ESRS 2 General disclosures [ESRS 2] General disclosures

Basis for preparation [BP-1] General basis for preparation of Sustainability Statements

This Group Sustainability Statement (Sustainability Report) is presented for the 2024 fiscal and calendar year and aims to inform our stakeholders about our sustainability activities in a transparent manner. The Sustainability Statement is prepared in full compliance with the European Sustainability Reporting Standards (ESRS) in order to fulfill the CSRD. It further fulfills the requirements for the non-financial Group report to be prepared in accordance with Sections 315b to 315c in connection with Sections 298c to 2998e of the German Commercial Code (HGB).

In addition, with the information provided in this Sustainability Report, the Fresenius Group complies with the requirements of Regulation (EU) 2020 / 852 of the European Parliament and of the Council of June 18, 2020 on the establishment of a framework to facilitate sustainable investment and amending Regulation (EU) 2019 / 2088 (hereinafter referred to as the EU Taxonomy Regulation), as explained in the section Disclosures pursuant to article 8 of regulation (EU) 2020 / 852 (EU taxonomy regulation).

The Sustainability Report has been prepared on a consolidated basis and refers to the same scope of consolidation as the financial reporting. The report therefore covers the Group including its business segments, i.e. all fully consolidated companies under the legal or actual control of Fresenius SE & Co. KGaA, Bad Homburg, Germany.

The Sustainability Report covers both our own business operations and the upstream and downstream value chain, provided that the identified significant impacts, risks, and opportunities affect our value chain. Those focusing only on the value chain are addressed accordingly. Information on the extent to which policies, actions, targets and metrics cover the value chain is presented in the relevant sections of the respective topical standards. The business segments Fresenius Kabi and Fresenius Helios are described as operating companies.

Information provided on approaches, guidelines and controls at Fresenius apply to the geographies in which the company operates production sites, healthcare facilities or other operating entities. We also consider the upstream and downstream value chain if required due to contractual or regulatory provisions. The most relevant stakeholder groups are explained in section SBM-2 Stakeholders and partnerships in this standard.

The information in the Sustainability Report is comprehensive from Fresenius’ perspective. No information has been omitted due to intellectual property, know-how or the results of innovations.

The entities of the business segment Fresenius Vamed (investment company) that were sold, or for which a disposal is planned, or a reverse of operation is conducted, in accordance with the announcement of May 8, 2024 are included in the information until completion of disposal of the respective entity:

• Only those units whose disposal has not yet been completed are included in the reporting date figures.
• For units sold during the year, figures are taken into account on a pro rata basis.
• If estimates were used for the consolidation, explanations are provided in the respective topical standards.

Due to the reverse of operation of the remaining Vamed project business, we assume that impacts, risks, and opportunities from these activities will continue to decrease in future. Therefore, these risks are no longer considered to be material. Fresenius has not made use of the exemption (pursuant to Article 19a (3) and Article 29a (3) of Directive 2013 / 34 / EU) to provide information on pending developments or matters under negotiation. Further information on the scope of consolidation and the transactions can be found in the Notes and in the Management Report. Explanations of definitions and reporting scope of metrics are provided in the respective topical standards of this Sustainability Report. From the 2025 reporting year, the Fresenius Vamed entities that are consolidated in the Corporate / Other segment will be integrated into the segment’s existing control and reporting processes and the proportion of estimates used will be reduced.

All references in this report to information outside the Sustainability Report are additional information and not part of the Sustainability Report and its audit by PricewaterhouseCoopers GmbH Wirtschaftsprüfungsgesellschaft (PwC). No further information has been included by reference to sources outside this Sustainability Report, which would be obligatory ESRS information. References to additional information outside the Sustainability Report are noted under the relevant topics.

PwC has subjected the information in the Sustainability Report to a business audit in accordance with ISAE 3000 (Revised) to obtain limited assurance against the relevant legal requirements and has issued an independent auditor’s report. Individual selected indicators of the Sustainability Report were audited with reasonable assurance. This is indicated by a footnote in the presentation of the selected indicators:

• Total Scope 1 and Scope 2 CO₂ emissions (market-based approach) in tons of CO₂ equivalents (Fresenius Group)
• Employee Engagement Index (EEI) (Fresenius Group)
• Medical Quality: Audit & Inspection Score (Fresenius Kabi) Inpatient Quality Indicators (Fresenius Helios)

The independent auditor’s report can be found on page 407 of the Annual Report.

The Sustainability Report is part of the Group Management Report. It is available in German and English. In the event of discrepancies between the versions, the German document shall prevail.

Disclosures in relation to specific circumstances [BP-2] Disclosures in relation to specific circumstances

For medium- (>1 to 5 years) and long-term (>5 years) time horizons, the definitions set out in the European Sustainability Reporting Standards (ESRS) 1 section 6.4 were used in the reporting, unless otherwise stated for a specific topic.

Estimates on the value chain are made, for example, in topical standard E1 Climate change. Estimates for our own operations are used in all environmental topical standards and in the topical standard S1 Own workforce, see S1-13 Training and skills development metrics. For the calculation of Scope 3 emissions, we used the established Scope 3 data models, as explained in section GHG emissions.

For all quantitative information and monetary amounts, the explanation is given in respective definitions or explanations of formulas on the basis of which sources we have carried out estimates. Further, we explain the basis for the preparation of the metrics. This information is explained specifically for the respective key figures in the individual topical standards. If estimates are used, the responsible central function evaluates annually if this approach meets our expectations regarding accuracy and completeness. Where key figures are based on an estimate, this is explained accordingly.

Unless otherwise stated, the information contained in this Sustainability Report on the market environment, market developments, growth rates, market trends, and competition in the markets in which the Group operates comes from publicly available sources. These include, but are not limited to, third-party studies or the Group’s own estimates; these are also based primarily on data from publicly available sources. Information cited here from third-party sources has been reproduced accurately. As far as the company is aware and based on the information published by these third parties, no facts have been omitted that would make the information reproduced inaccurate or misleading.

If the comparability of disclosures to previous reporting periods is not given, the changes and the reasons for them will be explained in the respective topical standards in accordance with ESRS 1, section 7.4. Changes in the calculation, e.g. as applicable for headcount (see Characteristics of the employees), lead to non-comparability of KPIs to previous reported figures. In accordance with ESRS 1, section 7.4, we do not provide previous year’s figures (2023) for affected KPI.

Fresenius reports Additional Performance Measures (APMs) that are in line with the provisions set out in the ESRS and are declared as company-specific metrics, e.g. the quality of treatment. These metrics are a useful tool for evaluating the operating performance of Fresenius. The respective metric shown as company-specific is not necessarily comparable with similar performance metrics published by other companies. Usage of such APMs is only in addition to, and not as a substitute for, sustainability information prepared in accordance with the ESRS; APMs are also not considered to be of a higher quality than the information required by the ESRS. The same applies to financial information prepared in accordance with International Financial Reporting Standards (IFRS) and contained elsewhere in the Annual Report.

Costs for the implementation of action plans are included as OpEx (Operating Expenses) in the income statement, see the Notes, and as CapEx (Capital Expenses – investments) in the balance sheet, see the Notes. For information about the EU taxonomy, please refer to the section Disclosures pursuant to Article 8 of Regulation (EU) 2020 / 852 (EU Taxonomy Regulation).

In general, the key figures presented are not validated by any external body other than the auditor, see page 407 in the Annual Report. However, if this is the case, it is explained in the respective topical standard.

Governance

Our sustainability organization [GOV-1] The role of the administrative, management, and supervisory bodies

In the Group, the responsibilities of the management and supervisory bodies are distributed as follows: Management is the responsibility of the general partner Fresenius Management SE, represented by its Management Board, which consists of five persons. The Supervisory Board of Fresenius SE & Co. KGaA supervises the management by the general partner. It comprises 12 persons: 6 shareholder representatives, elected by the Annual General Meeting, and 6 employee representatives. The members of the Management Board are listed in the Annual Report by name on page 80 and the members of the Supervisory Board of Fresenius SE & Co. KGaA are listed by name on pages 78 f.

