Fresenius Medical Care AG (FMS) 2024 Q4 法說會逐字稿

Ladies and gentlemen, welcome to the Fresenius Medical Care report on the fourth-quarter 2024 conference call. I'm Sandra, the Chorus Call operator. I would like to remind you that all participants have been listening more than the conference is being recorded.

女士們，先生們，歡迎參加費森尤斯醫療保健2024年第四季電話會議報告。我是桑德拉，合唱團的接線生。我想提醒大家，所有與會者聆聽的時間比會議錄音的時間還要多。

This recording will also be available on the Fresenius Medical Care website. Additionally, the transcript of this conference will also be published on the website of the conference. (Operator Instructions) The presentation will be followed by a Q&A session. You can register for questions at any time by pressing and one in your telephone.

該錄音也將在費森尤斯醫療保健網站上發布。此外，本次會議的文字記錄也將在會議網站上公佈。（操作員指示）示範之後將進行問答環節。您可以隨時透過按電話上的 和 來登記提問。

The conference must not be recorded for publication or broadcast. At this time, it's my pleasure to hand over to Dr. Dominik Heger. Please go ahead, sir.

會議不得錄製以供出版或廣播。現在，我很高興將發言權交給 Dominik Heger 博士。先生，請繼續。

Thank you, Sandra. I would like to welcome everyone to our earnings call for the fourth quarter and financial year 2024. Thank you for joining us today. As always, I start out the call by mentioning our cautionary language that is in our Safe Harbor statement as well as in our presentation and in all the materials that we have distributed earlier today.

謝謝你，桑德拉。歡迎大家參加我們 2024 年第四季和財政年度的收益電話會議。感謝您今天加入我們。像往常一樣，我在電話會議開始時提到了我們在安全港聲明以及我們的簡報和今天早些時候分發的所有資料中的警告性語言。

For further details concerning risks and uncertainties, please refer to these documents and to our SEC filings. (Conference Instructions)

有關風險和不確定性的更多詳細信息，請參閱這些文件和我們的美國證券交易委員會文件。（會議指示）

Let me now welcome Helen Giza, CEO and Chair of the Management Board; and Martin Fischer, CFO of Fresenius Medical Care. Helen, the floor is yours.

現在，我歡迎執行長兼管理委員會主席海倫·吉薩 (Helen Giza)；以及費森尤斯醫療保健公司財務長馬丁·菲舍爾 (Martin Fischer)。海倫，請你發言。

Thank you, Dominik, and a warm welcome to everyone. Thank you for joining our presentation today. I'm excited to speak about the remarkable progress that we have made in executing our strategic plan and the strong set of financial results we have delivered.

謝謝你，多明尼克，熱烈歡迎大家。感謝您參加我們今天的演講。我很高興地談論我們在執行策略計劃方面取得的顯著進展以及我們取得的強勁財務業績。

Before I begin my prepared remarks, I want to take a moment to acknowledge that this success would not have been possible without the unwavering commitment of our employees around the world. We have set ambitious targets to turn around and transform our company all at the same time, and our employees continue to rise to the challenge.

在我開始我的準備好的發言之前，我想花一點時間承認，如果沒有我們世界各地員工的堅定承諾，這項成功是不可能實現的。我們制定了雄心勃勃的目標，要同時扭轉和改造我們的公司，我們的員工將繼續迎接挑戰。

I'm especially inspired by the way our teams have stepped up in the face of natural disasters and geopolitical challenges. During our last call, I talked about the hurricanes in the Southeastern United States and ongoing conflicts in Israel and Ukraine. Since then, we've also faced devastating wildfires in California, extreme ice and snow storms, especially in Texas and Louisiana in January and more recently in New England as well as flooding in the Mid-Atlantic.

我們的團隊在面對天災和地緣政治挑戰時所展現出的努力尤其令我深受啟發。在我們上次通話中，我談到了美國東南部的颶風以及以色列和烏克蘭正在發生的衝突。自那時起，我們還面臨著加州毀滅性的野火、極端冰雪風暴，尤其是一月份在德克薩斯州和路易斯安那州以及最近在新英格蘭地區發生的冰雪風暴，以及大西洋中部的洪水。

Through it all, our dedicated teams continue to ensure our patients receive their life-sustaining dialysis treatments with minimal interruption. An incredible testament to the strength of our teams and resiliency of our operations and recognized in this year's net promoter score of 72, matching last year's very high level. This score based on patient surveys demonstrates very strong patient satisfaction with the quality of our services.

在整個過程中，我們敬業的團隊將繼續確保我們的患者以最少的干擾接受維持生命的透析治療。這充分證明了我們團隊的實力和營運的彈性，今年的淨推薦值達到了 72，與去年的非常高的水平持平。根據患者調查得出的分數表明患者對我們服務的品質非常滿意。

Executing such a turnaround and transformation plan while maintaining an unwavering commitment to delivering the quality of care to our patients is no small feat, and I want to extend my deepest gratitude to our employees for their dedication and hard work.

執行這樣的扭轉和轉型計劃，同時堅定不移地致力於為我們的患者提供優質的護理，絕非易事，我要向我們的員工的奉獻和辛勤工作表示最深切的感謝。

Now I'll begin my prepared remarks on slide 4. Two years ago, we embarked on an ambitious plan to turn around and transform our company over a three-year period. I'm proud to say we have made significant progress on all dimensions, which is why this chart is so full, but I feel it's worth to recap or we have achieved. This serves as a reminder of our commitment to deliver on what we set out to do as it lays the foundation for the future success of our great company.

現在我將從投影片 4 開始我的準備好的演講。兩年前，我們制定了一項雄心勃勃的計劃，要在三年內扭轉和改造公司。我很自豪地說我們在各個方面都取得了重大進展，這就是為什麼這張圖表如此飽滿，但我覺得值得回顧一下我們所取得的成就。這提醒我們，我們要致力於實現我們所設定的目標，因為這為我們偉大公司的未來成功奠定了基礎。

In 2023, we implemented major structural changes, including the change in our global operating model, provided more transparent financial reporting, and changed our legal form. In parallel, we successfully advanced all aspects of our plan, and we did not stop there or let up the pace.

2023年，我們實施了重大結構性變革，包括改變我們的全球營運模式、提供更透明的財務報告以及改變我們的法律形式。同時，我們順利推進了計劃的各個方面，並且沒有就此止步或放鬆步伐。

In 2024, we built on this momentum, further strengthening our foundation and driving accelerated progress to position our company for sustained profitable growth in the future. We further upgraded our leadership team, including a new Head of Care Delivery and a new Head of Legal, HR and compliance at the Management Board level. Also, on the executive level, we have made several important changes, creating new key positions as well as upgrading our capabilities and talent bench.

2024年，我們在此基礎上進一步鞏固基礎，加速進步，為公司未來持續獲利成長做好準備。我們進一步升級了領導團隊，包括管理委員會層級的新任護理服務主管和新任法律、人力資源和合規主管。此外，在管理階層，我們做出了幾項重要調整，設立了新的關鍵職位，並提升了我們的能力和人才儲備。

In 2024, we further accelerated our FME25 transformation program, achieving incremental sustainable savings ahead of plan. As a result, we have been able to compensate the lower-than-expected volume growth in the US dialysis business over the last two years.

2024年，我們進一步加快FME25轉型計劃，提前實現增量可持續節約。因此，我們能夠彌補過去兩年美國透析業務銷售成長低於預期的現象。

Due to the great momentum in the FME25 program, we are now raising our total savings target from EUR650 million to EUR750 million by the end of 2025. We continued the execution of our portfolio optimization plan, ensuring our business is focused on a strengthened core with a higher return profile. And in 2024, we realized important milestones in our business.

由於 FME25 計畫的強勁勢頭，我們現在將總節省目標從 2025 年底的 6.5 億歐元提高到 7.5 億歐元。我們繼續執行投資組合優化計劃，確保我們的業務專注於具有更高回報的強化核心。2024年，我們實現了業務上的重要里程碑。

While we continue to experience elevated mortality in the United States, as is the case for the general population in the country, the work we have been doing in our US care delivery operations to drive operational excellence, upgrading and standardizing, and streamlining our operational processes as well as reducing mistreatments is really paying off.

儘管美國的死亡率與全國總人口一樣持續上升，但我們在美國醫療服務運營中為推動卓越運營、升級和標準化、簡化運營流程以及減少虐待所做的工作確實取得了成效。

Our same-market treatment growth in the US turned positive for the full year, supported by an accelerated 0.5% development in the fourth quarter when adjusted for the exit of less profitable acute contracts. Additionally, the excellence of our disaster response and clinic operations meant that despite more pronounced weather-related incidents, we only had a five basis point impact on third and fourth quarter volume development.

我們在美國全年的同市場治療成長轉為正值，這得益於第四季度 0.5% 的加速發展（經利潤較低的急性合約退出調整後）。此外，我們出色的災難應變和診所營運意味著，儘管天氣相關事件更加明顯，但對第三季和第四季的銷售發展僅產生了 5 個基點的影響。

We are further detailing the rollout plan of our high-volume hemodiafiltration capable 5008X machine in the US. We received FDA approval in early 2024, and we performed our first HDF treatments on the machine in our clinics in the meantime. We are excited about the opportunity this innovation brings to our US market.

我們正在進一步詳細說明在美國推出具有大容量血液透析濾過功能的 5008X 機器的計劃。我們於 2024 年初獲得了 FDA 批准，同時我們在診所使用機器進行了首次 HDF 治療。我們對這項創新為美國市場帶來的機會感到非常興奮。

The improvements we have made in care enablement not only supported recent performance, but strengthened the base of our operations and position us for profitable growth going forward. This includes rationalization of our supply chain and manufacturing footprint as well as broad-scale cost and efficiency improvements. These positive developments supported strong operational progress over the course of the year.

我們在護理支援方面所取得的改善不僅支持了近期的業績，而且加強了我們的營運基礎，並為我們未來的獲利成長奠定了基礎。這包括合理化我們的供應鏈和製造足跡以及大規模的成本和效率改進。這些積極的發展支持了全年強勁的營運進展。

By sharpening our focus on the core business, we delivered 4% organic growth and achieved the upper end of our earnings outlook for 2024. As a result, our group operating income margin further improved as planned. And our commitment to a disciplined financial policy and priority to deliver resulted in an improved leverage ratio, which brought us below our self-imposed range. For our shareholders, we are planning to propose a dividend increase of 21%, in line with our current dividend policy.

