Notes to the consolidated statements of income (Tables)

12 Months Ended

Dec. 31, 2025

Notes to the consolidated statements of income

The Company recognized the following revenue in the consolidated statements of income for the years ended December 31, 2025, 2024, and 2023:


Revenue
in € K
	Revenue from	Revenue from		Revenue from
	contracts with	insurance		lease
	customers	contracts		contracts		Total

	For the year ended December 31, 2025

Healthcare services	13,097,267	—		—		13,097,267
Healthcare products	4,325,723	—		87,902		4,413,625
Insurance contracts	—	2,116,710		—		2,116,710
Total	17,422,990	2,116,710		87,902		19,627,602

	For the year ended December 31, 2024

Healthcare services	13,471,363	—		—		13,471,363
Healthcare products	4,186,195	—		64,327		4,250,522
Insurance contracts	—	1,614,024		—		1,614,024
Total	17,657,558	1,614,024		64,327		19,335,909

	For the year ended December 31, 2023

Healthcare services	14,166,796	—		—		14,166,796
Healthcare products	3,979,122	—		80,559		4,059,681
Insurance contracts	—	1,227,140		—		1,227,140
Total	18,145,918	1,227,140		80,559		19,453,617

Schedule of disaggregation of revenue by categories


Disaggregation of revenue by categories
in € K
	For the year ended December 31,
	2025	2024	2023
Care Delivery	13,736,272	14,003,461	14,748,611
Thereof: U.S.	11,506,548	11,526,296	11,836,065
Thereof: International	2,229,724	2,477,165	2,912,546
Value-Based Care	2,247,373	1,752,456	1,277,116
Care Enablement	5,476,187	5,556,534	5,345,428
Inter-segment eliminations	(1,832,230)	(1,976,542)	(1,917,538)
Total	19,627,602	19,335,909	19,453,617

(1)	For further information on the revenue attributable to the Company’s operating segments, see note 29.

Schedule of trade accounts receivables from unrelated parties and contract liabilities


Trade accounts receivables from unrelated parties and contract liabilities
in € K
		2025		2024

Trade accounts receivables from unrelated parties		2,988,956		3,238,090
Contract liabilities		113,154		66,735

Schedule of unsatisfied performance obligations


Unsatisfied performance obligations
in € K
		2025		2024

1 year		288,738		234,739
1 - 3 years		301,932		308,734
3 - 5 years		110,105		122,351
5 - 10 years		70,527		31,796
Total		771,302		697,620

Schedule of selling, general and administrative expenses


Selling, general and administrative expense
in € K
		2025		2024		2023
Distribution costs⁽¹⁾		618,137		660,433		706,401
General and administrative expense⁽¹⁾		2,414,591		2,482,386		2,489,935
Selling, general and administrative expense		3,032,728		3,142,819		3,196,336

(1)The Company reclassified €116,099 and €101,560 from “Distribution costs” to “General and administrative expense” for the years ended December 31, 2024 and 2023 as a result of a change in accounting policy made to improve the presentation of core administrative functions that support the Company’s operational infrastructure, particularly in relation to patient service-related costs within the revenue cycle management process, including insurance verification, pre-authorizations, coding, claims submission, cash posting, and denial management.

Schedule of cost of materials


Cost of materials
in € K
		2025		2024		2023

Cost of raw materials, supplies and purchased components		4,107,887		4,023,978		4,170,690
Cost of purchased services		409,553		354,417		316,945
Cost of materials		4,517,440		4,378,395		4,487,635

Schedule of personnel expenses


Personnel expenses
in € K
		2025		2024		2023

Wages and salaries		6,242,754		6,425,067		6,437,582
Social security contributions and cost of retirement benefits and social assistance		1,408,300		1,363,751		1,330,628
thereof retirement benefits		185,119		199,265		194,307
Personnel expenses		7,651,054		7,788,818		7,768,210

Schedule of employees by function


Employees by function
		2025		2024		2023

Production and services		95,025		96,938		105,894
Administration⁽¹⁾		7,920		8,339		9,118
Sales and marketing⁽¹⁾		6,627		7,212		6,808
Research and development		1,452		1,351		1,300
Total employees		111,024		113,840		123,120

(1)The Company reclassified personnel on a total headcount basis, on average, in the amount of 1,071 and 1,185 from “Sales and marketing” to “Administration” for the years ended December 31, 2024 and 2023 as a result of a change in accounting policy made to improve the presentation of core administrative functions that support the Company’s operational infrastructure, particularly in relation to patient service - related costs within the revenue cycle management process, including insurance verification, pre-authorizations, coding, claims submission, cash posting, and denial management.

Schedule of amounts included in other operating income


Other operating income
in € K		For the year ended December 31,
		2025		2024		2023

Foreign exchange gains		359,962		352,041		280,323
Gains on right-of-use assets, from the sale of fixed assets, clinics and investments		9,136		29,579		33,921
Revaluation of certain investments ⁽¹⁾		7,254		51,572		14,671
Income from strategic transactions and programs		17,795		116,607		60,843
Income attributable to a consent agreement on foregone profits from the sale of certain pharmaceuticals to non-associated companies		43,050		71,994		46,919
Other		90,902		138,325		78,570
Other operating income		528,099		760,118		515,247

Schedule of amounts included in other operating expense


Other operating expense
in € K		For the year ended December 31,
		2025		2024		2023

Foreign exchange losses		403,756		375,098		315,821
Losses on right-of-use assets, from the sale of fixed assets, clinics and investments		8,143		14,923		29,082
Revaluation of certain investments ⁽¹⁾		84,292		7,544		—
Expenses from strategic transactions and programs		122,162		434,088		320,765
Other		102,304		101,285		98,625
Other operating expense		720,657		932,938		764,293

(1)	Primarily driven by the remeasurement of the Company’s investment in Humacyte, Inc. for the years ended December 31, 2025, 2024, and 2023.

