Fresenius Medical Care AG & Co. KGaA (FMS): Business Model Canvas [Dec-2025 Updated]

You're looking for the sharp, late-2025 snapshot of how the world's largest dialysis provider is actually making money, and honestly, the story hinges on a massive internal pivot. As an analyst who's tracked these giants for two decades, I see Fresenius Medical Care AG & Co. KGaA balancing its enormous scale-operating 3,674 global clinics for ~299,000 patients-with the high-stakes FME25+ transformation program targeting EUR 1.05 billion in savings by 2027. This Business Model Canvas breaks down precisely how they are shifting from pure service fees to value-based care premiums while maintaining their vertically integrated product sales, so check out the details below to see the mechanics of this complex strategy.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Key Partnerships

You're looking at the critical external relationships that fuel Fresenius Medical Care's operations, especially as they push deeper into value-based care models. These alliances are where a lot of the future revenue and risk-sharing happens.

InterWell Health: Majority-Owned Entity Driving U.S. Value-Based Kidney Care

Fresenius Medical Care significantly strengthened its control over InterWell Health (IWH) in late 2025. The company invested EUR 312 million to increase its ownership stake by purchasing all shares from non-physician investors, accelerating the timeline set during the 2022 merger. This move consolidates decision-making authority within the Value-Based Care segment. IWH is showing strong growth, validating this capital deployment.

Here are the key performance numbers for InterWell Health as reported for the first half of 2025:

Metric	Value / Amount
Revenue (H1 2025)	EUR 1,035 million
Revenue Growth (H1 2025)	23.5%
Nephrologist Partners (U.S.)	Over 2,200
Medical Costs Under Management Target (2025)	$11 billion

Government Payors: Reimbursement Foundation

Alliances with government payors remain foundational for the core Care Delivery business. These relationships dictate the rates for a significant portion of patient services. For the six months ended June 30, 2025, approximately 17% of consolidated revenue came from U.S. federally-funded programs like Medicare and Medicaid reimbursement, where rates are set by CMS.

Nephrologist Networks: Clinical Integration

The success of the value-based care model hinges on deep integration with practicing physicians. InterWell Health's model is built on partnerships with physician organizations. As of late 2025, IWH partners with over 2,200 nephrologists in the U.S. This network is essential for managing patient care pathways and achieving better outcomes under risk-sharing contracts.

Technology/Pharma Companies: Innovation Pipeline

Fresenius Medical Care utilizes strategic equity investments to access innovation outside its direct operations. Fresenius Medical Care Ventures participated in the $191 million Series D financing for eGenesis, a biotechnology company focused on developing human-compatible engineered organs for transplantation. This investment, which closed in September 2024, supports advancing eGenesis's lead product candidate for kidney transplant to a first-in-human study.

The company's broader collaborations include:

• Partnerships for product innovation.
• Supply agreements with pharmaceutical companies.
• Equity stakes in firms advancing organ transplantation technology.

Finance: draft 13-week cash view by Friday.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Key Activities

You're looking at the core engine of Fresenius Medical Care AG & Co. KGaA (FMS) as of late 2025, which is all about execution across its integrated model. The company's key activities center on delivering care, making the necessary gear, managing risk-based contracts, and driving internal efficiency.

Dialysis Service Delivery: Operating 3,674 global dialysis clinics as of March 31, 2025. This forms the foundation of the Care Delivery segment, where the company treats patients with end-stage renal disease (ESRD) through its Fresenius Kidney Care and NephroCare networks.

Product Manufacturing: Producing dialysis machines, dialyzers, and related disposables, which falls under the Care Enablement segment. This activity supports both internal needs and external customers in over 140 countries. Fresenius Medical Care claims about 35% market share in dialysis equipment/consumables. The operational focus here involves driving efficiency and volume, as seen in the segment's Q3 2025 revenue.

Value-Based Care Management: This involves contracting and performance management for kidney care, moving beyond pure fee-for-service. The aspiration for this segment's operating income margin is set at a low-single digit percent. The company is also increasing its ownership in its Value-Based Care entity, Interwell Health.