透過更專注於核心業務，我們實現了 4% 的有機成長，並達到了 2024 年獲利預期的上限。因此，我們集團的營業收入利潤率按計劃進一步提高。我們致力於實施嚴格的財務政策並優先履行交付承諾，從而提高了槓桿率，使其低於我們自己設定的範圍。對於我們的股東，我們計劃提議將股利提高 21%，以符合我們目前的股利政策。

Slide 5 shows how our progress translates into numbers. This slide highlights the tangible impact of our strategic execution reflected in our strengthened financial performance and enhanced value creation. Our operating income margin has shown consistent improvement towards our target margin band for 2025, supported by both operating segments.

幻燈片 5 展示了我們的進展如何轉化為數位。這張投影片重點介紹了我們的策略執行所帶來的實際影響，體現在我們增強的財務表現和增強的價值創造上。在兩個營運部門的支持下，我們的營業利潤率持續改善，朝著 2025 年的目標利潤率區間邁進。

Care delivery has already reached the lower end of its target band with a margin over 10% in full year 2024. This improvement reflected our turnaround efforts, including positive price and volume effects, realization of productivity gains, and labor efficiency enhancements as well as a focused international portfolio. Care enablement has improved its full year margin to 6.1%, almost tripling the margin from only a year ago.

醫療服務已達到其目標區間的低端，2024 年全年的利潤率將超過 10%。這項改善反映了我們扭轉局面的努力，包括正面的價格和數量效應、實現生產力提高、勞動效率提高以及重點國際投資組合。護理支援業務的全年利潤率提高至 6.1%，幾乎是一年前的三倍。

The improved profitability of both segments has been supported by the acceleration of our FME25 program Here, we have already achieved EUR567 million in sustainable savings through 2024. As a result, we are now on track to realize a new increased target of EUR750 million savings by the end of this year.

我們的 FME25 計畫的加速推進促進了這兩個部門獲利能力的提高，到 2024 年，我們已經實現了 5.67 億歐元的可持續節約。因此，我們預計在今年年底前實現節省 7.5 億歐元的新目標。

In line with our dividend policy and improving financial results, we plan to propose a dividend of EUR1.44, reflecting a 13% compound annual growth rate over the past two years. As outlined, our leverage ratio has improved as a consequence of our current financial policy from 3.4 times at the end of 2022 to 2.9 times and below our self-improve self-imposed target range. S&P, Moody's, and Fitch now have us rated as investment grade with stable outlook.

根據我們的股息政策和不斷改善的財務業績，我們計劃提議派發 1.44 歐元的股息，反映過去兩年 13% 的複合年增長率。如上所述，由於我們目前的財務政策，我們的槓桿率有所改善，從 2022 年底的 3.4 倍降至 2.9 倍，低於我們自我改善的目標範圍。標準普爾、穆迪和惠譽目前將我們評為投資等級，前景穩定。

Moving to slide 6. We have continued to execute against our portfolio optimization plan as we look to divest non-core and lower margin assets. Just yesterday, we announced the divestiture of select assets of Spectra Laboratories, our US lab service business.

移至幻燈片 6。我們將繼續執行投資組合優化計劃，尋求剝離非核心和利潤率較低的資產。就在昨天，我們宣布剝離美國實驗室服務業務 Spectra Laboratories 的部分資產。

Collectively, in addition to exiting noncore assets like Spectra, NCP, and Cura, we have now exited around a dozen dialysis service markets as we strategically refocused our international portfolio on growth markets with attractive returns.

總的來說，除了退出 Spectra、NCP 和 Cura 等非核心資產外，我們還退出了約十幾個透析服務市場，因為我們策略性地將我們的國際投資組合重新聚焦於具有可觀回報的成長市場。

This includes the exit of all of our Latin America service business with only Brazil left, which we expect to close in the first half of this year.

這包括退出我們所有的拉丁美洲服務業務，只剩下巴西，我們預計將在今年上半年關閉這項業務。

We have made significant progress since we first presented this slide at our last Capital Markets Day 2023. By the end of 2024, we had realized total cash proceeds of EUR750 million. We remain focused on our core business and continue (technical difficulty)

自從我們在上屆 2023 年資本市場日首次展示這張投影片以來，我們已經取得了重大進展。截至 2024 年底，我們已實現現金收益總額 7.5 億歐元。我們將繼續專注於核心業務，（技術難度）

Okay. So we actually don't know where we lost you. We will restart at slide 7. Sorry for the inconvenience. So going back to slide 7.

好的。所以我們實際上不知道在哪裡失去了你。我們將從第 7 張投影片重新開始。帶來不便敬請諒解。回到投影片 7。

Thank you, Dominik. On slide 7, I'm proud of the fact that we are setting ambitious targets and delivering on our commitment to achieve them. In 2024, we realized a 2% revenue growth after accounting for a 1.6% headwind from divestments.

謝謝你，多米尼克。在第 7 張投影片上，我為我們設定了雄心勃勃的目標並履行實現這些目標的承諾而感到自豪。2024 年，在計入資產剝離帶來的 1.6% 的不利影響後，我們實現了 2% 的收入成長。

We achieved an impressive 18% operating income growth at the upper end of our earnings outlook for the year. I will now hand over to Martin to take you through the fourth quarter financial performance in more detail.

我們實現了令人印象深刻的 18% 的營業收入成長，達到了我們今年獲利預期的上限。現在我將讓馬丁向大家更詳細地介紹第四季的財務表現。

Thank you, Helen, and welcome to everyone to the call also from my side. I will give you an overview of the fourth quarter performance beginning on slide 9. Starting with the highlights. In the fourth quarter, we delivered strong organic revenue growth of 7.4%, supported by both care delivery as well as care enablement.

謝謝你，海倫，我也歡迎大家來參加我的電話會議。從第 9 張投影片開始，我將為您概述第四季的表現。從亮點開始。第四季度，我們實現了 7.4% 的強勁有機收入成長，這得益於醫療服務和醫療支援。

For the second consecutive quarter, we recorded positive volume growth in the US. When adjusted for the exit of acute care contracts, our same-market treatment growth increases to 0.5%.

我們連續第二季在美國實現了銷量正成長。當根據急性護理合約的退出進行調整時，我們的同市場治療成長率將增加到 0.5%。

We continued our accelerated progress on our FME25 savings target with a strong fourth quarter that contributed an additional EUR48 million in sustainable savings. We realized EUR221 million for the full year.

我們持續加速實現 FME25 儲蓄目標，第四季表現強勁，額外貢獻了 4,800 萬歐元的可持續儲蓄。全年利潤2.21億歐元。

We exceeded our already increased incremental savings targets for 2024 of originally EUR200 million. On an outlook base, both segments delivered further improved operating income and operating income margins. This keeps us fully on track to achieve our 2025 margin ambitions. We delivered a significant improvement in operating and free cash flow in the fourth quarter, and our net leverage ratio of 2.9 times remains below our self-imposed paid.

我們超額完成了原本已增加的 2024 年增量儲蓄目標 2 億歐元。從前景來看，兩個部門的營業收入和營業收入利潤率都進一步提高。這使我們完全有望實現 2025 年的利潤目標。我們在第四季度實現了營運和自由現金流的顯著改善，我們的淨槓桿率為 2.9 倍，仍然低於我們自己設定的支付水準。

I will continue on slide 10. In the fourth quarter, we realized 5% revenue growth on an outlook base driven by accelerated organic revenue growth with contributions from both segments. As we continue to execute our portfolio optimization plans, we realized divestitures did negatively impact our revenue development by 250 basis points in the fourth quarter. As a reminder, we decided not to adjust our numbers in the fiscal year 2024 or 2025, for the divestiture that we closed in those years, but to absorb it in our guidance range for the respective year.

我將在第 10 張投影片上繼續講。第四季度，我們實現了 5% 的收入成長，這得益於兩個部門的貢獻以及有機收入的加速成長。隨著我們繼續執行投資組合優化計劃，我們意識到資產剝離確實對第四季度的收入發展產生了 250 個基點的負面影響。提醒一下，我們決定不調整 2024 或 2025 財年的數字（針對我們在那些年完成的資產剝離），而是將其納入相應年份的指導範圍內。

We saw a significant increase in operating income in the fourth quarter. On an outlook base, operating income grew by 31%, driven by both segments. This positive development led to an improved margin of 9.6% compared to 7.7% in the previous year.

我們看到第四季的營業收入大幅成長。從前景來看，在兩個部門的推動下，營業收入成長了 31%。這一積極發展使利潤率從上年的 7.7% 提高至 9.6%。

Divestitures realized in 2024, as part of our portfolio optimization plan had a neutral effect on group margin development in the fourth quarter. Special items negatively affected operating income by EUR230 million. They mainly included costs related to the execution of our portfolio optimization plan. Our FME25 transformation program also added to those. The biggest impact had our portfolio optimization plan, where the sale of select assets of Spectra Laboratories was classified as an asset held for sale.

作為我們投資組合優化計劃的一部分，2024 年實現的資產剝離對第四季度的集團利潤率發展產生了中性影響。特殊項目對營業收入產生了2.3億歐元的負面影響。它們主要包括與執行我們的投資組合最佳化計劃相關的成本。我們的 FME25 轉型計劃也增加了這些內容。影響最大的是我們的投資組合優化計劃，其中 Spectra Laboratories 的部分資產的出售被歸類為持有待售資產。

Moving to slide 11. The slide provides an overview of the strong group margin improvement we achieved in the fourth quarter. On the left, you can see how we get from the reported fourth-quarter 2023 operating income to the starting point of our outlook place by adjusting for special items and 2023 divestitures as well as the effect of the substantial Tricare settlement.

移至投影片 11。這張幻燈片概述了我們在第四季度實現的強勁集團利潤率成長。在左側，您可以看到我們如何透過調整特殊項目和 2023 年資產剝離以及大量 Tricare 和解的影響，從報告的 2023 年第四季營業收入達到我們的展望起點。

We achieved a margin improvement of 190 basis points with a positive contribution from care delivery and an impressive step-up in profitability from care enablement. The development of corporate income included the negative valuation effect of virtual purchase power agreements, amounting to EUR7 million in the fourth quarter. As mentioned on the previous slide, Special items negatively affected reporting operating income, while foreign currency translation had a neutral effect this quarter.