The employee representatives on the Supervisory Board of Fresenius SE & Co. KGaA are elected by the European Works Council. If substitute members are appointed, they will take their place on the Supervisory Board after an employee representative leaves before the end of his or her term of office.

In the Management Board, at least one member should have many years of experience in each of the company’s key areas of activity. For Fresenius, these include essential medication, medical devices, and services for the critically and chronically ill and operation of hospitals as well as healthcare services. In addition, one member should have many years of experience and expertise in finance and in the areas of corporate governance, law, and compliance. The majority of the members of the Management Board of Fresenius Management SE should have international experience in at least one of Fresenius’ key markets through their background, education or professional activity. The Personnel Committee of the Supervisory Board of Fresenius Management SE assesses the necessary experience and acquired skills when selecting suitable persons. The listed requirements are met by the existing Management Board members.

The Supervisory Board members must have both the professional and personal qualifications to advise and supervise the Executive Board in managing a global healthcare Group. The Supervisory Board of Fresenius SE & Co. KGA proposes suitable persons to the Supervisory Board for its election proposals to the Annual General Meeting for the appointment of new shareholder representatives to the company’s Supervisory Board. The presentation of the election proposals at the Annual General Meeting is based on an orderly nomination process: first, a candidate profile is drawn up based on the objectives for the composition of the Supervisory Board, the skills profile and the concept in accordance with Section 289f (2) No. 6 HGB (diversity concept). The requirements in terms of skills and knowledge, professional experience, balanced composition and personal suitability are defined in detail. The Nomination Committee then evaluates potential candidates based on the defined profile. The result of the selection process is presented to the full committee. Each member of the Supervisory Board should have the knowledge of good corporate governance of a capital market-oriented company required for the proper performance of their duties. This includes knowledge of the basic principles of accounting, risk management, internal control mechanisms and compliance. Further, each member of the Supervisory Board should have general knowledge of the healthcare industry and a basic understanding of Fresenius’ international activities.

An appropriate number of Supervisory Board members should have in-depth knowledge and / or experience in the areas of work that are important to the company: essential medicines and medical devices for critically and chronically ill patients, and operation of hospitals and health care services. The Supervisory Board should include an appropriate number of members with management experience in the healthcare sector.

Fresenius has subsidiaries in more than 60 countries. There-fore, the Supervisory Board as a whole should have knowledge and experience in the regions that are important for Fresenius. The Supervisory Board should include an appropriate number of members who, due to their background or business experience, have a special connection to the international markets that are important for Fresenius. The Supervisory Board fulfills these requirements in full.

Fresenius is striving for an balanced composition in terms of age, gender, country of birth, education, professional background, and international experience on the Management Board and on the Supervisory Board of Fresenius SE & Co. KGaA. To this end, the concept in accordance with Section 289f (2) No. 6 HGB defines criteria that are to be implemented when nominating candidates.

In the 2024 reporting year, the proportion of female members on the Management Board was 20% (ratio of female to male: 1:4) and on the Supervisory Board 33% (ratio of female to male: 4:8).

At least half of the shareholder representatives on the Supervisory Board should be independent within the meaning of the German Corporate Governance Code. Independent in this sense means anyone who does not have a personal or business relationship with the company, its executive bodies, a controlling shareholder or a company affiliated with the latter that could give rise to a significant and not merely temporary conflict of interest. The ownership structure can be given appropriate consider-ation. When assessing independence, the Supervisory Board is of the opinion all shareholder representatives are independent. Some external stakeholders view employee representatives as non-independent. Based on this perspective, 50% of the members of the Supervisory Board are considered to be independent.

The Management Board, i.e. its members, is responsible for managing Fresenius SE & Co. KGaA and conducting its business. The Group-wide topic of sustainability, related impacts, risks and opportunities, are anchored in the Management Board member for Legal Affairs, Compliance, Risk Management, Sustainability, Human Resources (Labor Director), Corporate Audit and for the Fresenius Vamed business segment (subsequently Sustainability Board member). In the reporting year 2024, this was Dr. Michael Moser.

The Supervisory Board of Fresenius SE & Co. KGaA monitors the management by the general partner Fresenius Management SE also with regard to Sustainability, related impacts, risks and opportunities. The members of the Audit Committee in the reporting year are Ms. Susanne Zeidler (Chairwoman), Mr. Bernd Behlert, Ms. Grit Genster, Mr. Wolfgang Kirsch and Dr. Christoph Zindel. They conducted a pre-audit of the Group Management Report and also the Sustainability Report. To take account of the growing importance of sustainability, the Audit Committee has appointed Dr. Zindel as an ESG expert.

Responsibility for compliance, business conduct, and corporate governance in the Group lies with the Management Board and is assigned to the Sustainability Board member. The member is also responsible for the internal control and risk management systems.

The responsibilities of the Management Board of Fresenius Management SE and the Supervisory Board of Fresenius SE & Co. KGaA as well as the individual members of the corporate bodies are defined in the Articles of Association of Fresenius Management SE and Fresenius SE & Co. KGaA as well as the rules of procedures both for the Management Board of Fresenius Management SE as well as the Supervisory Board of Fresenius SE & Co. KGaA. The key sustainability issues are anchored in the company’s governance structure.

The rules of procedure for the Management Board issued by the Supervisory Board of Fresenius Management SE determine the details of the work of this body. In particular, they regulate which areas the members of the Management Board are responsible for, which matters are reserved for the Management Board as a whole, and which resolutions are to be passed by it.

Internal reporting and control processes are designed to cover the impacts, risks, and opportunities within the company. Details of the responsibilities of the Management Board and Supervisory Board are explained in the respective topical standards. Furthermore, other internal committees inform, support, or advise the Management Board and the Supervisory Board on decisions as described. Expert knowledge of the persons involved is ensured via defined recruiting criteria, job profiles and the following training and development based on the job requirements.

The Group Sustainability function acts as a center of expertise for all sustainability aspects within the Group. The function monitors regulatory developments, identifies material topics, and develops priorities and potential for implementing the ESG strategy. The Group function supports its Group-wide implementation and reviews progress as part of the annual reporting. Furthermore, there are repeated exchanges with all Group functions and the ESG officers of the operating companies during the course of the year in order to take into account the respective business models and discuss the feasibility of measures. In addition, the Group Sustainability function is responsible for internal and external stakeholder communication related to sustainability and, together with the Group Controlling function, for sustainability reporting.

The identification, assessment, monitoring, management and supervision of potential sustainability risks takes place both at Group level and in the business segments as part of the risk management system Sustainability risks are covered by the Group’s existing risk catalogs and risk reporting. In 2023, a Group-wide project to implement the requirements of the ESRS based on the Sustainability Reporting Directive (CSRD) also examined whether there are any further potential sustainability risks for material topics. Additional information on this can be found in section IRO-1 Our materiality analysis.

Fresenius Group Sustainability Organization

As part of risk management and the internal control cycle, material sustainability issues are subject to regular reviews, as described in the relevant sections of this Sustainability Statement. As part of risk reporting, the Management Board is informed on a quarterly basis about the key sustainability aspects if risks arise or incidents occur that could have a significant impact on the operating business, reputation, or value chain of the Group and its business segments. In 2024, for example, this concerned the shortage of personnel in the healthcare sector. The Audit Committee of the Supervisory Board is informed of developments every six months and the Supervisory Board as a body is informed bi-annually.

External partners, supervisory authorities and internal audit experts from Corporate Audit Group function or the responsible expert function carry out the audits – at least every two years or more frequently, e.g. certification audits. As explained in Fresenius’ Opportunities and Risk Report there were no significant deviations from the Group’s ethical standards in 2024. Information on audits can also be found in the respective topical standards of this report. The Group Management Report contains additional information on opportunities and risks as well as a detailed description of the risk management and internal control system.

