Fresenius Se & Co

Hello everyone, welcome to our Q1 2026 earnings call and webcast.

The presentation was emailed to our distribution list earlier today and is available on Presenius.com. On slide two of the presentation, you'll find the usual safe harbor statements. Unless stated otherwise, we'll comment on our performance using constant exchange rates. Today, I'm pleased to welcome Mike and Sarah, who will present the results of another quarter of competitive growth. As usual, the call will last approximately one hour, with the presentation taking around 30 minutes, with remaining time for your questions. To give everyone a chance to participate, please limit your questions to one to two in the first instance, and we can always come back for a second round if needed. And with that, I will now hand the call over to Michael.

Thank you, Nick, and welcome to everybody joining us today. I am, we are pleased to report an excellent start to 2026, fully in line with our expectations, building on our great momentum and reconfirming our full year guidance. As always, Sarah and I will walk you through the key operational and financial highlights of our individual businesses within CABI and Helios in a moment. Rejuvenating action means that our next strategy phase of future Fresenius is in full swing with greater focus, speed, and sharper execution. 2026 is all about accelerating our performance and building a resilient healthcare company for the future by upgrading our core with targeted investments, scaling our platforms, and further elevating our performance. It's about being consistent Quarter after quarter, and Team Fresenius is fully aligned. We keep doing what we're doing, but do it even better. The first quarter demonstrates that Fresenius is better prepared than ever, delivering strong results in a market dominated by geopolitical tensions and global uncertainty, which continue to shape the operating environment. Recent developments in the Middle East are a clear reminder that volatility is no longer temporary. It has become a constant, taking center stage in the boardroom. Over the past few years, we have fundamentally, fundamentally reshaped our company, simplified our structure, strengthened our balance sheet, and built more agile and competitive operating businesses. Consequently, we have a different organizational and leadership maturity level, which provides resilience and flexibility to navigate uncertainty while staying firmly on course to deliver on our future ambitious. This is impressively reflected in our Q1 performance, which once again proved we deliver on our commitment Core EPS grew by 13% in constant currency, clearly outpacing top-line growth, driven by operating strength and nice operating leverage. And we've been achieving this while investing in innovation if you look at the OpEx development. Our Kabi business remains a strong performer with growth vectors moving closer to our recently upgraded structural margin band of 17 to 19%. Helios delivered a strong EBIT margin of 10.5 with double digit EBIT growth in Germany and Spain, a great achievement. Our balance sheet continues to strengthen with net debt to EBITDA improving to 2.6 times. We're now moving towards the lower end of the self-imposed leverage corridor, which in turn enhances our strategic and financial flexibility in a challenging macro environment. Future Fresenius is delivering, and encouragingly, this was most recently recognized by S&P Global Ratings, which revised Fresenius' credit outlook from stable to positive. This reflects a lot of hard work over the past several years and demonstrates our commitment to delivering long-term profitable growth and balance sheet strength while positioning the company for future innovation-led growth. The S&P rating marks the best credit position in our history, which is a testament to the strong progress Fresenius has made. Acknowledging today's challenging operating environment, I remain confident in Fresenius' resilience and adaptability. Today, we are reconfirming our full-year 2026 guidance with great confidence based on this quarter's performance with 5% organic top-line growth and strong 13% EPS growth at constant currencies. Now let's dive deeper into our core businesses with Kabi and Helios, both of which delivered very strong performances during the quarter. At Kabi, we are accelerating new product launches and innovation to further strengthen our market leadership position. In pharma, we continue to expand our IV therapy portfolio in the U.S., converting our pipeline into commercial launches most recently with a new pre-mixed, ready-to-use, ready-to-administer solution in our FreeFlex bag. Generic drugs and biosimilars currently remain largely exempt from U.S. tariffs. We continue to double down on our pipeline and launch excellence while further strengthening local-for-local value chains by diversifying suppliers and sources, mitigating risks, and building supply networks to ensure long-term success. In nutrition, we are maintaining a strong pace, expanding geographically and accelerating our innovation pipeline. In Q1, we completed two new global launches in enteral nutrition to support patients with additional nutritional needs, including those at high risk of malnutrition. And we also launched a new product to address the specific dietary needs of dialysis patients. In parenteral nutrition, we continue to gain market share in the U.S. And within just a few years, Fresenius Kabi has established itself as the leading provider of lipid emulsions. Overall, our nutrition business continues to deliver attractive growth with highly accretive margins. In Medtech, we secured a multi-year contract with a major French GPO in infusion, an important commercial win. And we achieved another milestone in Q1 with Class III CE certification for our blood bag systems under the medical device regulation in Europe. Now let's turn to biopharma. We continue to see excellent momentum across all regions with our launch portfolio, broad portfolio, starting this year very strongly. Tyene, our Toxelitumo biosimilar, continues to gain sequential market share with 40% and 27% in the top five EU countries and the US, respectively. Given our early launch, we secured many