Fresenius Medical Care AG & Co. KGaA

Investor Presentation • May 6, 2025

Analyst Presentation

Helen Giza CEO & Chair of the Management Board

Martin Fischer CFO

May 6, 2025

Q1 2025 IR Conference Call

Safe harbor statement: In this Safe harbor statement, "the Company" and "Fresenius Medical Care" refer to Fresenius Medical Care AG & Co. KGaA, a German partnership limited by shares, prior to its conversion of legal form, and to Fresenius Medical Care AG, a German stock corporation, after its conversion of legal form. This presentation includes certain forward-looking statements within the meaning of Section 27A of the U.S. Securities Act of 1933, as amended, and Section 21E of the U.S. Securities Act of 1934, as amended. Forward-looking statements are inherently subject to risks and uncertainties, many of which cannot be predicted with accuracy or might not even be anticipated. The Company has based these forward-looking statements on current estimates and assumptions which we believe are reasonable and which are made to the best of our knowledge. Actual results could differ materially from those included in the forward-looking statements due to various risk factors and uncertainties, including changes in business, economic or competitive conditions, changes in reimbursement, regulatory compliance issues, regulatory reforms, foreign exchange rate fluctuations, uncertainties in litigation or investigative proceedings, cyber security issues and the availability of financing. Given these uncertainties, readers should not put undue reliance on any forward-looking statements. These and other risks and uncertainties are discussed in detail in the Company's Annual Report on Form 20-F under the headings "Forward-Looking Statements" and "Risk Factors" and under the headings in that report referred to therein, and in the Company's other reports filed with the Securities and Exchange Commission (SEC) and the Frankfurt Stock Exchange (Frankfurter Wertpapierbörse).

Forward-looking statements represent estimates and assumptions only as of the date that they were made. The information contained in this presentation is subject to change without notice and the company does not undertake any duty to update the forward-looking statements, and the estimates and assumptions associated with them, except to the extent required by applicable law and regulations.

If not mentioned differently the term net income refers to the net income attributable to the shareholders of Fresenius Medical Care. Amounts are in Euro if not mentioned otherwise.

Implementation of measures as presented herein may be subject to information and consultation procedures with works councils and other employee representative bodies, as per local laws and practice. Consultation procedures may lead to changes on proposed measures.

Execution against strategic plan 1

Q1 Business update 2

Outlook 3

Q1 2025 | Key developments at Group level

• Strong organic revenue growth1 of 5% driven by Care Enablement and Care Delivery
• Stable U.S. same market treatment development despite impact from a severe flu season
• FME25 savings of EUR 68 million contributed to earnings
• Operating income2 growth of 11% at constant currency resulting in margin expansion
• Net leverage ratio at 2.8x
• Very limited impact from tariff changes currently expected
• FY 2025 outlook confirmed

1 Organic growth represents growth in revenue, adjusted for certain reconciling items including revenue from acquisitions, closed or sold operations and differences in dialysis days and presented at constant currency. 2 Reconciliation table for special items and currency to reported growth rates: page 18.

Q4 2024

Conference Call Q1 2025 Highlights | Strong organic revenue and income growth

• Same market treatment growth:
  • U.S. stable, despite impact from a severe flu season, and partly offset by continuously increasing patient referrals
  • International accelerated to 2.5%
• U.S. volumes impacted by a decrease of one dialysis day
• Revenue growth contribution from value-based care
• Phasing of operating income in-line with expectations
• Favorable U.S. reimbursement rate and mix development
• Positive impact from phosphate binders
• Ongoing treatments with 5008x in U.S. pilot clinic

Care Delivery Care Enablement

Q4 2024

• Solid volume growth in all geographic regions
• Further positive pricing momentum
• Continued delivery of FME25 initiatives and savings: optimization of manufacturing and supply chain footprint
• Operating income margin reached 2025 target band
• 5008x U.S. commercial launch on track for end of year

