ESRS E5 Resource use and circular economy [E5] Resource use and circular economy

Impacts, risks, and opportunities [E5 SBM-3] Material impacts, risks, and opportunities and their interaction with strategy and business model

Impacts, risks, and opportunities

Within the scope of the materiality analysis, Fresenius has identified the following material impacts related to Circular economy:

Approach [E5-1] Policies related to resource use and circular economy

Environmental Policy

At Group level, there is a central Environmental Policy that also addresses the use of resources and the circular economy. In this policy, Fresenius commits to the efficient use of resources and the use of sustainably sourced, renewable, or recycled materials as an alternative to new raw materials, where legal regulations permit. Fresenius supports the transition to a circular economy. The company strives to maximize the lifespan of materials, reduce the amount of waste generated, and increase the proportion of recyclable materials in the waste streams. The waste hierarchy (prevention, preparation for reuse, recycling, energy recovery, disposal) and waste separation concepts form an integral part of the waste management processes.

Further information on the Environmental Policy can be found in topical standard E1 Climate change, section E1-2 Approach. Information on responsibilities and requirements for the Management Board as well as the Supervisory Board are explained in standard ESRS 2 General disclosures, section GOV-1 Sustainability organization.

Further concepts related to resource use and circular economy

The handling of waste in the health sector is strictly regulated. All locations are subject to their respective local regulations and laws. In addition, internal requirements for waste management are included in the environmental standard operating procedures.

As a healthcare Group, professional, safe waste disposal goes hand in hand with the requirements of hygiene and sterility in production processes and treatments in hospitals. The approach extends from the selection of suitable disposal containers to cleaning and sterilization procedures and the occupational safety of employees in the professional disposal of hazardous, e.g., infectious, waste. The waste must not pose a danger to patients or the environment, either.

As the business models of the Operating Companies differ, Fresenius conducts waste management on a decentralized basis. Responsibility for that lies with the management of the sites, local EHS (Environment, Health, and Safety) managers, waste managers, or waste officers. Risks are assessed individually and, where necessary, internal guidelines for dealing with waste are established.

At Fresenius Helios in Spain for example, waste management is carried out in accordance with a procedure that applies to all Spanish hospitals. This procedure outlines the methods for identifying, classifying, separating, and storing waste. The procedure is documented and has been published internally. It was last updated during the reporting year.

The responsible persons provide training to their employees and carry out checks to ensure that the standards contained in the guidelines are adhered to. In the hospitals, the right handling of waste is trained during introduction of new employees. Where necessary, local training courses on waste management are conducted. The waste management systems of Fresenius are part of internal and external audits.

Fresenius Kabi is developing an internal framework that defines the minimum requirements for calculating Product Carbon Footprints (PCF) and conducting Life Cycle Assessments (LCA), aligned with global standards. The framework includes a cradle-to-gate approach, addressing environmental impacts such as greenhouse gas emissions – from raw material extraction (cradle) to the point where the product leaves the factory (gate). Initial assessments on selected products and packaging systems have already been carried out.

In the following, the systematic waste management at Fresenius is described. It aims at an efficient use of resources and at minimizing the impact of waste management on people and the environment.

Further information on the comprehensive environmental management and responsibilities can be found in topical standard E1 Climate change, section E1-2 Approach.

Waste disposal

Responsibility for the disposal of waste in accordance with the applicable local regulations lies with local organizations and healthcare facilities. All sites are required to separate their waste according to local, national, and industry-specific regulations and to store the waste under consideration of measures to protect the environment. Non-recyclable waste is disposed of by incineration or is sent to landfill.

Fresenius Kabi records waste volumes generated at the production sites, logistics centers, compounding centers, and the other ISO 14001-certified organizations and categorizes them by waste type and disposal method. Waste is mainly generated as a by-product of production processes or in the downstream value chain as packaging material of the product containers in hospitals, private households, or nursing homes. This includes both non-hazardous and hazardous waste, i.e., solvents, cytostatics, or antibiotics.

Plastic waste represents the largest portion of classified non-hazardous waste in production. Hazardous waste is, to a large extent, processed and reused. Non-recyclable hazardous waste is disposed of in accordance with legal requirements.