exclusive contracts in both Europe and the U.S., giving us a meaningful head start and supporting continued share momentum. Othulfi, our Ustekinoma biosimilar, has now launched in 16 markets worldwide. In France, we see encouraging momentum, including the introduction of auto substitution and contract wins, including the country's largest retail pharmacy, where Atulti positioned as the number one product. In addition, and that is hot of the press, our US team recently secured a contractual agreement for Atulti with a large federal buyer. With Denusoma, we are firmly positioned in the top three across selected EU markets and have reached 8% market share in EU5. Most recently, we achieved regulatory approval in Canada, further underscoring the strong, consistent progress we are making. Next, let's focus on highlights in our care provision business. Present is Helios, where performance was positively impacted by increases in inpatient admissions and pricing. We also continue to speed up innovation and digitization to improve operations in our core businesses. In Germany, we are accelerating the adoption of technology and AI through our recently announced strategic partnership with SAP. Together, we invested in Avelios Medical, a state-of-the-art hospital software developer, which will enable us to build an open, interoperable, and AI-enabled digital ecosystem. Through this investment, we are targeting innovative software that will improve clinical workflows, decision support, and ultimately productivity. At Care and Salute, we continue to advance medical excellence and quality with 14 hospitals now recognized in the 2026 World's Best Hospital ranking, a phenomenal achievement. In addition, A peer-reviewed publication in the New England Journal of Medicine Catalyst demonstrated clearly that value-based hospital operators consistently outperform traditional public hospitals across quality, efficiency, patient satisfaction, and cost per capita. This demonstrates that you can scale profitability within universal health systems while improving access for lower-income populations, reinforcing our confidence in the long-term resilience of our model. Let me spend a moment on the current German regulatory environment, which obviously remains key in investor conversations. And let me use this opportunity to separate the wheat from the chaff. The German healthcare system is under increasing pressure. Structural inefficiency, rising deficits in public health insurance, and many hospitals operating at a loss are driving the need for reform. Policymakers acknowledge the challenge and are responding with measures focused on outcome quality, efficiency, and spending discipline, income-oriented expenditure controls. So if you think it through, tomorrow's environment favors scale, quality, and excellence, strengths that differentiate Helios. We're further executing our cluster strategy, concentrating complex medical services in centers of excellence while maintaining strong regional networks. Helios continues to be Germany's most efficient hospital operator. We're utilizing digitization and AI to achieve additional productivity and efficiency improvement, all while enhancing care delivery and patient outcomes. The newly proposed regulations accelerate our strategy enabling Helios to emerge as a long-term champion, delivering quality, scale, and innovation. It's an opportunity for us that reinforces our established competitive advantage. We can work with the current and future regulatory environment. We are part of the solution and we're going to thrive through it. and our ambition vis-à-vis our business remains and prevails. As I mentioned, we're operating in a more volatile geopolitical environment with the situation in the Middle East, the most recent example. However, given our resilient operating model, the direct impact on Fresenius remains limited and manageable. Our balanced portfolio and active measures to create a more agile operating model have proven highly effective, even allowing us to increase R&D investment this quarter, while also improving gross margin despite continued uncertainty. On supply and logistics, we have largely maintained operations through proactive rerouting and disciplined inventory management. We're also doubling down on local for local manufacturing, to further strengthen resilience and flexibility. Obviously, we're closely monitoring the situation, including potential secondary effects, such as higher material input costs, and we're also taking the necessary action to secure supply chains, providing continuity while mitigating risk. On energy, we are well protected with an active hedging strategy for 2026 and 2027 that we continue to review given the dynamic situation. Overall, this again underscores the strength of our operating model, diversified exposure, resilient supply chain, and disciplined risk management. We remain focused on execution while remaining agile in this operating environment. Across Fresenius, our businesses, all our businesses, are structurally resilient, not just cyclically defensive, but strategically positioned to perform through digital disruption and geopolitical volatility. Our products are system critical and essential, highly regulated and deeply embedded in healthcare systems and patient care. Combined with our vertically integrated manufacturing footprint and local-for-local supply chain, this creates a strong moat and reliable cash generation. As Europe's leading private hospital operator, we provide critical healthcare infrastructure. Digitization and AI further strengthen our ability to drive efficiency while simultaneously improving patient outcomes. At its core, this remains a highly differentiated, non-replicable business defined by human touch. Together, Fresenius benefits from three layers of protection, a mission-critical role in healthcare, high real asset entry barriers, and defensive growth characteristics. This resilience reinforces not limited growth, Our growth vectors are contributing increasingly to earnings, while our stable cash flows continue to fund investment and transformation. That combination, resilience and growth, is central to rejuvenate as we upgrade our core and scale our platforms. With this, over to Sarah.