我們的利潤率提高了 190 個基點，這得益於醫療服務提供的積極貢獻以及醫療支持帶來的盈利能力的顯著提升。企業營收的發展包括虛擬購買力協議的負面估值效應，第四季達到 700 萬歐元。正如上一張投影片所提到的，特殊項目對報告營業收入產生了負面影響，而外幣折算對本季產生了中性影響。

Turning to slide 12. In the fourth quarter, care delivery revenue increased by 3% on an outlook base. This includes a 370 basis point headwind from divestitures realized in 2024. At the same time, organic growth for care delivery accelerated to 6% in the quarter.

翻到第 12 張投影片。第四季度，醫療服務收入預計將成長 3%。其中包括 2024 年實現的資產剝離帶來的 370 個基點的逆風。同時，本季醫療服務有機成長率加速至 6%。

In the US, organic growth of 7% was driven by growth in our value-based care business, higher treatment volumes with an underlying same-market treatment growth of 0.5%, as well as improved rates and payer mix. Our excellent disaster response and clinic operations teams mitigated the severe weather-related incidents to an impact of only 5 basis points on the fourth quarter volume development.

在美國，7% 的有機增長得益於我們基於價值的護理業務的增長、治療量的增加（基本同市場治療量增長 0.5%），以及費率和付款人組合的改善。我們出色的災難應變和診所營運團隊將惡劣天氣相關事件對第四季度銷售發展的影響減輕到僅 5 個基點。

Care delivery International contributed a solid 4% organic growth. Same market treatment growth in our international markets continued to outpace the US.

國際護理服務貢獻了 4% 的穩健有機成長。我們國際市場的同類市場治療成長持續超過美國。

In the fourth quarter, care delivery achieved a 10 percentage points increase in operating income on an outlook basis. The segment also saw a margin improvement of 70 basis points, leading to a margin of 10.7%. Positive effects mainly came from the business growth driven by a lower negative contribution from the value-based care business, high treatment volumes, and favorable rate and mix effects.

第四季度，醫療服務業務的營業收入預期增加了 10 個百分點。該部門的利潤率也提高了 70 個基點，達到 10.7%。正面影響主要來自於價值型護理業務負面貢獻降低、治療量增加以及有利的費率和組合效應所推動的業務成長。

Business growth compensated for the phasing of a consent agreement on certain pharmaceuticals which we had highlighted to you in our quarter three earnings call. While the loss was reduced year over year, our value-based care business did realize a revenue of EUR1.8 billion and the negative contribution roughly in line with the midpoint of the communicated range of negative EUR20 million to EUR40 million.

業務成長彌補了我們在第三季財報電話會議上向您強調的某些藥品同意協議的分階段實施。雖然虧損年減，但我們的價值型護理業務確實實現了 18 億歐元的收入，負貢獻大致與所公佈的負 2000 萬歐元至 4000 萬歐元區間的中點一致。

Care delivery earnings growth was additionally supported by savings from our FME25 program and partially offset by labor and inflationary headwinds in line with our expectations for the year. While being margin neutral in the full year, care delivery also faced a EUR30 million headwind from divestitures realized during the year. As in the revenue line, this was absorbed in our outlook range for 2024.

我們的 FME25 計劃帶來的節省也支持了醫療服務的獲利成長，但勞動力和通膨阻力部分抵消了這一增長，這符合我們對今年的預期。雖然全年利潤率保持中性，但醫療服務也因年內實現的資產剝離而面臨 3000 萬歐元的阻力。與收入線一樣，這被納入了我們對 2024 年的展望範圍。

Next slide. Next, on slide 13. In the fourth quarter, care enablement revenue grew by 10% on an outlook basis with impressive 10% organic growth, driven by volume growth in all geographies and continued positive pricing momentum. As expected, volume growth in China did accelerate as a consequence of the implementation of volume-based procurement, which was partially -- which has partially offset the negative pricing impact from volume-based procurement. Care enablement realized a significant increase in earnings.

下一張投影片。接下來，請看第 13 張投影片。第四季度，護理支持收入預期增長 10%，其中有機增長率達到令人印象深刻的 10%，這得益於所有地區的銷售增長和持續的積極定價勢頭。正如預期的那樣，由於實施了帶量採購，中國的銷售成長確實加快了，這部分抵消了帶量採購對定價造成的負面影響。護理賦能實現了收益的大幅提升。

Compared to the fourth quarter of 2023, operating income on an outlook base grew by more than sixfold. As a result, care enablement accelerated margin expansion trajectory with 650 basis points improvement to a 7.8% compared to prior year. This strong increase was driven by positive volume and price effects and supported by savings from the FME25 program.

與 2023 年第四季相比，預期營業收入成長了六倍以上。因此，護理支持加速了利潤率擴張軌跡，與前一年相比提高了 650 個基點，達到 7.8%。這一強勁增長是由積極的數量和價格效應推動的，並受到 FME25 計劃節省的支持。

In the fourth quarter, we continued our organizational optimization and realized further cost efficiencies in manufacturing and supply chain. The positive drivers offset inflationary cost increases as well as the mentioned negative price impact from volume-based procurement in China.

第四季度，我們繼續進行組織最佳化，並進一步提高了製造和供應鏈的成本效率。這些積極的驅動因素抵消了通貨膨脹成本的增加以及中國批量採購帶來的負面價格影響。

Next on slide 14. In the fourth quarter, we realized a 16% increase in operating cash flow, driven by favorable development in working capital. This strong result comes on top of a tough prior year comparison, which included the settlement payment.

接下來是第 14 張投影片。第四季度，受營運資金良好發展的推動，我們的營運現金流成長了 16%。這一強勁業績是在與去年同期相比（包括和解金）較為艱難的情況下取得的。

On a full-year basis, we saw a decline in operating cash flow mainly due to the negative impact from phasing of dividend payments that we received from equity method investments and the absence of the Tricare settlement in 2024. In line with our current strategic ambition, we further reduced our total debt and lease liabilities as well as total net debt and lease liabilities compared to the prior year period.

從全年來看，我們的經營現金流有所下降，主要是由於權益法投資分階段支付股利帶來的負面影響，以及 2024 年沒有 Tricare 結算。按照我們目前的策略目標，與去年同期相比，我們進一步減少了總債務和租賃負債以及總淨債務和租賃負債。

As a result of our strict financial discipline, our leverage ratio of 2.9 times continues below our self-imposed target range corridor. We are taking a holistic approach in detailing our strategy beyond 2025, including considerations of future capital needs for the profitable organic growth and the importance of shareholder returns. With that, I will now hand back to Helen to go through our outlook.

由於我們嚴格的財務紀律，我們的槓桿率為 2.9 倍，繼續低於我們自己設定的目標區間。我們正在採取整體方法來詳細制定 2025 年以後的策略，包括考慮獲利性有機成長的未來資本需求以及股東回報的重要性。說完這些，我現在將交還給海倫來介紹我們的展望。

Thank you, Martin. I'll pick it up on slide 16. Now moving on to the assumptions for 2025, starting with revenue. We are assuming positive USA market treatment growth above 0.5% based on similar elevated mortality trends as in 2024. Annualization of mortality in earlier chronic kidney disease states has clearly taken longer to normalize than the industry expected.

謝謝你，馬丁。我將從第 16 張投影片開始講解。現在我們來談談 2025 年的假設，首先是收入。基於與 2024 年類似的死亡率上升趨勢，我們假設美國市場治療成長率將超過 0.5%。早期慢性腎臟病患者的死亡率年化顯然比業界預期的要花費更長的時間才能恢復正常。

We are encouraged by the trends we saw in the last two quarters and in January. Once mortality has normalized, there is no indication that we would not see a recovery to a 2%-plus same-market treatment growth in 2026 and beyond. Of course, we are monitoring the current flu season, but we wouldn't expect -- we would expect an acceleration throughout the year.

過去兩個季度和一月份的趨勢令我們感到鼓舞。一旦死亡率恢復正常，沒有跡象顯示我們不會在 2026 年及以後看到同市場治療成長率恢復到 2% 以上。當然，我們正在監測當前的流感季節，但我們預計全年流感疫情不會加速。

Our 2025 revenue outlook assumes headwinds from the successful execution of our portfolio optimization plan. Divestments executed in 2024 are expected to have a negative impact of around 1% in 2025. We also expect an additional EUR100 million in revenue from our value-based care business, increasing revenue in that book of business to around EUR1.9 billion.

我們對 2025 年收入的展望假設我們的投資組合最佳化計畫的成功執行會帶來阻力。預計 2024 年實施的撤資將對 2025 年產生約 1% 的負面影響。我們也預期基於價值的護理業務將額外帶來 1 億歐元的收入，從而使該業務的收入增加至約 19 億歐元。

On the earnings side, we now expect an incremental EUR180 million FME25 savings, which has helped to cover the cumulative effects of the lower-than-expected same-market treatment growth in the US in the last three years. Business growth is expected to positively contribute EUR500 million to EUR600 million in earnings in 2025.

在獲利方面，我們現在預期FME25將節省1.8億歐元，這有助於彌補過去三年美國同市場治療成長低於預期的累積影響。預計到 2025 年，業務成長將為收益貢獻 5 億歐元至 6 億歐元。

In addition to volume growth and pricing improvements across both operating segments, the business growth range includes a benefit of around EUR100 million in our care delivery business, resulting from the inclusion of binders in the bundle. The size of this benefit in the TDAPA period significantly depends on the uptake, prescription patterns, and the mix of branded versus generic products as well as the impact on the assets we have in our portfolio.

除了兩個營運部門的銷售成長和價格改善之外，業務成長範圍還包括我們的醫療服務業務因在捆綁包中加入活頁夾而獲得的約 1 億歐元的收益。TDAPA 期間此福利的規模很大程度上取決於吸收量、處方模式、品牌藥與仿製藥的組合以及對我們投資組合中資產的影響。

Business growth also includes our value-based care book of business, which we assume to have a slightly negative to breakeven operating income contribution in 2025. Similar to previous years, we expect a net labor headwind of EUR150 million to EUR200 million, mainly in category. In addition, we anticipate cost inflation of EUR100 million to EUR150 million.

業務成長還包括我們基於價值的護理業務，我們預計該業務在 2025 年的營業收入貢獻將略微為負，以實現盈虧平衡。與往年類似，我們預計淨勞動力逆風將達到 1.5 億歐元至 2 億歐元，主要集中在類別方面。此外，我們預計成本通膨將達到 1 億歐元至 1.5 億歐元。

In respect to tariffs, we recognize this is a fluid situation, and we continue to evaluate the impact on our business. So far, we estimate the impact to be very limited due to the nature of our footprint and supply chain.

