The increase in our operating income was largely driven by a positive impact from business growth (across all operating segments), net savings associated with the FME25+ Program, and reduced expenses from Legacy Portfolio Optimization, partially offset by higher personnel expense (including elevated medical benefit costs), a negative impact from Humacyte Remeasurements, inflationary cost increases, a negative impact from foreign currency translation, and an unfavorable impact from foreign currency transaction effects. Care Delivery Care Delivery operating income increased primarily as a result of a favorable impact from business growth (driven by favorable Impacts from TDAPA Reimbursement Regulation, reimbursement rate increases, and favorable payor mix effects), reduced expenses from Legacy Portfolio Optimization, and net savings associated with the FME25+ Program, partially offset by higher personnel expense (including elevated medical benefit costs), a negative impact from foreign currency translation, and inflationary cost increases. Value-Based Care For the year ended December 31, 2025, Value-Based Care recorded operating income as compared to an operating loss for the year ended December 31, 2024, mainly driven by a favorable savings rate for certain contracts, partially offset by an unfavorable effect from CKCC programs. Care Enablement Care Enablement operating income increased primarily due to net savings from the FME25+ Program and a favorable impact from business growth (driven by higher volumes and positive pricing developments, despite volume-based procurement and other regulatory policies in China). The increase in operating income was partially offset by inflationary cost increases, a negative impact from the remeasurement of receivables related to a royalty stream that we are entitled to base on sales made by Humacyte, Inc. in the U.S., and an unfavorable impact from foreign currency transaction effects. 81 Table of Contents Secondary performance indicators and other contributors to profit and loss Costs of revenue remained stable as compared to the year ended December 31, 2024 as higher costs associated with business growth (mainly related to higher membership in our Value-Based Care segment), higher personnel expense in Care Delivery, and inflationary cost increases were mostly offset by a positive impact from foreign currency translation and net savings from the FME25+ Program. Costs of revenue by segment for the years ended December 31, 2025 and 2024 are provided in the following table: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Costs of revenue in € M ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Change in % ​ ​ ​ ​ ​ ​ ​ ​ Currency ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ translation ​ Constant ​ ​ ​ 2025 ​ ​ 2024 ​ ​ As reported ​ ​ effects ​ ​ Currency(1) Care Delivery segment 10,517 10,922 (4) 4 0 Value-Based Care segment 2,132 1,679 27 6 33 Care Enablement segment 3,780 3,915 (3) 4 1 Inter-segment eliminations (1,836) (1,952) (6) 3 (3) Corporate 6 15 (68) 0 (68) (1) For further information on Constant Exchange Rates, see “I. Performance management system” above. ​ Selling, general and administrative (SG&A) expense decreased for the year ended December 31, 2025 as compared to the prior year comparable period, primarily driven by net savings from the FME25+ Program and a positive impact from foreign currency translation, partially offset by higher personnel expense (including elevated medical benefit costs). The decrease in research and development expense was largely driven by higher capitalization of development costs, partially offset by higher personnel costs for R&D projects. The increase in income from equity method investees was primarily driven by higher earnings attributable to VFMCRP. The decrease in other operating income was primarily driven by lower gains from divestitures in connection with Legacy Portfolio Optimization, a decline in the contribution from the remeasurement of our investment in Humacyte, Inc., and an unfavorable impact from the phasing of income attributable to a consent agreement on certain pharmaceuticals, partially offset by higher foreign exchange gains. The decrease in other operating expense was primarily driven by reduced expenses from Legacy Portfolio Optimization, partially offset by a negative impact from the remeasurement of our investment in Humacyte, Inc. and higher foreign exchange losses. For additional information regarding other operating income and expense, see note 5 e) of the notes to the consolidated financial statements included in this report. Net interest expense decreased by 6% from €335 M to €315 M, primarily due to a favorable impact from refinancing activities (mainly driven by lower debt) and lower interest expense resulting from lease liabilities, partially offset by unfavorable effects from foreign currency swaps. The effective tax rate decreased from 29.9% to 21.2%, primarily driven by a positive impact from Legacy Portfolio Optimization, the Interwell Health Deferred Tax Reversal, and an increase in tax-free income related to equity method investees, partially offset by lower tax provisions in 2024 related to the release of certain valuation allowances which did not recur in 2025. The increase in net income attributable to noncontrolling interests was primarily due to higher earnings from entities in which we have less than 100% ownership and are fully consolidated. The increase in net income attributable to shareholders of FME AG resulted from the combined effects of the items discussed above. Basic earnings per share increased primarily due to the increase in net income attributable to shareholders of FME AG described above. The average weighted number of shares outstanding for the period decreased to 291.2 M in 2025 as compared to 293.4 M in 2024, primarily driven by purchases of treasury stock under our share buyback program. 82 Table of Contents We employed 109,698 people (total headcount) as of December 31, 2025 (December 31, 2024: 111,513). This 2% decrease was largely due to the divestiture of certain businesses in connection with Legacy Portfolio Optimization. Year ended December 31, 2024 compared to year ended December 31, 2023 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Results of operations in € M ​ ​ ​ ​ ​ ​ Change in % ​ ​ ​ ​ ​ ​ ​ ​ Currency ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ translation ​ Constant ​ ​ ​ 2024 ​ ​ 2023 ​ ​ As reported ​ ​ effects ​ ​ Currency(1) Revenue 19,336 19,454 (1) (1) 0 Costs of revenue (14,579) (14,529) 0 1 1 Selling, general and administrative costs (3,143) (3,196) (2) 1 (1) Research and development (158) (232) (32) 0 (21) Income from equity method investees 181 122 48 37 11 Other operating income 528 515 3 45 48 Other operating expense (720) (765) (6) 29 23 Operating income 1,827 1,369 ​ 33 ​ 30 ​ 3 Operating income margin 7.2 7.0 ​ ​ ​ Interest income 70 88 (19) (1) (18) Interest expense (385) (424) (9) 5 (4) Income tax expense (321) (301) 7 (1) 6 Net income 1,191 732 63 61 2 Net income attributable to noncontrolling interests (213) (233) (13) 0 (13) Net income attributable to shareholders of FME AG 978 499 96 87 9 Basic and diluted earnings per share in € ​ 3.36 ​ 1.70 ​ 98 ​ 89 ​ 9 (1) For further information on Constant Exchange Rates, see “I. Performance management system” above. ​ Key Performance Indicators The following discussions include our operating and reportable segments and the measures we use to manage these segments. Due to the change in our operating structure as of June 1, 2025, as mentioned above, we have restated the financial information for 2024 and 2023 for our operating segments in order to conform to the current year’s presentation. For further information, see note 1 and note 29 of the notes to the consolidated financial statements included in this report. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Revenue in € M, except dialysis treatment, patient and clinic data ​ ​ ​ ​ ​ Change in % ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Same ​ ​ ​ ​ ​ ​ ​ ​ Currency ​ ​ ​ ​ ​ Market ​ ​ ​ ​ ​ ​ ​ ​ translation ​ Constant ​ Organic ​ Treatment ​ ​ ​ 2024 ​ ​ 2023 ​ ​ As reported ​ ​ effects ​ ​ Currency(1) ​ ​ growth ​ ​ Growth(2) Revenue 19,336 19,454 (1) (1) 0 4 ​ Care Delivery segment 14,003 14,749 (5) 0 (5) 1 0.3 Thereof: U.S. 11,526 11,836 (3) 0 (3) 0 (0.1) Thereof: International 2,477 2,913 (15) (2) (13) 4 1.4 Value-Based Care segment 1,752 1,277 37 0 37 37 ​ Care Enablement segment 5,557 5,345 4 (1) 5 5 ​ Inter-segment eliminations (1,976) (1,918) 3 0 3 ​ ​ Thereof: Care Delivery (3) (480) (448) 7 0 7 ​ ​ Thereof: Care Enablement (3) (1,496) (1,469) 2 0 2 ​ ​ Dialysis treatments 47,617,071 51,654,540 (8) ​ ​ ​ ​ Patients 299,352 332,548 (10) ​ ​ ​ ​ Clinics 3,675 3,925 (6) ​ ​ ​ ​ Member Months 1,534,053 1,330,582 15 ​ ​ ​ ​ Membership 131,750 122,242 8 ​ ​ ​ ​ (1) For further information on Constant Exchange Rates, see “I. Performance management system” above. 