At Fresenius Helios, no special requirements are placed on the collection and disposal of non-hazardous hospital-specific waste from an infection prevention perspective. Together with wound and plaster dressings, underwear, disposable clothing, and diapers, for example, they make up the largest proportion of the total waste generated in the healthcare facilities. Potential hazardous waste such as infectious items or cytotoxic and cytostatic waste is specially disposed of by professionals.

Fresenius Helios in Germany reworked the uniform color and container scheme for waste disposal in 2024, to make it more intuitive. This scheme has been gradually introduced at all clinics. It is designed to prevent incorrect waste disposal, which in turn could lead to higher costs and GHG emissions. An awareness campaign for employees was launched in fall 2025.

Disposal routes were not fully recorded in the reporting year and therefore will not be disclosed.

Waste reduction and recycling

If the design of a product is under the control of an ISO 14001-certified entity, as part of the life cycle perspective, the design phase must take environmental aspects into account, for instance, recycled components or packaging. The influence on pharmaceutical products can be limited due to the importance of patient safety and product quality requirements. Fresenius Kabi tries to reduce the environmental impact of its products, e.g., by reducing the amount of plastic in containers, while at the same time ensuring the quality of the products.

There are also various projects in the hospitals of Fresenius to reduce resource use in the form of medical instruments, devices, and packaging, as well as to improve the reduction, recycling, avoidance, and reuse of waste. Where possible, medical instruments and supplies are cleaned, sterilized, and repackaged for reuse, except single-use products as established by law.

An initiative by employees of Helios Germany to reduce packaging waste in hip and knee surgeries was also implemented at the German hospitals. For this purpose, the supplier hygienically assembles the essential surgical consumables into a standardized package – instead of packaging the items individually. This saves staff time during surgery preparation and reduces the amount of plastic required compared to the previous solution by approximately 80%.

Fresenius Helios in Spain tested a new approach to reducing hazardous waste in operating rooms in the reporting year. Certain surgeries – particularly some orthopedic and urology procedures – generate large amounts of liquid hazardous waste, which is collected in single-use canisters and incinerated. By using a specific equipment, the liquid can be filtered, and the final waste is substantially reduced. The assessment of the pilot project is planned for completion in the course of 2026.

Actions [E5-2] Actions and resources related to resource use and circular economy

In the reporting year 2025, Fresenius did not adopt any central guidelines for measures relating to resource use and circular economy. At present, approaches to this are mainly organized locally, but the framework is provided by the environmental management systems of the Operating Companies.

In the reporting year, Fresenius implemented different activities to address actual negative impacts related to resource use and circular economy. Further information can be found in this topical standard in section E5-1 Approach.

Goals and ambitions [E5-3] Targets related to resource use and circular economy

Fresenius strives to maximize the lifespan of materials, reduce the amount of waste generated, and increase the proportion of recyclable materials in its own waste streams. In addition, the Group aims to reduce its material consumption and minimize the amount of waste produced through systematic waste management. Beyond that, there is currently no measurable Group target for the use of resources and the circular economy. Fresenius plans to set a target in the future.

The company monitors the effectiveness of its policies by measuring and evaluating defined metrics, as described in the following section.

Metrics

Resource inflows [E5-4] Resource inflows

The resource inflows associated with material impacts differ between the Operating Companies.

The most important materials in the production of Fresenius Kabi are active pharmaceutical ingredients (API), and excipients, followed by plastic parts, and primary and secondary packaging.

In the healthcare facilities of Fresenius Helios, the main resource inflows are consumables for nursing care and for medical treatment, pharmaceuticals, and prostheses.

In the upstream supply chain, various raw materials, and preliminary products such as metals, plastics, silicone and rubber components, water, wood, chemicals, and animal and plant products are used to manufacture the products and preliminary products that the Group sources. For information on the approach to conflict minerals, please refer to topical standard S2 Workers in the value chain, section S2-1 Approach.