The internal control system (ICS) is an important component of Fresenius’ risk management. It covers all critical processes, such as financial reporting, quality and patient safety management, cybersecurity, inventory, supply chain management, data protection, and sustainability management. Fresenius has documented the corresponding key control objectives in a Group-wide framework, thus bringing together the various management systems in the ICS in a holistic manner. Fresenius strives to ensure the security and reliability of its business processes through internal measures and their structured monitoring. Monitoring and evaluation by management also helps to ensure that process-inherent risks are identified and that controls are in place to minimize risks.

The operating companies carry out regular internal and external controls, analyses, and quality audits by the responsible specialist functions, topic-specific management systems, or external audit bodies. Such so-called reviews of key topics concern, e.g., a review of the application of quality management guidelines in a production area. These reviews are supplemented by the audit activities of the Corporate Audit Group function. Its activities are aimed at increasing and protecting the corporate value of the Group and improving Fresenius’ business activities. To this end, Corporate Audit conducts independent, objective audits to improve the appropriateness and effectiveness of risk management, control, and governance processes at all levels of the Group. Aspects such as sustainability, cybersecurity, and compliance are also taken into account in a risk-oriented manner.

The control and reporting structures defined within the Group form the basis for setting targets. Targets for the Group as a whole are presented to the Management Board and the Supervisory Board, e.g. by the respective Group function. Key sustainability targets have been defined as compensation-relevant targets for the compensation of the Management Board, as explained in section GOV-3 ESG targets in the compensation of the Management Board. Further explanations can be found in the respective topical standards. Targets for the operating companies are set by the respective management and, where relevant for the Group as a whole, communicated to the entire Management Board.

The organization and management of the Group and its business segments are structured in such a way that we can identify and analyze the impacts, risks, and opportunities in the often fragmented markets and align our actions accordingly. In order to tap into new potential, we exchange information with research groups and scientific institutions, for example. Details on this can be found in the company-specific standard Innovation. We also keep a close eye on our markets and the competition. Our business segments communicate on experiences internally, in order to identify and exploit additional opportunities and synergies. As part of our strategic and operational planning process, we identify and analyze short-, medium-, and long-term opportunities and risks and derive targets from them. As explained above, the Management Board’s rules of procedure specify whether a key topic is assigned to an individual Management Board member or to the entire Management Board.

The Supervisory Board discusses the company’s planning and objectives on an annual basis. The Audit Committee, as the appointed body, also deals with sustainability reporting. The Audit Committee already received reports on the preparatory work for the first-time reporting in accordance with the provisions of the EU CSRD guidelines at the meetings on October 16, 2024 and December 4, 2024. In particular, the legal framework for sustainability reporting for the 2024 fiscal year and the recording of KPIs and qualitative data points based on the applicable sustainability reporting standards (ESRS) were discussed.

The material sustainability aspects (see the section on our materiality analysis in this topical standard) are each covered by Group functions, as explained in the topical standards. In the case of the operating companies, the respective management and central segments perform these tasks. Clearly defined responsibilities within the Management Board, our internal governance structure, and processes for monitoring impacts, risks, and opportunities are designed to ensure that it is always informed about important business transactions, plans, developments, and measures within the business segments, as well as material sustainability aspects. These structures and processes are explained in more detail in the respective topical standards.

The members of the Supervisory Board are responsible for the training and development measures required to fulfill their duties. Training and further training measures are intended to build up new skills (training) and update and strengthen existing skills (further training). The members of the Supervisory Board regularly obtain information from internal and external sources on the current status of the requirements for their supervisory activities. The Supervisory Board ensures that its members are continuously qualified, that their specialist knowledge is updated and that their judgment and experience are further developed. Fresenius provides them with appropriate support in this regard. For example, experts from Fresenius’ specialist areas and external specialists provide ongoing information on relevant developments, e.g. on relevant changes in legislation and case law and on changes in accounting and auditing in accordance with IFRS. In the 2024 financial year, there was also extensive internal training on the topic of ESG with a focus on CSRD and sustainability strategy with the participation of speakers from the Fresenius Sustainability Advisory Board.

In 2024, Fresenius established an independent Sustainability Advisory Board for sustainability issues. Four experts from science, business and consulting support us in further developing our sustainability strategy and advise the Sustainability Board member. The Sustainability Advisory Board is designed to help advance the relevant topics programmatically within the Group. The expertise of the advisory council covers Fresenius’ main areas of activity in the field of sustainability: from the design and implementation of health-care policies and climate protection to corporate sustainability principles, future-oriented business practices, sustainable leadership, and the transformation towards greater sustainability.

Consideration of sustainability aspects in management [GOV-2] Information provided to and sustainability matters addressed by the undertaking’s administrative, management, and supervisory bodies

In the sustainability organization of the Fresenius, the ESG Steering Committee, founded in 2023, is responsible for defining the sustainability topics and aspects that the management and supervisory boards will address as a priority. The ESG Steering Committee is made up of the Sustainability Board member (Chair), the Group Sustainability function, defined functions at the corporate level, and the ESG officers from the operating companies. The committee has met at least quarterly since 2024 and is tasked with providing information on current developments, selecting suitable measures for improving ESG performance, and monitoring the progress of implementation. In the 2024 reporting year, the sole focus was on implementing the CSRD. To this end, the committee was expanded to include other Group functions. The CFO was also appointed to the committee as an additional member of the Executive Board. The measures proposed by the ESG Steering Committee are submitted by the Sustainability Board member on the Management Board for approval, if necessary.

In addition to the risk reporting, the Management Board and Supervisory Board are also informed, where applicable also their committees, about significant impacts and opportunities, the implementation of due diligence in the area of sustainability and the results and effectiveness of the policies, actions, metrics and targets adopted.

The Management Board and Supervisory Board take into account the impacts, risks, and opportunities when monitoring strategy, making decisions about important transactions and in the risk management process for Group-wide risk management. In dealing with risks and opportunities, we act exclusively within the applicable legal framework and our internal guidelines.

The Supervisory Board dealt in particular with the following items in 2024, among other topics:

• strategic alignment of the Fresenius Group and its business segments as part of the #FutureFresenius transformation process
• transformation of the Fresenius Group, including restructuring and divestment at Fresenius Vamed
• cybersecurity, and
• further development of the corporate governance management systems (compliance management system, risk management system, internal audit system, and internal control system).

In addition, the Supervisory Board was informed about projects to expand production capacities and the product portfolio. The ESG expert appointed by the Audit Committee provided information about the work of the external Sustainability Committee. The Management Board of the general partner also regularly informed the Supervisory Board about the risk situation, risk management, and compliance within the Group.

ESG targets in the compensation of the Management Board [GOV-3] Integration of sustainability-related performance in incentive schemes

Sustainability is a material component of our business strategy. That is why Fresenius has defined ESG targets for the Management Board as part of their compensation system. In doing so, we aim to align the interests of our employees and patients as well as climate and environmental issues with our ambitions. Initially, all material aspects were considered and then prioritized. Subsequently, we have defined our ESG targets in the following areas:

• Employees: Employee Engagement Index (EEI) (Fresenius Group)
• Medical quality: Audit & Inspection Score (Fresenius Kabi) Inpatient Quality Indicators (Fresenius Helios)
• Reduction of CO₂ emissions: Total Scope 1 and Scope 2 CO₂ emissions (market-based approach) in tons of CO₂ equivalents (Fresenius Group)

The targets reflect identified material sustainability aspects from the materiality analysis. Further, in selecting the specific ESG targets, the company took into account the requirements of investors and society, as well as the current market practice of most DAX companies. The ESG targets are relevant to Fresenius, ambitious, and transparently measurable. They are aligned with the business strategy and can be pursued in an integrated manner within the governance structure. The compensation system for the Executive Board and its components are approved by the Supervisory Board. The remuneration of the Supervisory Board does not foresee a variable component.

