Foreword
by Dr. Michael Moser
Member of the Management Board
“Acting together” – that is the motto of this year’s Sustainability Highlights Magazine. And it perfectly reflects how we understand sustainability at Fresenius: as a shared responsibility. We take responsibility where we have influence: in our hospitals in Germany and Spain, and across our global network of medical device manufacturing sites.
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When every day counts: EASYGEN is set to make cell therapy more accessible
In severe cancer cases, time can become a critical factor. However, CAR-T cell therapy, a highly effective form of individually engineered immunotherapy, often takes a very long time to prepare and manage. This is where the EU-funded EASYGEN (Easy workflow integration for gene therapy) project comes in: A consortium of 18 international partners is examining how the complex manufacturing and care processes for this special form of therapy can be simplified and better integrated into everyday hospital operations.
CAR-T cell therapy is a form of immunotherapy whereby T cells are removed from a patient and genetically modified in the laboratory before being returned to the body to detect and destroy certain cancer cells. The manufacturing process is always individual for each person, requiring specialized infrastructure as well as extensive quality controls. This can take up to six weeks. Then there are international transport routes and the currently limited number of centers capable of administering the therapy. These structural factors mean that only a small proportion of eligible patients have thus far been able to access treatment. To date, around 45,000 people worldwide have received such therapy (as of December 2025), while the majority of patients – around 80% in Europe (according to the IQVIA Report 2025) – still haven’t had the treatment.
The classic manufacturing process:
The cells pass through many stages, including transport and laboratory processes, such as freezing and quality testing. It typically takes up to six weeks before the patient receives the CAR-T cells back.
The manufacturing process with EASYGEN:
The cells are processed in the place where they are needed using an automated closed-system approach. This is designed to shorten the entire process – from the collection of the cells to their return to the patient – to less than 24 hours.
The aim of EASYGEN is to better coordinate the many individual work stages in laboratories and hospitals. Various European companies and scientific institutions are working together under the direction of Fresenius to give patients faster and easier access to the treatment. Standardized modules, digital documentation, clearly defined interfaces, and more automated processes are designed to simplify both the complex cell manufacturing process and the use of the cells to treat patients in the long term. Thanks to EASYGEN, the task of manufacturing personalized cell therapies alone could take a matter of days instead of several weeks.
Various skills come together at Fresenius for this purpose: Fresenius Kabi is supporting the project with its expertise in the field of automated cell processing. Additional functionalities are being added to the existing Cue closed cell washing system for this purpose. Helios and Quirónsalud are helping the project with their experience gained from using CAR-T therapies in German and Spanish hospitals. Over the course of the project, both hospital groups are testing the new manufacturing process under real care conditions. As part of the Corporate Development function, the Research Office is taking the scientific and strategic lead for the European consortium. It designed and initiated the project and now acts as the Principal Investigator under EU rules while managing the overarching governance structures. With the project’s targeted approach to the networking of partners, its international positioning, and its continuous focus on scientific and technological developments, EASYGEN is likely to consolidate Fresenius’ role in the innovative field of cell and gene therapy.
The project can thus help to deliver more efficient and modern healthcare and create the conditions for innovative therapies to reach more patients in the future.
HeSaMeDa: Using data securely for better care
With diagnostic and therapeutic information, test samples from the laboratory, and other treatment data – hospitals are sitting on a wealth of data. Evaluating this data can help to better understand the relationships between therapy procedures and treatment outcomes, identify patterns, and develop innovative treatment methods. In addition, a targeted approach can be taken to analyzing and optimizing processes. Data analysis can thus contribute to quality assurance in patient care on the one hand, while also playing a useful role in answering scientific questions on the other.
At Fresenius Helios in Germany, our approach is to improve the quality of treatment with the aid of data analysis and thus contribute to the “Helios Principle”.
Medical data as part of the Helios Principle
Data analyses can lead to better medicine
Treatment quality can be improved and better understood with data
Processes can be analyzed and optimized using data
Further information on the Helios Principle is available here.
Helios Safe Medical Data
The problem is that the data is often not uniformly structured because many different IT systems are being used. The HeSaMeDa platform (Helios Safe Medical Data) can help by standardizing different kinds of data from the Helios hospitals. HeSaMeDa processes medical data solely in pseudonymized form so that no individual persons can be identified.