關於關稅，我們認識到這是一個不穩定的情況，我們將繼續評估其對我們業務的影響。到目前為止，由於我們的足跡和供應鏈的性質，我們估計影響非常有限。

While supply -- while special items are excluded from guidance and are hard to predict, we do expect FME25 costs of around EUR100 million to EUR150 million and costs relating to legacy portfolio optimization of EUR50 million to EUR100 million.

雖然供應——特殊項目被排除在指導之外並且很難預測，但我們確實預計 FME25 成本約為 1 億歐元至 1.5 億歐元，與遺留投資組合優化相關的成本為 5000 萬歐元至 1 億歐元。

To help with your modeling, we are assuming a tax rate of 25% to 27% and net financial result of EUR300 million to EUR320 million. And for corporate costs, we expect EUR70 million to EUR90 million.

為了幫助您建模，我們假設稅率為 25% 至 27%，淨財務表現為 3 億歐元至 3.2 億歐元。對於企業成本，我們預計為 7,000 萬歐元至 9,000 萬歐元。

I will now continue to the outlook on slide 17. Against this background, we approach 2025 with confidence in our strengthened foundation and ability to further accelerate earnings growth. For full year 2025, we expect a positive to low single-digit percent revenue development, which only looks muted as it includes a 1% headwind from our portfolio optimization as just outlined.

我現在將繼續討論第 17 張投影片上的展望。在此背景下，我們對2025年充滿信心，相信我們的基礎將更加牢固，獲利成長將進一步加快。對於 2025 年全年，我們預計收入成長將達到正數至低個位數百分比，但由於其中包括我們剛才概述的投資組合優化帶來的 1% 的阻力，因此看起來增長幅度不大。

For operating income growth, we expect a very strong year. We are guiding for our high teens to high 20%s growth range. And while this seems like a wide range, this outlook raises the implied operating income margin to around 11% to 12% in 2025.

對於營業收入成長，我們預計今年將非常強勁。我們的預期成長範圍為 15% 至 20% 之間。雖然這似乎是一個很大的範圍，但這種前景將隱含的營業收入利潤率提高到 2025 年的 11% 至 12% 左右。

We are tightening our former 2025 midterm range of 10% to 14%, and we do expect both operating segments to make progress within or into their margin target bands. We remain laser-focused on executing this third and final year of our turnaround and transformation plan, ensuring we are well positioned for our company's future strategy and to enhancing shareholder value and returns.

我們正在將先前 2025 年中期目標範圍從 10% 收緊至 14%，並且我們確實預計兩個營運部門都將在其利潤率目標範圍內取得進展。我們將繼續專注於執行扭虧為盈和轉型計畫的第三年也是最後一年，確保我們為公司的未來策略做好準備，並提高股東價值和回報。

I look forward to sharing the details of our strategy beyond 2025 at our upcoming Capital Markets Day on June 17 in London. We hope many of you will be able to attend, so please save the date and look out for future communications from Investor Relations. This concludes my prepared remarks, and I'll now hand back to Dominik to start the Q&A.

我期待在 6 月 17 日於倫敦舉行的資本市場日上分享我們 2025 年以後策略的細節。我們希望你們中的許多人能夠參加，因此請保存日期並留意投資者關係部未來的溝通。我的準備好的發言到此結束，現在我將把發言權交還給多明尼克，開始問答環節。

Thank you, Helen, and Martin. Thank you for your presentation and to the listeners, apologies for the disruption. (Conference Instructions) So with that, I hand it over to Sandra to open the Q&A, please.

謝謝你，海倫和馬丁。感謝您的演講，對於造成的打擾，我們向各位聽眾表示歉意。（會議指示）好了，現在我把時間交給桑德拉，請她開始問答環節。

(Operator Instructions)

（操作員指示）

Hassan, Barclays.

哈桑，巴克萊銀行。

Hi, good afternoon. Thank you for taking my questions. A couple for me, please. Firstly, on margins. It'd be great to get some color on your expectation on segment margins in 2025 as well as phasing. You're already in the 10% to 14% initial range provided for care delivery. So how are you thinking about incremental improvement here versus care enablement, where there's a bit more to go, but presumably a lot more pricing benefits coming through?

嗨，下午好。感謝您回答我的問題。請給我幾張。首先，關於利潤。如果您能對 2025 年細分市場的利潤率以及分階段發展做出一些預測，那就太好了。您已經處於護理服務提供的初始範圍的 10% 到 14% 之內。那麼，您如何看待這裡的漸進式改進與護理支援？護理支援雖然還有很長的路要走，但大概會帶來更多的定價優勢？

And then secondly, can you talk a bit about your expectations for same-store growth throughout 2025. How is Q1 trending? And any expectations given a delayed flu season. And I appreciate your giving guidance for at least 0.5% growth, but you've also in the past talked about an exit rate of 2% coming out of 2025. So any color on phasing would be helpful.

其次，您能否談談對 2025 年同店成長的預期。Q1 趨勢如何？以及由於流感季節延遲而產生的任何預期。我很感謝您給予至少 0.5% 的成長預期，但您過去也曾談到 2025 年的退出率為 2%。因此，任何有關分階段的顏色都會有幫助。

Hi, Hassan. Thanks for your question. I'll take one of those. We're not guiding to margin segments for '25. We've obviously given the total group guidance there. But that color that you rightly play back is, we do expect both segments to move along that margin band in 2025.

你好，哈桑。謝謝你的提問。我要其中一個。我們不會指導 25 年的利潤細分。我們顯然已經為整個團隊提供了指導。但是您正確播放的顏色是，我們確實預計這兩個部分將在 2025 年沿著該利潤帶移動。

As you can imagine, we are really excited and encouraged by the progress and big step-up we saw in CE in Q4. And they're sitting at 7.8% for Q4. So really just right at the edge of the tip of that margin band of 8% to 12% that we put out there. So we do expect to just continue to move along that. And obviously, we'll provide updates as we go through the year.

你可以想像，我們對第四季在 CE 領域的進展和巨大進步感到非常興奮和鼓舞。第四季的成長率為 7.8%。因此，實際上正好處於我們設定的 8% 至 12% 的利潤區間的邊緣。所以我們確實希望繼續沿著這個方向前進。顯然，我們會在年內提供更新資訊。

Same market treatment growth, let me unpack that because I'm expecting a lot of people to have a similar question. Look, we are very -- feeling really good about the progress that we have made over the last couple of quarters, moving from 0.2% in Q3 to 0.5% in Q4, turning the full year positive. The work we are doing is really paying off. And we've clearly talked about that turnaround plan in CD for quite a while. The work on streamlining admissions, reducing mistreatments is really helping our processes.

同樣的市場治療成長，讓我來解釋一下，因為我預期很多人都會有類似的問題。你看，我們對過去幾季取得的進展感到非常滿意，從第三季的 0.2% 上升到第四季的 0.5%，使全年實現了正成長。我們所做的工作確實取得了成效。而且我們顯然已經在 CD 中討論了很長一段時間的扭虧為盈計劃。簡化入院流程、減少受虐的工作確實對我們的流程有幫助。

The other thing that we are seeing is a sequential slight improvement in referrals on new patient starts. We clearly see that mortality remains elevated. And our view here is that's clearly -- once that normalizes, there's no reason for us to not believe that the 2% returns.

我們看到的另一件事是新患者轉診數量連續略有改善。我們清楚地看到死亡率仍然很高。我們的觀點是，一旦恢復正常，我們就沒有理由不相信 2% 的回報。

We're watching the flu season closely. Obviously, we didn't see much of an impact in January and our underlying growth looks good in January. We're clearly watching the spike probably following the same flu tracker. We saw it really spike in, I think, week seven and kind of came down as quickly the following week. So we're kind of watching that to see what effect that would have in the quarter.

我們正在密切關注流感季節。顯然，我們在一月份沒有看到太大的影響，而且我們一月份的潛在成長看起來很好。我們顯然觀察到了這種激增，可能與同一種流感追蹤器有關。我認為，我們看到它在第七週真正飆升，並在接下來的一周迅速下降。因此，我們正在觀察這一點，看看這會對本季產生什麼影響。

But as far as our volume growth of 0.5% plus for the year, we expect for that acceleration to continue through the year. I feel really good about the resilience of our operations. I mean we've had -- I mean I think the industry has had more than its fair share of weather. But for that to only impact us for 5 basis points, I think that really shows not just are we rebuilding core processes, but we're building more resilient core processes as well.

但就我們今年 0.5% 以上的銷售成長率而言，我們預計這種加速成長將持續到今年年底。我對我們的營運的彈性感到非常滿意。我的意思是我們已經——我的意思是我認為這個行業所遭受的天氣影響已經超過了它應有的份額。但這僅對我們的影響為 5 個基點，我認為這確實表明我們不僅在重建核心流程，而且還在建立更具彈性的核心流程。

And then maybe the other thing I would say is, for us, we're not really seeing -- we didn't get the headwind for IV and PD. So I think clearly, that's probably a question that comes into that in terms of, for us, when we look at our PG patient numbers, our analysis would show that we picked up less than 100 patients. So that's also why I feel really good about the underlying volume trend here that it's pretty pure.

然後我想說的另一件事是，對於我們來說，我們並沒有真正看到——我們沒有遇到 IV 和 PD 的逆風。因此，我認為很明顯，這可能是一個問題，對於我們來說，當我們查看 PG 患者數量時，我們的分析會顯示我們接收的患者人數不到 100 名。這也是為什麼我對這裡的潛在交易量趨勢感到非常滿意，因為它非常純粹。

So the mortality is obviously what we're watching. And again, once that mortality normalizes no expectation for us that we don't return to the 2% growth rate in 2026.

因此，死亡率顯然是我們所關注的。而且，一旦死亡率恢復正常，我們就有理由相信，2026 年的成長率不會回到 2%。

Very helpful. Thank you.

非常有幫助。謝謝。

Giang, Citi.

江，花旗。

Hello. Hope you can hear me and thank you for letting me ask questions. Two questions, please. I suppose the first one is, I have noticed that you have been talking about a recovery to a 2%-plus volume growth in 2026 and beyond. Is there anything that you could comment on where you are expecting the US to exit in 2025? Are we still talking about a 2% rate that we have been talking about for the last few quarters? Otherwise, how do you envision the ramp that we're expecting through to 2025 once -- after Q1.