Within the framework of the short-term variable compensation (Short-Term Incentive – STI) with a measurement period of one year, the ESG objectives continue to be included with a weighting of 15%. The focus here is on the areas of medical quality and employees. Medical quality is measured for the two business segments on the basis of metrics, further information on which can be found in the topical standard S4 Consumers and end-users, section Health and safety.

In the area of employees, employee satisfaction is measured for the Group on the basis of the Employee Engagement Index (EEI). Further information on the EEI can be found in the topical standard S1 Own workforce.

In the long-term variable compensation of the Management Board (Long-Term Incentive – LTI), with a measurement period of four years, ESG criteria account for 25% of target achievement. ESG target achievement in the LTI is measured on the basis of CO₂e reduction. The target range is aligned with the long-term targets of Fresenius: By 2030, we plan to reduce our own direct Scope 1 and indirect Scope 2 emissions by a total of 50% compared to the base year 2020 and to achieve climate neutrality by 2040.

Emissions are calculated as CO₂ equivalents and Scope 2 emissions on a market basis. General information on our greenhouse gas emissions can be found in the topical standard E1 Climate change.

In the reporting year, not all ESG targets for the members of the Management Board were achieved. This would have required an achievement rate of at least 100% per target. A detailed presentation can be found annually in the Compensation Report. The ESG scoring methodology for determining ESG-target achievement is published on the website www.fresenius.com. The target achievement in 2024 was:

• Employee Engagement Index (EEI): 76.5%
• Audit & Inspection Score: 116.7% Inpatient Quality Indicators: 141.9%
• Total Scope 1 and Scope 2 CO₂ emissions (market-based approach) in tons of CO₂ equivalents: 250%

The indicators relevant for determining the annual target achievement in relation to the remuneration components for the Management Board, which are labeled by footnote, are audited with reasonable assurance, as stated on page 407 in the independent practitioner´s audit report in the Annual Report. The indicators are explained in more detail in the respective topical standards.

Declaration on due diligence [GOV-4] Statement on due diligence

The table below provides the required information on due diligence in this report.

Risk management and internal controls for sustainability reporting [GOV-5] Risk management and internal controls over sustainability reporting

Sustainability risks are assessed as described in section Governance in risk management; this includes risks related to the sustainability reporting process. No new risks were identified in relation to sustainability reporting in the reporting year.

Strategy and management

The business model and our value chain [SBM-1] Strategy, business model, and value chain

Fresenius is a globally active healthcare Group and one of the leading companies in its respective markets. The Group includes two independently operating, fully consolidated business segments (operating companies), which are managed by the operating holding company Fresenius SE & Co. KGaA: Fresenius Kabi specializes in products for the therapy and care of critically and chronically ill patients. Fresenius Helios is Europe’s leading private healthcare provider. The company includes Helios Germany and Helios Spain, which are the largest hospital operators in their respective home markets.

The segment Corporate / Other comprises the holding functions of Fresenius SE & Co. KGaA and Fresenius Digital Technology GmbH, which offers services in the field of information technology. The Group Management Report contains additional information on the business model and ownership structure of the Group, in particular on legal and economic factors as well as material sales markets and competitive positions.

The business activities of Fresenius are divided into the market segments of healthcare services (Fresenius Helios) and healthcare products (Fresenius Kabi). The healthcare services segment accounts for the majority of sales (around 60%). These are generated by treating patients in the healthcare facilities of Fresenius Helios. Healthcare products, such as the innovative solutions for critically and chronically ill patients provided by Fresenius Kabi, account for around 40% of our sales.

We report the number of our employees by geographic area in the topical standard S1 Own workforce.

Our sustainability goals and programs

Committed to Life, i.e. patient care, is the basis of our daily activities and our understanding of how we perceive sustainability in the context of our social responsibility. We want to make a difference in healthcare and thus bring about changes for the benefit of people, especially our patients.

Our sustainability ambition

At the level of Fresenius SE & Co. KGaA and its operating companies, we therefore pursue specific sustainability goals, define ambitions, and implement corresponding sustainability projects. Progress is regularly reviewed and evaluated. From this, we determine the extent to which the goals can be further developed and optimized. Further details on the already existing ambitions are explained in the topical standards E1, E3, S1 and S4. Reporting on our new ambitions will begin in 2025.

If not otherwise specified, our ESG ambitions encompass the consolidated entities, and our products and services of the Group.

Fresenius’ corporate strategy is closely linked to sustainability aspects. The focus is on people: our employees and our patients. At the same time, we care for our planet, whose resources we use to manufacture and provide health-promoting products and services. The individual topical standards elaborate on our corporate and sustainability strategy. Our ESG ambitions clearly define the material elements of our strategy, including the most important challenges. They are supported by numerous measures and projects, which we also explain in the respective topical standards.

Our value chain

Fresenius is active in more than 60 countries with subsidiaries, maintains an international sales network, and operates more than 50 production sites as well as more than 130 hospitals. In the Group, all purchasing processes are controlled by central coordination offices in the business segments. Teams of experts bundle demand, conclude framework agreements, and continuously monitor current market and price developments. They coordinate global procurement for individual production sites or healthcare facilities and organize quality and safety checks on the raw materials and procured goods.

In an environment characterized by ongoing cost containment efforts by payers in the healthcare system and price pressure in the sales markets, security of supply and quality of supply play an important role. We therefore continuously optimize our purchasing processes, standardize procurement materials, develop new purchasing sources, and negotiate the best possible prices. In doing so, it is important to maintain a high degree of flexibility while meeting our strict quality and safety standards. A broad supplier portfolio reduces possible procurement or raw material bottlenecks in both the product and service business.

In the downstream value chain, our activities focus on the distribution of pharmaceutical products and the care of patients and leads to different approaches to the management and control of business activities.

We differentiate between different value chains, since in the product area the focus is on the distribution of products downstream, while in the hospital area, health services are provided in our own facilities and are therefore part of the value of our own business.

The products of Fresenius Kabi are shipped from the production plants to central warehouses, wholesalers, or directly to hospitals or patients via homecare organizations. Fresenius Kabi maintains an international hub, e.g. in Friedberg, Germany, for a significant proportion of its range of products. We have our own sales organization with trained employees. However, we also use external distributors in countries where we do not have our own sales team.

Fresenius Kabi’s customer base is broad. It includes hospitals, wholesalers, purchasing organizations, and healthcare facilities including home care organizations, as well as research institutes. In the United States, Fresenius Kabi distributes its products through GPOs (Group Purchasing Organizations). Internationally, we participate in public tenders by government entities, which are particularly relevant for our products.

We offer after-sales services, training, technical support, servicing, and maintenance and warranty arrangements in every country in which we sell our products. Fresenius Kabi provides product training and the operation of regional service centers, which are responsible for day-to-day international service support.

For the information provided in topical standard S4 Consumers and end-users, section Health and safety, we focus primarily on patients as well as healthcare professionals, as they come into direct contact with our products, use them or are treated with them.

Procurement and related processes are key non-medical elements regarding the treatment of patients and proper operation of a hospital or other healthcare facilities at Fresenius Helios. These extend from warehousing to storing medication and supplies in the cabinets to ensure that the wards are equipped with their required materials. Fresenius Helios has own logistics centers. In addition, the segment’s own and third-party pharmacies deliver prescription drugs to our facilities. Customers or end-users include societal security institutions, health insurers, and patients.

Our business activities generate waste, such as packaging material, electronic devices, and medical supplies. This waste is always disposed of in accordance with local legislation.

Stakeholders and partnerships [SBM-2] Interests and views of stakeholders

Fresenius is integrated into a diverse network of interest groups. From this exchange, we gain valuable insights that help us to continuously improve the management of material topics and reporting. We present our most important stakeholders in the graphic below. The exchange with political institutions and external organizations takes place primarily in the areas of health and patient care.

