Comprehensive Stock Comparison
Compare Fresenius Medical Care AG & Co. KGaA (FMS) vs The Oncology Institute, Inc. (TOI) Stock
Analyze side-by-side fundamentals, valuation, growth, and profitability to decide which stock is the better buy.
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Quick Verdict
| Category | Winner | Why |
|---|---|---|
| Growth | TOI | 21.3% revenue growth vs FMS's 1.5% |
| Quality / Margins | FMS | 5.0% net margin vs TOI's -14.4% |
| Stability / Safety | FMS | Beta 0.40 vs TOI's 1.56, lower leverage |
| Dividends | Tie | Neither pays a meaningful dividend |
| Momentum (1Y) | TOI | +239.2% vs FMS's +0.2% |
| Efficiency (ROA) | FMS | 3.2% ROA vs TOI's -40.5%, ROIC 5.6% vs -40.9% |
Who Each Stock Is For
Income & stability
Growth exposure
Long-term compounding (10Y)
Sleep-well-at-night portfolio
Defensive / Recession hedge
Business Model
What each company does and how it makes money
Fresenius Medical Care is a global leader in dialysis care and products for patients with chronic kidney failure. It generates revenue through two main segments: dialysis services (about 75% of revenue) from its network of outpatient clinics and hospital contracts, and dialysis products (about 25%) including machines, dialyzers, and related supplies. The company's key advantage is its vertically integrated model—combining clinics, products, and services—which creates patient stickiness and economies of scale in the capital-intensive dialysis industry.
The Oncology Institute operates a network of outpatient cancer care clinics providing comprehensive oncology services including chemotherapy, radiation, and clinical trial management. It generates revenue primarily from fee-for-service medical oncology treatments — with infusion services and physician consultations being major contributors — supplemented by clinical trial management fees. The company's competitive advantage lies in its integrated care model that combines clinical services with research capabilities across its 67 clinic locations, creating a scalable platform for community-based cancer care.
Revenue Breakdown by Segment
How each company's revenue is distributed across its business units
Financial Metrics Comparison
Side-by-side fundamentals across 2 stocks. BestLagging
Financial Scorecard
FMS leads in 3 of 6 categories (Financial Metrics, Profitability & Efficiency). TOI leads in 1 (Valuation Metrics). 1 tied.
Financial Metrics (TTM)
FMS is the larger business by revenue, generating $19.6B annually — 42.6x TOI's $461M. FMS is the more profitable business, keeping 5.0% of every revenue dollar as net income compared to TOI's -14.4%. On growth, TOI holds the edge at +36.7% YoY revenue growth, suggesting stronger near-term business momentum.
| Metric | FMSFresenius Medical… | TOIThe Oncology Inst… |
|---|---|---|
| RevenueTrailing 12 months | $19.6B | $461M |
| EBITDAEarnings before interest/tax | $3.3B | -$34M |
| Net IncomeAfter-tax profit | $978M | -$66M |
| Free Cash FlowCash after capex | $1.2B | -$28M |
| Gross MarginGross profit ÷ Revenue | +25.6% | +14.8% |
| Operating MarginEBIT ÷ Revenue | +9.3% | -8.9% |
| Net MarginNet income ÷ Revenue | +5.0% | -14.4% |
| FCF MarginFCF ÷ Revenue | +6.0% | -6.0% |
| Rev. Growth (YoY)Latest quarter vs prior year | -0.3% | +36.7% |
| EPS Growth (YoY)Latest quarter vs prior year | +8.5% | +22.2% |
Valuation Metrics
| Metric | FMSFresenius Medical… | TOIThe Oncology Inst… |
|---|---|---|
| Market CapShares × price | $13.6B | $219M |
| Enterprise ValueMkt cap + debt − cash | $24.4B | $292M |
| Trailing P/EPrice ÷ TTM EPS | 11.84x | -4.07x |
| Forward P/EPrice ÷ next-FY EPS est. | 9.89x | — |
| PEG RatioP/E ÷ EPS growth rate | 2.32x | — |
| EV / EBITDAEnterprise value multiple | 6.33x | — |
| Price / SalesMarket cap ÷ Revenue | 0.59x | 0.56x |
| Price / BookPrice ÷ Book value/share | 0.81x | 60.43x |
| Price / FCFMarket cap ÷ FCF | — | — |
Profitability & Efficiency
FMS delivers a 6.8% return on equity — every $100 of shareholder capital generates $7 in annual profit, vs $-2 for TOI. FMS carries lower financial leverage with a 0.76x debt-to-equity ratio, signaling a more conservative balance sheet compared to TOI's 34.31x. On the Piotroski fundamental quality scale (0–9), FMS scores 5/9 vs TOI's 3/9, reflecting solid financial health.