Execution against strategic plan

Q1 Business update 2

Outlook 3

1

Q1 2025 | Strong organic revenue growth and margin expansion

Q1 2024 Q1 2025 4,725 4,881 +1.2% at cc¹ Revenue | in € million +3.3% as reported

• Strong organic revenue growth with contributions from both segments
• Divestitures negatively impacted development by approx. 260 bps

• Operating income1 growth mainly driven by Care Enablement
• Special items mainly include costs related to legacy portfolio optimization and FME25, as well as negative effects from Humacyte remeasurements

1 At cc = at constant currency; operating income (growth) excluding special items | Q1 2025 €446 million operating income excl. special items at cc | Reconciliation table for special items and currency to reported growth rates: page 18. 2 Organic growth represents growth in revenue, adjusted for certain reconciling items including revenue from acquisitions, closed or sold operations and differences in dialysis days and presented at constant currency.

Q4 2024

Conference Call Q1 2025 | Operating income and margin growth mainly driven by Care Enablement

Reconciliation table for special items and currency to reported growth rates: page 18

Q4 2024

Conference Call Q1 2025 | Care Delivery with strong organic growth despite seasonally muted U.S. volumes

• U.S. organic growth of +4% driven by value-based care and favorable rate/mix effects, offsetting impacts from severe flu season
• Strong organic growth internationally of +5%
• One dialysis less day; portfolio changes negatively impacted growth by approx. 370 bps

• Business growth supported by phosphate binders and positive rate/mix, compensating less treatments and less positive value-based care contributions
• Higher labor cost and inflation in line with expectations, partly compensated by FME25 savings

1 At cc = at constant currency; operating income (growth) excluding special items | Q1 2025 €346 million operating income excl. special items at cc | Reconciliation table for special items and currency to reported growth rates: page 18 2 Organic growth represents growth in revenue, adjusted for certain reconciling items including revenue from acquisitions, closed or sold operations and differences in dialysis days and presented at constant currency.

Q4 2024

Q4 2024 Conference Call Q1 2025 | Care Enablement continued strong momentum on both revenue and margins

• Solid volume growth across all geographical regions and continued positive pricing momentum globally
• China developed in line with expectations, supportive to volume growth yet a headwind to price development

• Business growth driven by improved volume growth and pricing
• Positive contributions from the FME25 program savings, offsetting inflationary cost increases that developed as expected

1 At cc = at constant currency; operating income (growth) excluding special items | Q1 2025 €113 million operating income excl. special items at cc | Reconciliation table for special items and currency to reported growth rates: page 18 2 Organic growth represents growth in revenue, adjusted for certain reconciling items including revenue from acquisitions, closed or sold operations and differences in dialysis days and presented at constant currency.

Q4 2024 Conference Call Q1 2025 | Continued strong cash flow development and further improved net leverage ratio

in € million	Q1 2025	Q1 2024	in % ∆
Operating cash flow	163	127	27.9
 Capital expenditures, net	(142)	(129)	9.9
Free cash flow	21	(2)	n.a.
 Free cash flow after investing activities	55	59	-7.4
Total net debt and lease liabilities	9,753	11,001	-11.3

Net leverage ratio (Net debt/EBITDA)

Key developments

• Operating cash flow driven by seasonality of invoicing, in line with expectations
• Total debt and lease liabilities (EUR 10.8bn) as well as total net debt and lease liabilities (EUR 9.8bn) further decreased compared to Q1 2024
• Continued strict financial discipline, net leverage ratio of 2.8x remains below the selfimposed target corridor
• In April, successful placement of two bond tranches with an aggregate volume of EUR 1.1 billion and tender of EUR 300 million of bonds maturing in 2026

1 Excl. U.S. federal relief funding and advanced payments under the CARES Act

Execution against strategic plan

Q1 Business update 2

Outlook 3

1

FY 2025 | Outlook confirmed

FY 2025 Revenue & Operating Income

Revenue	Positive to a low-single digit percent growth FY 2024 basis: EUR 19,336 million	Implied Group operating income margin
Operating income	High-teens to high-twenties percent growth FY 2024 basis: EUR 1,797 million	around 11% to 12%

Revenue and operating income, as referred to in the outlook, are both on a constant currency basis and excluding special items. Special items will be provided as separate KPI ("Operating income excl. special items") to capture effects that are unusual in nature and have not been foreseeable or not foreseeable in size or impact at the time of providing the outlook. These items are excluded to ensure comparability of the figures presented with the Company's financial targets which have been defined excluding special items. See page 18 for reconciliation table for special items.