Stakeholders & Partnerships

In addition to these stakeholder groups, other third parties, such as patients’ relatives, and professional groups that have a connection to our products and services, may also represent an important target group, depending on the circumstances. For better readability, this report therefore does not provide a full list of relevant stakeholder groups for individual topics and, where appropriate, uses third parties as a collective term.

Stakeholder dialog in all areas

We engage with our stakeholders through a variety of channels. The corporate functions at Fresenius primarily focus on stakeholders who are relevant to the Group as a whole. The business segments actively engage with patients, employees, customers, and regulatory authorities, among others. In particular, Fresenius SE & Co. KGaA is continuously in dialog with investors and analysts due to its stock market listing.

For the integration of affected stakeholders into our operating activities, we consider, for example:

• regular communication with authorities,
• an analysis of the questions from shareholders at the last Annual General Meeting,
• findings from existing due diligence processes and risk assessments in the area of quality,
• criteria of ESG ratings that are highly relevant to the capital market,
• insights from the informational needs of investors in collaboration with the communication functions in the Group and the operating companies,
• scientific reports, e.g. for environmental standards, or for exchange in internal specialist committees,
• internal employee satisfaction surveys,
• dialogs with employee representatives and works councils,
• patient and customer surveys.

In the reporting year 2024, the intensive exchange of ideas and experiences as part of the CSRD project has led to comprehensive new insights and improved knowledge transfer within the company. The impacts, risks and opportunities in the topical standards were discussed jointly with various Group functions and the resulting perspectives were taken into account, e.g. for newly established processes.

Another important element of our stakeholder dialogs is our active participation in industry and interest groups, as well as our exchange with business partners. Our employees contribute their expertise to national and international bodies, committees, and associations. In some cases, this is accompanied by industry agreements or commitments. Here, too, our involvement was expanded in the reporting year. The following initiatives and memberships are currently of particular strategic importance for the business segments:

• AMRIA – Anti-microbial Resistance Industry Alliance – Member: Fresenius Kabi
• BAH – German Medicines Manufacturers’ Association – Member: Fresenius SE & Co. KGaA
• BVMed – Business Association of the Medical Technology Industry – Member: Fresenius SE & Co. KGaA, represented on the board by Fresenius Kabi; voluntary commitment to comply with the Code of Conduct
• DAI – Deutsches Aktieninstitut – Member: Fresenius SE & Co. KGaA
• DIN – German Institute for Standardization – Member: Fresenius Kabi
• DIRK – German Investor Relations Association – Member: Fresenius SE & Co. KGaA
• econsense – Forum for Sustainable Development of German Business e.V. – Member: Fresenius SE & Co. KGaA
• ENHA – The European Nutrition for Health Alliance – Member: Fresenius Kabi
• IQM – Initiative Qualitätsmedizin – Founding and board member: Fresenius Helios Germany; active management of expert committees; voluntary commitment to quality principles
• Medicines for Europe – Member: Fresenius Kabi; Commitment to the Code of Conduct
• MedTech Europe – Member: Fresenius SE & Co. KGaA; voluntary commitment to comply with the Code of Conduct
• Pro Generika – Member: Fresenius Kabi
• VCI – German Chemical Industry Association – Member: Fresenius SE & Co. KGaA
• UN Global Compact – Member: Fresenius SE & Co. KGaA (since October 2024)

We are committed to observing the codes and principles associated with our membership in various associations. In addition, we disclose all contributions made to healthcare professionals in the companies of Fresenius in accordance with the applicable disclosure requirements.

Stakeholder engagement is organized on a topic- and area-specific basis. Responsibility lies with the Group functions and the specialist functions of the business segments. For stakeholders whose engagement is prescribed by regulation, as in the area of drug approval, for example, the affected specialist functions must ensure that appropriate internal guidelines and controls are established. Further information is provided in the topical standard S4 Consumers and end-users, section Health and safety.

The exchange in expert committees and the direct interaction with stakeholders is target-group-specific and needs-based. This is to ensure that the insights gained from discussions or other communication formats serve to improve reporting as well as external and internal communication. At the same time, we want to maintain the already good reputation of our company and its business segments. Further information can be found in the topical standard G1 Business conduct, section Political influence and lobbying activities.

Depending on their materiality, the results of the exchange with stakeholders can either be incorporated into existing communication and reporting formats or transferred into the strategic design of operational topics. This is done voluntarily. Mandatory adjustments result, for example, from external inspections or audits, which are explained in the topical standard S4 Consumers and end-users, section Health and safety.

The inclusion of the interests and viewpoints of the most important stakeholders is based on existing guidelines and controls as well as established information channels, e.g. patient surveys. Further information on whistleblower systems can be found in the topical standard G1 Business conduct. Explanations of patient surveys can be found in section Engaging with patients.

If the positions and interests of affected stakeholders represent material positive or negative impacts, risks, or opportunities, these are documented in the internal process and control structure and communicated to the Management Board and the Supervisory Board in accordance with the prescribed reporting processes. Examples include regulatory and health policy trends or geopolitical changes. Fresenius comments on these at least once a year in its external reporting. Additional information can be found in the Group Management Report and in the Report of the Supervisory Board.

Impact, risk, and opportunity management

Our materiality analysis [IRO-1] Description of the process to identify and assess material impacts, risks, and opportunities

Our materiality analysis is based on the principle of double materiality and complies with the requirements of the ESRS. The aim is to identify the material impacts, risks, and opportunities (IROs) that arise in our own business and along our value chain. The sustainability aspects that are relevant for us and our stakeholders and the corresponding report content arise from this.

In line with the principle of double materiality, we have considered sustainability from two different perspectives:

• Impact materiality: includes all potential and actual positive and negative impacts of Fresenius’ operations on our stakeholders, including social and environmental impacts
• Financial materiality: includes all financial risks and opportunities that could affect Fresenius’ future profitability due to sustainability aspects. This encompasses the financial performance, results of operations, cash flows, access to finance or cost of capital of Fresenius

Double Materiality Analysis

A sustainability aspect fulfills the double materiality criterion if it is material from either or both perspectives.

The identification of the material sustainability aspects for Fresenius, according to the double materiality procedure, was carried out in a multi-stage process and is the responsibility of the Group Sustainability function. We used the recommendations of the EFRAG Implementation Guidance and adapted them to the specific circumstances of Fresenius, except for one aspect, because the company considered the severity and relevance of material impacts each on a four-level scale.

Process of double materiality analysis in accordance with CSRD

In the first step, we selected potentially relevant topics based on the sustainability topics defined in ESRS 1 in the categories of environment, social, and governance. In addition, we also considered Fresenius-specific topics as well as topics specific to our competitors in accordance with ESRS 1 AR 16.

We derived the Fresenius-specific topics from our previous sustainability reporting in the context of our non-financial Group reports and included the new regulatory requirements in order to establish reporting continuity in the material topics. These include the provisions of applicable SASB standards (Sustainability Accounting Standard Board) or the requirements through Carbon Disclosure Project (CDP).

We then defined the relevant stakeholders and users of sustainability information for the identified topics. In order to cover as many topics as possible, we examined whether internal representatives, rather than external stakeholders (according to ESRS 1 AR 8), are better suited to bundle external stakeholder expectations and evaluate them for the analysis. We therefore selected experts with in-depth knowledge of both our own business area and the upstream an downstream value chain, who regularly interact with respective stakeholders as part of their jobs. We used a stakeholder matrix to take into account the perspectives and interests of the relevant stakeholders; external stakeholders or affected communities were not directly involved. We conducted consultations and involved various areas of the company in the assessment through stakeholder mapping. No further consultations took place.

In a series of workshops, we identified and assessed the negative and positive impacts of our business activities on the environment and society, as well as the financial risks and opportunities for the relevant sustainability aspects. In doing so, we took into account both Fresenius’ direct material IROs and those arising from direct and indirect business relationships in our upstream and / or downstream value chain. The workshops were held at both the Group and business segment level. Subsequently, the Group Sustainability function aggregated and evaluated the results to ensure that the interests of the affected stakeholders were sufficiently considered in the identification, assessment, and evaluation of the IROs.