你好。希望您能聽到我的聲音，並感謝您允許我提問。請問兩個問題。我想第一個問題是，我注意到您一直在談論 2026 年及以後銷售成長將恢復到 2% 以上。您能否評論一下您預計美國 2025 年的退出情況？我們還在談論過去幾季一直在談論的 2% 的利率嗎？否則，您如何設想我們預計到 2025 年（第一季之後）的成長動能？

And I guess just a second question is, looking at slide 6 under the assessed area on the graph, can you make any comments on the other assets that are within that bubbles? Thank you.

我想第二個問題是，看圖表上評估區域下方的第 6 張投影片，您能否對泡棉內的其他資產發表一些評論？謝謝。

Thanks, Giang. Yeah, I'll take those questions and maybe just picking up on the back of the -- maybe answer to Hassan's question as well. Yeah, look, we do expect volume to ramp up as we go through the year. I think the exit rate, obviously, will be dependent on that elevated mortality and when that normalizes. So that's why I think Dominik would say, does exit rate mean 12/31 or does it mean 11/26.

謝謝，Giang。是的，我會回答這些問題，也許只是回答哈桑的問題。是的，我們確實預計銷量會隨著時間的推移而增加。我認為退出率顯然將取決於死亡率的上升以及何時恢復正常。所以我認為多明尼克會說，退出率是指 12/31 還是 11/26。

And not to be flip with that comment at all, is that we just feel we'll continue to see volume momentum as we go through the year, and we'll see that 2% normalizing in 2026, what we're looking at and encouraged by is the kind of the positive trend quarter after quarter. Obviously, that elevated mortality is there, but we're also encouraged by what we're hearing from nephrologists in terms of waiting lists filling up and patients waiting to see their physician kind of this normalization of the earlier stages of CKD.

並且完全沒有對這一評論表示反感，我們只是覺得，隨著時間的流逝，我們將繼續看到銷量增長勢頭，並且我們將看到 2026 年 2% 的正常化，我們所看到和鼓舞的是季度復一季度的積極趨勢。顯然，死亡率確實在上升，但我們也從腎病專家那裡聽到的消息中感到鼓舞，候診名單已經排滿，患者正在等待看醫生，這在某種程度上表明 CKD 早期階段已經正常化。

On your question on divestitures, obviously, that was -- there was a lot that we put out there at last Capital Markets Day, and you can see the checkmarks of what's been done. It wasn't meant to suggest that if they were in that bottom mark that they were all going to be divested. I think you can see the assessment of them in terms of growth potential and strategic value to FME.

關於您提出的資產剝離問題，顯然，我們在上次資本市場日上公佈了很多內容，您可以看到已完成工作的標記。這並不意味著如果他們處於最低點，他們都將被剝離。我認為您可以從成長潛力和對 FME 的策略價值來看待它們。

We like those assets. Some of those assets that are in there that haven't been divested, and they're kind of part of our overall strategy and portfolio. Obviously, we continue to evaluate that portfolio and would provide a further update of how we're thinking about the growth opportunities on this portfolio when we get to Capital Markets Day in June. And as you can appreciate, we revisit this periodically as we refresh our strategy.

我們喜歡這些資產。其中一些資產尚未被剝離，它們是我們整體策略和投資組合的一部分。顯然，我們會繼續評估該投資組合，並將在 6 月資本市場日時進一步更新我們對該投資組合成長機會的看法。正如您所理解的，我們在更新策略時會定期重新審視這一點。

Thank you.

謝謝。

Lisa Clive, Bernstein.

麗莎·克萊夫，伯恩斯坦。

I've got two questions. Number one, while there is still a lot of uncertainty in DC on just about everything, I just wanted to ask about the potential impact from the increased ACA insurance subsidies that were created during COVID, which potentially end in December of this year.

我有兩個問題。第一，雖然華盛頓在幾乎所有事情上仍然存在很多不確定性，但我只想問一下在 COVID 期間增加的 ACA 保險補貼的潛在影響，這些補貼可能會在今年 12 月結束。

Your main competitors indicated this has been a tailwind to private payer mix over the last few years, and they've quantified the impact of cumulative EUR75 million, EUR120 million hit to EBIT by 2028, which they expect to be faced over three years. Do you have any thoughts on how this could affect your payer mix and any quantifications?

您的主要競爭對手錶示，這在過去幾年中一直是私人付款人組合的順風，並且他們已經量化了累計 7500 萬歐元、到 2028 年 1.2 億歐元的息稅前利潤損失的影響，他們預計這些影響將在三年內出現。您是否認為這會對您的付款人組合和量化產生影響？

And then second question, given the shift of phosphate binders into the clinic reimbursement, could you talk about FreseniusRx which also used to be quite a bit bigger before Sensipar went into the bundle and just how we should think about that part of your formerly sort of care coordination initiatives? Thanks.

然後第二個問題，考慮到磷酸鹽結合劑轉移到診所報銷中，您能否談談 FreseniusRx 的情況？在 Sensipar 加入捆綁銷售之前，它的規模也相當大，我們應該如何看待您以前的護理協調計劃的這一部分？謝謝。

Thanks, Lisa, and thank you for those questions. I'll take both of those. Yeah, on the ACA we had kind of estimated that to be about -- below a 2% hit to EBIT if they all went to Medicare instead of anywhere else. So I think we had sized that overall number smaller than what you quoted. But it's about 2% EBIT for us on that CD US book of business.

謝謝，麗莎，謝謝你提出這些問題。我會接受這兩個。是的，關於 ACA，我們估計如果他們都去醫療保險而不是其他地方，EBIT 的損失將低於 2%。所以我認為我們將這個總體數字確定得比您引用的數字要小。但在 CD US 業務中，我們的息稅前利潤約為 2%。

On binders in the bundle, it's a bit more complicated or complex for us because we do have three assets in that portfolio. Clearly, the part that goes into -- the part that's gone into bundle and the extra payment into that benefit is hitting the FKC business. And then as you rightly said, there is an impact to the pharmacy where the shift goes from pharmacy into FKC. So negative on the pharmacy.

對於捆綁包中的活頁夾來說，這對我們來說有點複雜，因為我們在該投資組合中確實有三項資產。顯然，進入捆綁的部分以及進入該福利的額外付款正在衝擊 FKC 業務。正如您所說，從藥房向 FKC 的轉變會對藥房產生影響。對藥局的看法非常負面。

And then depending on how the prescribing habits play out over the course of the year and what drugs are being taken by the patients, we're also estimating a positive impact on our pharma business there. So taking all of those three businesses into account, we're estimating that to be around EUR100 million benefit in 2025. And if you want to kind of get at the comparable level just for the FKC piece, we would see FKC at about half of that estimate of the EUR100 million.

然後，根據一年中處方習慣的變化以及患者服用的藥物，我們還估計這會對我們在那裡的製藥業務產生積極的影響。因此，考慮到所有這三項業務，我們估計 2025 年的收益將達到約 1 億歐元。如果您只想了解 FKC 部分的可比水平，我們會發現 FKC 的價值約為 1 億歐元估值的一半。

Victoria, Berenberg.

維多利亞，貝倫伯格。

Thanks for taking my questions. The first one is just about guidance. Does this include contribution from the 5008X launch due later this year? And then just how you guys are thinking about CapEx this year and in 2026 as it relates to the 5008X.

感謝您回答我的問題。第一個只是關於指導。這是否包括今年稍後推出的 5008X 的貢獻？然後你們如何看待今年和 2026 年與 5008X 相關的資本支出。

And then just a clarification question on the excess mortality rate. In Q3, I think you mentioned, Helen, that there's 60 bps headwind from vitality in H1 and that you expected a similar negative impact on H2. Can you confirm that it was around that negative 60 bps and that you expect that same rate for 2025? Thank you.

然後只是想澄清超額死亡率的問題。海倫，我想你提到過，在第三季度，上半年的活力將帶來 60 個基點的逆風，而你預計下半年也會出現類似的負面影響。您能否確認利率在-60個基點左右，並且您預計2025年的利率也將保持相同？謝謝。

Thanks, Victoria. Why don't I have Martin take the 5008 question for one and two since you have some financial connotations, and I'll take the third question.

謝謝，維多利亞。既然您問的問題涉及一些財務方面的內容，那麼我為什麼不讓馬丁回答第一和第二個問題 5008，而我來回答第三個問題呢？

Hi, Veronica. So on the 5008X, since we are starting our commercial launch in 2025 and more also towards the second half of 2025, there is not much of an impact into our guidance out of that launch. That would be too early for it to have an impact. We are ramping up through the year, and the full commercial launch is then in 2026.

你好，維羅妮卡。因此，對於 5008X，由於我們將於 2025 年開始商業發布，並且預計在 2025 年下半年發布，因此該發布對我們的指導不會產生太大影響。這對於產生影響來說還為時過早。我們今年正在加緊努力，預計在 2026 年實現全面商業化。

Similar on the CapEx, I would say, there is a, let's say, lower CapEx involved in the ramp-up. But also when we look at '26 and beyond, I would not expect this to be massive CapEx. It's more like a, let's say, regular medium-sized topic that when you think about the EUR900 million that we normally have in our guidance outlook that also published, it's more towards, let's say, a mid with double-digit CapEx number, I would think about in '25.

就資本支出而言，我想說的是，在產能提升過程中涉及的資本支出較低。但當我們展望 26 年及以後時，我並不認為這將是大規模的資本支出。它更像是一個常規的中型主題，當你想到我們通常在發布的指導展望中提到的 9 億歐元時，它更像是一個具有兩位數資本支出數字的中型主題，我會考慮在 25 年。

Thanks, Martin. Victoria, on your question on excess mortality, yeah, look, we're still seeing it elevated a slight improvement in H2, but I would say, slight. Even on a full-year basis, we are still seeing kind of a much higher number than we would like to see at this point, but a slight improvement from half two to half one, but still more elevated than prior.

謝謝，馬丁。維多利亞，關於你關於超額死亡率的問題，是的，你看，我們仍然看到 H2 略有改善，但我想說，只是輕微的。即使從全年來看，我們看到的數字仍然比我們目前希望看到的數字高得多，但從第二季到第一季略有改善，但仍比以前更高。

Great. Thank you.

偉大的。謝謝。

Oliver Metzger, ODDO BHF.

梅茲格（Oliver Metzger），ODDO BHF。

Good afternoon. Thanks for taking my questions. First question on the care enablement. So we saw quite good growth and also a nice margin accretion. So how should we think about the volume price mix for '25? So do you expect a similar price contribution in '25 compared to '24?