| Metric | FMSFresenius Medical… | TOIThe Oncology Inst… |
|---|---|---|
| ROE (TTM)Return on equity | +6.8% | -2.1% |
| ROA (TTM)Return on assets | +3.2% | -40.5% |
| ROICReturn on invested capital | +5.6% | -40.9% |
| ROCEReturn on capital employed | +6.9% | -40.8% |
| Piotroski ScoreFundamental quality 0–9 | 5 | 3 |
| Debt / EquityFinancial leverage | 0.76x | 34.31x |
| Net DebtTotal debt minus cash | $9.2B | $73M |
| Cash & Equiv.Liquid assets | $1.6B | $50M |
| Total DebtShort + long-term debt | $10.8B | $123M |
| Interest CoverageEBIT ÷ Interest expense | 6.84x | -4.92x |
Total Returns (with DRIP)
A $10,000 investment in FMS five years ago would be worth $7,718 today (with dividends reinvested), compared to $2,651 for TOI. Over the past 12 months, TOI leads with a +239.2% total return vs FMS's +0.2%. The 3-year compound annual growth rate (CAGR) favors TOI at 27.0% vs FMS's 9.1% — a key indicator of consistent wealth creation.
| Metric | FMSFresenius Medical… | TOIThe Oncology Inst… |
|---|---|---|
| YTD ReturnYear-to-date | -0.2% | -21.3% |
| 1-Year ReturnPast 12 months | +0.2% | +239.2% |
| 3-Year ReturnCumulative with dividends | +29.7% | +105.0% |
| 5-Year ReturnCumulative with dividends | -22.8% | -73.5% |
| 10-Year ReturnCumulative with dividends | -28.5% | -70.2% |
| CAGR (3Y)Annualised 3-year return | +9.1% | +27.0% |
Risk & Volatility
FMS is the less volatile stock with a 0.40 beta — it tends to amplify market swings less than TOI's 1.56 beta. A beta below 1.0 means the stock typically moves less than the S&P 500. FMS currently trades 77.0% from its 52-week high vs TOI's 59.2% drawdown — a narrower gap to the peak suggests stronger recent price momentum.
| Metric | FMSFresenius Medical… | TOIThe Oncology Inst… |
|---|---|---|
| Beta (5Y)Sensitivity to S&P 500 | 0.40x | 1.56x |
| 52-Week HighHighest price in past year | $30.46 | $4.88 |
| 52-Week LowLowest price in past year | $20.95 | $0.60 |
| % of 52W HighCurrent price vs 52-week peak | +77.0% | +59.2% |
| RSI (14)Momentum oscillator 0–100 | 49.0 | 55.5 |
| Avg Volume (50D)Average daily shares traded | 518K | 1.5M |
Analyst Outlook
Wall Street rates FMS as "Hold" and TOI as "Buy". Consensus price targets imply 73.0% upside for TOI (target: $5) vs 19.4% for FMS (target: $28).
| Metric | FMSFresenius Medical… | TOIThe Oncology Inst… |
|---|---|---|
| Analyst RatingConsensus buy/hold/sell | Hold | Buy |
| Price TargetConsensus 12-month target | $28.00 | $5.00 |
| # AnalystsCovering analysts | 18 | 3 |
| Dividend YieldAnnual dividend ÷ price | — | — |
| Dividend StreakConsecutive years of raises | 3 | — |
| Dividend / ShareAnnual DPS | — | — |
| Buyback YieldShare repurchases ÷ mkt cap | 0.0% | 0.0% |
Historical Charts
Charts are rendered on first load. Hover for details.
Chart 1Total Return — 5 Years (Rebased to 100)
| Stock | Jul 20 | Feb 26 | Change |
|---|---|---|---|
| Fresenius Medical C… (FMS) | 100 | 51.59 | -48.4% |
| The Oncology Instit… (TOI) | 109.28 | 27.63 | -74.7% |
Fresenius Medical C… (FMS) returned -23% over 5 years vs The Oncology Instit… (TOI)'s -73%.
Chart 2Revenue Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Fresenius Medical C… (FMS) | $17.0B | $19.6B | +15.3% |
| The Oncology Instit… (TOI) | $155M | $393M | +153.2% |
Fresenius Medical Care AG & Co. KGaA's revenue grew from $17.0B (2016) to $19.6B (2025) — a 1.6% CAGR.
Chart 3Net Margin Trend — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Fresenius Medical C… (FMS) | 6.9% | 5.0% | -28.2% |
| The Oncology Instit… (TOI) | -2.6% | -16.4% | -535.2% |
Fresenius Medical Care AG & Co. KGaA's net margin went from 7% (2016) to 5% (2025).
