Fresenius Medical Care AG

Ladies and gentlemen, welcome to the report on the third quarter 2025 conference call. I am Sandra, the chorus call operator. I would like to remind you that all participants have been listed in only mode and the conference is being recorded. The presentation will be followed by a Q&A session. You can register for questions at any time by pressing star and 1 on your telephone. For operator assistance, please press star and 0. The conference must not be recorded for publication or broadcast. At this time, it's my pleasure to hand over to Dr. Dominic Hager. Please go ahead, sir.

Thank you, Sandra. Welcome, everyone, to our earnings call for the third quarter 2025. As always, I start out the call by mentioning our cautionary language that is in our safe harbor statement as well as in our presentation and in all the materials that we have distributed earlier today. For further details concerning risks and uncertainties, please refer to these documents and to our SEC filings. We will have roughly one hour for the call. In order to give everyone the chance to ask questions, we would limit the number of questions to two. Thank you for making this work, as always. Let me now welcome Helen Gieser, CEO and Chair of the Management Board, and Martin Fischer, our Chief Financial Officer. Helen, the floor is yours.

Thank you, Dominic. I'd also like to extend a warm welcome to everyone on the call. Thank you for taking the time to join us today and your continued interest in Fresenius Medical Care. As many of you know, the U.S. is in government shutdown since the 1st of October, and many healthcare policy decisions are open. like the questions of extended tax subsidies for the exchanges and whether they will expire by the end of this year, or the publication of final 2026 ESRD PPS rule. This requires us to remain flexible in planning and agile in running our business. We remain focused on what we can influence. In Q3, we made meaningful progress in advancing our FME Reignite strategy and positioning ourselves for sustained value creation. Our strong third quarter results reflect continued momentum and disciplined execution as we further accelerated top-line growth while delivering a clear step-up in earnings growth and profitability. And the step-up is in line with our full year planning. I will begin my prepared remarks on slide four. In the third quarter, we realized strong organic revenue growth of 10% with positive contributions from all three operating segments. In the U.S., same market treatment growth was slightly positive. This is in line with our assumption of flat to slightly positive growth for 2025. Operating income growth increased for a third consecutive quarter and accelerated to 28%. As a result, this drove a step change in profitability with our operating income margin expanding from 9.9% to 11.7%. The improvement in profitability was supported by continued momentum in our FME25 Plus program, which generated a further $47 million us already to 174 million euro of savings for 2025. As part of our new FME Reignite strategy and capital allocation framework, we announced an initial share buyback of 1 billion euro in line with our commitment to reignite value creation for shareholders. The share buyback program officially commenced in August with a first tranche of up to 600 million euro. Through 30th of September, 3.6 million shares had been repurchased for a total investment amount of 151 million euro. And until October 31st, we have repurchased in total 4.35 million shares for a total investment of 188 million euro. For full year 2025, we are very well on track to achieve our outlook for the year and therefore reiterate our guidance. Next on slide five, the American Society of Nephrology's Kidney Week takes place in Houston this week. Already last year, we saw a lot of interest in high volume HDF on our 5008X machine at the ASN. I do expect a high level of interest and engagement again this year, especially as we start the 5008X rollout, and with that, a new therapy becomes available in the United States. This will set a new standard of care. We submitted around a dozen of clinical abstracts that are specifically focused on high-volume HDF, from the risk reduction resulting from HDF therapy to the implementation of HDF in clinics to AI support for clinicians during implementation. Besides the scientific side of HDF, it's also great to see how the feedback is from the phrologists that visited one of our clinics that already run with HDF. And I want to share what they said. Being able to see the human experience of HVHDF firsthand was one of the most pivotal moments for me. And given our mission and the potential of the HVHDF therapy, we would love to explore having our clinics serve as index centers for the North American rollout of this modality. This shows that we are not only excited about the broad rollout in 26, but how well prepared we are in all dimensions and how well received it might be. Next on slide six, with the launch of the FME Reignite Strategy, we have committed to reignite growth and innovation across our organization. In care delivery, we are supporting overall volume growth by raising the bar on quality even higher, further enhancing clinical outcomes and patient safety. This is especially important to me because it directly reflects our purpose-driven, patient-centric approach where the patient is at the heart of everything we do. We are already seeing encouraging progress on our quality and safety initiatives, and I would like to share some examples from the U.S. market. Frequent adherence