The key findings from building the platform are summarized in a scientific study.
An overview of the key findings:
Agility beats perfection: Since hospitals use different IT systems, a flexible, incremental approach to standardizing data has proven to be more effective than an immediate end-to-end solution.
“Raw data first” approach: In order to prevent information loss by incorrectly assigning it or standardizing it too early, data is initially stored unchanged in its raw format and only later processed and standardized.
Automation is essential: Automated processes and versioned code – that is to say, software whose modifications are documented and can be tracked – are crucial for being able to work reliably in research areas where there are frequent personnel changes.
Interoperability: The task of converting data into a common standard remains complex because important detailed information can be lost during the standardization process.
A focus on consent and data privacy
There are two levels of consent for patients: Firstly, they can choose whether to approve the use of their data for research purposes. Furthermore, they can agree to being contacted for studies at a later date. All data is processed solely by Fresenius Helios.
The use of data is strictly regulated, with high IT and data privacy standards protecting the sensitive information in accordance with the German Good Practice in Secondary Data Analysis (GPS) guidelines, among others. A higher-level committee set up by Fresenius Helios decides who may use the data and for what purpose. All access to the platform is documented and can be tracked.
Data analyses and technologies can support scientific projects and internal quality assurance measures as well as help to deliver efficient and individual treatment for patients in line with recognized medical standards.
“We have shown that HeSaMeDa can directly improve everyday clinical practice. Whether identifying redundant diagnostics to reduce the number of unnecessary blood samples taken or contributing to patient safety by promptly analyzing complications in instances where there has been a change of manufacturer, this platform is the tool we want to use to take a targeted approach to enhancing medical evidence and improving operational excellence.”
“A practical example is the use of robotics in operations. We evaluated data from 2025, which shows how these minimally invasive procedures can improve the quality of care. Compared to conventional surgical procedures performed in the past, smaller incisions and more precise movements have shortened hospital stays and reduced pain. At the same time, the data analyses have helped to organize processes in the operating room more efficiently and make costs transparent. This case shows that HeSaMeDa can be used to set standards, better assess risks, and plan investments.”
Moments that create impact: How patient experience takes shape at Quirónsalud
A hospital stay is shaped not only by medical outcomes, but by everyday moments: a nurse who takes time to listen, a doctor who explains the next step clearly, or a team that works well together. These interactions strongly influence how patients and their relatives experience care.
At Quirónsalud, patient experience is understood as the sum of these moments. That is why they introduced several initiatives that focus on human behavior, empathy, and teamwork in daily practice: Beyond Empathy, the Emergency Care Treatment Manual, and the Quirónsalud Olympics.
Recognize: Beyond Empathy
Patients often remember how they are treated just as much as what is done medically. Beyond Empathy was created to make day-to-day moments visible. The initiative invites patients and colleagues to highlight concrete, positive behaviors that make a difference in their experience.
Patients can share messages of gratitude, and staff members can recognize one another for actions that made a difference via a corporate recognition form or a Recognition Dashboard. These examples are collected and shared, helping teams see what patient‑centered care looks like in practice – and learn from them.
More than 4,800 professionals took part in the initiative.
Over 18,000 recognitions of positive behavior were submitted by staff members.
More than 270,000 patient recognition messages were shared via the Recognition Dashboard.
Humanize: Emergency Care Treatment Manual
Emergency departments are fast‑paced, complex environments where patients often feel stressed or uncertain. Clear communication and empathetic behavior can make an important difference to the patient’s perceived quality of care. The Emergency Care Treatment Manual offers practical guidance for everyone involved in the emergency patient journey – from admissions and nursing staff to physicians, porters, security, and cleaning teams. It provides a shared understanding of how patients should be addressed and supported throughout their stay.
The manual is structured around five simple principles:
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HEARING (OÍDO) – How we listen and explain.
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SIGHT (VISTA) – How we look, observe, and acknowledge.
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TOUCH (TACTO) – A professional and respectful physical approach.
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HEART (CORAZÓN) – Empathy, emotional presence, and compassion.
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TEAM (EQUIPO) – Coordination and shared responsibility.
In hospitals where it has been implemented, an increase in patient satisfaction of up to 15 NPS points1 was measured. In the next years, similar manuals are planned to be implemented for additional care areas such as outpatient surgery and consultations.