83 Table of Contents (2) Same market treatment growth represents growth, in percent, in treatments, adjusted for certain reconciling items including (but not limited to) treatments from acquisitions, closed or sold clinics and differences in dialysis days (Same Market Treatment Growth). (3) Services provided by the Care Delivery segment in the U.S. for patients managed under the Value-Based Care segment are provided at fair market value. We also transfer products from the Care Enablement segment to the Care Delivery segment at fair market value. Consolidated Revenue decreased as compared to the year ended December 31, 2023, primarily driven by the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization), the absence, in 2024, of a settlement agreement in 2023 related to a previous complaint we filed against the U.S. government in 2019 which sought to recover amounts owed to us under the Tricare program (Tricare Settlement) and a negative impact from foreign currency translation, partially offset by an increase in organic growth in both all segments. Care Delivery The decrease in Care Delivery revenue as compared to the year ended December 31, 2023 was driven by the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization) and the absence, in 2024, of the Tricare Settlement. Organic growth was supported by reimbursement rate increases and a favorable payor mix, which were offset by increased implicit price concessions. As of December 31, 2024, the number of patients treated in dialysis clinics that we own or operate in Care Delivery decreased as compared to December 31, 2023, primarily driven by divestitures in connection with our Legacy Portfolio Optimization plan. Treatments in our Care Delivery segment decreased as compared to the year ended December 31, 2023, mainly due to the effect of closed or sold clinics (primarily related to Legacy Portfolio Optimization). During the year ended December 31, 2024, we acquired 3, opened 30 and combined, closed or sold 283 dialysis clinics. U.S. In the U.S., the decrease in revenue was driven by the absence, in 2024, of the Tricare Settlement and the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization). Organic growth in the U.S. was supported by reimbursement rate increases and a favorable payor mix, which were offset by increased implicit price concessions. In the U.S., 206,436 patients (December 31, 2023: 205,308) were treated in dialysis clinics that we own or operate. Treatments remained relatively stable at 31,213,447 for the year ended December 31, 2024 as compared to 31,210,375 for the year ended December 31, 2023, primarily as Same Market Treatment Growth was limited by the cancellation of less profitable acute care contracts (-0.2%). We owned or operated 2,624 dialysis clinics in the U.S. at December 31, 2024 as compared to 2,615 dialysis clinics at December 31, 2023. During the year ended December 31, 2024, we opened 27 and combined, closed or sold 18 dialysis clinics. International In International, the decrease in revenue was driven by the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization) and a negative impact from foreign currency translation, partially offset by an increase in organic growth and an increase in dialysis days. There were 92,916 patients, a decrease of 27% (December 31, 2023: 127,240) treated in dialysis clinics that we own or operate in International, primarily driven by divestitures in connection with Legacy Portfolio Optimization. Treatments in International decreased by 20% to 16,403,624 for the year ended December 31, 2024 as compared to 20,444,165 for the year ended December 31, 2023, driven by the effect of closed or sold operations (primarily related to Legacy Portfolio Optimization), partially offset by Same Market Treatment Growth and an increase in dialysis days. We owned or operated 1,051 dialysis clinics in International at December 31, 2024 as compared to 1,310 dialysis clinics at December 31, 2023. During the year ended December 31, 2024, we acquired 3, opened 3, and combined, closed, or sold 265 dialysis clinics. Value-Based Care Value-Based Care revenue increased as compared to the year ended December 31, 2023 primarily due to an increase in organic growth, driven by an increase in Member Months mainly due to contract expansion and membership growth. 84 Table of Contents Care Enablement Care Enablement revenue increased as compared to the year ended December 31, 2023, primarily driven by higher revenues related to in-center disposables, machines for chronic treatment, home hemodialysis products, and products for acute care treatments, partially offset by a negative impact from foreign currency translation. The development was driven by volume increases for our products across all of our geographical regions. Additionally, pricing momentum outside of China remained positive. In China, pricing was negatively impacted by volume-based procurement. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Operating income (loss) in € M ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Change in % ​ ​ ​ ​ ​ ​ ​ ​ Currency ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ translation ​ Constant ​ ​ ​ ​ 2024 ​ ​ ​ 2023 ​ ​ ​ As reported ​ ​ ​ effects ​ ​ ​ Currency(1) Operating income (loss) ​ 1,392 ​ 1,369 ​ 2 ​ (1) ​ 3 Care Delivery segment ​ 1,218 ​ 1,612 ​ (24) ​ 0 ​ (24) Value-Based Care segment ​ (28) ​ (96) ​ (71) ​ 0 ​ (71) Care Enablement segment ​ 267 ​ (67) ​ n.a. ​ ​ ​ n.a. Inter-segment eliminations ​ (17) ​ (13) ​ 30 ​ 5 ​ 25 Corporate ​ (48) ​ (67) ​ (29) ​ (1) ​ (28) Operating income (loss) margin ​ 7.2 ​ 7.0 ​ ​ ​ ​ ​ ​ Care Delivery segment ​ 8.7 ​ 10.9 ​ ​ ​ ​ ​ ​ Value-Based Care segment ​ (1.6) ​ (7.5) ​ ​ ​ ​ ​ ​ Care Enablement segment ​ 4.8 ​ (1.2) ​ ​ ​ ​ ​ ​ (1) For further information on Constant Exchange Rates, see “I. Performance management system” above. ​ Consolidated The increase in our operating income was largely driven by a positive impact from business growth, net savings associated with the FME25+ Program, and a positive impact from value and risk-based care programs, partially offset by higher personnel expense, the absence, in 2024, of the Tricare Settlement, inflationary cost increases, and an unfavorable impact from Legacy Portfolio Optimization. Care Delivery Care Delivery operating income decreased primarily as a result of an unfavorable impact from Legacy Portfolio Optimization, the absence, in 2024, of the Tricare Settlement, higher personnel expense and inflationary cost increases, partially offset by a positive impact from business growth, a positive impact from value and risk-based care programs and net savings associated with the FME25+ Program. Value-Based Care The operating loss for Value-Based Care decreased primarily due to a favorable savings rate and an increase in Member Months, mainly due to contract expansion and membership growth. Care Enablement For the year ended December 31, 2024, Care Enablement recorded operating income as compared to an operating loss for the year ended December 31, 2023, primarily due to a favorable impact from business growth (driven by positive volume and pricing developments which were partially offset by volume-based procurement in China), a favorable impact from Legacy Portfolio Optimization, net savings from the FME25+ Program, and a positive impact from the remeasurement of receivables related to a royalty stream that we are entitled to base on sales made by Humacyte, Inc. in the U.S., partially offset by inflationary cost increases and unfavorable foreign currency transaction effects. 85 Table of Contents Secondary performance indicators and other contributors to profit and loss Costs of revenue remained relatively stable as compared to the year ended December 31, 2023 as increased value and risk-based care program expenses (contract expansion and membership growth) in Value-Based Care, higher personnel expense in Care Delivery and inflationary cost increases were mostly offset by lower costs associated with business growth in Care Delivery (partially offset by higher costs in Care Enablement), the absence, in 2024, of the results of operations for businesses previously divested under Legacy Portfolio Optimization primarily within Care Delivery, net savings from the FME25+ Program and a positive impact from foreign currency translation. Costs of revenue by segment for the year ended December 31, 2024 and 2023 are provided in the following table: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Costs of revenue in € M ​ ​ ​ ​ ​ Change in % ​ ​ ​ ​ ​ ​ ​ ​ Currency ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ translation ​ Constant ​ ​ ​ 2024 ​ ​ ​ 2023 ​ ​ ​ As reported ​ ​ ​ effects ​ ​ ​ Currency(1) Care Delivery segment 10,922 11,350 (4) 1 (3) Value-Based Care segment 1,679 1,250 34 0 34 Care Enablement segment 3,915 3,834 2 1 3 Inter-segment eliminations (1,952) (1,905) 2 1 3 Corporate 15 0 n.a. ​ n.a. (1)For further information on Constant Exchange Rates, see “I. Performance management system” above. SG&A expense decreased for the year ended December 31, 2024 as compared to the prior year comparable period driven by lower costs associated with business growth. The decrease in research and development expense for the year ended December 31, 2024 as compared to the year ended December 31, 2023 was largely driven by lower personnel costs for R&D projects, higher capitalization of development costs, and lower costs related to activities in the field of regenerative medicine, partially offset by increased R&D activity. The increase in income from equity method investees was primarily driven by higher earnings attributable to VFMCRP. The increase in other operating income was primarily driven by foreign exchange gains, a positive impact from Humacyte Remeasurements, and the impacts from Legacy Portfolio Optimization. The increase in other operating expense was primarily driven by the impacts from Legacy Portfolio Optimization, foreign exchange losses, and an unfavorable impact from the valuation of vPPAs, partially offset by the absence, in 2024, of the results of operations for businesses previously divested under Legacy Portfolio Optimization. For additional information regarding other operating income and expense, see note 5 e) of the notes to the consolidated financial statements included in this report. Net interest expense remained relatively stable at €335 M from €336 M as a favorable impact from refinancing activities and favorable effects from foreign currency swaps were mostly offset by higher net interest expense on taxes related to a settlement, lower interest associated with receivables related to a royalty stream that we are entitled to base on sales made by Humacyte, Inc. in the U.S., a negative impact from the cyber attack on one of our third party service providers leading to a shutdown of its financial clearinghouse service systems resulting in a delay in claims processing (the Third-party Cyber Incident), and unfavorable foreign currency translation effects. The effective tax rate increased to 29.9% from 29.1% for the same period of 2023, primarily driven by a negative impact from Legacy Portfolio Optimization, partially offset by lower tax provisions related to the recognition of a previously unrecognized deferred tax asset and tax law changes. For information regarding the impact of Pillar Two tax legislation, see note 5 g) of the notes to the consolidated financial statements included in this report. 