Access to products and services

Impacts, risks, and opportunities [S4 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 one material impact and one material risk related to Access to products and services:

Approach [S4-1] Policies related to consumers and end-users

Access to healthcare and medicine

Fresenius’ long-term goal is to further develop its position as one of the leading international providers of healthcare products and services. In recent years, the company has expanded its activities along the value chain, thereby increasing the global availability of its products and services. The #FutureFresenius transformation was launched in February 2023 with the aim of positioning the company with a clear focus for future growth.

Promoting access to healthcare and medicine is part of the Group-wide strategy. Fresenius focuses on the following areas:

• Affordable medical products

• Integrated healthcare concepts

• Patient support in crisis and emergency situations

The Sustainability Framework adopted in 2025 is described in standard ESRS 2 General disclosures. It examines access to healthcare and medicine from a sustainability perspective.

Group-wide governance and responsibilities

Access to products and services is defined as a material topic of the overarching corporate strategy and is subject to the ongoing transformation process of #FutureFresenius. In the implementation, the Operating Companies specify their respective strategies with the support of the Group functions, and from these, the healthcare service and product markets in which Fresenius will be active in the long-term are derived. Information in this topical standard encompass the operating business and the downstream value chain. Within the Management Board, the Chief Executive Officer is responsible for the Group’s overall strategy. Operational implementation takes place within the Operating Companies and their units. It is anchored in the local organizations and managed by the respective management functions. Information on the Supervisory Board and related procedures for material sustainability aspects are explained in standard ESRS 2 General disclosures, section GOV-1 Sustainability organization. The information provided in this topical standard provides additional context.

The highest management functions of the Operating Companies decide on the implementation of the strategy, define management approaches, and regulate responsibility within the management, e.g., through a business allocation plan. The sustainability perspective on access to healthcare and medicine is being sharpened with a forward-looking approach and is emphasized as a focus topic within the Sustainability Framework, complemented by strategic KPIs in the future.

Fresenius’ Group-wide Human Rights Program is aligned with internationally recognized instruments relevant to consumers and end-users, including the United Nations Guiding Principles on Business and Human Rights. Further information can be found in topical standard S2 Workers in the value chain.

Affordable medical products

With the comprehensive range of products, which also includes generics and biosimilars, Fresenius provides access to modern, high-quality, and affordable therapies for patients in the downstream value chain. Generics and biosimilars are cost-effective alternatives to originator drugs. They help to lower the price of treatments and thus reduce the burden on healthcare systems. There is a risk that amended regulatory requirements may restrict access to products or services. For example, companies may not always be able to respond promptly to changes, or reimbursement systems may no longer cover certain products or services.

To promote accessibility and affordability of healthcare products in a resilient way, Fresenius supports various initiatives and works together with other companies in international, European, and national associations. For further information, please refer to the standard ESRS 2 General disclosures, section SBM-2 Stakeholders and partnerships.

Fresenius also strives to ensure equal access to medical care and non-discriminatory treatment of people as part of the vision of Health Equity. As many people as possible worldwide should have the chance to participate in this progress. Fresenius therefore wants to help make access to critical medicines and health services more equitable worldwide and support the development of sustainable health systems. This means that treatment and health education should be made available to everyone who needs them, irrespective of age, income, race or ethnicity, or education. This ambition is particularly reflected in the Group’s commitment to society. In 2024 Fresenius has solidified its commitment to promoting equal opportunities in healthcare by signing the Zero Health Gaps Pledge. The goal is to overcome financial inequalities by making healthcare more affordable and fair. Fresenius is also committed to providing gender-equitable medical care.

Ensuring the availability of its products and access to its services is an important concern for the company: Avoiding bottlenecks in the supply of important medications is a top priority. This equally applies to ensuring uninterrupted care in Fresenius’ own hospitals.

Integrated healthcare concepts

In recent years, healthcare providers, regulatory authorities, and insurance companies around the world have been working to improve treatment outcomes for patients while simultaneously reducing healthcare costs. This benefits- and results-oriented concept is known as value-based healthcare.

This scientific approach supports the long-standing strategy of Fresenius: Systematic establishment of regional care clusters and interdisciplinary knowledge sharing among experts, from which all hospitals in the Group’s network can benefit. Patients should benefit from the focus on technological advances, innovative treatment options, and investments in high-level healthcare infrastructure and technical equipment. With this approach, Fresenius wants to help to tackle the increasing cost pressure for insurers and relieve the burden on healthcare systems.

Fresenius firmly believes that combining healthcare facilities, known as cluster formation, is beneficial both for the quality of healthcare and when it comes to the potential for reducing costs. In 2025, Fresenius Helios completed its announced cluster structure in Germany: Driven by a shared medical and strategic approach, Fresenius Helios consolidates medical expertise into 21 regional clusters, meaning networks of healthcare facilities and hospitals. The strategy takes into account the Hospital Care Improvement Act (KHVVG) for each cluster. One key objective is to identify and expand medical specializations and centers of excellence to improve access to healthcare and consistently meet internal quality standards over the long term.

Fresenius Helios in Germany, for example, supports certain projects that involve deploying multidisciplinary teams following surgical interventions in order to help speed up and improve patients’ recovery. One area of focus is on rapid mobilization after operations.

In order to counter the specific effects on healthcare, Fresenius Helios in Spain is pursuing the goal of significantly optimizing care processes. For example, the structured medical information already obtained with the help of digitalized processes is to be linked to a newly generated healthcare model. This should give doctors more capacity to provide valuable care to an increasing number of patients. Further details can be found in the company-specific standard S-Digital transformation.