Here's a quick look at the recent revenue performance for the segments tied to manufacturing and value-based care:

Key Activity Metric	Segment	Revenue (Q3 2025)	Revenue Growth (Organic)
Product Manufacturing (Care Enablement)	Care Enablement	EUR 4,075 million	+4% at constant currency
Value-Based Care Contracting	Value-Based Care	EUR 1,611 million	+31% at constant currency

FME25+ Transformation: Executing this program is a critical activity aimed at structural improvement. Fresenius Medical Care AG & Co. KGaA (FMS) targets realizing EUR 1.05 billion of sustainable savings by the end of 2027 through operational efficiencies. For the first nine months of 2025, the company already delivered EUR 174 million of its full-year FME25+ target of around EUR 180 million additional annual savings. One-time costs associated with this program are anticipated to total EUR 1,000 million to 1,050 million by year-end 2027.

R&D and Innovation: Advancing high-volume Hemodiafiltration (HDF) and AI-powered care are key focus areas to set the new standard of care. The company is executing the continued rollout of the 5008X dialysis machine in the U.S. This innovation is part of the ambition to lead kidney care through exceptional patient care.

• Advancing the rollout of the 5008X dialysis machine in the U.S.
• Focus on advancing high-volume Hemodiafiltration (HDF) treatments.
• Incorporating AI and diagnostics into care pathways.
• Investing annually between EUR 800 million and 1 billion in the core business for sustainable profitable growth through 2030.

Finance: draft 13-week cash view by Friday.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Key Resources

When you look at the foundation of Fresenius Medical Care AG & Co. KGaA (FMS), you see assets that are hard to replicate, which is what makes this company such a dominant player in renal care. These aren't just numbers on a balance sheet; they represent physical presence and deep operational know-how.

Global Clinic Network

The sheer physical footprint is a massive barrier to entry for competitors. As of March 31, 2025, Fresenius Medical Care AG & Co. KGaA (FMS) maintained a physical asset base of 3,674 clinics worldwide. This network is where the core service delivery happens, treating approximately 299,358 patients globally as of that same date. This scale allows for significant operational efficiencies and deep market penetration, especially in the U.S. where they treat around 38% of all dialysis patients.

Proprietary Technology

It isn't just about having clinics; it's about what you put inside them and what you sell to others. Fresenius Medical Care AG & Co. KGaA (FMS) is vertically integrated, meaning they develop and manufacture the tools of the trade. For instance, in 2024, the company sold around 174 M dialyzers. They also hold a significant market share in hemodialysis machines, estimated at around 50 %. This internal manufacturing capability helps control system costs and operating efficiency within their own clinics, and the technology itself is a product sold to competitors, like DaVita Inc.

Clinical Expertise

The human capital supporting this massive operation is substantial. As of the end of the first quarter of 2025, Fresenius Medical Care AG & Co. KGaA (FMS) employed globally 112,035 people. This large workforce includes the specialized nephrologists and medical staff necessary to manage complex, life-sustaining treatments for patients with end-stage renal disease (ESRD). This expertise is critical for maintaining quality of care and navigating the regulatory landscape of healthcare delivery.

Data and Informatics

You can't run a global operation this complex without sophisticated information systems. Fresenius Medical Care AG & Co. KGaA (FMS) uses tech-enabled platforms to manage patient engagement and conduct clinical data analysis across its vast network. This data-driven approach informs everything from optimizing treatment protocols to driving the development of new products. The focus on value-based care, which they segmented out in mid-2025, definitely relies on robust data infrastructure to manage risk and outcomes.

Brand Reputation

The reputation is built on being the world's leading provider in this niche. Fresenius Medical Care AG & Co. KGaA (FMS) is recognized as the global leader in dialysis care products and services, caring for about 9% of all dialysis patients worldwide. This leadership position is reinforced by strong financial health metrics, such as an improved net leverage ratio of 2.8x as of Q1 2025, and a strong operating cash flow margin of 9.7% in the first half of 2025. The estimated global dialysis market size in 2024 was between €80 to €84 billion.