86 Table of Contents The decrease in net income attributable to noncontrolling interests was primarily due to lower earnings in fully consolidated entities in which we have less than 100% ownership, partially offset by a favorable impact from Legacy Portfolio Optimization. The increase in net income attributable to shareholders of FME AG resulted from the combined effects of the items discussed above. Basic earnings per share increased primarily due to the increase in net income attributable to shareholders of FME AG described above. The average weighted number of shares outstanding for the period was unchanged at 293.4 M in 2024 (2023: 293.4 M). We employed 111,513 people (total headcount) as of December 31, 2024 (December 31, 2023: 119,845). This 7% decrease was largely due to the divestiture of certain businesses in connection with Legacy Portfolio Optimization. IV.Financial position Our investment and financing strategy did not change substantially in the past fiscal year as our business model, which is based on stable and high cash flows, allows for a reasonable proportion of debt. We regard our refinancing options as being very stable and flexible. During the past fiscal year, the focus of our investing activities was on our healthcare products business. Financing strategy Our financing strategy aims at ensuring financial flexibility, managing financial risks, and optimizing financing costs. Financial flexibility is ensured through maintaining sufficient liquidity. Refinancing risks are limited due to the Company’s balanced maturity profile, which is characterized by a wide range of maturities of up to 2032. Corporate bonds in euro and U.S. dollar form the basis of our mid- and long-term financing instruments. Corporate bonds in euro are issued under our €10 BN debt issuance program. For short-term financing we use our €1.5 BN commercial paper program and bilateral credit lines. The €2 BN Syndicated Credit Facility serves as a backup facility and was undrawn at December 31, 2025. 87 Table of Contents The following chart summarizes our main financing debt mix as of December 31, 2025: In our long-term capital management, we focus primarily on the net leverage ratio, a Non-IFRS measure, and manage against our self-imposed target of 2.5x - 3.0x (see “I. Performance management system — Net leverage ratio (Non-IFRS Measure),” above). The following table shows the reconciliation of net debt and adjusted EBITDA and the calculation of the net leverage ratio as of December 31, 2025 and 2024. 88 Table of Contents ​ ​ ​ ​ ​ Reconciliation of adjusted EBITDA and net leverage ratio to the most directly comparable IFRS Accounting Standards financial measure in € M, except for net leverage ratio ​ ​ ​ ​ ​ ​ December 31, ​ December 31, ​ ​ ​ ​ 2025 ​ ​ ​ 2024 Debt and lease liabilities (1) ​ 10,795 ​ 10,988 Minus: Cash and cash equivalents (2) (1,599) ​ (1,185) Net debt 9,196 ​ 9,803 Net income 1,191 ​ 741 Income tax expense 321 ​ 316 Interest income (70) ​ (72) Interest expense 385 ​ 407 Depreciation and amortization 1,463 ​ 1,536 Adjustments (3) 447 ​ 450 Adjusted EBITDA 3,737 ​ 3,378 Net leverage ratio 2.5 ​ 2.9 (1) Debt includes the following balance sheet line items: short-term debt, current portion of long-term debt, long-term debt, less current portion, and debt and lease liabilities included within liabilities directly associated with assets held for sale. (2) Includes cash and cash equivalents included within assets held for sale (see note 4 of the notes to the consolidated financial statements included in this report). (3) Acquisitions and divestitures made for the last twelve months with a purchase price above a €50 M threshold as defined in the Syndicated Credit Facility (2025: €1 M; 2024: -€23 M), non-cash charges, primarily related to pension expense (2025: €47 M; 2024: €52 M), impairment loss (2025: €37 M; 2024: €207 M), and special items, including costs related to the FME25+ Program (2025: €185 M; 2024: €164 M), Legacy Portfolio Optimization (2025: €83 M; 2024: €113 M), Legal Form Conversion Costs (2025: €4 M; 2024: €9 M), and Humacyte Remeasurements (2025: €90 M; 2024: -€72 M). ​ The key financial risks we are exposed to include foreign exchange risk and interest rate risk. To manage these risks, we enter into various hedging transactions that have been authorized by the Management Board. Counterparty risks are managed via internal credit limits, taking into account the external credit ratings of the respective hedging counterparty. We do not use financial instruments for trading or other speculative purposes (for financial risks as well as information regarding vPPAs, see Item 11. “Quantitative and qualitative disclosures about market risk — Management of foreign exchange and interest rate risks” below as well as note 26 of the notes to the consolidated financial statements included in this report). For information on our credit ratings, see note 21 of the notes to the consolidated financial statements included in this report. A rating is not a recommendation to buy, sell, or hold securities of the Company, and may be subject to suspension, change, or withdrawal at any time by the assigning rating agency. We have established guidelines for risk management procedures and controls which govern the use of financial instruments. These guidelines include a clear segregation of duties with regards to execution on the one hand and administration, accounting, and controlling on the other. Effect of off-balance-sheet financing instruments on our financial position, assets and liabilities We are not involved in off-balance-sheet transactions that have or are reasonably likely to have a material current or future effect on our financial condition, changes in financial condition, revenues or expenses, results of operations, liquidity, cash requirements, or capital resources. Sources of liquidity Our primary sources of liquidity are typically cash provided by operating activities, cash provided by short-term debt, proceeds from the issuance of long-term debt, and divestitures. We require this capital primarily to finance working capital needs, fund the FME25+ Program and acquisitions, operate clinics, develop free-standing renal dialysis clinics and other healthcare facilities, purchase equipment for existing or new renal dialysis clinics and production sites, repay debt, pay dividends, repurchase shares (see “Net cash provided by (used in) investing activities” and “Net cash provided by (used in) financing activities” below), and to satisfy put option obligations to holders of minority interests in our majority-owned subsidiaries (see note 26 of the notes to the consolidated financial statements included in this report). As of December 31, 2025, our available borrowing capacity under unutilized credit facilities amounted to approximately €3.3 BN, including €2.0 BN under the Syndicated Credit Facility, which we maintain as a backup for general corporate purposes (see note 17 of the notes to the consolidated financial statements included in this report). At December 31, 2025, we had cash and cash equivalents of €1,599 M (December 31, 2024: €1,180 M). 89 Table of Contents Free cash flow (Net cash provided by (used in) operating activities, after capital expenditures, before acquisitions and investments) is a Non-IFRS Measure, see “— I. Performance management system — Net cash provided by (used in) operating activities in % of revenue” and “— Free cash flow in % of revenue (Non-IFRS Measure)” above. The following table shows the cash flow performance indicators for the years ended December 31, 2025, 2024, and 2023 and reconciles free cash flow to Net cash provided by (used in) operating activities, the most directly comparable IFRS Accounting Standards measure, and free cash flow in percent of revenue to Net cash provided by (used in) operating activities in percent of revenue: ​ ​ ​ ​ ​ ​ ​ Cash flow measures ​ ​ ​ ​ ​ ​ in € M, except where otherwise specified ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2025 ​ ​ ​ 2024 ​ ​ ​ 2023 Revenue 19,628 ​ 19,336 ​ 19,454 Net cash provided by (used in) operating activities 2,681 ​ 2,386 ​ 2,629 Capital expenditures (915) ​ (699) ​ (685) Proceeds from sale of property, plant and equipment 16 ​ 14 ​ 16 Capital expenditures, net (899) ​ (685) ​ (669) Free cash flow 1,782 ​ 1,701 ​ 1,960 Net cash provided by (used in) operating activities in % of revenue 13.7 ​ 12.3 ​ 13.5 Free cash flow in % of revenue 9.1 ​ 8.8 ​ 10.1 ​ Net cash provided by (used in) operating activities Net cash provided by (used in) operating activities is impacted by the profitability of our business, the development of our working capital, principally inventories and receivables, and cash outflows that occur due to a number of specific items as discussed below. The increase in net cash provided by operating activities in percent of revenue for the year ended December 31, 2025 as compared to the year ended December 31, 2024 was driven by an increase in net income, an improvement in cash collections and the combined positive prior year impacts of the phasing of income tax payments, particularly in the U.S., (positive) and cash received in 2024 from our former general partner, Fresenius Medical Care Management AG, related to pension obligations for management board members as a result of the Conversion, which did not recur in 2025 (negative), further muted by a negative impact in 2025 from the development of certain other working capital items (driven by the development of inventories). The decrease in net cash provided by operating activities in percent of revenue for the year ended December 31, 2024 as compared to the year ended December 31, 2023 was driven by a negative impact from the phasing of dividend payments received from equity method investments and the absence, in 2024, of the Tricare Settlement, partially offset by a favorable effect from certain working capital items (mainly accounts receivable from related parties and inventories). Delays in collections of trade accounts receivable in the U.S. (including significant delays in the first half of 2024 from the Third-party Cyber Incident) were partially mitigated by the substantial resolution of the impacts related to the Third-party Cyber Incident during the second half of 2024. The profitability of our business depends significantly on reimbursement rates for our services. For the year ended December 31, 2025, approximately 78% of our revenue was generated by providing healthcare services (including insurance services), a major portion of which is reimbursed by either public healthcare organizations or private insurers. In 2025, approximately 16% of our consolidated revenue was attributable to reimbursements from U.S. federal healthcare benefit programs such as Medicare and Medicaid. Legislative changes could affect Medicare reimbursement rates for a significant portion of the services we provide as well as the scope of Medicare coverage. A decrease in reimbursement rates or the scope of coverage could have a material adverse effect on our business, financial position and results of operations and thus on our capacity to generate cash flow. See “II. Financial condition and results of operations — Overview,” above. We intend to continue to address our current cash and financing requirements using net cash provided by operating activities, issuances under our commercial paper program (see note 16 of the notes to the consolidated financial statements included in this report), as well as from the use of our bilateral credit lines. We expect that we will have adequate sources of financing available to us. Our Syndicated Credit Facility is also available for backup financing needs. In addition, to finance acquisitions or meet other needs, we expect to utilize long-term financing arrangements, such as the issuance of bonds (see “Net cash provided by (used in) financing activities” and note 17 of the notes to the consolidated financial statements included in this report). 