Growth rates as shown above are year-on-year basis

Q4 2024

2025 | Capital Markets Day

June 17, 2025 | London, UK

For more information and to participate, please reach out to ir@freseniusmedicalcare.com

Q4 2024

Your questions are welcome.

Appendix

Q1 2025 | Profit and Loss

	Q1 2025 € million	Q1 2024 € million	Growth in %	Growth in % cc
Revenue	4,881	4,725	3	1
Operating income	331	246	35	32
Operating income margin in %	6.8	5.2
Operating income excl. special items	457	403	13	11
Operating income margin excl. special items in %	9.4	8.5
Net interest expense	81	88	-8	-11
Income before taxes	250	158	59	55
Income tax expense	61	40	54	52
Tax rate in %	24.4	25.0
Non-controlling interest	38	47	-19	-21
Net income	151	71	113	109
Net income excl. special items	246	188	31	29

Reconciliation table for special items and currency to reported growth rates: page 18

Q4 2024

2024 base for 2025 targets, reconciliation adjustments

Reconciliation of non-IFRS financial measures to the most directly comparable IFRS financial measures for comparison with outlook

		Group			Care Delivery			Care Enablement		Corporate		eliminations	Inter-segment
€ million	Q1 2025	Q1 2024	in %	Q1 2025	Q1 2024	in %	Q1 2025	Q1 2024	in %	Q1 2025	Q1 2024	Q1 2025	Q1 2024
Revenue	4,881	4,725	3	3,857	3,788	2	1,367	1,297	5	--	--	-343	-360
Foreign currency translation	-99			-101			-6					8
Revenue at cc	4,782			3,756			1,361					-335
Operating Income	331	246	35	323	189	71	94	70	34	-81	-14	-5	1
FME25 program	28	28		15	12		11	16		2	0	--	--
Humacyte remeasurements	74	-15		--	--		7	-10		67	-5	--	--
Legacy portfolio optimization	24	143		22	147		2	0		--	0	--	-4
Legal form conversion costs	0	1		--	--		--	--		0	1	--	--
Sum of special items	126	157		37	159		20	6		69	-4	--	-4.
Operating income excl. special items	457	403	13	360	348	4	114	76	50	-12	-18	-5	-3.
Foreign currency translation	-11			-14			-1			4		0
Operating income excl. special items at cc	446			346			113			-8		-5

Q4 2024

Debt

	Q1 2025 € million	FY 2024 € million	FY 2023 € million
Debt
Short-term debt from unrelated parties	95	2	457
+ Current portion of long-term debt	591	575	487
+ Current portion of lease liabilities from unrelated parties	603	616	593
+ Current portion of lease liabilities from related parties	25	25	24
+ Long-term debt, less current portion	6,149	6,261	6,960
+ Lease liabilities from unrelated parties, less current portion	3,275	3,412	3,419
+ Lease liabilities from related parties, less current portion	83	88	110
+ Debt and lease liabilities included within liabilities directly associated with assets held for sale	11	9	137
Total debt and lease liabilities	10,832	10,988	12,187
Cash and cash equivalents1 −	-1,079	-1,185	-1,427
Total net debt and lease liabilities	9,753	9,803	10,760

1 Includes cash and cash equivalents included within assets held for sale.

Q4 2024

Reconciliation of adjusted EBITDA and net leverage ratio to the most directly comparable IFRS financial measures