午安.感謝您回答我的問題。第一個問題是關於護理支援。因此，我們看到了相當不錯的成長以及利潤率的良好成長。那我們該如何考慮 25 年的量價組合呢？那麼，您是否預期 25 年的價格貢獻與 24 年類似？

Second question on value-based care. You named for '24 of EUR1.8 billion in recognized revenues or EUR1 million for next year. But you mentioned also negative contributions of EUR20 million to EUR30 million on bottom line. In the past, you talked only about the medical costs under management. And you had said a few years ago, the target of less than $1 billion medical customer management for '25.

第二個問題是關於基於價值的照護。您為‘24 億歐元確認的收入或明年的 100 萬歐元收入命名。但您也提到了底線的負面貢獻，即 2000 萬至 3000 萬歐元。過去您只談到管理下的醫療費用。幾年前您就說過，25 年醫療客戶管理的目標是低於 10 億美元。

And can you first provide still some credit were just $11 billion is still a valid number? And also what is needed to achieve positive bottom line contribution because initially, you talked about more above 1% EBIT margin for the medical cost under management. And there seems to be a gap. Thank you.

首先，您能否提供一些證據，證明 110 億美元仍然是一個有效的數字？還有，需要什麼才能實現積極的底線貢獻，因為最初，您談到了管理下的醫療成本的息稅前利潤率高於 1%。而且似乎還有差距。謝謝。

Thanks, Oliver. I'll snag both of those questions. Yeah, look, on CE, we're very, very pleased with the performance there. And as you rightly point out, we will expect to see continued volume and pricing going into 2025.

謝謝，奧利佛。我會回答這兩個問題。是的，看，在 CE 上，我們對那裡的表現非常非常滿意。正如您正確指出的那樣，我們預計到 2025 年銷售和價格仍將持續上漲。

I mean I think the color that Martin gave on value-based procurement for China, we've also kind of guided to the fact that we would see that annualize into next year but also see the volume pickup in China. So not just price and volume on the top line for CE and very positive developments but I think also the whole P&L is being worked. And the progress that the team is making on manufacturing, supply chain efficiency is remarkable.

我的意思是，我認為馬丁對中國基於價值的採購的描述，我們也在某種程度上引導了這樣一個事實，即我們會看到這種採購在明年實現年度化，同時也會看到中國採購量的增長。因此，我認為，不僅 CE 的頂線價格和銷量出現了非常積極的發展，而且整個損益表也正在發揮作用。該團隊在製造和供應鏈效率方面取得的進步是顯著的。

We'd always said for the care enablement business that while we've guided to 8% to 12% through 2025, our goal, particularly as we continue to launch new products and drive the innovation that we would -- our goal there is to get back to real medtech margins, even though making significant progress.

對於護理支援業務，我們一直表示，雖然我們預計到 2025 年利潤率將達到 8% 至 12%，但我們的目標，特別是隨著我們繼續推出新產品並推動創新 — — 我們的目標是回到真正的醫療技術利潤率，儘管取得了重大進展。

We also, as a reminder, also said that it would always be back-ended. And some of those benefits that we'll see in '25 will obviously continue to pay off in '26 and '27 as their sustainable savings. And we really look forward to showing that progress at Capital Markets Day in June.

我們也提醒大家，它永遠都是後端的。我們將在 25 年看到的一些好處顯然會在 26 年和 27 年繼續產生可持續的回報。我們非常期待在六月的資本市場日展示這項進展。

On value-based care, yeah, I mean, you're remembering the numbers correctly. And this is kind of still -- it's an important business, but it's still a nascent industry. And obviously, we continue -- we had hoped to be positive in '24, and we were still negative.

關於基於價值的護理，是的，我的意思是，你記得正確的數字。這仍然是一項重要的業務，但仍是一個新興產業。顯然，我們會繼續下去——我們曾希望在 24 年取得積極成果，但我們的成果仍然是消極的。

I think the growth that we're seeing is real, but this is still an industry. The nascency of it still means that we are obviously getting a lot of adjustments and true-ups, both in the government program with the kind of the payers. So I think for us, the revenue that we book, I mean, that's an important measure.

我認為我們看到的成長是真實的，但這仍然是一個行業。它的初期仍然意味著我們顯然正在進行大量的調整和完善，無論是在政府計劃中還是在付款人方面。所以我認為對我們來說，我們預定的收入是一個重要的衡量標準。

I think also the margin piece, so you can all see the overall dilutive nature that it has on the margin. So I think the -- we'll have to -- I think I don't have the 2025 expected medical cost under management number to share. But I think for us, we're thinking about that kind of booked revenue number and the margin number, which -- because of the nature of the type of contracts and the volatility there, we feel that is perhaps a better statement on EBIT contribution and revenue in absolute.

我也想到了利潤部分，所以大家都能看到它對利潤的整體稀釋性質。所以我認為——我們必須——我認為我沒有 2025 年預期的管理醫療成本數字可以分享。但我認為，對於我們來說，我們正在考慮那種預訂收入數字和利潤數字，由於合約類型的性質及其波動性，我們認為這也許是對息稅前利潤貢獻和絕對收入的更好的陳述。

So again, I think value-based care is an area that we will go into in more detail at Capital Markets Day in June as we kind of think about how we see this evolving as an important strategic lever for us supporting our clinic business in the US.

因此，我認為基於價值的照護是我們將在 6 月的資本市場日上更詳細地討論的一個領域，因為我們正在思考如何將其視為支持我們在美國診所業務的重要戰略槓桿。

Okay, great. Thank you very much.

好的，太好了。非常感謝。

Graham, UBS.

格雷厄姆，瑞銀。

Just one question for the short term and one for longer term. In terms of this year in the phasing, just on margin or EBIT contribution, usually, you can hopefully give us the Q1 sort of rough sense as to how we should think about that contribution given the flu season, it would be quite helpful just to understand that.

僅針對短期和長期分別提出一個問題。就今年的分階段而言，僅就利潤率或息稅前利潤貢獻而言，通常，您可以給我們提供第一季度的大致情況，說明在流感季節我們應該如何考慮這一貢獻，了解這一點將非常有幫助。

And then just like longer term, I suppose, you had this 10% to 14% mid-term target range for margins for '25. That's been narrow for this year, but you've obviously talked about more cost savings, and we'll get more information, I suppose, to the Capital Markets Day.

然後，我想，就像長期一樣，25 年的中期利潤率目標範圍是 10% 到 14%。今年的範圍比較窄，但您顯然談到了更多的成本節約，我想我們會在資本市場日獲得更多資訊。

But if we think about volume growth maybe coming out of that 1 to 2 rather than 2 necessarily, what is the sustainable margin once you've extracted the bulk of the cost, I suppose, from FY25 at a lower growth rate? Just to understand what's kind of better in and from what you build and in terms of we think about the optionality of volume growth going back to 2%-plus. Thank you.

但是，如果我們考慮銷售成長可能來自 1 到 2，而不是必然來自 2，那麼，一旦您以較低的成長率從 FY25 中提取出大部分成本，可持續利潤率是多少？只是為了了解您所建造的內容和內容的優劣，以及我們考慮將銷售成長可選性回升至 2% 以上。謝謝。

Thanks, Graham. We're smiling on the phasing question because normally in our script every year, we talk about Q1 is traditionally lower. But it is definitely kind of the weaker quarter. But other than that, we don't have anything more to provide in terms of color on saving for '25.

謝謝，格雷厄姆。我們對分階段問題感到高興，因為通常我們每年在腳本中討論第一季傳統上會較低。但這肯定是一個較弱的季度。但除此之外，我們在 25 年儲蓄方面沒有任何其他可提供的資訊。

Obviously, as you've rightly said, we're watching the flu season, I feel good about where we're seeing January. So more to come, I guess, once we report Q1. But kind of similar phasing, I would guess, to the traditional pattern.

顯然，正如您所說，我們正在關注流感季節，我對一月份的情況感到滿意。我想，一旦我們報告第一季度，就會有更多消息傳來。但我猜想，這種階段與傳統模式有些類似。

So your tough question on question two on the margin bands and how that's going to move, clearly, we'll show the building block of what we see post 2025. And as you can imagine, both care delivery and care enablement have a lot of levers specific to your question on same market treatment growth and if that was lower, what would it do? Obviously, that's not our current assumption. We would also look at what the cost structure would be there to support it.

因此，您關於第二個問題的難題是保證金區間及其將如何變動，顯然，我們將展示 2025 年後我們所看到的基石。正如您所想像的，對於您關於同一市場治療成長的問題，護理服務和護理支援都有很多具體的槓桿，如果增長較低，會有什麼影響？顯然，這不是我們目前的假設。我們還將研究支持它的成本結構。

Look, I think the other thing that we're super excited about, which would also play into that future growth potential is clearly HDF. And that is kind of that -- that's kind of the implementation plan of getting those machines in our clinics and then seeing the improved mortality that we see in Europe for having HDF treatments and that 23% improvement.

你看，我認為另一件讓我們非常興奮的事情，它顯然也會對未來的成長潛力產生影響，那就是 HDF。這就是那種 — — 那是將這些機器引入我們診所的實施計劃，然後我們會看到歐洲透過 HDF 治療而出現的死亡率改善，即 23% 的改善。

It's -- there's still, I think, a lot of moving parts on the volumes to unpack. Clearly, we're not seeing an impact of the new drugs. So you could argue mortality would be lower. We're excited about what we think we can bring to the HDF in volume. So I think more to come at CMD, and I think also the kind of the guards of how we're thinking about it.

我認為，卷宗上仍有許多未解之謎。顯然，我們沒有看到新藥的效果。因此你可以說死亡率會更低。我們對於能夠為 HDF 帶來大量成果感到非常興奮。所以我認為 CMD 還會有更多進展，而且我還認為我們正在考慮如何應對這種情況。

And maybe just a quick one on HDF. In terms of -- as you roll that out, would you expect to see just new patients benefits or do you think everyone benefits to some extent as they switch over even if there's a halfway through their treatment course as you'd expect in, say, year 2.5 of the therapy?

也許只是對 HDF 進行快速介紹。就此而言——當您推出這項服務時，您是否期望只看到新患者受益，或者您是否認為每個人在轉換治療方案時都會在一定程度上受益，即使他們的治療過程已經進行到一半，就像您預期的那樣，比如說，治療的第 2.5 年？

Yeah, we believe everyone could benefit in the study, no patient lived less as a result of being on HDF.