Gamify: Quirónsalud Olympics
The Quirónsalud Olympics use gamification to encourage teamwork and engagement around patient experience goals. In the “Summer Olympics”, multidisciplinary hospital teams work together on outpatient challenges such as reducing waiting times, optimizing scheduling, or coordinating handovers. The “Winter Olympics” focus on inpatient experience, including hospitalization NPS, clarity of information, rest, courtesy visits, and safety.
Beyond competition, the Olympics foster continuous improvement: teams review results, share success stories, and learn from one another across hospitals and disciplines.
Together, these initiatives show how patient experience can be strengthened through recognition, practical guidance, and collaboration.
1 Quirónsalud measures patient satisfaction using the Net Promoter Score (NPS). Further information on the NPS at Quirónsalud can be found in the audited Sustainability Statement 2025.
How Fresenius Kabi supports access to essential therapies in everyday care
Healthcare progress is not only driven by major medical innovations. In everyday practice, reliable access to essential medicines, medical devices, and nutrition therapies is equally critical. These therapies form the basis for safe and effective care and enable clinicians to deliver treatment consistently day by day. Fresenius Kabi contributes to the stable availability of affordable, high‑quality therapies and works closely with healthcare partners to support this effort.
Impact at a glance
Patients reached: In 2025, we reached 450 million patients by providing essential medicines, medical devices, and nutritional therapies.
Essential medicines: In the United States, 67% of Fresenius Kabi IV drug units shipped in 2025 appear on the Food and Drug Administration (FDA) Essential Medicines List. In Europe, 69% of the total units of Fresenius Kabi generics product range sold in 2025 are part of the Union list of critical medicines by the European Medicines Agency.
Affordability and system value: Access to high‑quality generics and biosimilars can support cost‑conscious care and help healthcare systems manage treatment needs (source: Medicines for Europe1).
Impact stories from selected countries
Examples from everyday care demonstrate how reliable supply structures, collaboration, and professional expertise enable patient-focused care across different settings. The following case studies outline the practical impact of Fresenius Kabi’s approach to healthcare delivery and illustrate how access to essential therapies makes a meaningful difference for patients and their families, while also supporting the healthcare system.
1 – Germany: Individualized home nutrition supporting continuity of care
When conventional care pathways reach their limits, access to specialized nutrition therapies can offer additional options for patients with complex needs like Sonja. After a long and medically challenging course of treatment, Sonja’s health deteriorated to the point that she was placed on an end‑of‑life care pathway. At that stage, no further nutritional options were available within the existing care framework.
A specialized Fresenius Kabi homecare nursing team reassessed her situation and initiated individualized home parenteral nutrition. The therapy was accompanied by close monitoring, regular dose adjustments, and practical education. Over time, Sonja regained strength, independence, and quality of life. Her example demonstrates how access to specialized nutrition therapies can enable continuity of care and help patients maintain autonomy and dignity during vulnerable phases.
2 – Brazil: Strengthening health literacy in cancer care
For patients with leukemia or lymphoma and their families, navigating treatment pathways can be complex. Unequal access to reliable information, fragmented care structures, and logistical barriers can further complicate an already demanding situation.
Patient support partnerships can help address these challenges. Through corporate sponsorship of ABRALE, Brazil’s leading patient association for blood cancers, patients and caregivers gain access to structured information, guidance, and support throughout the disease journey. This contributes to improved health literacy, reduced information gaps, and greater confidence for families managing complex cancer care, showing how partnerships can promote more equitable access to information within healthcare systems.
By the end of 2024, ABRALE has already served approximately 57,000 patients.
3 – Austria: Adapting immune therapy to pediatric needs
Children with severe immune-mediated conditions need therapies adapted to their size and clinical realities – yet many technologies were not originally designed with pediatric needs in mind. For children with severe immune‑mediated conditions, extracorporeal photopheresis (ECP) is an essential treatment option, but earlier systems were often associated with long procedures and limited suitability for pediatric use.
With the introduction of Amicus Blue, treatment teams were able to better adapt ECP procedures to a child’s size and condition. Hospitals have gained an option that aligns more closely with the realities of treating children, helping to reduce treatment burden and support more appropriate care for highly vulnerable young patients. This example underscores how refining established technologies can make complex therapies more feasible in pediatric settings.
