Fresenius Medical Care shares tumbled 7% Tuesday after the dialysis giant projected broadly flat revenue and operating income for 2026, contrasting sharply with its strong 2025 performance. The company reported a 27% jump in adjusted operating income to €2.21 billion and a 31% increase in reported operating income to €1.83 billion for 2025, driven by cost-cutting initiatives.

The 2026 guidance disappointed investors, with Jefferies noting the forecast implied incremental headwinds despite additional cost efficiencies. The company expects revenue to remain "broadly flat" compared to 2025, with adjusted operating income margins of 10.5% to 12%. Fresenius Medical Care raised its FME25+ savings target to €1.2 billion by end-2027 from €1.05 billion, projecting €250 million in savings for 2026.

The company's portfolio optimization continued with divestitures reducing 2025 revenue by €244 million, including 391 facilities and 53,600 dialysis patients. Despite the near-term headwinds, CEO Helen Giza emphasized the company's commitment to improving profitability while investing in future growth, including a large-scale rollout of its 5008X CAREsystem in the United States.