Operating margins compressed to 8.1% in 2026Q1 from 11.7% in 2025Q4, reflecting structural constraints in the core dialysis service business.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 | Dec'07 | Dec'06 | Dec'05 | Dec'04 | Dec'03 | Dec'02 | Dec'01 | Dec'00 | Dec'99 | Dec'98 |
|---|
| Sales/Revenue | 19.36B | 19.63B | 19.34B | 19.45B | 19.4B | 17.62B | 17.86B | 17.48B | 16.55B | 17.78B | 17.03B | 15.31B | 13.02B | 10.58B | 10.43B | 9.87B | 9.06B | 7.85B | 7.62B | 6.67B | 6.44B | 5.72B | 4.59B | 4.39B | 4.84B | 5.46B | 4.47B | 3.82B | 2.99B |
| Revenue Growth % | -0.69% | 1.51% | -0.61% | 0.29% | 10.1% | -1.35% | 2.19% | 5.62% | -6.96% | 4.42% | 11.24% | 17.59% | 23.06% | 1.39% | 5.7% | 8.93% | 15.45% | 2.98% | 14.35% | 3.53% | 12.63% | 24.45% | 4.68% | -9.41% | -11.29% | 22.09% | 17.21% | 27.68% | - |
| Cost of Goods Sold | 14.33B | 14.6B | 14.58B | 14.53B | 14.5B | 12.85B | 12.32B | 12.08B | 11.39B | 11.78B | 11.53B | 10.43B | 8.91B | 7.15B | 6.96B | 6.38B | 5.95B | 5.18B | 5.02B | 4.37B | 4.26B | 3.75B | 3.06B | 2.94B | 3.27B | 3.62B | 2.91B | 2.13B | 1.64B |
| COGS % of Revenue | - | 74.38% | 75.4% | 74.68% | 74.77% | 72.91% | 68.99% | 69.13% | 68.85% | 66.24% | 67.73% | 68.15% | 68.44% | 67.57% | 66.66% | 64.67% | 65.61% | 65.93% | 65.81% | 65.48% | 66.14% | 65.55% | 66.51% | 66.91% | 67.43% | 66.27% | 65.09% | 55.73% | 54.96% |
| Gross Profit | 5.03B | 5.03B | 4.76B | 4.93B | 4.89B | 4.77B | 5.54B | 5.4B | 5.16B | 6B | 5.5B | 4.88B | 4.11B | 3.43B | 3.48B | 3.49B | 3.12B | 2.67B | 2.61B | 2.3B | 2.18B | 1.97B | 1.54B | 1.45B | 1.58B | 1.84B | 1.56B | 1.69B | 1.35B |
| Gross Margin % | 25.96% | 25.62% | 24.6% | 25.32% | 25.23% | 27.09% | 31.01% | 30.87% | 31.15% | 33.76% | 32.27% | 31.85% | 31.56% | 32.43% | 33.34% | 35.33% | 34.39% | 34.07% | 34.19% | 34.52% | 33.86% | 34.45% | 33.49% | 33.09% | 32.57% | 33.73% | 34.91% | 44.27% | 45.04% |
| Gross Profit Growth % | - | 5.73% | -3.42% | 0.64% | 2.53% | -13.8% | 2.62% | 4.67% | -14.14% | 9.25% | 12.71% | 18.68% | 19.73% | -1.37% | -0.25% | 11.92% | 16.53% | 2.59% | 13.26% | 5.57% | 10.7% | 28% | 5.96% | -7.98% | -14.34% | 17.96% | -7.56% | 25.48% | - |
| Operating Expenses | 3.15B | 3.2B | 3.36B | 3.56B | 3.38B | 2.92B | 3.23B | 3.13B | 3B | 3.71B | 3.05B | 2.78B | 2.28B | 1.82B | 1.84B | 1.89B | 1.67B | 1.45B | 1.41B | 1.22B | 1.18B | 1.18B | 909.96M | 850.78M | 915.85M | 1.42B | 900.7M | 1.13B | 929.57M |
| OpEx % of Revenue | - | 16.31% | 17.4% | 18.28% | 17.43% | 16.58% | 18.1% | 17.89% | 18.12% | 20.86% | 17.91% | 18.13% | 17.48% | 17.23% | 17.65% | 19.12% | 18.43% | 18.46% | 18.44% | 18.27% | 18.35% | 20.58% | 19.81% | 19.38% | 18.9% | 25.93% | 20.13% | 29.68% | 31.1% |
| Selling, General & Admin | 3.03B | 3.03B | 3.14B | 3.2B | 3.17B | 2.77B | 3.13B | 3.03B | 2.87B | 3.58B | 2.9B | 2.65B | 2.18B | 1.73B | 1.68B | 1.83B | 1.6B | 1.38B | 1.35B | 1.17B | 1.17B | 1.13B | 872.07M | 811.32M | 870.65M | 1.09B | 866.7M | 818.01M | 665.07M |