	LTM Q1 2025 € million	FY 2024 € million	FY 2023 € million
Net income	812	741	732
+ Income tax expense	338	316	301
− Interest income	-71	-72	-88
+ Interest expense	399	407	424
+ Depreciation and amortization	1,530	1,536	1,613
Adjustments1 +	432	450	409
Adjusted EBITDA	3,440	3,378	3,391
Net leverage ratio (Net debt/EBITDA)	2.8	2.9	3.2

1 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: -€9 M; 2024: -€23 M), non-cash charges, primarily related to pension expense (2025: €52 M; 2024: €52 M), impairment loss (2025: €94 M; 2024: €207 M) and special items, including costs related to the FME25 Program (2025: €167 M; 2024: €164 M), Legacy Portfolio Optimization (2025: €103 M; 2024: €113 M), Legal Form Conversion Costs (2025: €8 M; 2024: €9 M) and Humacyte Remeasurements (2025: €17 M; 2024: -€72 M).

Q4 2024

Return on Invested Capital (ROIC)

• For the years 2015-17 ROIC as reported within the Form 20-F.
• ROIC adjusted in 2018 for the divestiture of Care Coordination activities, FCPA-related charge, U.S. Ballot Initiatives, U.S. tax reform / including these effects, ROIC for FY 2018 was 12.4%
• ROIC adjusted in 2019 for the effects of IFRS 16, NxStage, FCPA, Cost optimization costs, divestiture of Care Coordination activities / including these effects, ROIC for FY 2019 was 6.8% (excl. IFRS 16)
• ROIC in 2020 excl. the impact of the Latin America impairment (special item) and in 2021 excluding FME25 (special item)
• ROIC for 2020 and 2021 was 7.5% and 5.5% excl. IFRS 16 and excl. Latin America impairment in 2020
• ROIC in 2022 adjusted for the effects of the FME25 program, the Humacyte Investment Remeasurement, the net gain related to InterWell Health, the effects of hyperinflation in Turkiye and impacts related to the war in Ukraine
• ROIC in 2023-2025 adjusted for the effects of the FME25 program, Legal Form Conversion Costs, Legacy Portfolio Optimization and Humacyte Remeasurements

Q4 2024

Exchange rates, U.S. dialysis days per quarter, definitions

		Q1 2025	FY 2024	FY 2023
€:USD	Period end	1.082	1.039	1.105
	Average	1.052	1.082	1.081
€:CNY	Period end	7.844	7.583	7.851
	Average	7.655	7.788	7.660
€:RUB	Period end	91.425	115.968	100.215
	Average	98.487	100.458	92.461
€:BRL	Period end	6.251	6.425	5.362
	Average	6.165	5.830	5.401

Exchange rates U.S. dialysis days per quarter

	Q1	Q2	Q3	Q4	Full year
2025	76	78	79	79	312
2024	77	78	79	80	314
2023	77	78	79	79	313

Definitions

at constant currency
Hemodialysis
Peritoneal dialysis
Net income attributable to shareholders of FME
Last-Twelve-Months

Q4 2024

Patients, treatments, clinics

			as of March 31, 2025	as of March 31, 2024
	Patients	Treatments	Clinics	Patients	Treatments	Clinics
United States	205,662	7,548,182	2,623	205,610	7,630,349	2,617
Growth in %	0	-1	0
International	93,696	3,459,226	1,051	119,274	4,647,301	1,245
Growth in %	-21	-26	-16
Total	299,358	11,007,408	3,674	324,884	12,277,650	3,862
Growth in %	-8	-10	-5

Q4 2024

Continuous monitoring of clinical performance to enhance care

Quality index components

Dialysis effectiveness

Measures how sufficiently the body is cleansed of waste substances

Vascular access

Measures the share of patients who do not receive dialysis via a dialysis catheter but rather via safer vascular access alternatives that reduce risk of infection and improve outcomes

Anemia management

Measures hemoglobin levels and specific medications given during dialysis to achieve optimum clinical outcomes, such as overall health and well-being

Q4 2024

	Q1 2025	Q4 2024
Quality index	80%	80%
Dialysis effectiveness	93%	93%
Vascular access	77%	77%
Anemia management	71%	71%