Patient support in crisis and emergency situations

As a healthcare Group, Fresenius has to be crisis-proof in all areas and be able to respond flexibly to unforeseeable challenges: Patients are to be provided with unrestricted access to services and seamless care even under difficult conditions. To ensure this, Fresenius has established high-performance and resilient emergency systems and programs in its Operating Companies.

Crisis situations refer to unforeseen events that may have negative consequences for the company or society, for example. The Fresenius crisis management organization aims to ensure a rapid and coordinated response to crisis situations, including a comprehensive flow of information to relevant stakeholders and a structured recovery of critical business operations to enable the fastest possible return to normal business activities. A crisis team is convened immediately after an event that could potentially lead to a crisis. This crisis team consists of a core team with fixed members, regardless of the scenario, as well as representatives from relevant functions of the company depending on the requirements of the situation. The crisis team also involves the units in affected markets and the members of the Management Board of the Fresenius Group. It coordinates the activities to maintain business operations and monitors the measures specifically defined and initiated to deal with a crisis. Members of the crisis team and representatives of the business units are also responsible for coordinating product donations if requested by affected countries, e.g., in the event of a natural disaster or war.

Internal rules of procedure describe processes, reporting and related responsibilities to communicate critical events to relevant internal and external stakeholders. The provisions encompass monitoring and responding to inquiries and defines appropriate communication tools.

At Fresenius Helios, there are legal requirements for how care is to be organized in the event of an emergency. Accordingly, Fresenius has dedicated emergency plans to respond immediately to incidents that might be critical for patients. They encompass, among other aspects, evacuation plans, emergency systems in case of interruption of power or water supply, and plans to respond to impacts on local infrastructure, e.g. due to flooding. Emergency power generators ensure that operations or vital therapies, such as artificial respiration, can continue even in the event of a power failure. Pandemic plans that guide behavior in the event of a pandemic outbreak are also included. These approaches have proven to be effective in early 2026, after a wider power outage in Berlin, Germany. At an affected hospital of Fresenius Helios, the established preventive measures supported the continuation of its operations.

Engaging with patients [S4-2] Processes for engaging with consumers and end-users about impacts [S4-3] Processes to remediate negative impacts and channels for consumers and end-users to raise concerns

Fresenius’ risk management is designed to identify material negative impacts on consumers and / or end-users, as outlined, for example, in the topical standard S4 Consumers and end-users, section Health and safety. The aim is to evaluate these impacts as part of the risk management and, if necessary, to develop corrective measures. Fresenius obtains new insights, for example, through whistleblower systems, patient surveys, or through interest groups, such as workplace representation bodies or industry organizations. The respective assessments can also be used to check whether and how the concepts are sufficient to support trust in the company’s processes and procedures or to protect individuals from retaliation.

Fresenius is integrated into a diverse network of interest groups. Through the exchange with stakeholders, the company gains valuable insights that help to continuously develop the management of material topics and to address the material impacts on patients. The same applies to the opportunity and risk management. Further information on Fresenius’ most important stakeholders and their integration can be found in the standard ESRS 2 General disclosures, section SBM-2 Stakeholders and partnerships. The exchange with political institutions and external organizations focuses on the areas of health and patient care. In the topical standard G1 Business conduct, the policy is described in connection with this material topic.

Information on patient engagement and reporting systems is provided in this topical standard, section Health and safety. There are no special mechanisms in place regarding access to products and services.

Actions [S4-4] Taking action on material impacts on consumers and end-users, and approaches to managing material risks and pursuing material opportunities related to consumers and end-users, and effectiveness of those actions

In the 2025 reporting year, Fresenius adopted a sustainability concept that defines access to healthcare and products as a focus area. The company plans to define strategic key performance indicators starting in 2026 to document its progress. These will serve as the basis for deriving future measures. Therefore, no central actions were implemented in 2025 related to the described management approaches.

This includes both the identified actual impacts on consumers and end-users, as well as material risks for the Group relating to this topic.

Goals and ambitions [S4-5] Targets related to managing material negative impacts, advancing positive impacts, and managing material risks and opportunities

All people should be able to benefit from healthcare services – and not experience any disadvantage, for example due to a lack of financial resources or their geographical location. Fresenius is therefore committed to ensuring and improving access to medical care even amid changing regulatory requirements and market developments, for example by expanding the medical infrastructure and collaborating with organizations and initiatives on Group and Operating Company level. Since this ambition cannot be tracked by targets, Fresenius assesses the effectiveness of the implemented policies and the progress achieved based on the expansion of healthcare facilities and patient numbers on an annual basis and in comparison to the previous year. In addition, Fresenius uses patient satisfaction as an indicator to measure progress, as described in this topical standard, section Health and safety.

Fresenius wants to simplify access to healthcare and medicine through, for example, digital processes and applications. The targets in the area of digitalization can be found in the company-specific standard S-Digital transformation.

Metrics [MDR-M] S4-Company-specific

Number of patients at Fresenius Helios

The Number of patients is defined as the absolute number of patients treated in the Fresenius Helios facilities in Germany and Spain in the reporting year.

In 2025, 27.1 million patients were treated at Fresenius’ hospitals, of which 24.7 million were outpatients and 2.4 million were inpatients. The number of patients in Germany was slightly above the previous year’s level with an increase of 4% in the inpatient sector and 1% in the outpatient sector. In Spain, the number increased by about 3% in the outpatient sector and by approximately 1% in the inpatient sector.