90 Table of Contents Net cash provided by (used in) operating activities depends on the collection of accounts receivable. Commercial customers and government institutions generally have different payment cycles. Lengthening their payment cycles could have a material adverse effect on our capacity to generate cash flow. In addition, we could face difficulties enforcing and collecting accounts receivable under the legal systems of, and due to the economic conditions in, some countries. Accounts receivable balances, net of expected credit losses, represented Days Sales Outstanding (DSO) (Non-IFRS Measure) of 59 days at December 31, 2025 (December 31, 2024: 63 days). DSO by segment is calculated by dividing the respective segment’s trade accounts and other receivables from unrelated parties (including receivables related to assets held for sale) less contract liabilities, converted to euro using the average exchange rate for the period presented by the average daily sales for the last twelve months of that segment, including sales or value-added tax, converted to euro using the average exchange rate for the period. In order to ensure comparability of line items included in the consolidated balance sheets and consolidated statements of income, trade accounts and other receivables from unrelated parties (including receivables related to assets held for sale) and contract liabilities as of December 31, 2025 are adjusted for an increase in the amount of €101.3 M and €3.7 M, respectively (December 31, 2024: a decrease of €78.5 M and an increase of €1.5 M, respectively), which represents the impact on these line items from foreign currency translation. Additionally, daily revenues in the amount of €(0.1) M and €(0.6) M for the twelve months ended December 31, 2025 and December 31, 2024, respectively, are adjusted in relation to amounts related to acquisitions and divestitures made within the reporting period with a purchase price above a €50 M threshold, to increase consistency with the respective adjustments in the determination of adjusted EBITDA (See “— I. Performance management system — Net leverage ratio (Non-IFRS Measure)” above) and in the amount of €1.1 M and €1.0 M for the twelve months ended December 31, 2025 and December 31, 2024, respectively to include sales or value-added tax and other smaller effects. The development of DSO by reporting segment is shown in the table below: ​ ​ ​ ​ ​ ​ ​ ​ Development of days sales outstanding (Non-IFRS Measure) in days ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ ​ ​ ​ ​ 2025 ​ ​ ​ 2024 ​ ​ ​ Explanation of movement ​ ​ ​ ​ ​ ​ ​ Care Delivery ​ 54 ​ 56 ​ Improvement in cash collections ​ ​ ​ ​ ​ ​ ​ Value-Based Care ​ 33 ​ 33 ​ Remained stable ​ ​ ​ ​ ​ ​ ​ Care Enablement ​ 86 ​ 95 ​ Improvement through sharpened focus on credit management and cash collection ​ ​ ​ ​ ​ ​ ​ FME AG 59 ​ 63 ​ ​ ​ Due to the fact that a large portion of our reimbursement is provided by public healthcare organizations and private payors, we expect that most of our accounts receivable will be collectible. For information regarding litigation exposure as well as ongoing and future tax audits, see note 25 of the notes to the consolidated financial statements included in this report. 91 Table of Contents Net cash provided by (used in) investing activities Net cash used in investing activities in 2025, 2024, and 2023 was €723 M, €85 M, and €544 M, respectively. The following table shows a breakdown of our investing activities for 2025, 2024, and 2023: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash flows relating to investing activities in € M ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Acquisitions, investments, ​ ​ ​ ​ Capital expenditures, net, including purchases of intangible assets and Proceeds from divestitures and the ​ capitalized development costs ​ investments in debt securities ​ sale of debt securities ​ ​ ​ ​ 2025 ​ ​ ​ 2024 ​ ​ ​ 2023 ​ ​ ​ 2025 ​ ​ ​ 2024 ​ ​ ​ 2023 ​ ​ ​ 2025 ​ ​ ​ 2024 ​ ​ ​ 2023 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Care Delivery ​ 321 ​ 352 ​ 329 ​ 49 ​ 35 ​ 55 ​ 226 ​ 658 ​ 194 Value-Based Care ​ 1 ​ 1 ​ 1 ​ 0 ​ 2 ​ — ​ 0 ​ — ​ 1 Care Enablement ​ 577 ​ 332 ​ 339 ​ 60 ​ 68 ​ 82 ​ 59 ​ 47 ​ 67 Total 899 ​ 685 ​ 669 ​ 109 ​ 105 ​ 137 ​ 285 ​ 705 ​ 262 ​ The majority of our capital expenditures was used for the expansion of production capacity (including the purchase of previously leased facilities), capitalization of certain development costs, capitalization of machines provided to our customers, maintaining existing clinics and centers, and equipping new clinics and centers. Capital expenditures accounted for approximately 5%, 4%, and 3% of total revenue in 2025, 2024, and 2023, respectively. Acquisitions in 2025 relate primarily to the purchase of clinics and centers. Investments in 2025 were primarily comprised of purchases of debt securities. Divestitures in 2025 mainly related to the divestment of equity investments and debt securities, including divestitures under our Legacy Portfolio Optimization program as well as cash received related to the sale of select assets of the Company’s wholly owned Spectra Laboratories (see note 4 of the notes to the consolidated financial statements included in this report). Investments in 2024 were primarily comprised of purchases of debt securities and equity investments. Divestitures in 2024 were mainly related to the divestment of equity investments (including divestitures under our Legacy Portfolio Optimization program) and debt securities. Investments in 2023 were primarily comprised of purchases of debt securities. Divestitures in 2023 were mainly related to the divestment of equity investments (including divestitures under our Legacy Portfolio Optimization program) and debt securities. Acquisitions in 2023 related primarily to the purchase of dialysis clinics. Additionally, purchases of intangibles in 2023 related primarily to emission rights certificates. In 2026, we anticipate capital expenditures around €0.8 BN to €1.0 BN and will remain disciplined with regard to acquisition and investment spending, while focusing on the organic growth of our business. Our anticipated capital expenditures are driven by the need to position us well to capture growth opportunities, including the large-scale rollout of our HVHDF-capable 5008X CAREsystem (for which we are targeting to replace around 20% of our machines in 2026 with the ultimate goal of replacing 100% by 2030), as well as to maintain quality levels and patient experience. Additionally, we plan accelerated capital expenditures in new production facilities as well as into R&D activities for a more globalized product portfolio. Further information regarding our acquisitions, investments and divestitures, see notes 3, 4, and 5 e) of the notes to the consolidated financial statements included in this report. Net cash provided by (used in) financing activities In 2025, 2024, and 2023, net cash used in financing activities was €1,403 M, €2,569 M and €1,859 M, respectively. In 2025, cash was mainly used in the repayment of debt and lease liabilities, the purchase of our shares through the share buyback program, distributions to noncontrolling interests (including the settlement of Interwell Health put options), and the payment of dividends, partially offset by proceeds from debt (including the issuance of bonds during the second quarter of 2025). In 2024, cash was mainly used in the repayment of debt (including short and long-term debt, the accounts receivable securitization program as well as lease liabilities), payment of dividends and distributions to noncontrolling interests. 