| SG&A % of Revenue | - | 15.45% | 16.25% | 16.43% | 16.34% | 15.74% | 17.55% | 17.35% | 17.31% | 20.12% | 17% | 17.3% | 16.71% | 16.37% | 16.12% | 18.49% | 17.62% | 17.62% | 17.68% | 17.58% | 18.22% | 19.83% | 18.98% | 18.49% | 17.97% | 19.88% | 19.37% | 21.43% | 22.25% |
| Research & Development | 272.17M | 158M | 183.49M | 231.97M | 228.62M | 220.78M | 193.77M | 168.03M | 134M | 131M | 154.04M | 128.05M | 100.33M | 91.11M | 84.41M | 85.51M | 72.58M | 65.48M | 57.64M | 45.63M | 38.86M | 43.02M | 37.89M | 39.45M | 45.2M | 40.12M | 34M | 32.29M | 26.6M |
| R&D % of Revenue | - | 0.8% | 0.95% | 1.19% | 1.18% | 1.25% | 1.08% | 0.96% | 0.81% | 0.74% | 0.9% | 0.84% | 0.77% | 0.86% | 0.81% | 0.87% | 0.8% | 0.83% | 0.76% | 0.68% | 0.6% | 0.75% | 0.82% | 0.9% | 0.93% | 0.73% | 0.76% | 0.85% | 0.89% |
| Other Operating Expenses | 0 | 11M | 37.95M | 127.26M | -17.06M | -72.87M | -94.52M | -73.68M | 0 | 0 | 0 | 0 | 0 | 0 | 75.61M | 0 | 0 | 0 | 0 | 0 | -30.48M | 0 | 0 | 0 | 0 | 290.15M | 0 | 282.44M | 237.89M |
| Operating Income | 1.87B | 1.83B | 1.39B | 1.37B | 1.51B | 1.85B | 2.3B | 2.27B | 3.04B | 2.36B | 2.51B | 2.13B | 1.85B | 1.63B | 1.68B | 1.6B | 1.45B | 1.23B | 1.2B | 1.08B | 998.73M | 792.74M | 628.76M | 601.43M | 662.28M | 426.21M | 661M | 556.74M | 416.87M |
| Operating Margin % | 9.67% | 9.31% | 7.2% | 7.04% | 7.79% | 10.51% | 12.9% | 12.99% | 18.36% | 13.28% | 14.73% | 13.9% | 14.24% | 15.44% | 16.08% | 16.22% | 15.96% | 15.61% | 15.76% | 16.26% | 15.51% | 13.87% | 13.69% | 13.7% | 13.67% | 7.8% | 14.78% | 14.59% | 13.95% |
| Operating Income Growth % | - | 31.21% | 1.68% | -9.41% | -18.38% | -19.62% | 1.54% | -25.29% | 28.62% | -5.83% | 17.85% | 14.78% | 13.5% | -2.6% | 4.79% | 10.67% | 18.05% | 1.99% | 10.85% | 8.51% | 25.99% | 26.08% | 4.54% | -9.19% | 55.39% | -35.52% | 18.73% | 33.55% | - |
| EBITDA | 3.46B | 3.27B | 3.13B | 3.12B | 3.35B | 3.48B | 4.09B | 3.86B | 3.76B | 3.1B | 3.21B | 2.78B | 2.43B | 2.1B | 2.13B | 2.03B | 1.82B | 1.54B | 1.5B | 1.33B | 1.23B | 1.01B | 800.33M | 773.24M | 862.94M | 789.79M | 972.82M | 839.18M | 654.76M |
| EBITDA Margin % | 17.85% | 16.67% | 16.21% | 16.05% | 17.27% | 19.73% | 22.9% | 22.1% | 22.74% | 17.42% | 18.85% | 18.19% | 18.66% | 19.88% | 20.45% | 20.57% | 20.14% | 19.67% | 19.68% | 19.99% | 19.14% | 17.58% | 17.42% | 17.62% | 17.81% | 14.46% | 21.75% | 21.99% | 21.9% |
| EBITDA Growth % | 30.53% | 4.38% | 0.42% | -6.83% | -3.62% | -15.02% | 5.89% | 2.65% | 21.48% | -3.5% | 15.29% | 14.61% | 15.5% | -1.41% | 5.06% | 11.27% | 18.17% | 2.96% | 12.53% | 8.14% | 22.64% | 25.58% | 3.5% | -10.39% | 9.26% | -18.81% | 15.93% | 28.17% | - |
| D&A (Non-Cash Add-back) | 1.58B | 1.44B | 1.74B | 1.75B | 1.84B | 1.62B | 1.79B | 1.59B | 724.85M | 735.48M | 701.54M | 655.81M | 574.83M | 469.43M | 455.87M | 429.75M | 378.37M | 318.97M | 298.59M | 249.2M | 233.9M | 212.3M | 171.57M | 171.81M | 200.65M | 363.59M | 311.81M | 282.44M | 237.89M |