是的，我們相信每個人都可以從這項研究中受益，沒有患者因為接受 HDF 治療而壽命縮短。

Perfect. Thanks a lot guys.

完美的。非常感謝大家。

David, JPMorgan.

摩根大通的戴維。

Hi, guys. Thanks for questions. First one is, it might be my maths, but I think there's a bit of a disconnect between the 11% to 12% margin in the high teens to high 20s expansion. 12% seems unlikely unless you don't get much revenue growth at all. I'm just wondering what I'm missing there.

嗨，大家好。感謝您的提問。首先，這可能是我的數學問題，但我認為在十幾歲到二十多歲的擴張時期，11% 到 12% 的利潤率之間存在一點脫節。除非你的收入根本沒有成長，否則 12% 似乎不太可能。我只是想知道我在那裡錯過了什麼。

And then secondly, just on the phosphate binder split, also a bit surprised to see you getting EUR100 million additional profit we're going to bundle. We've seen before with bundle changes that CMS quite quickly claws back any benefits that the industry gets. Just wondered how sustainable you thought that EUR100 million benefit was?

其次，僅就磷酸鹽黏合劑的拆分而言，我們也有點驚訝地看到您獲得了我們將要捆綁的 1 億歐元額外利潤。我們之前已經看到，隨著捆綁變化，CMS 很快就收回了行業獲得的任何利益。只是想知道您認為這 1 億歐元的收益能維持多久？

Yeah, look, I think the David grabbed both of those. In terms of the 11% to 12%, clearly, we have a wide OI range. And obviously, the 11% to 12% is reflecting that. So I don't know how else to answer that question other than you see the building blocks of how we get there and the range that that would provide.

是的，看，我認為大衛抓住了這兩個。就 11% 到 12% 而言，顯然我們的 OI 範圍很廣。顯然，11%到12%反映了這一點。因此，除了了解我們如何實現這一目標的基礎以及這將提​​供的範圍之外，我不知道如何回答這個問題。

On binders in the bundle, yeah, clearly, right, there is benefit of having these assets, actually an unfavorability too of having some of these assets. So it's not just FKC. We do have a pharma business, and we have a pharmacy business. So that's why I wanted to put color on the EUR100 million is a proportion of that is there's two positive and a negative, if you will. And overall, it's netting to EUR100 million.

關於捆綁包中的活頁夾，是的，顯然，擁有這些資產是有好處的，但實際上擁有其中一些資產也有不利之處。所以不只是 FKC。我們確實有製藥業務，也有藥局業務。所以這就是為什麼我想給 1 億歐元加上顏色，如果你願意的話，它的比例是兩個正數和一個負數。總體而言，其淨利潤達到 1 億歐元。

Obviously, as the binders utilization changes, we may see the kind of utilization going down and the cost of those drugs changing. So I think that's why we have the TDAPA period to monitor what happens to the utilization.

顯然，隨著黏合劑利用率的變化，我們可能會看到利用率下降以及這些藥物的成本發生變化。所以我認為這就是我們設立 TDAPA 期限來監控利用率變化的原因。

Look, this is a little different, I would say, as well to calcimimetic, which is the other kind of bundle addition. We all recall -- well, maybe before my time, but you all recall. In binders in the bundle, there is -- different to calcimimetic is that there's already generics and branded in the mix. So we'll see how this plays out, obviously, over time. But we feel good about the assumption across the entire portfolio. And that's why we will also keep looking at the assets in the portfolio as that evolves over the TDAPA period.

你看，我想說，這與擬鈣劑有一點不同，這是另一種捆綁添加。我們都記得——好吧，也許是在我之前，但你們都記得。在捆綁的黏合劑中，與擬鈣劑不同的是，混合物中已經有仿製藥和品牌藥。因此，我們會看到隨著時間的推移，情況將如何發展。但我們對整個投資組合的假設感到滿意。這就是為什麼我們也將繼續關注 TDAPA 期間投資組合中資產的變化。

Robert, Morgan Stanley.

羅伯特，摩根士丹利。

Afternoon. Thanks for taking my questions. I had one around just on the additional savings that you announced. Could you kind of break it down, components of where that's coming from? And just in terms of the phasing and time line, how you expect those to play out through '25?

下午。感謝您回答我的問題。我剛剛了解到您宣布的額外節省措施。您能否將其分解一下，看看它的組成部分來自哪裡？就分階段和時間表而言，您預計這些計劃將在 25 年內如何實施？

And then just the second one was around the commentary you provided on labor and cost inflation. Just perhaps could you give us a little more detail? What's the sort of main areas of labor cost inflation?

第二個問題是關於您對勞動力和成本通膨的評論。您能否提供我們更多細節？勞動成本上漲主要集中在哪些領域？

Is it bringing in new nurses? Is it higher sort of turnover and bringing people back? I know you'd mentioned previously that it sort of started to settle down. So I just wondered if you could get a bit more color where the remaining bite points are Thank you. .

會招募新護士嗎？這是否能提高人員流動率並吸引回頭客？我知道您之前提到過，事情開始逐漸平息下來。所以我只是想知道你是否可以在剩餘的咬合點處獲得更多的顏色，謝謝。。

Yeah. Thanks, Robert. I have Martin take the first question on the FME25 additional value creation, and then I'll take the labor cost.

是的。謝謝，羅伯特。我請馬丁回答有關 FME25 附加價值創造的第一個問題，然後我將回答勞動成本問題。

So when we look at the program, we have accelerated the execution quite a bit as we saw also in our quarter four results, where we ended with the EUR221 million. Main drivers in that, when you look at the savings, is, number one, being anchored in our more efficient setup of the functions, which contributed about 50% of the savings. And we see more potential as we doubled down on those and drive efficiency in our processes as well as a significant contribution to our care enablement business.

因此，當我們審視該計劃時，我們發現執行速度已經大大加快，正如我們在第四季度業績中所看到的那樣，最終實現了 2.21 億歐元的業績。從節省的角度來看，其中的主要驅動因素首先在於我們更有效率的功能設置，這貢獻了約 50% 的節省。隨著我們加倍努力並提高流程效率以及為我們的護理支援業務做出重大貢獻，我們看到了更多的潛力。

And this is on the back of continued manufacturing optimization, logistics, supply chain. And those are the bulk of the initiatives also for the EUR100 million additional savings. And lastly, there is a smaller portion of about 10% being with the care delivery business when we think about the clinic network.

這是在持續優化製造、物流和供應鏈的基礎上實現的。這些措施的主要內容也是為了額外節省 1 億歐元。最後，當我們考慮診所網路時，大約有 10% 的較小部分涉及醫療服務業務。

Yeah. And Robert, on the labor cost, thank you for asking that. We're assuming in that headwind around a net 3% increase. There's two pieces of that. Obviously, we say that because we're continuing to drive efficiencies and managing wage inflation.

是的。羅伯特，關於勞動成本，謝謝你問這個問題。我們預計在這種不利因素的影響下，淨增幅約為 3%。有兩個部分。顯然，我們這樣說是因為我們正在繼續提高效率並控制薪資通膨。

But I think the other piece to think about that for '25 is as we have now normalized our head count and open positions have reduced again further. So we're pretty normal now on positions. It means we have people, which is great for keeping our operations running. So that's the way to think about the labor headwind. The net 3% of efficiency and growth. And we're managing through that accordingly.

但我認為，對於 25 年需要考慮的另一件事是，由於我們現在已經實現了員工人數正常化，因此空缺職位也進一步減少。所以我們現在的立場非常正常。這意味著我們擁有人力，這對維持我們的營運非常有幫助。這就是思考勞動力逆風的方式。淨3%的效率和成長。我們正在採取相應的措施。

Marianne, Bank of America.

瑪麗安，美國銀行。

Hi, good afternoon. And thank you for taking my questions. The first one is, could you please remind us how much debt is coming up to maturity in page 25 and what evolution we should see for the net debt-to-EBITDA ratio given you're already below the self-imposed target for next year?

嗨，下午好。感謝您回答我的問題。第一個問題是，您能否提醒我們第 25 頁有多少債務即將到期，以及考慮到您已經低於明年自己設定的目標，我們應該看到淨債務與 EBITDA 比率發生怎樣的變化？

And as a quick follow-up, can you talk a little bit about the capital priorities for 2025, especially you were mentioning the CapEx. So just wondering how is the order looking between CapEx and cash return to shareholders? Thank you.

作為快速的跟進，您能否談談 2025 年的資本優先事項，特別是您提到的資本支出。所以只是想知道資本支出和股東現金回報之間的順序是怎麼樣的？謝謝。

Thanks, Marianne. Let me take those two. So number one is the maturities. It's about EUR500 million that we are upcoming in 2025. And then we have a bigger tower upcoming in 2026 with about EUR1.9 billion.

謝謝，瑪麗安。讓我拿下那兩個。因此，最重要的是成熟度。我們將在 2025 年實現約 5 億歐元的支出。2026 年我們將建造一座更大的塔，耗資約 19 億歐元。

We feel well positioned. As you saw also, we are a strong cash generator, both in quarter four as well as the full fiscal year. With that capital allocation priorities. We will give a more comprehensive update at the Capital Market Day, together with the strategic priorities of the company. But you saw that we came down on the back of the strong cash generation, which we expect to continue in 2025 as well in the leverage ratio to the 2.9% and are already below our current import range.

我們覺得自己處於有利地位。正如您所看到的，無論是在第四季度還是在整個財政年度，我們都是強大的現金產生器。有了這個資本配置優先權。我們將在資本市場日上提供更全面的更新，以及公司的策略重點。但您也看到了，我們受到強勁現金流的支撐，預計 2025 年槓桿率仍將維持在 2.9%，並且已經低於我們目前的進口範圍。

We have limited upside from further improving our investment grade rating. For us, it was important to keep the investment grade rating, and we have accomplished that, which is good.

進一步提高投資等級評級的上升空間有限。對我們來說，保持投資等級非常重要，我們已經做到了這一點，這是件好事。

Now, when we think about a comprehensive set of capital allocation, I think there's two main focus points. Number one, supporting the business and profitable sustainable growth in alignment with the strategy as I point out and make sure that we cover that; and number two, then also with the strong cash generation, we are thinking about how to -- well, we think about the importance of shareholder returns as well. And I think you can expect to get more crystallization about that in the Capital Markets Day.