In order to assess material impacts, we first determined their severity level in accordance with regulatory requirements. To do this, we considered the following three dimensions (according to ESRS 1 section 45) and weighted them with a factor depending on their severity and relevance each on a four-level scale:

• Extent: measures how severe the negative or positive impact is
• Scope: indicates how widespread the impact is
• Irreversibility: records the extent to which negative impacts can be mitigated and the effort involved in doing so

We assess the severity of adverse impacts on the basis of all three dimensions. Positive impacts are only assessed on the basis of extent and scope, since no remediation is required and therefore irreversibility is not relevant for the assessment.

Furthermore, we have determined where the impacts occur in our value chain and distinguished between potential and actual impacts. Actual impacts are those that have already occurred or have not been remedied by missing or ineffective corrective measures. Potential impacts may possibly or conceivably occur in the short-, medium-, or long-term in the future, whereby the probability of occurrence within a 10-year period is also assessed. A severe impact such as a human rights violation, is considered material for Fresenius, irrespective of the probability of occurrence.

To assess the materiality of an impact, the factors of severity in the form of extent, scope, and irreversibility are summed and then multiplied by a factor for probability of occurrence in the case of potential impacts. The result is a materiality score. If the result exceeds a defined threshold, an impact is considered material and is included in the report. The threshold value was set at half the maximum value. The criteria were applied in accordance with ESRS 1 section 3.4 Materiality of Impacts.

In identifying, assessing, prioritizing, and monitoring the potential and actual impacts of Fresenius on people and the environment, we have taken into account our business model and geographical circumstances. Assumptions were included as follows in the aspects:

• The Group function Risk & Integrity is responsible for risk management and the internal control system. It supports the Management Board in designing and maintaining appropriate and effective internal control and risk management activities by coordinating, monitoring and reporting on these processes. Findings from this functional monitoring of the risk management and internal control system are addressed by appropriate measures. As part of the materiality analysis, relevant criteria were used for Fresenius to assess materiality, including location, business activity and sector affiliation. In addition to the potential and actual impacts, risks and opportunities were also considered. The results are explained in the topical standards. The criteria for assessing impacts, risks or opportunities were always identical. With regard to compliance and corporate policy, for example, we additionally used the criteria from our compliance management system, which we describe in the topical standard G1 Corporate Governance, section Risk management.
• Our materiality analysis focused on manufacturing operations, as these are most likely to cause environmental pollution. In addition, applicable European laws were considered and used to assess the impact.
• We used a prior water stress analysis to identify areas where water is essential for our business activities. In addition, process experts evaluated the respective activities and products of Fresenius and their potential impact on marine resources.
• With regard to resource utilization and the circular economy, process experts from the respective business segments have evaluated the relevant resources. In addition to our own operational activities, the greatest resource utilization at Fresenius is associated with the upstream value chain.
• The consideration of the upstream and downstream value chain was only possible to a limited extent, as not all of our suppliers’ and partners’ production sites are fully known to us. Therefore, we have made assumptions about the severity and, where necessary, the likelihood of occurrence. In addition, applicable European laws were used to estimate the impact.

We have also taken into account impacts in which we as a Group are involved through our own business activities or our business relationships, and of which we are aware through continuous dialog and exchange formats.

As part of the financial materiality analysis, we have analyzed sustainability aspects in terms of their potential to positively or negatively influence the company’s value and financial development. These risks and opportunities can affect the financial performance, results of operations, cash flows, access to finance, or cost of capital of Fresenius. When assessing the extent of the financial effects, a gross analysis is used, i.e. we evaluate the negative financial effects independently of existing risk mitigation measures. This prevents us from classifying material sustainability aspects that are already successfully mitigated as non-material.

To determine whether risks and opportunities related to a topic are material for Fresenius, we first considered the magnitude of the financial effects. In this context, risks and opportunities can arise from our dependence on economic, natural, and social resources. As a company, Fresenius relies on these resources being available at reasonable prices and in sufficient quality.

We divide the triggers for financial effects into two categories:

• They may affect Fresenius’ ability to continue to use and obtain the resources necessary in its business process, as well as the quality and pricing of these resources.
• They may affect Fresenius’ ability to continue to rely on the relationships needed for its business process under acceptable conditions.

To assess the extent of the financial impact, we have defined ranges for both the Group as a whole and the business segments that reflect the risks and opportunities in monetary terms, and we have given each a weighting factor. In doing so, we used the scales and thresholds from Fresenius’ risk management. This is to ensure that the findings of the double materiality analysis can be integrated into the Group risk management and associated management processes. Additional information is provided in the Group Management Report.

In the following, we have assessed the probability of financial risks and opportunities occurring. In contrast to the extent of the financial effects, we took into account existing risk mitigation measures that influence the probability of occurrence (net view). In addition, we determined the stages in our value chain at which risks and opportunities arise.

To assess the financial materiality of an issue, the factor for the extent is multiplied by the factor for the probability of occurrence. If this materiality value exceeds a defined threshold, an issue is considered material and is included in the reporting.

We considered the identification, assessment, prioritization, and monitoring of risks and opportunities that have or may have financial effects on the basis of the following aspects:

• in which context the effects and dependencies on our operating business, our markets, or the overarching risk criteria according to our risk management stand,
• how we assess the probability, extent, and nature of the impacts, and
• how sustainability risks relate to other risks, whether they are mutually dependent, whether they should be considered separately, or whether they occur upstream or downstream.

If an IRO is material for at least one business segment, the corresponding sustainability aspect is considered material for the Group. If an aspect is material for several business segments, we use the highest materiality score for the Group.

After the initial assessment of the materiality of the sustainability aspects, a further validation was carried out by overarching Group functions, which discussed the results and possible need for adjustment in workshops. Group Sustainability then decided on any adjustments. The results were then validated at business segment level, and the material topics for reporting were selected and disclosed within this report.

We conducted our last comprehensive materiality analysis according to GRI in the 2020 reporting year. Reviews were carried out in the following years. The issues that are relevant for understanding the business performance, results, and position of Fresenius as well as the impacts of our own business activities on non-financial aspects were classified as material.

In 2023, a new materiality analysis was carried out for the first time according to the principle of double materiality in order to identify the material sustainability aspects for Fresenius.

In 2024, the assessment was updated based on new developments by the Group Sustainability function, in close cooperation with the Group functions involved and the business segments within the project structure established for the implementation of CSRD in Group reporting.

For the environmental topical standards, for the topical standard S2 Workers in the value chain, and for the topical standard S4 Consumers and end-users and the company-specific topics, we conducted a supplementary, more in-depth analysis later. The reason for this is the ongoing transformation of the company, which entails strategic and thus operational changes. The aim of the in-depth analysis was to compare the results of the materiality analysis with the corporate strategy and to map changes in the upstream and downstream value chain. Based on this analysis, impacts, risks, and opportunities were partially re-evaluated. For example, we found that the topics of health and safety and access to products are material in the topical standard S4 Consumers and end-users. They are an integral part of our operating business and the corporate strategy. Therefore, we present the required information in relation to the responsible Group or central functions as well as strategic KPI. Additional topics required in the topical standard were added based on their materiality.

Risk management was fully involved in the entire materiality process, including the subsequent evaluation in 2024.

All Group functions with responsibility for material topics were also asked about opportunities, the future strategy, current developments, and stakeholder expectations in the 2024 review. These findings have not changed the prioritization of topics, but have contributed to the addition of existing information in this report. In addition, we have informed the employee representatives in accordance with CSRD 2022 / 2464 section 19a (5) and the draft of the CSRD Implementation Act about the analysis and the preliminary results.

For 2025, we plan an update of the double materiality analysis.