| EBIT | 1.73B | 1.51B | 1.46B | 1.46B | 1.58B | 1.93B | 2.35B | 2.33B | 2.18B | 2.41B | 2.47B | 2.23B | 1.92B | 1.66B | 1.82B | 1.65B | 1.47B | 1.24B | 1.22B | 1.1B | 1.01B | 792.74M | 628.76M | 601.43M | 662.28M | 426.21M | 972.82M | 556.74M | 416.93M |
| Net Interest Income | -218.42M | -315M | -335.47M | -336.42M | -292.48M | -280.43M | -368.02M | -429.44M | -301.06M | -364.82M | -363.41M | -352.82M | -338.09M | -295.87M | -322.16M | -228.79M | -210.58M | -209.36M | -241.9M | -254.49M | -266.14M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Interest Income | 37.1M | 0 | 71.58M | 88.22M | 67.66M | 73.17M | 41.96M | 61.62M | 147M | 51.38M | 63.4M | 105.07M | 69.08M | 28.2M | 33.63M | 46.16M | 19.11M | 14.93M | 17.82M | 19.61M | 15.48M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Interest Expense | 170.52M | 0 | 407.04M | 424.64M | 360.14M | 353.6M | 409.98M | 491.06M | 448M | 416.2M | 426.81M | 457.89M | 407.07M | 324.07M | 355.79M | 274.95M | 229.69M | 224.3M | 259.72M | 274.1M | 281.62M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Income/Expense | -401.7M | -315M | -335.47M | -336.42M | -292.48M | -280.43M | -368.02M | -429.44M | -301.06M | -364.82M | -363.41M | -352.82M | -337.99M | -295.87M | -216.6M | -228.79M | -210.58M | -209.36M | -241.9M | -254.49M | -266.14M | -146.23M | -135.55M | -169.56M | -200.68M | -252.5M | -233.14M | -816.4M | -189.29M |
| Pretax Income | 1.47B | 1.51B | 1.06B | 1.03B | 1.22B | 1.57B | 1.94B | 1.84B | 2.74B | 2.01B | 2.12B | 1.77B | 1.52B | 1.34B | 1.46B | 1.37B | 1.24B | 1.02B | 959.48M | 829.27M | 732.6M | 646.51M | 493.21M | 431.87M | 461.6M | 173.71M | 427.86M | -259.67M | 131.74M |
| Pretax Margin % | 7.59% | 7.7% | 5.47% | 5.31% | 6.29% | 8.92% | 10.84% | 10.53% | 16.54% | 11.29% | 12.46% | 11.57% | 11.65% | 12.65% | 14% | 13.9% | 13.64% | 12.94% | 12.59% | 12.44% | 11.38% | 11.31% | 10.74% | 9.84% | 9.53% | 3.18% | 9.56% | -6.8% | 4.41% |
| Income Tax | 302.24M | 321M | 316.06M | 300.56M | 324.95M | 352.83M | 500.56M | 401.61M | 511M | 454M | 649.42M | 569.83M | 480.26M | 428.72M | 457.57M | 463.78M | 434.86M | 342.29M | 351.37M | 319.38M | 313.3M | 260.68M | 195.79M | 168.9M | 174.22M | 102.5M | 202.06M | -12.66M | 115.45M |
| Effective Tax Rate % | 20.57% | 21.23% | 29.9% | 29.1% | 26.65% | 22.45% | 25.85% | 21.83% | 18.67% | 22.61% | 30.6% | 32.18% | 31.67% | 32.04% | 31.32% | 33.8% | 35.18% | 33.69% | 36.62% | 38.51% | 42.77% | 40.32% | 39.7% | 39.11% | 37.74% | 59.01% | 47.22% | 4.88% | 87.64% |
| Net Income | 947.01M | 978M | 537.91M | 499M | 673.4M | 969.31M | 1.16B | 1.2B | 1.98B | 1.28B | 1.18B | 941.19M | 859.37M | 803.76M | 897.39M | 826.45M | 735.75M | 621.98M | 587.32M | 491.86M | 406.69M | 384.12M | 296.55M | 262.97M | 276.16M | 71.2M | 225.8M | -247M | 16.29M |
| Net Margin % | 4.89% | 4.98% | 2.78% | 2.57% | 3.47% | 5.5% | 6.52% | 6.86% | 11.98% | 7.2% | 6.94% | 6.15% | 6.6% | 7.6% | 8.6% | 8.37% | 8.12% | 7.92% | 7.7% | 7.38% | 6.32% | 6.72% | 6.45% | 5.99% | 5.7% | 1.3% | 5.05% | -6.47% | 0.54% |