Here's a quick snapshot of the scale you're dealing with as of early 2025:

Metric	Value	Date/Period
Global Dialysis Clinics	3,674	March 31, 2025
Patients Treated	299,358	March 31, 2025
Global Employees (Headcount)	112,035	March 31, 2025
Dialyzers Sold	Around 174 M	2024
Operating Cash Flow Margin	9.7%	H1 2025

The ability to translate this massive operational scale into financial performance, like achieving a margin of 9.9% on operating income excluding special items in Q2 2025, shows how effectively these key resources are being deployed. Honestly, that operational leverage is what you're paying a premium for when you look at their market position.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Value Propositions

You're looking at the core value Fresenius Medical Care AG & Co. KGaA (FMS) delivers to its stakeholders. It's not just about providing a service; it's about owning the entire ecosystem, from the machine to the chair the patient sits in.

Vertically Integrated Care: Providing both dialysis services and proprietary products.

Fresenius Medical Care AG & Co. KGaA operates as the world's leading vertically integrated kidney care company. This integration means they capture value across the continuum of care delivery and product manufacturing. You see this clearly when you look at their scale in both segments.

Metric	Value	Year/Date	Source Context
Dialyzers Sold	174 M	2024
Hemodialysis Machine Market Share	~50%	2024
Dialysis Treatments Performed	Around 48 M	2024

Global Access to Treatment: Life-sustaining dialysis for ~299,000 patients globally.

The sheer scale of their global footprint is a massive value driver, offering consistency and reach. As of March 31, 2025, Fresenius Medical Care AG & Co. KGaA was treating 299,358 patients across 3,674 dialysis clinics worldwide. This represents life-sustaining care for roughly 299,000 patients globally. That's a massive installed base providing predictable service demand.

Value-Based Kidney Care: Shifting risk to improve patient outcomes and manage costs.

The strategic shift toward Value-Based Care (VBC) in the U.S. is central to their forward strategy. This segment manages risk under contracts with payors, aiming for better patient health at a lower total cost of care. In fiscal year 2024, this segment generated EUR 1.8 billion in revenue in the U.S. alone. For the first quarter of 2025, the Care Delivery U.S. revenue, which includes VBC, grew by 6% year-on-year to EUR 3,302 million, with the growing VBC business cited as a positive impact factor. The Q2 2025 presentation also highlighted that Value-Based Care revenue growth was driven by member months.

High-Quality Clinical Standards: 65% of U.S. centers achieved 3+ star CMS ratings (2023 data).

Quality metrics, as measured by the Centers for Medicare & Medicaid Services (CMS) Star Ratings, underpin trust with payors and patients. The commitment to clinical excellence is a key value proposition:

• 65% of U.S. centers achieved 3+ star CMS ratings (2023 data).
• Patient satisfaction is tracked, with a global patient Net Promoter Score (NPS) of 72 achieved in 2024.

Innovation in Therapy: Rollout of advanced therapies like high-volume HDF.

Fresenius Medical Care AG & Co. KGaA is actively bringing advanced treatment modalities to market, which improves clinical value. The CONVINCE research study demonstrated significant clinical benefit for High-Volume Hemodiafiltration (Hv-HDF), showing a 23% reduction in all-cause mortality compared to high-flux dialysis. The company is executing the U.S. rollout of the enabling 5008X CAREsystem, with a full commercial launch planned for 2026, following the report of the first U.S. chronic dialysis unit implementing high-volume HDF in late 2025.

The value here is offering a superior, evidence-based therapy that promises better longevity for patients.

Finance: draft 13-week cash view by Friday.

Fresenius Medical Care AG & Co. KGaA (FMC) - Canvas Business Model: Customer Relationships

You're looking at how Fresenius Medical Care AG & Co. KGaA (FMC) manages its relationships with the people and institutions it serves. It's a mix of direct, high-touch care and sophisticated B2B contracting, all underpinned by a massive global footprint.

Personalized Care: Integrated and personalized care models for chronic patients.

Fresenius Medical Care AG & Co. KGaA (FMC) is shifting its focus toward integrated, outcome-oriented care, especially in the U.S. market, which is reflected in the new Value-Based Care (VBC) segment, established as of June 1, 2025. This segment is designed to manage the long-term care for chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients by aligning incentives with better health results, such as reducing hospital admissions and encouraging home dialysis transitions. The company's commitment to personalized, high-quality treatment is supported by clinical evidence from its own studies.