現在，當我們考慮一套全面的資本配置時，我認為有兩個主要關注點。第一，正如我所指出的，支持業務和盈利性可持續增長，與戰略保持一致，並確保我們涵蓋這一點；第二，在現金產生能力強勁的情況下，我們正在考慮如何——我們也考慮股東回報的重要性。我認為您可以在資本市場日上獲得更多關於此內容的明確資訊。

James, Jefferies.

詹姆斯、傑弗里斯。

Just a couple on FME25, if I may. I guess you just take a step back when you first sort of announced the program, there's sort of EUR500 million of savings, I think it was. And now we're sort of sitting at EUR750 million. Given it was such a comprehensive review at the outset, can you help us sort of understand how this has evolved?

如果可以的話，我只想說幾句關於 FME25 的話。我想，當您第一次宣布該計劃時，您只是退一步考慮，我認為大約有 5 億歐元的節省。現在我們的資金已經達到 7.5 億歐元。鑑於一開始就進行瞭如此全面的審查，您能否幫助我們了解其發展過程？

Was it initial conservatism to the market on the scope? Was it a forward impact of some savings which you made, which had a better benefit to the business or additional programs or perhaps kind of announce sort of down the line?

這是最初對市場範圍的保守態度嗎？這是您所做的一些節省的前瞻性影響嗎？這對業務或其他計劃有更好的好處，或者可能在以後宣布某種消息？

I know you sort of said that this is sort of evolutionary rather than kind of revolutionary from here. But just in terms of how that's evolved and how we should think about sort of incremental improvements from operationally.

我知道您說過，這是一種進化，不是革命。但就其如何演變以及我們應該如何從營運角度考慮漸進式改進而言。

Thanks, James. Great question. And I know, when I kind of architected this program, I think people had thought I lost my mind when I size is EUR500 million. So it does feel good to sit here today and say, we're clearly at EUR567 million and achieved that and so much more.

謝謝，詹姆斯。好問題。我知道，當我設計這個程式時，我想人們認為當我的規模達到 5 億歐元時我失去了理智。因此，今天坐在這裡說我們顯然已經達到了 5.67 億歐元並且實現了這一目標，這確實令人感到高興。

Look, James, what I would say, it's not just about the cost program and the efficiencies. This is all kind of embedded in the reorientation of the company into the operating model. And that real visibility into end-to-end P&L, every line item, the financial transparency to look at where we have opportunities, I think, as clearly outperformed our own initial expectations.

聽著，詹姆斯，我想說的是，這不僅涉及成本計劃和效率。這一切都融入了公司營運模式的重新定位。我認為，對端到端損益表、每個項目的真正可視性、財務透明度讓我們能夠看到我們的機會，這明顯超出了我們最初的預期。

Obviously, with the program at size at the beginning in the EUR500 million, we had hoped we could do more, but we didn't have any living experience of running the company this way. So I think clearly, as we have now been running this company as the segment for a little while, we are continuing to go deeper. And I think that's really important with the color that Martin gave you of where it's coming from.

顯然，由於該計劃最初的規模為 5 億歐元，我們希望能夠做得更多，但我們沒有以這種方式經營公司的實際經驗。因此，我認為，由於我們已經將這家公司作為一個部門運營了一段時間，因此我們將繼續深入發展。我認為馬丁給你的顏色以及它的來源非常重要。

So I think, you're right. It continues to evolve, and we will continue to look for every opportunity we can. We know what we're trying to get to to be leading industry margins and improve the margins that we had. And I think that progress is visible.

所以我認為你是對的。它將繼續發展，我們將繼續尋找每一個可能的機會。我們知道我們要努力成為行業領先利潤率並提高我們現有的利潤率。我認為進步是顯而易見的。

So very, very excited about the momentum and the sustainability of those savings into '25 and beyond. So yeah, happy to upgrade it, and actually put the execution behind it. So thank you for the question.

我對這些儲蓄在 2025 年及以後的勢頭和可持續性感到非常非常興奮。是的，我很高興能夠升級它，並且真正地執行它。謝謝你的提問。

And I guess maybe just in terms of delivering the EUR750 million, I mean it's obviously costs you mentioned in the release, EUR700 million to EUR750 million to get that. And I think related to is about EUR164 million or so in 2024.

我想也許只是就交付 7.5 億歐元而言，我的意思是，這顯然是您在新聞稿中提到的成本，需要 7 億歐元到 7.5 億歐元才能實現。我認為到 2024 年相關金額約為 1.64 億歐元。

So I'm not expecting you guide beyond '25 today, and I know you're going to be talking about stuff at the Capital Markets Day. But should we think that the sort of what you've been having in terms of related to this program of EUR130 million, EUR160 million of costs, whatever is actually kind of disappear because as we get into next year, the sort of sustainable savings have kind of come through? Just help us sort of understand what detail we considered adjusted?

所以我並不指望你今天能指導 25 年後的事情，而且我知道你會在資本市場日談論一些事情。但是，我們是否應該認為，與該計劃相關的 1.3 億歐元、1.6 億歐元的成本實際上已經消失了，因為隨著我們進入明年，可持續的節省已經實現？只是幫助我們了解我們考慮調整的細節嗎？

Capital Markets Day?

資本市場日？

Hugo, BNP Paribas.

雨果，法國巴黎銀行。

Thanks for taking my questions. I just left with one. On the [5008x], the clinical benefits are impressive. Just conceptually, Helen, maybe how critical do you think this platform is to drive volumes maybe back to 2%? Should volumes remain noted beyond 2026 or maybe help drive volumes higher than that? And what's the time line here?

感謝您回答我的問題。我剛剛帶著一個離開了。在 [5008x] 上，臨床效益令人印象深刻。海倫，從概念上講，您認為這個平台對於推動交易量回升至 2% 有多重要？2026 年以後產量是否仍應受到關注，或有助於推動產量更高？這裡的時間線是怎樣的？

Yeah. Look, this is part of why I'm so excited about this opportunity. We're obviously all looking for mortality to come down and volumes to normalize, which we fully expect them to. What we haven't had in this industry is the kind of innovation that drives this significant improvement in mortality that 5008x and HDF treatment can do.

是的。瞧，這就是我對這個機會如此興奮的原因之一。顯然，我們都希望死亡率下降、病例數恢復正常，我們也完全有信心實現這一目標。我們在這個行業中還沒有像 5008x 和 HDF 治療那樣能夠顯著降低死亡率的創新。

Look, when we talk about elevated 17% mortality in the United States, we do need to compare that to the 12% that's in Europe, where HDF has been on the market for a decade, and it is the standard of care. So with the convinced study really supporting that 23% improvement in all-cause mortality, there's no reason to believe that we don't get that in the US. And the exciting opportunity.

你看，當我們談論美國 17% 的高死亡率時，我們確實需要將其與歐洲的 12% 進行比較，在歐洲，HDF 已經上市十年，並且是治療標準。因此，既然有確切的研究證明全因死亡率確實改善了 23%，那麼就沒有理由相信美國沒有實現這一目標。這是一個令人興奮的機會。

So taking that on average to the end degree, you could say, it's a 23% improvement in volume, not a 2% improvement in volume. Now obviously, that needs to ramp up over time, and we'll see how the numbers restack up in the United States. But I think that is obviously the opportunity that we're excited about.

因此，以最終程度的平均數計算，您可以說音量提高了 23%，而不是提高了 2%。顯然，隨著時間的推移，這個數字需要不斷上升，我們將拭​​目以待美國的數字將如何重新累積。但我認為這顯然是令我們興奮的機會。

So the volume growth there, we're clearly -- want to plan for and I think understanding how that all impacts our footprint will be key and also why HDF will form a key part of our CLA update in June.

因此，我們顯然希望為那裡的銷售成長做好計劃，我認為了解這一切如何影響我們的足跡將是關鍵，也是為什麼 HDF 將成為我們 6 月 CLA 更新的關鍵部分。

Congrats on the results.

恭喜取得成果。

Thank you. Really appreciate that.

謝謝。真的很感激。

And as we are out of time, we'll take one last caller who hasn't had a chance to ask a question so far. Falko, Deutsche Bank.

由於時間已經到了，我們將接聽最後一位尚未有機會提問的來電者。法爾科，德意志銀行。

I have one. On the same market treatment growth, do you feel like you are gaining a little bit of market share again here in the fourth quarter and feel like you're in a position to potentially gain a little bit again throughout 2025?

我有一個。在同樣的市場治療成長方面，您是否覺得您在第四季度再次獲得了一點市場份額，並且覺得您有可能在 2025 年再次獲得一點市場份額？

Yeah. Thank you for the question. I think a little bit of both. Obviously, you've seen our results from what we posted today. You've seen some other industry numbers.

是的。謝謝你的提問。我認為兩者都有一點。顯然，您已經從我們今天發布的內容中看到了我們的結果。您已經看到了一些其他行業的數據。

I think our work is paying off. Clearly, we had been kind of lagging where we wanted to be operationally. So I think the -- our work in terms of accepted referrals, improving our processes, and better disaster management is clearly enabling us to get those patients, but keep those patients as well.

我認為我們的工作正在獲得回報。顯然，我們在營運方面已經落後於我們想要達到的目標。因此我認為——我們在接受轉診、改善流程和更好的災害管理方面的工作顯然使我們能夠接收這些患者，同時也能留住這些患者。

So it's probably a little bit of both, but it's very complex where all the patients coming in, but also keeping those patients. So I feel the team is doing a terrific, terrific job, which is what gives us the confidence going into 2025 from what we've seen in the last couple of quarters and even January.

所以可能兩者都有一點，但情況非常複雜，既要讓所有病人進來，又要留住這些病人。所以我覺得團隊做得非常出色，從過去幾季甚至一月的情況來看，這讓我們對 2025 年充滿信心。

And you know we wouldn't be guiding if we didn't kind of see that was the kind of the projections that we have because it is an element of our own work and that strength and our performance.

你知道，如果我們沒有意識到我們所做的預測，我們就不會提供指導，因為這是我們自身工作、實力和表現的要素。

So thank you, Helen, Martin, for running over. I apologize to everyone who couldn't make it in the queue. So thank you very much. We'll be out on the road in many conferences, road shows, and calls. So I guess you get more opportunity to learn more about our exciting 2025. And with that, thank you.

所以，感謝海倫、馬丁的到來。我向所有未能排隊的人表示歉意。非常感謝。我們將參加許多會議、路演和電話會議。所以我想你會有更多機會了解我們令人興奮的 2025 年。最後，謝謝大家。

Yeah. Thank you, everybody. Take care.

是的。謝謝大家。小心。