| Net Income Growth % | 53.2% | 81.81% | 7.8% | -25.9% | -30.53% | -16.75% | -2.94% | -39.47% | 54.84% | 8.3% | 25.58% | 9.52% | 6.92% | -10.43% | 8.58% | 12.33% | 18.29% | 5.9% | 19.41% | 20.94% | 5.87% | 29.53% | 12.77% | -4.78% | 287.84% | -68.47% | 191.42% | -1616.66% | - |
| Net Income (Continuing) | 1.17B | 1.19B | 740.87M | 732.46M | 894.33M | 1.22B | 1.44B | 1.44B | 2.23B | 1.55B | 1.42B | 1.21B | 1.04B | 909.3M | 1B | 908.32M | 801.07M | 673.68M | 617.76M | 518.04M | 419.3M | 384.12M | 296.55M | 262.97M | 287.38M | 71.2M | 225.8M | -247M | 112.22M |
| Discontinued Operations | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 813.12K | 287.09K | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Minority Interest | 962.88M | 0 | 1.19B | 1.21B | 1.46B | 1.28B | 1.12B | 1.27B | 1.14B | 1.01B | 616.47M | 556.9M | 481.13M | 181.38M | 200.19M | 316.34M | 110.27M | 145.71M | 0 | 72.57M | 56.95M | 12.16M | 13.3M | 11.2M | 21.46M | 22.74M | 22.65M | 21.64M | 16.97M |
| EPS (Diluted) | 1.72 | 1.68 | 0.92 | 0.85 | 0.57 | 0.83 | 1.31 | 1.35 | 3.23 | 2.08 | 1.87 | 1.57 | 1.43 | 1.33 | 1.47 | 1.35 | 1.22 | 1.04 | 0.98 | 0.83 | 0.69 | 0.65 | 0.51 | 0.63 | 0.66 | 0.17 | 0.42 | -0.52 | 0.04 |
| EPS Growth % | 146.27% | 82.61% | 8.24% | 49.12% | -31.33% | -36.64% | -2.96% | -58.2% | 55.29% | 11.23% | 19.11% | 9.79% | 7.52% | -9.52% | 8.89% | 10.66% | 17.31% | 6.12% | 18.07% | 20.29% | 6.15% | 27.45% | -19.05% | -4.55% | 288.24% | -59.52% | 180.77% | -1436.76% | - |
| EPS (Basic) | - | 1.68 | 0.92 | 0.85 | 0.57 | 0.83 | 1.31 | 1.35 | 3.24 | 2.09 | 1.87 | 1.57 | 1.43 | 1.33 | 1.48 | 1.37 | 1.22 | 1.04 | 0.99 | 0.83 | 0.69 | 0.66 | 0.51 | 0.63 | 0.66 | 0.17 | 0.42 | -0.52 | 0.04 |
| Diluted Shares Outstanding | 550.44M | 582.38M | 586.83M | 586.83M | 1.17B | 1.17B | 887.33M | 887.33M | 614.45M | 614.57M | 612.66M | 610.53M | 605.74M | 608.98M | 613.77M | 610.34M | 604.02M | 596.65M | 595.81M | 593.75M | 592.02M | 588.3M | 644.11M | 420M | 420M | 420M | 539.17M | 473.42M | 420M |
| Basic Shares Outstanding | 550.49M | 582.38M | 587.88M | 587.06M | 1.17B | 1.17B | 888.24M | 888.24M | 614.55M | 615.28M | 613.39M | 610.19M | 605.95M | 608.16M | 613.34M | 605.95M | 596.24M | 596.52M | 594.06M | 591.34M | 588.39M | 583.27M | 466.67M | 420M | 420M | 420M | 536.9M | 473.42M | 420M |
| Dividend Payout Ratio | - | 41.5% | 64.91% | 65.86% | 58.74% | 40.49% | 30.16% | 29.56% | 16.39% | 22.97% | 20.67% | 25.16% | 30.42% | 26.68% | 22.9% | 26.2% | 23.71% | 0.04% | 30.87% | 26.27% | 28.64% | 30.22% | 30.37% | 32.54% | 26.48% | 103.83% | 24.16% | - | 257.59% |
Regulatory reimbursement and labor costs
According to the most recent quarterly data, FMS reported a revenue contraction of 5.5% in 2026Q1, signaling a departure from the modest growth observed in previous periods and highlighting the ongoing difficulty in achieving consistent volume expansion within its core dialysis service delivery business.