Chart 4P/E Ratio History — 9 Years
| Stock | 2017 | 2025 | Change |
|---|---|---|---|
| Fresenius Medical C… (FMS) | 25.3 | 14.2 | -43.9% |
Fresenius Medical Care AG & Co. KGaA has traded in a 10x–39x P/E range over 9 years; current trailing P/E is ~12x.
Chart 5EPS Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Fresenius Medical C… (FMS) | 1.87 | 1.68 | -10.2% |
| The Oncology Instit… (TOI) | -0.06 | -0.71 | -1037.8% |
Fresenius Medical Care AG & Co. KGaA's EPS grew from $1.87 (2016) to $1.68 (2025) — a -1% CAGR.
Chart 6Free Cash Flow — 5 Years
Fresenius Medical Care AG & Co. KGaA generated $0M FCF in 2025 (-100% vs 2021). The Oncology Institute, Inc. generated $-30M FCF in 2024 (+15% vs 2021).
FMS vs TOI: Frequently Asked Questions
8 questions · data-driven answers · updated daily
01Is FMS or TOI a better buy right now?
Fresenius Medical Care AG & Co. KGaA (FMS) offers the better valuation at 11.8x trailing P/E (9.9x forward), making it the more compelling value choice. Analysts rate The Oncology Institute, Inc. (TOI) a "Buy" — based on 3 analyst ratings — the highest consensus in this comparison. The "better buy" depends entirely on your goals: growth investors should weight revenue trajectory, value investors should weight P/E and PEG, and income investors should weight dividend yield and streak.
02Which is the better long-term investment — FMS or TOI?
Over the past 5 years, Fresenius Medical Care AG & Co. KGaA (FMS) delivered a total return of -22.8%, compared to -73.5% for The Oncology Institute, Inc. (TOI). A $10,000 investment in FMS five years ago would be worth approximately $8K today (assuming dividends reinvested). Over 10 years, the gap is even starker: FMS returned -28.5% versus TOI's -70.2%. Past returns do not guarantee future results, and the stock with the higher historical return may already have its best growth priced in.
03Which is safer — FMS or TOI?
By beta (market sensitivity over 5 years), Fresenius Medical Care AG & Co. KGaA (FMS) is the lower-risk stock at 0.40β versus The Oncology Institute, Inc.'s 1.56β — meaning TOI is approximately 290% more volatile than FMS relative to the S&P 500. On balance sheet safety, Fresenius Medical Care AG & Co. KGaA (FMS) carries a lower debt/equity ratio of 76% versus 34% for The Oncology Institute, Inc. — giving it more financial flexibility in a downturn.
04Which has better profit margins — FMS or TOI?
Fresenius Medical Care AG & Co. KGaA (FMS) is the more profitable company, earning 5.0% net margin versus -16.4% for The Oncology Institute, Inc. — meaning it keeps 5.0% of every revenue dollar as bottom-line profit. Operating margin tells a similar story: FMS leads at 9.3% versus -15.3% for TOI. At the gross margin level — before operating expenses — FMS leads at 25.6%, reflecting greater pricing power or product mix advantage. Stronger margins indicate durable pricing power, lower cost of revenue, or higher mix of software/services. They are one of the clearest signs of business quality.
05Is FMS or TOI more undervalued right now?
Analyst consensus price targets imply the most upside for TOI: 73.0% to $5.00.
06Which pays a better dividend — FMS or TOI?
None of the stocks in this comparison currently pay a material dividend. All are effectively zero-yield and should be held for capital appreciation rather than income.
07Is FMS or TOI better for a retirement portfolio?
For long-horizon retirement investors, Fresenius Medical Care AG & Co. KGaA (FMS) is the stronger choice — it scores higher on the combination of lower volatility, dividend reliability, and long-term compounding (low volatility (β 0.40)). The Oncology Institute, Inc. (TOI) carries a higher beta of 1.56 — meaning larger drawdowns in market downturns, which matters significantly when you cannot wait years for a recovery. Both have compounded well over 10 years (FMS: -28.5%, TOI: -70.2%), confirming both are viable long-term holds — but the lower-volatility option typically results in less emotional selling during corrections. Retirement portfolios generally favour predictability over maximum returns. Consult a financial advisor before making allocation decisions.
08What are the main differences between FMS and TOI?
Both stocks operate in the Healthcare sector, making this a peer-level intra-sector comparison — the same macro tailwinds and headwinds will affect both. In terms of investment character: FMS is a mid-cap deep-value stock; TOI is a small-cap quality compounder stock. These fundamental differences mean investors should not choose between them on a single metric — the "better stock" depends entirely on which of these characteristics aligns with your investment strategy.
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