Here's a snapshot of the scale and focus areas driving these relationships as of mid-2025:

Metric	Value (As of March 31, 2025, unless noted)	Context
Patients Treated Worldwide	299,358	Directly cared for by Fresenius Medical Care AG & Co. KGaA (FMC)
Dialysis Clinics Global Network	3,674	The physical touchpoints for patient care delivery
Projected U.S. Annual Patient Growth (2025-2035)	2 plus percent	Indicates expected growth in the core relationship base
HVHDF Mortality Reduction (CONVINCE Study)	4.4%	Reduction over 2.5 years with High-Volume Hemodiafiltration (HVHDF) therapy

The company's aspiration is to lift renal care to the next level using digitalization, data analytics, and artificial intelligence to move from reactive to preventive healthcare. This involves monitoring each patient's wellbeing with algorithms to forecast the future and intervene as early as possible.

Dedicated Clinic Staff: Direct, high-touch interaction in the Care Delivery segment.

The Care Delivery segment is where the most direct, high-touch relationship occurs. This involves the day-to-day interaction between patients and the dedicated clinical staff across the global network of clinics. The sheer scale of this operation means that consistency in care quality is a major focus for maintaining patient trust. The company measures this relationship quality directly through global satisfaction scores.

Key indicators of the relationship environment include:

• Global patient Net Promoter Score (NPS) of 72 in 2024 (unchanged from 2023).
• Total employees globally as of March 31, 2025: 112,035 (headcount).
• The company cares for approximately 4.2 million patients worldwide who regularly undergo dialysis treatment, positioning Fresenius Medical Care AG & Co. KGaA (FMC) as the leading provider.

Honestly, maintaining a high NPS score across nearly 3,700 clinics is a testament to the frontline staff's daily efforts.

Account Management: B2B relationships with hospitals and independent dialysis centers.

For B2B customer relationships, Fresenius Medical Care AG & Co. KGaA (FMC) engages with hospitals and independent providers both through direct service delivery and through its Care Enablement segment, which supplies products to others. The newer Value-Based Care (VBC) segment, which focuses on contracting and performance management, represents a key evolution in this B2B relationship, moving toward shared risk and reward with payors and partners.

The relationship structure involves deep integration with external healthcare providers:

Relationship Aspect	Metric/Detail	Year/Date
Value-Based Care Partner Nephrologists	2,200 partner nephrologists	2024
Value-Based Care Revenue	1.8 billion euros	2024
Global Dialysis Market Size Estimate	€80 to €84 billion	2024
Product Sales Reach	Customers in more than 140 countries	Current

The Strategic Procurement Team manages the acquisition interface, focusing on quality, service, and total cost when cultivating partnerships with suppliers, which is an extension of their B2B relationship management philosophy.

Tech-Enabled Engagement: Digital platforms for patient communication and monitoring.

Digital platforms are crucial for keeping patients and care teams connected, allowing for continuous monitoring of medical outcomes and user experience. Fresenius Medical Care AG & Co. KGaA (FMC) uses proprietary informatics and patient engagement tools to support its VBC models and general patient management. The company has a history of deploying these tools to enhance access and continuity of care.

The digital engagement tools include:

• PatientHub app: Used predominantly in the U.S. market.
• MyCompanion app: Available across 23 countries in Europe, Africa, Asia-Pacific, and Latin America.
• Remote Telehealth Visits (U.S. only): Almost 250,000 recorded between patients, care teams, and physicians.
• Combined Active App Users (PatientHub/MyCompanion): More than 25,000 as of December 2022.

These platforms give users real-time access to treatment data, supporting the shift toward holistic home care solutions powered by AI advancements.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Channels

You're looking at how Fresenius Medical Care AG & Co. KGaA gets its services and products to the people who need them, which is quite a global operation, honestly.

Dialysis Clinic Network: Primary channel for B2C service delivery.

The physical clinic network remains the backbone for in-center dialysis service delivery. As of March 31, 2025, Fresenius Medical Care AG & Co. KGaA treated approximately 299,358 patients across a global network of 3,674 dialysis clinics. This is slightly down from the year-end 2024 figure of roughly 3,700 clinics caring for over 299,000 patients. In the United States, the company serves over 190,000 patients, operating within a market where Fresenius Medical Care AG & Co. KGaA and DaVita control about 70% of the dialysis centers. The in-center modality still dominates the US market, accounting for 75.6% of the market share in 2024. The estimated size of the global dialysis market in 2024 was between €80 billion and €84 billion.