4 – United States: Strengthening resilience in oncology supply
Oncology clinics in the United States continue to face intermittent shortages of generic cancer medicines, creating a persistent public health challenge. These disruptions can affect treatment planning, creating uncertainty for both healthcare professionals and patients, and in some cases compromise outcomes.
To help address this risk, Project GOLD (Generic Oncology Lifesaving Drugs) – a multi‑stakeholder pilot launched by Angels for Change, with Fresenius Kabi as a founding member and two additional industry partners – aims to protect patient access to life‑saving oncology medicines. The initiative aims to prevent shortages by maintaining a strategic buffer supply of essential oncology injectables in the U.S. Integrated with the Angels for Change Drug Crisis Hotline and Global Supply Sharing Network, it enables real‑time visibility into urgent needs and rapid deployment during supply constraints.
By reinforcing resilience across the generic oncology supply chain, Project GOLD helps safeguard continuity of care and informs a scalable, long‑term model for reducing shortage‑related risk nationwide.
5 – United States: Continuity of care in rare immune disorders
For patients with rare immune disorders such as Common Variable Immunodeficiency (CVID), uninterrupted access to intravenous immunoglobulin therapy is essential. Disruptions in plasma supply can quickly create serious health risks.
Cannan lives with CVID. Reliable access to plasma-derived immunoglobulin therapies allows patients like him to continue treatment consistently and maintain a more predictable daily routine. Fresenius Kabi supports this continuity of care by providing medical technologies that enable safe, efficient plasma collection – an essential first step in producing reliable plasma-derived therapies. Strong, dependable plasma collection is a critical foundation for consistent treatment and long-term disease management. Cannan’s story underscores the human impact behind plasma-supply reliability: Consistent treatment access keeps patients on therapy, reduces stress for families, and ensures continuous care for people with rare immune disorders.
6 – United Kingdom: Delivering complex nutrition care at home
For people who rely on Home Parenteral Nutrition (HPN), daily life can be closely tied to hospital routines, limiting independence and affecting family life.
In the United Kingdom, specialized Fresenius Kabi homecare nurses enable patients to continue HPN safely at home. Through regular visits, monitoring, and hands‑on training, patients are supported in managing their therapy outside the hospital setting. For individuals living with conditions such as Crohn’s disease or recovering from bowel cancer, this approach can help restore routine and autonomy. The example demonstrates how homecare models extend healthcare capacity beyond hospital walls, enabling more accessible and patient‑centered care.
7 – Colombia: Supporting access to treatment through biosimilars
Living with a chronic condition can involve ongoing physical strain and uncertainty about access to effective treatment. For patients like Gloria, concerns about long‑term affordability and continuity of care affected both her health and sense of security and independence.
With the introduction of a Fresenius Kabi biosimilar, Gloria gained access to a more affordable treatment option that meets the same standards of safety and effectiveness as the reference biologic. The reliable availability of this therapy supported ongoing disease management and reduced concerns about treatment interruptions. Her experience reflects the broader role of biosimilars in improving access to essential therapies, especially for patients with chronic conditions. By improving affordability and continuity of care, biosimilars can generate social value that extends beyond individual patients.
1 Source: Medicines for Europe; IQVIA, “Beneath the Surface: Unravelling the True Value of Generic Medicines”, 2024
Frembassadors: employees as ambassadors
What makes Fresenius so special as an employer? The people who work together here. We want their authentic everyday stories from the workplace to be seen by the outside world, which is why the Employer Branding team launched a special program in 2022: the Frembassadors, a portmanteau word combining Fresenius and ambassadors. Colleagues from all over the world are free to join this community.
Sarah-Ann Krüger, Manager of Employer Branding and University Relations at Fresenius, leads the program and explains the idea to us.
Sarah-Ann Krüger: “The Frembassador Community is aimed at anyone who wishes to participate in employer branding activities – by contributing content to social media and the careers website, for example, or by providing support at careers events to present Fresenius as an attractive employer. At the same time, it offers space for dialogue and networking across the boundaries of employees’ own departments and business segments. We have grown into a large, heterogeneous group, with more than 170 Frembassadors in 19 countries on four continents part of the community as of the end of 2025.”