Segment information for FY 2021, 2022, 2023 and 2024

€ million; % change year-over-year	FY 2024	Growth	Growth at cc	Organic growth	FY 2023	Growth	Growth at cc	Organic growth	FY 2022	Growth	Growth at cc	Organic growth	FY 2021
Total
Revenue	19,336	-1	0	4	19,454	0	5	4	19,398	10	2	2	17,619
Operating income	1,392	2	3		1,369	-9	-7		1,512	-18	-25		1,852
Operating income margin in %	7.2				7.0				7.8				10.5
Operating income excl. special items	1,797	17	18		1,741	13	15		1,540	-20	-26		1,915
Operating income margin in % excl. special items	9.3				8.9				7.9				10.9
Care Delivery segment
Revenue	15,275	-2	-2	4	15,578	0	5	3	15,593	11	2	1	14,031
Operating income	1,190	-22	-21		1,516	-10	-8		1,686	3	-8		1,643
Operating income margin in %	7.8				9.7				10.8				11.7
Operating income excl. special items	1,565	6	6		1,687	14	16		1,478	-13	n.a.		1,693
Operating income margin in % excl. special items	10.3				10.8				9.5				12.1
Care Enablement segment
Revenue	5,557	4	5	5	5,345	0	5	4	5,353	5	0	0	5,086
Operating income	267	n.a	n.a		-67	123	123		-30	--	--		315
Operating income margin in %	4.8				-1.2				-0.6				6.2
Operating income excl. special items	336	178	184		119	16	19		103	-68	n.a.		327
Operating income margin in % excl. special items	6.1				2.2				1.9				6.4
Inter-segment elimination
Revenue	-1,496	2	2		-1,469	-5	0		-1,548	3	-4		-1,498
Operating income	-17	30	25		-13	n.a.	n.a.		0	--	--		7
Corporate
Operating income	-48	-29	-28		-67	-54	-52		-144	29	14		-113
Operating income excl. special items	-80	76	77		-52	26	33		-41	-63	n.a.		-112

Note: cc = constant currency; n.a. = not applicable; FY 2021, FY 2022 and FY 2023 as published on Feb 20, 2024

Q4 2024

IR event calendar

	Date	Event
g n rti M & G o A p e R	May 6, 2025 May 22, 2025 August 5, 2025 November 4, 2025	Report on Q1 2025: Earnings Release and Conference Call Annual General Meeting Report on Q2 2025: Earnings Release and Conference Call Report on Q3 2025: Earnings Release and Conference Call
D M C	June 17, 2025	Capital Markets Day, London
s s e w c o n h e & r s e d f a n o o R C	May 7, 2025 June 18, 2025 June 19, 2025 June 23, 2025 September 2, 2025 September 4, 2025	UBS Q1 2025 C-level Roadshow, virtual Self-imposed Quiet Period Ahead of CMD Citi European Healthcare Conference, London J.P. Morgan European Healthcare Conference, London Barclays C-Suite Call, Virtual BNP Exane Paribas Bus Tour, Frankfurt Goldman Sachs Annual European MedTech & Healthcare Services Conference, London
	September 8, 2025	Morgan Stanley Global Healthcare Conference, New York

Dates and/or participation might be subject to change

Q4 2024

Dr. Dominik Heger

Head of Investor Relations and Head of Investor Relations, Strategic Development & Communications | EVP

+49(0) 6172-609-2525

Dominik.Heger@ FreseniusMedicalCare.com

Ilia Kuerten

Vice President Investor Relations

+49(0) 6172-268 5966

Ilia.Kuerten@ FreseniusMedicalCare.com Alicia Cahill

Senior Director Investor Relations

+1 860-609-2394

Alicia.Cahill@ FreseniusMedicalCare.com Fresenius Medical Care AG Investor Relations Else-Kröner-Str. 1 61352 Bad Homburg v. d. H. Germany

ir@FreseniusMedicalCare.com

Ticker: FME and FMS (NYSE/ADR)

WKN: 578 580

ISIN: DE00057858002

CUSIP (ADR): 358029106