Here's a quick look at the scale of the Care Delivery channel as of early 2025:

Metric	Value (As of Q1 2025 or latest reported)	Scope
Global Dialysis Patients Cared For	299,358	As of March 31, 2025
Global Dialysis Clinics	3,674	As of March 31, 2025
US Patients Served	Over 190,000	Current estimate
US In-Center Market Share (2024)	75.6%	Market Segment Share

Direct Sales Force: For B2B sales of dialysis equipment and consumables (Care Enablement).

The Care Enablement segment handles the distribution of healthcare products and equipment, which relies on a commercial operation and sales force to reach customers. Fresenius Medical Care AG & Co. KGaA sells its dialysis products to customers in more than 140 countries. This segment also encompasses manufacturing and R&D activities. For context on the product side, R&D expenditure in 2024 corresponded to 4% of the company's health care product revenue. The company's vertical integration means this sales force also supplies the company's own clinics.

Home Dialysis Programs: Direct delivery of equipment and supplies to patient homes.

The push toward home dialysis is a key channel strategy, offering flexibility and potentially better outcomes. In the US market, in-home dialysis centers are projected to grow at the fastest Compound Annual Growth Rate (CAGR) of 7.0% from 2025 to 2030. This aligns with the ambition, though challenging, set forth by US initiatives to shift a high percentage of End-Stage Renal Disease (ESRD) patients to home treatment before 2025. Fresenius Medical Care AG & Co. KGaA has been actively expanding its home dialysis program, announcing such an expansion in a key European market in July 2022.

Key aspects of the home treatment channel include:

• In-home segment CAGR (US, 2025-2030) projected at 7.0%.
• The company is a leading player in the Home Dialysis Machines market.
• The strategy aims to support earlier interventions to prevent kidney failure.

Value-Based Care Platforms: Digital and clinical networks like InterWell Health.

The Value-Based Care (VBC) segment, officially created as a reportable segment on June 1, 2025, is a critical channel for managing the total cost of care for chronic kidney disease patients outside of traditional fee-for-service models. The core of this channel is InterWell Health (IWH), which resulted from a three-way merger announced in 2022. Fresenius Medical Care AG & Co. KGaA recently reinforced this channel by investing EUR 312 million in September 2025 to increase its ownership stake in IWH by buying out non-physician investors. IWH is partnering with over 2,200 nephrologists in the US.

The financial performance and scale of this channel are significant:

InterWell Health demonstrated strong performance, generating €1,035 million in revenue for the first half of 2025 (H1 2025), showing a 23.5% revenue growth. The initial merger projected that by 2025, IWH would manage more than 270,000 covered lives and have $11 billion in costs under management, up from $6 billion and 100,000 lives previously. This strategic expansion significantly increased the total addressable market in the US from about $50 billion to approximately $170 billion.

Finance: draft 13-week cash view by Friday.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Customer Segments

The customer segments for Fresenius Medical Care AG & Co. KGaA are diverse, spanning direct patient care, business-to-business product sales, and relationships with the entities that finance the care.

ESRD Patients: Individuals requiring life-sustaining dialysis treatment.

Fresenius Medical Care AG & Co. KGaA directly cares for a significant portion of the global dialysis population. As of March 31, 2025, the company was serving approximately 299,358 patients across its global network of 3,674 dialysis clinics. This patient base is the core of the Care Delivery segment. The company estimates that around 4.2 million patients worldwide regularly undergo dialysis treatment, positioning its direct patient base as a substantial, but not total, market share of those needing the service. Looking forward, the global market for dialysis patients is projected to see an average annual growth of 4 to 5 percent between 2025 and 2035. In the U.S. specifically, the patient number growth is projected at 2 plus percent in the same timeframe. For context on the U.S. market as of March 31, 2025, there are 7,556 dialysis centers treating over 500,000 patients for dialysis, with about 433,400 receiving in-center treatment and 78,400 at home.

CKD Patients (Stages 3-5): Focus on early intervention through the Value-Based Care segment.