Fresenius also sources organic materials for production, such as certain fish, soybean, sunflower, and rapeseed oils, that are certified for their sustainably sourced origins, e.g., fish oil certified by Friend of the Sea® or soybean oil in accordance with the ProTerra Standard™.

In order to indicate the total weight of the products as well as technical and biological materials consumed during the reporting period, Fresenius made different assumptions depending on the Operating Company. For Fresenius Helios, for example, the underlying assumption was that the quantity of material outflows is equal to the material inflows. In order to record consumed materials that are not recorded in the material outflow (e.g., food, and medicines such as infusions), the corresponding value is converted into kilograms using the conversion factor and added to the material outflow.

At Fresenius Kabi, the quantities of materials consumed are based on the material weight multiplied by the total invoiced amount. Weight data for materials are mostly based on information from master data. In some cases, e.g., missing master data, weights are manually adjusted based on information from the suppliers or average values.

Resource outflows [E5-5] Resource outflows

Products and materials

Fresenius Kabi manufactures medical devices such as infusion pumps and equipment for blood collection and processing. All the devices are developed to last for several years and can be repaired by trained and certified service personnel after fault diagnosis. Fresenius Kabi provides relevant manuals for this purpose and manufacture appropriate spare parts at its production facilities. If the production of a device is discontinued, spare parts are kept in stock for seven to ten years to enable further repairs. Fresenius Kabi also provides its customers with the necessary software updates.

Fresenius manufactures a wide range of products with varying durability ranging from 7 to 15 years if maintained regularly. The company recommends appropriate maintenance intervals for all products, which depend on how they are used or, in the case of batteries, on how long they are used for. Due to the large number of different products, they are not listed individually here. As one example, the AmiCORE Apheresis System is used for blood donation and has a minimum expected lifetime of 7 years or 7,000 operating hours. Due to lack of data, Fresenius is currently unable to provide information on industry averages.

In the healthcare sector, for reasons of hygiene, disposable items are needed, and their repairability is not assessed. In addition, Fresenius does not have an established assessment system for evaluating the repairability of reusable products.

The options for recycling medical products are limited. Taking into account legal and hygiene requirements, Fresenius tries to close recycling loops. Items made of paper, e.g., manuals, as well as packaging, like corrugated packaging and folded boxes, are recyclable. Fresenius does not yet systematically record the recycling share of its products.

Waste¹

Due to the diverse activities of Fresenius, there is a large number of waste streams. At Fresenius Kabi, plastic waste, paper and cardboard waste, wood waste, electronic waste, metal waste, glass waste, organic waste, residual waste, demolition and construction waste, non-hazardous pharmaceutical waste, non-hazardous industrial effluent sludges, and hazardous waste are generated. Fresenius Helios generates infectious and non-infectious hospital waste, electronic waste from medical equipment, food waste from canteens, construction waste from remodeling work, chemical waste from laboratory work, and household waste such as packaging waste, paper waste, and residual waste. The materials contained in the waste include, biomass, plastics, chemicals, pharmaceuticals, textiles, paper, metals, glass, wood, construction waste, and aluminum.

The total amount of hazardous waste generated in the reporting year was 25,549 t (2024: 29,314 t). There was no radioactive waste.

Fresenius records the total amount of waste in accordance with the European waste classification codes where required by regulations or voluntarily. In addition, there are countries where local waste codes are used. For consolidation, Fresenius transfers these values into the system based on the European waste codes. If the further processing option (e.g., recycling, reuse or incineration) is known, Fresenius categorize the waste accordingly and add it up. If the further processing is not known, country-specific statistics are used for allocation to recovery and disposal types. The total amount of waste of the following units is based on data per FTE (full-time equivalent) collected at the Bad Homburg site: outpatient clinics, offices, research & development sites, locations with unavailable data, and employees of the segment Corporate / Other outside Bad Homburg.

At sites with ISO 14001 certification, the waste management systems, which are also used to collect the metrics, are audited by an external auditor. The auditor determines the specific aspects to be audited.

¹ Starting in fiscal year 2025, the remaining units of Fresenius Vamed will no longer be included in the waste data. According to the recalculation policy, the change compared to the previous year is insignificant, so no recalculation was performed.