Climate-related scenario analysis [E1 IRO-1] Description of the processes to identify and assess material climate-related impacts, risks, and opportunities

As part of the double materiality analysis, we analyzed our own operations as well as the upstream and downstream value chain for potential and actual impacts on climate change. Our greenhouse gas accounting, which is based on the internationally recognized Greenhouse Gas (GHG) Protocol methodology, forms the basis for assessing our impact on climate change. In doing so, we consider our direct and indirect emissions (Scope 1 and 2) as well as indirect emissions in our upstream and downstream value chains (Scope 3). Our actual GHG emission sources are reported in topical standard E1 Climate change, section E1-6 GHG emissions. Based on our current operating model, alternative future GHG emission sources are not likely to occur as we plan to continue operating in the healthcare sector. The assessment of our actual and potential impact on climate change has been conducted in our materiality assessment.

We consider climate risks in our risk management system. In the 2024 reporting year, we adjusted the climate risk analysis to meet regulatory requirements. For climate risks, we have reevaluated the time horizons, scenarios, risk classification and level of assessment. This enables us to better identify and assess physical risks as a result of climate change, transitional risks resulting from the transition to a low-carbon economy, and opportunities in our own business and along our value chain. The climate scenario analysis was conducted by Group Sustainability in collaboration with the internal Insurance department and Risk Management. In doing so, the functions followed the recommendations and risk catalogue of the Task Force on Climate-related Financial Disclosures (TCFD).

As part of the analysis, we looked at our production sites and hospitals based on their geocoordinates and, with the help of an external tool, considered the acute and chronic physical climate risks over different time horizons and with regard to different scenarios. Hereby climate related hazards were identified for our assets varying by horizon, scenario and location. The identified hazards include temperature-related, wind-related and water-related acute and chronic climate hazards. The likelihood and magnitude were analyzed by the external tool, the duration was selected per hazard.

We have analyzed material locations for business activities in terms of the probability of a climate risk occurring in the following different scenarios of the Intergovernmental Panel on Climate Change (IPCC) (see IPCC AR6 Report (2021)):

• SSP1-2.6: The optimistic social development path expects a limitation of global warming to 1.8°C by 2100 (best-case scenario).
• SSP2-4.5: With the business-as-usual scenario, a 2.7°C limit is expected by 2100.
• SSP5-8.5: In the worst-case scenario, a temperature increase of 4.4°C by the end of the century is to be expected.

By considering these three IPCC scenarios, we have fully covered the extremes in our analysis. This allows us to minimize uncertainties if the same results are achieved despite different assumptions.

Depending on the respective scenario, we have considered different drivers: developments that affect regulation, the energy industry, society, technology, and innovation, as well as climate-related investments. The drivers were selected based on their business relevance, the availability of information and the aspiration to ensure a multifaceted view.

In addition to considering the IPCC scenarios, we have identified adverse financial effects for our Group in connection with physical climate risks. We have considered short-, medium-, and long-term time horizons and tested the results in accordance with the approaches of the internal risk management system. The time horizons chosen are aligned with those used for reporting our key financial figures:

• Short (1-3 years): includes the current budget period
• Medium (2030): includes the projected budget period of 4 to 10 years and includes our climate target for 2030
• Long (2050): includes the planning horizon for our climate targets up to 2040 and 2050 and the weighted average lifetime of buildings (20 years), machinery and equipment (13 years), and customer relationships (18 years)

We have evaluated the financial risks to our business capabilities based on the scope, duration, and extent of the climate risks. Due to the large number of suppliers and the limited overview of their production sites, we modeled and analyzed the relevant regions with the help of our Scope 3 data. Since our suppliers are located in similar regions as Fresenius, i.e. our locations, they were evaluated equally according to regional allocation. If the risk was high to extreme and there was a business interruption that exceeded the threshold of our risk management system, this location was evaluated. We analyzed the material locations in terms of their resilience, taking into account existing or planned adaptation and mitigation measures.

Our own business activities are affected by the risk of transition through higher pricing of greenhouse gas emissions. The sites that are currently covered by an emissions trading system were considered for the assessment. The future availability and pricing of the certificates were estimated. The risk was evaluated on the basis of the Net Zero Emissions by 2050 Scenario (NZE) of the International Energy Agency (IEA). According to the IEA, the NZE is the only scenario that will limit global warming to 1.5°C by 2050. The analysis is based on a long-term time horizon up to 2050 and a medium-term horizon up to 2030.

We have not identified any of the Group’s business activities as being inconsistent with the transition to a carbon-neutral economy. However, investments are needed to contribute to this transition.

In the financial report, no climate-related assumptions are made regarding the valuation of assets in the consolidated financial statements.

Resilience analysis

In conjunction with the scenario analysis, the resilience analysis is an important tool that we use to analyze how resilient our strategy and business model are in terms of physical and transition climate risks. In 2024, we evaluated our production sites and hospitals in this regard in various scenarios and time horizons as part of the climate-related scenario analysis as described above. Our upstream and downstream value chain was considered using an aggregated view. A detailed assessment of our value chain was not possible due to the multiplicity of suppliers and the required exact location. For a pre-screening we used the EEIO-data from our Scope 3 assessment where raw material sourcing per region is indicated. We and our suppliers are present in similar regions, concluding that comparable physical climate risk may impact our supply chain. The resilience analysis was limited to our own operations and not conducted for the up- and downstream value chain due to the limited available information on location and adapting and mitigating measures in place.

Resilience Analysis¹

With regard to the transition to a low-carbon, resilient economy, Fresenius has included the following critical assumptions in the analysis:

• Energy efficiency: Increasing energy efficiency and reducing energy consumption supports the objectives of Fresenius. Targeted measures can lead to energy and cost savings.
• Renewable energies: The significant increase in renewable energies supports the goals of the Group and enables the availability of these energy sources through corresponding investments, the expansion of the energy grid, and the decarbonization of the supply chain.
• Economic growth: The transition to a low-carbon and resilient economy is leading to a transformation of workplaces, for example through digitalization. This is accompanied by changing demands on our employees.
• Technologies: From a business perspective, the development of climate-friendly and scalable technologies is essential to enable the electrification and use of renewable energies, for example through long-term energy storage.

In addition, we have considered existing or planned adaptation and mitigation measures when assessing physical and transitional climate risks. We describe these climate protection measures as part of our transition plan in the topical standard E1 Climate change.

The resilience analysis is based on a scenario analysis, which is inherently subject to uncertainty and does not represent a forecast. The analysis is based on models of past climate data, which is why no acute risks, no new risks or developments caused by climate change and their dependencies can be fully included and evaluated. Mathematical assumptions were made behind each model to describe possible scenarios. We want to continuously evaluate and optimize data quality in risk assessment, as well as the evaluation and effectiveness of measures.

Based on the results of the analyses carried out, we have determined that our locations and supply chains are subject to physical climate risks (mainly heat stress, water stress, flooding), but that these do not currently require us to adapt our business model. We take strategic decisions related to environmental issues, taking economic aspects into account. We consider climate risks as a sub-aspect. Part of our operational units already implemented measures to adapt to climate change, others are planning to take appropriate short-, medium-, and long-term measures, such as installing flood protection, reducing water consumption in water-stressed areas, or having emergency plans for earthquakes. In this way, our business model can become even more resilient through climate protection measures – however, due to the unpredictability of all climatic changes, we cannot fully protect ourselves from physical climate risks. We make investments to make production facilities and healthcare facilities more modern, efficient, and climate-friendly. We are constantly reviewing the extent to which changes to our product and service portfolios are necessary.

Sustainability is a material and integral part of our corporate strategy. To pursue this in a focused way, we analyze risk-bearing assets and evaluate investment decisions for climate protection measures based on their effectiveness in achieving our goals.

Report contents [IRO-2] Disclosure requirements in ESRS covered by the undertaking’s Sustainability Statement

The table in the section Downloads at the end of this standard shows all data points in accordance with ESRS 2 Annex B that arise from other EU legislation and where they can be found in this Sustainability Report. Non-material data points are marked accordingly.