A key focus area is the earlier management of Chronic Kidney Disease (CKD) through the Value-Based Care segment, which was formally introduced as a reportable segment as of June 1, 2025. This segment targets patients before they reach End-Stage Renal Disease (ESRD). The revenue performance shows rapid adoption; for the first half of 2025, this segment saw a 23.5% increase in revenue. More recently, in the third quarter of 2025, Value-Based Care revenue grew by 27% (or 31% at constant currency) to €1,611 million. To illustrate the scale of this focus, in 2024, this segment served over 130,000 patient lives and worked with more than 2,000 nephrologists, generating approximately €1.8 billion in revenue that year. The strategic ambition in this area, established earlier, targeted managing care for over 270,000 people with kidney disease by 2025.

The scale of the Value-Based Care segment's financial contribution relative to the whole is important to track:

Metric	Time Period	Value
Value-Based Care Revenue	Q3 2025	€1,611 million
Value-Based Care Revenue Growth (Organic)	Q3 2025	31%
Care Delivery Revenue	Q1 2025	€3,857 million
Care Enablement Revenue	Q3 2025	€4,075 million

Other Healthcare Providers: Hospitals and independent dialysis centers purchasing products (B2B).

The Care Enablement segment serves other healthcare providers by supplying products, equipment, and related services. This segment is vertically integrated with the company's own clinics but also sells externally. For instance, in the third quarter of 2025, Care Enablement revenue reached €4,075 million. In 2024, the Care Enablement products business generated €5,557 million in revenue. Fresenius Medical Care AG & Co. KGaA is a major supplier in the MedTech space, holding around a 50% share in the hemodialysis machines market and selling approximately 174 million dialyzers in 2024. The company sells its healthcare products to customers in more than 140 countries.

Government/Commercial Payors: Insurers and state-funded programs covering treatment costs.

Government payors are a critical customer segment because they fund a significant portion of the services provided. For the nine months ended September 30, 2025, approximately 16% of the company's consolidated revenue came from U.S. federally-funded healthcare benefit programs like Medicare and Medicaid. This is consistent with the figure for the six months ended June 30, 2025, which was approximately 17%. Reimbursement rates set by the Centers for Medicare & Medicaid Services (CMS) directly impact revenue realization. For calendar year 2025, the proposed U.S. ESRD PPS (Prospective Payment System) base rate was $273.82. Legislative changes to these rates represent a direct financial risk to the revenue stream from this segment. The company's ability to manage a favorable payor mix is noted as a positive impact on Care Delivery U.S. revenue in Q1 2025.

You should keep a close eye on the CMS proposed rate for CY 2026, which CMS anticipated would result in a payment increase of 1.9% to ESRD facilities.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Cost Structure

You're looking at the expense side of the Fresenius Medical Care AG & Co. KGaA (FMS) engine, which is heavily weighted toward service delivery and manufacturing. The cost structure reflects a vertically integrated model where a significant portion of spending supports the global clinic network and product supply chain.

Personnel Costs

Labor is a major component here, supporting the care of hundreds of thousands of patients. As of June 30, 2025, Fresenius Medical Care had a global headcount of 112,445 employees, up from 111,513 at the end of 2024. These costs cover the essential nurses, technicians, and physicians running the clinics.

• The development of operating income in Q1 2025 was negatively impacted by higher personnel expenses, which developed in line with expectations.
• As of December 31, 2024, 1,384 employees were dedicated to Research & Development worldwide.

Operating Expenses

These are the day-to-day costs of keeping the lights on and the machines running across the massive global footprint. The prompt specifies costs for running 3,674 global clinics, though as of June 30, 2025, Fresenius Medical Care operated 3,676 dialysis clinics worldwide. For the full year 2024, Total Operating Expenses were reported at $4.41 billion.

Cost of Goods Sold

This category covers the manufacturing and distribution expenses for the dialysis products Fresenius Medical Care sells both internally to its clinics and externally to other providers. Based on 2024 figures, this is the largest single cost component. Here's a quick look at the 2024 financial breakdown, which sets the baseline for 2025 costs:

Metric (2024)	Amount (USD millions)	Source Context
Total Revenue	$20,010	Change of 24.1% over 10 years
Total Gross Profit	$4,920
Inferred Cost of Goods Sold	$15,090	Calculated as Revenue minus Gross Profit

Transformation Costs

Fresenius Medical Care is investing heavily in its FME25+ transformation program to optimize its operating structure. The total one-time investment anticipated for the entire program, which is targeted to run until the end of 2027, is set between EUR 1,000 million to EUR 1,050 million. For the current fiscal year 2025, the company specifically assumed related one-time costs in the range of EUR 100 million to EUR 150 million.