92 Table of Contents In 2023, cash was mainly used in the repayment of lease liabilities (including lease liabilities from related parties), the repayment of long-term debt (including the repayment at maturity of bonds in an aggregate principal amount of €650 M), the payment of dividends, distributions to noncontrolling interests and the repayment of short-term debt (including borrowings under our commercial paper program and short-term debt from related parties), partially offset by proceeds from long-term debt and short-term debt (including borrowings under our commercial paper program and short-term debt from related parties). On May 27, 2025, we paid a dividend with respect to 2024 of €1.44 per share (€1.19 per share for 2023 paid in 2024 and €1.12 per share for 2022 paid in 2023). The total dividend payments in 2025, 2024, and 2023 were €423 M, €349 M and €329 M, respectively. The following chart summarizes our significant long-term financing instruments as well as their maturity structure at December 31, 2025: ​ For a description of our short-term debt, long-term sources of liquidity, and contractual cash flows (including interest) resulting from recognized financial liabilities and derivative financial instruments recorded in the consolidated balance sheets, see notes 16, 17, and 26 of the notes to the consolidated financial statements included in this report. The following table summarizes our available sources of liquidity at December 31, 2025: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Available sources of liquidity ​ ​ ​ ​ ​ ​ ​ ​ ​ in € M ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Expiration per period of ​ ​ Less than 1 ​ ​ ​ ​ ​ ​ ​ Total ​ ​ ​ year ​ ​ ​ 1-3 years ​ ​ ​ 3-5 years ​ ​ ​ Over 5 years Syndicated Credit Facility 2,000 ​ — ​ 2,000 ​ — ​ — Other unused lines of credit 1,307 ​ 997 ​ 310 ​ — ​ — ​ 3,307 ​ 997 ​ 2,310 ​ — ​ — ​ An additional source of liquidity is our commercial paper program, under which up to €1,500 M of short-term notes can be issued on a flexible and continuous basis. As of December 31, 2025 and 2024, we did not utilize the commercial paper program. At December 31, 2025, we had short-term debt from unrelated parties (excluding the current portion of long-term debt) in the total amount of €17 M. For information regarding other contractual commitments, see note 25 of the notes to the consolidated financial statements included in this report. 93 Table of Contents Although current and future economic conditions could adversely affect our business and our profitability, we believe that we are well positioned to continue to operate our business while meeting our financial obligations as they come due, and to resume growing our business as macroeconomic conditions improve and headwinds subside. Because of the non-discretionary nature of the healthcare services we provide, the need for healthcare products utilized to provide such services, and the availability of government reimbursement for a substantial portion of our healthcare services, our business is generally not cyclical. A substantial portion of our accounts receivable is generated by governmental payors. While payment and collection practices vary significantly between countries and even between agencies within one country, government payors usually represent low to moderate credit risk. However, limited or expensive access to capital could make it more difficult for our customers to do business with us, or to do business generally, which could adversely affect our business by causing our customers to reduce or delay their purchases of our healthcare products (see “III. Results of operations, financial position and net assets” and Item 3.D, “Key Information — Risk factors,” above). If the conditions in the capital markets worsen, this could increase our financing costs and limit our financial flexibility. At our AGM scheduled to be held on May 21, 2026, our Supervisory Board intends to propose to the shareholders a dividend of €1.49 per share for 2025, payable in 2026. The total expected dividend payment is approximately €416 M based on shares outstanding as of December 31, 2025. This amount considers the 14,124,564 treasury shares held by the Company as of December 31, 2025, which are not entitled to dividends. Our principal financing needs in 2026 relate to the repayment of bonds at maturity and to repurchase shares under our share buyback program. The dividend payment in May 2026, anticipated capital expenditures as well as further acquisition payments are expected to be covered by our cash flow, including the use of existing credit facilities and, if required, additional debt financing. We have sufficient flexibility to meet our financing needs in 2026. V. Balance sheet structure Total assets as of December 31, 2025 decreased by 8% to €31.0 BN from €33.6 BN as compared to 2024. Apart from a 9% negative impact resulting from foreign currency translation, total assets increased by 1% to €34.1 BN primarily due to increases in certain working capital items such as cash and cash equivalents, inventories, and other receivables from unrelated parties. Current assets as a percent of total assets increased to 25% at December 31, 2025 as compared to 24% at December 31, 2024, primarily due to decreased goodwill, right of use assets and property, plant and equipment driven by the impact from foreign currency translation. The equity ratio, the ratio of our equity divided by total liabilities and shareholders’ equity, decreased to 46% at December 31, 2025 as compared to 47% at December 31, 2024, primarily due to a decrease in shareholders’ equity driven by a negative impact from foreign currency translation adjustments and purchases of treasury stock under our share buyback program, partially offset by the impact of net income on shareholders’ equity and the impact from the settlement of Interwell Health put options. The decrease in the equity ratio was mitigated by a decrease in lease liabilities (mainly due to impacts from foreign currency translation) and other financial liabilities (including a decrease related to the settlement of Interwell Health put options). ROIC increased to 5.0% at December 31, 2025 as compared to 3.5% at December 31, 2024 primarily driven by an overall increase in our operating income, a decrease in costs related to Legacy Portfolio Optimization, the impact from the Interwell Health Deferred Tax Reversal, and a decrease in average invested capital (mainly due to impacts from foreign currency translation). Goodwill, included in the item “Invested capital,” has a significant impact on the calculation of ROIC. The weighted average cost of capital (WACC), including weighted risk premiums for country risks, was 7.0%. See “— I. Performance management system — Return on invested capital (ROIC) (Non-IFRS Measure)” above. For supplementary information on capital management and our capital structure, see note 21 of the notes to the consolidated financial statements included in this report. VI. Risk Matrix In addition to the consolidated financial statements prepared in accordance with IFRS Accounting Standards included in this report, we are subject to home country reporting requirements in Germany. These require that we provide an assessment of the probability and impact of certain risks and uncertainties that could materially affect our outlook. A summary of such risk assessment is set forth below. 94 Table of Contents Although we believe our FY 2026 outlook, which we issued in connection with the announcement of our results for the 2025 fiscal year, is based on reasonable assumptions, it is subject to risks and uncertainties that may materially impact the achievement of the outlook. In the following table, we have listed certain risks and the corresponding risk factor (or other discussion of such risks) within this report as well as our assessment of the reasonable probability and potential impact of these known risks on our results for the FY 2026. The risks and their related risk factors or other disclosure headings have been paired together to provide further information on the risks as well as provide an indication of the locations at which they are discussed in this report. The assessment below should be read together with the discussions of such risks and uncertainties contained in Item 3.D, “Key Information — Risk factors” and Item 11, “Quantitative and qualitative disclosures about market risk.” Our Litigation risk represents an assessment of material litigation currently known or threatened and is discussed in note 25 of the notes to the consolidated financial statements included in this report. These assessments by their nature do not purport to be a prediction or assurance as to the eventual resolution of such risks. As with all forward-looking statements, actual results may vary materially. See “Forward-looking Statements” immediately following the Table of Contents to this report. Other risks discussed in Item 3.D, “Key Information — Risk factors,” that are not included in the table below were deemed to have a medium to long-term potential effect on our business, financial condition, and results of operations. The classification of potential impact and likelihood as well as the localization of the risks within the risk matrix are depicted below: ​ ​ ​ ​ ​ ​ ​ ​ ​ Potential impact ​ ​ ​ Description of impact ​ ​ ​ Classification ​ ​ ​ Likelihood Severe Material negative impact Almost certain > 90% to 100 % Major Significant negative impact Likely > 50% to 90 % Medium Moderate negative impact Possible > 10% to 50 % Low Small negative impact Unlikely 0% to 10 % ​ Likelihood Almost Certain ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Likely ​ ​ ​ 9, 10, 16 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Possible ​ 1, 2, 7, 8, 13 ​ 3, 4, 5, 6, 12, 14, 15, 18, 20 ​ 17, 19 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Unlikely ​ ​ ​ ​ 11 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Low ​ Medium ​ Major ​ Severe ​ ​ ​ ​ ​ High Risk ​ ​ ​ ​ ​ Medium Risk ​ ​ ​ ​ ​ Low Risk ​ 95 Table of Contents Risk Number ​ ​ Risk factor (or other related disclosure) within the report ​ ​ ​ ​ 1 ​ If we do not comply with the numerous governmental regulations applicable to our business, we could suffer adverse legal consequences, including exclusion from government healthcare programs or termination of our authority to conduct business, any of which would result in a material decrease in our revenue; this regulatory environment also exposes us to claims and litigation, including “whistleblower” suits. 2 ​ If certain of our investments or value and risk-based care programs with healthcare organizations and healthcare providers are found to have violated the law, our business could be adversely affected. 3 ​ If we fail to estimate, price for and manage medical costs in an effective manner, the profitability of our value and risk-based care programs could decline and could materially and adversely affect our results of operations, financial position and cash flows. 4 ​ There are significant risks associated with estimating the amount of healthcare service revenues that we recognize that could impact the timing of our recognition of revenues or have a significant impact on our operating results and financial condition. 5 ​ Any material disruption in government operations and funding could have a material adverse impact on our business, financial condition, and results of operations. 