The recent decline suggests that the company is struggling to overcome the combined headwinds of patient population stabilization and potential pricing pressures. Investors should monitor whether this deceleration reflects a structural shift in demand or temporary volatility in the company's North American clinical operations.
Based on financial statements, the company's gross margin of 25.6% in 2026Q1 remains tightly bound by fixed government reimbursement rates, which appear to limit the firm's ability to offset inflationary pressures through pricing adjustments compared to the 27.4% margin achieved in 2025Q4.
The inability to consistently expand gross margins suggests that the company's high-fixed-cost model is highly sensitive to labor and supply chain inflation. This structural rigidity implies that profitability improvements may remain elusive until the company successfully executes its shift toward lower-cost, home-based dialysis delivery models.
As reported in recent filings, the operating margin compressed to 8.1% in 2026Q1, down from 11.7% in 2025Q4, indicating that the company is currently failing to achieve the necessary operating leverage to scale its profitability effectively despite its massive global clinical footprint.
The volatility in operating income suggests that SG&A expenses are not scaling efficiently with revenue, potentially due to the high administrative burden of managing complex joint ventures and regulatory compliance. This trend warrants further investigation into whether the FMG25 transformation program is successfully streamlining the cost base.
Data from the last ten quarters reveals that net margins have fluctuated significantly, dropping to 2.6% in 2026Q1 from a peak of 6.4% in 2025Q4, which suggests that the company's earnings quality remains highly vulnerable to idiosyncratic operational shocks and regulatory reimbursement changes.
Short-term observers may point to these erratic net income figures as evidence that the company's integrated model is becoming a liability rather than a competitive advantage. The reliance on government-funded care, combined with rising labor costs, suggests that the path to sustainable earnings growth remains fraught with significant execution risk.
Quick answers to the most common questions about buying FMS stock.
For fiscal year 2025, Fresenius Medical Care AG & Co. KGaA (FMS) reported total revenue of $19.63B. This represents a 556.6% increase compared to $2.99B in 1998.
Fresenius Medical Care AG & Co. KGaA (FMS) is profitable, generating $978.0M in net income for the fiscal year ending 2025 with a net profit margin of 5.0%.
Fresenius Medical Care AG & Co. KGaA (FMS) reported an operating income of $1.83B, resulting in an operating profit margin of 9.3%. This margin reflects the operational efficiency of the business before interest and taxes.
Fresenius Medical Care AG & Co. KGaA (FMS) generated $5.03B in gross profit for the year, representing a gross profit margin of 25.6%. This demonstrates the company's core pricing power and production efficiency.