We did not apply any thresholds when determining the material information to be disclosed in connection with the impacts, risks, and opportunities assessed as material, but instead performed a qualitative mapping. In doing so, we considered the criteria listed in paragraph 3.2 of ESRS 1.

The disclosure requirements we have reported in accordance with the ESRS as well as the reported data points from other EU legal acts in accordance with IRO-2.56 can be found in the following section for download.

Our impacts, risks, and opportunities [SBM-3] Material impacts, risks, and opportunities and their interaction with strategy and business model

The material impacts, risks, and opportunities (IROs) identified in the materiality analysis are described in the respective topical standards.

The identified IROs are related to our business model and have an impact on both people and the environment. In our own operations, the IROs arise, on the one hand, from the production processes and the associated upstream procurement processes. On the other hand, they affect consumers and end-users of our products or services, in particular patients that we treat in our own clinics or who use our products outside of our healthcare facilities. We also see effects on our workforce and those in the value chain. For this reason, we are also integrating the identified impacts, risks and opportunities into our business model and our Group strategy. Further information can be found in the respective topical standards.

Our business model and Group strategy are characterized by the necessity for sustainable action. In addition to the actual impacts, such as the change in job profiles due to the increasing use of digital solutions or applications, we see demographic change, the associated change in disease patterns and the future demands in healthcare markets as significant effects that could influence our future business activities as well as our value chain. Information is provided in topical standard S1 Own workforce, section S1-1 Our approach. We also report on our approach regarding Health and safety in topical standard S4 Consumers and end-users. For example, rising costs, increasing regulatory requirements, and innovative treatment options present new challenges and opportunities that we take into account in our strategic development, e.g. in innovations or digitalization.

During the reporting year, there were no further events in connection with the identified impacts, risks and opportunities that led to material financial effects. No material adjustments to the assets and liabilities recognized in the associated financial statements are expected in the next reporting year either. The Group Management Report contains additional information on opportunities and risks as well as a detailed description of the risk management and internal control system.

Only by firmly integrating sustainability into our business strategy can we remain competitive and resilient in the long term while continuing to provide high-quality healthcare. The measures we take to address the identified IROs in the respective topical standards or company-specific standards, and how we design each approach, are explained in detail in the topic-specific sections of the environmental, social, and governance standards. You will also find details of our resilience analysis in this standard in the section Impact, risk, and opportunity management. The periods we use are aligned with those used for the disclosure of our key financial figures.

The responsible entities must not only identify possible risks, but also design internal processes in such a way that business operations can be resumed quickly after an incident or, in the best case, are not disrupted at all.

At the Group level, the Corporate Business Continuity function assumes global responsibility for security, crisis management, and travel security. As our Group operates internationally and is confronted with a number of security-related issues, the managers in charge deal with questions regarding the maintenance or resumption of business operations in or after crisis situations. If necessary, they also provide operational support. Further information on business continuity is provided in the respective standards, where required, e.g. in topical standard S4 Consumers and end-users, section Access to products and services, S4-1 Our approach, see Patient support in crisis and emergency situations.

The IROs are assigned to the topic-specific ESRS and the sub-topics listed in ESRS 1 and are covered by the ESRS disclosure requirements. In addition, we have identified company-specific topics (cybersecurity, digital transformation, innovation), which we report on in accordance with the minimum disclosure requirements.

Information in accordance on HGB ESRS 1.114

This Sustainability Report was prepared in accordance with ESRS and also meets the regulatory requirements for a separate Group Non-financial Report in accordance with Sections 315b to 315c of the German Commercial Code (HGB). For the preparation of the Sustainability Statement, we considered the ESRS (European Sustainability Reporting Standards) as possible frameworks. Due to our global business activities and the expected implementation of the European Corporate Sustainability Reporting Directive (CSRD) into national law, we decided to use the ESRS for the first time as a framework within the meaning of Section 315c HGB in conjunction with Section 289d HGB and to apply these in full. This leads to a change in the consistency principle of sustainability reporting in order to transfer the new regulation into the reporting processes before implementation in national law and to create transparency and comparability with the reports of other companies. The report is published annually. The last separate Group Non-financial Report was published in March 2024.

In accordance with Section 315c HGB in conjunction with Section 289c HGB, the reporting company must comment on legally defined sustainability aspects. The following presentation of the requirements according to the HGB with parallel application of the ESRS is intended to facilitate the understanding of the reconciliation.

The criterion of materiality is of particular importance in sustainability reporting under the ESRS, as not all aspects of sustainability are to be included in sustainability reporting. To this end, companies must carry out a materiality analysis. Both the material impacts of the company’s activities on people and the environment (materiality of impacts) and the material impacts of sustainability aspects on the company (financial materiality), i.e. how, for example, climate change affects (or may affect) the company’s development, performance, and position, must be reported. This is known as the principle of double materiality. You can find more information on this within this standard in section IRO-1 Our materiality analysis.

The materiality analysis following the ESRS requirements is used for ensuring that the sustainability report contains the relevant information for a non-financial Group statement that is necessary for an understanding of the course of business, the business results, the situation of Fresenius and the effects of its activities. Accordingly, it can be assumed that a topic that is immaterial under ESRS is also not reportable under Section 289c (3) HGB.

A description of the business model can be found within this standard in section SBM-1 The business model and our value chain.

Environmental matters in accordance with Section 315c HGB in conjunction with 289c (2) No. 1 HGB are reported by Fresenius applying the ESRS topical standards E1, E2, E3, and E5. They relate, among other things, to greenhouse gas emissions, air pollution, water consumption, and resource consumption.

Employee matters pursuant to Section 315c HGB in conjunction with Section 289c (2) No. 2 HGB are reported by the Fresenius Group applying the ESRS topical standards S1 and S2. This includes information on management concepts and measures taken to ensure gender equality, working conditions, implementation of the fundamental conventions of the International Labour Organization, respect for the rights of employees to be informed and consulted, social dialog, respect for trade union rights, health protection, and safety in the workplace. In thematic topical standard S2, we also address employee concerns in the value chain.

The topic standards S1, S2, and S4 also cover social matters in accordance with Section 315c HGB in conjunction with the Section 289c (2) No. 3 HGB, e.g. dialog formats, whistleblower systems, and the protection of patients.

Respect for human rights in accordance with Section 315c HGB in conjunction with Section 289c (2) No. 4 HGB is part of topical standard S2, whereby further explanations in other topical standards refer to this standard accordingly.

The fight against corruption and bribery in accordance with Section 315c HGB in conjunction with Section 289c (2) No. 5 HGB is part of the explanations in topical standard G1. Here, for example, we explain the existing instruments for combating corruption and bribery.

The matters to be reported in accordance with the HGB are fully covered through the disclosure requirements in accordance with the ESRS topical standards. The topical standards also include references to the amounts reported in the Group financial statements and additional explanatory notes on key actions related to sustainability matters, if necessary.

In the reporting period, no material non-financial risks were identified and reported in accordance with Sections 315c HGB in conjunction with Section 289c (3) No. 3 and 4 HGB taking into account mitigating risk management measures (net view), that are linked to our business activities, business relationships, products or services and that are very likely to have or will have a severe negative impact on the aforementioned non-financial aspects or our business activities. The Group Management Report contains additional information on opportunities and risks as well as a detailed description of the risk management and internal control system.

The most significant non-financial performance indicators (remuneration-related indicators) that are relevant to business activities are:

• Total Scope 1 and Scope 2 CO₂ emissions (market-based approach) in tons of CO₂ equivalents (Fresenius Group)
• Employee Engagement Index (EEI) (Fresenius Group)
• Medical Quality: Audit & Inspection Score (Fresenius Kabi) Inpatient Quality Indicators (Fresenius Helios)

The explanations can be found in the respective topical standards. Additional information can be found in the Outlook section of the Group Management Report.

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