6 ​ A dependency on the payment behavior and decision-making of our business partners can affect the collectability of accounts receivable and impact our operating results. 7 ​ Changes in reimbursement, payor mix and/or governmental regulations for healthcare could materially decrease our revenues and operating profit. 8 ​ We operate in a highly regulated industry such that the potential for legislative reform provides uncertainty and potential threats to our operating models and results. 9 ​ We could be adversely affected if we experience shortages of goods or material price increases from our suppliers, or an inability to access new and improved products and technology. 10 ​ If we are unable to attract and retain skilled medical, technical, engineering or key strategic personnel, or if legislative, union, other labor-related activities or changes or employee absenteeism and turnover result in significant increases in our operating costs or decreases in productivity, we may be unable to manage our growth, continue our technological development or execute our strategy. 11 ​ We operate in many different jurisdictions and we could be adversely affected by violations of the U.S. Foreign Corrupt Practices Act and similar worldwide anti-corruption laws. 12 ​ Cyber-attacks or other privacy and data security incidents could disrupt our business and expose us to significant losses, liability, and reputational damage. 13 ​ Our indebtedness may prevent us from fulfilling our debt-service obligations or implementing certain elements of our business strategy. 14 ​ Foreign currency and interest rate exposure. See Item 5, “Operating and financial review and prospects – IV. Financial position,” Item 11, “Quantitative and qualitative disclosures about market risk – Market risk” and note 26 of the notes to the consolidated financial statements included in this report. 15 ​ Legal and regulatory matters (see note 25 of the notes to the consolidated financial statements included in this report). 16 ​ Diverging views of fiscal authorities or changes in tax legislation could require us to make additional tax payments. 17 ​ As a company with operations spanning more than 140 countries, we face specific risks from our global operations. 18 ​ We are subject to risks associated with unpredictable events, such as public health crises and epidemics/pandemics or other significant events beyond our control. 19 ​ Global economic conditions as well as disruptions in financial markets could have an adverse effect on our businesses. 20 ​ If we are unable to meet applicable legal requirements and/or market expectations with respect to sustainability, both our business and our reputation could suffer. We could be subject to fines and other financial burdens associated with global environmental, social and governance regulations, laws and activities, and we could alienate our patients, employees, customers, partners, investors, and the communities we serve. Furthermore, if we do not meet investors’ or certain markets’ ESG standards, the market for our securities could be adversely impacted. At the same time, any efforts to meet ESG standards involving diversity and equity could subject us to allegations of unlawful discrimination. ​ VII. Research and development Healthcare systems face major financial challenges. With the R&D activities, Fresenius Medical Care therefore aims to develop innovative products and therapies that not only meet high quality standards and improve clinical outcomes but are also cost efficient. As an operator of proprietary dialysis clinics and a provider of comprehensive dialysis solutions – including equipment, services, and support for both clinical and home settings – the Company believes that these goals are entirely compatible. 96 Table of Contents Global research and development strategy Our R&D strategy contributes to our corporate strategy, which aims to provide healthcare for chronically and critically ill patients by developing adjacent products and therapies across the full spectrum of renal care (e.g., digital health solutions, AI-supported care models, and home-based renal therapies), as well as by developing and acquiring complementary assets such as data platforms and service offerings that support value-based integrated renal care. Furthermore, our globally oriented R&D strategy enables us to respond effectively to the worldwide rise in demand for high-quality yet cost-efficient treatment and therapy methods. In so doing, Fresenius Medical Care takes regional and local market conditions into account and offers a differentiated product portfolio in line with its strategic goal of achieving industry-leading treatment outcomes. See Item 4B “Business overview — Major markets and competitive position” and “— Corporate strategy and objectives” above. In conjunction with the R&D activities, Fresenius Medical Care actively collaborates with a broad range of external partners to strengthen the global innovation and technology ecosystem. These partnerships include numerous academic institutions and research institutes at prestigious universities across the U.S. and beyond. The Renal Research Institute (RRI), our wholly owned subsidiary, is an important player in data-driven research, artificial intelligence, mathematical modeling, and other advanced analytics research. The Renal Research Institute explores critical scientific questions related to all aspects of CKD and renal therapies. In addition, the Renal Research Institute fosters collaborations with nephrology societies and technology-focused organizations to jointly explore and implement digital health innovations, AI-enabled tools, and evidence-based solutions that enhance patient care. In 2025, the global Clinical Research team supported commercialization of products and services within Fresenius Medical Care, including company-sponsored clinical trials and investigator-initiated clinical studies globally. In addition, Fresenius Medical Care Ventures (FMCV) collaborates with start-ups and early-stage companies with the objective of promoting an open culture of innovation and enabling access to the latest technologies. R&D highlights in 2025 In 2025, the Renal Research Institute and Clinical Research within the Global Medical Office undertook several R&D initiatives. These efforts highlighted Fresenius Medical Care’s commitment to improving care for patients with ESKD and advancing the field of nephrology. A unifying theme across all these initiatives is the enhancement of patient care through personalized and precision medicine. Advancements in dialysis technology and personalized therapy The global Clinical Research team plays a pivotal role in validating and advancing technologies and practices, ensuring the implementation of safer, more personalized treatments that enhance patient experience and outcomes. High-Volume hemodiafiltration and clinical validation Following the 2024 publication of the CONVINCE study (Kidney International, 2024 Nov;106(5):961-971), our research in 2025 has centered on translating its findings into clinical practice through the widespread adoption of HVHDF. Over the past year, we have consolidated the evidence base by validating HVHDF’s cognitive benefits through real-world data collected across our European network. Most recently, analyses of 2025 Fresenius Medical Care clinic data confirmed sustained reductions in mortality and hospitalization rates. These latest results, presented at international scientific congresses during the autumn of 2025, highlight the transition from clinical trial achievement to the establishment of HVHDF as a new standard of care in advanced dialysis treatment. Clinical trial outcomes and progress Our registration and post-market studies demonstrate our commitment to rigorous clinical validation across our product portfolio. The SAfety of Regional Citrate Anticoagulation (SARCA) Study is aiming to support the introduction of the multiFiltratePRO acute dialysis machine and citrate anticoagulation procedure to the U.S. market. This open-label, prospective, multi-center registration study successfully enrolled 31 patients across ten U.S. clinics, confirming that all components of the therapy can be considered both safe and effective, with no unexpected safety events observed. Based on these strong results, Fresenius Medical Care remains on track to submit the registration for our citrate solution in the U.S. in December 2025, with market launch expected in 2026. 97 Table of Contents A retrospective, multi-center analysis known as the MFT PRO Adult Study confirmed the performance and safety of the multiFiltratePRO device for continuous kidney replacement therapy in adult patients with acute kidney injury (AKI). The study successfully met performance and safety objectives, demonstrating that the target for effluent dose – set by the Kidney Disease: Improving Global Outcomes (KDIGO) initiative was consistently achieved. These findings support the continued Conformité Européenne (CE) mark certification of the device for routine clinical use. In critical care, the multicenter, prospective, interventional multiECCO2R Study investigated the safety and effectiveness of the multiECCO2R gas exchanger in 28 patients with combined renal insufficiency and hypercapnia due to acute lung failure. Patients were treated for up to 72 hours, and a comprehensive analysis of the study data is currently being prepared. Additionally, the SEPIAR Study, which evaluated the safety and effectiveness of the CE-certified Immunoglobulin G (IgG) immunoadsorber GLOBAFFIN® in routine clinical practice, has been completed, and data analyses are currently ongoing. Artificial intelligence applications The Renal Research Institute is also developing AI applications in the dialysis space. These applications underscore the Renal Research Institute´s commitment to harnessing data-driven insights to address complications and improve care delivery. a. Nutrition plays a vital role in the well-being of patients with kidney disease, necessitating a personalized approach to address their unique dietary needs. The Renal Research Institute is leveraging generative AI to enhance precision nutrition strategies, considering medical, socio-economic, and cultural factors for a highly diverse patient