Schedule of expenses from strategic transactions and programs


Expenses from strategic transactions and programs
in € K
		For the year ended December 31,
		2025		2024		2023
Derecognition of capitalized development costs and termination costs⁽¹⁾		—		—		58,818
Legacy Portfolio Optimization		—		—		58,818
Impairment of intangible and tangible assets⁽²⁾		14,961		112,095		48,768
Legacy Portfolio Optimization		13,797		105,845		34,894
FME25+ Program		1,164		6,250		13,874
Impairment resulting from the measurement of assets held for sale		8,793		118,375		74,616
Legacy Portfolio Optimization		8,793		118,375		62,724
FME25+ Program		—		—		11,892
Loss from the sale of business		47,241		132,202		93,859
Legacy Portfolio Optimization		47,241		132,202		93,859
Other⁽³⁾		51,167		71,416		44,704
Legacy Portfolio Optimization		47,660		61,536		14,744
Legal Form Conversion Costs		3,507		9,330		29,960
FME25+ Program		—		550		—
Expenses from strategic transactions and programs		122,162		434,088		320,765

(1)	Primarily R&D expense.

(2)	For the years ended December 31, 2025 and 2024, the amounts relate primarily to costs of revenue and selling, general and administrative expense, while the amounts for the year ended December 31, 2023 relates primarily to R&D expense.

(3)	For the years ended December 31, 2025, 2024, and 2023, the amounts relate primarily to selling, general and administrative expense.

Schedule of income before income taxes according to region


Income before income taxes
in € K
		2025		2024		2023

Germany		179,681		(30,436)		(91,082)
United States		863,117		688,903		725,848
Other		469,440		398,459		398,249
Total		1,512,238		1,056,926		1,033,015

Schedule of income tax expense (benefit)


Income tax expense (benefit)
in € K
		2025		2024		2023
Current
Germany		45,967		69,971		20,947
United States		168,024		179,423		290,787
Other		134,192		139,333		110,972
		348,183		388,727		422,706
Deferred
Germany		11,033		(37,765)		34,018
United States		(13,922)		(48,565)		(150,225)
Other		(24,323)		13,659		(5,942)
		(27,212)		(72,671)		(122,149)
Total		320,971		316,056		300,557

Schedule of reconciliation of expected and actual income tax expense


Reconciliation of income taxes
in € K
		2025		2024		2023

Expected corporate income tax expense		457,906		320,671		313,158
Tax free income		(41,691)		(40,859)		(39,550)
Income from equity method investees		(53,085)		(33,142)		(25,570)
Tax rate differentials		(62,739)		(45,636)		(47,586)
Non-deductible expenses		47,103		97,141		114,182
Tax expense (income) for prior years		(32,129)		10,087		(16,867)
Noncontrolling partnership interests		(54,363)		(46,779)		(58,345)
Tax rate changes		(7,463)		(166)		442
Change in realizability of deferred tax assets and tax credits		30,529		32,415		44,287
Withholding taxes		21,820		8,371		15,124
Other		15,083		13,953		1,282
Income tax expense		320,971		316,056		300,557

Effective tax rate		21.2	%	29.9	%	29.1	%

Schedule of deferred income taxes and net operating loss carryforwards


Deferred income tax assets and liabilities
in € K
		2025		2024
Deferred tax assets
Trade accounts receivable		49,679		46,585
Inventories		72,048		93,831
Intangible assets		1,395		1,193
Property, plant and equipment and other non-current assets		74,131		95,587
Lease liabilities		643,689		779,241
Provisions and other liabilities		283,654		286,048
Pension liabilities		97,252		123,368
Net operating loss carryforwards, tax credit carryforwards and interest carryforwards		97,891		119,453
Derivatives		2,535		8,704
Other		7,824		7,168
Total deferred tax assets		1,330,098		1,561,178

Deferred tax liabilities
Trade accounts receivable		35,502		3,650
Inventories		4,041		3,464
Intangible assets		812,160		936,036
Property, plant and equipment and other non-current assets		175,443		183,762
Right-of-use assets		548,195		676,860
Provisions and other liabilities		5,665		39,826
Pension liabilities		1,978		1
Derivatives		4,073		6,530
Other		196,017		190,430
Total deferred tax liabilities		1,783,074		2,040,559
Net deferred tax liabilities		(452,976)		(479,381)


Net deferred income tax assets and liabilities
in € K
		2025		2024

Deferred tax assets		236,547		229,509
Deferred tax liabilities		689,523		708,890
Net deferred tax liabilities		(452,976)		(479,381)


Net operating loss carryforwards
in € K
For the year ended December 31, 2025		For the year ended December 31, 2024
2026	31,501	2025	13,993
2027	48,245	2026	32,500
2028	31,521	2027	49,674
2029	84,242	2028	34,646
2030	26,498	2029	89,237
2031	1,960	2030	23,492
2032	6,738	2031	12,357
2033	2,796	2032	5,175
2034	801	2033	2,127
2035 and thereafter	235,354	2034 and thereafter	202,457
Without expiration date	442,371	Without expiration date	491,773
Total	912,027	Total	957,431