Overall business development
The Management Board’s assessment of the effect of general economic developments and those in the healthcare sector for Fresenius as well as business results and significant factors affecting operating performance
In 2024, economic conditions improved overall. Although uncertainties, inflation-related cost increases and staff shortages persisted, they have eased significantly. In this macroeconomic environment, the Fresenius Group was able to increase its revenue and earnings guidance twice over the course of the year.
For this reason, the Management Board believes that 2024 was a very successful fiscal year for the Fresenius Group.
Fresenius Kabi achieved organic revenue growth of 10%. EBIT1 increased by 15% (16% in constant currency) to €1,319 million (2023: €1,145 million).
The organic revenue growth of Fresenius Helios was 6%. EBIT1 increased by 8% (8% in constant currency) to €1,288 million (2023: €1,190 million).
Following the deconsolidation of Fresenius Medical Care, this business segment is accounted for using the equity method. The profit attributable to the shareholders of Fresenius SE & Co. KGaA is recognized in a separate line in the income statement. From fiscal year 2024, it will also include the shares in Fresenius Vamed, which are also accounted for using the equity method. In fiscal year 2024, the result from the equity method amounted to €38 million (2023: -€12 million).
Comparison of the actual business results with the forecasts
Over the course of the year, Group revenue and earnings1 guidance was increased twice.
The following table shows how the outlook for the Group and the business segments developed in 2024.
Revenue1 increased organically by 8% in fiscal year 2024 and was thus at the upper end of the guidance adjusted in November 2024 (guidance for 2024: 6–8% growth). The increase is driven by the ongoing strong performance of our Operating Companies.
EBIT1 increased by 10% in constant currency and was therefore at the upper end of the guidance adjusted in November 2024 (guidance for 2024: 8–11% growth). The increase was driven by strong performance at Fresenius Kabi and Fresenius Helios.
We invested €960 million in property, plant and equipment (2023: €1,136 million). At 4.5% of Group revenue1, the investments in property, plant and equipment are below the prior-year level of 5.6%, but in line with the expectation (expectation for 2024: less than 5%).
The cash conversion rate (CCR) was 1.0 and is therefore in line with expectations (expectation for 2024: around 1).
The net financial debt / EBITDA ratio was 3.0×2 (December 31, 2023: 3.8×2) and thus in line with expectations. We had projected that the leverage ratio would be at the lower end of the self-imposed target corridor of 3.0× to 3.5×2 by the end of 2024.
Group ROIC was 6.2%1,3 (2023: 5.2%1,3) and thus in line with expectations. We had projected a figure of above 6% for fiscal year 2024.
The non-financial performance targets of the Fresenius Group cover the key sustainability topics of medical quality / patient satisfaction and employees and are anchored in the compensation of the Management Board. The following actual figures for the 2024 fiscal year were determined as part of the assessment of target achievement for the short-term variable compensation of the Management Board (STI) of Fresenius SE & Co. KGaA.
In the area of medical quality, Fresenius Kabi achieved an Audit & Inspection Score of 1.7 (target value: no more than 2.3), Fresenius Helios Germany achieved an Inpatient Quality Indicator (G-IQI) Score of 90.7% (target value: at least 88.0%) and Fresenius Helios Spain an Inpatient Quality Indicator (E-IGI) Score of 73.3% (target value: at least 55.0%). As a result, all divisions met their respective targets for the 2024 fiscal year.
In the area of employees, the Employee Engagement Index (EEI) of the Fresenius Group was 4.02 in the 2024 fiscal year (target value: 4.33).
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Guidance 2024, published February 2024 |
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Guidance adjustment / update, published May 2024 |
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Guidance adjustment / update, published June 2024 |
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Guidance adjustment / update, published November 2024 |
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Achieved in 2024 |
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Group1 |
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Revenue (growth, organic) |
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3–6% growth |
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4–7% growth |
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Confirmed |
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6–8% growth |
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8% |
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EBIT (growth, in constant currency) |
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4–8% growth |
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6–10% growth |
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Confirmed |
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8–11% growth |
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10% |
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Operating Companies |
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Fresenius Kabi1 |
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Revenue (growth, organic) |
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Mid-single-digit percentage growth |
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Mid-to-high single-digit percentage growth |
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Confirmed |
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Confirmed |
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10% |
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EBIT margin |
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Around 15% (structural margin band of |
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Between |
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Confirmed |
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Confirmed |
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15.7% |
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Fresenius Helios1 |
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Revenue (growth, organic) |
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Low-to-mid-single-digit percentage growth |
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Confirmed |
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Mid-single-digit percentage growth |
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Confirmed |
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6% |
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EBIT margin |
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Within the structural margin band of |
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Confirmed |
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Between |
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Confirmed |
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10.1% |
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1 Before special items
2 Both net debt and EBITDA calculated at LTM average exchange rates; pro forma closed acquisitions / divestitures; before special items; including leasing liabilities; including Fresenius Medical Care dividend
3 Pro forma acquisitions
Organic growth rate adjusted for accounting effects related to Argentina hyperinflation.
Growth rates adjusted for Argentina hyperinflation and the divestment of the fertility services group Eugin and the hospital stake in Peru.
For a detailed overview of special items please see the reconciliation table.