is a key focus as patients with chronic illnesses often struggle to adhere to their care plans. This frequently involves helping our patients to understand the importance of sticking to their treatment plan and working with them to remove barriers. Since the beginning of this year, controllable mistreatments have decreased due to improved alignment amongst physicians, patients, and clinicians. Many ESRD patients begin dialysis with a central venous catheter, which, while necessary, poses a high infection risk. Although our long-term goal is to transition patients to permanent access, bloodstream infection prevention remains even more critical during this period. Antimicrobial interventions reduce infection rates by 70% compared to conventional care. In August, we launched a program to further increase antimicrobial catheter treatments to eligible patients. Adoption to date has been strong, with 84% of eligible catheter patients now receiving bloodstream infection protection, and we are on track to achieving greater utilization. Protection against the flu is especially critical for our vulnerable patient population. And because flu strains change yearly, annual vaccination is necessary to maintain protection. Our U.S. clinic network has launched its annual vaccination campaign, and vaccination rates are 34% higher than where they were at this point in 2024. We already have more than 72% of our patients vaccinated. And like in previous years, we expect to come to 85% before the end of the year. These are just a few examples for reducing hospitalization and costs for the healthcare system, and at the same time, increasing the number of treatments while improving patient outcomes and reducing mortality over time. I'm extremely proud of the work we are doing and the results we are already achieving. It gives me great confidence and excitement for the path ahead. Turning to slide seven, this quarter we saw strong execution across all three of our operating segments. I will take you through some of the key highlights by segment. In care delivery, in line with our expectations, U.S. same-market treatment growth was slightly positive with 0.1%. This reflected the carryover effect from elevated mortality, which was driven by the severe flu season earlier in the year. and positively offset by improving admissions, as well as slight improvements in mistreatments. In our international markets, same market treatment growth increased to 1.2%. Third quarter care delivery performance benefited from favorable rate and mix development in the U.S., as well as accelerated contributions from phosphate binders in our pharma business. We further executed on our portfolio optimization plan, closing clinic divestitures in Brazil, Malaysia, and some other smaller markets. One highlight for me in care delivery, which I'm sure comes as no surprise, is the availability of high-volume HDF treatments in select U.S. clinics. We are progressing every day and are very encouraged by the initial feedback we have heard from our patients that have been receiving HDF treatments. The work we are doing is paying off, and I'm very proud of the team's focus and execution while never wavering on the highest quality of patient care. These patients report feeling significantly better with increased energy levels and improved sleep quality and reduced post-treatment recovery time. Clinic staff have highlighted the benefits of quieter, less stressful workflows, thanks to the enhanced automation of the machine, which supports more efficient and patient-focused care. The excitement is palpable. While we are not expecting this to be a major driver of operational performance this year, our learnings are rapid from the early rollout of select clinics, which is providing valuable insights, allowing us to further enhance and refine the clinic training and conversion process. This will set us up for a seamless, large-scale launch in 2026, which will be the start of the broad transition of our clinic network. Turning to value-based care. As expected, we continue to face a degree of earnings fluctuations. We are also facing delays to 2026 by CMS in providing reporting data for the CKCC program, which adds to these fluctuations as these cannot be planned. In value-based care, we realized a higher number of member months due to continued contracting growth, as well as a growing network of providers. and we are further enhancing our care models through increased use of artificial intelligence. As part of our Reignite strategy, we took an important step forward by increasing and strengthening our ownership stake in our value-based care asset into WellHealth. This reinforces our leadership position in renal value-based care, which is supported by the vertical integration benefits that our business model offers. With this step, we are better able to leverage the full scale and size that Fresenius Medical Care as a total company offers. This and the underlying progress we are already making in value-based care is positioning this business for long-term, more profitable growth. Care enablement delivered another strong quarter, supported by volume growth and positive price We continued to capture sustainable savings as part of FME25+, driven by disciplined execution of the next level of footprint optimization across both manufacturing and supply chain. And as a result, our care enablement margin further progressed compared to the prior year, despite being increasingly challenged by transactional exchange rate impacts. I will now hand over to Martin to take you through the financial performance in more detail.