Andre Jochen is Director of Regulatory Affairs and Quality at Fresenius Kabi in Brazil and has been a Frembassador since 2022. He told us why it’s worth getting involved.
Andre Jochen: “As Frembassadors, we help make our work and locations more visible beyond our organization. We can take part in digital courses that are both practical and enjoyable, covering personal branding, networking and social media best practices. I especially benefited from the courses because they helped me better position myself on my LinkedIn profile and communicate, in a clear and approachable way, what it is like to work at Fresenius in the Regulatory Affairs & Quality area. I enjoy being part of the Frembassador Community because it builds bridges across regions, including Brazil, and inspires us to communicate responsibly about our work.”
In 2026, the company will assess how the program can be further expanded.
What exactly is … a hospital cluster?
Fresenius Helios has grouped its roughly 80 hospitals in Germany into 21 clusters. A cluster contains an average of three to four hospitals in a region that work closely together. These include smaller local hospitals, specialized hospitals, and large centers for complex treatment.
The aim is to deliver patient care while further enhancing medical quality and efficiency. Each hospital in a cluster focuses on its own field of specialization. Complex, demanding procedures are performed in centers with a great deal of experience, with other hospitals providing care closer to home. The sharing of expertise, equipment, and infrastructure alongside close cooperation between the medical departments make it possible to provide well-coordinated and high-quality care. At the same time, duplicate structures are avoided. This allows patients to be treated where they can receive the best care.
The clusters also include more than 200 medical care centers (known as MVZs in Germany) managed by Helios. These are outpatient clinics for examinations and treatments that do not require a hospital stay. Close integration between hospitals and MVZs is designed to enable better coordination of appointments, diagnoses, and therapies while also improving treatment processes. Digital services, such as video consultations and the electronic sharing of important findings, also make cooperation easier.
By forming clusters, Helios is adopting key elements of hospital reform in Germany at an early stage. The aim of the reform is to connect care structures more closely with one another in order to raise quality and improve efficiency in care settings. This is designed to ensure that high-quality care is delivered throughout Germany in the long term.
Enhancing patient experience: Bridging digital care and energy consumption
Enhancing patient experience is one of Fresenius’ top priorities – and digitalization plays an important role in achieving this. In 2025, Quirónsalud launched a pilot project at a hospital in Southern Spain to connect our digital platform Casiopea with the hospital’s Building Management System. This initiative aims to ensure that air conditioning is supplied only to rooms that are currently in use. If the pilot proves successful, the solution will be rolled out to all hospitals using the same Building Management System.
Join patient María as she receives treatment for knee pain and discovers the advantages this approach could bring to her care.
Resistant pathogens: Prevention in hospitals and when manufacturing antibiotics
Antibiotics play a key role in modern medicine. They treat bacterial infections and prevent them from spreading. In certain cases, however, their reliability can no longer be relied upon. That’s because antimicrobial resistance (AMR) – the incidence of resistant pathogens – is spreading worldwide.
Such bacteria are mainly transmitted from person to person, often in hospitals. If they enter the environment via wastewater, however, they can also spread in this way. As a result, infections that were once easily treatable can now be life-threatening. The main cause of this development is the incorrect and excessive use of antibiotics in humans, animals, and plants.
As a healthcare company, Fresenius wants to play its part in containing the spread of resistant pathogens. To this end, the Group is taking various measures – both in the manufacture of antibiotics and in everyday clinical practice.
The responsible manufacture of antibiotics
Fresenius Kabi makes intravenous antibiotics. Careful monitoring of waste and wastewater is essential to prevent antibiotic residues from entering natural ecosystems in an uncontrolled manner. In 2025, Fresenius Kabi received BSI Kitemark™ certification for Minimized Risk of Antimicrobial Resistance for four antibiotics manufactured across three sites in Austria, Poland, and Portugal. This certification confirms compliance with the AMR Industry Alliance’s Antibiotic Manufacturing Standard and that antibiotic residues in waste and wastewater are appropriately controlled and that companies therefore promote responsible antibiotic manufacturing.
What is the AMR Industry Alliance?