population. The results from this work have been published in the Journal of Renal Nutrition (Bergling K, Wang LC, Shivakumar O, Nandorine Ban A, Moore LW, Ginsberg N, Kooman J, et al. From bytes to bites: application of large language models to enhance nutritional recommendations. Clin Kidney J. 2025 Mar 17;18(4):sfaf082. doi: 10.1093/ckj/sfaf082. PMID: 40226366; PMCID: PMC11992566.) and presented at international conferences, showcasing the potential of AI-driven solutions to improve dietary guidance and overall patient care. b. Home dialysis offers significant clinical and lifestyle benefits to patients with kidney failure, yet adoption is increasing slowly due to multifactorial barriers. In a study, conducted by the Renal Research Institute, advanced machine learning techniques were applied to develop a predictive model that identifies ideal candidates for home dialysis, using a wide range of demographic, clinical, and treatment-related variables. Published in the Journal of Kidney Medicine (Monaghan CK, Willetts J, Han H, Chaudhuri S, Ficociello LH, Kraus MA, Giles HE, Usvyat L, Turk J. Home Dialysis Prediction Using Artificial Intelligence. Kidney Med. 2024 Dec 16;7(2):100949. doi:10.1016/j.xkme.2024.100949), this work demonstrates the potential of AI-driven tools to enhance individualized modality selection and support shared decision-making between patients and care teams. These innovations aim to improve home dialysis penetration by matching the right therapy to the right patient, advancing both quality of care and patient empowerment. c. Understanding the clinical impact of AI-driven decision support is crucial. Hence, this study from the Renal Research Institute evaluates the association between the use of an AI-based Anemia Control Model (ACM) and patient outcomes in dialysis care. Published in BMC Nephrology (2025), the analysis demonstrates that consistent use of ACM tools was associated with both economic and patient improvements. These findings highlight the potential for AI-driven clinical support to meaningfully improve care delivery and patient outcomes, while also offering a scalable approach to integrating predictive analytics into everyday nephrology practice (Gandjour A, Apel C, Kendzia D, Neri L, Bellocchio F, Usvyat L, Larkin J, Petrovic Vorkapic J. Health-economic evaluation of an AI-powered decision support system for anemia management in in-center hemodialysis patients. BMC Nephrol. 2025 Aug 28;26(1):496. doi: 10.1186/s12882-025-04298-7. PMID: 40877797; PMCID: PMC12392536.). For information on the impact of AI as it relates to cybersecurity and our response to managing those impacts, see Item 16K. “Cybersecurity.” 98 Table of Contents Biomarker research and lab sciences Metabolomics and proteomics provide insights into a patient’s condition. In 2025 the Renal Research Institute Research Lab continues to focus on the following projects within the field of dialysis-related multiomics: a. Studies on peritoneal dialysis: Spent peritoneal dialysate contains thousands of metabolites that provide valuable information about the function of the peritoneal membrane. The Renal Research Institute Research Lab is leveraging advanced laboratory techniques and machine learning to analyze these metabolomic patterns in greater detail, aiming to assess the membrane’s ability to remove fluid and waste products efficiently. This continued approach seeks to replace some of the current testing methods, which are often cumbersome and time-consuming, with faster, more precise evaluations. By streamlining the assessment process, the Renal Research Institute aims to enhance the management and outcomes of PD therapy. b. Identification of a uremic toxin: When the kidneys fail, waste products known as uremic solutes accumulate in the body, contributing to various complications. In collaboration with academic partners, the Renal Research Institute has identified a specific solute, uremic solute 3-carboxy-4-methyl-5-propyl-2-furanpropionate (CMPF), which is believed to play a role in the development of anemia in patients with kidney disease. Our current research is now focused on developing real-world methods to enhance the removal of CMPF, aiming to mitigate its impact on anemia and improve patient outcomes. This work represents a significant step toward better understanding and managing the complex effects of uremic solutes in kidney failure, as well as translating research into viable ways to improve therapy. Strengthening global research partnerships In 2025, the Renal Research Institute strengthened its global collaborations with academic and clinical partners, driving innovation in kidney care through expanded initiatives. Highlights include the growth of the MONDO (MONitoring Dialysis Outcomes) International Network and partnerships with leading institutions such as Mayo Clinic, Imperial College London, Massachusetts General Hospital, Utrecht University, the University of Maryland, the University of California, Santa Barbara, and Maastricht University. Additional collaborative initiatives include ApolloDialDBTM, Inspire initiative, and others. These collaborations promote data-sharing and knowledge exchange, fostering a dynamic ecosystem for research and development. These R&D highlights reflect the multifaceted approach by the Renal Research Institute and Clinical Research to enhance ESKD treatment and patient quality of life, from advanced technologies to translational research. The developments set a foundation for ongoing innovation in renal care. Innovations in 2025 In 2025, Fresenius Medical Care worked on several new products that are now close to market launch or have already launched, and maintains an extensive portfolio of innovation projects with a focus on technologies in our core business as well as related areas of strategic interest. The digitalization of healthcare products and processes is a key aspect of innovation at Fresenius Medical Care. Our primary objectives are to connect patients, physicians, and nursing staff, improve nursing documentation at the point of care, and enhance water treatment technologies through automation. To this end, we leverage data and know-how from our Care Enablement MedTech segment, our Care Delivery clinics, and Global Medical Office to identify innovative medical products and services, as well as to harness the potential to enhance our product portfolio with digital solutions and data analytics. Our goal in doing so is to achieve better treatment results for patients on dialysis and other organ support therapies, enable seamless connectivity, optimize the workflow for healthcare professionals, and attain sustainable savings in treatment-related costs for our customers. Home dialysis Home dialysis is a growing part of our overall business. In 2025, more than 15,300 U.S.-based patients used the NxStage portable HHD system designed with home use in mind (2024: more than 14,500). This was enabled by the introduction of the new FDA-approved GuideMe software on the NxStage VersiHD cycler to the U.S. market. GuideMe’s digital technology leverages the touchscreen interface to offer enhanced user experience for patients and nurses, with walk-through graphical guidance that makes it easier to learn and retain skills while facilitating the transition to home dialysis. This is why all of Fresenius Kidney Care’s home hemodialysis patients in the U.S. now use our NxStage systems. Its 100% adoption rate underscores the integral role of NxStage technology in enabling patient-centered at-home care. 99 Table of Contents VersiHD with GuideMe also recently received EU MDR approval for CE markets and will soon be rolled out in Europe. In addition, we continued our drive to optimize the cost of the NxStage portfolio by insourcing pre-mixed dialysate bags. These were cleared by the FDA in January 2024. Furthermore, we introduced the Liberty Select Cycler with kinexus PD bidirectional remote therapy management in the U.S. in 2024. This technology makes it possible for clinical teams to remotely access and monitor patient treatment data and programs or update patient prescriptions. In 2025, approximately 58,000 therapy prescription programs were delivered remotely, and data for over 7.7 M patient treatments digitally transmitted. In May 2024, we introduced kinexus PD remote therapy management in certain European countries for both continuous ambulatory peritoneal dialysis patients and automated peritoneal dialysis patients who use the sleep.safe harmony cycler. Rollout to additional countries in Europe and Asia started in 2025. Fresenius Kidney Care also expanded its automated peritoneal dialysis APD portfolio for home patients with the introduction of a mobile version of the Silencia system in Latin America, Asia, and selected countries in Europe. In-center dialysis In June 2025, we received 510(k) clearance from the FDA for the latest version of the hemodiafiltration-capable 5008X CAREsystem. Following a successful user experience on an earlier version of the CAREsystem – which had received 510(k) clearance from the FDA in February 2024 – we continued to roll out the program to Fresenius Kidney Care dialysis centers across the United States ahead of its planned commercial launch in 2026. With FDA clearance secured, the first HDF therapies were conducted in 2025, marking a major milestone in the evolution of end stage renal disease treatment – the biggest leap in innovation the industry has seen in decades. The learnings from the initial pilot program at Fresenius Kidney Care clinics will be applied as the Company moves forward with its plan to offer this treatment modality to more of its dialysis patients as well as other dialysis providers in the U.S. in the coming years. During 2025, we launched updated versions of the 5008S CorDiax and 6008 CAREsystems in line with recent MDR requirements. We continued expanding both systems into new markets in collaboration with healthcare organizations (HCOs) to establish multiple centers of excellence dedicated to HVHDF. We continued roll out our patented sodium management tool, a unique add-on treatment option that enables precision medicine in dialysis at scale. This will help boost sales of our 6008 CAREsystem in new and existing markets while supporting healthcare professionals in leveraging sodium management