• The FME25+ program targets a cumulative total of €1.05 billion of sustainable savings by the end of 2027.
• In Q3 2025 alone, related one-time costs (special items) for the transformation program amounted to EUR 41 million.

R&D Investment

Funding research and development is intrinsic to the growth strategy, focusing on improving renal therapies and developing new products like the 5008X high-volume hemodiafiltration machine, which is anticipated for a U.S. launch by year-end 2025. While a specific 2025 absolute spend isn't immediately clear, the commitment is shown through investment focus and personnel.

• In 2024, R&D expenditure was 4% of the company's health care product revenue.
• The patent portfolio at the end of 2024 comprised some 9,529 property rights across approximately 1,586 patent families.
• Fresenius Medical Care Ventures makes targeted investments in start-ups across diagnostics, therapies, and digital solutions.

Finance: review the Q3 2025 operating cash flow margin of 11.3% against the 2024 COGS percentage to project 2026 product cost leverage by next Tuesday.

Fresenius Medical Care AG & Co. KGaA (FMS) - Canvas Business Model: Revenue Streams

You're looking at how Fresenius Medical Care AG & Co. KGaA actually brings in the money, which is critical for understanding its valuation. Honestly, it's all about the volume of patients and the services provided, plus the growing shift to value-based models. Here's the quick math on the streams we see as of late 2025, based on the latest reports.

The core revenue generation is split across its operating segments, which now explicitly include Value-Based Care as a distinct unit. The 2024 revenue base for the current year's guidance was quite substantial.

Revenue Stream Component	Most Recent Reported Period Figure	Context/Segment
2024 Revenue Base for 2025 Outlook	EUR 19,336 million	Full Year 2024 Reported Revenue
Value-Based Care Premiums (VBC)	EUR 1,035 million	Q2 2025 Revenue for VBC Segment
Dialysis Services Revenue (Care Delivery)	EUR 3,857 million	Q1 2025 Revenue for Care Delivery Segment
Product Sales Revenue (Care Enablement)	EUR 1,367 million	Q1 2025 Revenue for Care Enablement Segment

Dialysis Services Revenue is the bread and butter, covering the fees for every in-center and home dialysis treatment you know they provide. The Care Delivery segment brought in EUR 3,857 million in the first quarter of 2025, showing the ongoing scale of their care delivery operations.

Product Sales Revenue, which falls under Care Enablement, represents the sales of the necessary hardware and supplies. For the first quarter of 2025, this stream generated EUR 1,367 million. This segment benefits from the vertical integration, selling machines and consumables to their own clinics and external customers.

Value-Based Care Premiums are becoming a more distinct and important revenue stream, reflecting the shift to performance-based contracts. In the second quarter of 2025 alone, this segment generated EUR 1,035 million. To give you a sense of scale, the U.S. VBC business generated EUR 1.8 billion in revenue for the full year 2024.

Pharmaceutical Sales revenue is typically embedded within the service or product segments, but the focus remains on the major buckets. You won't find a standalone Pharma Sales number that cleanly separates from the others in the primary reporting structure, but the overall segment performance reflects the entire value chain.

The 2025 Outlook confirms management's expectation for revenue growth to be positive to a low-single digit percent rate when compared to the 2024 figure of EUR 19,336 million. This suggests continued, albeit modest, top-line expansion this year, defintely a sign of stabilization.

• 2024 Full Year Revenue Base: EUR 19,336 million.
• Expected 2025 Revenue Growth Rate: Positive to a low-single digit percent rate.
• Q2 2025 VBC Revenue: EUR 1,035 million.
• 2024 U.S. VBC Revenue: EUR 1.8 billion.
• Q1 2025 Care Delivery Revenue: EUR 3,857 million.

Finance: draft 13-week cash view by Friday.