In 2022, the AMR Industry Alliance published the Antibiotic Manufacturing Standard, which Fresenius Kabi as a member helped to develop. This standard is designed to give manufacturers guidance on how to manufacture antibiotics responsibly. Since 2023, manufacturers have been able to have their compliance with the standard externally certified by the BSI Group in the form of the BSI Kitemark™ for Minimized Risk of Antimicrobial Resistance.
Antibiotic management in hospitals
There is also a focus on ensuring that a consistent approach is taken to antibiotic management in our hospitals. Helios and Quirónsalud use antibiotics to treat bacterial infections in their hospitals. Effective hygiene measures are an important way of preventing AMR and ultimately nosocomial infections, which are infections that can be acquired during a hospital stay. In addition, all Helios hospitals introduced antibiotic reporting back in 2012 to monitor how often and to what extent antibiotics are used. This was followed in 2019 by an antibiotic stewardship (ABS) program, which includes training for medical staff, joint therapy guidelines, digitally managed prescriptions, and a central infection monitoring system.
“The problem of antimicrobial resistance is still a relatively minor one in Germany compared to other countries, but it is expected to increase – which means that fewer antibiotics could be effective here in the future. Only targeted antibiotic management can prevent or at least curb that.”
A similar program was launched in 2020 at the Quirónsalud Hospital in Barcelona, promoting the targeted and responsible use of antibiotics – on the basis of standardized guidelines, interdisciplinary teams, and the continuous review of prescriptions. Quirónsalud has also developed an AI-supported infection control and prevention system.
What do anesthetic gases have to do with the climate?
Anesthetic gases are an indispensable part of modern medicine. At the same time, they represent one of the largest direct sources of emissions in hospital operations, with their global warming potential exceeding that of CO2 many times over. Most of these gases normally reach the outside air in an unfiltered state. Thanks to modern medical technology, special systems can be used to capture anesthetic gases instead of releasing them unimpeded into the atmosphere. In 2023, a system for capturing these anesthetic gases was introduced across 19 Helios hospitals. Since 2025, all ventilation spaces on intensive care units in Germany have also been equipped with the system.
But how exactly does the system work – and what does it mean for everyday life on the unit? We asked our experts.
The interviewees:
Dr. Achim Labuhn, Lead Physician in Conservative Critical Care at Helios Hospital Krefeld and Head of Critical Care at Helios
Dr. Stefan Wirtz, Chief Physician in Anesthesiology, Critical Care, and Perioperative Pain Therapy at Helios Hospital Bad Saarow and Head of Anesthesiology at Helios
Constanze von der Schulenburg, Head of Sustainability Communication at Helios
How does the system for capturing gases work?
Dr. Achim Labuhn: “Since 2025, 51 of our intensive care units have been using activated carbon filters fitted to the ventilator. The anesthetic gases exhaled by the patient are captured by these filters to prevent them from being released into the outside air. Once the filters are filled to capacity, they are disconnected from the ventilator. The filter manufacturer can then extract the captured gases from the activated carbon and potentially reuse them.”
Does this change any of the processes for the nursing staff and patients?
Dr. Stefan Wirtz: “The switchover entails only minor changes for the nursing teams and medical technology. The filters are easy to use, and we provide training and digital instructions to make sure that everyone involved is well prepared. Everything also remains unchanged for patients: The systems used are safe, proven, and medically approved. That is why we have decided to switch the anesthesia machines in over 30 more hospitals to the system that collects anesthetic gases in 2026. According to the latest internal evaluations, the selected hospitals have been responsible for about 80% of Helios’ anesthetic gas consumption to date.”
What other measures are used when anesthetizing patients?
Constanze von der Schulenburg: “Capturing anesthetic gases is one of several measures we are taking to deal with the issue of emissions in hospital operations. For example, we completely ceased using nitrous oxide for anesthesia in 2024. We also consistently use minimal flow anesthesia, which involves only using as little fresh gas as necessary. In addition, we are substituting the anesthetic gas desflurane, which is particularly harmful to the climate, for sevoflurane, which is less harmful.1”
In this video, Dr. Wirtz demonstrates how the capturing system works:
Subtitles in English can be activated.
Detailed information on our climate transition action plan can be found in our audited Sustainability Statement 2025.
1 Desflurane has a global warming potential more than 2,500 times greater than CO2. Sevoflurane, meanwhile, has a lower impact with a global warming potential 130 times greater.