as an important therapy-enhancing option. We also accelerated our activities to develop and implement fluid management and body composition monitoring for dialysis patients, with a particular emphasis on enhancing the user experience and strengthening the value proposition of our product portfolio. In the area of digitalization, Fresenius Kidney Care continued to roll out and implement its digital product portfolio with a focus on therapy data management system (TDMS) and industrial data management system (IDMS) for water quality monitoring, as well as 7Connect for connectivity and interoperability. This was in response to increasing demand for digitalization in the area of core therapy management (e.g., for patients transitioning to HVHDF) and clinic processes with the aim of driving efficiency. As digitalization is an important pillar of our in-center product strategy, in 2025 we laid the foundation for the next generation of digital products with increased automation, ease of use, improved patient outcomes, and sustainability. Within our dialyzer portfolio we made important strides forward in terms of both sustainability and treatment. We continued to broaden patient access to high-quality care. At the same time, we expanded FX CorAL, our most advanced dialyzer, into new markets, including the U.S., where it is already reaching a growing number of patients and receiving very positive customer feedback. Increasing the sustainability of our dialysis products is a very important goal for us. In 2025, we lowered our environmental impact by reducing the material consumption of our 5008 bloodline portfolio, among other measures. 100 Table of Contents The introduction of the 5008X CAREsystem together with HVHDF in the U.S. will allow us to further reduce our environmental impact by removing the need for most saline bags for dialysis while enabling a more efficient use of water, energy, and dialysis concentrates in dialysis clinics. Critical care Fresenius Kidney Care provides hospitals and intensive care units (ICUs) with a comprehensive portfolio of technologies to offer extracorporeal organ support for critically ill patients. Our multiFiltratePRO platform gives ICU staff a wide range of features to support patients undergoing continuous renal replacement therapy. In 2025, we obtained the CE mark for hemoperfusion (HP) mode. The software update enables clinicians to perform stand-alone hemoperfusion using validated adsorbers and a blood-gas exchanger, supported by a dedicated HP workflow. This gives ICU teams access to an additional extracorporeal therapy. Further technological developments include an advanced monitor and the Secure Connectivity Board (SCB) to bolster cybersecurity, scheduled for release in 2026. We also stepped up production of the domestic multiFiltratePRO in China designed specifically for this market after obtaining approval from the Chinese authorities and successfully delivering the first machines to our Chinese customers in August 2024. The introduction of Fresenius Kidney Care’s own, PVC-free Biofine® foil for our Ci-Ca® dialysate bags in 2025, which went into production at the end of 2024, led to cost reductions. In 2024, we obtained 510(k) clearance for our pureFLOW fluids 400, 401, 402, and 407, as well as Special 510(k) clearance for the multiFlux 1000 filter for use in acute renal failure. We now manufacture pureFLOW fluids in-house and made them widely available across the United States in 2025. The multiFlux 1000 filter, cleared in 2024, will play an important role in our acute renal care portfolio in the future. The Apheresis Pathogen Reduction Device (APRΞD) represents a next-generation platform for therapeutic apheresis, designed to deliver enhanced performance and operational efficiency in clinical settings. CE MDR certification was granted in August 2024, followed by the start of lipoprotein apheresis treatments in September 2024 and re-approval by the notified body in October 2025. APRΞD was introduced to the market at the end of 2025 prior to commercial launch in January 2026. A key development in clinician education was the continued evolution of Fresenius Kidney Care’s Augmented Reality (AR) training application Ready4 multiFiltratePRO AR. Originally launched to support ICU teams in mastering the multiFiltratePRO acute dialysis device, the scope of this digital tool was extended in 2025 to offer expanded educational modules that deepen users’ clinical understanding and confidence. Through immersive 3D anatomy and physiology models, they can explore the kidney and nephron structure in detail. Dynamic AR visuals also bring continuous kidney replacement therapy principles such as diffusion, convection, and modality differences to life, bridging theory and practice in a vivid, interactive format. With ongoing updates and new content, the Ready4 multiFiltratePRO AR experience ensures clinicians have access to the latest insights, reinforcing its value as a continuously evolving training resource. In 2025, Fresenius Kidney Care focused on significant improvements to manufacturing operations for its heart and lung business. Through process optimization, automation, and targeted investments, we successfully removed key bottlenecks and streamlined production workflows. As a result, we more than doubled our manufacturing capacity and output, increasing the reliability and flexibility of supply to meet the growing global demand for extracorporeal life support (ECLS) systems. A key milestone in our heart and lung business in 2025 was the successful regulatory approval of synchronized cardiac support therapy. This innovative, synchronized, and pulsatile extracorporeal membrane oxygenation (ECMO) therapy represents a breakthrough in extracorporeal life support. By actively synchronizing blood flow with the patient’s cardiac cycle, it improves end-organ perfusion and reduces cardiac afterload, potentially improving myocardial recovery and overall patient outcomes. The approach combines the benefits of mechanical circulatory support with physiological pulsatility, bringing ECMO therapy one step closer to natural heart function. In addition, Fresenius Kidney Care developed multiHL7 in 2024, a connectivity solution for multiFiltratePRO devices. Connectivity was a key driver in upgrading our Xenios 2.0 console, which we launched in April 2025. The system simplifies the implementation of standards-based medical data, allowing machine data to be incorporated flexibly into a variety of patient monitoring systems. Medical information is automatically transferred to patient data management systems (PDMS) or electronic medical records (EMR), significantly reducing the workload for healthcare providers by streamlining documentation and data management processes. 101 Table of Contents Access to transplants As a patient’s path to a transplant starts with a referral, Fresenius Medical Care launched its ReferralReady program in 2023 to redesign the process. Historically, the fragmentation of referral policies led to process bottlenecks, extra work, and lengthy delays that eroded patients’ belief in the transplant system. Based on extensive feedback from transplant intake personnel and dialysis social workers, we developed a semi-automated workflow to create the industry’s most comprehensive referral program with two specific aims: 1. Quality: ReferralReady draws on more than 167 data points across Fresenius Medical Care systems to provide a highly transparent system that enables transplant intake teams to make timely decisions for each patient. 2. Efficiency: The semi-automated workflow saves dialysis social workers two hours of administration per referral, giving them more time to help patients become stronger transplant candidates. ReferralReady has strengthened the working relationship between transplant centers and dialysis teams, laying the foundation to continue increasing the number of our patients placed on the kidney transplant waitlist. R&D resources R&D expenditure corresponded to 4% (2024: 4%) of our healthcare product revenue. At the end of 2025, our patent portfolio comprised some 7,890 property rights across approximately 1,498 patent families, i.e. groups of patents linked to the same invention. In 2025, we produced around 67 additional patent families. Our broad portfolio of patents provides us with a wide range of treatment options in this competitive field. As of December 31, 2025, 1,488 employees (total headcount) worked for the Company in R&D worldwide (December 31, 2024: 1,384). These employees come from diverse backgrounds, with professionals from medical, business, and technical fields working alongside software, data, and AI specialists on interdisciplinary teams. The majority of our R&D staff, over 940 employees, are based in Europe. Most R&D activities are carried out at our facilities in Schweinfurt and Bad Homburg v. d. Höhe (Germany). Other development sites are in St. Wendel (Germany) and Palazzo Pignano (Italy). In the U.S., we maintain a center of excellence for the development of dialyzers and other disposable products in Ogden, Utah. In China, development activities in Shanghai and Changshu focus on the growing demand for cost-effective dialysis systems in Asia and emerging markets. The Global R&D organization coordinates collaboration and knowledge-sharing across all these sites. More information is shown in the table below: ​ ​ ​ ​ ​ ​ ​ Research and development expenditures in € M ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2025 ​ ​ ​ 2024 ​ ​ ​ 2023 Total 158 183 232 ​ ​ ​ ​ ​ ​ ​ ​ Employees Total headcount, as of December 31, for the respective period presented ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2025 ​ ​ ​ 2024 ​ ​ ​ 2023 Total 1,488 1,384 1,358 ​ ​ ​ ​ ​ ​ ​ ​ Number of patents As of December 31, for the respective period presented ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 2025 ​ ​ ​ 2024 ​ ​ ​ 2023 Total 7,890 9,529 9,537 ​ VIII. Trend information For information regarding significant trends in our business see Item 5, “Operating financial review and prospects.” 102 Table of Contents IX. Tabular disclosure of contractual obligations The information required by this item may be found in Item 5B under the caption “– IV. Financial position – net cash provided by (used in) financing activities.”