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what it is
FMS runs dialysis clinics and sells the machines and supplies people with kidney failure need to stay alive.
how it gets paid
Last year Fresenius Medical Care made $22.5B in revenue. Kidney dialysis services was the main engine at ~$14.0B, or 62% of sales (percent mix applied to the consolidated total).
what just happened
Last quarter, FMS posted $0.72 in EPS versus $0.52 expected, a 38.46% beat.
At a glance
B++ balance sheet — above average — nothing keeping you up at night
70/100 earnings predictability — reasonably predictable
17.5x trailing p/e — the market's not buying it — or you found a deal
3.6% dividend yield — cash in your pocket every quarter
7.0% return on capital — nothing to write home about
xvary composite: 59/100 — below average
What they do
FMS runs dialysis clinics and sells the machines and supplies people with kidney failure need to stay alive.
When your kidneys fail, you do not shop around. FMS is the world's largest provider of dialysis products and services, and it runs that network with 111,513 employees across clinics, hospitals, and treatment centers. It also sells the machines and disposables used in treatment, and that two-layer model helped support an 18.0% operating margin.
How they make money
$22.5B
annual revenue
Kidney dialysis services
$14.0B
+12.0%
Dialysis products and equipment
$4.7B
−3.0%
Clinical laboratory testing
$1.6B
0.0%
Renal diagnostic services
$1.1B
0.0%
Hospital-contracted renal services
$1.1B
0.0%
The products that matter
delivers dialysis treatments
Kidney dialysis services
4,000+ clinics · 350,000+ patients
this is the operating core. a 4,000+ clinic footprint serving 350,000+ patients is why the business produces $22.5B in annual revenue.
recurring demand
supports renal treatment
Dialysis products & equipment
~$4.7B in segment table
The how they make money rows already split services vs. products—this line is the equipment and product piece next to the ~$14B services engine. It is not a separate mystery segment; it is the second-largest named row on this page.
paired with services
operates treatment infrastructure
Global clinic network
$14B market cap
you are effectively buying a global care network at roughly a $14B equity value. that scale matters, but with only a 5.8% net margin the market is not treating it like a high-return compounder.
scale asset
Key numbers
5.8%
net margin
This is the quiet part. The business is essential, but only 5.8 cents of each revenue dollar becomes profit.
17.5x
trailing p/e
You are paying a market-like multiple for a company with past earnings growth of -18.0%.
$7.4B
long-term debt
Debt equals 34% of capital, which limits how much room management has if the turnaround slips.
3.6%
dividend yield
The yield pays you to wait, but it does not fix a weak margin structure on its own.
Financial health
B++
strength
- balance sheet grade B++ — above average financial health
- risk rank 3 — safer than 50% of stocks
- price stability 65 / 100
- long-term debt $7.4B (34% of capital)
- net profit margin 5.8% — keeps ~5.8 cents of each revenue dollar
- return on equity 8% — $0.08 profit for every $1 investors have put in
B++ — functional but not a standout on the balance sheet.
Total return vs. market
You invested $10,000 in FMS 3 years ago → it's now worth $13,000.
The index would have given you $13,880.
source: institutional data · total return
What just happened
beat estimates
Last quarter, FMS posted $0.72 in EPS versus $0.52 expected, a 38.46% beat.
The beat lines up with management's turnaround push. Wire copy below frames full-year 2025 profit near $1.80 per ADR (almost doubled) on a 12% revenue rebound—that is an annual story, not the same window as the $0.72 quarterly EPS in the KPI row.
$0.72
eps (q)
$0.52
est. eps (q)
38.46%
surprise
the number that mattered
The 38.46% EPS surprise matters because this stock needs proof that the turnaround is real, not another promise tied to next year.
-
year-toyear comparisons also got a lift from higher euro-to-dollar conversion rates.
-
in all, we think 2025 profits nearly doubled, to $1.80 per adr, on a 12% revenue rebound.
-
cost savings from turnaround initiatives have been significant.
-
these are part of fresenius’ broader fme reignite strategy.
-
indeed, its fme25+ transformation plan, aimed at cutting costs and driving efficiencies, was on track to save 180 million euros ($200 million) in 2025.the plan, which was extended by two years, should yield total savings of 1.05 billion euros (over $1.2 billion) by 2027. optimizing the portfolio, by divesting noncore assets to focus on businesses with better profit growth potential, ought to prove beneficial, too. in this vein, the company bought a stake in interwell health in the u.s., which is affiliated with 2,200 nephrologists, widening its renal care network.
source: company earnings report, 2026
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What could go wrong
the #1 risk is legal and regulatory pressure on a global dialysis network.
med
legal and regulatory costs
Public risk analysis already flags Legal & Regulatory as the top category, and the latest 20-F keeps that front and center. In a healthcare business spread across thousands of clinics, compliance problems do not stay local for long.
With only a 5.8% net margin on $22.5B of revenue, extra legal cost or reimbursement friction hits earnings faster than you would like.
med
GLP-1s shrinking future dialysis demand
The most interesting threat is not a competitor opening another clinic. It is better metabolic care upstream. If GLP-1 drugs reduce progression to kidney failure, the future patient pool gets smaller.
That would pressure the long-term value of a network built around 350,000+ recurring dialysis patients.
med
thin profitability leaves less room for error
FMS has scale, but the economics are only decent: 7.0% return on capital, 8% return on equity, and a 5.8% net margin. That is not fragile, but it is not luxurious either.
The combination of $7.4B in long-term debt and 34% debt-to-capital means a small margin hit matters more than it would at a higher-return business.
med
the market may keep treating this as dead money
Three-year returns turned $10,000 into $13,000, while the index reached $13,880. That underperformance is the market saying stable demand is not enough by itself.
If management cannot push results toward the $26B 2029 revenue path with better returns, the 17.5x multiple has little reason to expand.
A $22.5B revenue base, a 5.8% net margin, and $7.4B of debt make this a stock where small operating disappointments can matter a lot.
source: institutional data · regulatory filings · risk analysis
Pay attention to
earnings
next earnings report
the date is not listed in this snapshot. what matters is whether management can keep the $26B long-term revenue path intact without sacrificing already-thin profitability.
metric
return on capital
7.0% is the number to watch. if a dominant clinic network cannot lift returns from here, scale is doing less work than the bull case needs.
risk
GLP-1 impact on kidney-care demand
this is the strategic question hanging over the stock. fewer patients progressing to dialysis would be good for public health and awkward for a dialysis giant.
trend
institutional buying streak
three straight quarters of net buying is supportive. if that reverses while price stays stuck near $24, the market message gets louder.
Analyst rankings
earnings predictability
70 / 100
in human-speak, the business is fairly steady, but not steady enough to eliminate surprises.
risk rank
3
safer than about half of stocks. not a bunker stock, not a chaos stock.
price stability
65 / 100
the chart has been calmer than the thesis. that usually means the market is waiting for a reason to care.
source: institutional data
Institutional activity
institutions have been net buying for 3 consecutive quarters — 102 buyers vs. 86 sellers in 3q2025. total institutional holdings: 0.6B shares. net buying for 3 quarters.
source: institutional data
Price targets
3-5 year target range
$20
$35
$24
current price
$28
target midpoint · +15% from current · 3-5yr high: $50 (+105% · 22% ann'l return)
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